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1  :~._. .. . - CARDIOVASCULAR, PHARNtACOLOGY & CKRrifSTRY ... z ~ .... Na. 6~ :;cf:#i7 ;~ j TIIE COUNCIL rOR ToBACCOIE SUAhIC}I - USA Activated: . ~.. .. . , 633 TlriltD A4ENUE COMMCTTEE Dr. Reitnarin;-Cfim;: '- Dr. Bing :: Dr. Catitell. Dr. Sommers NMti YORIC. N. Y. 10017 Application For Research Grant Renewedt Annua 1. Name of fnvestigatoF(s): (include?itte and•Degrees) Jack P. Strong, M. D. - 2. Institution & Address: Myra L. Richards, A. M. Louisiana Sta.te.Uhiversity, Baton Rouge, La. .... .h~ 3. Short Title of Project: Relationship of Smoking and Other Environmental Factors to Atherosclerotic Lesions ; A. Proposed Starting Dote: February 1, 1968 . S5. Anticipated Duration of this Specific Study: 3 years 6. Brief Descripton of Objectives or Specific Aims: "~rA 1* With reference to studies already in progress and, to others being considered in `"d1; the Department of Pathology at the Louisiana State University Medical Center, we ~ wish to request reinstatement of support for continuation of our present autopsy study . of the relatioriship of smoking and other environmental factors to atherosclerotic lesions. Support toward this retrospective study of a cumulative sample of autopsied ~: .. : , . male deaths in New Orleans. was provided by the Tobacco Industry Research Committee ,._. h h h t roug out t e major developmental and testing phases begining February 1, 1958, and ' on through the first 3 years of the definitive phase. The last grant year ended on January3T;-I~'6S;'°i,vlth ari extension to July 31, 19,66, for the use of unexpended funds. The purpose (and plan) of our study continues, to be to investigate selected environ- mental factors, incltuding lifetime history of cigarette usage, occupation and occupational physical activity (last 5 years), dietary practices, habitual level of salt intake, and educational level attained, in relation to various measurements of type and extent of atherosclerotic lesions in the aorta and coronary arteries. 7. Give a Brief Stotement of your Working Hypothesis; Fo r human male s, holding age, 'rac e, and ca us e of death classification constant, amount of cigarette smoking is positively associated -~' on 2j2- 1959- Inclusive _.~ with atherosclerotic involment of both the aorta and the coronary arteries.

t Details of Exoarimentol Desian andProcedures: (Attach Separate Poaes) rno aample ox cases to oe 3nvestigatea is comprised of white and Negro resident r e . ia e v sua , an ra iograp ic met ods, previously developed : C autopsiedi at the Charity Hospital of Louisiana at New Orleans or the laboratories of f 1' 1.11 i I d ~1' h h •the Parish Corone R ; males, agedi 20 through 64 years at death, who die in' Orleans Parish and who are . in our laboratories in connection with the International Atherosclerosis Proiect_ fnT to the specimens which are dissected at autopsy by our technicians, processed for quantitation of various aspects of lesion development are applied by the pathologists ;' I ' prior to the evaluationk the pathologists have no information t+ertainine to the identi- preservation, preservation, and stored:for reevaluation. The specimens are blind-coded'y and ' sacauon oz• rne suo_ieci or to zne ciinicai or autoosv aata. -_ '•data for transfer to IBM punch cards by the Department of Biometry, LSU6M, where " view of surviving family members or other close associates,and prepare the basic viewers, *adequately trained and; experienced in social wor14 obtain the data by inter- The collection and preparation of the pathologicali data and that oE the environ- mental data are two distinct and; separate operations. Research associa•te inter- "`~ % it is programmed for computer analysis. Prior to the analysis stage of the study, : ~;<v° the interviewers have no knowledge of the artery findings. (see attached sheet for con- 9. -~' 9. Physical FadGies Available (Where Other than Administering Organization Indicate Geographical Location) Anuation) There is a large research team in the Department of Patholbgy engaged: in long term research on atherosclerosis. The head of•-the department (principal investigator)i co-investigator, and chief of the biophysics section are directly concerned with providing professional supervision, interviewing, (see attached sheet for continuation) 10. Additional Requirements C C 1. biographical sketthes of all principol and professionol personnel (oppend) Jack P. Strong, M. D. - Myra L. Richards, A. M. 14. List of publicotions: (Rve most recennas pertinent) (oppend) See attaehed sheet. . .~ -

