Black women battle obesity with dialogue, action

WASHINGTON (AP) — Nicole Ari Parker was motivated by frustration. For Star Jones, it was a matter of life or death. Toni Carey wanted a fresh start after a bad breakup.

All three have launched individual campaigns that reflect an emerging priority for African-American women: finding creative ways to combat the obesity epidemic that threatens their longevity.

African-American women have the highest obesity rate of any group of Americans. Four out of five black women have a body mass index above 25 percent, the threshold for being overweight or obese, according to the Centers for Disease Control and Prevention. By comparison, nearly two-thirds of Americans overall are in this category, the CDC said.

Many black women seem to not be be bothered that they are generally heavier than other Americans.

Calorie-rich, traditional soul food is a staple in the diets of many African-Americans, and curvy black women are embraced positively through slang praising them as “thick” with a “little meat on their bones,” or through songs like the Commodore’s “Brick House” or “Bootylicious” by Destiny’s Child. A study by the Kaiser Family Foundation and The Washington Post earlier this year found that 66 percent of overweight black women had high self-esteem, while 41 percent of average-sized or thin white women had high self-esteem.

Still, that doesn’t mean black women reject the need to become healthier.

Historically black, all-female Spelman College in Atlanta is disbanding its NCAA teams and devoting those resources to a campus-wide wellness program. In an open letter announcing Spelman’s “wellness revolution,” president Beverly Daniel Tatum cited a campus analysis that found many of Spelman’s 2,100 students already have high blood pressure, Type 2 diabetes or other chronic ailments.

“Spelman has an opportunity to change the health trajectory of our students and, through their influence, the communities from which they come,” Tatum’s letter said.

Jones, who underwent open heart surgery in 2010 at age 47 and now urges awareness about heart disease among black women, was met by an overflow crowd earlier this year when she convened a Congressional Black Caucus Foundation panel on black women and obesity.

“We have to get ourselves out of being conditioned to think that using soft words so we don’t hurt peoples’ feelings is doing them any favor,” Jones said. “Curvy, big-boned, hefty, full-figured, fluffy, chubby. Those are all words designed to make people feel better about themselves. That wasn’t helpful to me.”

Jones once embraced being large and fabulous, at 5 feet 5 inches tall and 300 pounds. But under that exterior, she said, she was morbidly obese, suffering from extreme fatigue, nausea, lightheadedness, heart palpitations and blurred vision. The attorney and TV personality also had gastric bypass surgery in 2003.

Now, she advises women to make simple changes such as reducing salt intake, exercising 30 minutes a day, quitting smoking, controlling portion sizes and making nutritious dietary choices.

Nutritionist and author Rovenia M. Brock, known professionally as Dr. Ro, agrees with Jones. She said getting active is only about 20 percent of the fight against obesity. The rest revolves around how much people eat.

“Our plates are killing us,” she said.

Brock said “food deserts,” or urban areas that lack quality supermarkets, are a real obstacle. She suggested getting around that by carpooling with neighbors to stores in areas with higher-quality grocery options or buying food in bulk. She also suggested growing herbs and vegetables in window-box gardens.

“Stop focusing on what’s not there, or what you think is not there,” Brock said. “We have to get out of this wimpy, ‘woe is me’ mentality.”

While first lady Michelle Obama has encouraged exercise through her “Let’s Move” campaign targeting childhood obesity, the spark for this current interest among black women may have been comments last year by Surgeon General Regina Benjamin, who observed publicly that women must stop allowing concern about their hair to prevent them from exercising.

Some black women visit salons as often as every two weeks, investing several hours and anywhere from $ 50 to hundreds of dollars each visit — activity that, according to the Black Owned Beauty Supply Association, helps fuel a $ 9 billion black hair care and cosmetics industry.

In an interview during a health conference in Washington last week, Benjamin said the damage sweat can inflict on costly hairstyles can affect women’s willingness to work out, and she hopes to change that. She goes to beauty industry conferences to encourage stylists to create exercise-friendly hairdos.

“I wouldn’t say we use it as an excuse, we use it as a barrier,” Benjamin said. “And that’s not one of the barriers anymore. We’re always going to have problems with balancing our lives, but we could take that one out.”

Parker, an actress who starred in “A Streetcar Named Desire” on Broadway earlier this year, understands this dilemma well. Out of personal frustration over maintaining both her workout and her hair, she created “Save Your Do” Gymwrap — a headband that can be wrapped around the hair in a way that minimizes sweat and preserves hairstyles.

“Not just as a black woman, but as a woman, since the beginning of time, beauty has been our responsibility,” Parker said in an interview. Because of that, she said, exercise has become linked with vanity instead of health.

“We’ve turned exercise into a weight-loss regimen,” Parker said. “No. Exercise is about being grateful for the body you have and sustaining the life you have. … Take all the hype out of the exercise and think of it as brushing your teeth.”

