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"content": "\u003cfigure id=\"attachment_22517\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/11/IMG_27381.jpg\">\u003cimg class=\"size-full wp-image-22517\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/11/IMG_27381.jpg\" alt=\"Hope House, a residential treatment program in Martinez, helps people in a mental health crisis make the transition back to the community. (Elaine Korry/KQED)\" width=\"640\" height=\"480\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2014/11/IMG_27381.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2014/11/IMG_27381-400x300.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2014/11/IMG_27381-320x240.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Hope House, a residential treatment program in Martinez, helps people in a mental health crisis make the transition back to the community. (Elaine Korry/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Elaine Korry\u003c/strong>\u003c/p>\n\u003cp>It's lunchtime at Hope House, a new 16-bed residential facility in Martinez, east of San Francisco. People who live here are busy preparing lunch in what looks like a big country kitchen.\u003c/p>\n\u003cp>\"We’ve designed it as much as possible to have a homelike atmosphere,\" says program director Christopher Roach. \"We want people to be thinking, this is a transition to the community.\"\u003c/p>\n\u003cp>Many of the residents here have arrived directly from a hospital. Among them are young adults facing a psychotic break, chronically-ill homeless men or mothers battling mental illness and addiction. After an average two-weeks of intense counseling, Roach says they’ll leave with hope for recovery.\u003c/p>\n\u003cp>\"What you’re able to accomplish in 14 days is huge if you know what you’re looking for,\" he says.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>19-year-old Chris Nguyen says his very life was on the line before he made it to this safe haven.\u003c/p>\n\u003cp>\"I have bipolar disorder,\" he explains, \"so I was having manic depressive symptoms and eventually it led to self-harm thoughts, suicidal thoughts, and I almost acted on it, but my family members were there to intervene and get me the help I needed.\"\u003c/p>\n\u003cp>Clinicians here helped Nguyen give up the marijuana and alcohol he had been using to treat his extreme anxiety. After getting proper medication, he started therapy -- individual, family and group -- where he began to talk about his fears of failure.\u003c/p>\n\u003cp>\"It let me calm down, slow things down finally, there’s all that pressure that you feel at a young age - so going here allowed me to take a step back and look at it. Wait, I need to build some support systems, take care of myself before I try to look at the path to success.\"\u003c/p>\n\u003cp>Now back home, Nguyen continues his treatment in an outpatient program.\u003c/p>\n\u003cp>Experts say residential treatment centers are a critical link in a system of care designed to keep people in a mental health crisis from spiraling downward.\u003c/p>\n\u003cp>\"What you have is a place where you can intervene to stop and redirect what would be an inpatient, involuntary, psychiatric admit to a hospital.\"\u003c/p>\n\u003cp>Randall Hagar is with the California Psychiatric Association, which has lobbied for years for more residential treatment options. Psychiatric services have been severely underfunded in California for decades. Cutbacks closed hospital wards and left big gaps in the system of care. But that process has been reversed over the last two years. Last year lawmakers passed the Investment in Mental Health Wellness Act.\u003c/p>\n\u003cp>Contra Costa County used grant money from the 2012 so-called \"Millionaires Tax\" proposition to fund Hope House. Hagar says without these sources of money, places like Hope House couldn’t exist. Cash-strapped counties simply can’t afford to build them on their own.\u003c/p>\n\u003cp>\"The money is very welcome, and it’s going toward very desperately needed services,\" Hagar says.\u003c/p>\n\u003cp>Besides residential treatment, counties around the state are using mental health grants to fund new urgent care units and \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/11/07/new-state-funding-improves-county-mental-health-services/\" href=\"http://ww2.kqed.org/stateofhealth/2014/11/07/new-state-funding-improves-county-mental-health-services/\" target=\"_blank\">mobile crisis teams\u003c/a> that pair clinicians with police officers to keep psychiatric patients out of jail.\u003c/p>\n\u003cp>\"The grants are going to do a great job of getting these things set up,\" Hagar said. \"Counties are going to have to find a way to keep them going, and that’s the rub.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Hagar says for counties that have few resources, finding long-term funding will be the toughest challenge.\u003c/p>\n\n",
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"content": "\u003cp>Fifteen students stand facing an imaginary line bisecting the room.\u003c/p>\n\u003cp>“If someone in your family has diabetes, cross the line,” said Sidra Bonner, the UCSF medical student leading the session on community health. Twelve of the 15 students cross the line. “If you have been affected by gun violence, cross the line.” Every student shuffles across.\u003c/p>\n\u003cp>The game is called \"cross the line.\" The students playing have all returned to school here at Civicorps, an Oakland-based non-profit that helps high-risk young adults get a high school diploma and job training. The school is right next to the Port of Oakland. Outside, trains whistle and trucks rumble down the freeway.\u003c/p>\n\u003cp>https://vimeo.com/109636449\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Bonner and other medical students leading the class talk about how rates of disease vary by neighborhood. In parts of east and west Oakland, life expectancy is a full 10 years less than it is in the more affluent hills neighborhoods, according to the Alameda County Public Health Department. Rates of heart disease, diabetes, and asthma all shake out in a similar way.\u003c/p>\n\u003cp>The students nod along, unsurprised. “Every day you see somebody sick, or in need. It's normal to see that,’” said Hassinnie Bennett, one of the Civicorps students.