Category Archives: Human Longevity

I began to write this essay in January 2020, what feels like years ago. The issues I wanted to raise are no longer even partly hidden. The effects of racism on the body, especially the black body, are in plain sight.

Most of these problems have been there for centuries, but are now called pandemics. Pandemics of murder, of disease and of social inequality. In the face of new waves of deaths, including those that precipitated the Black Lives Matter movement, the world is reawakening to the power of racism to kill people.

The Effects of Race Project at the Stellenbosch Institute for Advanced Study started in 2013. The goal of a team of academics was to better understand the everydayness of race and how race-thinking created durable and seemingly inescapable racialised realities in South Africa, the US and elsewhere.

Race thinking the idea that people belong to a race determined mostly by their skin colour has so framed our realities that we can scarcely imagine a world without it.

But race thinking has deformed us and society because its based on constructs of otherness and difference. These, in turn, underpin expectations of character, intelligence, motivation and behaviour. They can pave the way for the unleashing of suspicion, derogation and dehumanisation.

Racism affects health and often leads to early death. We now know in greater and more disturbing detail how this occurs. It kills directly and abruptly when people are murdered by police or vigilantes, but it also kills through disease. COVID-19 is new, but diseases common to the survival zones of the urban poor have been with us for a long time. It was only a century ago that the bone disease rickets was so common among African American children of eastern US cities that it was considered a rite of passage.

More sinister even are the health problems caused by acute and chronic stress on people who are subjected to racial othering and overt racial discrimination. The trauma of humiliation caused by racism creates recurrent stress in individuals, families and wider communities. These stresses manifest in manifold ways, and often transcend generations.

Racism has been described by sociologist Gran Therborn as an existential inequality that diminishes or denies agency and personhood. But racism is also a vital inequality in his classification because it shapes the human life course by determining life expectancy and overall health and well-being.

Racism operates at multiple levels to negatively affect health. Physical violence and rampant infectious diseases are the tip of the iceberg. Institutional racism negatively affects access to health services and healthy lifestyle choices by creating neighbourhoods or districts where people cannot thrive.

And when members of stigmatised racial populations respond to the pervasive negative racial stereotypes by accepting as true the dominant societys beliefs about their biological and cultural inferiority, they can internalise the racism. Internalised racism manifests itself in many ways. It leads to lower self-esteem and psychological well-being.

When people are worried, day in and day out, about their safety, their future, and how they are being perceived by others because of racism, they experience stress and anxiety from recurrent humiliation. These effects are not transient, nor merely psychological.

Its been known for years that the psychological stress attendant with racism has, for example, a significant effect on the development and progression of atherosclerosis, a precursor to serious heart disease. This outcome arose from a lifetime of experience.

But the full weight of psychological and physical damage caused by the chronic stress of racism is only now beginning to be fully understood.

The social context in which a child lives is a powerful predictor of their adult health. It can also affect their genes, in ways that are only now being recognised.

One of the most disturbing set of discoveries in the field of epigenetics is stress can affect the way an individuals genes work, and that some of the stress-related changes can be inherited.

Epigenetics is the study of changes caused by modification of how genes work rather than by altering the genetic code itself. Epigenesis is the transmission of information to new cells during cell division that determines how genes are expressed which genes present are turned on and which are silenced.

Read more: How the dimensions of human inequality affect who and what we are

Studies of epigenetic changes can illustrate the specific biological mechanisms by which social conditions become physically embodied. What we are now understanding is how feedback loops are established by early life stressors causing negative emotions which cause biochemical and physiological changes. These in turn cause changes in behaviour that alter the chemical environment in which genes are being expressed.

The chain of events from genetic modification to behaviour is long and there is no predetermined conclusion, but the mere fact that this can happen is profoundly disturbing. That some of the genetic changes may be inherited is even more so.

When we grasp the reality that human bodies and genes are being constantly remodelled by the physical and social environment and by life experience, the inescapable conclusion is that we must fight the origins of health disparity at their root, in the early social environment and life experiences of every person.

