Study: Whites More Likely to Abuse Drugs Than Blacks

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Black youth are arrested for drug crimes at a rate ten times higher than that of whites. But new research shows that young African Americans are actually less likely to use drugs and less likely to develop substance use disorders, compared to whites, Native Americans, Hispanics and people of mixed race.

“Our goal is to alert people to the burden of drug problems and also to how some of our concern about who has these problems may not be true,” says Dr. Dan Blazer, senior author of the study and a professor of psychiatry at Duke University. “There's a perception among many individuals that African Americans as a group — regardless of socioeconomic status — tend to abuse or use drugs at higher rate and this [does not support] that."

Using data from 72,561 youth interviewed for the National Survey on Drug Use and Health, researchers found that 37% of those aged between 12 and 17 had used alcohol or other drugs at least once in the past year. Nearly 8% met criteria for a substance use disorder — either the less severe “substance abuse” diagnosis or the more problematic “substance dependence,” which is more commonly known as addiction.

The study, which was published Monday in the Archives of General Psychiatry, controlled for variables like socioeconomic status because rates of severe drug problems tend to be greater amongst the poor. Despite this, Native American youth fared worst, with 15% having a substance use disorder, compared to 9.2% for people of mixed racial heritage, 9.0% for whites, 7.7% for Hispanics, 5% for African Americans and 3.5% for Asians and Pacific Islanders.

It is not known why rates for Native Americans were so elevated, but the category of substance use disorders does include alcoholism, a disorder for which this group is known to be at high risk.  Marijuana and prescription opioid problems also occurred at higher rates in Native Americans.

MORE: How to Find the Best Drug Treatment for Teens: A Guide for Parents

The authors considered abuse and dependence together rather than separating them because the next edition of psychiatry's diagnostic manual, the DSM-V, will combine them into one diagnosis, with different levels of severity.

“It's really difficult when you look at the data to actually separate out abuse and dependence,” says Blazer, while acknowledging that merging the categories could pose different problems.

For example, a large proportion of youth with drug problems recover without treatment. While rates of substance use disorders tend to be around 8% in the teen years, these rates dip to less than 2% for those over 26; the number of people who've gotten better far exceeds that which could have possibly attended treatment or even self-help groups.

That poses a problem: addiction treatment centers tend to focus on getting youth to acknowledge that they have a chronic, relapsing disease, but this — in combination with surrounding youth with peers who are also in trouble — could create a self-fulfilling prophecy.

MORE: Does Teen Rehab Cure Addiction or Create It?

“Labeling can be problematic,” says Blazer, “but also, treating these individuals is not easy. Most programs have modest success at best and with ongoing use over time the ability to actually reverse [the disorder] declines. Therefore, by identifying these individuals early and intervening early, they have a much better chance.”

That is, of course, if the treatment is effective and doesn't use tactics that can backfire. “I would hope we get a little more enlightened in the way we treat adolescents,” Blazer says, explaining that treatment must be culturally sensitive if it is to help all types of youth resolve drug problems.

MORE: The Authentic Self: How Do You Know If You're 'Really' Racist or Sexist?

Maia Szalavitz is a health writer at TIME.com. Find her on Twitter at @maiasz. You can also continue the discussion on TIME Healthland's Facebook page and on Twitter at @TIMEHealthland.

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Wealth Matters: People with Stuff Are More Likely to Marry

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People who have more personal wealth — in the form of a car, say, or a small nest egg — are more likely to get married than those who have less, according to a new analysis of data from the National Longitudinal Survey of Youth. It's further evidence, as if it were needed, that money and marriage are becoming increasingly intertwined in ways that are not yet fully understood.

One of the most striking sociological trends to emerge in recent decades is the widening wealth gap between those who are married and those who aren't. The marrying kind tend to be more educated, wealthier and whiter — so they often start with more advantages. But because marriage often brings with it extra benefits to health, finances and family, the economically disadvantaged unmarried are set back doubly, and the gap between the well-off and the struggling grows ever wider.

Marriage rates have been falling across the board since the 1980s, but particularly so among certain groups. "What is perhaps most striking is the increasing stratification in marriage by race and education," said Daniel Schneider, a Ph.D. candidate at Princeton University and the author of the study, in a statement. "From 1980 to 2000, the percentage of white women who had been married by ages 25 to 29 had dropped by 13 percentage points to 68%, but the drop was far larger for blacks, dropping 25 points, to just 38%."