\u003c/p>\n\u003cp>“No one wants to just sit there and hear how violent and oppressed their community is, ” said Bonner. “How do you say, ‘This is the epidemiology,’ but also say, ‘You guys should feel empowered to do something about this?’”\u003c/p>\n\u003cp>The medical students then distributed cameras, and instructed the students to take pictures of whatever affects health in their neighborhoods -- the good and the bad.\u003c/p>\n\u003cp>Hours later, the students came back with photos of trash, abandoned buildings, and liquor stores -- often the only place around to buy food. But the students also took photos of parks, public transit, swimming pools, and murals.\u003c/p>\n\u003cp>“It gives you a third eye,” said Bennett. “It opens up your eyes to things you wouldn’t normally notice -- more stuff that has light and beauty to it.”\u003c/p>\n\u003cp>As the Civicorps students began seeing their neighborhoods in a new light, the medical students were gathering insight into the lives of their future patients.\u003c/p>\n\u003cp>Bonner and co-facilitator Faby Molina are already studying medicine in a program that trains doctors to work in medically-underserved communities. Working with the Civicorps students added something they can’t get in class -- “being able to really spend time and hear what their day-to-day lives are is so important as a future provider,” said Bonner.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The medical students said the experience will make them more empathetic doctors, with a better understanding of their patients' lives and communities. \"Unless you have that basic understanding,\" Bonner says, \"you’re not going to be as effective in empowering your patients to take ownership of their health.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Fifteen students stand facing an imaginary line bisecting the room.\u003c/p>\n\u003cp>“If someone in your family has diabetes, cross the line,” said Sidra Bonner, the UCSF medical student leading the session on community health. Twelve of the 15 students cross the line. “If you have been affected by gun violence, cross the line.” Every student shuffles across.\u003c/p>\n\u003cp>The game is called \"cross the line.\" The students playing have all returned to school here at Civicorps, an Oakland-based non-profit that helps high-risk young adults get a high school diploma and job training. The school is right next to the Port of Oakland. Outside, trains whistle and trucks rumble down the freeway.\u003c/p>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Bonner and other medical students leading the class talk about how rates of disease vary by neighborhood. In parts of east and west Oakland, life expectancy is a full 10 years less than it is in the more affluent hills neighborhoods, according to the Alameda County Public Health Department. Rates of heart disease, diabetes, and asthma all shake out in a similar way.\u003c/p>\n\u003cp>The students nod along, unsurprised. “Every day you see somebody sick, or in need. It's normal to see that,’” said Hassinnie Bennett, one of the Civicorps students.\u003c/p>\n\u003cp>“No one wants to just sit there and hear how violent and oppressed their community is, ” said Bonner. “How do you say, ‘This is the epidemiology,’ but also say, ‘You guys should feel empowered to do something about this?’”\u003c/p>\n\u003cp>The medical students then distributed cameras, and instructed the students to take pictures of whatever affects health in their neighborhoods -- the good and the bad.\u003c/p>\n\u003cp>Hours later, the students came back with photos of trash, abandoned buildings, and liquor stores -- often the only place around to buy food. But the students also took photos of parks, public transit, swimming pools, and murals.\u003c/p>\n\u003cp>“It gives you a third eye,” said Bennett. “It opens up your eyes to things you wouldn’t normally notice -- more stuff that has light and beauty to it.”\u003c/p>\n\u003cp>As the Civicorps students began seeing their neighborhoods in a new light, the medical students were gathering insight into the lives of their future patients.\u003c/p>\n\u003cp>Bonner and co-facilitator Faby Molina are already studying medicine in a program that trains doctors to work in medically-underserved communities. Working with the Civicorps students added something they can’t get in class -- “being able to really spend time and hear what their day-to-day lives are is so important as a future provider,” said Bonner.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The medical students said the experience will make them more empathetic doctors, with a better understanding of their patients' lives and communities. \"Unless you have that basic understanding,\" Bonner says, \"you’re not going to be as effective in empowering your patients to take ownership of their health.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Study: Transgender Men Who Become Pregnant Face Social Challenges",
"title": "Study: Transgender Men Who Become Pregnant Face Social Challenges",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_22480\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/11/iStock_000012930481_Large-e1415732598555.jpg\">\u003cimg class=\"size-large wp-image-22480\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/11/iStock_000012930481_Large-640x460.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"460\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Robin Marantz Henig\u003c/strong>, \u003ca title=\"http://www.npr.org/blogs/health/2014/11/07/362269036/transgender-men-who-become-pregnant-face-health-challenges\" href=\"http://www.npr.org/blogs/health/2014/11/07/362269036/transgender-men-who-become-pregnant-face-health-challenges\" target=\"_blank\">NPR\u003c/a>\u003c/p>\n\u003cp>\"Pregnancy and childbirth were very male experiences for me,\" said a 29-year-old respondent in a study reported Friday in\u003cem> Obstetrics and Gynecology\u003c/em>. \"When I birthed my children, I was born into fatherhood.\"\u003c/p>\n\u003cp>If this statement at first seems perplexing, it's less so when you realize the person talking is a transgender man – someone who has transitioned from a female identity to a male or masculine identity.