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"content": "\u003cp>Budget woes at UC Berkeley could force the shut down of a program many people are unaware of -- its medical program.\u003c/p>\n\u003cp>The Joint Medical Program (JMP), part of Berkeley's School of Public Health, is small. Just 16 students a year are admitted. Under a \u003ca href=\"http://budget.berkeley.edu/budgetprocess\" target=\"_blank\">budget restructuring\u003c/a> process\u003ca href=\"http://ww2.kqed.org/news/2016/02/10/uc-berkeley-chancellor-says-big-deficit-will-lead-to-painful-changes\" target=\"_blank\"> initiated in February\u003c/a> by Berkeley's Chancellor Nicholas Dirks, the School of Public Health must cut expenses by roughly three percent -- or about $900,000.\u003c/p>\n\u003cp>One of the items on the list to meet that target is closure of the JMP. Losing 16 new doctors a year may not sound dramatic, but this particular population is unusual in medicine. While most medical students head into lucrative specialties, the majority of JMP graduates go into primary care.\u003c/p>\n\u003cp>John Balmes, acting director of the program, says California needs these doctors. \"(California) is 43rd in the nation in terms of primary care physicians,\" he said, \"and with the Affordable Care Act increasing the number of insured Californians, we need more primary care physicians, not less.\"\u003c/p>\n\u003cp>In 2014, just \u003ca href=\"http://www.theatlantic.com/health/archive/2014/09/why-im-becoming-a-primary-care-doctor/379231/\" target=\"_blank\">12 percent of medical students\u003c/a> nationally went into primary care residencies. The JMP was above\u003ca href=\"http://sph.berkeley.edu/jmp/residency-matches\" target=\"_blank\"> 50 percent\u003c/a> 1997-2014. It's unclear exactly why so many students go into primary care. One clue lies in the program's unusual approach to curriculum.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The program, established in 1971, prides itself on avoiding lecture halls and instead focusing on what it calls \"problem-based learning,\" where students review cases as a group. In addition, the medical program is one of few nationally, says second-year student Josh Pepper, that is housed within a school of public health, and that gives a broader focus to patients' lives.\u003c/p>\n\u003cp>\"We're constantly having to question how things like socio-economic status, insurance, housing and culture and addiction play a role in patients' health outcomes,\" Pepper said.\u003c/p>\n\u003cp>It gives a more holistic perspective, he said. \"We develop a whole skill set you don't normally get at a traditional medical school.\" Pepper has helped launch an \u003ca href=\"http://www.ipetitions.com/petition/savethejmp\" target=\"_blank\">online petition\u003c/a> in support of the program.\u003c/p>\n\u003cp>It's called a joint medical program because students do three years at Berkeley's School of Public Health, during which they complete an original research project and the first two years of medical school curriculum. They then head to UC San Francisco for two years of clinical rotation. They graduate with a master's in science from Cal and an M.D. from UCSF.\u003c/p>\n\u003cp>A \u003ca href=\"http://www.cpca.org/cpca2013/assets/File/Policy-and-Advocacy/Health%20Care%20Reform/2016-02-01-Horizon2030-PR.pdf\" target=\"_blank\">report earlier this year\u003c/a> commissioned by the California Primary Care Association detailed the shortfall in primary care providers in California. The state's ratio of primary care physicians in its Medicaid program, called Medi-Cal, is roughly half the federal recommendation, it said. By 2030, the analysis predicted a shortage of more than 8,000 primary care doctors.\u003c/p>\n\u003cp>Carmela Castellano-Garcia is the association's president and bemoaned the possible closure of Cal's medical program.\u003c/p>\n\u003cp>[contextly_sidebar id=\"KH05iLE8gCziGB39qVZNvU5QcFzHysTq\"]\"Certainly with the shortage we are facing, we should not eliminate any existing programs that we know have successful track records into funneling people into primary care,\" she said. \"We cannot afford that at this time.\"\u003c/p>\n\u003cp>All of Cal's professional schools, including the School of Public Health, must trim expenses by the same rate, said Dan Mogulof, a spokesman for the university, and it's up to the schools themselves to determine how to meet the target.\u003c/p>\n\u003cp>Linda Anderberg, director of communications for the School of Public Health, said it is considering several options to achieve the budget cuts. \"The school does not want to lose the (medical) program,\" she said.\u003c/p>\n\u003cp>She stressed that no decisions have been made and that the process would be completed during the summer. Most of the cuts would not go into effect until 2018, she said.\u003c/p>\n\u003cp>Meanwhile, staff and students are speaking out to try to save the program.\u003c/p>\n\u003cp>\"If I had to go to medical school all over again, I'd want to do it in the Joint Medical Program,\" said acting director Balmes. He said there's an advantage to being in a small, supportive environment.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"I think that translates into very fine doctors, because they're good human beings as well as good doctors,\" he said.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Budget woes at UC Berkeley could force the shut down of a program many people are unaware of -- its medical program.\u003c/p>\n\u003cp>The Joint Medical Program (JMP), part of Berkeley's School of Public Health, is small. Just 16 students a year are admitted. Under a \u003ca href=\"http://budget.berkeley.edu/budgetprocess\" target=\"_blank\">budget restructuring\u003c/a> process\u003ca href=\"http://ww2.kqed.org/news/2016/02/10/uc-berkeley-chancellor-says-big-deficit-will-lead-to-painful-changes\" target=\"_blank\"> initiated in February\u003c/a> by Berkeley's Chancellor Nicholas Dirks, the School of Public Health must cut expenses by roughly three percent -- or about $900,000.\u003c/p>\n\u003cp>One of the items on the list to meet that target is closure of the JMP. Losing 16 new doctors a year may not sound dramatic, but this particular population is unusual in medicine. While most medical students head into lucrative specialties, the majority of JMP graduates go into primary care.\u003c/p>\n\u003cp>John Balmes, acting director of the program, says California needs these doctors. \"(California) is 43rd in the nation in terms of primary care physicians,\" he said, \"and with the Affordable Care Act increasing the number of insured Californians, we need more primary care physicians, not less.\"\u003c/p>\n\u003cp>In 2014, just \u003ca href=\"http://www.theatlantic.com/health/archive/2014/09/why-im-becoming-a-primary-care-doctor/379231/\" target=\"_blank\">12 percent of medical students\u003c/a> nationally went into primary care residencies. The JMP was above\u003ca href=\"http://sph.berkeley.edu/jmp/residency-matches\" target=\"_blank\"> 50 percent\u003c/a> 1997-2014. It's unclear exactly why so many students go into primary care. One clue lies in the program's unusual approach to curriculum.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The program, established in 1971, prides itself on avoiding lecture halls and instead focusing on what it calls \"problem-based learning,\" where students review cases as a group. In addition, the medical program is one of few nationally, says second-year student Josh Pepper, that is housed within a school of public health, and that gives a broader focus to patients' lives.\u003c/p>\n\u003cp>\"We're constantly having to question how things like socio-economic status, insurance, housing and culture and addiction play a role in patients' health outcomes,\" Pepper said.\u003c/p>\n\u003cp>It gives a more holistic perspective, he said. \"We develop a whole skill set you don't normally get at a traditional medical school.\" Pepper has helped launch an \u003ca href=\"http://www.ipetitions.com/petition/savethejmp\" target=\"_blank\">online petition\u003c/a> in support of the program.\u003c/p>\n\u003cp>It's called a joint medical program because students do three years at Berkeley's School of Public Health, during which they complete an original research project and the first two years of medical school curriculum. They then head to UC San Francisco for two years of clinical rotation. They graduate with a master's in science from Cal and an M.D. from UCSF.\u003c/p>\n\u003cp>A \u003ca href=\"http://www.cpca.org/cpca2013/assets/File/Policy-and-Advocacy/Health%20Care%20Reform/2016-02-01-Horizon2030-PR.pdf\" target=\"_blank\">report earlier this year\u003c/a> commissioned by the California Primary Care Association detailed the shortfall in primary care providers in California. The state's ratio of primary care physicians in its Medicaid program, called Medi-Cal, is roughly half the federal recommendation, it said. By 2030, the analysis predicted a shortage of more than 8,000 primary care doctors.\u003c/p>\n\u003cp>Carmela Castellano-Garcia is the association's president and bemoaned the possible closure of Cal's medical program.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>\"Certainly with the shortage we are facing, we should not eliminate any existing programs that we know have successful track records into funneling people into primary care,\" she said. \"We cannot afford that at this time.\"\u003c/p>\n\u003cp>All of Cal's professional schools, including the School of Public Health, must trim expenses by the same rate, said Dan Mogulof, a spokesman for the university, and it's up to the schools themselves to determine how to meet the target.\u003c/p>\n\u003cp>Linda Anderberg, director of communications for the School of Public Health, said it is considering several options to achieve the budget cuts. \"The school does not want to lose the (medical) program,\" she said.\u003c/p>\n\u003cp>She stressed that no decisions have been made and that the process would be completed during the summer. Most of the cuts would not go into effect until 2018, she said.\u003c/p>\n\u003cp>Meanwhile, staff and students are speaking out to try to save the program.\u003c/p>\n\u003cp>\"If I had to go to medical school all over again, I'd want to do it in the Joint Medical Program,\" said acting director Balmes. He said there's an advantage to being in a small, supportive environment.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"I think that translates into very fine doctors, because they're good human beings as well as good doctors,\" he said.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Life Expectancy Down for White Women, Up for Black Men",
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"content": "\u003cp>For the first time since the U.S. government began keeping records, the life expectancy for white women has declined, according to a \u003ca href=\"http://www.cdc.gov/nchs/products/databriefs/db244.htm\" target=\"_blank\">report\u003c/a> from the Centers for Disease Control and Prevention's National Center for Health Statistics. The decline is slight -- from 81.2 to 81.1 years -- but worrisome.\u003c/p>\n\u003cp>While the report did not include causes of death, \u003ca href=\"http://www.npr.org/sections/health-shots/2016/04/20/474884894/life-expectancy-drops-for-white-women-increases-for-black-men\" target=\"_blank\">NPR reports\u003c/a> that the author of the analysis, Elizabeth Arias, looked deeper and examined causes of death for white people over the last 15 years.\u003c/p>\n\u003cp>\"For the age group 25 to 54, suicide went up,\" she told reporter Alison Kodjak. \"'Unintentional poisonings,' which is mainly alcohol and drug poisoning, and chronic liver disease -- those went up by quite a bit.\"\u003c/p>\n\u003cp>The report was drawn from all deaths recorded in the U.S. in 2014. Life expectancy for whites overall dropped to 78.8 years in 2014 from 78.9 in 2013.\u003c/p>\n\u003cp>The\u003ca href=\"http://www.nytimes.com/2016/04/20/health/life-expectancy-decline-mortality.html?_r=0\" target=\"_blank\"> New York Times\u003c/a> details that life expectancy for whites had been going up for decades but \u003ca href=\"http://www.nytimes.com/2015/10/28/health/death-rates-declining-for-decades-have-flattened-study-finds.html\" target=\"_blank\">stagnated more recently\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>It inched up in 2010 and 2011, and was flat in 2012 and 2013.\u003c/p>\n\u003cp>Recent research has documented surprising increases in death rates among less educated whites. Last year, a paper by Anne Case and Angus Deaton \u003ca href=\"http://www.pnas.org/content/112/49/15078\" target=\"_blank\">documented rising death rates among middle-age white Americans\u003c/a>, particularly those with no more than a high school education.\u003ca href=\"http://www.nytimes.com/2016/01/17/science/drug-overdoses-propel-rise-in-mortality-rates-of-young-whites.html\" target=\"_blank\"> Other research\u003c/a> has found rising rates among younger whites.\u003c/p>\n\u003cp>The pattern had puzzled demographers, but the recent analyses have pointed to suffering and anxiety among working-class whites.\u003c/p>\u003c/blockquote>\n\u003cp>(For a powerful look at one tragedy, read \u003ca href=\"http://www.washingtonpost.com/sf/national/2016/04/08/we-dont-know-why-it-came-to-this/\" target=\"_blank\">this Washington Post story\u003c/a> of the death of one 54-year-old woman in Tecumseh, Oklahoma.)\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>These structural conditions also affect men, but their overall life expectancy was unchanged.\u003c/p>\n\u003cp>While the news for whites is gloomy, other groups saw increases. Black men, in particular, had a relatively large gain in life expectancy of about six months, from 71.8 to 72.2 years (for blacks overall the rise was 75.1 to 75.2 years). Hispanic men and women both gained, from 81.6 to 81.8 years between 2013 and 2014.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"The gap between the white and black populations is quickly closing, and it's mainly because the black population is experiencing a great drop in mortality,\" \u003ca href=\"https://www.washingtonpost.com/news/to-your-health/wp/2016/04/20/cdc-life-expectancy-for-non-hispanic-white-women-dips-for-first-time-in-decades/\" target=\"_blank\">Arias told the Washington Post\u003c/a>.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>For the first time since the U.S. government began keeping records, the life expectancy for white women has declined, according to a \u003ca href=\"http://www.cdc.gov/nchs/products/databriefs/db244.htm\" target=\"_blank\">report\u003c/a> from the Centers for Disease Control and Prevention's National Center for Health Statistics. The decline is slight -- from 81.2 to 81.1 years -- but worrisome.