With their mutual family histories of diabetes and high blood pressure in mind, Carey, 28, and her sorority sister Ashley Hicks, 29, co-founded the running club Black Girls Run. Carey also considered it a new beginning after a bad breakup and a move across country. Since 2009, Black Girls Run has amassed 52,000 members who serve as a support system for runners.

Black Girls Run has about 60 groups nationwide that coordinate local races in Atlanta, New York, San Francisco, Washington, D.C, Houston and Greensboro, N.C. Most groups run at least five times a week. Next month, the national running club will take its first “Black Girls Run — Preserve the Sexy” tour to cities with high obesity rates. The tour includes health and fitness clinics with information on nutrition, hair maintenance and running gear.

“We found that when you want to get healthy and when you want to be active, it’s intimidating,” Carey said. “You don’t know where to start. There’s a little coaxing that has to go along with that.”

Parker said once African-American women place value on their bodies and longevity, everything else will follow. It costs her nothing, she said, to walk around an outdoor track with her husband, actor Boris Kodjoe, or run up and down stairs at home with her headphones.

“One good step breeds another one,” Parker said. “You’re going to have one less margarita, one less scoop of Thanksgiving macaroni … and yet you’re not doing anything fanatical or dramatic.”

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Seeing Through the Fog of ‘Chemo-Brain’

Two weeks ago, Diem Brown, contestant of the Real World/Road Rules Challenge, shared on her PEOPLE.com blog her frustration with her chemo-brain, after having received chemotherapy over the Thanksgiving holiday for recently diagnosed ovarian cancer.

She writes, “Stressed out, overwhelmed and soooo annoyed that your mind isn’t working as it should. This, my friends, is an example of chemo brain!”

Unfortunately, as a surgeon, I have witnessed too many patients get the diagnosis of cancer. If they can transcend the initial shock, there is a desperation to understand what their lives will be like as cancer patients, and what the odds are that they will be cancer survivors.

But for many women, their fear of death is as strong as their fear of chemotherapy, the poison that along with hope, is inseparable from the Hollywood images of the sick, nauseated, thin and bald.

Diem refers to “chemo-brain”, also known as “chemo-fog”, a side effect of chemotherapy that causes problems with memory, information processing, and mood –- effects that can persistent for as many as 20 years after treatment has subsided.

Mental dullness or fatigue and an inability to focus characterized by difficulty organizing thoughts and keeping memories has also been described by patients who suffer from chemotherapy induced cognitive dysfunction.

For years, chemo-brain went largely unrecognized by health care professionals, and those who suffered from it were left without answers to their confusion.

Recently, through the Internet, web chatting and blogging, many women who suffered from chemo-brain realized they were not alone, and over the last few years, several studies have been done giving credit to the condition. But, as they say, you have to see it to believe it.

And now we can see it. In the process of presenting my own research discussing the use of imaging in breast cancer patients at this week’s San Antonio Breast Cancer Symposium, I stumbled across a presentation discussing how scientists are trying to clear the chemo-fog by imaging the brain.

Dr. Bernadine Cimprich from the University of Michigan, along with a group of scientists from the University of Washington and University of Toronto took the stage in San Antonio Friday to shed some light through the fog, and offer a strategy at prevention.

Since chemo-brain doesn’t affect all cancer patients to the same degree, they asked the question, are some patients who receive chemotherapy predisposed to developing the disease?

Chemo-brain has been studied before, but has been difficult to characterize because so many different types of drugs and regimens are used, and for the most part patient’s memory and cognition are not studied prior to starting cancer therapy.

To help shed some light on the subject, these researchers used functional magnetic resonance imaging, or fMRI – a technology that uses magnets to image the brain as it works.

By taking pictures of the brain before and after chemotherapy, they found that patients who suffered from this condition had inherently different function from those who did not before they had even received treatment.

“Brain imaging before treatment showed reduced function in frontal [brain] regions” says Dr. Cimprich, the precise regions that are needed to perform working memory and guide our day-to-day activities, such as remembering the shopping list, our finding our way home.

Identifying patients who may be predisposed to developing chemo-brain can help oncologists alter treatment strategies in efforts to reduce or eliminate the fog.

Who are the patients at highest risk? Dr. Cimprich’s team used surveys to evaluate pre-treatment cognitive function and found that fatigue is a major factor. He suggests that “early interventions targeting fatigue may improve cognitive function and reduce the distress of chemo-brain”.

While the small study involved 98 patients, only 29 of which received chemotherapy, it still lays ground to understand the true nature of chemo-brain, and as Dr. Cimprich emphasizes, identifying the problem early is crucial, because early cognitive problems can become worse over time.

In her blog, Diem suggests making lists as a way to overcome her chemo-brain. And while we all know that stressful times can side track our minds and dull our spirits, until science can give us better answers, research suggests that a deep breath and a little yoga may help do the job of lifting the fog on chemo-brain.

