Author: Victoria Priester

Quantifying the effects of structural racism on health

On December 22, 2020

America is getting both older and Blacker. The proportion of non-white older adults is increasing, and by 2050 the majority of elderly people will be racial minorities. In his Langford Lecture “Who gets sick and why? How racial inequality gets under the skin” on November 10, Professor Tyson H. Brown discussed the importance of studying older minorities when learning about human health. His current project aims to address gaps in research by quantifying effects of structural racism on health.

Health disparities result in unnecessary fatalities. Dr. Brown estimates that if we took away racial disparities in health, we could avoid 229 premature deaths per day. Health disparities also have substantial economic costs that add up to about 200 billion dollars annually. Dr. Brown explained that the effects of structural racism are so deadly because it is complex and not the same as the overt, intentional, interpersonal racism that most people think of. Thus, it is easier to ignore or to halt attempts to fix structural racism. Dr. Brown’s study posits that structural racism has five key tenets: it is multifaceted, interconnected, an institutionalized system, involves relational subordination and manifests in racial inequalities in life chances.

A motivator for Brown’s research was that less than 1% of studies of the effects of race on health have focused on structural racism, even though macro level structural racism has deleterious effects on health of Black people. When thinking about inequalities, the traditional mode of thinking is the group that dominates (in this case, white people) receives all benefits and the subordinates (in Dr. Brown’s study, Black people) receive all of the negative effects of racism. In this mode of thinking, whites actively benefit from social inequality. However, Dr. Brown discussed another theory: that structural racism and its effects on health undermines the fabric of our entire society and has negative impacts on both whites and Blacks. It is possible for whites to be harmed by structural racism, but not to the same extent as Black people.

Dr. Brown identified states as “important institutional actors that affect population health.” As a part of his research, he made a state level index of structural racism based off of data from 2010. The index was composed of nine indicators of structural racism, which combine to make an overall index of structural racism in states. In mapping out structural racism across the domains, the results were not what most people might expect. According to Dr. Brown’s study, structural racism tends to be highest in the midwest of the United States, rather than the south. These higher levels of structural racism were associated with worse self-rated health: one standard deviation increase in level of structural racism correlated with the equivalent of two standard deviation increases in age. In other words, a person who is affected by structural racism has similar self-rated health to people two age categories above them who do not experience negative effects of structural racism.

As the structural racism index increases, the Black-white difference in COVID-19 related deaths also increases. Overall, Dr. Brown found that structural racism is a key driver of inequalities in COVID-19 deaths between whites and Blacks. Looking forward, Dr. Brown is interested in learning more about how contemporary forms of racism contribute to inequality—such as searching racial slurs on Google and implicit bias, both of which are high in the southern United States.

After his discussion, colleagues raised questions about what can be done to eliminate negative effects of structural racism. Dr. Brown listed options such as rent protection, COVID-19 test sites in lower income communities and another stimulus bill. He also explained that the distribution of a COVID-19 vaccine needs to be done in an ethical manner and not exclude those who are less fortunate who really need the vaccine. We also need better data collection in general—the more we know about the effects of structural racism, the better we will be able to adapt equity practices to mitigate harm on Black communities.

By Victoria Priester

The evolutionary advantage of being friendly

By Victoria Priester

On October 19, 2020

In Animals, Behavior/Psychology, Biology, Faculty, Science Communication & Education

We’ve all heard the term “survival of the fittest,” which scientist Charles Darwin famously coined to explain how organisms with heritable traits that give them an advantage — such as avoiding predators or beating out others for the chance to mate — are able to survive and pass on these advantageous traits to their offspring.

In his talk with ClubEvMed last Tuesday, Brian Hare of Duke Evolutionary Anthropology explained key points from his new book that he co-authored with his wife and research partner, Vanessa Woods, entitled Survival of the Friendliest: Understanding Our Origins and Rediscovering Our Common Humanity.

The term “fittest” is often associated with animals who are physically stronger or of more value than others, but being “fit” can also include an organism’s ability to communicate well with others in its group, which can provide an evolutionary advantage. For example, more social animals can form alliances with each other and protect each others’ young, so the whole population stays stronger in terms of number.

