Take charge of your health today. Be informed. Be involved.Scope of infant mortality disparitiesin Allegheny County unacceptable

This monthʼs issue on in-fant mortality is a continua-tion of the monthly seriesstarted last year focusing onhealth disparities in the Pitts-burgh region. The series is apartnership among the NewPittsburgh Courier, Commu-nity PARTners (a core ser-vice of the University of Pitts-burghʼs Clinical and Transla-tional Science Institute—CTSI) and the Urban Leagueof Greater Pittsburgh. Jes-sica Griffin Burke, PhD,MHS, associate professor ofbehavioral and communityhealth sciences at Pitt, satdown with Esther L. Bush,president and CEO of the Urban League, totalk about this monthʼs topic.by Jessica Griffin Burke, PhD, MHS

JGB: Ms. Bush, I know from working withyou that issues related to infant and childhealth are very important to you. What areyour thoughts about the topic this month?

EB: The numbers about the scope of thedisparities in infant mortality in AlleghenyCounty are staggering, overwhelming and,frankly, unacceptable. Iʼve been in Pitts-burgh for a long time; and, unfortunately, theentire time that Iʼve been in this wonderfulcity those numbers have been the same. Itʼstime for us to work together, as a commu-nity, to do something to improve maternalhealth and to reduce poor pregnancy out-comes.

JGB: What can or should we do differentlynow to deal with this issue?

EB: As I said, we need to work together.That means that researchers need to workwith community members to better under-stand the roots causes of these stark dis-parities. Dr. Dara Mendezʼs work exploringhow neighborhood context matters forhealth is very important. Where you live candefinitely affect your health. Dr. Mendezʼswork with the Birth Circle doulas andwomen gives us some clue about where tobegin addressing issues related to how aneighborhood may contribute to low birthweight and preterm birth. The answer to re-ducing disparities in infant mortality likelylies in our ability to think creatively and toexplore options that have not been consid-ered until now.

JGB: It seems as if Dr. Lisa Bodnarʼswork also falls into the category of issuesthat havenʼt been well investigated yet.

What do you think of herwork suggesting that vita-min D may be contributingto the disparities in infantmortality we see here inPittsburgh?

EB: Well, I do know thatitʼs cold and gray here inthe winter months and thatwe donʼt see the sun much!I didnʼt know about the po-tential connection betweenvitamin D deficiency andpoor pregnancy outcomes.While I understand that sheis still conducting necessaryresearch, itʼs possible that avitamin D supplement couldhelp. I look forward to learn-

ing more as her research continues.JGB: Letʼs go back to what you were say-

ing about making progress in our efforts toreduce infant mortality and, specifically, thedisparities that exist. How does thatprogress happen?

EB: I think progress can occur throughcreative, collaborative approaches. I was re-ally encouraged to read about the Inter-Conception Care (ICC) project, involving theAllegheny County Health Department ChildDeath Review Team and UPMC FamilyHealth Centers. The ICC model makessense. We need to work to make sure thatall mothers, children and families arehealthy in their homes and neighborhoods.Then they can care for themselves and theirchildren and will be ready and healthy forfuture pregnancies. This approach shouldextend beyond the clinic. In the end, I be-lieve weʼll be able to successfully improvebirth outcomes in Allegheny County if we re-member to think about moms as womenwho need help facing challenges. Also, wemust engage with health care providers andpolicy makers to make positive changes.

JGB: I absolutely agree. We can do it.What makes Allegheny County different isthat itʼs a smaller area than other urbanareas. The dynamic is different, and I thinkwe can do some things here because of oursize that you canʼt do in larger cities. I lookforward to our continued collaboration.

EB: I want to encourage others to learnmore, ask questions and get involved in re-search. People can call the CommunityPARTners Core for more information aboutparticipating in research at 412-624-8139.They can also call the contacts listed in thismonthʼs segment to learn how to participatein the highlighted studies.

ESTHER BUSH

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NATIONAL MINORITY HEALTH MONTHAPRIL 17-23, 2013

New Pittsburgh Courier

A6www.newpittsburghcourier.com

According to the Centersfor Disease Control and Pre-vention (CDC), more than25,000 infants die each yearin the United States. Infantmortality is defined as thedeath of an infant beforeone year of age. Infant mor-tality rates refer to the num-ber of infant deaths forevery 1,000 live births. Theinfant mortality rate in theU.S. is six deaths per 1,000live births and is worse thanthat of many other industrial-ized countries (CDC, 2013).