Dr. Christopher Tokin is a surgical resident at the University of California, San Diego School of Medicine and a resident alumnus of the ABC News Medical Unit.

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Wall Street edges up with help from McDonald’s

NEW YORK (Reuters) – Stocks were modestly higher on Monday, helped by stronger-than-expected sales from McDonald’s, but gains were constrained as investors awaited any sign of progress in talks to avert the so-called fiscal cliff.

Developments in Europe also tempered sentiment after Italian Prime Minister Mario Monti said he would resign once the 2013 budget is approved. The move added to uncertainty about reducing euro zone debt and drove Italy’s borrowing costs higher.

U.S. President Barack Obama met with Republican House Speaker John Boehner on Sunday to negotiate a deal for avoiding the “fiscal cliff” that is set to go into effect in the new year.

The two sides declined to provide details about the unannounced meeting. Obama is expected to make remarks at 2 p.m. (1900 GMT) from Michigan where he is touring an auto plant.

The fiscal cliff talks have kept markets on edge in the last month as investors worry the scheduled measures could send the economy into recession if politicians do not reach a deal.

While the negotiations are at the forefront of investors‘ minds, most have adopted the position that a deal will be reached, even if it is at the last minute, said Ryan Detrick, senior technical strategist at Schaeffer’s Investment Research in Cincinnati, Ohio.

“We haven’t had any ‘progress’ the last two weeks or so, yet all in all equity markets have continued to hang tough,” said Detrick. “The rhetoric from Washington is strong, but Wall Street is betting something probably will get done.”

The Dow was helped by a gain in McDonald’s Corp . The fast food chain’s stronger-than-expected November sales marked a rebound after a decline in October. The stock was up 1 percent at $ 89.33.

The Dow Jones industrial average <.dji> gained 32.64 points, or 0.25 percent, to 13,187.77. The Standard & Poor’s 500 Index <.spx> added 1.09 points, or 0.08 percent, to 1,419.16. The Nasdaq Composite Index <.ixic> rose 9.90 points, or 0.33 percent, to 2,987.95.</.ixic></.spx></.dji>

Ingersoll-Rand Plc said it will spin off its security division and announced a $ 2 billion share buyback, sending its shares up 2.4 percent at $ 49.86.

Cisco Systems boosted the Nasdaq after it laid out its midterm growth strategy on Friday. Its shares were up 2 percent at $ 19.72.

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Peru’s capital highly vulnerable to major quake

LIMA, Peru (AP) — The earthquake all but flattened colonial Lima, the shaking so violent that people tossed to the ground couldn’t get back up. Minutes later, a 50-foot (15-meter) wall of Pacific Ocean crashed into the adjacent port of Callao, killing all but 200 of its 5,000 inhabitants. Bodies washed ashore for weeks.

Plenty of earthquakes have shaken Peru‘s capital in the 266 years since that fateful night of Oct. 28, 1746, though none with anything near the violence.

The relatively long “seismic silence” means that Lima, set astride one of the most volatile ruptures in the Earth’s crust, is increasingly at risk of being hammered by a one-two, quake-tsunami punch as calamitous as what devastated Japan last year and traumatized Santiago, Chile, and its nearby coast a year earlier, seismologists say.

Yet this city of 9 million people is sorely unprepared. Its acute vulnerability, from densely clustered, unstable housing to a dearth of first-responders, is unmatched regionally. Peru’s National Civil Defense Institute forecasts up to 50,000 dead, 686,000 injured and 200,000 homes destroyed if Lima is hit by a magnitude-8.0 quake.

“In South America, it is the most at risk,” said architect Jose Sato, director of the Center for Disaster Study and Prevention, or PREDES, a non-governmental group financed by the charity Oxfam that is working on reducing Lima’s quake vulnerability.

Lima is home to a third of Peru’s population, 70 percent of its industry, 85 percent of its financial sector, its entire central government and the bulk of international commerce.

“A quake similar to what happened in Santiago would break the country economically,” said Gabriel Prado, Lima’s top official for quake preparedness. That quake had a magnitude of 8.8.

Quakes are frequent in Peru, with about 170 felt by people annually, said Hernando Tavera, director of seismology at the country’s Geophysical Institute. A big one is due, and the chances of it striking increase daily, he said. The same collision of tectonic plates responsible for the most powerful quake ever recorded, a magnitude-9.5 quake that hit Chile in 1960, occurs just off Lima’s coast, where about 3 inches of oceanic crust slides annually beneath the continent.

A 7.5-magnitude quake in 1974 a day’s drive from Lima in the Cordillera Blanca range killed about 70,000 people as landslides buried villages. Seventy-eight people died in the capital. In 2007, a 7.9-magnitude quake struck even closer, killing 596 people in the south-central coastal city of Pisco.

A shallow, direct hit is the big danger.