Indeed, the historically low rates of marriage among African Americans — U.S. Census data suggests that 40% of black women will not be married by the age of 40 — has led to a lot of debate in recent weeks, stirred partly by the publication of the not-at-all-controversially titled book Is Marriage for White People?

MORE: Q&A: Is Marriage for White People?

Researchers have tried to narrow down exactly what it is that makes people more likely to marry, and often they settle on education and income as the critical factors. Since blacks and the less educated traditionally face disadvantages in the job market, they may tend delay marriage longer, increasing gaps in marriage rates. But Schneider's study, published in the American Journal of Sociology, suggests that income explains only part of the gap. Personal assets may account for more of the willingness to wed, Schneider says, especially among men.

This makes intuitive sense. Marriage is not something to be entered into lightly — as the preachers like to say. And it requires quite a lot of optimism and hope — as the celebrants at second weddings like to say. It's much easier to imagine other people depending on you in the future, if you have even a little something to fall back on.

Schneider hypothesized that if accumulated riches matter in people's decisions to marry, then the fact that blacks often start off with less than whites would explain some of the disparity in marriage rates. To test this theory, he looked at whether personal wealth, such as having a car, money in a savings account or financial assets like stocks and bonds, was associated with the likelihood of entering into first marriage in any given year.

MORE: The Fathering Gap: Pitfalls of Modern Fatherhood

After controlling for income, employment and family background, Schneider found that, indeed, owning a car or having financial assets increased the probability that a man would get married in a given year. The effect was also true of women, but less so. Based on his analysis, Schneider concluded that personal wealth further accounted for a significant part of the racial gap in marriage rates; he estimates that about 30% of the gap could be attributed to accumulated wealth, while 20% could be explained by income, employment and public benefits. "What people own, not just what they earn or know, shapes entrance into marriage and so may perpetuate disadvantage across generations," writes Schneider.

What to do? Programs that help poorer people to accrue some assets, no matter how small should be encouraged, he believes. "Even small amounts of wealth may help disadvantaged men and women meet the economic standard of marriage," he said.

MORE: Whites and Blacks Are Intermarrying More Often

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Listeria cases likely to rise through October: officials

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Listeria bacteria in a microscopic image courtesy of the Center for Disease Control and Prevention.

Credit: Reuters/Handout

By Julie Steenhuysen

CHICAGO | Wed Sep 28, 2011 6:15pm EDT

CHICAGO (Reuters) - Cases of illness in the U.S. listeria outbreak linked to tainted cantaloupes -- already the deadliest in a decade -- likely will rise in the next month as more people who have been infected with the bacteria begin to develop symptoms, health officials said on Wednesday.

To date, 13 people have died and 72 people have been infected in the outbreak in 18 states, including two pregnant women, according to the U.S. Centers for Disease Control and Prevention. (For a graphic on the outbreak, click here: link.reuters.com/nax93s)

Unlike E. coli and salmonella, two common causes of foodborne disease, listeria bacteria can cause illness as long as two months after a person has consumed contaminated food, making these outbreaks especially vexing.

"We will see more cases likely through October," U.S. Food and Drug Administration Commissioner Margaret Hamburg said in a telephone briefing.

Dr. Barbara Mahon of the CDC said the agency is only reporting on laboratory-confirmed illnesses and deaths.

"We do expect the number of cases will increase and the number of deaths may well increase," Mahon told the briefing.

Health officials have traced the source of the outbreak to cantaloupes grown by Jensen Farms in Colorado shipped between July 29 and September 10. Such outbreaks are far more common in processed meats and cheeses and it is not yet clear how listeria bacteria got into the fruit.

"Listeria is a very common organism, which means it is very easily introduced into food at any point in a food chain -- in the field, at home and anywhere in between," said Martin Wiedmann, a professor of food science and a listeria expert at Cornell University in Ithaca, New York.

After consumption, symptoms of E. coli and salmonella usually take one to three days to emerge but listeria's symptoms are not noticed for one to eight weeks.

"That also makes it very difficult to trace back the source of outbreaks, particularly if they are small," Wiedmann said. "Most people don't remember what they ate in the last two months."

HIGH LEVELS OF CONSUMPTION

Listeria rarely causes serious illness. For listeria to do so, it needs to get onto the food and grow to levels where it can cause disease. Because it can grow at low temperatures, that can happen anywhere along the food chain.

"You need very high levels of listeria to get sick," Wiedmann said. "With listeria, we're talking about people having to ingest in excess of a million organisms."