\u003c/p>\n\u003cp>While the report did not include causes of death, \u003ca href=\"http://www.npr.org/sections/health-shots/2016/04/20/474884894/life-expectancy-drops-for-white-women-increases-for-black-men\" target=\"_blank\">NPR reports\u003c/a> that the author of the analysis, Elizabeth Arias, looked deeper and examined causes of death for white people over the last 15 years.\u003c/p>\n\u003cp>\"For the age group 25 to 54, suicide went up,\" she told reporter Alison Kodjak. \"'Unintentional poisonings,' which is mainly alcohol and drug poisoning, and chronic liver disease -- those went up by quite a bit.\"\u003c/p>\n\u003cp>The report was drawn from all deaths recorded in the U.S. in 2014. Life expectancy for whites overall dropped to 78.8 years in 2014 from 78.9 in 2013.\u003c/p>\n\u003cp>The\u003ca href=\"http://www.nytimes.com/2016/04/20/health/life-expectancy-decline-mortality.html?_r=0\" target=\"_blank\"> New York Times\u003c/a> details that life expectancy for whites had been going up for decades but \u003ca href=\"http://www.nytimes.com/2015/10/28/health/death-rates-declining-for-decades-have-flattened-study-finds.html\" target=\"_blank\">stagnated more recently\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>It inched up in 2010 and 2011, and was flat in 2012 and 2013.\u003c/p>\n\u003cp>Recent research has documented surprising increases in death rates among less educated whites. Last year, a paper by Anne Case and Angus Deaton \u003ca href=\"http://www.pnas.org/content/112/49/15078\" target=\"_blank\">documented rising death rates among middle-age white Americans\u003c/a>, particularly those with no more than a high school education.\u003ca href=\"http://www.nytimes.com/2016/01/17/science/drug-overdoses-propel-rise-in-mortality-rates-of-young-whites.html\" target=\"_blank\"> Other research\u003c/a> has found rising rates among younger whites.\u003c/p>\n\u003cp>The pattern had puzzled demographers, but the recent analyses have pointed to suffering and anxiety among working-class whites.\u003c/p>\u003c/blockquote>\n\u003cp>(For a powerful look at one tragedy, read \u003ca href=\"http://www.washingtonpost.com/sf/national/2016/04/08/we-dont-know-why-it-came-to-this/\" target=\"_blank\">this Washington Post story\u003c/a> of the death of one 54-year-old woman in Tecumseh, Oklahoma.)\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>These structural conditions also affect men, but their overall life expectancy was unchanged.\u003c/p>\n\u003cp>While the news for whites is gloomy, other groups saw increases. Black men, in particular, had a relatively large gain in life expectancy of about six months, from 71.8 to 72.2 years (for blacks overall the rise was 75.1 to 75.2 years). Hispanic men and women both gained, from 81.6 to 81.8 years between 2013 and 2014.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"The gap between the white and black populations is quickly closing, and it's mainly because the black population is experiencing a great drop in mortality,\" \u003ca href=\"https://www.washingtonpost.com/news/to-your-health/wp/2016/04/20/cdc-life-expectancy-for-non-hispanic-white-women-dips-for-first-time-in-decades/\" target=\"_blank\">Arias told the Washington Post\u003c/a>.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>John Oliver turned his righteous outrage to lead poisoning in his \u003ca href=\"https://www.youtube.com/watch?v=GUizvEjR-0U\" target=\"_blank\">weekly show \u003c/a>last night. And, as he tends to do, did it with humor.\u003c/p>\n\u003cp>\"There is no safe level of lead,\" Oliver said. \"It's one of those things so dangerous that you shouldn't even let a little bit inside you, like heroin, or Jeremy Piven.\"\u003c/p>\n\u003cp>He started with the Flint, Michigan water crisis and expanded from there, pointing out that there are 2.1 million homes in the U.S. where children under age six live that also have a lead dust hazard. The Centers for Disease Control and Prevention\u003ca href=\"http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6213a3.htm\" target=\"_blank\">estimates that 535,000 children\u003c/a> under age six have an elevated blood lead level.\u003c/p>\n\u003cp>\"Lead is almost as much a scourge in young children's homes as 'Frozen' merchandise,\" he said, to laughter.\u003c/p>\n\u003cp>Lead is a naturally occurring mineral, but is toxic to humans, especially children, and \u003ca href=\"http://www.who.int/mediacentre/factsheets/fs379/en/\" target=\"_blank\">can lead to irreversible neurodevelopmental \u003c/a>problems, including intellectual disability.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Oliver recounted the \"major public health victory\" starting in the U.S. in the 1970s when lead was removed from paint and then from gasoline. Children's blood lead levels plummeted.\u003c/p>\n\u003cp>In 2000, the federal government determined that totally removing lead from all homes, nationwide, would cost $16.6 billion every year for a decade, a very steep price tag.\u003c/p>\n\u003cp>Instead, the federal government funded a lead hazard control program in homes where families where low-income families lived. While $230 million was recommended, the HUD's Lead Hazard Control Program was never funded above $176 million, Oliver said, and has been steadily declining since 2003.\u003c/p>\n\u003cp>This year, the allocation is $110 million, not even as much as Ride Along 2 \u003ca href=\"http://www.the-numbers.com/movie/Ride-Along-2#tab=summary\" target=\"_blank\">has made so far\u003c/a>, a movie the \u003ca href=\"http://nypost.com/2016/01/13/the-worst-part-about-being-a-movie-critic-ride-along-2/\" target=\"_blank\">New York Post said \u003c/a>was \"as funny as lead poisoning.\" (How Oliver put those facts together, I don't know, but it' s true, follow the links.)\u003c/p>\n\u003cp>Oliver turned to all manner of archival news clips during his history lesson, including a 20-year-old clip from \"Sesame Street\" featuring a song about protecting yourself from lead.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"It's clearly time to address the problem again,\" Oliver said, and went off to visit \"Sesame Street\" where Elmo, Rosita and even Oscar teamed up to sing a song motivating everyone to conquer the problem.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>John Oliver turned his righteous outrage to lead poisoning in his \u003ca href=\"https://www.youtube.com/watch?v=GUizvEjR-0U\" target=\"_blank\">weekly show \u003c/a>last night. And, as he tends to do, did it with humor.\u003c/p>\n\u003cp>\"There is no safe level of lead,\" Oliver said. \"It's one of those things so dangerous that you shouldn't even let a little bit inside you, like heroin, or Jeremy Piven.\"\u003c/p>\n\u003cp>He started with the Flint, Michigan water crisis and expanded from there, pointing out that there are 2.1 million homes in the U.S. where children under age six live that also have a lead dust hazard. The Centers for Disease Control and Prevention\u003ca href=\"http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6213a3.htm\" target=\"_blank\">estimates that 535,000 children\u003c/a> under age six have an elevated blood lead level.\u003c/p>\n\u003cp>\"Lead is almost as much a scourge in young children's homes as 'Frozen' merchandise,\" he said, to laughter.\u003c/p>\n\u003cp>Lead is a naturally occurring mineral, but is toxic to humans, especially children, and \u003ca href=\"http://www.who.int/mediacentre/factsheets/fs379/en/\" target=\"_blank\">can lead to irreversible neurodevelopmental \u003c/a>problems, including intellectual disability.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Oliver recounted the \"major public health victory\" starting in the U.S. in the 1970s when lead was removed from paint and then from gasoline. Children's blood lead levels plummeted.\u003c/p>\n\u003cp>In 2000, the federal government determined that totally removing lead from all homes, nationwide, would cost $16.6 billion every year for a decade, a very steep price tag.\u003c/p>\n\u003cp>Instead, the federal government funded a lead hazard control program in homes where families where low-income families lived. While $230 million was recommended, the HUD's Lead Hazard Control Program was never funded above $176 million, Oliver said, and has been steadily declining since 2003.\u003c/p>\n\u003cp>This year, the allocation is $110 million, not even as much as Ride Along 2 \u003ca href=\"http://www.the-numbers.com/movie/Ride-Along-2#tab=summary\" target=\"_blank\">has made so far\u003c/a>, a movie the \u003ca href=\"http://nypost.com/2016/01/13/the-worst-part-about-being-a-movie-critic-ride-along-2/\" target=\"_blank\">New York Post said \u003c/a>was \"as funny as lead poisoning.\" (How Oliver put those facts together, I don't know, but it' s true, follow the links.)\u003c/p>\n\u003cp>Oliver turned to all manner of archival news clips during his history lesson, including a 20-year-old clip from \"Sesame Street\" featuring a song about protecting yourself from lead.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"It's clearly time to address the problem again,\" Oliver said, and went off to visit \"Sesame Street\" where Elmo, Rosita and even Oscar teamed up to sing a song motivating everyone to conquer the problem.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "San Francisco, Oakland Working to Put Soda Tax Before Voters",
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"content": "\u003cp>Berkeley was the trend setter in 2014 when voters there approved the first a soda tax in the U.S. with a resounding 75 percent of the vote.\u003c/p>\n\u003cp>That same year San Francisco voters rejected a soda tax. But supporters were not deterred. Now, new efforts have resumed in San Francisco and in Oakland to move through a tax with a goal of fighting the obesity and diabetes epidemic. Both cities seem to be applying lessons from the Berkeley playbook to see the taxes through.\u003c/p>\n\u003cp>First, a bit of review: in 2014 San Franciscans considered a dedicated tax, one that would be earmarked to fund specific health programs. That kind of earmarked tax needs a two-thirds supermajority approval to become law. With 55 percent of the vote, it fell short of the threshhold.\u003c/p>\n\u003cp>Berkeley, meanwhile, had pursued a different path, one where the proceeds of a tax would go toward the city's general fund. But the law called for the creation of a health panel to advise the Berkeley City Council on appropriate programs to fund. This approach requires only a simple majority -- 50 percent plus one vote -- to pass.\u003c/p>\n\u003cp>Backers of the Berkeley soda tax also cultivated a \u003ca href=\"http://www.berkeleyvsbigsoda.com/supporters\" target=\"_blank\">long list of supporters,\u003c/a> including health organizations and grassroots groups.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>That's where Oakland and San Francisco are today -- both proposals are remarkably similar to the Berkeley approach:\u003c/p>\n\u003cul>\n\u003cli>a penny per ounce fee on sugar-sweetened beverages\u003c/li>\n\u003cli>a dedicated health panel to advise city or county officials on spending\u003c/li>\n\u003cli>plenty of grassroots support\u003c/li>\n\u003cli>levied on distributors (in Berkeley much of the tax is passed through to consumers)\u003c/li>\n\u003c/ul>\n\u003cp>“We’re building a much stronger community coalition,\" says San Francisco Supervisor Malia Cohen, one of the sponsors of the 2014 effort and a backer of the current move. \"We’re taking a much more thoughtful and grassroots focused effort this time around. We have learned from errors.\"\u003c/p>\n\u003cp>Cohen says 10,000 signatures are needed by a July deadline to place the item on the San Francisco ballot. Nine-thousand people have already signed and she expects the remainder by late May, well in advance of the deadline.\u003c/p>\n\u003cp>The Oakland City Council, meanwhile, is weighing whether to directly place a soda tax on the ballot. The proposed measure will be heard in committee this Thursday. If it passes there, it goes before the full board. Adam Simons, chief of staff for City Council Member Annie Campbell Washington, one of the proponents of the ordinance, said he expects it will be approved for the November ballot.\u003c/p>\n\u003cp>\"We're feeling very confident it will move through,\" he says.\u003c/p>\n\u003cp>\u003cstrong>Mexico Was First\u003c/strong>\u003c/p>\n\u003cp>Globally, the first soda tax was in Mexico. Its tax took effect in January, 2014 -- 11 months before the Berkeley and San Francisco votes. Consumption of sugary drinks dropped 6-12 percent in the year after it was implemented and raised millions for the Mexican government.\u003c/p>\n\u003cp>More recently, the British Parliament \u003ca href=\"http://www.vox.com/2016/3/17/11256594/jamie-oliver-soda-tax\" target=\"_blank\">passed a soda tax\u003c/a> just last month. \u003ca href=\"http://www.nbcphiladelphia.com/news/politics/Mayor-Jim-Kenney-Philadelphia-Soda-Tax-371956832.html\" target=\"_blank\">Philadelphia's mayor \u003c/a>has pitched a three-cents-per-ounce tax. The \u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/03/09/soda-tax-is-again-before-california-legislators/\" target=\"_blank\">California legislature\u003c/a> is considering a two-cents-per-ounce tax. But multiple attempts at a tax or even a warning label have failed at the state level in recent years.\u003c/p>\n\u003cp>The taxes achieve multiple goals, advocates say, not just the obvious one to reduce consumption of sugar-sweetened beverages. The effect of a tax to \u003ca href=\"http://soda%20tax%20what%20a%20penny%20can%20do%20kqed\" target=\"_blank\">get people to switch to healthier beverages is, at best, modest\u003c/a>.\u003c/p>\n\u003cp>But the taxes also raise money and awareness. In just over a year, Berkeley's tax has already \u003ca href=\"http://www.berkeleyvsbigsoda.com/faq\" target=\"_blank\">generated more than $1.5 million \u003c/a>for nutrition and health programs.\u003c/p>\n\u003cp>[contextly_sidebar id=\"yZpoYrRYKbFsAhYAGSb8bRQ4dqMRfrax\"]Harold Goldstein, executive director of the California Center for Public Health Advocacy, has long worked on educating the public about the harms of sugar-sweetened beverages. He says \"soda tax's time has come.\"\u003c/p>\n\u003cp>\"We're at the point of no return where soda taxes are going to be sweeping the country and sweeping the world,\" he says.\u003c/p>\n\u003cp>Sugary drinks -- sodas, energy drinks and fruit-flavored beverages -- are the number one source of added sugar in the American diet. A 12-ounce can of Coke, for example, has more than nine teaspoons of added sugar. Health advocates argue that these beverages and their so-called empty calories put people at higher risk of type 2 diabetes and obesity.\u003c/p>\n\u003cp>\"So taxing soda to raise a lot of money to solve this problem is it,\" says Goldstein. \"They are a product that should be taxed so you have the revenue to solve the problem that they are causing.