\u003c/p>\n\u003cp>He is one of 41 participants\u003ca title=\"http://journals.lww.com/greenjournal/Abstract/publishahead/Transgender_Men_Who_Experienced_Pregnancy_After.99291.aspx\" href=\"http://journals.lww.com/greenjournal/Abstract/publishahead/Transgender_Men_Who_Experienced_Pregnancy_After.99291.aspx\" target=\"_blank\"> in a study \u003c/a>of how it feels to be male and pregnant, a study the authors think may be the first of its kind.\u003c/p>\n\u003cp>Pregnancy as a transgender man is unlike any other kind. No one expects a man to be pregnant, and the study participants said they were often greeted with double-takes, suspicion and even hostility from strangers and health care providers. \"Child Protective Services was alerted to the fact that a 'tranny' had a baby,\" one participant reported.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>There were plenty of insensitive comments and harsh experiences that troubled these men, both in and out of the health care setting, ranging from inappropriate use of pronouns (about three-quarters of the respondents preferred to be called \"he,\" while a handful preferred \"she,\" \"they,\" \"ey,\" or in one case, no pronoun at all), to actually turning them away and denying them prenatal care.\u003c/p>\n\u003cp>\"They just feel a lot of isolation from the health care community,\" said Dr. Jennifer Kerns, an assistant professor of obstetrics, gynecology at the U.C. San Francisco and the senior author. \"And we have some indication from our qualitative results that depression might be exacerbated for folks who are transgender, both during pregnancy and after.\"\u003c/p>\n\u003cp>The study came about because a medical student working with Kerns, Alexis Light, found herself fielding questions from transgender male friends about whether they'd be able to conceive and what pregnancy would be like.\u003c/p>\n\u003cp>[contextly_sidebar id=\"9iqaZPRPyoeMpVD1s6C8xL6BLz7UfIZq\"]\u003c/p>\n\u003cp>Light, now a first-year resident in obstetrics and gynecology at Washington Hospital Center in D.C., didn't know the answer and couldn't find it in the medical literature. So she asked Kerns to help her design a research project to find out. Kerns recognized it as a cutting-edge subject; \u003ca title=\"http://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Health-Care-for-Underserved-Women/Health-Care-for-Transgender-Individuals\" href=\"http://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Health-Care-for-Underserved-Women/Health-Care-for-Transgender-Individuals\" target=\"_blank\">a recent opinion paper\u003c/a> from the American College of Obstetricians and Gynecologists highlighted the need for high-quality health care for transgender individuals.\u003c/p>\n\u003cp>With such a small survey, it's impossible draw any firm conclusions. Kerns and Light both emphasize that more research is needed. But one thing they did learn was that prior testosterone use didn't seem to affect pregnancy outcome. Some transgender men use testosterone to look and \u003ca title=\"http://www.npr.org/blogs/health/2014/10/14/354858420/can-changing-how-you-sound-help-you-find-your-voice\" href=\"http://www.npr.org/blogs/health/2014/10/14/354858420/can-changing-how-you-sound-help-you-find-your-voice\" target=\"_blank\">sound more masculine.\u003c/a>\u003c/p>\n\u003cp>Twenty-five of the survey participants had taken testosterone before becoming pregnant; 16 had not. But the researchers found no difference in pregnancy, delivery, or birth outcomes between the two groups.\u003c/p>\n\u003cp>\"My friends were asking me be if they should delay starting testosterone if they had an interest in maintaining future fertility,\" Light said. Based on the experience of these 25 transgender men, she can tell them there's no need to delay — though they will need to discontinue testosterone when they decide to conceive, and stay off it throughout the pregnancy.\u003c/p>\n\u003cp>One complication unique to transgender male pregnancy is the re-emergence of gender dysphoria, the feeling that one's psychological gender identity is different from one's biological sex. \"Heavy time, having a baby, not passing as male,\" wrote a 35-year-old respondent, \"all the changes and a society telling me to just be happy.\"\u003c/p>\n\u003cp>But changes in gender dysphoria can work both ways, the investigators found. In some of the transgender men in the study, gender dysphoria actually declined with pregnancy. These people said they were, for the first time in their lives, pleased with their bodies, which were finally helping them do something they valued that a typical male body could not do. As one respondent put it, \"it was relieving to feel comfortable in the body I'd been born with.\"\u003c/p>\n\u003cp>More work is needed to find out how many transgender men get pregnant every year — it could easily be in the thousands, Kerns guessed — and to see how many more might be trying to get pregnant and failing. The men in this small study had little trouble conceiving — one-third hadn't even planned their pregnancies, and just 7 percent said they took fertility drugs — and the majority were able to get pregnant using their own eggs and their partner's sperm. But it's impossible to draw any inferences from that, since the only people recruited for the study were transgender men who had successfully had at least one child.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>One thing the study highlights is that, as Light put it, \"gender identity is a spectrum.\" And that building rapport with patients anywhere along that spectrum begins with the simplest step: with the physician finding out which pronoun the patient prefers, and using it.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_22480\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/11/iStock_000012930481_Large-e1415732598555.jpg\">\u003cimg class=\"size-large wp-image-22480\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/11/iStock_000012930481_Large-640x460.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"460\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Robin Marantz Henig\u003c/strong>, \u003ca title=\"http://www.npr.org/blogs/health/2014/11/07/362269036/transgender-men-who-become-pregnant-face-health-challenges\" href=\"http://www.npr.org/blogs/health/2014/11/07/362269036/transgender-men-who-become-pregnant-face-health-challenges\" target=\"_blank\">NPR\u003c/a>\u003c/p>\n\u003cp>\"Pregnancy and childbirth were very male experiences for me,\" said a 29-year-old respondent in a study reported Friday in\u003cem> Obstetrics and Gynecology\u003c/em>. \"When I birthed my children, I was born into fatherhood.