Hare cited a comparison between chimpanzees and bonobos, both of which have the potential for infanticide by aggressive males in a group. However, bonobos have zero cases of infanticide because female bonobos are able to communicate well and form alliances to protect each others’ young from aggressive males. Since the high cost of aggression for males outweighs the benefit, the males are friendlier, and the young bonobos survive. While this is a specific case with wild animals, other species have adopted social skills as a method of survival through domestication or self-domestication.

Hare referred to dogs as “exhibit A” of survival of the friendliest via domestication, because humans have bred dogs that are more playful, approachable and patient for centuries. Dogs are exceptionally good at understanding, responding to and communicating with humans as a result of domestication. Hare also explained one Russian study in which they began selecting foxes based on their friendliness towards people. They bred the most friendly foxes together and then compared the friendliness of their offspring to the offspring of randomly bred foxes. The results showed that friendlier foxes differed in physiology in addition to behavior, and were better at cooperating and communicating with humans. This is an example of self-domestication, which changes development patterns and has increased fitness via friendliness. Friendliness in this case means skill in cooperating and communication.

Survival of the Friendliest argues that humans today are the friendliest species of human, which may be why we have lasted so long evolutionarily. However, with the new type of friendliness also comes a new type of aggression. Mother bears are kind and nurturing to their cubs, but also have the most potential for aggression when they feel their cubs are threatened. Similarly in humans, when we feel people who share our identity are threatened, we want to protect those individuals.

Hare and Woods reason that this desire to protect also reduces our ability to cooperate or communicate with those who we feel threaten us or threaten our “group”— whether this be our family, our race or another trait. When our ability to communicate is reduced, we begin to dehumanize those who we feel threaten the people who share our identity. This then becomes a cycle, where people dehumanize those who they believe are dehumanizing them.

In order to stop this cycle, Hare and Woods argue that humans will need to alter their view of who they believe “belongs” to their group to include more people. We need to communicate openly and build a desire to protect other humans, rather than dehumanize them.

By Victoria Priester

Polymath Mae Jemison encourages bolder exploration, collaboration

By Victoria Priester

On February 25, 2020

In Biology, Biomedical Engineering, Climate/Global Change, Computers/Technology, Engineering, Lecture, Medicine

“I don’t believe that [going to] Mars pushes us hard enough.” This was just one of the bold, thought-provoking statements made by Dr. Mae Jemison, who came to speak at Duke on Monday, February 24 as part of the 15th annual Jean Fox O’Barr Distinguished Speaker Series, presented by Baldwin Scholars.

Dr. Jemison is at the pinnacle of interdisciplinary engagement—though she is most famous for serving as a NASA astronaut and being the first African American woman to go into space, she is also trained as an engineer, social scientist and dancer. Dr. Jemison always knew that she was going to space—even though there were no women or people or color participating in space exploration as she was growing up.

Dr. Jemison says that simply “looking up” brought her here. As a child, she would look up at the sky, see the stars and wonder if other children in other places in the world were looking at the same view that she had. Growing up in the 1960’s instilled into Dr. Jemison at an early age that our potential is limitless, and the political culture of civil rights, changing art and music and decolonization were all about “people declaring that they had a right to participate.”

One of the biggest pieces of advice that Dr. Jemison wanted to impart on her audience was the value of confidence, and how to build confidence in situations where people are tempted to feel incapable or forget the strengths they already possess. “They told me if I wanted to lead projects I needed an M.D.,” Dr. Jemison explained. “I went to medical school because I know myself and I knew I would want to be in charge one day.”

