By Hazel Trice Edney

WASHINGTON (NNPA) - As a $4.5 million effort to curb tobacco use among Blacks over three years is coming to an end in April, the American Legacy Foundation, which granted the money to six Black organizations in 2004, says the fight against tobacco use in the Black community is escalating.

“It was an unprecedented alliance of leadership organizations that came together for a common cause. And even though all these leadership organizations had their own respective reputations, missions, purposes, they were all able to minimize the differences and to use their leadership to publicize and support a public health message,” says Helen Lettlow, Legacy’s assistant vice president for the Priority Population Department. “By this collective group of partners, we were able to raise public awareness. We were able to showcase and spotlight the importance and the impact of tobacco use in the Black community.”

Notwithstanding, three years later, the impact of tobacco in the Black community can still be summed up in one word—”deadly.” It is still estimated to kill 45,000 Blacks each year and more than 120 Blacks a day. That’s 10 percent of the total 450,000 people each year or more than 1,200 a day.

The group of six organizations, called the African American Partners for a Tobacco-Free Society, laid the groundwork for education on issues such as youth smoking, second hand smoke, and how to quit. But, Ms. Lettlow says new campaigns will escalate the momentum as 22 percent of all adult Blacks still smoke—27 percent of Black men and 17 percent Black women.

The six organizations: the National Newspaper Publishers Association, the National Association for the Advancement of Colored People, the National Urban League, the National Conference of Black Mayors, the Congressional Black Caucus Foundation and the National Association of Neighborhoods, spread the message to millions of Blacks through forums, public service announcements, and news articles over the past three years as a part of Legacy’s “Priority Populations Initiative.” Legacy is the only foundation in the nation that focuses solely on tobacco prevention and cessation.

One of the more creative outreach campaigns is Legacy’s public health pilot program called “eX,” which is a cinema ad campaign that started last month running in eight Baltimore-area theaters and will continue for 12 weeks. The comical ad features a Black man who can’t perform normal everyday tasks without a cigarette.

Ultimately, the ad campaign will appear on more than 100 movie screens around the country. The commercial ends with the toll-free telephone number: 1-800-QUIT NOW.

Though reaching people is assured, it is difficult to measure the impact.

“Often times people will take actions weeks or months afterward. But, this program is to plant the seed that, one, this is a health issue, it’s one that needs to be addressed and that there’s help available,” says Ricardo C. Byrd, executive director of NAN, which is the coordinating organization for the partnership. “So we think a percentage of those people who hear the message will take action. But, even a greater number will feel that this is something doable as opposed to maybe feeling before that they were without capacity to try to stop.”

Legacy is now preparing to launch what it calls Phase Two of the Priority Populations Initiative, says Ms. Lettlow.

“Phase one was a grassroots, nationwide effort to provide funding to community organizations in African-American urban low income communities,” Ms. Lettlow says, “African-American partners was an expansion of Phase I, which said not only did we want grassroots involvement, but grass tops involvement.”

Phase Two of funding, to start in July and go for another three years, will focus largely on smoking among substance abusers by funding rehabilitation programs for anti-smoking initiatives. Phase I will also focus on the reduction of second-hand smoke in the home, and the integration of smoking cessation campaigns with other good health initiatives, such as diabetes education and healthy heart campaigns.

If the current smoking patterns of Blacks continue, an estimated 1.6 million Black people currently under the age of 18 will become regular smokers, and about 500,000 of them will eventually die of a smoking-related disease.

The key is apparently starting the education among the youth, says Lisa Fager, chair of the Partnership and director of the anti-smoking education initiative of the Congressional Black Caucus Foundation. Ms. Fager spent the past three years traveling to historically Black colleges and universities to disseminate information about the dangers of tobacco. She hopes she has motivated thousands of student to act against smoking.

“I think we definitely made an impact in their critical thinking in how to implement peer-health education on campuses and how to be more innovative and creative in talking to their peers about tobacco,” says Ms. Fager.

But, Ms. Fager acknowledges it is a difficult battle. “The people who are trying to send out the messages about tobacco are very creative about what they do. I’ve tried to show the students that they need to be just as good and that they definitely should think before they act.”

Main Category: Nutrition / Diet News

Almost no adolescents are meeting all four key obesity prevention behaviors eating five fruits and vegetables, spending less than two hours in front of the TV or computer, at least one hour of exercise and no sugar-sweetened drinks. Although some teens are meeting each goal separately, only 9 percent are eating the recommended servings of produce, according to a presentation today at the Pediatric Academic Society meeting in Toronto.

"Adolescence is when we start forming lifelong habits, so these results are not encouraging," said Jennifer Foltz, M.D., a pediatric fellow and an attending physician at the University of Rochester Medical Center. "Even still, small changes can completely reverse these data and adolescents can develop healthier lifelong habits that could prevent obesity."

