Conference Papers

“Zora Neale Hurston and Caribbean-U.S. Crosscurrents in Literature and Culture” Dr. Jeff Karem, Professor, Cleveland State University Hoodoo in Zora Neale Hurston\u27s Fiction and Folklore. Dr. Pearlie Mae Peters, Professor, Rider Universit

Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

Background: Understanding the health consequences associated with exposure to risk factors is necessary to inform public health policy and practice. To systematically quantify the contributions of risk factor exposures to specific health outcomes, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 aims to provide comprehensive estimates of exposure levels, relative health risks, and attributable burden of disease for 88 risk factors in 204 countries and territories and 811 subnational locations, from 1990 to 2021. Methods: The GBD 2021 risk factor analysis used data from 54 561 total distinct sources to produce epidemiological estimates for 88 risk factors and their associated health outcomes for a total of 631 risk–outcome pairs. Pairs were included on the basis of data-driven determination of a risk–outcome association. Age-sex-location-year-specific estimates were generated at global, regional, and national levels. Our approach followed the comparative risk assessment framework predicated on a causal web of hierarchically organised, potentially combinative, modifiable risks. Relative risks (RRs) of a given outcome occurring as a function of risk factor exposure were estimated separately for each risk–outcome pair, and summary exposure values (SEVs), representing risk-weighted exposure prevalence, and theoretical minimum risk exposure levels (TMRELs) were estimated for each risk factor. These estimates were used to calculate the population attributable fraction (PAF; ie, the proportional change in health risk that would occur if exposure to a risk factor were reduced to the TMREL). The product of PAFs and disease burden associated with a given outcome, measured in disability-adjusted life-years (DALYs), yielded measures of attributable burden (ie, the proportion of total disease burden attributable to a particular risk factor or combination of risk factors). Adjustments for mediation were applied to account for relationships involving risk factors that act indirectly on outcomes via intermediate risks. Attributable burden estimates were stratified by Socio-demographic Index (SDI) quintile and presented as counts, age-standardised rates, and rankings. To complement estimates of RR and attributable burden, newly developed burden of proof risk function (BPRF) methods were applied to yield supplementary, conservative interpretations of risk–outcome associations based on the consistency of underlying evidence, accounting for unexplained heterogeneity between input data from different studies. Estimates reported represent the mean value across 500 draws from the estimate's distribution, with 95% uncertainty intervals (UIs) calculated as the 2·5th and 97·5th percentile values across the draws. Findings: Among the specific risk factors analysed for this study, particulate matter air pollution was the leading contributor to the global disease burden in 2021, contributing 8·0% (95% UI 6·7–9·4) of total DALYs, followed by high systolic blood pressure (SBP; 7·8% [6·4–9·2]), smoking (5·7% [4·7–6·8]), low birthweight and short gestation (5·6% [4·8–6·3]), and high fasting plasma glucose (FPG; 5·4% [4·8–6·0]). For younger demographics (ie, those aged 0–4 years and 5–14 years), risks such as low birthweight and short gestation and unsafe water, sanitation, and handwashing (WaSH) were among the leading risk factors, while for older age groups, metabolic risks such as high SBP, high body-mass index (BMI), high FPG, and high LDL cholesterol had a greater impact. From 2000 to 2021, there was an observable shift in global health challenges, marked by a decline in the number of all-age DALYs broadly attributable to behavioural risks (decrease of 20·7% [13·9–27·7]) and environmental and occupational risks (decrease of 22·0% [15·5–28·8]), coupled with a 49·4% (42·3–56·9) increase in DALYs attributable to metabolic risks, all reflecting ageing populations and changing lifestyles on a global scale. Age-standardised global DALY rates attributable to high BMI and high FPG rose considerably (15·7% [9·9–21·7] for high BMI and 7·9% [3·3–12·9] for high FPG) over this period, with exposure to these risks increasing annually at rates of 1·8% (1·6–1·9) for high BMI and 1·3% (1·1–1·5) for high FPG. By contrast, the global risk-attributable burden and exposure to many other risk factors declined, notably for risks such as child growth failure and unsafe water source, with age-standardised attributable DALYs decreasing by 71·5% (64·4–78·8) for child growth failure and 66·3% (60·2–72·0) for unsafe water source. We separated risk factors into three groups according to trajectory over time: those with a decreasing attributable burden, due largely to declining risk exposure (eg, diet high in trans-fat and household air pollution) but also to proportionally smaller child and youth populations (eg, child and maternal malnutrition); those for which the burden increased moderately in spite of declining risk exposure, due largely to population ageing (eg, smoking); and those for which the burden increased considerably due to both increasing risk exposure and population ageing (eg, ambient particulate matter air pollution, high BMI, high FPG, and high SBP). Interpretation: Substantial progress has been made in reducing the global disease burden attributable to a range of risk factors, particularly those related to maternal and child health, WaSH, and household air pollution. Maintaining efforts to minimise the impact of these risk factors, especially in low SDI locations, is necessary to sustain progress. Successes in moderating the smoking-related burden by reducing risk exposure highlight the need to advance policies that reduce exposure to other leading risk factors such as ambient particulate matter air pollution and high SBP. Troubling increases in high FPG, high BMI, and other risk factors related to obesity and metabolic syndrome indicate an urgent need to identify and implement interventions

Keeping the Native on the Reservation: The Struggle for Leslie Marmon Silko's Ceremony