Infant mortality rates varyby the race of the mother.Sadly, the racial disparitiesseen in infant mortality ratesbetween African Americansand Whites in AlleghenyCounty are striking (Figure1). In Allegheny County in2009, there were 16 deathsper 1,000 live births amongAfrican Americans, while therate among whites was 5.6deaths per 1,000 births. TheAllegheny County numbersfor African Americans are

considerably higher thanboth the state (14.4 deathsper 1,000 births) and na-tional rates (11.6 deaths per1,000 births). Disparities arealso seen between AfricanAmericans and Whites onlow birth weight (infants bornweighing less than 5.5pounds) and preterm birth

(birth before 37 weeks ofpregnancy). These are twoof the major predictors of in-fant mortality.

The racial disparities in in-fant mortality rates are puz-zling. Itʼs not clear what fac-tors contribute to the differ-ences. For example, takethe complex problem ofpreterm birth. Differences inmaternal characteristics,such as socioeconomic sta-tus, prenatal care, infectionand nutrition, are known tocontribute to disparities inpreterm birth. But, in theU.S., African Americanwomen with advancedschooling are more likely tohave an infant die in the firstyear than are White womenwho did not finish highschool. The reasons for thisdisparity are not clear. Couldother factors (like neighbor-

hood environment) be con-tributing to the differences?Research is now focusingon the role of stress as onekey contributing factor.

The Community ChildHealth Network (CCHN) is alarge, federally funded re-search project currently un-derway to help understandhow communities and fami-lies create a context that in-fluences pregnancy and in-fant and child health. Thegoals of this research includelooking at how community,family and individual stres-sors can influence and affectpregnancy health. Re-searchers are also studyingwhether these factors mightresult in health disparities inpregnancy outcomes and in-fant mortality. Although theCCHN study does not in-clude Pittsburgh, the resultsfrom this research will pro-vide valuable insights intoways to reduce infant mortal-ity rates and to effectively ad-dress racial disparities inpregnancy outcomes. Moreinformation about the CCHNproject can be found athttp://www.communitychildhealthnetwork.com/index.html.

Researchers are now inter-ested in interventions arebeing planned that adopt aholistic (consideration of thecomplete person, physicallyand psychologically) ap-proach and focus on healthacross the entire lifespan,not just when a woman ispregnant. Reducing dispari-ties in infant mortality andimproving birth outcomeswill require an increase in ef-forts to better understandthe reality of African Ameri-can womenʼs lives, both dur-ing pregnancy and overall.

The AlleghenyCounty infant

mortality rates forAfrican Americansare considerably

higher than both thestate (14.4 deathsper 1,000 births) and national rates(11.6 deaths per1,000 births)

How does where you live affectyour health, pregnancy and birth?

Take charge of your health today. Be informed. Be involved.

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Where you live affects your health. Neighborhood environ-ments are important for understanding racial health dispari-ties, especially during pregnancy and birth. Neighborhoodenvironments differ by race and ethnicity in the U.S. For ex-ample, harmful air toxins and lead-based paint are morelikely to be located in communities of color. Qualities thatpromote health, like grocery stores and parks, are morelikely to be located in White communities. This difference isdue to zoning policies and business practices. But manystudies donʼt ask community members how they think theirneighborhood influences their health.

Recently, researchers from the University Of PittsburghGraduate School Of Public Health worked with The BirthCircle. The Birth Circle is a community-based doula pro-gram. Community-based doulas are women who receivedspecialized training but who are no health care profession-als. They provide pregnancy services, like labor and deliv-ery support. They also educate mothers about childbirth andnutrition. If a mom is having trouble breastfeeding, they offersupport and help. The researchers asked mothers anddoulas to talk about their views of neighborhood factors andhealth during pregnancy and birth.

The doulas and mothers talked about a wide range ofneighborhood-related issues that they felt were important forpregnancy and birth. These included good, affordable hous-ing; jobs; grocery stores; parks and access to high qualityhealth care services. The group felt the most importantissue was services related to health.

The group also talked about the relationships between af-

fordable, fun ac-tivities in theirneighborhoodand how they re-late to safety.Challenges werealso sharedabout publichousing environ-ments for moth-ers and children.Transportationwas thought to be very important to access health care re-sources. Mothers noted recent public transportationchanges that affect how theyʼre able to access health careand other services.

“Cost of transportation is one thing,” one mother said. “But,it goes beyond that. Is there actually a bus that goes pastyour house? In certain neighborhoods, entire bus routeshave been cut.”

The results from this study can be applied in future re-search. They can also be used for support in making con-nections between policies and better community programsin housing, transportation, urban development and health.

For more information about neighborhood environmentand pregnancy research in Pittsburgh, please contact DaraMendez, PhD, assistant professor, University of PittsburghGraduate School of Public Health, at ddm11@pitt.edu or412-624-3161.