Its incumbent on all governments to recognise the seriousness of epigenetic influences on human well-being, especially in early life. Findings such as these should be used to promote widespread social reforms that fight the larger geographic, sociocultural, economic and political contexts in which health disparities are embedded.

Read more: We need to unpack the word 'race' and find new language

In short, the development of a healthy citizenry depends on people growing up with adequate nutrition, protected from violence, gross insecurity and humiliation, and raised in environments conducive to the development of emotional security. We have known for a long time that poverty, poor nutrition, child abuse, trauma and fear were bad for health.

What epigenetic research offers is the shedding of light on the biological pathways through which such exposures are translated into concrete, measurable, increased risks of various diseases such as bipolar disease, asthma, adverse birth outcomes and the now widely recognised problem of decreased longevity.

Understanding how genes are differentially regulated by experience will affect how we conceptualise social inequalities and health disparities.

Rather than engaging in outdated nature vs nurture debates concerning race as a genetic or social construct, considering race as an epigenomic construct may be the most accurate and appropriate perspective yet.

The real world is the one in which we understand genes and the socially experienced world as perpetually entwined in the human body.

This article is part of a series that has been running for seven months. Other authors include Barney Pityana, Gran Therborn, Njabulo Ndebele, George Chaplin, Kira Erwin and Kathryn Pillay.

The three edited volumes of essays published by African Sun Media in 2018 (The Effects of Race, edited by Nina G. Jablonski and Gerhard Mar), 2019 (Race in Education, edited by Gerhard Mar), and 2020 (Persistence of Race, edited by Nina G. Jablonski) contain the complete representation of the projects scholarship.

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Racism has a physical impact on the body -- here's how - The Conversation CA

The assurance of longevity comes from this. The people who use our facilities will continue to get the best treatment, stated Kindra Mulch, RN, Director of Administrative Services for KCCHSD.

Were ensuring future generations of Kit Carson County residents have access to health care, added Centura Vice President of Integration Josh Neff.

The union became official in mid-January with a two-year contract amid the hopes of continuing the relationship for many years.

Centura Health is the largest health care network in Colorado and Western Kansas. It is a faith-based nonprofit organization formed in 1996 by Adventist Health System and Catholic Health Initiative. Centura Health has 21,000-plus mission-centered professionals sharing the organizations ministry and mission to extend the healing ministry of Christ by caring for those who are ill and by nurturing the health of the people in its communities.

Among the services Centura will provide is helping to vet and employ a permanent CEO for the KCCHSD. Darcy Howard has been CEO in an interim capacity since mid-summer, but has not expressed an interest in the position permanently. Howard has said she will remain onboard as long as the process takes to bring in her replacement.

Centura will also help and advise in a variety of other capacities, including operations, finance, quality, human resources, patient/safety experience, service line development, and additional health care providers including specialists if necessary, while not stepping on the toes of those providers currently working with the district.

Centura has no intent, nor do we have the capability to make sweeping staff changes, Neff stressed. Centura will consult with the board, but make no decision on staff.

These folks have been in the community a while, established patient care. We want to be careful to point out this is not a Centura-or-nothing situation.

There is no ownership change in this agreement. The KCCHSD Board retains all decision-making authority for the district, and Centura does not share in any financial or operational risk.

Also, Centura will have no say in charges administered by the KCCHSD. Howard acknowledged any price decisions are made with the help of a service named Chargemaster and are entirely separate from this union.

In fact, Neff noted that Centura has been working with Governor Jared Polis task force to reduce medical costs in the state.

We understand the cost of health care is expensive too expensive, Neff stated.

In other words, those receiving services from KCCHSD will continue to get the best treatment available, Howard noted.

KCCHSD has always put our patients and our communities first, and the relationship with Centura will not change that. Our patients will continue to maintain the same high-quality interaction with the hospital and our providers, Howard declared. Centura Health has a number of prestigious awards and honors recognizing their outstanding care, quality outcomes and patient satisfaction. We are confident our relationship will serve to help KCCHSD continue to achieve our goals of providing high quality patient care, patient experience and outcomes.