More than two in five Lima residents live either in rickety structures on unstable, sandy soil and wetlands that amplify a quake’s destructive power or in hillside settlements that sprang up over a generation as people fled conflict and poverty in Peru’s interior. Thousands are built of colonial-era adobe.

Most quake-prone countries have rigorous building codes to resist seismic events. In Chile, if engineers and builders don’t adhere to them they can face prison. Not so in Peru.

“People are building with adobe just as they did in the 17th century,” said Carlos Zavala, director of Lima’s Japanese-Peruvian Center for Seismic Investigation and Disaster Mitigation.

Environmental and human-made perils compound the danger.

Situated in a coastal desert, Lima gets its water from a single river, the Rimac, which a landslide could easily block. That risk is compounded by a containment pond full of toxic heavy metals from an old mine that could rupture and contaminate the Rimac, said Agustin Gonzalez, a PREDES official advising Lima’s government.

Most of Lima’s food supply arrives via a two-lane highway that parallels the river, another potential chokepoint.

Lima’s airport and seaport, the key entry points for international aid, are also vulnerable. Both are in Callao, which seismologists expect to be scoured by a 20-foot (6-meter) tsunami if a big quake is centered offshore, the most likely scenario.

Mayor Susana Villaran’s administration is Lima’s first to organize a quake-response and disaster mitigation plan. A February 2011 law obliged Peru’s municipalities to do so. Yet Lima’s remains incipient.

“How are the injured going to be attended to? What is the ability of hospitals to respond? Of basic services? Water, energy, food reserves? I don’t think this is being addressed with enough responsibility,” said Tavera of the Geophysical Institute.

By necessity, most injured will be treated where they fall, but Peru’s police have no comprehensive first-aid training. Only Lima’s 4,000 firefighters, all volunteers, have such training, as does a 1,000-officer police emergency squadron.

But because the firefighters are volunteers, a quake’s timing could influence rescue efforts.

“If you go to a fire station at 10 in the morning there’s hardly anyone there,” said Gonzalez, who advocates a full-time professional force.

In the next two months, Lima will spend nearly $ 2 million on the three fire companies that cover downtown Lima, its first direct investment in firefighters in 25 years, Prado said. The national government is spending $ 18 million citywide for 50 new fire trucks and ambulances.

But where would the ambulances go?

A 1997 study by the Pan American Health Organization found that three of Lima’s principal public hospitals would likely collapse in a major quake, but nothing has been done to reinforce them.

And there are no free beds. One public hospital, Maria Auxiliadora, serves more than 1.2 million people in Lima’s south but has just 400 beds, and they are always full.

Contingency plans call for setting up mobile hospitals in tents in city parks. But Gonzalez said only about 10,000 injured could be treated.

Water is also a worry. The fire threat to Lima is severe — from refineries to densely-backed neighborhoods honeycombed with colonial-era wood and adobe. Lima’s firefighters often can’t get enough water pressure to douse a blaze.

“We should have places where we can store water not just to put out fires but also to distribute water to the population,” said Sato, former head of the disaster mitigation department at Peru’s National Engineering University.

The city’s lone water-and-sewer utility can barely provide water to one-tenth of Lima in the best of times.

Another big concern: Lima has no emergency operations center and the radio networks of the police, firefighters and the Health Ministry, which runs city hospitals, use different frequencies, hindering effective communication.

Nearly half of the city’s schools require a detailed evaluation to determine how to reinforce them against collapse, Sato said.

A recent media blitz, along with three nationwide quake-tsunami drills this year, helped raise consciousness. The city has spent more than $ 77 million for retention walls and concrete stairs to aid evacuation in hillside neighborhoods, Prado said, but much more is needed.

At the biggest risk, apart from tsunami-vulnerable Callao, are places like Nueva Rinconada.

A treeless moonscape in the southern hills, it is a haven for economic refugees who arrive daily from Peru’s countryside and cobble together precarious homes on lots they scored into steep hillsides with pickaxes.

Engineers who have surveyed Nueva Rinconada call its upper reaches a death trap. Most residents understand this but say they have nowhere else to go.

Water arrives in tanker trucks at $ 1 per 200 liters (52 gallons) but is unsafe to drink unless boiled. There is no sanitation; people dig their own latrines. There are no streetlamps, and visibility is erased at night as Lima’s bone-chilling fog settles into the hills.

Homes of wood, adobe and straw matting rest on piled-rock foundations that engineers say will crumble and rain down on people below in a major quake.

A recently built concrete retaining wall at the valley’s head lies a block beneath the thin-walled wood home of Hilarion Lopez, a 55-year-old janitor and community leader. It might keep his house from sliding downhill, but boulders resting on uphill slopes could shake loose and crush him and his neighbors.

“We’ve made holes and poured concrete around some of the more unstable boulders,” he says, squinting uphill in a strong late morning sun.

He’s not so worried if a quake strikes during daylight.

“But if I get caught at night? How do I see a rock?”

___

Associated Press writer Franklin Briceno contributed to this report.