\"\u003c/p>\n\u003cp>If this statement at first seems perplexing, it's less so when you realize the person talking is a transgender man – someone who has transitioned from a female identity to a male or masculine identity.\u003c/p>\n\u003cp>He is one of 41 participants\u003ca title=\"http://journals.lww.com/greenjournal/Abstract/publishahead/Transgender_Men_Who_Experienced_Pregnancy_After.99291.aspx\" href=\"http://journals.lww.com/greenjournal/Abstract/publishahead/Transgender_Men_Who_Experienced_Pregnancy_After.99291.aspx\" target=\"_blank\"> in a study \u003c/a>of how it feels to be male and pregnant, a study the authors think may be the first of its kind.\u003c/p>\n\u003cp>Pregnancy as a transgender man is unlike any other kind. No one expects a man to be pregnant, and the study participants said they were often greeted with double-takes, suspicion and even hostility from strangers and health care providers. \"Child Protective Services was alerted to the fact that a 'tranny' had a baby,\" one participant reported.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>There were plenty of insensitive comments and harsh experiences that troubled these men, both in and out of the health care setting, ranging from inappropriate use of pronouns (about three-quarters of the respondents preferred to be called \"he,\" while a handful preferred \"she,\" \"they,\" \"ey,\" or in one case, no pronoun at all), to actually turning them away and denying them prenatal care.\u003c/p>\n\u003cp>\"They just feel a lot of isolation from the health care community,\" said Dr. Jennifer Kerns, an assistant professor of obstetrics, gynecology at the U.C. San Francisco and the senior author. \"And we have some indication from our qualitative results that depression might be exacerbated for folks who are transgender, both during pregnancy and after.\"\u003c/p>\n\u003cp>The study came about because a medical student working with Kerns, Alexis Light, found herself fielding questions from transgender male friends about whether they'd be able to conceive and what pregnancy would be like.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Light, now a first-year resident in obstetrics and gynecology at Washington Hospital Center in D.C., didn't know the answer and couldn't find it in the medical literature. So she asked Kerns to help her design a research project to find out. Kerns recognized it as a cutting-edge subject; \u003ca title=\"http://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Health-Care-for-Underserved-Women/Health-Care-for-Transgender-Individuals\" href=\"http://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Health-Care-for-Underserved-Women/Health-Care-for-Transgender-Individuals\" target=\"_blank\">a recent opinion paper\u003c/a> from the American College of Obstetricians and Gynecologists highlighted the need for high-quality health care for transgender individuals.\u003c/p>\n\u003cp>With such a small survey, it's impossible draw any firm conclusions. Kerns and Light both emphasize that more research is needed. But one thing they did learn was that prior testosterone use didn't seem to affect pregnancy outcome. Some transgender men use testosterone to look and \u003ca title=\"http://www.npr.org/blogs/health/2014/10/14/354858420/can-changing-how-you-sound-help-you-find-your-voice\" href=\"http://www.npr.org/blogs/health/2014/10/14/354858420/can-changing-how-you-sound-help-you-find-your-voice\" target=\"_blank\">sound more masculine.\u003c/a>\u003c/p>\n\u003cp>Twenty-five of the survey participants had taken testosterone before becoming pregnant; 16 had not. But the researchers found no difference in pregnancy, delivery, or birth outcomes between the two groups.\u003c/p>\n\u003cp>\"My friends were asking me be if they should delay starting testosterone if they had an interest in maintaining future fertility,\" Light said. Based on the experience of these 25 transgender men, she can tell them there's no need to delay — though they will need to discontinue testosterone when they decide to conceive, and stay off it throughout the pregnancy.\u003c/p>\n\u003cp>One complication unique to transgender male pregnancy is the re-emergence of gender dysphoria, the feeling that one's psychological gender identity is different from one's biological sex. \"Heavy time, having a baby, not passing as male,\" wrote a 35-year-old respondent, \"all the changes and a society telling me to just be happy.\"\u003c/p>\n\u003cp>But changes in gender dysphoria can work both ways, the investigators found. In some of the transgender men in the study, gender dysphoria actually declined with pregnancy. These people said they were, for the first time in their lives, pleased with their bodies, which were finally helping them do something they valued that a typical male body could not do. As one respondent put it, \"it was relieving to feel comfortable in the body I'd been born with.\"\u003c/p>\n\u003cp>More work is needed to find out how many transgender men get pregnant every year — it could easily be in the thousands, Kerns guessed — and to see how many more might be trying to get pregnant and failing. The men in this small study had little trouble conceiving — one-third hadn't even planned their pregnancies, and just 7 percent said they took fertility drugs — and the majority were able to get pregnant using their own eggs and their partner's sperm. But it's impossible to draw any inferences from that, since the only people recruited for the study were transgender men who had successfully had at least one child.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>One thing the study highlights is that, as Light put it, \"gender identity is a spectrum.\" And that building rapport with patients anywhere along that spectrum begins with the simplest step: with the physician finding out which pronoun the patient prefers, and using it.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "UCSF Initiative Links 'Sugar Science' to Your Health",