Howard commented that the decision was made to include Centura because, like many rural hospitals, Kit Carson County Memorial Hospital simply needed help to keep its doors open, particularly in the COVID-19 pandemic. While the quality of service has never been affected, maintaining a hospital is anything but cheap.

The rural healthcare landscape is complex and seeing rapid change; moreso now than any time in our history. The industry has seen over 100 independent critical access hospitals in communities just like ours across the country struggle to the point of closing the doors since 2010, with more than 600 rural hospitals vulnerable to closure today, Howard pointed out. The challenges brought on by the COVID-19 pandemic will only increase that for many rural hospitals. Many of the critical access hospitals that are surviving today are partnering with a larger organization or system to give them additional layers of support and help.

Neff added, What we do well is understand the needs of the rural community, Neff stated, adding that Centura is able to translate bigger systems into a local level is key to the success of such a union. He noted that it allows staunchly independent rural hospitals to maintain their independence while maintaining the highest quality of health care.

Stability can be a physical thing and an emotional thing. They are looking for both, Neff continued.

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In a union centered around longevity, Centura Health has joined forces with the Kit Carson County Health Services District (KCCHSD). - Burlington...

THE relentless pursuit of the elixir of youth has spurred anti-ageing research in attempts to achieve the triple goals of life extension, namely, the triumvirate of healthy lifespan, rejuvenation and longevity.

Sirtuins are a family of cellular enzymes that are powered by a chemical compound called nicotinamide adenine dinucleotide (NAD). They play an important role in preventing diseases and even reversing some aspects of ageing.

Studies have shown that increased sirtuin activity in mammals has been associated with a delayed onset of age-related diseases and increased longevity.

Increased sirtuin activity appears to inhibit nerve degeneration and reduces the development of cardiovascular and metabolic diseases (such as diabetes mellitus and abnormal lipid levels).

Hence, if sirtuin activity can be increased using compounds that can boost its activity (STACs or Sirtuin Activating Compounds), the use of STACs can potentially help a person stay healthy longer, even if longevity is not affected.

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Resveratrol

Resveratrol is a natural plant phenol STAC found in the skin of red grapes and other fruits such as blueberries and cranberries. Contrary to common belief, red wine contains very little of it. Resveratrol has been shown to have life-extending properties in studies on lower-order species such as yeast and nematodes, but this effect has marginal reliability in higher-order species. Nevertheless, it has been shown to have potentially beneficial effects.

Before you start taking large doses of resveratrol, you may be surprised to know that it is a Janus-faced compound. Low dietary doses may suffice to elicit the biological responses required to optimise the body's defence mechanisms against incipient disease. But at high doses, it behaves in a contrarian manner.

At low doses, resveratrol induces responses that overlap with the female hormone oestradiol. Low-dose effects seen in animal and human studies include beneficial metabolic effects such as more efficient glucose reduction in diabetics, reducing the development of obesity and non-alcoholic fatty liver disease, protecting against arterial degeneration, delaying development of neurodegeneration, and improving motor and cognitive functions.

At high doses, resveratrol has an anti-oestrogen effect which suggests that it may reduce the risk of oestrogen-dependent cancers. This Janus-faced hormetic effects of resveratrol may partly explain the French paradox, where there is a reduced incidence of cardiovascular diseases and certain types of cancer in some populations despite their consumption of high-fat diets.

NAD

NAD is an important molecule that is essential for over 500 enzyme reactions in the body which impact metabolism, ageing, cell death, DNA repair, and gene expression. Hence, NAD plays a pivotal role in human health span and longevity and is a necessary substrate for sirtuin enzymatic activity.