\"\u003c/p>\n\u003cp>The beverage industry fires back that obesity and diabetes are far more complicated problems than can be solved by taxing a single product. And the tax is regressive, they say, hitting poor people hardest. The American Beverage Association spent $9.1 million defeating the San Francisco tax and another $2.4 million fighting the Berkeley measure in 2014.\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/10/15/election-2014-san-francisco-berkeley-consider-soda-taxes/\" target=\"_blank\">Some voters in Berkeley voted against the tax\u003c/a> because they did not trust city government to spend the money on health programs. Since the tax is not earmarked, governments can allocate the money however they like.\u003c/p>\n\u003cp>In Berkeley, diet drinks with very low calories, 100 percent fruit juice and most milk products are exempt from the tax. Infant formulas are exempt.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Sports drinks like Gatorade, energy drinks, sweetened teas, fruit-flavored drinks and sodas sold both in bottles and cans as well as fountain drinks are taxed.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Berkeley was the trend setter in 2014 when voters there approved the first a soda tax in the U.S. with a resounding 75 percent of the vote.\u003c/p>\n\u003cp>That same year San Francisco voters rejected a soda tax. But supporters were not deterred. Now, new efforts have resumed in San Francisco and in Oakland to move through a tax with a goal of fighting the obesity and diabetes epidemic. Both cities seem to be applying lessons from the Berkeley playbook to see the taxes through.\u003c/p>\n\u003cp>First, a bit of review: in 2014 San Franciscans considered a dedicated tax, one that would be earmarked to fund specific health programs. That kind of earmarked tax needs a two-thirds supermajority approval to become law. With 55 percent of the vote, it fell short of the threshhold.\u003c/p>\n\u003cp>Berkeley, meanwhile, had pursued a different path, one where the proceeds of a tax would go toward the city's general fund. But the law called for the creation of a health panel to advise the Berkeley City Council on appropriate programs to fund. This approach requires only a simple majority -- 50 percent plus one vote -- to pass.\u003c/p>\n\u003cp>Backers of the Berkeley soda tax also cultivated a \u003ca href=\"http://www.berkeleyvsbigsoda.com/supporters\" target=\"_blank\">long list of supporters,\u003c/a> including health organizations and grassroots groups.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>That's where Oakland and San Francisco are today -- both proposals are remarkably similar to the Berkeley approach:\u003c/p>\n\u003cul>\n\u003cli>a penny per ounce fee on sugar-sweetened beverages\u003c/li>\n\u003cli>a dedicated health panel to advise city or county officials on spending\u003c/li>\n\u003cli>plenty of grassroots support\u003c/li>\n\u003cli>levied on distributors (in Berkeley much of the tax is passed through to consumers)\u003c/li>\n\u003c/ul>\n\u003cp>“We’re building a much stronger community coalition,\" says San Francisco Supervisor Malia Cohen, one of the sponsors of the 2014 effort and a backer of the current move. \"We’re taking a much more thoughtful and grassroots focused effort this time around. We have learned from errors.\"\u003c/p>\n\u003cp>Cohen says 10,000 signatures are needed by a July deadline to place the item on the San Francisco ballot. Nine-thousand people have already signed and she expects the remainder by late May, well in advance of the deadline.\u003c/p>\n\u003cp>The Oakland City Council, meanwhile, is weighing whether to directly place a soda tax on the ballot. The proposed measure will be heard in committee this Thursday. If it passes there, it goes before the full board. Adam Simons, chief of staff for City Council Member Annie Campbell Washington, one of the proponents of the ordinance, said he expects it will be approved for the November ballot.\u003c/p>\n\u003cp>\"We're feeling very confident it will move through,\" he says.\u003c/p>\n\u003cp>\u003cstrong>Mexico Was First\u003c/strong>\u003c/p>\n\u003cp>Globally, the first soda tax was in Mexico. Its tax took effect in January, 2014 -- 11 months before the Berkeley and San Francisco votes. Consumption of sugary drinks dropped 6-12 percent in the year after it was implemented and raised millions for the Mexican government.\u003c/p>\n\u003cp>More recently, the British Parliament \u003ca href=\"http://www.vox.com/2016/3/17/11256594/jamie-oliver-soda-tax\" target=\"_blank\">passed a soda tax\u003c/a> just last month. \u003ca href=\"http://www.nbcphiladelphia.com/news/politics/Mayor-Jim-Kenney-Philadelphia-Soda-Tax-371956832.html\" target=\"_blank\">Philadelphia's mayor \u003c/a>has pitched a three-cents-per-ounce tax. The \u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/03/09/soda-tax-is-again-before-california-legislators/\" target=\"_blank\">California legislature\u003c/a> is considering a two-cents-per-ounce tax. But multiple attempts at a tax or even a warning label have failed at the state level in recent years.\u003c/p>\n\u003cp>The taxes achieve multiple goals, advocates say, not just the obvious one to reduce consumption of sugar-sweetened beverages. The effect of a tax to \u003ca href=\"http://soda%20tax%20what%20a%20penny%20can%20do%20kqed\" target=\"_blank\">get people to switch to healthier beverages is, at best, modest\u003c/a>.\u003c/p>\n\u003cp>But the taxes also raise money and awareness. In just over a year, Berkeley's tax has already \u003ca href=\"http://www.berkeleyvsbigsoda.com/faq\" target=\"_blank\">generated more than $1.5 million \u003c/a>for nutrition and health programs.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>Harold Goldstein, executive director of the California Center for Public Health Advocacy, has long worked on educating the public about the harms of sugar-sweetened beverages. He says \"soda tax's time has come.\"\u003c/p>\n\u003cp>\"We're at the point of no return where soda taxes are going to be sweeping the country and sweeping the world,\" he says.\u003c/p>\n\u003cp>Sugary drinks -- sodas, energy drinks and fruit-flavored beverages -- are the number one source of added sugar in the American diet. A 12-ounce can of Coke, for example, has more than nine teaspoons of added sugar. Health advocates argue that these beverages and their so-called empty calories put people at higher risk of type 2 diabetes and obesity.\u003c/p>\n\u003cp>\"So taxing soda to raise a lot of money to solve this problem is it,\" says Goldstein. \"They are a product that should be taxed so you have the revenue to solve the problem that they are causing.\"\u003c/p>\n\u003cp>The beverage industry fires back that obesity and diabetes are far more complicated problems than can be solved by taxing a single product. And the tax is regressive, they say, hitting poor people hardest. The American Beverage Association spent $9.1 million defeating the San Francisco tax and another $2.4 million fighting the Berkeley measure in 2014.\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/10/15/election-2014-san-francisco-berkeley-consider-soda-taxes/\" target=\"_blank\">Some voters in Berkeley voted against the tax\u003c/a> because they did not trust city government to spend the money on health programs. Since the tax is not earmarked, governments can allocate the money however they like.\u003c/p>\n\u003cp>In Berkeley, diet drinks with very low calories, 100 percent fruit juice and most milk products are exempt from the tax. Infant formulas are exempt.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Sports drinks like Gatorade, energy drinks, sweetened teas, fruit-flavored drinks and sodas sold both in bottles and cans as well as fountain drinks are taxed.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "How Theater Helps This HIV-Positive Grandmother Transform Lives",
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"headTitle": "Vital Signs | State of Health | KQED News",
"content": "\u003cp>For decades, Cassandra Steptoe felt like she couldn’t talk about her HIV diagnosis with anyone.\u003c/p>\n\u003cp>\"I couldn't forgive myself for getting HIV,\" says Steptoe, who spent much of her early adult life in and out of jail for shoplifting and burglaries linked to her IV drug use. \"But someone told me a long time ago, if you are looking for a reason to feel shame, you can always find it. I learned to look for something else: forgiveness.\"\u003c/p>\n\u003cp>For Steptoe, now 59 and a grandmother, it wasn't until her 40s -- after decades of struggling with addiction -- that she finally completed a rehab program and committed to ongoing HIV treatment.\u003c/p>\n\u003cp>Today she talks openly about that experience onstage, as part of a theater project aimed at inspiring others. The quote about learning to forgive herself is part of an autobiographical monologue Steptoe wrote and performs in a San Francisco theater production of \u003ca href=\"https://www.facebook.com/MedeaProject/\" target=\"_blank\">The Medea Project: Theater for Incarcerated Women/HIV Circle\u003c/a>.\u003c/p>\n\u003cp>It was Steptoe's physician, \u003ca href=\"http://whp.ucsf.edu/about/team-members/edward-machtinger-m-d\">Dr. Edward Machtinger\u003c/a>, who first told her about the project. Established by playwright and director \u003ca href=\"http://www.culturalodyssey.org/v2/aboutus/rhodessa_bio.html\" target=\"_blank\">Rhodessa Jones\u003c/a> in 2008 as an extension of an improvisational production that draws on and explores the \u003ca href=\"http://www.npr.org/templates/story/story.php?storyId=15146105\" target=\"_blank\">experiences of jailed women\u003c/a>, the \"HIV Circle\" focuses on the experiences of women living with the AIDS virus.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The therapeutic aspect of the performance workshop is called \u003ca href=\"http://rtc.umn.edu/docs/pep_facguide.pdf\" target=\"_blank\">peer empowerment\u003c/a>, explains Machtinger, an internist and director of the Women's HIV Program at the University of California, San Francisco. The strength and healing Steptoe and others have gained from processing and sharing their stories this way is profound, he says — and can serve as a model for helping other patients deal with psychological trauma.\u003c/p>\n\u003cfigure id=\"attachment_164615\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"size-full wp-image-164615\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/03/RS18863_IMG_9455-qut.jpg\" alt=\"Cassandra Steptoe at the apartment she shares with her 8-year-old granddaughter in San Francisco. She credits The Medea Project with helping her improve her overall well-being.\" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18863_IMG_9455-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18863_IMG_9455-qut-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18863_IMG_9455-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18863_IMG_9455-qut-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18863_IMG_9455-qut-1440x960.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18863_IMG_9455-qut-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18863_IMG_9455-qut-960x640.jpg 960w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Cassandra Steptoe at the apartment she shares with her 8-year-old granddaughter in San Francisco. She credits The Medea Project with helping her improve her overall well-being. \u003ccite>(Farida Jhabvala Romero / KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Medications 'Not Enough'\u003c/strong>\u003c/p>\n\u003cp>With the theater group, Steptoe began writing about her experiences and sharing them with a small group of women, some of whom had gone through similar struggles of addiction and histories of incarceration. The process of uncovering her past and making sense of her experiences in a cathartic, supportive environment helped Steptoe end her feelings of isolation.\u003c/p>\n\u003cp>\"Having these women that really love you and support you ... it feels good to have some real friends, 'cause I never had that before,\" Steptoe says. \"We're all sharing something together 'cause we all get something out of everybody's story.\"\u003c/p>\n\u003cp>The potential of peer empowerment is not just anecdotal. Machtinger has \u003ca href=\"http://www.sciencedirect.com/science/article/pii/S1055329014000971\" target=\"_blank\">studied\u003c/a> the Medea Project's life-saving impact on his patients.\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/256844757\" params=\"color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" iframe=\"true\" /]\u003c/p>\n\u003cp>Machtinger says the patients in the Medea Project followed by his research team went through an extraordinary transformation. Many who had barely disclosed their HIV status to anyone when they began, became activists and leaders in their communities, helping to destigmatize HIV while pursuing personal goals and leading productive lives.\u003c/p>\n\u003cp>\"For them to develop what they described as \"sisterhood\" was the most important and most profound type of healing that I ever witnessed,\" Machtinger says.\u003c/p>\n\u003cp>He began seeking alternative methods to help his patients after increasingly noticing that a large proportion were successfully receiving antiretroviral treatment, but still dying from reasons that had \"nothing to do with HIV,\" such as murder, suicide or drug overdose.\u003c/p>\n\u003cp>\"They could have their HIV under control, (but) their lives were not getting better,\" Machtinger says. \"That was because their core issue -- a life of trauma and the impacts of depression, isolation and shame -- wasn’t being effectively addressed. And to us, that's not acceptable.\"\u003c/p>\n\u003cp>Machtinger's experience is reverberating beyond the Medea Project. He says witnessing and studying the impact of peer empowerment has helped inform a broader role. He is part of an advisory group helping to develop new guidelines for trauma-informed primary care for the federal Substance Abuse and Mental Health Services Administration.\u003c/p>\n\u003cp>The new guidelines will likely include a substantial focus on interventions with peer empowerment as one ingredient to help people with severe trauma heal, says Machtinger.\u003c/p>\n\u003cp>\"The core elements of the Medea Project are really lessons for other interventions to help people overcome trauma and other stigmatizing situations and conditions,\" says Machtinger, adding that childhood and adult trauma have been linked to a variety of illnesses, such as hepatitis C, heart disease and diabetes.\u003c/p>\n\u003cp>He expects the new guidelines for primary care clinics and other health providers to be finalized and published later this year.\u003c/p>\n\u003cp>\u003cstrong>Trauma at the Root of HIV Diagnosis\u003c/strong>\u003c/p>\n\u003cp>Steptoe now realizes she was infected with HIV through unprotected sex and sharing needles. She used to be addicted to heroin and cocaine. During a decades-long period of her life, she was in and out of the criminal justice system. She worked as a prostitute and survived abusive relationships -- getting beat up so badly one time that she spent three months recovering at a hospital, she said.