CTSI recently sat down with Lisa Bodnarfrom the University of Pittsburgh School ofPublic Healthʼs Department of Epidemiologyto discuss risk factors for pregnant womenand how they can be reduced.

CTSI: Briefly describe the problem of in-fant mortality (defined as a babyʼs deathduring the first year of life) in AlleghenyCounty.

Dr. Bodnar: The disparity we see in infantmortality rates between African Americansand Whites in Allegheny County is striking.Itʼs far worse than in other counties in Penn-sylvania, let alone in other parts of the coun-try. Putting that in context, the infant mortal-ity rates overall in the U.S. are much higherthan in many other developed countries. So,the fact that the rates in the U.S. are high—and knowing that the rates in AlleghenyCounty are very high, and the disparity inthose rates is even higher—is staggeringand tragic. We absolutely have to do some-thing about it.

CTSI: Please give us an overview of yourwork with vitamin D and its possible con-

nection with infant mortality.We used to think vitamin D was only im-

portant for things like bone health. What re-searchers realized in the last 15 years or sois that low vitamin D levels are also relatedto a number of other diseases. Low vitaminD has been related to some cancers, car-diovascular disease, diabetes, asthma,autism, depression and other mental health

illnesses. The reason researchers startedexploring these outcomes is because werealized vitamin D does more in the bodythan keep bones healthy and help the bodyuse calcium. In fact, all of our cells use vita-min D for some reason. So, when everysingle cell in the body uses vitamin D, westarted thinking that it must be related tosomething other than just bones.

We started looking at vitamin D in preg-nancy because the placenta makes vitaminD and takes it to the unborn baby (the pla-centa feeds and nourishes the baby andgets rid of waste). Vitamin D helps regulatehow the placenta works. Researchers won-dered whether vitamin D is related to harm-ful pregnancy outcomes. Weʼre particularlyconcerned about this in Pittsburgh. Manypeople donʼt get enough vitamin D here.This is especially true in the winter andspring months when we donʼt see as muchsunshine.

We get vitamin D through our food andfrom sunlight. People get most of their vita-min D just from being in the sunlight for a

few minutes. Melanin, which makes peo-pleʼs skin dark, absorbs vitamin D and actsas a natural sunscreen. It prevents sunlightfrom getting into the skin and beingchanged to vitamin D. So, we find that Afri-can Americans have a much harder timegetting enough vitamin D from sunlight.They need maybe 5 times as much time inthe sun as someone with lighter skin wouldneed. You can imagine that getting thismuch sun can be hard when we spend somuch of the winter months indoors. We alsosee high rates of vitamin D deficiency inWhites in Pittsburgh. But the difference wesee between Blacks and Whites is similar towhat we see for infant mortality in thecounty. We saw that vitamin D could be im-portant for pregnancy outcomes. This in-sight started to make us question whethervitamin D could be adding to racial differ-ences in infant mortality. The goal is to findout whether giving people extra vitamin Dwill reduce the inequality we see in the

DARA MENDEZ, PhD

NATIONAL MINORITY HEALTH MONTHNEW PITTSBURGH COURIER APRIL 17-23, 2013 A7

SEE REDUCING A8

LISA BODNAR, PhD, MPH, RD

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NATIONAL MINORITY HEALTH MONTHA8 APRIL 17-23, 2013 NEW PITTSBURGH COURIER

county. CTSI: Would taking prenatal vitamins help

with vitamin D deficiency?Prenatal vitamins contain about 600 inter-

national units (IU) of vitamin D. But thereʼsdisagreement about whether thatʼs enoughfor most women. We have found thatwomen who take prenatal vitamins about asmuch vitamin D deficiency as those whodonʼt. There are limitations with that re-search, though; weʼre basing it on whatpeople tell us. Vitamin D levels are a bithigher in women who take prenatal vitaminsbut not enough to make a dent in the dis-parity we see. It seems that higher doses, inthe 1,000 to 2,000 IU range, might bewhatʼs needed to raise vitamin D levels inmost people and prevent deficiency.

Itʼs hard because the definition of vitaminD deficiency in adults is controversial. Itʼshard to say how much vitamin D womenshould be taking because we donʼt knowwhat the best level is. Some of the work Iʼmdoing now is to relate levels of vitamin Dwith pregnancy outcomes to determinewhether thereʼs a point at which we see areduction in risk. If low levels and high lev-els arenʼt good, is there a middle level thatʼsa sweet spot for most women? Becausethere hasnʼt been much research done,weʼre starting from scratch in pregnantwomen. Right now, it seems that a womanʼsvitamin D level when she gets pregnant ismost important.