In mammalian cells, NAD is mainly generated by the conversion of nicotinamide (a soluble form of Vitamin B3) into nicotinamide mononucleotide (NMN) followed by its combination with another molecule to form NAD. There is also another precursor, nicotinamide riboside (NR), that is converted by enzymes to NMN in the cells. As this pathway is safe and also the most efficient route for production of NAD, NMN or NR supplementation has been used to increase NAD levels.

Animal studies have shown that NMN supplementation can ameliorate the age-related reduction in NAD production in cells and improve the body's cardiovascular response to ageing. Age-related decrease in arterial elasticity means that the aorta is less able to expand and buffer the increased blood pressure generated each time the heart pumps. With ageing, the production of a pressure-bearing protein, type 1 collagen, in the arterial wall increases, whereas the main protein responsible for the structural integrity and elastic properties of the arterial wall, elastin, decreases. Studies in mice have shown that NMN supplementation was able to reduce stiffness in large arteries by reversing the accumulation of type 1 collagen in arterial walls and improving elastin content.

From the age of 40 years onwards, there is a gradual decline in perfusion of the body tissues resulting in gradual deterioration in body function towards the last decades of life. A consequence of this is cognitive decline.

Optimal brain function is dependent on adequate oxygen and nutrient delivery via minute brain blood vessels (cerebral microvascular circulation). This modulation of brain blood flow in response to increased brain activity is impaired with age, contributing to age-related cognitive impairment. Studies in aged mice given NMN have demonstrated an improvement in the modulation of cerebral microvascular circulation. Animal studies have also shown that NMN can prevent age-related cognitive decline by reducing cell death in areas of the brain that control short- and long-term memory.

Use of NMN was also associated with decrease in the neurodegenerative changes seen in Alzheimer's disease and age-related retinal changes. This age-related decrease in the production of new vessels and a gradual decrease of blood vessels in the microcirculation also result in reduction in muscle mass and diminishing exercise capacity with age. Mice given NMN were able to demonstrate an increase in the production of new vessels in the muscle and an increase in density of small vessels, thereby improving exercise capacity.

Caloric restriction

Caloric restriction (CR) which involves calorie reduction without causing malnutrition, has been associated with an increase in lifespan in some animal studies. In these studies, dietary CR was associated with increased lifespan and reduced disease incidence, especially cancers. However, some studies did not show benefit and, in some mouse strains, CR was associated with shortened lifespan.

Observational studies on humans who have practised extreme CR over many years showed low levels of risk factors for cardiovascular disease and diabetes.

Similarly, a human study on CR, the CALERIE study, found that CR participants had lower blood pressure and lower cholesterol.

The study was too short to examine the impact of CR on lifespan. The current conclusion from the National Institute of Aging in the United States is that there is not enough evidence to recommend CR as a therapeutic measure for life extension. Although CR was associated with lower risk factors for cardiovascular diseases and diabetes, caution is urged as in a study using mouse lemurs on prolonged CR, MRI studies showed that there was more widespread age-related grey matter atrophy in CR animals while only a few regions in the brain showed atrophy in those not on CR.

Life extension

Globally, heart disease and stroke are the two main causes of death in most high-middle and high-income countries. Hence, the first cardinal principle in life extension is to control the risk factors such as blood pressure elevation, cholesterol elevation, sugar elevation and smoking.

The second principle is to have a healthy lifestyle such as keeping the weight within the healthy range and exercising regularly. Both physical exercise and dietary CR result in a significant increase in NAD production and increase sirtuin activity. CR may be an option as part of a weight-reduction regime to keep the weight optimal.

The third principle is to see your doctor regularly to control risk factors.

Finally, among the supplement options, scientific studies favour the use of low-dose resveratrol or NMN as they may potentially provide many health benefits via increased sirtuin activity, although more studies will be required to understand their efficacy in human life extension.

Read more:
Life extension health, rejuvenation and longevity - The Business Times

President Joe Biden announced on Wednesday night that he plans to issue a regulatory freeze on many of former President Donald Trump's last-minute new or pending rules.