\u003c/p>\n\u003cp>Steptoe says experiencing sexual abuse repeatedly as a child and teen led her on the path that eventually resulted in HIV infection.\u003c/p>\n\u003cp>\"Sexual abuse came from family,\" she says. \"And I guess I was kind of covering all that up by choosing the drugs. It kind of took me out there into the street, looking for love in the wrong places because I didn't have it at home. I started shooting drugs and that led into prostitution and to prison.\"\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/stateofhealth/2012/03/20/trauma-fuels-hiv-epidemic-among-women/http://ww2.kqed.org/stateofhealth/2012/03/20/trauma-fuels-hiv-epidemic-among-women/\">Recent studies\u003c/a> show that HIV-positive women suffer disproportionately from high rates of trauma and post-traumatic stress disorder. The high rates of trauma also lead to increased risk of further spreading HIV, according to researchers.\u003c/p>\n\u003cp>\u003cstrong>Transforming Her Life\u003c/strong>\u003c/p>\n\u003cp>Now Steptoe is busy and full of energy. She takes antiretroviral medication religiously every morning, eats a healthy diet and works out by taking Zumba fitness classes at her gym.\u003c/p>\n\u003cp>Steptoe, a mother of three and grandmother of nine has also taken full custody of her 8-year-old granddaughter, who frequently accompanies her to rehearsals.\u003c/p>\n\u003cp>\"She teaches me how to love, and she gives me patience,\" says Steptoe, who also cares for other kids in her Mission apartment building.\u003c/p>\n\u003cp>Rhodessa Jones, the Medea Project's dynamic and energetic director, says Steptoe has flourished since she joined the organization, becoming a leader and inspiration to other women.\u003c/p>\n\u003cp>\"She’s so powerful, positive and forceful. She gets it,\" says Jones, who founded Medea more than 23 years ago. \"Theater has really been expressive therapy for her. It gives her a space to speak her truth.\"\u003c/p>\n\u003cfigure id=\"attachment_164614\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"size-full wp-image-164614\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/03/RS18862_IMG_9445-qut.jpg\" alt='Performers at The Medea Project rehearse in San Francisco. Founder and director Rhodessa Jones, uses Greek, Roman and African mythology to introduce \"the universality of all of our stories.\"' width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18862_IMG_9445-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18862_IMG_9445-qut-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18862_IMG_9445-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18862_IMG_9445-qut-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18862_IMG_9445-qut-1440x960.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18862_IMG_9445-qut-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18862_IMG_9445-qut-960x640.jpg 960w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Performers at The Medea Project rehearse in San Francisco. Founder and director Rhodessa Jones, uses Greek, Roman and African mythology to introduce \"the universality of all of our stories.\" \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The Medea Project uses Greek, Roman and African mythology to introduce \"the universality of all of our stories,\" says Jones, who asked Steptoe to imagine going back in time to age 14 and write the lessons she would give herself. The result was Steptoe's piece \"Younger Self.\"\u003c/p>\n\u003cp>Steptoe wrote the piece, performed in January in San Francisco, about the moment in 1987 when she first found out she was HIV-positive. She was serving time in jail and received a health checkup.\u003c/p>\n\u003cp>\"My world crashed. I didn't have no education of what I had, I didn't have no support,\" says Steptoe, adding that she considered her condition \"a death sentence\" at the time. \"I had to relive that again by writing this because I needed to heal.\"\u003c/p>\n\u003cp>\u003cstrong>'HIV is a Health Condition, Not a Crime'\u003c/strong>\u003c/p>\n\u003cp>After receiving the diagnosis, she remembers crying at night with a pillow over her head so others wouldn't hear.\u003c/p>\n\u003cp>Steptoe then kept her HIV status a secret for many years.\u003c/p>\n\u003cp>But, years later, the key for her to find and use her voice was becoming a part of The Medea Project, she says. The main motivation for telling her story? She wants to give hope to others, and help them feel they are not alone.\u003c/p>\n\u003cp>\"Now I can tell the world that HIV is just a health condition, not a crime,\" says Steptoe, who doesn't hesitate to share her story as a lead actress for Medea in front of audiences of hundreds of people.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\"I don't have shame around it no more,” Steptoe says. “I let my grandkids know that even if you go the wrong way, you can still turn your life around.\"\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>For decades, Cassandra Steptoe felt like she couldn’t talk about her HIV diagnosis with anyone.\u003c/p>\n\u003cp>\"I couldn't forgive myself for getting HIV,\" says Steptoe, who spent much of her early adult life in and out of jail for shoplifting and burglaries linked to her IV drug use. \"But someone told me a long time ago, if you are looking for a reason to feel shame, you can always find it. I learned to look for something else: forgiveness.\"\u003c/p>\n\u003cp>For Steptoe, now 59 and a grandmother, it wasn't until her 40s -- after decades of struggling with addiction -- that she finally completed a rehab program and committed to ongoing HIV treatment.\u003c/p>\n\u003cp>Today she talks openly about that experience onstage, as part of a theater project aimed at inspiring others. The quote about learning to forgive herself is part of an autobiographical monologue Steptoe wrote and performs in a San Francisco theater production of \u003ca href=\"https://www.facebook.com/MedeaProject/\" target=\"_blank\">The Medea Project: Theater for Incarcerated Women/HIV Circle\u003c/a>.\u003c/p>\n\u003cp>It was Steptoe's physician, \u003ca href=\"http://whp.ucsf.edu/about/team-members/edward-machtinger-m-d\">Dr. Edward Machtinger\u003c/a>, who first told her about the project. Established by playwright and director \u003ca href=\"http://www.culturalodyssey.org/v2/aboutus/rhodessa_bio.html\" target=\"_blank\">Rhodessa Jones\u003c/a> in 2008 as an extension of an improvisational production that draws on and explores the \u003ca href=\"http://www.npr.org/templates/story/story.php?storyId=15146105\" target=\"_blank\">experiences of jailed women\u003c/a>, the \"HIV Circle\" focuses on the experiences of women living with the AIDS virus.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The therapeutic aspect of the performance workshop is called \u003ca href=\"http://rtc.umn.edu/docs/pep_facguide.pdf\" target=\"_blank\">peer empowerment\u003c/a>, explains Machtinger, an internist and director of the Women's HIV Program at the University of California, San Francisco. The strength and healing Steptoe and others have gained from processing and sharing their stories this way is profound, he says — and can serve as a model for helping other patients deal with psychological trauma.\u003c/p>\n\u003cfigure id=\"attachment_164615\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"size-full wp-image-164615\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/03/RS18863_IMG_9455-qut.jpg\" alt=\"Cassandra Steptoe at the apartment she shares with her 8-year-old granddaughter in San Francisco. She credits The Medea Project with helping her improve her overall well-being.\" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18863_IMG_9455-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18863_IMG_9455-qut-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18863_IMG_9455-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18863_IMG_9455-qut-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18863_IMG_9455-qut-1440x960.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18863_IMG_9455-qut-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18863_IMG_9455-qut-960x640.jpg 960w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Cassandra Steptoe at the apartment she shares with her 8-year-old granddaughter in San Francisco. She credits The Medea Project with helping her improve her overall well-being. \u003ccite>(Farida Jhabvala Romero / KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Medications 'Not Enough'\u003c/strong>\u003c/p>\n\u003cp>With the theater group, Steptoe began writing about her experiences and sharing them with a small group of women, some of whom had gone through similar struggles of addiction and histories of incarceration. The process of uncovering her past and making sense of her experiences in a cathartic, supportive environment helped Steptoe end her feelings of isolation.\u003c/p>\n\u003cp>\"Having these women that really love you and support you ... it feels good to have some real friends, 'cause I never had that before,\" Steptoe says. \"We're all sharing something together 'cause we all get something out of everybody's story.\"\u003c/p>\n\u003cp>The potential of peer empowerment is not just anecdotal. Machtinger has \u003ca href=\"http://www.sciencedirect.com/science/article/pii/S1055329014000971\" target=\"_blank\">studied\u003c/a> the Medea Project's life-saving impact on his patients.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cdiv class='utils-parseShortcode-shortcodes-__shortcodes__shortcodeWrapper'>\n \u003ciframe width='100%' height='166'\n scrolling='no' frameborder='no'\n src='https://w.soundcloud.com/player/?url=https://api.soundcloud.com/tracks/256844757&visual=true&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false'\n title='https://api.soundcloud.com/tracks/256844757'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Machtinger says the patients in the Medea Project followed by his research team went through an extraordinary transformation. Many who had barely disclosed their HIV status to anyone when they began, became activists and leaders in their communities, helping to destigmatize HIV while pursuing personal goals and leading productive lives.\u003c/p>\n\u003cp>\"For them to develop what they described as \"sisterhood\" was the most important and most profound type of healing that I ever witnessed,\" Machtinger says.\u003c/p>\n\u003cp>He began seeking alternative methods to help his patients after increasingly noticing that a large proportion were successfully receiving antiretroviral treatment, but still dying from reasons that had \"nothing to do with HIV,\" such as murder, suicide or drug overdose.\u003c/p>\n\u003cp>\"They could have their HIV under control, (but) their lives were not getting better,\" Machtinger says. \"That was because their core issue -- a life of trauma and the impacts of depression, isolation and shame -- wasn’t being effectively addressed. And to us, that's not acceptable.\"\u003c/p>\n\u003cp>Machtinger's experience is reverberating beyond the Medea Project. He says witnessing and studying the impact of peer empowerment has helped inform a broader role. He is part of an advisory group helping to develop new guidelines for trauma-informed primary care for the federal Substance Abuse and Mental Health Services Administration.\u003c/p>\n\u003cp>The new guidelines will likely include a substantial focus on interventions with peer empowerment as one ingredient to help people with severe trauma heal, says Machtinger.\u003c/p>\n\u003cp>\"The core elements of the Medea Project are really lessons for other interventions to help people overcome trauma and other stigmatizing situations and conditions,\" says Machtinger, adding that childhood and adult trauma have been linked to a variety of illnesses, such as hepatitis C, heart disease and diabetes.\u003c/p>\n\u003cp>He expects the new guidelines for primary care clinics and other health providers to be finalized and published later this year.\u003c/p>\n\u003cp>\u003cstrong>Trauma at the Root of HIV Diagnosis\u003c/strong>\u003c/p>\n\u003cp>Steptoe now realizes she was infected with HIV through unprotected sex and sharing needles. She used to be addicted to heroin and cocaine. During a decades-long period of her life, she was in and out of the criminal justice system. She worked as a prostitute and survived abusive relationships -- getting beat up so badly one time that she spent three months recovering at a hospital, she said.\u003c/p>\n\u003cp>Steptoe says experiencing sexual abuse repeatedly as a child and teen led her on the path that eventually resulted in HIV infection.\u003c/p>\n\u003cp>\"Sexual abuse came from family,\" she says. \"And I guess I was kind of covering all that up by choosing the drugs. It kind of took me out there into the street, looking for love in the wrong places because I didn't have it at home. I started shooting drugs and that led into prostitution and to prison.\"\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/stateofhealth/2012/03/20/trauma-fuels-hiv-epidemic-among-women/http://ww2.kqed.org/stateofhealth/2012/03/20/trauma-fuels-hiv-epidemic-among-women/\">Recent studies\u003c/a> show that HIV-positive women suffer disproportionately from high rates of trauma and post-traumatic stress disorder. The high rates of trauma also lead to increased risk of further spreading HIV, according to researchers.\u003c/p>\n\u003cp>\u003cstrong>Transforming Her Life\u003c/strong>\u003c/p>\n\u003cp>Now Steptoe is busy and full of energy. She takes antiretroviral medication religiously every morning, eats a healthy diet and works out by taking Zumba fitness classes at her gym.\u003c/p>\n\u003cp>Steptoe, a mother of three and grandmother of nine has also taken full custody of her 8-year-old granddaughter, who frequently accompanies her to rehearsals.\u003c/p>\n\u003cp>\"She teaches me how to love, and she gives me patience,\" says Steptoe, who also cares for other kids in her Mission apartment building.\u003c/p>\n\u003cp>Rhodessa Jones, the Medea Project's dynamic and energetic director, says Steptoe has flourished since she joined the organization, becoming a leader and inspiration to other women.\u003c/p>\n\u003cp>\"She’s so powerful, positive and forceful. She gets it,\" says Jones, who founded Medea more than 23 years ago. \"Theater has really been expressive therapy for her. It gives her a space to speak her truth.\"\u003c/p>\n\u003cfigure id=\"attachment_164614\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"size-full wp-image-164614\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/03/RS18862_IMG_9445-qut.jpg\" alt='Performers at The Medea Project rehearse in San Francisco. Founder and director Rhodessa Jones, uses Greek, Roman and African mythology to introduce \"the universality of all of our stories.