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BACKGROUND: This study investigated the role of key individual- and community-level determinants to explore persisting racial/ethnic disparities in breast cancer stage at diagnosis in California during 1990 and 2000. METHODS: We examined socio-demographic determinants and changes in breast cancer stage at diagnosis in California during 1990 and 2000. In situ, local, regional, and distant diagnoses were examined by individual (age, race/ethnicity, and marital status) and community (income and education by zip code) characteristics. Community variables were constructed using the California Cancer Registry 1990-2000 and the 1990 and 2000 U.S. Census. RESULTS: From 1990 to 2000, there was an overall increase in the percent of in situ diagnoses and a significant decrease in regional and distant diagnoses. Among white and Asian/Pacific Islander women, a significant percent increase was observed for in situ diagnoses, and significant decreases in regional and distant diagnoses. Black women had a significant decrease in distant -stage diagnoses, and Hispanic women showed no significant changes in any diagnosis during this time period. The percent increase of in situ cases diagnosed between 1990 and 2000 was observed even among zip codes with low income and education levels. We also found a significant percent decrease in distant cases for the quartiles with the most poverty and least education. CONCLUSIONS: Hispanic women showed the least improvement in breast cancer stage at diagnosis from 1990 to 2000. Breast cancer screening and education programs that target under-served communities, such as the rapidly growing Hispanic population, are needed in California.

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To determine the extent to which DoD carried out the original scope of work for the National Geospatial-Intelligence Agency's (NGA) Technology Center and whether the building it constructed constitutes a complete and usable facility, we reviewed budget and project documents and interviewed officials from NGA, the Army, and the Office of the Secretary of Defense. In particular, we focused our information-gathering efforts on NGA's identified need for data-storage capability, the original scope of work for the NGA Technology Center, and the final status of that construction project as of September 2011, the end of the BRAC 2005 implementation period. We also identified guidance, directives, and policies that govern the process for BRAC military construction projects and compared the process used for the NGA project to the procedures outlined in those documents. To identify the scope of work for the proposed new military construction project to fit out the third floor of the NGA Technology Center, and DoD's rationale for this project, we reviewed budget and project documents and interviewed officials from NGA, the Department of the Army BRAC Office, the Army Corps of Engineers, and the Office of the Secretary of Defense about NGA's identified need for data-storage capability and the scope of work for the new military construction project.

Congressional interest in the security of offshore energy infrastructure has increased because of the lives lost and the substantial damages that resulted from the Deepwater Horizon incident in April 2010. The U.S. Coast Guard -- a component of the Department of Homeland Security (DHS) -- is the lead federal agency for maritime security, including the security of offshore energy infrastructure. The Coast Guard oversees two main types of offshore energy infrastructure: facilities on the Outer Continental Shelf (OCS) and deepwater ports. GAO was asked to examine the following: (1) Coast Guard actions to ensure the security of OCS facilities and what additional actions, if any, are needed; (2) Coast Guard actions to ensure the security of deepwater ports and what additional actions, if any, are needed; and (3) what limitations in oversight authority, if any, the Coast Guard faces in ensuring the security of offshore energy infrastructure. GAO reviewed Coast Guard documents, such as inspection records, and relevant laws and regulations and interviewed Coast Guard inspectors and officials, including those at Coast Guard headquarters and the two Coast Guard districts that oversee all OCS facilities and deepwater ports that are subject to security requirements. GAO recommends that the Coast Guard develop policies or guidance to ensure that annual security inspections are conducted at OCS facilities, and that information entered into its database for both OCS facilities and deepwater ports is more useful for management. DHS and the Coast Guard concurred with these recommendations., Report to Congressional Requesters.