The freeze is likely to affect a variety of much-publicized U.S. Department of Health and Human Services rulemakings including proposed major HIPAA Privacy Rule changes, mandated regulatory reviews and efforts to streamline interoperability and prior authorization.

The Biden administration also announced a flurry of new HHS and other health-related hires, heralding a major overhaul for the agency.

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WHY IT MATTERS

Trump's HHS enacted several rules after the former president lost the 2020 election, raising questions even at the time of their longevity.

Biden's freeze will hit pause on several of them, at least for the time being.

According to a memo sent last night, the heads of executive departments and agencies are to propose or issue no rule in any manner until a Biden-appointed department head reviews and approves it.

The memo also directs decision-makers to withdraw any rule sent to the Office of the Federal Register but not published, which would appear to apply to a recently finalized prior authorization and interoperability rule.

With respect to rules that have been published but have yet to take effect, such as the mandated once-a-decade regulatory reviews and proposed HIPAA changes, the Biden memo directs leaders to "consider postponing the rules' effective dates for 60 days" and "consider opening a 30-day comment period," as well as implementing additional delays if necessary.

This section appears to apply to last-minute rules that would rescind the U.S. Food and Drug Authority's ability to regulate a number of medical devices.

The memo came amid several high-profile agency hires also announced on Inauguration Day.

These include the appointment of Micky Tripathi as the new National Coordinator for Health IT.

Elizabeth Richter will serve as acting administrator for the Centers for Medicare and Medicaid Services, pending Senate confirmation of a permanent administrator.

Norris Cochran will serve as acting HHS secretary pending Biden Nominee Xavier Becerra's Senate approval.

Perryn Ashmore, who was appointed as acting HHS chief information officer in September 2020, looks to be continuing in that role for now.

Other hires include Sean McCluskie as HHS chief of staff,Topher Spiro as head of health programs at the Office of Management and Budget,and Sarah Despres as a counselor to new HHS Secretary Xavier Becerra.

According to PoliticoPro, Anne Reid will be HHS deputy chief of staff,Lisa Barclay and Paul Rodriguez will be deputy general counsels,Josh Peck will be deputy assistant secretary for public engagement,and Kristin Avery will be White House liaison.

THE LARGER TREND

All eyes are on Biden's health policy moves as he takes office specifically, his plans to roll out a COVID-19 vaccine.

The rollout under Trump's administration faced several logistical and infrastructure hurdles, with states left to their own devices to schedule and allocate vaccines.

It remains to be seen whether Biden can right the ship.

ON THE RECORD

"We are in a race against time, and absent additional government assistance, the economic and public health crises could worsen in the months ahead; schools will not be able to safely reopen; and vaccinations will remain far too slow," said Biden in the COVID-19 relief package published to his website this past week.

Kat Jercich is senior editor of Healthcare IT News.Twitter: @kjercichEmail: kjercich@himss.orgHealthcare IT News is a HIMSS Media publication.

The rest is here:
Biden plans regulatory freeze amid flurry of health hires - Healthcare IT News

The pandemic has forced many people to rethink how they lead their lives. Research by Cambridge Weight Plan has found that more than two thirds of the public (68 percent) will be switching up their diet in 2021. Knowing how to maximise the health benefits of your dietary decisions can be challenging, however.

As Gilbert explains, type-2 diabetes is "virtually absent" in those who restrict calories and follow a low-calorie diet such as the 1:1 Diet.

In fact, the 1:1 Diet has been shown to reverse diabetes in those who undertake it, as long it is sufficiently nutritious, Gilbert says.

The Cambridge 1:1 diet is a VLCD (Very low-calorie diet) meal replacement diet in which 415 to 1500 calories are consumed daily through a combination of meal replacement bars, smoothies, shakes and soups.

Extensive evidence points to the benefits of following a low-calorie diet.

One study published in Cell Metabolism journal this month concluded that cutting calorie intake by 15 percent over two years can slow ageing and protect against diseases such as cancer, diabetes, and Alzheimers.