CTSI: Tell us about your pregnancy weightgain research.

Itʼs similar to the vitamin D work. There areclear racial inequalities in the amount ofweight women gain in pregnancy and theweight at which they start pregnancy. Afri-can American women have much higherlevels of obesity when they start pregnancy.They also tend to gain less weight duringpregnancy. In all body-mass index (BMI)groups, it looks as if Black women on aver-age gain less weight than White women.Gaining less weight than is recommended isassociated with babies being born too earlyor too small. These are factors related to in-fant mortality. Changing a womanʼs weightbefore she gets pregnant is very hard to do.

If a woman gets prenatal care, she is get-ting routine medical contact. She may bemore likely at that point to make lifestylechanges be-cause itʼsnot just forher health—itʼs also forher babyʼshealth. If wecould helpwomen gainthe appropri-ate amountof weight, itmight re-duce someof that dis-parity in infant mortality.

Starting a pregnancy at too high or too lowa BMI is unhealthy. Gaining too little or toomuch weight is also unhealthy. The reasonweʼre trying to target weight gain in preg-nancy is that once we see women who arepregnant, itʼs too late to change theirprepregnancy weight. The only thing we canhelp with at that point is their weight gainduring pregnancy. Scientists agree that awomanʼs BMI is more important that howmuch weight she gains in pregnancy. Weshould be doing more to promote weightloss in women before pregnancy, but thatʼs

proved to be a difficult task. Fifty percent ofpregnancies are unplanned, so women usu-ally arenʼt thinking about their weight with

regard togetting preg-nant.

Weʼre look-ing at howweight gainmay explaininfant mor-tality dispari-ties. Amongobese, over-weight, nor-mal weightor under-weight

women, is weight gain adding to infant mor-tality?

CTSI: How do other things, such as theenvironment or peopleʼs culture, affect preg-nancy weight gain?

So many things can interfere with peoplehaving a healthy weight. They include per-sonal choices, as well as the environmentsand cultures in which we live, how muchmoney we have and how much peopleknow about whatʼs healthy and whatʼs not.There are a tremendous numbers of barri-ers.

Pregnancy could be a time when we can

provide resources to women about theirweight. It may be a time when we can helpstop a weight-gain cycle. In women, wetend to see them gain too much weight inpregnancy, not lose it all after having thebaby and then start their next pregnancy ata higher weight. Then, women maybe gaintoo much weight in another pregnancy anddonʼt lose it. This cycle puts babies at ahigher risk for problems at birth. A womanmay start her first pregnancy at a decentweight, but after having three children, sheends up overweight or obese. If we can helpher gain an appropriate amount of weightduring pregnancy, that may help stop thecycle. Thatʼs what we want to try to do.

CTSI: What kind of practical advice canyou give to women who are concernedabout vitamin D or pregnancy weight gain?

Taking a supplement of 1,000 units of vita-min D is safe and wonʼt hurt most people. Ifwomen have easy access to health care,they can ask to have their vitamin D levelschecked. Itʼs safer than spending time out inthe sun because we donʼt know the amountof sun that is safe.

To control weight gain, women should tryeating more fruits and vegetables—fresh,canned, frozen, cooked, whatever—anddrink fewer sugary drinks and eat fewersweets. This would go a long way in pro-moting health, even without seeing a doctoror getting on a diet plan. Eating fruits andvegetables is better than eating processedfood.

Vitamin D is certainly about more than justbones. It can affect pregnancy outcomes inmany ways, and we donʼt know yet which ismost important. So, letʼs focus on the thingswe can control—healthy behaviors and get-ting the right nutrients.

If you are worried about infant mortalityand your risk factors, talk to a health careprofessional.

Dr. Lisa Bodnar, Ph.D., M.P.H., R.D., is anassistant professor in the University ofPittsburgh School of Public Healthʼs De-partment of Epidemiology. She was re-cently awarded the Young ProfessionalAchievement Award, given by the NationalCoalition for Excellence in Maternal andChild Health Epidemiology.

CONTINUED FROM A7

In all body-mass index (BMI) groups, itlooks as if Black women on average gainless weight than White women. Gainingless weight than is recommended is associated with babies being born too

early or too small.LISA BODNAR, PhD, MPH, RD

Take charge of your health today. Be informed. Be involved.

