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COLUMBIA, S.C. (AP) — Stefanie Brown James, the director of African-American outreach for President Barack Obama's re-election campaign, thought that the changes must have been typos.
The statement she'd written for the president honoring Black History Month had been immediately returned with every instance of the word "black" crossed out. They'd been replaced by "African-American," a term, she was later informed, was considered by his team to be "more generally acceptable."
"It was my first example as to how nuanced the conversations had to be," she said. "It was a tight wire act."
Four years later, Hillary Clinton seems far less worried about that balancing act.
As the race turns to Southern states, where black voters make up a significant portion of the Democratic electorate, Clinton is addressing race in increasingly blunt terms, talking about discrimination and inequality in ways that haven't been heard on a presidential stage since civil rights leader Jesse Jackson's 1988 run.
Calls to tackle the problem of "systemic racism" have become a standard part of Clinton's campaign speech, followed by a long list of areas, like housing and health, where she says disparities are prevalent. She says the lead-poisoned water in Flint, Michigan, wouldn't have happened in a "wealthy white suburb" and calls on white voters to "recognize our privilege."
"For many white Americans, it's tempting to believe that bigotry is largely behind us," she told civil rights leaders in a Harlem speech last week. "Race still plays a significant role in determining who gets ahead in America and who gets left behind."
At an unusually emotional event Tuesday night in Columbia, South Carolina, Clinton sat beside five black mothers whose children were killed by gun violence and urged white voters to "practice humility" and "do a better job listening."
"That's too many deaths. Too many young lives cut short," she said, prompting a few "amens" from the audience gathered in a Baptist church. "Something is very wrong."
Clinton's frank language underscores how the conversation around race has shifted after seven years of the first black president, a period some critics say marked little progress on criminal justice abuses and black poverty. But it also captures the relative freedom Clinton, a wealthy white woman from a Chicago suburb, has to aggressively discuss race.
"If President Obama said the same thing she said, he would be attacked," Jackson said in an interview with The Associated Press. "The white experience is accepted more in race discussion than the black perspective, that's the fact of it."
Obama largely shied away from the topic during both of his campaigns, particularly after he delivered a speech on race in March 2008, under pressure to address the fiery sermons by his minister, Rev. Jeremiah Wright. That address largely dealt with his biography and his "firm conviction" that the country can move beyond "old racial wounds."
A study by University of Pennsylvania researcher Daniel Q. Gillion found that Obama talked about race less in his first two years of office than any Democratic president at least since John F. Kennedy.
"The thing is, a black man can't be president in America, given the racial aversion and history that's still out there," Cornell Belcher, a pollster for Obama, said to reporter Gwen Ifill after the 2008 race. "However, an extraordinary, gifted, and talented young man who happens to be black can be president."
But the Black Lives Matter movement, born out of the prominent police killings of blacks, has changed the political calculous for candidates, particularly in Southern states, said Frederick Harris, director of the Center on African-American Politics and Society at Columbia University. African-American voters make up a majority of the Democratic electorate in South Carolina.
Protesters affiliated with the movement have demonstrated at several of Clinton's events, including a private gathering in South Carolina this week.
Clinton rival Bernie Sanders, too, has spoken about race in raw terms, though the topic is couched in his economic message. He frequently decries a "broken" criminal justice system, unequal arrest rates for marijuana use, black poverty and the water crisis in Flint. And he often attributes the Republican opposition to Obama to racism.
"The Black Lives Matter movement has been able to accomplish within two years where the civil rights establishment, President Obama and the Congressional Black Caucus haven't been able to do in six years," said Harris. "The question is: Will it be sustained, after Clinton has pretty much locked up the black vote?"
Now, race is a key piece of her message, which has shifted in recent weeks to focus on "breaking barriers" and expanding opportunities, a way for her to divert attention from questions about her trustworthiness and cast herself as an empathetic champion for struggling Americans.
Her aides believe that Obama's re-election victory four years ago, where he won just 39 percent of the white vote, proves that Democrats no longer win by wooing white independents but by galvanizing turnout among communities of color.
Friends and supporters say Clinton's commitment to the issue is sincere, going back to her early work as a young lawyer in the South and her long ties within the black community. But even some of her own aides were surprised by the forcefulness of the response she delivered to the deadly June shooting in a Charleston church — an attack she denounced as "racist violence."