Wiedmann said the reason there are not more outbreaks is that even when people are exposed to the bacteria, the numbers of organisms are usually too low to cause illness.

Dr. Thomas Frieden, director of the CDC, said the infected cantaloupe is being pulled off store shelves but there is still a risk of infection from fruit in people's refrigerators.

He said people should check with their grocery store if they are not sure of the source of their cantaloupe, and if they are in doubt, "throw it out."

Frieden said those most at risk are the elderly, the pregnant and people with a weakened immune system, such as people who have had an organ transplant or cancer.

Gene Grabowski, a food crisis expert at Levick Strategic Communications who handled an outbreak of tainted spinach in 2006-2007, said fresh produce is increasingly becoming a source of foodborne disease because more people are eating fruits and vegetables at every meal.

"People were not eating cantaloupes or blueberries for breakfast 10 to 15 years ago," Grabowski said.

Frieden said multi-state foodborne illnesses have increased in recent years. So far, there have been 12 in 2011.

"It is not that food is getting riskier but we are getting better at identifying problems," he said.

Grabowski said the cantaloupe outbreak underscores the challenges for all distributors of fresh produce.

And it is likely to renew perennial fears about the safety of the food supply, said Chris Waldrop, director of the food policy institute at the Consumer Federation of America.

Waldrop said some of these concerns should be addressed by the Food Safety Modernization Act, which gives the FDA more authority to regulate outbreaks. Hamburg said the FDA is working to release guidelines and regulations for the production of safe produce.

(Additional reporting by Anna Yukhananov in Washington; Editing by Michele Gershberg, Eric Beech and Bill Trott)

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Childless men more likely to die of heart disease: study

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By Julie Steenhuysen

CHICAGO | Mon Sep 26, 2011 6:08pm EDT

CHICAGO (Reuters) - A decade-long study of 135,000 men found that those who did not have children had a higher risk of dying from heart disease than those who did, raising new questions over the links between fertility and overall health, U.S. researchers said on Monday.

While the findings do not show that not having children causes heart problems in men, they do suggest that infertility may be a potential early warning sign of future heart trouble, the team reported in the journal Human Reproduction.

"There is emerging evidence to suggest that infertility may be a window into a man's later health," said Dr. Michael Eisenberg of Stanford University in California.

He said men who are infertile have a higher risk of certain cancers, and his team wanted to look for other signs that infertility might be playing a role later in a man's life.

The researchers used a large study of men over 50 who were members of AARP. The team did not know whether men in the study wanted to be fathers or not, so they specifically looked only at men who were married.

And they used childlessness as a surrogate for male infertility, Eisenberg said.

"In general, most married men will have the opportunity to reproduce. Whether they and their partner chose not to have children or whether there were some biological problems, we can't determine," Eisenberg said.

Eisenberg and colleagues focused on 135,000 married or formerly married men who were 50 or older at the start of the study in 1996. Almost all, or 92 percent, had fathered at least one child and 50 percent had three or more offspring.

Nearly all of the men -- 95 percent -- were white.

The researchers then tracked death rates from some 70 causes using Social Security and other databases and questionnaires sent to surviving family members.

Over the course of the 10-year follow up period, some 10 percent of the men died, and one out of every five of these deaths was from heart disease.

When looking at the parental status of these men, childless participants in the study had about a 17 percent higher risk of heart disease than those who were fathers.

Eisenberg said it was not possible to determine whether men in the study simply chose not to have children or whether the men's partners were infertile.

But excluding unmarried men offered an approximation of male infertility, and the link to heart disease raises important questions that merit further research.

"My belief it there is a biologic reason," Eisenberg said.

The researchers stress that the study does not suggest being childless causes heart problems, but since infertility affects a man's health at a much younger age, understanding this link could help doctors identify heart problems earlier, when there is more time to intervene.