Birth outcomes dependon a healthy lifestyle be-fore and during pregnancy.By the time a woman knows she is pregnant and goes toher doctor for prenatal care, it may be too late to makechanges that increase the likelihood that the birth will resultin a healthy baby. For this reason, the Allegheny CountyHealth Department Child Death Review Team and UPMCMcKeesport, Shadyside and St. Margaret Family HealthCenters have joined other family health centers from thenortheastern United States to develop strategies for improv-ing birth outcomes. Their newest strategy is the Inter-Con-ception Care (ICC) project.

The inter-conception period refers to the time betweenpregnancies—after the birth of one child and before thebirth of another child. During this time, new mothers arebusy. They may feel like they donʼt have time to get regularcheck-ups. This means that new mothers may not be get-ting the health care they need.

Although new mothers may not seek health care for them-selves, they do take their babies to the doctor for regularcheck-ups. The ICC project uses the babyʼs check-up tomake sure that both the mother and baby are healthy. Doc-tors involved in the ICC project take time at the babyʼscheck-up to screen mothers for specific health risks. Theserisks include smoking, depression, birth spacing, taking adaily multivitamin that contains folic acid and practicingsafe-baby sleep habits.

These five health risks were included in the ICC project be-cause research shows that these risks can negatively affectfamilies and future pregnancies. By identifying and address-ing these risks, doctors hope to improve family health and re-duce prematurity and low birth weight in future pregnancies.Also, doctors can assess mothers for these health risksquickly—the screening usually takes less than two minutes.

As mothers return to their childrenʼs doctor, the doctors re-screen the mothers for these health risks. This happenseach time a mother takes her child to check-ups, from thetime the child is born until the child is 2 years old. Thischeck-up allows doctors to monitor a motherʼs health risksand get her the care she needs to lead a healthy life.

The ICC project began at UPMC Family Health Centers in2012. As of December 2012, the three health centers werecollecting data on almost 130 mothers. Throughout the nextseveral years, UPMC Family Health Centers and their part-ners will collect and analyze data about the project. The

NATIONAL MINORITY HEALTH MONTHNEW PITTSBURGH COURIER APRIL 17-23, 2013 A9

findings will help determine how well the ICC project identi-fies and addresses these health risks in mothers. Thehealth centers plan to use this information to refine and im-prove the project over time.

The goal of UPMC Family Health Centers and their part-

ners, including the AlleghenyCounty Health Department, is todevelop a brief model of maternal

care that can be used in other primary care clinics. Formore information about the ICC project in Pittsburgh, pleasecontact the project principal investigator, Lisa Schlar, MD,UPMC Shadyside Family Health Center, atschlarl@upmc.edu or 412-623-2287.

Inter-Conception Care Project developsstrategies for improving birth outcomes

In the new movie“42” about JackieRobinson breakingthe color barrier inMajor League Base-ball Wendell Smithis the fourth mostimportant charac-ter in the movie be-hindBranchRickey,(Harrison Ford),and Jackie and Rachel Robinson, (Chad-wick Boseman and Nicole Beharie).The movie opens with Smith, played byAndre Holland, telling the story.Smith was sent by the Courier to coverRobinson’s effort to integrate MajorLeague Baseball and becomes the Robin-sons’ chauffer, finds places for them tostay and becomes their best friend whilecovering his year in the minor leagues aswell as his first in the Majors.Even though there has been to myknowledge two other movies made aboutJackie Robinson, this is the first to in-clude Smith who led the crusade to getMajor League Baseball integrated. Well,it really wasn’t just Smith, it was theCourier led by Bill Nunn Sr.After World War II ended the Double Vcampaign had to be revised by the Pitts-burgh Courier, then the largest Black news-paper in the country.With victory overseas,and the military being integrated half thebattle had been won, but the battle at homefor equal rights was far from ended. Thusthe Courier behind the leadership of BillNunn Sr., the managing editor, and a bigtime sports fan himself having been one ofthe greatest athletes to come out of West-inghouse, launched yet another battle, thisone was to integrate major league sports.And since Major League Baseball was thebiggest sport in this country at the time, thisis what they targeted, with a weekly cam-paignby the entire sports staff aswell as ed-itorials demanding the Major Leagues ac-cept Blacks into the league with the argu-ment that Blacks were just as good as ath-letes and just as intelligent asWhites. Thiscampaign was one of many the Courierlaunched to break down the walls of in-equality and segregation. Leading the fighton the Sports front was Courier sportswriter Smith and others on the staff. Alsojoining the fight was the Chicago Defender,whichwas the second largest Black paper ofthat time.But not only did they write in thepapers they sent letters to all the ownersand General Managers including BranchRickeyurging them to do the right thing,ac-cept Blacks into the league, explaining tothem how it would benefit their teams fi-nancially as well as in the win column. Butit fell on deaf ears until Rickey finally de-cided to give it a shot in 1946.The Courier sent Smith out to followRobinson wherever he went. This was thestory of the century, the biggest breakthrough for Negroes since the CivilWar ifit happened. Smith stuck to Robinsonlike glue, and many don’t believe Robin-son could have made it if not for Smith,who made sure the Robinsons’ werehoused in every city he traveled including