\"' width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18862_IMG_9445-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18862_IMG_9445-qut-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18862_IMG_9445-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18862_IMG_9445-qut-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18862_IMG_9445-qut-1440x960.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18862_IMG_9445-qut-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18862_IMG_9445-qut-960x640.jpg 960w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Performers at The Medea Project rehearse in San Francisco. Founder and director Rhodessa Jones, uses Greek, Roman and African mythology to introduce \"the universality of all of our stories.\" \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The Medea Project uses Greek, Roman and African mythology to introduce \"the universality of all of our stories,\" says Jones, who asked Steptoe to imagine going back in time to age 14 and write the lessons she would give herself. The result was Steptoe's piece \"Younger Self.\"\u003c/p>\n\u003cp>Steptoe wrote the piece, performed in January in San Francisco, about the moment in 1987 when she first found out she was HIV-positive. She was serving time in jail and received a health checkup.\u003c/p>\n\u003cp>\"My world crashed. I didn't have no education of what I had, I didn't have no support,\" says Steptoe, adding that she considered her condition \"a death sentence\" at the time. \"I had to relive that again by writing this because I needed to heal.\"\u003c/p>\n\u003cp>\u003cstrong>'HIV is a Health Condition, Not a Crime'\u003c/strong>\u003c/p>\n\u003cp>After receiving the diagnosis, she remembers crying at night with a pillow over her head so others wouldn't hear.\u003c/p>\n\u003cp>Steptoe then kept her HIV status a secret for many years.\u003c/p>\n\u003cp>But, years later, the key for her to find and use her voice was becoming a part of The Medea Project, she says. The main motivation for telling her story? She wants to give hope to others, and help them feel they are not alone.\u003c/p>\n\u003cp>\"Now I can tell the world that HIV is just a health condition, not a crime,\" says Steptoe, who doesn't hesitate to share her story as a lead actress for Medea in front of audiences of hundreds of people.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"I don't have shame around it no more,” Steptoe says. “I let my grandkids know that even if you go the wrong way, you can still turn your life around.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Representatives of the fast-growing vaping industry are promoting themselves as partners in the effort to reduce tobacco use, not as a public health scourge.\u003c/p>\n\u003cp>Industry officials held a Capitol news conference Tuesday urging California Gov. Jerry Brown to veto a bill that would subject vaping products to the same restrictions as cigarettes.\u003c/p>\n\u003cp>The bill is one of six anti-smoking bills awaiting action by the Democratic governor. Brown has not said whether he'll sign them.\u003c/p>\n\u003cp>Josh Krane, owner of Craft Vapery in Torrance, says e-cigarettes were the only way for him and many of his customers to quit smoking.\u003c/p>\n\u003cp>Proponents of the bill say vapor products are enticing to teenagers and threaten to get more young people addicted to nicotine.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n",
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"content": "\u003cp>Californians are used to big mortgages. Now, how about prescription drug loans?\u003c/p>\n\u003cp>That’s one idea for coping with prohibitively expensive drug prices. The unusual proposal is being pitched by academics at the Massachusetts Institute of Technology and Harvard University.\u003c/p>\n\u003cp>Writing last month in the journal Science Translational Medicine, the authors liken drug loans to mortgages, noting that both can enable consumers to buy big-ticket items requiring a hefty up-front payment that they could not otherwise afford.\u003c/p>\n\u003cp>Some consumer advocates and health insurance experts see it differently.\u003c/p>\n\u003cp>“Isn’t this why we have health insurance?” asked Mark Rukavina, a Boston-based health care consultant whose work has focused on affordability and medical debt. “Insurance used to protect people from financial ruin for these unpredictable, costly occurrences. Now, with large deductibles, we’ve got coverage for preventive care but not for treatment.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Andrew Lo, a financial economist at MIT’s Sloan School of Management, and Dr. David Weinstock, an oncologist at the Harvard-affiliated Dana-Farber Cancer Institute, agree that insurance would be a better option. But for many consumers that isn’t enough protection these days.\u003c/p>\n\u003cp>“This is a private sector stopgap way to deal with something right now,” said Lo.\u003c/p>\n\u003cp>Their proposal calls for the loans to be financed by a pool of investors who would buy bonds and equities issued by an organization that makes the loans to consumers.\u003c/p>\n\u003cp>While it’s “distasteful” to talk about patients mortgaging their lives for treatment, Lo said, they hope the proposal will spur change.\u003c/p>\n\u003cp>The health care installment loans that Lo, Weinstock and their co-author Vahid Montazerhodjat, a former MIT doctoral student who was working with Lo, propose would be aimed at helping people afford “transformative” therapies that cure potentially lethal conditions such as cancer or hepatitis C. They’re not designed to pay for maintenance drugs that help people deal with chronic illness. It’s easier for insurers to cover maintenance drugs because they’re purchased over an extended period of time, they said.\u003c/p>\n\u003cp>In contrast, breakthrough hepatitis C drugs Sovaldi and Harvoni, for example, can cure people of the liver-destroying disease in a few months, but the price tag of $84,000 or more has led many insurers to limit coverage to people whose disease has significantly progressed to show signs of liver damage.\u003c/p>\n\u003cp>“There are miraculous treatments like Harvoni, but they’re out of reach” for many people, said Lo.\u003c/p>\n\u003cp>Someone who wanted that Harvoni treatment might take out a health care loan with a nine-year term at an annual interest rate of about 9 percent, the authors suggest. In a twist on conventional loans, if a therapy doesn’t work or the patient relapses or dies, the patient isn’t obligated to repay the loan.\u003c/p>\n\u003cp>Are sick patients good loan prospects? Lenders might want to assess not only loan applicants’ creditworthiness but also their health to determine whether the applicant is likely to live long enough to pay it off.\u003c/p>\n\u003cp>The study authors say that requiring repayment only if the treatment works will protect patients and provide an incentive for the development of more effective drugs.\u003c/p>\n\u003cp>That’s a wrongheaded approach, said A. Mark Fendrick, director of the University of Michigan Center for Value-Based Insurance Design.\u003c/p>\n\u003cp>Medical treatment isn’t always straightforward. Even highly “transformative” drugs such as Sovaldi aren’t guaranteed to work, Fendrick said, and other factors come into play. For example, about 10 percent of people who were prescribed Sovaldi for hepatitis C didn’t finish their course of treatment, Fendrick said, referring to an analysis by the CVS Health Research Institute.\u003c/p>\n\u003cp>“In this situation, the person who does the right thing and gets the good outcome is penalized and has to pay the money back,” he said. Instead, he argued, patients who follow their doctor’s recommendations and “do what you’re supposed to do” should not be held liable for the loans.\u003c/p>\n\u003cp>The proposal doesn’t address drug prices, except to say that the potential for increase due to higher demand for previously unaffordable therapies needs to be addressed.\u003c/p>\n\u003cp>Price increases are a real concern, said Paul Ginsburg, director of public policy at the University of Southern California’s Schaeffer Center for Health Policy and Economics. The health law has made it easier for people to afford expensive drugs. It expanded Medicaid coverage to millions of lower income adults and capped at roughly $7,000 the amount consumers generally spend annually out-of-pocket for care.\u003c/p>\n\u003cp>“It’s helped people, but it’s also driven prices higher,” he said. From a drug company’s perspective, “It just means that more people can afford this drug, so we can charge more for it.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Lo said the MIT Laboratory for Financial Engineering and the Dana-Farber Cancer Institute will host a conference this winter to bring together drug manufacturers, insurers, patient advocates, financial engineers and others to discuss strategies to make expensive drug therapies more affordable. Health care loans will be on the agenda, he said.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Californians are used to big mortgages. Now, how about prescription drug loans?\u003c/p>\n\u003cp>That’s one idea for coping with prohibitively expensive drug prices. The unusual proposal is being pitched by academics at the Massachusetts Institute of Technology and Harvard University.\u003c/p>\n\u003cp>Writing last month in the journal Science Translational Medicine, the authors liken drug loans to mortgages, noting that both can enable consumers to buy big-ticket items requiring a hefty up-front payment that they could not otherwise afford.\u003c/p>\n\u003cp>Some consumer advocates and health insurance experts see it differently.\u003c/p>\n\u003cp>“Isn’t this why we have health insurance?” asked Mark Rukavina, a Boston-based health care consultant whose work has focused on affordability and medical debt. “Insurance used to protect people from financial ruin for these unpredictable, costly occurrences. Now, with large deductibles, we’ve got coverage for preventive care but not for treatment.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Andrew Lo, a financial economist at MIT’s Sloan School of Management, and Dr. David Weinstock, an oncologist at the Harvard-affiliated Dana-Farber Cancer Institute, agree that insurance would be a better option. But for many consumers that isn’t enough protection these days.\u003c/p>\n\u003cp>“This is a private sector stopgap way to deal with something right now,” said Lo.\u003c/p>\n\u003cp>Their proposal calls for the loans to be financed by a pool of investors who would buy bonds and equities issued by an organization that makes the loans to consumers.\u003c/p>\n\u003cp>While it’s “distasteful” to talk about patients mortgaging their lives for treatment, Lo said, they hope the proposal will spur change.\u003c/p>\n\u003cp>The health care installment loans that Lo, Weinstock and their co-author Vahid Montazerhodjat, a former MIT doctoral student who was working with Lo, propose would be aimed at helping people afford “transformative” therapies that cure potentially lethal conditions such as cancer or hepatitis C. They’re not designed to pay for maintenance drugs that help people deal with chronic illness. It’s easier for insurers to cover maintenance drugs because they’re purchased over an extended period of time, they said.\u003c/p>\n\u003cp>In contrast, breakthrough hepatitis C drugs Sovaldi and Harvoni, for example, can cure people of the liver-destroying disease in a few months, but the price tag of $84,000 or more has led many insurers to limit coverage to people whose disease has significantly progressed to show signs of liver damage.\u003c/p>\n\u003cp>“There are miraculous treatments like Harvoni, but they’re out of reach” for many people, said Lo.\u003c/p>\n\u003cp>Someone who wanted that Harvoni treatment might take out a health care loan with a nine-year term at an annual interest rate of about 9 percent, the authors suggest. In a twist on conventional loans, if a therapy doesn’t work or the patient relapses or dies, the patient isn’t obligated to repay the loan.\u003c/p>\n\u003cp>Are sick patients good loan prospects? Lenders might want to assess not only loan applicants’ creditworthiness but also their health to determine whether the applicant is likely to live long enough to pay it off.\u003c/p>\n\u003cp>The study authors say that requiring repayment only if the treatment works will protect patients and provide an incentive for the development of more effective drugs.\u003c/p>\n\u003cp>That’s a wrongheaded approach, said A. Mark Fendrick, director of the University of Michigan Center for Value-Based Insurance Design.\u003c/p>\n\u003cp>Medical treatment isn’t always straightforward. Even highly “transformative” drugs such as Sovaldi aren’t guaranteed to work, Fendrick said, and other factors come into play. For example, about 10 percent of people who were prescribed Sovaldi for hepatitis C didn’t finish their course of treatment, Fendrick said, referring to an analysis by the CVS Health Research Institute.\u003c/p>\n\u003cp>“In this situation, the person who does the right thing and gets the good outcome is penalized and has to pay the money back,” he said. Instead, he argued, patients who follow their doctor’s recommendations and “do what you’re supposed to do” should not be held liable for the loans.\u003c/p>\n\u003cp>The proposal doesn’t address drug prices, except to say that the potential for increase due to higher demand for previously unaffordable therapies needs to be addressed.\u003c/p>\n\u003cp>Price increases are a real concern, said Paul Ginsburg, director of public policy at the University of Southern California’s Schaeffer Center for Health Policy and Economics. The health law has made it easier for people to afford expensive drugs. It expanded Medicaid coverage to millions of lower income adults and capped at roughly $7,000 the amount consumers generally spend annually out-of-pocket for care.\u003c/p>\n\u003cp>“It’s helped people, but it’s also driven prices higher,” he said. From a drug company’s perspective, “It just means that more people can afford this drug, so we can charge more for it.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Lo said the MIT Laboratory for Financial Engineering and the Dana-Farber Cancer Institute will host a conference this winter to bring together drug manufacturers, insurers, patient advocates, financial engineers and others to discuss strategies to make expensive drug therapies more affordable. Health care loans will be on the agenda, he said.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "First Case of Sexually Transmitted Zika Virus in California Reported",