At 26 years old, Dr. Jemison was on call 24 hours a day, 7 days a week, 365 days a year as the Area Peace Corps Medical Officer for Sierra Leone and Liberia. She described a case where a man came back with a diagnosis of malaria from Senegal. When Dr. Jemison first took a look, the diagnosis seemed more likely to be meningitis. After making an “antibiotic cocktail,” from what she had on site, she realized this man might lose his life if they didn’t get him to a better hospital. At this point, Dr. Jemison wanted to call a military medical evacuation, and she had the authority to do it. However, another man working with her suggested calling a doctor in Ivory Coast, or a doctor at the hospital in Germany to see what he thought before making the evacuation. Dr. Jemison knew what the patient needed in this situation was to be flown to Germany regardless of the cost of the evacuation. In reflecting on this experience, she says that she could have given someone else her authority, but letting her confidence in herself and what she knew was the right thing to do would have negatively impacted her patient.

So, how do you maintain confidence? According to Dr. Jemison, you come prepared. She knew her job was to save people’s lives, not to listen to someone else. Dr. Jemison also admonished the audience to “value, corral and protect your energy.” She couldn’t afford to always make herself available for non-emergency situations, because she needed her energy for when a patient’s life would depend on it.

Dr. Jemison’s current project, 100 Year Starship, is about trying to ensure we have the capabilities to travel to interstellar space. “The extreme nature of interstellar hurdles requires we re-evaluate what we think we know,” Dr. Jemison explained. Alpha Centauri, the next closest star, is more than 25 trillion miles away. Even if we go 10% the speed of light, it will still take us 50 years to get there. We need to be able to travel faster, the vehicle has to be self-replenishing, and we have to think about space-time changes. What Dr. Jemison calls the “long pole in the tent” is human behavior. We need to know how humans will act and interact in a small spaceship setting for possibly decades of space travel. Dr. Jemison is thinking deeply about how we can apply the knowledge we already possess to fix world problems, and how we can start preparing now for problems we may face in the future. For example, how would health infrastructure in deep space look different? How would we act on a starship that contains 5,000 people when we can’t figure out how to interact with each other on the “starship” we’re on now?

Returning to the childhood love for stargazing that brought her here, Dr. Jemison discussed towards the end of her talk that a stumbling block for the majority of people is insufficient appreciation of our connection across time and space. She has worked with a team to develop Skyfie, an app that allows you to upload photos and videos of your sky to the Sky Tapestry and explore images other people in different parts of the world are posting of their sky. Dr. Jemison’s hope is this app will help people realize that we are interconnected with the rest of the universe, and we won’t be able to figure out how to survive as a species on this planet alone.

By Victoria Priester

Origami-inspired robots that could fit in a cell?

By Victoria Priester

On February 3, 2020

In Biomedical Engineering, Computers/Technology, Engineering, Physics

Imagine robots that can move, sense and respond to stimuli, but that are smaller than a hair’s width. This is the project that Cornell professor and biophysicist Itai Cohen, who gave a talk on Wednesday, January 29 as a part of Duke’s Physics Colloquium, has been working on with and his team. His project is inspired by the microscopic robots in Paul McEuen’s book Spiral. Building robots at such a small scale involves a lot more innovation than simply shrinking all of the parts of a normal robot. At low Reynolds number, fluids are viscous instead of inertial, Van der Waals forces come into play, as well as other factors that affect how the robot can move and function.

Cohen’s team designs robots that fold similar to origami creatures. Image from Origami.me

To resolve this issue, Cohen and his team decided to build and pattern their micro robots in 2D. Then, inspired by origami, a computer would print the 2D pattern of a robot that can fold itself into a 3D structure. Because paper origami is scale invariant, mechanisms built at one scale will work at another, so the idea is to build robot patterns than can be printed and then walk off of the page or out of a petri dish. However, as Cohen said in his talk last Wednesday, “an origami artist is only as good as their origami paper.” And to build robots at a microscopic scale, one would need some pretty thin paper. Cohen’s team uses graphene, a single sheet of which is only one atom thick. Atomic layer deposition films also behave very similarly to paper, and can be cut up, stretch locally and adopt a 3D shape. Some key steps to making sure the robot self-folds include making elements that bend, and putting additional stiff pads that localize bends in the pattern of the robot. This is what allows them to produce what they call “graphene bimorphs.”