The nation's economy and security are heavily dependent on oil, gas, and other energy commodities. Nearly half of the nation's oil is natural transported from overseas by tankers. For example, about 49 percent of the nation's crude oil supply-one of the main sources of gasoline, jet fuel, heating oil, and many other petroleum products-was transported by tanker into the United States in 2009.11 The remaining oil and natural gas used in the United States comes from Canada by pipeline or is produced from domestic sources in areas such as offshore facilities in the Gulf of Mexico. With regard to these domestic sources, the area of federal jurisdiction-called the Outer Continental Shelf (OCS)12-contains an estimated 85 million barrels of oil, more than all onshore resources and those in shallower state waters combined.13 In addition, the Louisiana Offshore Oil Port (LOOP), a deepwater port, is responsible for transporting about 10 percent of imported oil into the United States.

Before the passage of federal environmental legislation in the 1970s and 1980s, Department of Defense (DoD) activities contaminated millions of acres of soil and water on and near DoD sites. The Environmental Protection Agency (EPA) has certain oversight authorities for cleaning up contaminants on federal property, and has placed 1,620 of the most contaminated sites -- including 141 DoD installations -- on its National Priorities List (NPL). As of February 2009, after 10 or more years on the NPL, 11 DoD installations had not signed the required interagency agreements (IAG) to guide cleanup with EPA. GAO was asked to examine the following: (1) the status of DoD cleanup of hazardous substances at selected installations that lacked IAGs; and (2) obstacles, if any, to cleanup at these installations. GAO selected and visited three installations, reviewed relevant statutes and agency documents, and interviewed agency officials. GAO is recommending, among other things, that EPA and DoD identify options that would provide a uniform method for reporting cleanup progress at the installations and allow for transparency to Congress and the public. EPA and DoD agreed with the recommendations directed at them. GAO is also suggesting that Congress may want to consider giving EPA certain tools to enforce CERCLA at federal facilities without IAGs. DoD disagreed with this suggestion. GAO believes that EPA needs additional authority to ensure timely and proper cleanup at such sites., Report to Congressional Requesters.

The Department of Defense (DOD) established the military munitions response program (MMRP) in 2001 to clean up sites known to be or suspected of being contaminated with military munitions and related hazardous substances. Cleanup of sites on active and base realignment and closure installations is the responsibility of the military service?Air Force, Army, Navy, or Marine Corps?that currently controls the land, and the Army has delegated execution of cleanup of formerly used defense sites (FUDS) to the U.S. Army Corps of Engineers (Corps). GAO was mandated to assess the (1) MMRP staffing and funding levels; (2) progress DOD has made in cleaning up munitions response sites; (3) extent to which DOD has established MMRP performance goals; and (4) extent to which DOD collects data on factors influencing project duration, as well as the accuracy of its cleanup cost estimates. GAO analyzed MMRP data and DOD documents and interviewed officials from DOD, the military services, and the Corps.

Under DERP, DOD is required to carry out a program of environmental restoration activities at sites located on former and active defense installations that were contaminated while under DODs jurisdiction. The goals of the program include the identification, investigation, research and development, and cleanup of contamination from hazardous substances, pollutants, and contaminants; the correction of other environmental damage (such as detection and disposal of unexploded ordnance) which creates an imminent and substantial endangerment to public health or welfare or the environment; and demolition and removal of unsafe buildings and structures. To that end, DOD has established performance measures and goals and identified over 31,600 sites that are eligible for cleanup, including about 4,700 FUDS, 21,500 sites on active installations, and 5,400 sites on installations that have been closed or are designated to be closed or realigned under the Base Realignment and Closure (BRAC)Under DERP, DOD is required to carry out a program of environmental restoration activities at sites located on former and active defense installations that were contaminated while under DOD's jurisdiction. The goals of the program include the identification, investigation, research and development, and cleanup of contamination from hazardous substances, pollutants, and contaminants; the correction of other environmental damage (such as detection and disposal of unexploded ordnance) which creates an imminent and substantial endangerment to public health or welfare or the environment; and demolition and removal of unsafe buildings and structures. To that end, DOD has established performance measures and goals and identified over 31,600 sites that are eligible for cleanup, including about 4,700 FUDS, 21,500 sites on active installations, and 5,400 sites on installations that have been closed or are designated to be closed or realigned under the Base Realignment and Closure (BRAC)a process.