"title": "UCSF Initiative Links 'Sugar Science' to Your Health",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_22428\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/11/iStock_000015590176_Large-e1415408861531.jpg\">\u003cimg class=\"size-large wp-image-22428\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/11/iStock_000015590176_Large-640x426.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>These days, sugar is pretty close to everywhere in the American diet. You probably know that too much sugar is probably not great for your health.\u003c/p>\n\u003cp>Now, a new initiative from UC San Francisco is spelling out the health dangers in clear terms. The project is called \"sugar science,\" and science there is.\u003c/p>\n\u003cp>A team of researchers distilled 8,000 studies and research papers, and found strong evidence showing overconsumption of added sugar overloads vital organs and contributes to three major chronic illnesses: heart disease, Type 2 diabetes and liver disease.\u003c!--more-->\u003c/p>\n\u003cp>While there are no federal guidelines recommending a limit on sugar consumption, the American Heart Association (AHA) recommends cutting our consumption way down. Right now, the average American consumes the equivalent of \u003ca title=\"http://www.cdc.gov/nchs/data/databriefs/db122.pdf\" href=\"http://www.cdc.gov/nchs/data/databriefs/db122.pdf\" target=\"_blank\">19.5 teaspoons \u003c/a>a day in added sugars. The AHA says men should cut that down to no more than \u003ca title=\"http://www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/HealthyDietGoals/Added-Sugars_UCM_305858_Article.jsp\" href=\"http://www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/HealthyDietGoals/Added-Sugars_UCM_305858_Article.jsp\" target=\"_blank\">9 teaspoons and women should consume less than 6 teaspoons\u003c/a>.\u003c/p>\n\u003cp>UCSF Professor Laura Schmidt is lead investigator on the project. \"Right now, the reality is that our consumption of sugar is out of whack, and until we bring things back into balance, we need to focus on helping people understand what the consequences are to having the average American … consume too much added sugar.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>As part of its outreach, Schmidt's team has created a\u003ca title=\"Sugar Science\" href=\"http://sugarscience.org\" target=\"_blank\"> user-friendly website\u003c/a> and is partnering with health departments across the country to spread the word. The website includes downloadable resources, including television commercials, that public health officials can localize for their own cities.\u003c/p>\n\u003cp>\u003ciframe src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/176317993&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" frameborder=\"no\" scrolling=\"no\">\u003c/iframe>\u003c/p>\n\u003cp>\"And that's what sugar science is all about,\" Schmidt says. \"It's about translating the information that's locked up in the medical journals and sharing it with the public in ways that are understandable.\"\u003c/p>\n\u003cp>Health departments from San Francisco to New York City have already agreed to participate in outreach. In a statement, the New York Department of Health called Sugar Science a \"wonderful resource\" and said it was \"\u003cspan style=\"color: #000000\">something that can be used by researchers, the public health community and those who just want thorough information.\"\u003c/span>\u003c/p>\n\u003cp>Schmidt is quick to point to the food environment as a driver in the increase of obesity that America has seen in the last generation. \"It's not like Americans suddenly lost their willpower,\" she says. \"The only major change in the diet that explains the obesity epidemic is this steep rise in added sugar consumption that started in the 1980s.\"\u003c/p>\n\u003cp>That sugar isn't just making us fat, she says, \"it's making us sick.\"\u003c/p>\n\u003cp>Schmidt insists the team, which includes researchers from UC Davis and Emory University, is not \"anti-sugar.\" Instead, it's really about knowing how much sugar is too much.\u003c/p>\n\u003cp>But knowing how much sugar you're eating can be challenging. Some key facts on the Sugar Science website are these:\u003c/p>\n\u003cul>\n\u003cli>Added sugar is hiding in 74 percent of packaged foods. (\u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/02/27/fda-proposes-food-label-overhaul/\" href=\"http://ww2.kqed.org/stateofhealth/2014/02/27/fda-proposes-food-label-overhaul/\" target=\"_blank\">Proposed changes\u003c/a> to the nutrition label would change this by including a separate line for added sugars.)\u003c/li>\n\u003cli>A common type of sugar can damage your liver -- just like too much alcohol.\u003c/li>\n\u003cli>One 12-ounce can of soda a day can increase your risk of dying of heart disease by one-third.\u003c/li>\n\u003c/ul>\n\u003cp>The site also includes tips on concrete steps that people can take to cut down on sugar. \u003ca title=\"http://sugarscience.org/ask-the-sugarscientists.html#.VF1q3EvJ4Ts\" href=\"http://sugarscience.org/ask-the-sugarscientists.html#.VF1q3EvJ4Ts\" target=\"_blank\">The most straightforward\u003c/a> way to cut down on sugar is to stop drinking sugar-sweetened drinks, like sodas, sports drinks and energy drinks, the researchers say. More than one-third of added sugar in the diet \u003ca title=\"http://www.health.gov/dietaryguidelines/dga2010/DietaryGuidelines2010.pdf\" href=\"http://www.health.gov/dietaryguidelines/dga2010/DietaryGuidelines2010.pdf\" target=\"_blank\">comes from sugary drinks\u003c/a>. They also recommend reading nutrition labels. While there are 61 different names for sugar on ingredients labels, the UCSF team says that \"if the chemical name has an 'ose' at the end—as in dextrose, fructose, lactose —- it’s likely to be added sugar.\"\u003c/p>\n\u003cp>\u003cstrong>Seeing Diabetes as the AIDS Crisis of This Generation\u003c/strong>\u003c/p>\n\u003cp>Dean Schillinger is also part of the Sugar Science team. He's a primary care doctor at San Francisco General Hospital. He first came to San Francisco in 1990 at the peak of the AIDS epidemic. \"At that point, one out of every two patients we admitted was a young man dying of AIDS,\" he says. At that time, there were no treatments, little any doctor could do.\u003c/p>\n\u003cp>Today, he says, there are good treatments, and it's rare to admit someone to the hospital dying of AIDS.\u003c/p>\n\u003cp>Instead, Schillinger says, that same ward, Ward 5A, where young men died of AIDS is now filled with diabetes patients.