Cilia on the surface of a cell. Image from MedicalXpress.

Cohen and his team are looking to use microscopic robots in making artificial cilia, which are small leg-like protrusions in cells. Cilia can be sensory or used for locomotion. In the brain, there are cavities where neurotransmitters are redirected based on cilial beatings, so if one can control the individual beating of cilia, they can control where neurotransmitters are directed. This could potentially have biomedical implications for detecting and resolving neurological disorders.

Right now, Cohen and his lab have microscopic robots made of graphene, which have photovoltaics attached to their legs. When a light shines on the photovoltaic receptor, it activates the robot’s arm movement, and it can wave hello. The advantage of using photovoltaics is that to control the robot, scientists can shine light instead of supplying voltage through a probe—the robot doesn’t need any tethers. During his presentation, Cohen showed the audience a video of his “Brobot,” a robot that flexes its arms when a light shines on it. His team has also successfully made microscopic robots with front and back legs that can walk off a petri dish. Their dimensions are 70 microns long, 40 microns wide and two microns thick.

Cohen wants to think critically about what problems are important to use technology to solve; he wants make projects that can predict the behavior of people in crowds, predict the direction people will go in response to political issues, and help resolve water crises. Cohen’s research has the potential to find solutions for a wide variety of current issues. Using science fiction and origami as the inspiration for his projects reminds us that the ideas we dream of can become tangible realities.

By Victoria Priester

Starting Over in New Neighborhoods Helps Ex-Offenders Stay Out of Jail

By Victoria Priester

On April 3, 2019

In Behavior/Psychology

Are prisoners who go back to their old neighborhoods upon release more or less likely to get arrested again than those who move? That’s the question
University of Oxford sociology professor David Kirk posed in a seminar he gave at Duke March 28. Recidivism is the tendency of a convicted criminal to re-offend, and Kirk wondered if the risk of recidivism might be lower when former prisoners reside in a geographic area different from where they lived prior to incarceration.

To test his hypothesis, Kirk first designed a study in New Orleans following Hurricane Katrina. A full 72 percent of dwellings in New Orleans were damaged in some manner following the hurricane, but the neighborhoods that were hit the hardest tended to be areas that were socioeconomically disadvantaged and home to ethnic minorities. These also tended to be areas to which released prisoners would have returned. Realizing they would not be able to return because of the damage, Kirk designed a study to compare the likelihood of recidivism in people who moved to a different parish pre vs. post-Katrina. The results of the study showed that 50 percent of people were induced to move post-Katrina, compared to 25 percent before Katrina. Parolees who moved to a new neighborhood were less likely to be rearrested.

Based on the Moving to Opportunity (MTO) project, a government-funded housing mobility program in the 1990’s for poor families in five cities, Kirk decided to build on his Katrina results to launch a pilot program in Maryland called MOVE, or Maryland Opportunity through Vouchers Experiment. In the first design, the treatment group received a six-month housing subsidy upon release, but it had to be used in a new jurisdiction. The control group received a six-month subsidy in their home jurisdiction. In the results for this experiment, no one in either group that received free housing was rearrested. However, in the control group where released prisoners received no free housing and returned to their old neighborhoods, 22 percent were rearrested.

The second design gave no subsidy for staying in the home jurisdiction, but incentivized moving to a new city with free housing. In the Maryland experiment, the ‘home’ jurisdiction was Baltimore, and the treatment group housing subsidy was in Prince George’s County, about forty-five minutes away in neighboring Washington, D.C. The pilot implemented four prisons in the state of Maryland and male prisoners hailing from Baltimore were eligible, with the exception of sex offenders.

Graph courtesy of David Kirk, University of Oxford

In the second design where the treatment group got free housing in a new environment and the control group moved to their old communities with no free housing, 22 percent of the treatment group was rearrested compared to 57 percent of the control group. Kirk explained that this second design is more practical than the first because only one group has to receive subsidized housing, thus it is half the cost of the first design. However, since the treatment group gets free housing and moves in the second design, it is harder to tease out the exact reason for lower rearrest rates. Other general trends Kirk has found through his research are that younger individuals who have been imprisoned tend to benefit more from district changes than older individuals. There is also a much larger gap between ‘movers’ and ‘stayers’ in rearrest rates for women, so Kirk hopes to conduct future studies involving female released prisoners.