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Vitamin D, otherwise known as the sunshine vitamin, is obtained through direct exposure to sun, although supplements are usually required to top up the vitamin in winter time.

"Vitamin D is intimately involved in immunity, protecting us particularly by helping our T cell immune response," Gilbert explains.

Studies have shown that vitamin D levels in the body are inversely related to the risk of death.

According to a large review study, low vitamin D levels have been linked to all-cause, cardiovascular, cancer and infectious-related mortality.

Gilbert explains: Berries have a number of health advantages and have been shown to improve heart health, reduce incidence and risk of cancer and diabetes, and to reduce blood pressure.

According to Gilbert, adding berries to a sugary meal can slow and reduce the appearance of blood sugar (glucose) in your blood.

"In turn this assists blood flow by helping your blood vessels dilate but also reduce the 'stickiness' of your blood, preventing inflammation and build-up of cholesterol," he says.

Cholesterol is a waxy substance that raises your risk of heart disease.

Test-tube and human studies suggest that they berries protect your cells from high blood sugar levels, help increase insulin sensitivity, and reduce blood sugar and insulin response to high-carb meals.

"Those who drink green tea seem to be protected from the dreaded all-cause mortality (death from any cause), even when researchers control for other behaviours," explains Gilbert.

This should raise few eyebrows. As Gilbert points out, green tea consumption protects DNA, helps with blood sugar control and may help prevent diabetes, decreases blood pressure and reduces arterial plaque.

According to a review of seven studies with a total of 286,701 individuals, tea drinkers had an 18 percent lower risk of diabetes.

See more here:
How to live longer: Four simple dietary decisions that are proven to boost longevity - Express

There is little chance that anyone in Maryland or anywhere will hold power as long as the late Thomas V. Mike Miller Jr., the former president of the state Senate who died on Friday.

A one-term delegate who won a Senate seat in 1974, Miller ruled the chamber from 1987 to 2019, a tenure widely believed to be the longest in American history.

In a series of interviews conducted byMaryland Matters over the last 18 months, those who served alongside Miller described a complex man of extraordinary talent who had a deep, authentic love for the state and its institutions, particularly the Maryland Senate.

He was a fervent Democrat who believed that government had a role to play in helping those with fewer advantages achieve success, who also understood that the pace of change had to be calibrated to suit a state that is home to both very liberal and very conservative voters.

A gregarious backslapper with a big laugh, Miller dominated large rooms and small. He was a history buff, loyal, true to his word, and a passionate advocate for public education and the Chesapeake Bay. He steered the Senate through recessions, tense policy debates and all manner of crises.

While members of his chamber occasionally got entangled in legal wrongdoing, Miller (to borrow former Virginia Rep. Tom Davis favorite phrase) left office undefeated and un-indicted.

And while the public view of him was as the presiding officer of the Senate, much of the influence he exerted on the states political eco-system occurred off-stage encouraging some candidates to run and connecting them with support, and discouraging others.

Miller was a very loyal, real Democrat, said U.S. House Majority Leader Steny H. Hoyer (D-Md.) in a 2020 interview.

He (was) a more conservative Democrat than some others, but he did not allow that to impede his support for items central to what he believed the Democrat ethos was in terms of helping people whether it be education, health care, social issues.

Although Miller insisted on decorum in the Senate chamber, he was a larger-than-life presence around the State House. Behind closed doors, he deployed a broad mix of skills.His language was often salty.

I never worked with [former president Lyndon Baines Johnson], but I did work with Mike Miller, said former Gov. Martin J. OMalley (D). He was capable of the full range of human emotion and persuasive skills and tactics.

He could be overbearing, hard-charging and threatening in one instant, and he could be kind and listening and compassionate in the next moment. He was not a one-dimensional person by any means, OMalley added. He understood that progress in the public arena is about the art of accomplishing the possible in the moment. That requires persuasion. It requires compromise.

He didnt always win. And sometimes his tactics backfired and caused people to dig in their heels. But in the longer run, weve never had a more successful Senate presidency than his.