Through analyzing data of 4,414 children 12 to 19 years old from the National Health and Nutrition Examination Survey conducted between 1999 and 2002, Foltz and her coauthors found that only 0.4 percent of adolescents meet all four obesity prevention objectives, or 5-2-1-0 goals. On individual objectives:

9 percent ate five or more daily servings of fruits and vegetables 27 percent spent two or fewer hours in front of the TV or computer every day 32 percent had an hour or more of daily physical activity 14 percent had no sweetened beverages

Most importantly, 41 percent of the adolescents did not meet any of the prevention goals.

The majority (56 percent) of 4,414 adolescents in the survey ate one or less fruit or vegetable a day. Over time, they could add in an apple for a snack or have a salad in addition to a vegetable at dinner, and that would make a big difference, Foltz said. Similarly, if the 22 percent of teens who spend five or more hours in front of a TV or computer traded some of that time for a walk or if the 43 percent who drink three or more servings of sweetened beverages switched to water, the lifelong impact could be huge, Foltz said.

"Clinicians and community leaders need to focus on these four, simple goals to get the message across to adolescents and families that small changes can reap lifelong benefits," Foltz said. "Doctors should be talking to their patients about nutrition, physical activity and screen time, and the public health community should be promoting and increasing the availability of fruits and vegetables while decreasing consumption of sugar-sweetened beverages."

By Damon Adams, AMNews staff

In this era of patient safety, some are turning to legislation and others to litigation to change the makeup and authority of state medical boards. Those pushing for reforms believe the proposed changes will better protect the public and police the profession.

Lawmakers this year filed bills in Florida, Georgia, New Jersey and New Hampshire to add more public nonphysician members to the boards and give patients a greater voice in overseeing physicians. Board leaders said such legislation is part of a steady trend of placing more nonphysicians on boards, which some view as a way to keep physicians honest about regulating other doctors.

Meanwhile, a physician and three patients filed a lawsuit in North Carolina, claiming that the state medical society has too much power over the medical board. The suit asks that the process calling for the society to nominate physicians for board appointment be declared unconstitutional.

Medical board officials said these efforts are the latest wave of scrutiny for boards, which typically become targets of legislation after media reports focus on problem physicians or lax discipline by boards. Even if some of the measures fail to become law, the proposals have brought new examination of the boards that could lead to later reforms, officials said.

"Everybody's always looking to change the medical board in some way," said Jim McNatt, MD, medical director of Georgia's Composite State Board of Medical Examiners.

At present, all but three states (Alabama, Louisiana and Mississippi) have public members on their medical boards, according to the Federation of State Medical Boards. MDs and DOs make up 71% of medical board members while 24% are public members. The remaining board spots are filled by other health care professionals. About 10 years ago, public members made up roughly 10% of boards.

MITCHEL L. ZOLER (Philadelphia Bureau)

ORLANDO — The prevalence of morbid obesity has grown dramatically among American adolescents and children, according to an analysis of data collected by the most recent national health survey.

On the basis of data from the National Health and Nutrition Examination Survey (NHANES) 1999–2004, about 418,000 adolescents aged 12–19 had a body mass index (BMI) of at least 40 kg/m2, Dr. Stephen Cook reported in a poster at a conference on cardiovascular disease epidemiology and prevention sponsored by the American Heart Association. This represented about 1.3% of the adolescent population in the United States in 2000. Included in this group were 71,000 adolescents with a BMI of 50 kg/m2 or greater.

With another definition of severe obesity, 3.8% of American children aged 2–19 had a BMI at or above the 99th percentile for their age in the NHANES 1999–2004 sample, reported Dr. Cook and his associates. This prevalence translates into about 2.7 million children.

By convention, children younger than 12 are defined as severely obese if their BMI meets or exceeds the 99th percentile for age because the usual definition of morbid obesity—40 kg/m2 or greater—is not relevant for younger children. The spread of obesity is reflected by the fact that BMI levels that, several years ago, were only reached by the heaviest 1% of children in each age group have now been reached by 3.8% on average.

More specifically, the prevalence of BMIs at or above the 99th percentile for age jumped by more than 50% between the prior NHANES survey in 1988–1994 and the 1999–2004 survey, said Dr. Cook, a pediatrician at the University of Rochester (N.Y.).

“The high prevalence and rapid increase of this group of children and adolescents portend a large burden to the health care system,” the researchers said in their poster.

“The progress that we've made in preventing and treating cardiovascular disease in adults will be reversed by childhood and teenage obesity,” Dr. Cook said in an interview.

The jump in obesity rates between the current and prior surveys was sharpest among Mexican Americans, African Americans, and those classified as “other” racial and ethnic groups.

There was essentially no change among children classified as white.

In NHANES 1999–2004 the highest prevalence of a BMI of 40 or greater was among African Americans, affecting 3.4% of this subgroup.

NHANES 1999–2004 collected data on 12,384 American children who were selected to create a sample that represented the total American population at that time.