Mixed Race Studies

How Do Integrated Health Care Systems Address Racial and Ethnic Disparities in Colon Cancer?

Journal of Clinical Oncology
Published online: 2015-01-26
DOI: 10.1200/JCO.2014.56.8642

Kim F. Rhoads, Colon and rectal surgeon, Colorectal surgeon, Surgical oncologist; Assistant Professor of Surgery at the Stanford University Medical Center
Stanford Cancer Institute
Stanford University School of Medicine

Manali I. Patel, MD
Stanford Cancer Institute
Stanford University School of Medicine

Yifei Ma, Statistician
Stanford University School of Medicine

Laura A. Schmidt, Professor of Health Policy
Philip R. Lee Institute for Health Policy Studies
University of California, San Francisco

Presented as a poster at the American Society of Clinical Oncology Quality Care Symposium, San Diego, CA, November 30-December 1, 2012.

Purpose: Colorectal cancer (CRC) disparities have persisted over the last two decades. CRC is a complex disease requiring multidisciplinary care from specialists who may be geographically separated. Few studies have assessed the association between integrated health care system (IHS) CRC care quality, survival, and disparities. The purpose of this study was to determine if exposure to an IHS positively affects quality of care, risk of mortality, and disparities.

Patients and Methods: This retrospective secondary-data analysis study, using the California Cancer Registry linked to state discharge abstracts of patients treated for colon cancer (2001 to 2006), compared the rates of National Comprehensive Cancer Network (NCCN) guideline–based care, the hazard of mortality, and racial/ethnic disparities in an IHS versus other settings.

Results: More than 30,000 patient records were evaluated. The IHS had overall higher rates of adherence to NCCN guidelines. Propensity score–matched Cox models showed an independent and protective association between care in the IHS and survival (hazard ratio [HR], 0.87; 95% CI, 0.85 to 0.90). This advantage persisted across stage groups. Black race was associated with increased hazard of mortality in all other settings (HR, 1.15; 95% CI, 1.04 to 1.27); however, there was no disparity within the IHS for any minority group (P > .11 for all groups) when compared with white race.

Conclusion: The IHS delivered higher rates of evidence-based care and was associated with lower 5-year mortality. Racial/ethnic disparities in survival were absent in the IHS. Integrated systems may serve as the cornerstone for developing accountable care organizations poised to improve cancer outcomes and eliminate disparities under health care reform.

Read or purchase the article here.

The Garifuna Exodus

Latino USA
2015-01-23

Maria Hinojosa, Executive Producer & Anchor

Marlon Bishop, Producer

For centuries, the Garifuna people — descendents of both Africans and indigenous Arawak people from the Caribbean — have lived peacefully in seaside towns on the North Coast of Honduras. There’s always been a trickle of migration from the community to the United States – especially the Bronx, where the largest Garifuna community outside of Central America lives.

But starting last spring, the trickle of migrants became a flood. Hundreds of Garifuna from each town left, thousands all together, embarking on the dangerous journey through Central America and Mexico to the U.S. border. It was mostly mothers with small children. They showed up in places like the Bronx, seeking refuge with family members, wearing GPS ankle monitors placed on them by U.S. immigration officers who detained them. They await court dates in limbo, unsure if they will be forced to go back to the homes they fled…

Read the entire introduction and listen to the story here.

Black Germans and the Holocaust

International Slavery Museum
Liverpool, England, United Kingdom
2015-01-14

The International Slavery Museum will be marking Holocaust Memorial Day on Tuesday 27 January with a special free guest lecture by Professor Eve Rosenhaft from the University of Liverpool, who will be talking about the experiences of the Black German community during the Holocaust.

Eve tells us more:

“When Hitler came to power in 1933, there were a several thousand people of African descent in Germany. They included African Americans, African-Caribbean and Africans passing through, working or recently settled, but the core of Germany’s Black community was made up of men from Germany’s former colonies – East Africa, Togo, and especially Cameroon – with their German-born wives and ‘mixed-race’ children.

This talk focuses on those families. While Hitler was still hoping to recover colonies in Africa, the Nazis hoped to make use of them for political propaganda. But ‘mixed’ families represented a particular challenge to Nazi racial policies, and in the long run they suffered exclusion, harassment, internment, and compulsory sterilisation. At the same time people’s experiences were varied and sometimes adventurous. Most individuals survived in Germany or as emigrants, thanks to support from other members of the community and from their families, though the community itself came out of World War II largely broken and scattered…

Read the entire article here.