As Leslie Marmon Silko was preparing to publish her first novel, Ceremony (1977), she faced serious interventions from her editor at Viking Press, Richard Seaver. Most notably, in the final proofs sent to Silko before Ceremony went to press, Seaver had eliminated much of the author’s most challenging literary and cultural material, particularly her representations of the world-historical forces connected to her protagonist’s personal quest. Seaver’s battery of revisions suggested a discomfort with the globalizing aspirations of Silko’s novel and a preference for a more contained narrative of reservation life. According to Silko, Seaver was so committed to his changes that he “made ominous sounds about ‘not being able to support the book’ unless [she] gave in.”l Fortunately, Silko stood by her original manuscript, replying to her editor with a letter entitled “A Commentary on the Galleys,” in which she defended the “unconventional” elements of her novel as essential to her fictional and cultural vision. Although Silko succeeded in convincing Seaver to restore her text, it is important for scholars to consider her conflicts with her editor, as this episode offers a cautionary tale about the dangers Native American authors face from a literary establishment that seeks to shape their works into more familiar representations. In this essay I use previously unpublished archival evidence from Silko’s papers at the Beinecke Library to document her conflicts with Seaver, reconstructing the “horizon of expectations” against which the author had to struggle in order to realize her innovative vision. My reading of Ceremony refocuses critical attention on Silko’s global aims because most of her readers, like her editor, have tried to minimize the globalizing aspects of her work. Many scholars have employed structuralist paradigms for interpreting the text, reading the healing process in the novel as the realignment of intracultural vectors, such as a rebalancing of the power of the sun in the east with the power of the mountains in the north

The Romance of Authenticity: The Cultural Politics of Regional and Ethnic Literatures

To what extent has the growing popular demand for a vicarious experience of other cultures fueled the expectation that the most important task for regional and ethnic writers is to capture and convey authentic cultural material to their readers? In The Romance of Authenticity, Jeff Karem argues that, in contrast to prevailing assumptions that authenticity should be prized as a goal of regional and ethnic literatures, it is in fact a dangerously restrictive category of literary judgment. He draws on a large body of archival evidence to show how intense political and economic interests have determined what literary representations are deemed authentic, not only constraining what such writers can publish but also limiting the ways in which their works are interpreted. The author specifically discusses the work of William Faulkner, Richard Wright, Ernest Gaines, Rolando Hinojosa, and Leslie Marmon Silko. Exploring these writers’ different responses to the expectation that they act as cultural representatives of the Southern, Southwestern, African American, Latino, or Native American experience, Karem finds that some refuse that role and others embrace it. The Romance of Authenticity concludes that despite the celebration of hybridity in contemporary theories of identity, the politics of cultural authenticity in publishing and criticism produce precisely the opposite effect, reducing regional and ethnic writers to exotic objects of desire.https://engagedscholarship.csuohio.edu/scholbks/1142/thumbnail.jp

The Purloined Islands: Caribbean-U.S. Crosscurrents in Literature and Culture, 1880–1959

The Purloined Islands offers the first book-length exploration of literary and cultural exchanges between the United States and the Caribbean during the roughly eighty-year period of their greatest interaction, from the close of the Spanish-American War to the Cuban Revolution. The interconnected histories of colonization, migration, slavery, and political struggle thrust writers from both regions into a vibrant literary conversation across national borders. Jeff Karem charts this dialogue and its patterns of influence through an analysis of key literary and cultural sources in English, French, and Spanish, including a large body of rare archival evidence. What the author identifies in this wide-ranging exchange is the Caribbean’s vital contribution not only to the literatures of the American hemisphere but also to the literary and intellectual culture of the United States itself. Specifically, he shows how such movements as pan-Africanism, the New Negro Renaissance, and pan-American modernism have significant Caribbean roots, although the United States has often failed to recognize them, effectively purloining those resources without acknowledgment. As his title’s allusion to Poe’s The Purloined Letter suggests, Karem argues that the contributions of the Caribbean have been borrowed, appropriated, and nationalized by U.S. culture but are hidden in plain sight. Both its multilingual character and its emphasis on the reciprocity in cultural cross-currents will make the book of interest to readers not only in Caribbean and American cultural and literary studies but also in pan-American or border studies, Black Atlantic studies, and African American studies.https://engagedscholarship.csuohio.edu/scholbks/1141/thumbnail.jp

The Romance of Authenticity: The Cultural Politics of Regional and Ethnic Literatures

To what extent has the growing popular demand for a vicarious experience of other cultures fueled the expectation that the most important task for regional and ethnic writers is to capture and convey authentic cultural material to their readers? In The Romance of Authenticity, Jeff Karem argues that, in contrast to prevailing assumptions that authenticity should be prized as a goal of regional and ethnic literatures, it is in fact a dangerously restrictive category of literary judgment. He draws on a large body of archival evidence to show how intense political and economic interests have determined what literary representations are deemed authentic, not only constraining what such writers can publish but also limiting the ways in which their works are interpreted. The author specifically discusses the work of William Faulkner, Richard Wright, Ernest Gaines, Rolando Hinojosa, and Leslie Marmon Silko. Exploring these writers’ different responses to the expectation that they act as cultural representatives of the Southern, Southwestern, African American, Latino, or Native American experience, Karem finds that some refuse that role and others embrace it. The Romance of Authenticity concludes that despite the celebration of hybridity in contemporary theories of identity, the politics of cultural authenticity in publishing and criticism produce precisely the opposite effect, reducing regional and ethnic writers to exotic objects of desire.https://engagedscholarship.csuohio.edu/scholbks/1142/thumbnail.jp

Conference Papers

“Zora Neale Hurston and Caribbean-U.S. Crosscurrents in Literature and Culture” Dr. Jeff Karem, Professor, Cleveland State University Hoodoo in Zora Neale Hurston\u27s Fiction and Folklore. Dr. Pearlie Mae Peters, Professor, Rider Universit