,v.,.. as,t•,..,....:.~'~.+r.. - 'f..:....- . . i~ . .. t.. ; M ~ z !' ,~, ,~ - ~~t ~ a4(7 i ' ~ '~ ' 4x ~ 1 ',scecognizmg mai a sampie ot necrops:ea suojects is a setectea group ana tnere- `••2~-•:••~ ~ ' • s ~ . - . . . ..,:.a ''' = fore not representative of the living pppulation, it is necessary that co;nparative - •' study of the values derived by measurement be made within appropriate race-age ~ groups, subdivided further according to major cause-of-death classification. In -~;: this connection, preliminarY tabulations were -made in late 1966 of the firstr645 . ;' cases completed, and in Table I(at•tached) is presented the race-age distribution of ::the sample according to the classification of "basal", without evidence of Coronary ' Heart Disease (CHD), and "non-basal", with evidence of CHD. ":;:~::... .. . . , • .. . . » The sample is 54%sNegro and 46%white. It is of interest that 208 (60%4 of .the 347 Negro cases fall, into the basal[ group, while the 298 white cases break about evenly between basal and non-basal; 51 %.and 49 %a, respectively. It follows that, since 45 % of alb Negro cases fall in the younger age groups (20 through 44 : years), a large proportion of the Negro cases would be basal, --that is, free of evidence of CHD or disease thought to be related to CHD or to smoking (hypertension, stroke, diabetes, lung cancer, emphysema). .: We are preparing for an interim analysis of the present total of 756 cases in which both the pathological and the environmental data have been transferred to punch cards. This interim sample represent•s approximately the half-way point in reachin our revi d L 1 500- f L h l R i i f g se goa o a case samp ev ,. e ( s on o t e origina goal of 500 cases was necessary in order to ama§s a greater number and a more nearly equal distribution of the cases•among the sub-groups, thereby permitting more meanin ful anal ses ) g y . '..,.. . - Envisonmental histories have been obtained at interview of quali£ied' family members or other close associat'es in another 200 cases. These cases now await coding and the visual and; radiographic measurements of the lesions by the pathologists and by the staff of the Biophysics Section, Department of Pathology. Another 40-odd new cases were assigned for interview in,April, and upon com- pletion of these and others awaiting assignment, the total cumulated sample should exceed 1, 000 cases by September first. This cumulation, of cases• will represent the obtainable environmental data: on all white and Negro male necropsied deaths, begin- ning January 1, 1963', whose artery specimens were collected by our technicians at necropsy and who have met the criteria for the study sample as defined in our Stand- ard Operating Protocol. (The autopsies of the 70 male cases of the pilot study, now - included in the study sample, were performed between June I, 1961, and May 31, 196Z. );.( ' At our present rate of completing• the cases, the collection of the last 500 will require approximately 2 years, and the analysis of the data for the total 1500-case sample, one additional year. Continuation to question 9, second page • or obtaining and evaluating•anatomie materiabfor this specific project. A medical research technologi,st and typist-clerk are engaged in the project and there is a posi- tion open for a• social worker interviewer. Ample autopsy material from Charity Hosp- ital of Louisiana at New Orleans and the Office of the Coroner, Orleans Parishi is available. The Department, of Biometry LS'U School of Medicine has supervised the de- velopment and, testing of the methods of collecting information on smoking habits and is collaborating in analyzing the data. Qr Q • `=

^ o Relationship of Environmentax Factors to Athoreclerosis Table 1. Distribution of the Cumulated Sample bf 645 Cases (N) for Preliminary Analysiso of the Basal Grou I Number , . .., • of WHITE • NEGRO ' ' Cases Jc AGE - •in ~Ion-Ba®al* ~ All Non=Basa1# ~ Sam le p All Basal Group' Group Basal Group' Group . (N) :~ ~._ ~. (white) -.~•,.: . .....-........r...~..~..> (the remainc',er) ~.~....~.e..,_..._ (Negro) (ttn iecnainder 20-g,} 38 ? 4 13 1 24 21 3 25-3.4 89 29 .. Z7 . 2. .. 60 . 52 8. , ~ . 35~4 ,.4 lzz 51 31 , . 20 7 1 47 24 . - . 45-54 191 93 I 43 50 98 .46 52 ... r':'. 55-64 ~ 205 ~ 111 38 73 94 42 52 ' . TOTAL 645 298 152 146 347 208 139 (46% of sa-3e) (51% of white ) (49% of wh4te ) ,(54% of aunp]e) (60% ct NqTro) (40~10 of Nagro) of 360 Casoo. and of the Non-Basal Group (the Remainder) of 285 Casce, by Race and by Ago. "Basal" = thoee subjects without evidence of CHD or discase related to CI•ID or to smoking ~e "Non-T3asaP" = those subjects with it to it It •11 11 11 " " " " ~ UBWSE00T I