"Our problem is not all kooks and Klansmen," she told the U.S. Conference of Mayors three days later. "Let's be honest: For a lot of well-meaning, open-minded white people, the sight of a young black man in a hoodie still evokes a twinge of fear."
RIO DE JANEIRO (AP) — Often drowned out by the dire warnings and fear surrounding Zika, some medical professionals are saying that Brazil and international health officials have prematurely declared a link between the virus and what appears to be a surge in birth defects.
A few even argue that the Brazilian government is being irresponsible, given that a connection hasn't been scientifically proven between the mosquito-borne virus and the birth defect known as microcephaly, which causes infants to be born with abnormally small heads.
"It's a global scandal. Brazil has created a worldwide panic," said Alexandre Dias Porto Chiavegatto Filho, a professor of epidemiology at the University of Sao Paulo, one of the most-respected universities in Latin America. "I'm not saying that Zika is not causing microcephaly, but I am saying that the ministry has yet to present any scientifically credible evidence to support that conclusion."
Chiavegatto and others argue there are still too many unanswered questions to blame Zika. Why are the vast majority of the cases of microcephaly being reported in Brazil? Why haven't they also shown up in proportional numbers in other countries hit hard by Zika, such as Colombia? (The answer, some say, is that Brazil was hit by Zika first, and microcephaly cases might be expected to crest elsewhere in the months ahead.)
And how can conclusions be drawn from government statistics that are flawed and possibly vastly underreported in the past, before Brazilian officials required doctors to report microcephaly cases?
In an article published Wednesday by the Annals of Internal Medicine, 14 Brazilian and American researchers said the link between Zika and microcephaly "remains presumptive." The strongest evidence is circumstantial, they said, and there are challenges in confirming the connection.
But Brazilian Health Minister Marcelo Castro recently said he was "absolutely sure" of a causal link between Zika and microcephaly. He and other scientific experts around the world have pointed to studies that detected the presence of Zika in the brains of dead fetuses and in the placentas of babies diagnosed with microcephaly in the womb.
While visiting Brazil on Wednesday, Margaret Chan, director-general of the World Health Organization, said microcephaly can be caused by many things but that her organization was affirming that "Zika is responsible (for it in Brazil) until evidence to the contrary emerges." And the Atlanta-based Centers for Disease Control and Prevention has warned pregnant women against traveling to more than 30 destinations where the virus has been registered, most in Latin America.
Every week, the evidence is "getting stronger and stronger," Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told a U.S. Senate committee Wednesday. He cited several published cases where the virus was found after fetal or newborn deaths.
Still, despite the heavyweight support and anecdotal evidence, some critics are not satisfied.
Luis Correia, who teaches scientific method at the Bahia School of Medicine and Public Health, said the small-scale studies cited by health officials don't equal proof.
"There appears to be a sort of scientific illiteracy within the ministry that has led them to mix up association with causality," said Correia. "They are confusing hypothesis with fact."
Correia compared the situation to finding a bystander at the scene of a murder. That person could have committed the crime or just have been a witness.
Correia and Chiavegatto stressed that another unknown factor, either alone or in tandem with Zika, might be triggering microcephaly. Both suggested that because the majority of mothers of babies with the condition are poor women from Brazil's less-developed northeast, this theoretical unknown factor could be lurking in poverty and poor living conditions.
Some speculate that politics, not science, may have pushed Brazil's health ministry to jump the gun on Zika. The line of thinking is that President Dilma Rousseff's deeply unpopular, scandal-plagued government is facing so many problems that health officials felt compelled to err on the side of caution and a robust response.
This week, the CDC and Brazilian health officials started work in Paraiba aimed at trying to scientifically establish the link.
Several CDC teams hope to recruit more than 100 mothers with babies with microcephaly, and two to three times that number of mothers with healthy infants born around the same time and in the same area. The recruitment phase will take at least four or five weeks, and it's unclear how long the teams will need to analyze the data.
There are also many questions surrounding Brazil's baseline of microcephaly cases.
Since October, the Health Ministry says 5,640 cases of microcephaly have been reported. Of those, 950 have been discarded and 583 have been confirmed as microcephaly. The remaining cases are still being investigated.