\u003c/p>\n\u003cp>\"I feel like we are with diabetes where we were in 1990 with the AIDS epidemic,\" Schillinger said. \"The ward is overwhelmed with diabetes –- they're getting their limbs amputated, they're on dialysis. And these are young people. They are suffering the ravages of diabetes in the prime of their life.\"\u003c/p>\n\u003cp>But unlike AIDS, where activists pushed hard for action from researchers and governments, there's little activist response for diabetes \"because it affects low-income communities disproportionately,\" Schillinger said. \"We're at the point where we need a public health response to it.\"\u003c/p>\n\u003cp>The timing of the SugarScience launch is not a coincidence. The UC researchers waited until after the election last week voters in Berkeley and San Francisco were considering soda tax measures. \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/11/04/will-berkeley-and-san-francisco-soda-tax-measures-set-precedent/\" href=\"http://ww2.kqed.org/stateofhealth/2014/11/04/will-berkeley-and-san-francisco-soda-tax-measures-set-precedent/\" target=\"_blank\">Measure D in Berkeley passed \u003c/a>with 75 percent of the vote. Schmidt says that since the university is a public institution, it could not be seen as trying to sway votes with the announcement of the new initiative.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Sugar Science was funded by a grant from the\u003ca title=\"http://www.arnoldfoundation.org\" href=\"http://www.arnoldfoundation.org\" target=\"_blank\"> Laura and John Arnold Foundation\u003c/a>.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_22428\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/11/iStock_000015590176_Large-e1415408861531.jpg\">\u003cimg class=\"size-large wp-image-22428\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/11/iStock_000015590176_Large-640x426.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>These days, sugar is pretty close to everywhere in the American diet. You probably know that too much sugar is probably not great for your health.\u003c/p>\n\u003cp>Now, a new initiative from UC San Francisco is spelling out the health dangers in clear terms. The project is called \"sugar science,\" and science there is.\u003c/p>\n\u003cp>A team of researchers distilled 8,000 studies and research papers, and found strong evidence showing overconsumption of added sugar overloads vital organs and contributes to three major chronic illnesses: heart disease, Type 2 diabetes and liver disease.\u003c!--more-->\u003c/p>\n\u003cp>While there are no federal guidelines recommending a limit on sugar consumption, the American Heart Association (AHA) recommends cutting our consumption way down. Right now, the average American consumes the equivalent of \u003ca title=\"http://www.cdc.gov/nchs/data/databriefs/db122.pdf\" href=\"http://www.cdc.gov/nchs/data/databriefs/db122.pdf\" target=\"_blank\">19.5 teaspoons \u003c/a>a day in added sugars. The AHA says men should cut that down to no more than \u003ca title=\"http://www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/HealthyDietGoals/Added-Sugars_UCM_305858_Article.jsp\" href=\"http://www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/HealthyDietGoals/Added-Sugars_UCM_305858_Article.jsp\" target=\"_blank\">9 teaspoons and women should consume less than 6 teaspoons\u003c/a>.\u003c/p>\n\u003cp>UCSF Professor Laura Schmidt is lead investigator on the project. \"Right now, the reality is that our consumption of sugar is out of whack, and until we bring things back into balance, we need to focus on helping people understand what the consequences are to having the average American … consume too much added sugar.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>As part of its outreach, Schmidt's team has created a\u003ca title=\"Sugar Science\" href=\"http://sugarscience.org\" target=\"_blank\"> user-friendly website\u003c/a> and is partnering with health departments across the country to spread the word. The website includes downloadable resources, including television commercials, that public health officials can localize for their own cities.\u003c/p>\n\u003cp>\u003ciframe src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/176317993&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" frameborder=\"no\" scrolling=\"no\">\u003c/iframe>\u003c/p>\n\u003cp>\"And that's what sugar science is all about,\" Schmidt says. \"It's about translating the information that's locked up in the medical journals and sharing it with the public in ways that are understandable.\"\u003c/p>\n\u003cp>Health departments from San Francisco to New York City have already agreed to participate in outreach. In a statement, the New York Department of Health called Sugar Science a \"wonderful resource\" and said it was \"\u003cspan style=\"color: #000000\">something that can be used by researchers, the public health community and those who just want thorough information.\"\u003c/span>\u003c/p>\n\u003cp>Schmidt is quick to point to the food environment as a driver in the increase of obesity that America has seen in the last generation. \"It's not like Americans suddenly lost their willpower,\" she says. \"The only major change in the diet that explains the obesity epidemic is this steep rise in added sugar consumption that started in the 1980s.\"\u003c/p>\n\u003cp>That sugar isn't just making us fat, she says, \"it's making us sick.\"\u003c/p>\n\u003cp>Schmidt insists the team, which includes researchers from UC Davis and Emory University, is not \"anti-sugar.\" Instead, it's really about knowing how much sugar is too much.\u003c/p>\n\u003cp>But knowing how much sugar you're eating can be challenging. Some key facts on the Sugar Science website are these:\u003c/p>\n\u003cul>\n\u003cli>Added sugar is hiding in 74 percent of packaged foods. (\u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/02/27/fda-proposes-food-label-overhaul/\" href=\"http://ww2.kqed.org/stateofhealth/2014/02/27/fda-proposes-food-label-overhaul/\" target=\"_blank\">Proposed changes\u003c/a> to the nutrition label would change this by including a separate line for added sugars.)\u003c/li>\n\u003cli>A common type of sugar can damage your liver -- just like too much alcohol.\u003c/li>\n\u003cli>One 12-ounce can of soda a day can increase your risk of dying of heart disease by one-third.