R: REDACTED MATERIAL Technical :; Mariz Longoria; Typist-Clerk IIh 50 :'Tunius Solomon, Medical Research Techno- 50 logi sG. , . . _ . . . - . G.t:_T..~..I L Consurnable SuppGes (list by categories). ,Computer time Interview forms and supplies C. Other Expenses Gtemize) D. Pernwnent•Equipment (temize) _ Travel to professional meetings; one trip to England(London School of Hygiene)for consultation on analyses and results(May not be utilized until following year). • E. Overhead (15°.U•of.A+af C) Estimated Future Requirementsc Year 2 Year3 Solaries Consumable Suppl. ~ 1,500 i~. 1,500, Sub-Total I 500 1,000. 2,675 17,841 Toto!' 2 ©, 516 OtherExpanses PermanentEquip, Overhead * Total Travel, 5001 ~ 2,586 19,826 Travel 500 2, 64fi 20, 283 SignatOre. It is understood -that the applicant and institulional,afficers in applying for a grant hove read and found acceptalile the Council's "Statement of Policy Containing Conditions and Terms Under Which Project Grants Are Made." O~nen.nr9,utear /1 r/ . ~ JI Telehone ' J <j. "p /1 5ignotureL W.;n.u OUiu,r of t'w Icf IituFon TelephonE di= 4=5K

' -~ lht finondal.upport far nteorch from all wurcet,lncludtng own tniHtvtton, for thls and/a..nlat.d m.arch proj.dt: Organized Research Budgeteupporting Athero®- clerosis reeearch.

R: REDACTED MATERIAL CURRICULUM VITAE-" Tack Perry Strong, M.1). av . . ~ " - l ' ..` - . . . - . . . , . ' . . . i _ .. Secondary Education: Phillips High School - 1941- - 1945, College: B. S. University of Alabama, 1948 M. D. Louisiana State University'School of Medicine, 1951 i Honors: Phi Beta Kappa - 1947 Alpha Omega Alpha - 195 0' Phi Kappa Phi. - 1967 Academic and; Professional Appointments: . . ,: `' Internship (rotating), Jefferson Hillman Hospital, Birmingham, Alabama, 1951 - 1952 Assistant, Department of Pathology, Louisiana State University School of Medicine, 1952 - 1953- Medical Officer and Pathologist, Ui. S. A. F. , 1953 - 1955 Consultant in Pathology, Southwest Foundation for Research an Education, 1954 - 1955 Instructor in Pathology, Louisiana State University School of Medicine, 1955 - 1957 , - - Assistant Professor of Pathology, Louisiana State Uhiversity School of Medicine, 1957 - 1960 Associate Professor of Pathology, Louisiana State University School of Medicine, 1960 - 1964 -- Assigned to Professor J. N. Morris, Social Medicine Research Unit of the Medical Researeh-Council, London, England September 1962 - September 1963 %~ Combined Course in Medical Statistics by Professors P. Armitage and D. D. Reid, London School of Hybiene and Tropical~ . Medicine, Jianuary - Ap-ril', 1963• Professor of Pathology, Louisiana State University School'of Medicine, 1964 to date Head, Department of Pathology, Louisiana State University School of Medicine, 1966 to date . ~ ....,~ .. _ . . . . . . ~ ~ . ~ • . . . _ •,~.< . :a.=~ •

t t i men s: n ~Hospital Appo 5 p ar y o s , at o; Assisting Visiting :_. ital of Louisiana Hos Ch it i E h l P ` 2 - 1953; 1955 - 1958 - at New Orleans, 19 ' .. Visiting,Pathologist, CharibyHospital of Louisiana at New ' Orleans, 1958 to 1966 : Division, 1966 ta date :•Senior Visiting Pathologist and Pathologist-in-Chief, LSU .`. Louisiana Hearb Association Research Committee, 1960 to date 71. 1965 to date • World Health Organization Atherosclerosi•s Project, 1962-1963 Pathology A Study Section, United States Public Health Service, Fellowships ; Senior Research Fellow, United States Public Health Service, 1957 - 1962 American Association of Pathologists and Bacteriologists; . ' Assistant Secretary, I959=196Z American Society for Experimental Pathology International Academy, of Pathology American Society of Clinical Pathologists; Councilor for Louisiana, 1966 American Society for the Study of Arteriosclerosis Research Career Development A*ard, United States Public Health Service, 1962-1964 Profes sional Organizations: College of American Pathologists ResearchInteresYs: Epidemiology, geographic pathology and pathogenesis of atherpsclerosis; atherosclerosis in primates Current Grants: Natural and Experimental Atherosclerosis (HE-08974) Pathology Training (GM-01202) Frost Foundation Comnuuiity, Activities,: :. Anatomy, 1957; Clinical Pathology, 1958 Diplomate of American Board of Pathology - Pathologic President, Bissonct Elcincntary Parent Teachers Association, 1961• Viee.President, Jefferson. Conueaittec for Better Schools, 1-964 Mrn.hnr nf G)fficial llnardL Mnnholland' Meihodist Church. L96S