Montreal where hespent his first yearin White profes-sional ball.Smith also be-came a trailblazerby becoming thefirst Negro to get aseat in the MajorLeague Press Box.Before this event

Blacks had to sit out in the stands withtheir typewriters.Even though Rickey was the man whomade the final decision to accept Blacksinto the Majors, and Robinson was theplayer who accomplished this great feat,it was the Courier behind the leadershipof Nunn Sr., with the backing of PublisherJesse Vann, who initiated the whole cam-paign to keep pressure on theMajors, andmake everyone aware of the great Blackbaseball players, and why they were justas good as the White players. And whythe Negro should not and would not ac-cept anything but equal opportunity.Meet the Press had Rachel Robinson andmovie historian Ken Burns, who is work-ing on a biography of Jackie Robinson, onthe program.Burns called Robinson one ofthe greatest heroes of history and I totallyagree with him.And I also agree with himthat Robinson’s accomplishment was thegreatest achievement for Blacks since, hesaid the Civil War, but I say since theEmancipation Proclamation, because theCivil War really wasn’t fought to free theslaves. Rachel said she was very pleasedand thrilled with the movie but wonderedout loud what took Hollywood so long. I’mstill wondering why Oprah Winfrey, TylerPerry, Spike Lee or some of those richBlack baseball players didn’t put up themoney for the movie years ago.She said hopefully young people, Blackand White, would go out to see it and beinspired to lead more productive lives.I agreewith her also on howdisappointingit is that so many young people don’t knowabout Robinson, and what he did to openthe doors for them? I’m talking about youngathletes as well. Especially when I hearthem thankingMichael Jordan.That is oneof the reasons there’s still a long way to gowhen it comes toBlacks getting a total pieceof the sports or corporate pie. Managers,coaches and management is still nowherenear what it should be and the number ofBlack American born players are rapidlydropping, despite the fact that baseballplayers are the highest paid players of anysport, and with the longest life expectancywhich means they make more longer.If you haven’t seen it go out and watchit. Take your kids. It doesn’t matter howold they are. It brought tears to my eyes,it made me mad, it made me happy, itmade me laugh.What more could you askfrom a movie.I strongly feel it should be required of allPublic Schools, and other students towatch this movie to know something ofour history.(Ulish Carter is the managing editor of the NewPittsburgh Courier.)

Pittsburgh Courier

Commentary

It can happen anywhereby LZ GrandersonGRAND RAPIDS, Michigan (CNN)—If Sept. 11, 2001,was the day everything changed, then April 15, 2013,serves as another reminder of that change, of our frail-ties and of a new reality in which “it can’t happen here”has been replaced by “it can happen anywhere.”When initial reports came out of Boston about two ex-plosions occurring near the finish line of the 116thmarathon—a marathon that began with 26 seconds ofsilence in honor of the 26 victims of the Newtown mas-sacre—we held our collective breaths and hoped it wasa freak infrastructure accident.Or compromised electrical wiring.Or a gas leak.Anything other than...President Barack Obama did not say the word “terror-ism” in his brief address, perhaps waiting until morefacts are learned. We don’t know how many are respon-sible, we don't know motive, if any, and we don’t knowwhether it's domestic or foreign. But we do know theFBI said the explosions were well-planned. We know theBoston Marathon is seen around the world. And weknow three people are dead, including an 8-year-oldboy, more than 100 are injured, and countless lives havebeen scarred.So if Sept. 11, 2001, was the day our innocence wastaken, then April 15, 2013, is the reminder that it isnever coming back.And we do not need the president to say the word tofeel the word.It is felt each time we have to take off our shoes at theairport, have a TSA officer pat us down, throw away atube of toothpaste because it’s over the allotted 3.4ounces. The FAA temporarily restricted flights over thebombing site while security was increased in cities asfar away as Miami and Los Angeles.We do not need the president to say the word to feel it.I was in central London earlier this month and washaving a difficult time finding a garbage can whenever Ihad something to discard. Finally, I asked some of theresidents why it was so hard to find one and was re-minded that the Irish Republican Army hid bombs ingarbage cans during the 1990s and as a result they arestill seen as a security threat.This is what happens when evil like the kind experi-enced in Boston takes away our innocence.It forces us to empty our pockets, have our bags in-spected and remove trash cans from the streets of amajor international city.We don’t need the president to say the word to be re-minded constantly that if we see something, we need tosay something, blurring the lines between a healthyawareness of our surroundings and irrational paranoia.But then again, is our paranoia that irrational if some-thing as celebratory as the Boston Marathon is nolonger a safe place to be?If Sept. 11, 2001, made you cry, then April 15, 2013,should make you angry.All of the laws, the creation of Homeland Security, thetrillions spent, the political grandstanding and debatesand yet the best we can do is make the country safer. Wewill never, ever be safe again. Not in the way many of usremember being safe growing up.When I'm in a large crowded space, I check for emer-gency exits…and I hate it.But like love and good, evil is an omnipresent force im-posing itself on the rest of society like an untreatablecancer. So while Obama telling the American peoplethose responsible will “feel the full weight of justice,” weare haunted by the fact that “justice” won’t bring the vic-tims back.“Justice” won’t undo the fear embedded in the peoplewho were closest to the blast. “Justice” won’t take usback to Sept. 10, 2001…back before the word “terror-ism” was on the tip of every American’s tongue.And make no mistake, while the president did not usethat word in his news conference, that is the word fed-eral authorities are using. Doesn’t matter if the culpritsof this heinous act came from afar or home. The originof the person or persons responsible won't bring us thepeace that we took for granted not so long ago. Thatpeace is gone, forever. Our children will hear storiesabout this peace and our children’s children will treat itas a fairy tale.If April 15, 2013, was the day the Boston Marathon be-came a target for terrorism, then Sept. 11, 2001, wasthe day we all were warned that it would be. Since thennothing has been the same.Nothing will be the same.