___

Frank Bajak on Twitter: http://twitter.com/fbajak

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Kevin Smith: “Clerks III” will be my last writing/directing effort

LOS ANGELES (TheWrap.com) – “Clerks III” will be Kevin Smith‘s last writing/directing effort, the filmmaker tweeted on Friday morning:

“So with the ‘HIT SOMEBODY‘ shift, the minute Jeff Anderson signs on, my last cinematic effort as a writer/director will be ‘CLERKS III’”

Referring to the ice-hockey comedy he’s writing that takes place over the course of 30 years, the “shift” means now it will be not a theatrical release but a television mini-series.

“Since ‘HIT SOMEBODY’ is now gonna be a mini-series,” the 42-year-old wrote. “Yes – that leaves room for a new final flick before I retire from directing feature films.”

So pending the participation of Anderson, the actor who played Randal Graves in the first two “Clerks” films, Smith’s fans will get the ultimate goodbye gift – a complete trilogy for the convenient store comedy franchise.

The first installment was the director’s mirco-budgeted breakthrough independent film, which launched characters Jay and Silent Bob into pop culture and led to four more spinoffs.

Minimum-wage earners Randal and Dante (Brian O’Halloran) were featured in a series of “Clerks” comics in the late ’90s before becoming the focus of a short-lived animated television series in 2000 (and eventually making it back to the big screen for a quick cameo in 2001′s “Jay and Silent Bob Strike Back”). Smith finally finished their story in 2006′s “Clerks II.”

Or so we thought. Apparently, he wants to end his film-directing career with the characters and actors that helped it begin. However, the tweet heard around the world of cinema suggests it may be somewhat of a challenge to persuade at least one half of the “Clerks” duo to come aboard.

Beyond “Hit Somebody” and “Clerks III,” Smith will keep himself busy with “SModcast,” a weekly podcast, and AMC’s “Comic Book Men,” which has been renewed for a second season.

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Health workers march in Spain’s capital against cuts, reforms

MADRID (Reuters) – Thousands of health workers, on strike since last month, marched on Sunday in Madrid to protest against budget cuts and plans from the Spanish capital’s regional government to privatize the management of public hospitals and medical centers.

It was the third time doctors, nurses and health workers have rallied since the local authorities put forward a plan in October to place six hospitals and dozens of medical practices under private management. The plan also calls for patients to be charged a fee of 1 euro for prescriptions.

Workers launched an indefinite strike last month against the plan, which has not been endorsed by the centre-right government of Prime Minister Mariano Rajoy. Health workers in the capital are striking Monday-Thursday each week and seeing patients only on Fridays, while also responding to emergencies.

Spain’s 17 autonomous regions control health and education policies and spending. They have all had to implement steep cuts this year as the country struggles to meet tough European Union-agreed deficit targets.

Dressed in white scrubs, the protesters shouted slogans such as “Health is not for sale” and “Health 100 percent public, no to privatizations”.

“Of course, privatization can be reversed. Actually the question is not if it can be reversed, because privatization should never have a future,” said Luis Alvarez, an unemployed man from Madrid attending the demonstration.

Belen Padilla, a doctor at Madrid’s hospital Gregorio Maranon, said one million citizens had already signed a petition rejecting the plan.

(Reporting by Reuters Television; Writing by Julien Toyer; Editing by Peter Graff)

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The Fiscal Cliff Isn’t the Problem

Early in Bill Bryson’s book A Walk in the Woods, the story of his ill-starred Appalachian Trail expedition, the author’s out-of-shape and impulsive hiking companion, Katz, decides his backpack is too heavy. So he starts throwing out the food they’d packed for the trip: rice, pepperoni, cheese, peanuts, Spam—he even discards coffee filters, which weigh next to nothing.

Panic about the fiscal cliff is threatening to lead Congress into the same short-term thinking. Investments in education, scientific research, and infrastructure—which account for a tiny portion of federal spending but make the economy more productive in the long run—are at risk. Restraining them by spending cap or sequester would be as dumb as discarding coffee filters to lighten one’s backpack. Yet if Democrats and Republicans don’t agree on a budget compromise by the end of the year, that’s what could happen.

A new Bloomberg Government analysis makes clear just how much pressure Washington is under. Instead of needing $ 4 trillion in deficit cuts over 10 years to stabilize the ratio of debt to gross domestic product ratio, negotiators need $ 5.9 trillion in cuts, according to Bloomberg Government’s calculations. In a Dec. 4 interview with Bloomberg Television, President Obama said he’ll fight to protect investments in things like education. He’s right. House Speaker John Boehner says the U.S. needs to grapple with big projected deficits in Medicare, Medicaid, and Social Security. He’s right, too. But their two rights have made a wrong: stalemate.