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"content": "\u003cp>The first case of Zika virus acquired in California was confirmed by health department officials on Friday.\u003c/p>\n\u003cp>A San Diego woman contracted the virus in February after sexual contact with a male partner who had been infected with Zika on a trip to Colombia, a country where the virus is prevalent, San Diego County officials \u003ca href=\"http://www.countynewscenter.com/news/first-sexually-transmitted-zika-virus-case-san-diego-county-reported\" target=\"_blank\">report\u003c/a>.\u003c/p>\n\u003cp>The woman was not pregnant and she and her partner have fully recovered, the California Department of Public Health said.\u003c/p>\n\u003cp>“This is the first confirmed case in California where Zika virus was transmitted sexually,” California Department of Public Health Director and State Public Health Officer Karen Smith \u003ca href=\"https://www.cdph.ca.gov/Pages/NR16-016.aspx\" target=\"_blank\">said\u003c/a>. “If your partner has traveled to an area where Zika is present, protecting yourself by abstaining from sex or using condoms during sex is the best way to prevent sexual transmission of the Zika virus.”\u003c/p>\n\u003cp>In California, there have been 22 travel-associated Zika cases in 2015 and 2016. There have been no cases of the virus being acquired from mosquito bites here.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The spread of Zika virus has caused alarm worldwide because it can spread from a woman to her baby during pregnancy and lead to birth defects including microcephaly, a condition, where a baby is born with a smaller head due to abnormal brain development.\u003c/p>\n\u003cp>State and local health officials offered recommendations to help prevent the spread of Zika virus.\u003c/p>\n\u003cp>Men who have traveled to an area where Zika virus is present should abstain from sex or use condoms with a partner who is pregnant or trying to become pregnant for the duration of the pregnancy, state health officials said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Women who want to get pregnant with a partner who has had exposure to Zika virus should talk to their doctor about the risks of Zika virus during pregnancy, state officials said.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The first case of Zika virus acquired in California was confirmed by health department officials on Friday.\u003c/p>\n\u003cp>A San Diego woman contracted the virus in February after sexual contact with a male partner who had been infected with Zika on a trip to Colombia, a country where the virus is prevalent, San Diego County officials \u003ca href=\"http://www.countynewscenter.com/news/first-sexually-transmitted-zika-virus-case-san-diego-county-reported\" target=\"_blank\">report\u003c/a>.\u003c/p>\n\u003cp>The woman was not pregnant and she and her partner have fully recovered, the California Department of Public Health said.\u003c/p>\n\u003cp>“This is the first confirmed case in California where Zika virus was transmitted sexually,” California Department of Public Health Director and State Public Health Officer Karen Smith \u003ca href=\"https://www.cdph.ca.gov/Pages/NR16-016.aspx\" target=\"_blank\">said\u003c/a>. “If your partner has traveled to an area where Zika is present, protecting yourself by abstaining from sex or using condoms during sex is the best way to prevent sexual transmission of the Zika virus.”\u003c/p>\n\u003cp>In California, there have been 22 travel-associated Zika cases in 2015 and 2016. There have been no cases of the virus being acquired from mosquito bites here.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The spread of Zika virus has caused alarm worldwide because it can spread from a woman to her baby during pregnancy and lead to birth defects including microcephaly, a condition, where a baby is born with a smaller head due to abnormal brain development.\u003c/p>\n\u003cp>State and local health officials offered recommendations to help prevent the spread of Zika virus.\u003c/p>\n\u003cp>Men who have traveled to an area where Zika virus is present should abstain from sex or use condoms with a partner who is pregnant or trying to become pregnant for the duration of the pregnancy, state health officials said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Women who want to get pregnant with a partner who has had exposure to Zika virus should talk to their doctor about the risks of Zika virus during pregnancy, state officials said.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>California plans to delay state-required warnings on metal cans lined with the chemical BPA, arguing too-specific warnings could scare stores and shoppers in poor neighborhoods away from some of the only fruits and vegetables available — canned ones, officials said Thursday.\u003c/p>\n\u003cp>The decision and rationale of the California Environmental Protection Agency are angering some community and public-health groups.\u003c/p>\n\u003cp>It's \"ridiculous. It's paternalistic,\" said Martha Dina Arguello, executive director of Physicians for Social Responsibility-Los Angeles. \"I just can't imagine that it's a better idea not to let us know what's in our food.\"\u003c/p>\n\u003cp>The warnings are coming on line in California under the state's Proposition 65, a measure approved by voters in 1986 that requires businesses to notify the public about high levels of chemicals in products or places.\u003c/p>\n\u003cp>California officials decided last year to add BPA, or bisphenol A, to the list of about 800 other chemicals requiring Proposition 65 notices. Manufacturers use BPA in epoxy liners of some cans, bottles and jars.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The state based its action on a 2008 finding by the National Toxicology Program, which determined the chemical was an estrogen-like substance that could harm the female reproductive system at high levels.\u003c/p>\n\u003cp>That 2015 decision by California is controversial. The U.S. Food and Drug Administration banned BPA from baby bottles and sippy cups in 2012, but it says the level of BPA that leeches into food is safe otherwise. The federal agency also is awaiting the results of more studies.\u003c/p>\n\u003cp>Ordinarily, the state would either require manufacturers to put those warnings on the cans, or make grocers post signs on canned-goods shelves specifically warning that \"Brand X tomato sauce, Brand Y green beans\" have the targeted chemical in the can, said Allan Hirsch, chief deputy director of the state EPA's Office of Environmental Health Hazard Assessment.\u003c/p>\n\u003cp>For BPA, though, \"we think that would be kind of chaotic,\" the state official said. \"Retailers might react ... by just pulling canned and bottled foods off their shelves entirely,\" which would be bad news in neighborhoods without good grocery stores.\u003c/p>\n\u003cp>\"We would want to make sure that people, especially in low-income communities, still have access to canned fruits and vegetables. That's certainly better than not having access to them,\" the state official said.\u003c/p>\n\u003cp>Hirsch also acknowledged hearing \"some concern from retailers\" about how the warning is going to work.\u003c/p>\n\u003cp>Kathleen Roberts, executive director of the can industry's North American Metal Packaging Alliance, said Thursday that confusion \"from these warning signs could further limit healthy choices, particularly for low-income families in inner-city neighborhoods and rural communities.\"\u003c/p>\n\u003cp>Rather than require warnings for specific cans and other goods when the warning-requirement kicks in in May, the state plans to make merchants place general notices saying some cans for sale in the store have BPA.\u003c/p>\n\u003cp>State officials foresee requiring more specific notices after perhaps a year. That would give can manufacturers more time to label their cans and to see what ongoing medical studies find regarding safe and unsafe levels of the chemicals, Hirsch said.\u003c/p>\n\u003cp>It's the state's arguments about BPA and canned vegetables in so-called food deserts — neighborhoods too poor to attract top grocery chains — that offend the community groups.\u003c/p>\n\u003cp>\"California is willingly putting out the language ... excluding a whole sub-population of people from protection,\" said Jose T. Bravo, executive director of Just Transition Alliance, an environmental health and labor coalition in San Diego.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The community representatives say they plan to file protests before a final decision by another state agency that approves such regulatory changes.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The state based its action on a 2008 finding by the National Toxicology Program, which determined the chemical was an estrogen-like substance that could harm the female reproductive system at high levels.\u003c/p>\n\u003cp>That 2015 decision by California is controversial. The U.S. Food and Drug Administration banned BPA from baby bottles and sippy cups in 2012, but it says the level of BPA that leeches into food is safe otherwise. The federal agency also is awaiting the results of more studies.\u003c/p>\n\u003cp>Ordinarily, the state would either require manufacturers to put those warnings on the cans, or make grocers post signs on canned-goods shelves specifically warning that \"Brand X tomato sauce, Brand Y green beans\" have the targeted chemical in the can, said Allan Hirsch, chief deputy director of the state EPA's Office of Environmental Health Hazard Assessment.\u003c/p>\n\u003cp>For BPA, though, \"we think that would be kind of chaotic,\" the state official said. \"Retailers might react ... by just pulling canned and bottled foods off their shelves entirely,\" which would be bad news in neighborhoods without good grocery stores.\u003c/p>\n\u003cp>\"We would want to make sure that people, especially in low-income communities, still have access to canned fruits and vegetables. That's certainly better than not having access to them,\" the state official said.\u003c/p>\n\u003cp>Hirsch also acknowledged hearing \"some concern from retailers\" about how the warning is going to work.\u003c/p>\n\u003cp>Kathleen Roberts, executive director of the can industry's North American Metal Packaging Alliance, said Thursday that confusion \"from these warning signs could further limit healthy choices, particularly for low-income families in inner-city neighborhoods and rural communities.\"\u003c/p>\n\u003cp>Rather than require warnings for specific cans and other goods when the warning-requirement kicks in in May, the state plans to make merchants place general notices saying some cans for sale in the store have BPA.\u003c/p>\n\u003cp>State officials foresee requiring more specific notices after perhaps a year. That would give can manufacturers more time to label their cans and to see what ongoing medical studies find regarding safe and unsafe levels of the chemicals, Hirsch said.\u003c/p>\n\u003cp>It's the state's arguments about BPA and canned vegetables in so-called food deserts — neighborhoods too poor to attract top grocery chains — that offend the community groups.\u003c/p>\n\u003cp>\"California is willingly putting out the language ... excluding a whole sub-population of people from protection,\" said Jose T. Bravo, executive director of Just Transition Alliance, an environmental health and labor coalition in San Diego.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The community representatives say they plan to file protests before a final decision by another state agency that approves such regulatory changes.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Hundreds of thousands of low-income, undocumented children in California will be eligible to enroll in full-scope health coverage through Medi-Cal starting on May 1 under legislation approved last year.\u003c/p>\n\u003cp>As officials try to get the word out about California's decision to open the program to children from low-income families regardless of immigration status, these kids will still face significant barriers to obtaining the coverage, says the \u003ca href=\"http://www.sbsun.com/social-affairs/20160323/group-gets-the-word-out-undocumented-children-now-eligible-for-health-care\" target=\"_blank\">\u003cem>San Bernardino County Sun\u003c/em>\u003c/a>.\u003c/p>\n\u003cp>Officials say they hope community clinics, religious groups and ethnic media outlets will help alert undocumented immigrants to enroll their children. Even so, state officials expect only about half of eligible kids to enroll in the program in its first year, the Sun writes.\u003c/p>\n\u003cp>Many undocumented families may be reluctant to participate out of fear that it would put at risk their chance to obtain a legal immigration status. Lack of empowerment and confusion over how and why to enroll may also make it difficult to reach the eligible families, experts say.\u003c/p>\n\u003cp>The expansion will extend Medi-Cal coverage to about 170,000 undocumented immigrant children under age 19. About 115,000 undocumented children are currently enrolled in restricted Medi-Cal programs and 55,000 eligible children aren’t receiving coverage, the Sun writes.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Also, the process of moving eligible children into full scope Medi-Cal from their current more limited plans creates administrative hurdles that could cause disruptions in care or even lead to families dropping out of the system, the \u003ca href=\"http://www.chcf.org/articles/2015/11/medical-enrolls-undocumented-kids\" target=\"_blank\">California Health Care Foundation\u003c/a> writes.\u003c/p>\n\u003cp>The Medi-Cal expansion will help these undocumented children get preventive care, such as physicals and immunizations, mental health care, and vision care, Assemblywoman Cheryl Brown, D-San Bernardino, told the Sun.\u003c/p>\n\u003cp>How to provide health care to undocumented immigrants has been the subject of recent political debate. Under the Affordable Care Act, undocumented immigrants were excluded from purchasing coverage through Covered California.\u003c/p>\n\u003cp>After rejecting the idea of covering both undocumented adults and children, California lawmakers granted full-scope coverage to the children as long as they meet the income standards. The program will cost $40 million in this year's budget and an estimated $132 million each following year.\u003c/p>\n\u003cp>\"This is a major investment that California is doing, and it's completely the reverse of what we’re seeing at the national level,\" said state Sen. Ricardo Lara, D-Bell Gardens, who led the health care expansion effort, told the \u003ca href=\"http://www.latimes.com/local/political/la-me-pc-california-immigrant-healthcare-20151009-story.html\" target=\"_blank\">\u003cem>Los Angeles Times\u003c/em>\u003c/a> in October.\u003c/p>\n\u003cp>Offering Medi-Cal coverage to undocumented children is a good long-term investment for the state, experts say. It will bring down health care costs by reducing trips to the emergency room for routine care and help ease stress on community health centers, which often treat undocumented patients without reimbursement, experts told \u003ca href=\"http://californiahealthline.org/morning-breakout/advocates-extending-medical-to-undocumented-kids-a-good-first-step/\" target=\"_blank\">\u003cem>California Healthline\u003c/em>\u003c/a> in July.