Post by Victoria Priester

When policy changes opportunities — intentionally and unintentionally

By Victoria Priester

On February 1, 2019

In Faculty, Policy

Assistant professor Deondra Rose researches the intersection between political history and policymaking. Photo from Duke Sanford School of Public Policy.

The intent of the National Defense of Education Act in 1958 was not to expand the rights for women in higher education. But it happened.

That’s something Duke Sanford assistant professor Deondra Rose called “accidental egalitarianism” in her talk at The Regulator Bookshop in Durham on Jan. 29. Rose discussed citizenship from the lens of historical policy research.

During the 1950s, the Soviet Union and the United States were in fierce competition to be the first country in space. This was the push the US government needed to start putting more funding towards higher education for a greater subset of the population. The 1944 GI Bill was the beginning of government-funded need-based financial aid for higher education, but until this point, aid had only been given to white men.

In Congress at this time, southern Democrats did not want to pass any legislation that would affect segregation, but at the same time, policymakers also needed to produce a policy that would be approved by northerners, who would not pass any policy that appeared discriminatory. They made the wording of the National Defense of Education Act intentionally vague to please both sides, and as a result it greatly expanded provisions for scholarships and loans to all kinds of students in higher education.

Much of professor Rose’s talk, entitled “Citizens by Degree” after her book, was centered around breaking down the idea of citizenship into different degrees of afforded opportunities. “First class citizens” — usually white Americans — are generally afforded all of the rights that come with being an American citizen without opposition, she said. Second class citizens, usually minorities and women, can miss out on opportunities for advancement afforded to others because of their minority status.

Rose also discussed how we can re-define the implications of certain terms such as “welfare state” to be used positively. Government assistance is not simply temporary assistance to new families, families with children or food stamps, but also includes Pell Grants and need-based financial aid. Similarly, “regulation” sometimes carries negative connotations, but Title IX can be thought of “regulation” that ensures women equal access in higher education.

Photo from Annual White House Summit on Historically Black Colleges and Universities (whitehouse.gov).

Rose’s latest research focuses on the relationship between policy, citizenship and education, and her next book is about historically black colleges and universities (HBCUs). In her political history research, she found that Title III is all about HBCUs, and the wording of the act suggests we as a nation ought to support and prize these institutions.

Rose wants to learn more about the role the US government has played in empowering HBCUs, and the role of HBCUs in restructuring political power — for example, 60 percent of black judges in the US have at least one degree from an HBCU.

At one point in history, the obstacle to higher education for second class citizens was access, then affordability, but have those two obstacles been completely overcome? What are new obstacles to higher education?

Rose believes that policies have the power to reshape politics by reshaping citizens, and we must keep finding and tackling obstacles to higher education.

By Victoria Priester

Meet Dr. Sandra K. Johnson, Engineering “Hidden Figure”

By Victoria Priester

On November 6, 2018

In Computers/Technology, Data, Engineering

When Dr. Sandra K. Johnson first tried her hand at electrical engineering during a summer institute in high school, she knew that she was born to be an electrical engineer. Now, as the first African-American woman to receive a Ph.D. in computer engineering in the United States, Johnson visited Duke to share her story as a “hidden figure” and inspire not just black women, but all students not to be discouraged by obstacles they may face in pursuit of their passion.

Though she did discuss her achievements, Johnson’s talk also made it clear that more than successes, it was the opposition she faced that most motivated her to persevere in electrical engineering. While pursuing a Master’s degree at Stanford, she met Dr. William Shockley, who in his free time was conducting research he believed would prove that African Americans were intellectually inferior to other races. Johnson had originally been planning on just finishing her program with a Master’s and then going into the workforce, but after hearing what this man was trying to prove, she decided she would prove to him that she was capable of doing anything that the non-black students in the same program could do. She finished the program with a Ph.D. in electrical engineering. She continued to make this declaration to anyone who didn’t believe she was capable: “before I leave this place, I will make a believer out of you.”