Illustration by Ana Benaroya

The solution is to figure out what problems need solving on which time scale. The most urgent priority is keeping the roughly $ 600 billion hit to GDP from kicking in. Edward Kleinbard, a professor at the University of Southern California’s Gould School of Law, who was chief of staff for the Joint Committee on Taxation from 2007 to 2009, proposes turning the cliff into a ramp. He would suspend the automatic spending cuts and allow the Bush tax cuts to expire in three years instead of overnight. Congress would commit to devote all of the savings from future spending cuts to lowering tax rates, but starting with the lowest brackets, not the highest. Says Kleinbard: “None of this is impossible.”

After that comes a bigger challenge: getting the economy to grow faster and foster innovation to make burdens on future generations as light as possible. Supporting the aged and infirm will be far easier if median household income rises to, say, $ 75,000 adjusted for inflation, rather than remaining stuck at just over $ 50,000. And Medicare and Medicaid expenses will be less daunting if medicine can find cures for killers such as diabetes and dementia.

That’s why it’s foolish to slash public programs indiscriminately to get out of the fiscal hole. It’s up to government to fund growth-enhancing investments that the private sector does too little of. James Heckman, a Nobel prize-winning economist at the University of Chicago, has shown that the return on a dollar invested in human capital is highest from birth to age five, lower during the school years, and lowest for adult job training. Yet the budget for Head Start, which helps children from low-income families aged five and younger to get ready for school, is paltry relative to the benefits bestowed on older Americans.

Physical capital is underfunded as well. In 2009 the American Society of Civil Engineers gave the U.S. a grade of D for infrastructure. It’s doubtful that things are much better now; only about $ 100 billion of the Obama administration’s nearly $ 800 billion stimulus program went toward roads, bridges, and other needs. Infrastructure investment would make the U.S. more competitive in the long run while creating jobs in the short run, and since the U.S. can borrow for next to nothing, the financing would be cheap. But Boehner is opposing Obama’s debt proposal—which includes $ 50 billion in infrastructure spending—because it doesn’t cut spending enough. That’s unfortunate.

Where could the U.S. cut that wouldn’t damage its growth potential? The obvious targets are defense and entitlements, which together account for nearly three-quarters of federal spending outside of interest payments. The U.S. spends more on its military than the next 13 countries combined; that would suggest potential for some nips and tucks. Social Security’s imbalance could be fixed by raising the ceiling for wages subject to the payroll tax. The knottier problems are Medicare and Medicaid, whose costs have been driven up by extraordinarily inefficient health-care spending. The U.S. spends 53 percent more on health care per capita than No. 2 Norway while getting worse results. (Norwegians’ life expectancy at birth is a year and a half longer.)

Making benefits less generous is the no-brainer way to close the gap. The forward-thinking way is to conquer diseases that sap America’s human and economic potential, as Jonas Salk’s vaccine did for polio in the 1950s. Medicare and Medicaid alone spend $ 140 billion a year on dementia care, the Alzheimer’s Association estimates, yet the U.S. spends only about half a billion dollars a year researching cures. George Vradenburg, chairman of USAgainstAlzheimer’s, argues that the disease could be mostly eliminated by 2020 with Manhattan Project-size funding; cuts to research could make the problem worse. “This disease could very well become the financial and social sinkhole of the 21st century,” says gerontologist Ken Dychtwald, chief executive officer of the consulting firm Age Wave.

Taxes, too, need to be reformed to amplify growth. Loopholes are a good place to start. The home mortgage interest deduction could be phased out over a long period, since all it does is encourage people to buy bigger houses and take on more debt. Savings incentives in the tax code mostly benefit the rich without actually increasing the rate of savings. But zeroing out all tax breaks would be a mistake. Some, like the one for research and development, enhance growth.

There is, of course, a point at which high tax rates slow the economy. Conservatives argue for holding down rates on capital gains and dividends while preserving all of the Bush high-end cuts on ordinary income. But the U.S. appears to be well shy of the tipping point at which hiking taxes would be counterproductive. The economy grew faster in the 1950s when the highest rate was 91 percent.

What’s limiting business investment and hiring today isn’t the prospect of slightly higher tax rates but the fear that there won’t be enough customers. Weak, uncertain demand is the lasting legacy of the Great Recession and the slow rebound since. In manufacturing, mining, and utilities, depreciation has outpaced fresh investment since the start of the recession in December 2007, leaving the sector with a decline in productive capacity, according to Federal Reserve data. Recessions have lasting consequences: Eroding capacity, they limit the economy’s ability to grow—and generate tax revenue—in the future.

Refocusing the budget debate on the future is something that both conservatives and liberals should support. Representative Jim Cooper of Tennessee, a fiscally conservative Democrat, worries that Congress isn’t taking the long-term entitlements crisis seriously. He says the government should copy the private sector by adopting accrual accounting instead of just measuring each year’s cash in and cash out. Accrual accounting would acknowledge how much the country owes future retirees. It would also differentiate investments in roads, bridges, and Head Start from day-to-day spending on paper clips and electricity. “The government is the last major entity left in America that doesn’t use accrual accounting,” says Cooper. “The business mantra is, if you can’t measure it, you can’t manage it.” Without that kind of discipline, he says, “Congress has very poor eyesight and won’t necessarily cut in the right place.”