R: REDACTED MATERIAL I Curriculuwn yitae :.Place of tirth: , - Marital status: ; ~Education ~. Secondary: Liberty High School :College: `Graduate: L1_- Tulane University: Completion,of the 2-year curriculum Medical-SociW, 1930-1932. Myra L. Richards SchoQl of Social lYork* Specialty, - ROACTED Graduate School____------------------ ___1930-1932...A.A'I.deeree-7~.~ Experience - Bocial Service Dept., Charity Hospital La. State Univ. School of Medicine Public Health Dept., Night V-D Clinic OSocial Service Dept. Charit_y- Hospital Social Research,Inc. (of Chicago) La. State University Medical Center Dep`t. of Pathology -(see page 2 for positions 1932-1942 held in- the Dept. ) - Field Supervisor of 6 1933--1934 senior medical students in "Social Aspects of bledicine" - biec:'.,i:al-Socia1 Worker ....... 1934-1935 (approx. '5 - Medical-Social SYorker... 1955 (Sept.-Nov.) part-time Eye clinics and:wards. - Survey interviewer. . . - 1957, 1958 part time , N.O.Dir., Dr.Rob't.Stone, Tulane: (1) "alcoholic beverages" ; (2) "attitudes tow•ard the dr•, ft (parents of draft-age boys, prior to induction). F-~ - Research Assistant(Clinical).. ~ pa:rt-time ... _ 1956-1958 - Research Associate (Clin.ical) . . tjt part-time.... - 1958-1960 ~ - Associate (Research)......... 1960-1966 ~ -,Instructor ................... 1966_to date ~ *G-raduate School: Tuition Award (library) .............................. (1 yr.) °5ocial Service Dept. - Medical-Social SYorker........ 193].-32 (half-day) Emerg. Relief A•dmin...certification interviewer. .. . .1931 (3 months) Charity Hospital

I Social Serv . July, 1931 Dec.1935- ~ Oct..1937 (aPProx. ) ~ June-Dec. 1941 Dec.1941- July 1942 Sept. -Nev. . , . . 1955 -.Formulated operational policies and procedures for a: _ _ joint W.P.A. - Charity Hospital medical certi~ieation `' project, (staffed by ~I~PA physician and registered nurse for screening applicants; served as liaison worker in the Charity clinics for applicants who required further examination and evalt~ation for work ' ~ . . . , . . . . . . . . . . .. ..:~i: ;9 clinics and wards. Medical-Social Case Worker --_-9 general and special ivhite Organized and supervised the Dept's. Intake Service; ` supervised clerical staff of 15 and an N.Y.A. clerical project. ` Accident Rooms. Set up a•nd super.vised the first program of inedical- social services:in Charity Hospital Admitting and Designed and supervised the hospital's first program of establishing eligibility by standardized interview procedure; trained the interviewers. Case Supervisor of 7 medical-social woxkers,in clinics .and Admitting Room. Director, Social Service Dept. (acting)---professional of 16. (Unable to accept permanent appointment as husband was to be commissioned in War II). 'staff of 35 medical-social w•orkers and clerical staff Supervisor: Charity Hospital A'dmissions Unit interviewers and 7 medical-social workers in,clinics and Adm. Dept. (Resigned to join husband at air base --ZYar II). (S•ee-preceding page). Professional Organizations Publicat.i ons N O O C..W Grl Co-author -"Relatioiiship Between Cigarette Smoking Habits and ~p Coronary Atherosclerosis in Autopsied JIales." ~ Circulation Suppl No III - 0ctober 1966 , , . , , V01. XXXIV, No. 4, p. 31. Abs-iract. ACTED ACTED .ru....~iL...L.'.r ., .S':... .z~.i...sa. a.._ ..-~.. .. w.' ~ .. . .~. .. ... . .... _.. . ... ....... .-. ., , .~......._ ...........f::...,~,..~-....-,.... ~...._.«,t.:::--__.>.-<'...