Miller: Times change, but people dont

Although there were coup attempts, as colleagues chafed at his longevity, they never got far.

Those who worked closely with Miller said the key to his epic tenure was his uncanny ability to adapt to changing times.

During his 33-year run as the upper chambers presiding officer, Maryland become more diverse racially and more liberal politically, and women began to rise through the ranks.

A history buff who was deeply involved in national legislative organizations, Miller tracked political and policy trend-lines closely. He knew that to stay atop the heap, he had to repositionhimself after every election and sometimes more often than that.

His one major political stumble occurred in 1989, when he told a Washington, D.C., TV reporter in Baltimore that the city was a goddamn ghetto.

He quickly claimed that he used the phrase to show his constituents how dire conditions in the city were. But the damage was done: Any aspirations Miller had for statewide office were extinguished. But his power in Annapolis was never diminished.

In his last in-depth interview, Miller told Maryland Matters in December that his ability to find the new center of the Democratic caucus was the key to his longevity.

I would say [that was] 90% of it, quite frankly. Honestly and truly. I knew where the Senate had been, I knew where the Senate was now, and I could predict where the Senate was going, the lawmaker said.

Times change, but people dont, he added. They make the same mistakes over and over again. And I was determined not to do that. And at the same time recognizing where the demographics of the state are going to take us. Recognizing that the House and Senate need to adjust to accommodate the changing demographics.

U.S. Sen. Chris Van Hollen (D) recalled that when he was running against state Sen. Patricia Sher (D) in the 1994 primary, he received a call from Miller, 10 days before the election, inviting him to breakfast. The call was a surprise, because Miller was backing Sher.

The two met at a posh country club in Montgomery County.

He said, Youre gonna win, Van Hollen said.

Miller asked Van Hollen, then a member of the House of Delegates, what committee assignment he wanted. Budget and Taxation, Van Hollen replied. Done, Miller responded.

The heart of Mikes success, and the fact that he has made such a difference in the history of our state, is his instinctive, tactile sense of politics and where the center of gravity is, and what direction its moving in, Van Hollen asserted.

And his ability to adapt.

In 1996, Van Hollen and another liberal lawmaker, Sen. Paul G. Pinsky (D-Prince Georges), who were first-term senators at the time, nearly derailed a high-profile Miller priority, to bring two new football stadiums to Maryland, in Baltimore and Landover.

Miller was furious, and the back-benchers fell one vote short. But Miller eventually appointed to both to leadership positions.

While Miller is best known for the 33 years he guided the state Senate through its annual 90-day sessions, he also wielded extraordinary power in encouraging candidates up and down the political ladder throughout the state.

Former Prince Georges County Executive Rushern L. Baker III (D) recalled being aghast that he had to get Millers blessing if he hoped to be successful.

And when Baker became chairman of the countys House delegation, the two clashed over a zoning measure Miller was eager to advance.

After the dust-up blew over, Baker came to appreciate Millers skills and the two became close allies.

Once he put his imprimatur on you, you instantly got it didnt mean you were going to win but it meant that you got access to people who could help you, Baker said.

You had access to people with money. You had access to other politicians who would start meeting with you, which is what happened with me. You had access to community groups. You had access to congressmen.

A former two-term county executive, Baker said he frequently leaned on his relationship with and the lessons he learned from Miller.

There is not a single thing I did as county executive that was important and significant that I did not ask his help. And it was given unconditionally. Even if he didnt agree with it and there was a lot that I did that he thought was nuts, Baker recalled with a laugh.

Miller vs. Glendening

Former Gov. Parris N. Glendening (D) rose through the ranks of Prince Georges politics in the 1970s, just as Miller did. But the two were polar opposites.

Glendening was a liberal college professor, bookish and a newcomer to Maryland; Miller was more conservative, more social, and an old-school pol.