Or, to put it in terms Katz might understand: When you still have 2,000 miles to hike, don’t throw away all of your pepperoni.

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Election underscores Ghana’s democratic reputation

ACCRA, Ghana (AP) — Voters in Ghana selected their next president Friday in a ballot expected to mark the sixth transparent election in this West African nation, known as a beacon of democracy in a tumultuous region.

Proud of their democratic heritage, residents of this balmy, seaside capital trudged to the polls more than four hours before the sun was even up, standing inches apart in queues that in some places stretched 1,000-people deep.

By afternoon, some voters were getting agitated, after hitches with the use of a new biometric system caused delays at numerous polling stations.

Each polling station had a single biometric machine, and if it failed to identify the voter’s fingerprint, or if it broke down, there was no backup. At one polling station where the machine had broken down, a local chief said he’d barely moved a few inches: “I’m 58 years old, and I’ve been standing in this queue all day,” Nana Owusu said. “It’s not good.”

Late Friday, when it became clear that large numbers of people had not been able to vote, the election commission announced it would extend voting by a second day. This nation of 25 million is, however, deeply attached to its tradition of democracy, and voters were urging each other to remain calm while they waited their turn to choose from one of eight presidential contenders, including President John Dramani Mahama and his main challenger, Nana Akufo-Addo. The election commission

“Elections remind us how young our democracy is, how fragile it is,” said author Martina Odonkor, 44. “I think elections are a time when we all lose our cockiness about being such a shining light of democracy in Africa, and we start to get a bit nervous that things could go back to how they used to be.”

Ghana was once a troubled nation that suffered five coups and decades of stagnation, before turning a corner in the 1990s. It is now a pacesetter for the continent’s efforts to become democratic. No other country in the region has had so many elections deemed free and fair, a reputation voters hold close to their hearts.

The incumbent Mahama, a former vice president, was catapulted into office in July after the unexpected death of former President John Atta Mills. Before becoming vice president in 2009, the 54-year-old served as a minister and a member of parliament. He’s also written an acclaimed biography, recalling Ghana’s troubled past, called “My First Coup d’Etat.”

Akufo-Addo is a former foreign minister and the son of one of Ghana’s previous presidents. In 2008, Akufo-Addo lost the last presidential election to Mills by less than 1 percent during a runoff vote. Both candidates are trying to make the case that they will use the nation’s oil riches to help the poor.

Besides being one of the few established democracies in the region, Ghana also has the fastest-growing economy. But a deep divide still exists between those benefiting from the country’s oil, cocoa and mineral wealth and those left behind financially.

A group of men who had just voted gathered at a small bar a block away from a polling station in the middle class neighborhood of South Labadi. Danny Odoteye, 36, who runs the bar, said that the country’s economic progress is palpable and that the ruling party, and its candidate, are responsible for ushering in a period of growth.

“I voted for John Mahama,” he said. “Ghana is a prosperous country. Everything is moving smoothly.”

Administrator Victor Nortey, sitting on a plastic chair across from him, disagreed, saying the country’s newfound oil wealth should have resulted in more change.

“I voted for Nana Akufo-Addo,” He said. “Now we have oil. What is Mahama doing with the oil money?” Nortey said. “We can use that money to build schools.”

In an interview on the eve of the vote, Akufo-Addo told The Associated Press that the first thing he will do if elected is begin working on providing free high school education for all. “It’s a matter of great concern to me,” he said, adding that he plans to use the oil wealth to educate the population, industrialize the economy and create better jobs for Ghanaians.

Policy-oriented and intellectual, Akufo-Addo is favored by the young and urbanized voters. He was educated in England and comes from a privileged family. The ruling party has depicted him as elitist.

“The idea that merely because you are born into privilege that automatically means you are against the welfare of the ordinary people, that’s nonsense,” he said.

Ghana had one of the fastest growing economies in the world in 2011. Oil was discovered in 2007 and the country began producing it in December 2010.

Throughout the capital, new condominiums are rising up next to slums and luxury cars creep along narrow alleys lined with open sewers. A mall downtown features a Western-style cinema and is packed on weekends with middle class families. At the same time shantytowns are cropping up, packed with the urban poor.

Polls show that voters are almost evenly split over who can best deliver on the promise of development.

Kojo Mabwa said that he is voting for Akufo-Addo, because he is impressed by his promise of free education. He dismissed critics that say the project is too ambitious. “There is money,” he said. “(The ruling party) has done nothing for us. They are misusing our money.”

Paa Kwesi, a 30-year-old systems analyst, said he doesn’t think Akufo-Addo is making promises he can keep.