\u003c/li>\n\u003c/ul>\n\u003cp>The site also includes tips on concrete steps that people can take to cut down on sugar. \u003ca title=\"http://sugarscience.org/ask-the-sugarscientists.html#.VF1q3EvJ4Ts\" href=\"http://sugarscience.org/ask-the-sugarscientists.html#.VF1q3EvJ4Ts\" target=\"_blank\">The most straightforward\u003c/a> way to cut down on sugar is to stop drinking sugar-sweetened drinks, like sodas, sports drinks and energy drinks, the researchers say. More than one-third of added sugar in the diet \u003ca title=\"http://www.health.gov/dietaryguidelines/dga2010/DietaryGuidelines2010.pdf\" href=\"http://www.health.gov/dietaryguidelines/dga2010/DietaryGuidelines2010.pdf\" target=\"_blank\">comes from sugary drinks\u003c/a>. They also recommend reading nutrition labels. While there are 61 different names for sugar on ingredients labels, the UCSF team says that \"if the chemical name has an 'ose' at the end—as in dextrose, fructose, lactose —- it’s likely to be added sugar.\"\u003c/p>\n\u003cp>\u003cstrong>Seeing Diabetes as the AIDS Crisis of This Generation\u003c/strong>\u003c/p>\n\u003cp>Dean Schillinger is also part of the Sugar Science team. He's a primary care doctor at San Francisco General Hospital. He first came to San Francisco in 1990 at the peak of the AIDS epidemic. \"At that point, one out of every two patients we admitted was a young man dying of AIDS,\" he says. At that time, there were no treatments, little any doctor could do.\u003c/p>\n\u003cp>Today, he says, there are good treatments, and it's rare to admit someone to the hospital dying of AIDS.\u003c/p>\n\u003cp>Instead, Schillinger says, that same ward, Ward 5A, where young men died of AIDS is now filled with diabetes patients.\u003c/p>\n\u003cp>\"I feel like we are with diabetes where we were in 1990 with the AIDS epidemic,\" Schillinger said. \"The ward is overwhelmed with diabetes –- they're getting their limbs amputated, they're on dialysis. And these are young people. They are suffering the ravages of diabetes in the prime of their life.\"\u003c/p>\n\u003cp>But unlike AIDS, where activists pushed hard for action from researchers and governments, there's little activist response for diabetes \"because it affects low-income communities disproportionately,\" Schillinger said. \"We're at the point where we need a public health response to it.\"\u003c/p>\n\u003cp>The timing of the SugarScience launch is not a coincidence. The UC researchers waited until after the election last week voters in Berkeley and San Francisco were considering soda tax measures. \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/11/04/will-berkeley-and-san-francisco-soda-tax-measures-set-precedent/\" href=\"http://ww2.kqed.org/stateofhealth/2014/11/04/will-berkeley-and-san-francisco-soda-tax-measures-set-precedent/\" target=\"_blank\">Measure D in Berkeley passed \u003c/a>with 75 percent of the vote. Schmidt says that since the university is a public institution, it could not be seen as trying to sway votes with the announcement of the new initiative.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Sugar Science was funded by a grant from the\u003ca title=\"http://www.arnoldfoundation.org\" href=\"http://www.arnoldfoundation.org\" target=\"_blank\"> Laura and John Arnold Foundation\u003c/a>.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "'Village' Movement for Aging Seniors Faces Some Challenges",
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"content": "\u003cfigure id=\"attachment_16541\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/12/RS1562_Aging_Healthy_Patrick_Flickr_02212012-e1386288838603.jpg\">\u003cimg class=\"size-large wp-image-16541\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/12/RS1562_Aging_Healthy_Patrick_Flickr_02212012-640x512.jpg\" alt=\"(Patrick/Flickr)\" width=\"640\" height=\"512\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Patrick/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>“It takes a village” is a common refrain.\u003c/p>\n\u003cp>Now \"Villages\" -- yes, with a capital V -- are sweeping the U.S., looking to redefine how people age in their communities.\u003c/p>\n\u003cp>The Village movement brings together older adults who want to age in their homes independently, but believe it will be too hard to do so, unless they have some support. These virtual villages link independent living seniors together. Members offer support to each other as they are able, and ask for support when they need it through an organized system.\u003c/p>\n\u003cp>Half of all villages in the U.S. started in the last three years. Because they are such a recent phenomenon, there have not been many studies about their outcomes.\u003c!--more-->\u003c/p>\n\u003cp>Now, the initial results from a retrospective,\u003ca title=\"http://heb.sagepub.com/search/results?fulltext=+SCHARLACH&x=-905&y=-237&submit=yes&journal_set=spheb&src=selected&andorexactfulltext=and\" href=\"http://heb.sagepub.com/search/results?fulltext=+SCHARLACH&x=-905&y=-237&submit=yes&journal_set=spheb&src=selected&andorexactfulltext=and\" target=\"_blank\"> three year study \u003c/a>from UC Berkeley find support for many of the movement’s positive claims. Butthe data, being presented at the Gerontological Society of America conference, also raises flags about the communities’ diversity and sustainability.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“People, by and large, report that the village has made a substantial difference in their life,” says Andrew Scharlach, a professor at UC Berkeley and the principal investigator of the ongoing study that includes in-person interviews with 300 residents at nine California villages.\u003c/p>\n\u003cp>The study has shown that over time village members’ desire to move out of their home and community decreased.\u003c/p>\n\u003cp>Also, 55 to 80 percent of respondents reported a jump in quality of life. The more involved they were with the village, the higher the impact.\u003c/p>\n\u003cp>But, Sharlach says, there are some caveats.\u003c/p>\n\u003cp>People in the study self-reported big gains in social connections — knowing more people, getting out of the house more, and interacting with people more than they used to.\u003c/p>\n\u003cp>But when the researchers looked at data from the 133 people they followed over the course of 12 months, there was no evidence that the number of interactions or social connections these people had, had actually changed.