The Life and Death of Davis Knight after State vs. Knight (1948)

Renegade South: Histories of Unconventional Southerners
2009-04-08

Victoria E. Bynum, Emeritus Professor of History
Texas State University, San Marcos

Davis Knight, the great-grandson of the infamous “Free State of Jones” guerrilla, Newt Knight, became the centerpiece of his own drama some 25 years after the death of his notorious ancestor. Although Davis was descended from Newt and his wife, Serena, both of whom were white, he was also the great-grandson of Rachel Knight, a former slave of Newt’s grandfather. And although Davis was white in appearance, because of his descent from Rachel, he was defined as black by his white neighbors. Some of those neighbors did not take kindly to Davis Knight’s marriage in 1946 to Junie Lee Spradley, a local white woman. In 1948, Davis ended up in court, accused of having married across the color line (a crime in several states until 1967). Despite a vigorous defense by Attorney Quitman Ross, a jury pronounced Davis guilty. Convicted of miscegenation, the Ellisville Court sentenced him to five years in Mississippi’s notorious Parchman prison.

Attorney Ross immediately appealed the decision on grounds the court had failed to prove that Davis had 1/8th or more African ancestry, and won his case. The Mississippi State Supreme Court overturned the lower court’s decision and remanded Davis’s case for retrial–a retrial that never took place. In legal terms, the High Court ruled in this important case, the “one drop rule” did not determine one’s racial identity, regardless of social custom. Davis Knight thus escaped going to prison and, for the rest of his life, lived as a white man…

Read the entire article here.

From Behind the Counter: Poems From a Rural Jamaican Experience

Ian Randle Publishers
2000-09-05
216 pages
5.5 x 0.5 x 8.5 inches
Paperback ISBN: 978-9768123879

Easton Lee

Photographs by Owen Minott

Easton Lee was born to a Chinese father and a Jamaican mother of mixed racial heritage in the 1930s at Wait-a-bit, Trelawny, Jamaica. The family lived in several villages and towns as his parents ‘moved shop’ in search of a livelihood. Life was different then – no television, no telephones, inadequate road systems, no radio. The life of rural communities revolved and evolved around the church, the school and the village shop. The majority of these shops were owned and operated by Chinese families. Lee recalls that many evenings during his elementary schooldays were spent under the counter of his parents’ shop so he could be near to his mother as she attended to customers and helped him with homework. Customers, unaware of his presence, often discussed the village happenings and their private business in the most intimate details, giving him insight and information not otherwise available. His mother who was born at the turn of the century, fed him with stories and legends she had gleaned from her older relatives. An avid reader and a great storyteller, she often entertained her children and their friends with fascinating tales she had read or had heard in her childhood. His attention later turned to his Chinese heritage with his father and other Chinese relatives providing the link to that source. He found to his amazement that those teachings were not all that different from those of other sources, and in some instances were identical. This lively interest in and knowledge of Jamaican folklore which began in his schooldays was broadened and enhanced when, in adulthood, he went to work with Jamaica Social Welfare Commission, now the Social Development Commission, in a job which took him to every corner of the country.

Penn PIK Professor Dorothy Roberts to Receive APA’s 2015 Fuller Award

Penn News
University of Pennsylvania
2015-01-23

Jacquie Posey, Media Contact
Telephone: 215-898-6460

The American Psychiatric Association has named University of Pennsylvania professor Dorothy Roberts recipient of the 2015 Solomon Carter Fuller Award in recognition of her demonstrated leadership and exceptional achievements.

The award honors “a Black citizen who has pioneered in an area which has significantly benefitted the quality of life for Black people.”

Roberts is an acclaimed scholar of race, gender and the law who joined the University in 2012 as its 14th Penn Integrates Knowledge Professor. She is the George A. Weiss University Professor of Law and Sociology. Her appointment is shared between the School of Law and the departments of sociology and Africana studies in Penn Arts & Sciences. She is also the founding director of Penn’s Program on Race, Science and Society.

Roberts’ path-breaking work explains the mechanisms and consequences of racial inequities for women, children, families and communities and counters scientific misunderstandings about racial identity. Her research focuses on family, criminal and civil-rights law; bioethics; child welfare; feminist theory; reproductive justice; critical race theory;  and science and society.

Her major books include Fatal Intervention: How Science, Politics and Big Business Re-Create Race in the Twenty-first Century; Sex, Power and Taboo: Gender and HIV in the Caribbean and Beyond; Shattered Bonds: The Color of Child Welfare; and Killing The Black Body: Race, Reproduction and the Meaning of Liberty…

Read the entire news release here.