Dr. Johnson is the founder, CTO and CEO of Global Mobile Finance, Inc., a finance and tech startup based in Research Triangle Park, NC. Photo from BlackComputeHER.

While mapping out her own path to pursuing her goals, Johnson also firmly believed in making the path easier for other black people pursuing advanced degrees. When asked what the current generation of students could be doing to help themselves, she said to find mentors and to mentor others. Johnson shared an anecdote of sitting in a lab at Stanford waiting to begin an experiment when a man walked up to her and said she was in the wrong place. After talking to him for several minutes and showing him that she knew even more about the subject than he did and was in the right place, she told him that the next time someone who looked like her walked into the lab, not to be so sure of himself. Johnson went on to become an IBM Fellow, an IEEE Fellow, and a member of the prestigious Academy of Electrical Engineers. At the end of her talk, Johnson discussed what she believes is the best way to expedite change — to have people of color as founders and CEOs of major corporations that have the power to increase minority representation in their workforce. This is what she intends to do with her own company, Global Mobile Finance, Inc. If her current track record is any indication, there is no doubt her company will become a major corporation in the years to come, opening more doors for black women and other minorities pursuing their passions.

Post by Victoria Priester

Considerations about AIDS from Brazilian literature

By Victoria Priester

On October 24, 2018

In Biology, Global Health, Medicine, Science Communication & Education

To know what illness is, you have to be ill first.

This was one of the points that post-doctoral student and essayist Milena Mulatti Magri emphasized in her talk on Oct. 15. She was discussing Brazilian writer Caio Fernando Abreu’s writings about AIDS and its effect on groups who already faced societal prejudice before the breakout of AIDS in the 1980’s and 90’s, when patients were identified mainly as homosexual.

By studying research done by Professor Vladimir Safatle and physician and philosopher Georges Canguilhem, Magri has pieced together that health is seen as a form of normativity and disease as a deviation. Thus, ostracizing and excluding those who contract disease is seen as justifiable because they have deviated from what is seen as normal, even when the disease is not the fault of the patient.

Magri has also analyzed essays about the relationship between disease, metaphor and patient stigma, such as cancer patients who, in addition to combating the illness growing unwelcome inside their own bodies, also have to deal with social stigmas that come with disease, such as cancer as a representation for evil.

Brazilian author and columnist Caio Fernando Abreu. (Image from KD Frases.)

However, while Magri emphasized that social metaphors of different diseases should be deconstructed, she has also found that literature and personal writing can be a way to discuss and otherwise “incommunicable experience.”

During a time when it was seen as shameful to have AIDS, Caio Fernando Abreu began a biweekly publication of his health chronicles in the newspaper O Estado de São Paulo, which was one of the first instances of someone publicly discussing their experience with AIDS from the perspective of the ill person, as opposed to from the perspective of doctors or health experts.

Abreu’s columns confronted the difficulty of living with disease and living in proximity to death, and discuss the increased social prejudice as a result of the disease. Abreu also wrote a play called “O homem e amancha” (in English, “The Man and the Stain”), which is an intertextual reading of the famous Spanish novel Don Quijote de la Mancha. In her talk, Magri explained that “Mancha,” which in English means “stain,” can refer to both the home of Don Quijote before he sets off of on his adventures and the rare skin cancer that often accompanies AIDS called Kaposi Sarcoma, which forms lesions on the skin that resemble stains.

Abreu intended to use his own experiences to question the social prejudice against AIDS, and there Magri highlighted a marked change, even between his own writings at the beginning of his diagnosis compared to those at the end of his life, when he spoke openly and without metaphor about suffering that is amplified by social exclusion.

Magri believes that Abreu’s writings were pioneering acts of courage, and that from his writing we learn to empathize rather than to judge and stigmatize.

Post by Victoria Priester

Victoria Priester