(Editing by Jackie Frank)

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Study: Dads less likely to die of heart problems

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FILE - In this April 3, 2011 file photo, a father and son head for their fishing hole at Muddy Run Recreation Park in southern Lancaster County, Pa. New research suggests that dads are less likely to die of heart-related problems than childless men are. The study by AARP, the government and several universities is the largest ever look at men, fertility and mortality. (AP Photo/Intelligencer Journal, Marty Heisey) FILE - In this April 3, 2011 file photo, a father and son head for their fishing hole at Muddy Run Recreation Park in southern Lancaster County, Pa. New research suggests that dads are less likely to die of heart-related problems than childless men are. The study by AARP, the government and several universities is the largest ever look at men, fertility and mortality. (AP Photo/Intelligencer Journal, Marty Heisey) In this Jan. 29, 2004 file photo, a father and son play basketball at Independence Park near uptown Charlotte, N.C. New research suggests that dads are less likely to die of heart-related problems than childless men are. The study by AARP, the government and several universities is the largest ever look at men, fertility and mortality. (AP Photo/The Charlotte Observer, Gary O'Brien, File)eval("var currentItemd57851005a80479aaeeb90a12c70b9ff = 1;");eval("var nextd57851005a80479aaeeb90a12c70b9ff = 0;");eval("var previousd57851005a80479aaeeb90a12c70b9ff = 0;"); Fatherhood may be a kick in the old testosterone, but it may also help keep a man alive. New research suggests that dads are a little less likely to die of heart-related problems than childless men are.

The study — by the AARP, the government and several universities — is the largest ever on male fertility and mortality, involving nearly 138,000 men. Although a study like this can't prove that fatherhood and mortality are related, there are plenty of reasons to think they might be, several heart disease experts said.

Marriage, having lots of friends and even having a dog can lower the chance of heart problems and cardiac-related deaths, previous research suggests. Similarly, kids might help take care of you or give you a reason to take better care of yourself.

Also, it takes reasonably good genes to father a child. An inability to do so might mean a genetic weakness that can spell heart trouble down the road.

"There is emerging evidence that male infertility is a window into a man's later health," said Dr. Michael Eisenberg, a Stanford University urologist and fertility specialist who led the study. "Maybe it's telling us that something else is involved in their inability to have kids."

The study was published online Monday by the journal Human Reproduction.

Last week, a study by other researchers of 600 men in the Philippines found that testosterone, the main male hormone, drops after a man becomes a dad. Men who started out with higher levels of it were more likely to become fathers, suggesting that low levels might reflect an underlying health issue that prevents reproduction, Eisenberg said.

In general, higher levels of testosterone are better, but too much or too little can cause HDL, or "good cholesterol," to fall — a key heart disease risk factor, said Dr. Robert Eckel, past president of the American Heart Association and professor of medicine at the University of Colorado, Denver.

"This is a hot topic," Eckel said. "I like this study because I have five children," he joked, but he said many factors such as job stress affect heart risks and the decision to have children.

Researchers admit they couldn't measure factors like stress, but they said they did their best to account for the ones they could. They started with more than 500,000 AARP members age 50 and over who filled out periodic surveys starting in the 1990s for a long-running research project sponsored by the National Cancer Institute.

For this study, researchers excluded men who had never been married so they could focus on those most likely to have the intent and opportunity to father a child. Men with cancer or heart disease also were excluded to compare just men who were healthy when the study began.

Of the remaining 137,903 men, 92 percent were fathers and half had three or more children. After an average of 10 years of follow-up, about 10 percent had died. Researchers calculated death rates according to the number of children, and adjusted for differences in smoking, weight, age, household income and other factors.

They saw no difference in death rates between childless men and fathers. However, dads were 17 percent less likely to have died of cardiovascular causes than childless men were.

Now for all the caveats.

Researchers don't know how many men were childless by choice and not because of a fertility problem.

They don't know what fertility problems the men's partners may have had that could have left them childless.

They didn't have cholesterol or blood pressure information on the men — key heart risk factors.

Less than 5 percent of participants were blacks or other minorities, so the results may not apply to them.

All those questions aside, however, some prominent heart experts were reassured by the study's large size and the steps researchers took to adjust for heart disease risk factors.

"I think there's something there," and social science supports the idea that children can lower heart risks, said Dr. Eric Topol, a cardiologist and genetics expert at Scripps Health in La Jolla, Calif. "Whether it's with a pet, a spouse or social interaction ... all those things are associated with better outcomes."

Dr. Daniel Rader, director of preventive cardiology at the University of Pennsylvania, said: "It's biologically plausible that there's a connection," but the reduced risk attributed to having children "is pretty modest."

Men often ask him what they can do to keep from dying of a heart attack, he said.

"I'm not really prepared to, on the basis of this, tell them to start having a few kids," Rader said.

___

Online:

Medical journal: http://humrep.oxfordjournals.org/content/early/recent

___

Marilynn Marchione can be followed at http://twitter.com/MMarchioneAP

Associated Press

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