\u003c/p>\n\u003cp>Eligible children can be enrolled in-person at \u003ca href=\"http://www.dhcs.ca.gov/services/medi-cal/Pages/CountyOffices.aspx\" target=\"_blank\">county social services offices\u003c/a>, or online or by mail through \u003ca href=\"http://www.coveredca.com/\" target=\"_blank\">Covered California\u003c/a>, according to the \u003ca href=\"http://www.dhcs.ca.gov/services/medi-cal/eligibility/Pages/SB75Children.aspx\" target=\"_blank\">California Department of Health Care Services\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"We have a big challenge ahead of us to dispel the perception that undocumented people are forever left out,\" Daniel Zingale, senior vice president at the California Endowment told \u003cem>California Healthline\u003c/em>.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Hundreds of thousands of low-income, undocumented children in California will be eligible to enroll in full-scope health coverage through Medi-Cal starting on May 1 under legislation approved last year.\u003c/p>\n\u003cp>As officials try to get the word out about California's decision to open the program to children from low-income families regardless of immigration status, these kids will still face significant barriers to obtaining the coverage, says the \u003ca href=\"http://www.sbsun.com/social-affairs/20160323/group-gets-the-word-out-undocumented-children-now-eligible-for-health-care\" target=\"_blank\">\u003cem>San Bernardino County Sun\u003c/em>\u003c/a>.\u003c/p>\n\u003cp>Officials say they hope community clinics, religious groups and ethnic media outlets will help alert undocumented immigrants to enroll their children. Even so, state officials expect only about half of eligible kids to enroll in the program in its first year, the Sun writes.\u003c/p>\n\u003cp>Many undocumented families may be reluctant to participate out of fear that it would put at risk their chance to obtain a legal immigration status. Lack of empowerment and confusion over how and why to enroll may also make it difficult to reach the eligible families, experts say.\u003c/p>\n\u003cp>The expansion will extend Medi-Cal coverage to about 170,000 undocumented immigrant children under age 19. About 115,000 undocumented children are currently enrolled in restricted Medi-Cal programs and 55,000 eligible children aren’t receiving coverage, the Sun writes.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Also, the process of moving eligible children into full scope Medi-Cal from their current more limited plans creates administrative hurdles that could cause disruptions in care or even lead to families dropping out of the system, the \u003ca href=\"http://www.chcf.org/articles/2015/11/medical-enrolls-undocumented-kids\" target=\"_blank\">California Health Care Foundation\u003c/a> writes.\u003c/p>\n\u003cp>The Medi-Cal expansion will help these undocumented children get preventive care, such as physicals and immunizations, mental health care, and vision care, Assemblywoman Cheryl Brown, D-San Bernardino, told the Sun.\u003c/p>\n\u003cp>How to provide health care to undocumented immigrants has been the subject of recent political debate. Under the Affordable Care Act, undocumented immigrants were excluded from purchasing coverage through Covered California.\u003c/p>\n\u003cp>After rejecting the idea of covering both undocumented adults and children, California lawmakers granted full-scope coverage to the children as long as they meet the income standards. The program will cost $40 million in this year's budget and an estimated $132 million each following year.\u003c/p>\n\u003cp>\"This is a major investment that California is doing, and it's completely the reverse of what we’re seeing at the national level,\" said state Sen. Ricardo Lara, D-Bell Gardens, who led the health care expansion effort, told the \u003ca href=\"http://www.latimes.com/local/political/la-me-pc-california-immigrant-healthcare-20151009-story.html\" target=\"_blank\">\u003cem>Los Angeles Times\u003c/em>\u003c/a> in October.\u003c/p>\n\u003cp>Offering Medi-Cal coverage to undocumented children is a good long-term investment for the state, experts say. It will bring down health care costs by reducing trips to the emergency room for routine care and help ease stress on community health centers, which often treat undocumented patients without reimbursement, experts told \u003ca href=\"http://californiahealthline.org/morning-breakout/advocates-extending-medical-to-undocumented-kids-a-good-first-step/\" target=\"_blank\">\u003cem>California Healthline\u003c/em>\u003c/a> in July.\u003c/p>\n\u003cp>Eligible children can be enrolled in-person at \u003ca href=\"http://www.dhcs.ca.gov/services/medi-cal/Pages/CountyOffices.aspx\" target=\"_blank\">county social services offices\u003c/a>, or online or by mail through \u003ca href=\"http://www.coveredca.com/\" target=\"_blank\">Covered California\u003c/a>, according to the \u003ca href=\"http://www.dhcs.ca.gov/services/medi-cal/eligibility/Pages/SB75Children.aspx\" target=\"_blank\">California Department of Health Care Services\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"We have a big challenge ahead of us to dispel the perception that undocumented people are forever left out,\" Daniel Zingale, senior vice president at the California Endowment told \u003cem>California Healthline\u003c/em>.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Persistent, heavy use of marijuana is associated with economic and social problems in adults, according to an international study led by researchers at UC Davis.\u003c/p>\n\u003cp>The analysis was done on a group of more than 900 people whom researchers have followed since they were born almost 40 years ago.\u003c/p>\n\u003cp>In the study, the people who smoked marijuana four or more times per week over many years were much more likely to end up in a lower social class than their parents.\u003c/p>\n\u003cp>\"By that we mean they ended up in jobs that were lower paying, they were less prestigious and they required less skills than jobs that their parents have,\" said lead author \u003ca href=\"https://www.ucdmc.ucdavis.edu/emergency/ourteam/faculty/cerda.html\" target=\"_blank\">Magdalena Cerda\u003c/a>, an associate professor of emergency medicine at UC Davis.\u003c/p>\n\u003cp>Cerda and other co-authors interviewed stressed that their study was observational and could not prove that marijuana use caused these problems, but the researchers took into account many factors that could skew results, including any history of criminal conviction for marijuana use, history of antisocial behavior during adolescence, impulsivity problems, and lower IQ.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003ca href=\"http://psychandneuro.duke.edu/people?Gurl=&Uil=6568&subpage=profile\" target=\"_blank\">Terrie Moffitt\u003c/a>, a professor in the department of psychology and neuroscience at Duke University, was a co-author of the study, published in the journal \u003ca href=\"http://www.psychologicalscience.org/index.php/publications/journals/clinical\" target=\"_blank\">Clinical Psychological Science\u003c/a>. She said that in the group, the longer people used marijuana, the more their credit ratings fell. \"So they were at the point in their late 30s where they wouldn't be able to get a mortgage or borrow money to start a small business,\" she said. \"So this is a pretty crippling level of financial difficulties.\"\u003c/p>\n\u003cp>The team also looked closely at people's job performance and relationship issues. Those who were long term, persistent users of marijuana, were more likely to have problems with coworkers and productivity problems, like calling in sick when they weren't actually sick, Moffitt said.\u003c/p>\n\u003cp>In short, long-term, persistent marijuana use was \"not safe\" for the users in their study, Cerda said. Problems were comparable to those seen in people who are dependent on alcohol.\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/254670305\" params=\"color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" iframe=\"true\" /]\"We found that in the case of economic and social harms, cannabis was not safer than alcohol and, in fact, in the case of financial difficulties, cannabis was more harmful than alcohol.\"\u003c/p>\n\u003cp>Cerda said she was surprised when they saw that heavy pot users also reported more domestic violence than those who were not heavy users. \"We found that it was comparable to the effect of alcohol dependence on abuse,\" she said.\u003c/p>\n\u003cp>The people followed are part of the \u003ca href=\"http://dunedinstudy.otago.ac.nz\" target=\"_blank\">Dunedin Longitudinal Study\u003c/a>. Every child born in Dunedin, a city in New Zealand, between April, 1972 and March 1973 was enrolled and has been followed in three to six year intervals since. More than 1,000 papers have been published in the 40 years of follow up about everything from asthma to experience in the workforce. The group is mostly white, but of varying socio-economic levels that is similar to the general population of the U.S., Cerda said.\u003c/p>\n\u003cp>But critics say the study is inherently flawed, because all current recreational pot smokers in New Zealand -- and in much of the U.S. -- are people who are willing to break the law.\u003c/p>\n\u003cp>\"It's really not a good indicator of marijuana's effects itself,\" said Mason Tvert, communications director for the Marijuana Policy Project in Washington, D.C., \"but more of who's more likely to break the law and use marijuana.\"\u003c/p>\n\u003cp>Magdalena Cerda was on KQED Forum Wednesday morning talking about the study, and at least one caller had the same reaction as Tvert. (Others had stronger reactions, \u003ca href=\"http://www.kqed.org/a/forum/R201603230900\" target=\"_blank\">you can listen\u003c/a> if you want to hear more.)\u003c/p>\n\u003cp>But journalist David Downs, who writes \u003ca href=\"http://legalization%20nation%20east%20bay%20express\" target=\"_blank\">Legalization Nation\u003c/a> for the East Bay Express and described himself as supportive of updating both medicinal and recreational marijuana use laws, said he found the study \"super fascinating.\"\u003c/p>\n\u003cp>He said the study suggested a common sense approach.\u003c/p>\n\u003cp>\"If you drink a lot, if you smoke a lot, if you do any mind-altering activity heavily every day, I imagine it’s going to alter a lot of people’s life courses,\" Down said. \"I don’t hear anybody saying, 'Smoke pot every day, it’s going to turn out great.' \"\u003c/p>\n\u003cp>(Several people who called or emailed Forum said they were daily users and their lives were fine.)\u003c/p>\n\u003cp>Professor Wayne Hall directs the Centre for Youth Substance Abuse Research at Australia's University of Queensland. He was not involved with the study, but he said the findings about economic and social problems were consistent with other studies, including in \u003ca href=\"http://onlinelibrary.wiley.com/doi/10.1111/j.1468-0084.2007.00480.x/abstract\" target=\"_blank\">the Netherlands\u003c/a> where marijuana is \"defecto legal.\"\u003c/p>\n\u003cp>\"It's an important study,\" he said and seemed especially interested by the comparison with alcohol use.\u003c/p>\n\u003cp>\"It's telling us what people don't want to hear,\" he said. \"There are patterns with marijuana use that can provide the same social outcomes as patterns we see with drinking.\"\u003c/p>\n\u003cp>To be clear, this study did not look at health effects, which the authors agreed are far worse for alcohol than for marijuana. And because alcohol is more widely used it is \"still a bigger problem,\" UC Davis' Cerda said.\u003c/p>\n\u003cp>But the study comes as it's widely expected that a ballot measure to approve adult use of marijuana will be before California voters in November.\u003c/p>\n\u003cp>The study authors said they took no position on whether recreational marijuana should be legal. Moffitt said that among the study authors, some used marijuana and some did not. But the study highlights the importance of investing in programs to prevent regular marijuana use and to treat addiction early.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"What we don't know with legalization is if cannabis abuse will start to become more prevalent like alcohol abuse is,\" said Moffitt. \"That's the $64 million question.\"\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Persistent, heavy use of marijuana is associated with economic and social problems in adults, according to an international study led by researchers at UC Davis.\u003c/p>\n\u003cp>The analysis was done on a group of more than 900 people whom researchers have followed since they were born almost 40 years ago.\u003c/p>\n\u003cp>In the study, the people who smoked marijuana four or more times per week over many years were much more likely to end up in a lower social class than their parents.\u003c/p>\n\u003cp>\"By that we mean they ended up in jobs that were lower paying, they were less prestigious and they required less skills than jobs that their parents have,\" said lead author \u003ca href=\"https://www.ucdmc.ucdavis.edu/emergency/ourteam/faculty/cerda.html\" target=\"_blank\">Magdalena Cerda\u003c/a>, an associate professor of emergency medicine at UC Davis.\u003c/p>\n\u003cp>Cerda and other co-authors interviewed stressed that their study was observational and could not prove that marijuana use caused these problems, but the researchers took into account many factors that could skew results, including any history of criminal conviction for marijuana use, history of antisocial behavior during adolescence, impulsivity problems, and lower IQ.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"http://psychandneuro.duke.edu/people?Gurl=&Uil=6568&subpage=profile\" target=\"_blank\">Terrie Moffitt\u003c/a>, a professor in the department of psychology and neuroscience at Duke University, was a co-author of the study, published in the journal \u003ca href=\"http://www.psychologicalscience.org/index.php/publications/journals/clinical\" target=\"_blank\">Clinical Psychological Science\u003c/a>. She said that in the group, the longer people used marijuana, the more their credit ratings fell. \"So they were at the point in their late 30s where they wouldn't be able to get a mortgage or borrow money to start a small business,\" she said. \"So this is a pretty crippling level of financial difficulties.\"\u003c/p>\n\u003cp>The team also looked closely at people's job performance and relationship issues. Those who were long term, persistent users of marijuana, were more likely to have problems with coworkers and productivity problems, like calling in sick when they weren't actually sick, Moffitt said.\u003c/p>\n\u003cp>In short, long-term, persistent marijuana use was \"not safe\" for the users in their study, Cerda said. Problems were comparable to those seen in people who are dependent on alcohol.