“He says he can do free education, but you have to crawl before you can walk. It’s not possible,” he said.

__

Associated Press writer Francis Kokutse contributed to this report from Accra, Ghana.

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Zynga seeks real-money gambling license in Nevada

SAN FRANCISCO (Reuters) – Social games maker Zynga Inc said on Wednesday it filed a preliminary application to run real-money gambling games in Nevada, a significant step in cracking a complex but potentially massive new market that could resuscitate its faltering business.

The Nevada Gaming Control Board will now examine whether Zynga is fit to hold a gaming license that would allow gamblers in the state to bet real money on the San Francisco-based company’s popular games like Zynga Poker, which currently involve only virtual chips with no monetary value.

Zynga is hoping that a lucrative real-money market could make up for a steep slide in revenue from its games like “FarmVille” and other fading titles that still generate the bulk of its sales.

“We anticipate that the process will take approximately 12 to 18 months to complete,” Zynga Chief Revenue Officer Barry Cottle said in a statement. “As we’ve said previously, the broader U.S. market is an opportunity that’s further out on the horizon based on legislative developments, but we are preparing for a regulated market.”

Zynga, along with many major gaming industry players, is hoping that a tide of proposed legislation to regulate gaming could sweep through states across the U.S. and open a massive new online market.

Nevada, Delaware and New Jersey are among the states that have moved or are moving toward interactive gaming after the U.S. Justice Department last year declared that only online betting on sporting contests was unlawful, presenting the opportunity for states to legalize some forms of online gambling, from lotteries to poker.

Although widespread legalization of online gaming in the United States appears years away at the minimum, obtaining a license in Nevada would be a meaningful foot in the door for Zynga’s nationwide aspirations.

Zynga has told investors in recent quarters that a concerted move into real-money gaming could represent a hefty – and badly needed – source of new revenue for the company, which has seen revenues sag and its stock plummet by more than three-quarters in the past year as gamers abandoned titles like “CityVille.”

In October, the company slashed its 2012 full-year earnings outlook for the second time and laid off employees to trim costs, while CEO Mark Pincus implored investors to give him time to turn around the company by pursuing initiatives like real-money gaming.

That month, Zynga struck a deal with bwin.party, a Gibraltar-based gaming company, to provide real money casino games like poker and slots in the United Kingdom beginning in the first half of 2013.

(Reporting By Gerry Shih; Editing by Chris Gallagher)

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Quentin Tarantino: if you think “Django Unchained” is violent, try slavery

LOS ANGELES (TheWrap.com) – If you think “Django Unchained” is violent, Quentin Tarantino has a historical reality check for you: Try slavery.

The “Pulp Fiction” auteur is back with an Antebellum revenge flick that according to early screenings pours on the blood and gore. Tarantino told an audience of British Academy of Film and Television Arts members on Thursday that if anything he spared the lash in his depiction of slavery, according to the Guardian.

“We all intellectually ‘know’ the brutality and inhumanity of slavery,” Tarantino said, “but after you do the research it’s no longer intellectual any more, no longer just historical record – you feel it in your bones. It makes you angry and want to do something … I’m here to tell you, that however bad things get in the movie, a lot worse shit actually happened.”

Tarantino’s comments indicate that he anticipates the irreverent “Django Unchained” – which opens on Christmas Day – will court controversy for setting its story against the backdrop of the slave trade.

The film centers on a bounty hunter (Christoph Waltz) who partners with a freed slave (Jamie Foxx) to take down a plantation owner, Calvin Candie (Leonardo DiCaprio) who controls his wife. Candie, who speaks with Magnolia-scented menace in the trailers, owns a mixed-race club in Greenville, Miss., and deals in slave-fights.

Perhaps because the film features Tarantino’s trademark sardonic humor, some early viewers have compared “Django Unchained” to the works of Mel Brooks.

“Just watched what was basically a three-hour homage to BLAZING SADDLES,”@LouLumenick tweeted.

But despite the humor, in an interview with Howard Stern this week, Tarantino indicated that he took the responsibility of depicting slavery very seriously. In particular, he said that shooting a scene where a female slave is brutalized brought him to tears and deeply impacted the crew.

“It was early on in the production, and it was the first time we started officially dealing with that kind of ugliness,” Tarantino said. “We later got used to dealing with that kind of ugliness. But that first – it was traumatizing to everybody, none less because of the fact that we were doing it in the real slave area of a real plantation where the slaves lived.

“This actually happened on the grounds,” he added. “There was blood in that ground. Those trees had memories of everything that happened there. We could feel the spirits of the old slaves on the property.”

Of course, Tarantino has taken on controversial subjects before. He turned an ultra-violent and satiric eye at the Nazis and an SD colonel nicknamed the “Jew Hunter” and turned it into “Inglourious Basterds.” Dealing with charges of insensitivity, it nonetheless collected over $ 300 million worldwide and was nominated for a Best Picture Oscar.

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