In 1974, when he was running for the County Council, Glendening said he was stunned, on election night, when he got more votes in Millers backyard, the southern part of Prince Georges, than he did in the precincts where he was more well-known.

The Miller machine had delivered.

It was a phenomenal demonstration from a political science perspective of how it worked, Glendening said. And it worked in part because people like Mike Miller ran his district.

I was teaching urban politics at the time I was talking [to my students] about urban machines! the former governor added, still amazed by that nights outcome. But I never had actually been involved and saw how smoothly it works.

Despite all the ups and downs, the Maryland Senate, the state of Maryland and the [state] Democratic Party are better off today because Mike Miller devoted his whole life to being president of the Maryland Senate, Glendening added. I feel very strongly about that.

Glendening became governor in 1995, and there was a widespread expectation that the two would clash, because they often did in Prince Georges County.

Miller had made rude comments about Glendening in the media and the pair were not close. Glendenings insistence that he and not the political machine run by Peter OMalley would choose his department heads in Upper Marlboro, had upset the prevailing order.

But the governor said he had a secret weapon once he got to Annapolis his director of legislative affairs, Joseph C. Bryce, who had served as Millers chief of staff. Bryces advice was simple: Attach any policy initiative to one of Millers three loves the state of Maryland, the state Senate or the Democratic Party.

The strategy worked and the expected ill will rarely materialized.

What has saved him from becoming his own worst enemy at times is that he has been so effective, Glendening said. And even if you dont like him, and even if youre the focus of some of his explosiveness and comments and all, as I have been, you still have to take one step back and say wow, he is effective.

A man of his word

Baker, Glendening and others said that when Miller gave his word on something, you could take it to the bank.

The thing I like about Miller is when he said yes, it was real yes, said Baker. It wasnt yes and good luck. You didnt have to check his pulse. It didnt matter how many enemy were coming over [the wall], he was there.

He was going to berate you. He was going to beat you up. He was going to test your commitment to this crazy idea that you had, Baker added. But he wasnt going to abandon you. He would yell at me in ways I just found so offensive, for a grown man with three children and a law degree, but I never felt abandoned.

Baker said Miller was particularly tough on him when he sought reforms in the countys education system.

He would say youre weak, youre a sorry leader. Itll never get done. You asked for this crazy s and I told you not to do it and you did it anyway. So youre going to be fed and all this stuff. And then at the end, hed pat you on the back and say, well make it happen. Dont worry, Baker, were gonna make it happen. And hed walk out!

Hoyer, whose rise through Maryland politics coincided with Millers, said the late Senate president got his outspokenness from his mother, Esther Miller. He gets great values [from his mother] a deep sense of duty and empathy for people that sometimes is hard to find or you wouldnt think that that would be part of his personality, because of his gruffness.

Mike is very smart. Very tough. Very candid. He can be vulgar at times, ribald at times, Hoyer added. He can be very gruff, as you know. And also very funny. But also biting. But again, all of that is on the surface. And underneath is this really deep sense of fairness and of wanting to make sure that people have a shot in life and have help in life.

Several times during his epic tenure, Miller allowed legislation that he opposed personally to come to the floor. Measures allowing an abortion-rights referendum, a gay marriage referendum and the death penalty repeal were the most prominent.

Those who worked with him say his unwillingness to shelve policy that has ripe was primary to his long hold on power.

Mike is always 10 steps ahead of everybody else, Van Hollen said last year.

Here you have a Senate president from Southern Maryland a relatively conservative part of our state who has presided over a state that is one of the most progressive in the country. And that is really a testament to his both political sense but also his historical sense of where were heading, Van Hollen said.

We have a way of turning our leaders into cartoons, said OMalley. But Mike Miller was not a cartoon. He was a guy with an appreciation of history, a love of our state, an understanding of human nature, and the capacity to be tough when he needed to be tough and to be understanding and listening and accommodating when that was what the mission called for.

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'He Was Capable of the Full Range of Human Emotion and Persuasive Skills and Tactics' Maryland Matters - Josh Kurtz