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cdiv class='utils-parseShortcode-shortcodes-__shortcodes__shortcodeWrapper'>\n \u003ciframe width='100%' height='166'\n scrolling='no' frameborder='no'\n src='https://w.soundcloud.com/player/?url=https://api.soundcloud.com/tracks/254670305&visual=true&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false'\n title='https://api.soundcloud.com/tracks/254670305'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\"We found that in the case of economic and social harms, cannabis was not safer than alcohol and, in fact, in the case of financial difficulties, cannabis was more harmful than alcohol.\"\u003c/p>\n\u003cp>Cerda said she was surprised when they saw that heavy pot users also reported more domestic violence than those who were not heavy users. \"We found that it was comparable to the effect of alcohol dependence on abuse,\" she said.\u003c/p>\n\u003cp>The people followed are part of the \u003ca href=\"http://dunedinstudy.otago.ac.nz\" target=\"_blank\">Dunedin Longitudinal Study\u003c/a>. Every child born in Dunedin, a city in New Zealand, between April, 1972 and March 1973 was enrolled and has been followed in three to six year intervals since. More than 1,000 papers have been published in the 40 years of follow up about everything from asthma to experience in the workforce. The group is mostly white, but of varying socio-economic levels that is similar to the general population of the U.S., Cerda said.\u003c/p>\n\u003cp>But critics say the study is inherently flawed, because all current recreational pot smokers in New Zealand -- and in much of the U.S. -- are people who are willing to break the law.\u003c/p>\n\u003cp>\"It's really not a good indicator of marijuana's effects itself,\" said Mason Tvert, communications director for the Marijuana Policy Project in Washington, D.C., \"but more of who's more likely to break the law and use marijuana.\"\u003c/p>\n\u003cp>Magdalena Cerda was on KQED Forum Wednesday morning talking about the study, and at least one caller had the same reaction as Tvert. (Others had stronger reactions, \u003ca href=\"http://www.kqed.org/a/forum/R201603230900\" target=\"_blank\">you can listen\u003c/a> if you want to hear more.)\u003c/p>\n\u003cp>But journalist David Downs, who writes \u003ca href=\"http://legalization%20nation%20east%20bay%20express\" target=\"_blank\">Legalization Nation\u003c/a> for the East Bay Express and described himself as supportive of updating both medicinal and recreational marijuana use laws, said he found the study \"super fascinating.\"\u003c/p>\n\u003cp>He said the study suggested a common sense approach.\u003c/p>\n\u003cp>\"If you drink a lot, if you smoke a lot, if you do any mind-altering activity heavily every day, I imagine it’s going to alter a lot of people’s life courses,\" Down said. \"I don’t hear anybody saying, 'Smoke pot every day, it’s going to turn out great.' \"\u003c/p>\n\u003cp>(Several people who called or emailed Forum said they were daily users and their lives were fine.)\u003c/p>\n\u003cp>Professor Wayne Hall directs the Centre for Youth Substance Abuse Research at Australia's University of Queensland. He was not involved with the study, but he said the findings about economic and social problems were consistent with other studies, including in \u003ca href=\"http://onlinelibrary.wiley.com/doi/10.1111/j.1468-0084.2007.00480.x/abstract\" target=\"_blank\">the Netherlands\u003c/a> where marijuana is \"defecto legal.\"\u003c/p>\n\u003cp>\"It's an important study,\" he said and seemed especially interested by the comparison with alcohol use.\u003c/p>\n\u003cp>\"It's telling us what people don't want to hear,\" he said. \"There are patterns with marijuana use that can provide the same social outcomes as patterns we see with drinking.\"\u003c/p>\n\u003cp>To be clear, this study did not look at health effects, which the authors agreed are far worse for alcohol than for marijuana. And because alcohol is more widely used it is \"still a bigger problem,\" UC Davis' Cerda said.\u003c/p>\n\u003cp>But the study comes as it's widely expected that a ballot measure to approve adult use of marijuana will be before California voters in November.\u003c/p>\n\u003cp>The study authors said they took no position on whether recreational marijuana should be legal. Moffitt said that among the study authors, some used marijuana and some did not. But the study highlights the importance of investing in programs to prevent regular marijuana use and to treat addiction early.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"What we don't know with legalization is if cannabis abuse will start to become more prevalent like alcohol abuse is,\" said Moffitt. \"That's the $64 million question.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Hip-Hop Pioneer Phife Brought Attention to Diabetes",
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"content": "\u003cp>Rapper Phife Dawg, of the iconic group Tribe Called Quest, is continuing to raise awareness around diabetes in his death, as he did in life, throughout his music career.\u003c/p>\n\u003cp>The rapper’s family confirmed Wednesday that \u003ca href=\"http://ww2.kqed.org/arts/2016/03/23/why-phife-mattered-remembering-hip-hops-relatable-mc/\" target=\"_blank\">Phife died at age 45\u003c/a> at his home near Antioch due to complications resulting from diabetes, sparking a wave of disease-related tributes on social media.\u003c/p>\n\u003cblockquote class=\"twitter-tweet\">\n\u003cp dir=\"ltr\" lang=\"en\">Rest in peace and poetry, Phife Dawg. We will continue the fight against Diabetes in your honor. \u003ca href=\"https://t.co/ofG6ATsq02\">pic.twitter.com/ofG6ATsq02\u003c/a>\u003c/p>\n\u003cp>— Youth Speaks (@youthspeaks) \u003ca href=\"https://twitter.com/youthspeaks/status/712686618096771072\">March 23, 2016\u003c/a>\u003c/p>\u003c/blockquote>\n\u003cp>“Rest in peace and poetry, Phife Dawg. We will continue the fight against Diabetes in your honor,” Youth Speaks posted on Twitter.\u003c/p>\n\u003cp>Phife, born Malik Taylor, was diagnosed with diabetes when he was 19. It was May 1990, just one month after Tribe released its first album. Phife later talked about his struggle with the disease in interviews, and even rapped about it.\u003c/p>\n\u003cp>“Mr. Energetic, who me sound pathetic?/When’s the last time you heard a funky diabetic?” he rhymed in Tribe’s 1993 song “\u003ca href=\"http://genius.com/A-tribe-called-quest-oh-my-god-lyrics\" target=\"_blank\">Oh My God\u003c/a>.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In 2010, Phife told the \u003ca href=\"http://www.eastbayexpress.com/oakland/phife-dawgs-triumphal-return/Content?oid=2043994\" target=\"_blank\">East Bay Express\u003c/a> that he was working on a solo album, \"Songs in the Key of Phife,\" though it was never released. Reporter David MacFadden-Elliott got to hear a few samples in the IHOP parking lot after the interview, including a song about diabetes called “God Send.”\u003c/p>\n\u003cblockquote>\u003cp>“[It’s] a three-part song that turns from a smooth love joint into a warning from a doctor: 'You got to start dialysis.' The news ushers in a discordant, claustrophobic, pulsing beat that rocks, while voice-mail messages of support play for minutes on end. The song concludes with an emotional verse of thanks: \u003cem>If it wasn't for y'all/Who knows what would have happened?”\u003c/em>\u003c/p>\u003c/blockquote>\n\u003cp>It was a couple years after Phife’s initial diagnosis before he opened up about it, or even really took care of himself.\u003c/p>\n\u003cp>[contextly_sidebar id=\"TJXUTnoR8uufGFRG5wvhJikCbmLNY4hZ\"]His coming out was in a video interview on \u003ca href=\"http://www.dlife.com/dlifetv/video/phife-dawgs-dlife\" target=\"_blank\">dLife\u003c/a>, a website devoted to living with diabetes. He described finding out about his diagnosis. He was riding home from a concert in 1990 and kept asking the driver to pull over so he could go to the bathroom. He was really thirsty. When he got home, his grandmother, a nurse, did a test and confirmed he was diabetic.\u003c/p>\n\u003cp>“I thought it was over,” he told dLife. “I just automatically thought I was done rapping.”\u003c/p>\n\u003cp>He went into denial.\u003c/p>\n\u003cp>“I was just an idiot,” he said. “I still thought I was everybody else -- Twinkies, Suzie Qs, potato chips -- junk food anonymous.”\u003c/p>\n\u003cp>In 1992, Tribe was on \"The David Letterman Show\" and then immediately had to go to another shoot for \"The Dennis Miller Show.\" Pfife's blood sugar count was almost in the thousands -- normal levels are between 70 and 100.\u003c/p>\n\u003cp>“Everything was slow motion,” Phife described. “I couldn’t even do the show. I had to get hospitalized.”\u003c/p>\n\u003cp>Even then, he still struggled to get enough exercise and eat right.\u003c/p>\n\u003cp>“I’d get on the diet. Wouldn’t stick to the diet. Get back on diet, wouldn’t stick to the diet,” he said. “And it just got to point where I had to be put on dialysis.”\u003c/p>\n\u003cp>Phife was eventually put on a waiting list for a kidney transplant, and received one from his wife in 2008. By 2013, he was back on dialysis and back on the transplant list. In an interview with \u003ca href=\"http://www.npr.org/player/v2/mediaPlayer.html?action=1&t=1&islist=false&id=455764350&m=455936755\" target=\"_blank\">NPR\u003c/a> earlier this year, he talked about waiting for another kidney.\u003c/p>\n\u003cp>“I’m doing fine,” he said. “I really, really can’t complain. I could. But I won’t because God is really, really a good God.”\u003c/p>\n\u003cp>But he also had a message for other young people newly diagnosed with diabetes.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“It’s not a game. You can lose your life because of this,” he said during the dLife interview. “You need to love yourself, love your life.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Rapper Phife Dawg, of the iconic group Tribe Called Quest, is continuing to raise awareness around diabetes in his death, as he did in life, throughout his music career.\u003c/p>\n\u003cp>The rapper’s family confirmed Wednesday that \u003ca href=\"http://ww2.kqed.org/arts/2016/03/23/why-phife-mattered-remembering-hip-hops-relatable-mc/\" target=\"_blank\">Phife died at age 45\u003c/a> at his home near Antioch due to complications resulting from diabetes, sparking a wave of disease-related tributes on social media.\u003c/p>\n\u003cblockquote class=\"twitter-tweet\">\n\u003cp dir=\"ltr\" lang=\"en\">Rest in peace and poetry, Phife Dawg. We will continue the fight against Diabetes in your honor. \u003ca href=\"https://t.co/ofG6ATsq02\">pic.twitter.com/ofG6ATsq02\u003c/a>\u003c/p>\n\u003cp>— Youth Speaks (@youthspeaks) \u003ca href=\"https://twitter.com/youthspeaks/status/712686618096771072\">March 23, 2016\u003c/a>\u003c/p>\u003c/blockquote>\n\u003cp>“Rest in peace and poetry, Phife Dawg. We will continue the fight against Diabetes in your honor,” Youth Speaks posted on Twitter.\u003c/p>\n\u003cp>Phife, born Malik Taylor, was diagnosed with diabetes when he was 19. It was May 1990, just one month after Tribe released its first album. Phife later talked about his struggle with the disease in interviews, and even rapped about it.\u003c/p>\n\u003cp>“Mr. Energetic, who me sound pathetic?/When’s the last time you heard a funky diabetic?” he rhymed in Tribe’s 1993 song “\u003ca href=\"http://genius.com/A-tribe-called-quest-oh-my-god-lyrics\" target=\"_blank\">Oh My God\u003c/a>.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In 2010, Phife told the \u003ca href=\"http://www.eastbayexpress.com/oakland/phife-dawgs-triumphal-return/Content?oid=2043994\" target=\"_blank\">East Bay Express\u003c/a> that he was working on a solo album, \"Songs in the Key of Phife,\" though it was never released. Reporter David MacFadden-Elliott got to hear a few samples in the IHOP parking lot after the interview, including a song about diabetes called “God Send.”\u003c/p>\n\u003cblockquote>\u003cp>“[It’s] a three-part song that turns from a smooth love joint into a warning from a doctor: 'You got to start dialysis.' The news ushers in a discordant, claustrophobic, pulsing beat that rocks, while voice-mail messages of support play for minutes on end. The song concludes with an emotional verse of thanks: \u003cem>If it wasn't for y'all/Who knows what would have happened?”\u003c/em>\u003c/p>\u003c/blockquote>\n\u003cp>It was a couple years after Phife’s initial diagnosis before he opened up about it, or even really took care of himself.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>His coming out was in a video interview on \u003ca href=\"http://www.dlife.com/dlifetv/video/phife-dawgs-dlife\" target=\"_blank\">dLife\u003c/a>, a website devoted to living with diabetes. He described finding out about his diagnosis. He was riding home from a concert in 1990 and kept asking the driver to pull over so he could go to the bathroom. He was really thirsty. When he got home, his grandmother, a nurse, did a test and confirmed he was diabetic.\u003c/p>\n\u003cp>“I thought it was over,” he told dLife. “I just automatically thought I was done rapping.”\u003c/p>\n\u003cp>He went into denial.\u003c/p>\n\u003cp>“I was just an idiot,” he said. “I still thought I was everybody else -- Twinkies, Suzie Qs, potato chips -- junk food anonymous.”\u003c/p>\n\u003cp>In 1992, Tribe was on \"The David Letterman Show\" and then immediately had to go to another shoot for \"The Dennis Miller Show.\" Pfife's blood sugar count was almost in the thousands -- normal levels are between 70 and 100.\u003c/p>\n\u003cp>“Everything was slow motion,” Phife described. “I couldn’t even do the show. I had to get hospitalized.”\u003c/p>\n\u003cp>Even then, he still struggled to get enough exercise and eat right.\u003c/p>\n\u003cp>“I’d get on the diet. Wouldn’t stick to the diet. Get back on diet, wouldn’t stick to the diet,” he said. “And it just got to point where I had to be put on dialysis.”\u003c/p>\n\u003cp>Phife was eventually put on a waiting list for a kidney transplant, and received one from his wife in 2008. By 2013, he was back on dialysis and back on the transplant list. In an interview with \u003ca href=\"http://www.npr.org/player/v2/mediaPlayer.html?action=1&t=1&islist=false&id=455764350&m=455936755\" target=\"_blank\">NPR\u003c/a> earlier this year, he talked about waiting for another kidney.\u003c/p>\n\u003cp>“I’m doing fine,” he said. “I really, really can’t complain. I could. But I won’t because God is really, really a good God.”\u003c/p>\n\u003cp>But he also had a message for other young people newly diagnosed with diabetes.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“It’s not a game. You can lose your life because of this,” he said during the dLife interview. “You need to love yourself, love your life.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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