Courier gets big play in ‘42’

(NNPA)--The rightwing seems deter-mined to associatePresident Obamawith any govern-ment program thathelps people on thebottom. Thus, theterm Obamacarewas used to attackthe health care pro-gram that President Obama fashionedand worked with Congress to approve.While Obamacare is not perfect, it bringsmore people into the health care system,and further solidifies the safety net thatmany have attempted to fray.Now these folks are running with theterm “Obamaphone,” which speaks to thefact that President Obama has simply ex-tended a Lifeline plan that was autho-rized by Republican President RonaldReagan when it was clear that those whowere either isolated by poverty or by theirrural status needed telephones to connectthemselves to the world.The Reagan program used taxes onsome of us to provide telephones for therest of us. People were able to get a tele-phone that offered basic service for abasic fee. With the onset of technology,Lifeline customers had the option of get-ting a landline phone or a cellularphone.This is not an Obama initiative. Itbegan in 1996.Those who get a subsidized telephonehave numerous restrictions. They don’tget to choose their phone, but are offeredwhatever is available, usually a refur-bished phone. They get 250 minutes amonth if they get a cell phone. The 250minutes is about four hours a month, oran hour a week. Is this really some kindof rip off, or is it a reasonable way to bringpeople on the periphery to the center?What do you do with no phone whenthere is a medical emergency or even ajob call? Absent Lifeline, you are yetagain a peripheral citizen.Obamaphone? Givemeabreak. Until theTea Party began to hold sway on our na-tional consciousness, Republicans wereamong those who embraced the notion thatevery American should have basic tele-phone service. Now, anything associatedwith government assistance is associatedwith PresidentObama,despite the fact thatbothDemocratic andRepublican presidentshave attempted to assist people at the bot-tom, albeit with different levels of energy.Let’s not forget that it was Democratic

President BillClinton whopushed the “wel-fare reform” thatlimited govern-ment assistance to60 months or fiveyears. When Pres-ident Clinton, longa favorite amongAfrican-Ameri-

cans, proffered a 1996 reform that I de-scribed as “welfare deform,” several of hisAfrican-American supporters excoriatedhim. He weathered the storm, as did thepublic assistance program. Still,nobodyde-scribes it as Clintonwelfare. It was an ill-conceived andpandering policy change thatallowed President Clinton to brag that he’dgotten “tough” on public assistance.Associating President Obama with gov-ernment support to the poor is a subtle wayof associating people ofAfrican descentwithpublic assistance, and with the pejorativeterm “welfare.” This is a most understatedform of racial coding, a coding that enabledformer Congressman Newt Gingrich to de-scribe President Obama as a “food stamps”president and to falsely assert that Presi-dent Obama “put” more people on foodstamps than any other president in history.Does Mr. Gingrich remember the Great Re-cession that the scion of his party, formerPresident GeorgeW.Bush, enabled, or is hetoo busy purchasing jewelry for his blushingbride of a decade to pay attention to our na-tion’s economic situation?One in six Americans lives in poverty.More than one in four African-Americansand Latinos live in poverty. One in 10 ofall Whites live in poverty. The Great Re-cession and economic restructuring havekicked these diverse groups of poor people,many who are grateful for food assistance,to the curb. President Obama has been re-sponsive to this group of people to the ex-tent that a hostile Congress has allowed it.If I were President Obama, I’d be flat-tered by descriptions of Obamacare andObamaphones. I would not even mindhaving food stamps being described asObamafood. Would we prefer to describepoverty as Romney starve, or sequesterstarve? Make it plain. Associating Pres-ident Obama with health care, Lifelinetelephones and healthy eating is to hiscredit, not his detriment.(Julianne Malveaux is a Washington, D.C.-