Before this outbreak, authorities said that on average Brazil had about 150 reported cases a year. If true, that would mean the country had a rate that was only a fraction of that of much richer countries. "It is possible that the baseline number in Brazil includes a lot of underreporting," said Ganeshwaran H. Mochida, a pediatric neurologist and researcher at Boston Children's Hospital.
And of the 583 confirmed cases of microcephaly, only 67 have been connected to Zika by blood tests. Government health officials argue that the presence of the virus can't always be detected, as it doesn't stay active in the body more than a few weeks.
There are also anomalies, such as in southern Sao Paulo state, far from the hard-hit northeast. On Jan. 30, the Health Ministry reported 101 cases of microcephaly, a huge jump from the total of 18 for the two previous months combined.
"It's very difficult to make any conclusions based on this data," said Eugene Brusilovskiy, a statistics lecturer at the University of Pennsylvania. "The weight of the reporting is not uniform. There is also not uniformity from state to state, or from week to week."
WASHINGTON (AP) — Republican presidential candidate Ted Cruz on Thursday lifted a hold he placed on bipartisan legislation to address the water crisis in Flint, Michigan, where lead-contaminated pipes have resulted in an ongoing public health emergency.
Senators had reached a tentative deal a day earlier for a $220 million package to fix and replace the city's lead-contaminated pipes, make other infrastructure improvements and bolster lead-prevention programs nationwide.
Cruz and at least one other GOP senator objected to a quick vote on the deal, delaying Senate consideration of the bill until at least next week. A spokesman for the Texas senator, Phil Novack, said Thursday night that Cruz had reviewed the bill and will not prevent it from moving forward in the Senate.
There was no word on whether other holds on the legislation had been removed. Earlier Thursday, Kristina Baum, a spokeswoman for Sen. James Inhofe, R-Okla., said there were "a few holds" on the bill. Inhofe chairs the Senate Environment and Public Works Committee and was a main architect of the Flint deal.
Baum declined to identify senators who were objecting to the bill, but said Inhofe and other senators were "genuinely trying to work through their concerns."
Sen. Lisa Murkowski, R-Alaska, chairwoman of the Senate Energy Committee, said she was optimistic lawmakers could resolve the dispute and take up both the Flint bill and a larger energy package it is tied to next week.
Novack declined to specify the nature of Cruz's concern, but many Republican senators have said it's too early to provide funds for Flint without specific plans from state and local officials. Some Republicans also question whether Flint is analogous to natural disasters such floods or hurricanes, since the crisis was the result of a political decision.
Flint's drinking water became tainted when the city switched from the Detroit water system and began drawing from the Flint River in 2014 to save money. The impoverished city was under state control at the time.
Regulators failed to ensure the water was treated properly and lead from aging pipes leached into the water supply.
Elevated levels of lead have been found in some children's blood. Lead contamination has been linked to learning disabilities and other problems.
The crisis in Flint has become an issue in the presidential campaign. Campaigning in Flint on Thursday, Democratic presidential candidate Bernie Sanders said he hopes people will look at the city's water crisis and say, "Never again."
Hillary Clinton said there are a "lot of Flints" and that she wants to help them. Flint is a majority black city, and Clinton questioned whether a similar crisis would have occurred in a "white, affluent suburb of Detroit."
The legislative impasse over Flint has blocked a bipartisan energy bill that had been moving forward in the Senate. Under the tentative agreement, the Senate would vote on the energy bill before taking up the Flint legislation as a separate bill.
Sen. Gary Peters, D-Mich., said the plan provides $100 million for subsidized loans and grants to any state that declares an emergency due to a public health threat from lead or other contaminants in its public drinking water supply.
"Certainly Flint is an extreme example right now, but there are problems all over the country" with lead in aging pipes, Peters said. "We've got a widespread national problem and there should be resources to help every state in the union."
Peters and other supporters said the deal would use federal credit subsidies to provide incentives for up to $700 million in loan guarantees and other financing for water infrastructure projects nationwide.
The bill would be paid for by redirecting up to $250 million from an Energy Department loan program approved in the 2009 economic stimulus law.
In comments issued after Cruz's hold became known, Michael Brune, executive director of the Sierra Club, the nation's largest environmental organization, said: "Ted Cruz only cares about one thing — and that's Ted Cruz. It's clear that he'll do anything to promote his own political aspirations without any regard for what's right for Flint and communities like Flint across the country."