based economist and writer. She is PresidentEmerita of Bennett College for Women in Greens-boro, N.C.)

OPINIONA10 APRIL 17-23, 2013 NEW PITTSBURGH COURIER

A tale of twoAmericas, part 2(NNPA)—It is better to beprepared for an opportunityand not have one than to havean opportunity and not be pre-pared.—The late NationalUrban League and civil rightsleader,Whitney M. Young Jr.Last week, during the Na-tional Urban League’s 10thannual Legislative PolicyConference in Washington,D.C., we released the 37thedition of the State of BlackAmerica, Redeem the Dream:Jobs Rebuild America. Thisyear’s report commemoratesthe racial milestones thathave occurred in the 50 yearssince the height of the civilrights movement and shinesa sobering light on the unfin-ished business of achievingfull equality and empower-ment for every citizen.One of the most encouragingsigns in the report is theprogress African-Americanshave made in fulfilling Whit-ney Young’s vision of prepar-ing ourselves for real andhoped for opportunitiesthrough education.Since 1963, the high schoolcompletion gap has closed by57 percentage points. Thereare more than triple the num-ber of Blacks enrolled in col-lege. And for every collegegraduate in 1963, there arenow five.Anti-poverty measures havealso improved our living stan-dard since 1963. The percent-age of Blacks living in povertyhas declined by 23 points.Andthe percentage of Blacks whoown their homes has grownby 14 points.But these numbers don’t tellthe full story. While BlackAmerica has achieved double-digit gains in educational at-tainment, employment, andwealth over the past 50 years,we still have made only sin-gle-digit gains againstWhites. With an EqualityIndex of 71.7 percent,African-Americans enjoy less thanthree-fourths of the well-being and economic status ofWhite Americans. Similarly,Hispanic Americans, with anindex of 75.4 percent, are ex-periencing only three-quar-ters of the full opportunityAmerica has to offer.For example, in the past 50years, the Black-White incomegap has only closed by 7 points(now at 60 percent). The un-employment rate gap has onlyclosed by 6 points (now at 52percent). And with March un-employment figures showingAfrican-American joblessnessnow at 13.3 percent and His-panic unemployment at 9.2percent, compared to an over-all rate of 7.6 percent, we stillsee a tale of twoAmericas thatcontinues to break down alongthe color line.But rather than bemoanthese problems, the NationalUrban League is using thesefindings to sharpen our focuson meaningful solutions. Ear-lier this year, we launched aground-breaking endeavorJobs Rebuild America, a $70million series of pub-lic/private investments to cre-ate pathways to jobs and puturban America back to work.But Washington must alsobe part of the solution. Duringour visit to Capitol Hill thisweek, we reiterated our sup-port of the Urban Jobs Actand the Project Ready STEMAct, a bill sponsored by Con-gressional Black CaucusChairwoman Marcia Fudge.We also support the statedgoal in the president’s 2014budget released last week: toinvest in the things needed togrow our economy and createjobs while reducing the deficitin a way that does not un-fairly impact the most vulner-able communities.Again, while much progresshas been made over the past50 years, The State of BlackAmerica remains a tale of twoAmericas. The NationalUrban League has put somereal solutions on the table. Itstime for Washington to putthem to work.To obtain a copy of the Stateof Black Americavisit www.nul.org.(Marc H.Morial, former mayor of

New Orleans, is president and CEOof the National Urban League.)

Pittsburgh Courier

John H. SengstackeEditor & Publisher Emeritus

(1912-1997)

Rod DossEditor & Publisher

Stephan A. BroadusAssistant to the Publisher

Allison PalmOffice Manager

Eric GainesAdvertising Manager

Jeff MarionCirculation Consultant

Ulish CarterManaging EditorAshley N. Johnson

Associate Editor

Founded 1910

NEW

‘Obama’ as a prefix

Ulish Carter

Just Sayin’

Marc H. Morial

To BeEqual

Julianne Malveaux

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