\u003c/p>\n\u003cp>“If you ask, the first day of the village, ‘How many people do you know? How often do you get out of the house? How many social activities are you participating in?’ and then you come back a year later and ask the exact same questions,” says Sharlach, “there’s not a significant difference.”\u003c/p>\n\u003cp>He says it’s possible one year may be too soon to see significant changes in numbers, or the questions may not be capturing the growth areas for people. Another possibility is that people join the village during transitions in life and their social circle doesn’t grow, it just shifts.\u003c/p>\n\u003cp>Village participants’ health outcomes are another area policy experts are eager for data about. Sharlach’s team is looking at changes over time in incidents of falls, emergency department visits and hospital admissions. But he says that data is still being processed.\u003c/p>\n\u003cp>The weakest points the study found were around diversity and sustainability.\u003c/p>\n\u003cp>Villages are 94 percent white, according to studies. If they are going to be a model to serve a greater aging population, Sharlach says, the challenges that communities have reflecting the whole population need to be addressed.\u003c/p>\n\u003cp>He says those could include some cultural barriers. The village model is aimed at helping individuals age in place, but in some cultures families and other communities are inextricably linked to their elders. That means adapting the model to serve existing communities.\u003c/p>\n\u003cp>Right now, though, given that they are largely white, Sharlach says that raises questions. “invite someone who is African-American, or Latino or Asian Pacific Islander to join a village,” he says. “And they come to a meeting that is based on social connections and these aren’t people who are naturally part of their social connections, are they going to want to join this club?”\u003c/p>\n\u003cp>Another challenge the study found was the sustainability of Villages.\u003c/p>\n\u003cp>Nationally, and also in California, about 50 percent of the budgets are covered by membership dues, but the other 50 percent has to be raised.\u003c/p>\n\u003cp>“Whether that’s through contracts and grants or through the government, [in order to succeed for the long term] that’s the area that really needs to be figured out,” says Sharlach.\u003c/p>\n\u003cp>The city of San Francisco stands out as a government that has supported its two villages. In February 2013 the city gave $50,000 each to the San Francisco Village and the NEXT Village. But these grants are the exception, not the rule.\u003c/p>\n\u003cp>Sharlach says the study shows there are great benefits to be had from the Village model, but the challenges suggest the model really needs to be models, plural, to serve the many communities that could take advantage of them.\u003c/p>\n\u003cp>The UC Berkeley study followed residents at nine communities in California. Most were suburban but it included the rural Community Connections program in Plumas County and the urban San Francisco Village were also included. The remaining study sites were Ashby Village (Berkeley), Avenidas (Palo Alto), Santa Barbara Village, Wise Connections (Santa Monica), Westchester Playa Village, Real Connections (Claremont-Pomona), and Tierra Santa in San Diego.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Rachel Dornhelm wrote this story through a Fellowship from New America Media and the Gerontological Society of America, supported by AARP.\u003c/em>\u003c/p>\n\n",
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"description": "“It takes a village” is a common refrain. Now "Villages" -- yes, with a capital V -- are sweeping the U.S., looking to redefine how people age in their communities. The Village movement brings together older adults who want to age in their homes independently, but believe it will be too hard to do so,",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_16541\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/12/RS1562_Aging_Healthy_Patrick_Flickr_02212012-e1386288838603.jpg\">\u003cimg class=\"size-large wp-image-16541\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/12/RS1562_Aging_Healthy_Patrick_Flickr_02212012-640x512.jpg\" alt=\"(Patrick/Flickr)\" width=\"640\" height=\"512\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Patrick/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>“It takes a village” is a common refrain.\u003c/p>\n\u003cp>Now \"Villages\" -- yes, with a capital V -- are sweeping the U.S., looking to redefine how people age in their communities.\u003c/p>\n\u003cp>The Village movement brings together older adults who want to age in their homes independently, but believe it will be too hard to do so, unless they have some support. These virtual villages link independent living seniors together. Members offer support to each other as they are able, and ask for support when they need it through an organized system.\u003c/p>\n\u003cp>Half of all villages in the U.S. started in the last three years. Because they are such a recent phenomenon, there have not been many studies about their outcomes.\u003c!--more-->\u003c/p>\n\u003cp>Now, the initial results from a retrospective,\u003ca title=\"http://heb.sagepub.com/search/results?fulltext=+SCHARLACH&x=-905&y=-237&submit=yes&journal_set=spheb&src=selected&andorexactfulltext=and\" href=\"http://heb.sagepub.com/search/results?fulltext=+SCHARLACH&x=-905&y=-237&submit=yes&journal_set=spheb&src=selected&andorexactfulltext=and\" target=\"_blank\"> three year study \u003c/a>from UC Berkeley find support for many of the movement’s positive claims. Butthe data, being presented at the Gerontological Society of America conference, also raises flags about the communities’ diversity and sustainability.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“People, by and large, report that the village has made a substantial difference in their life,” says Andrew Scharlach, a professor at UC Berkeley and the principal investigator of the ongoing study that includes in-person interviews with 300 residents at nine California villages.\u003c/p>\n\u003cp>The study has shown that over time village members’ desire to move out of their home and community decreased.\u003c/p>\n\u003cp>Also, 55 to 80 percent of respondents reported a jump in quality of life. The more involved they were with the village, the higher the impact.\u003c/p>\n\u003cp>But, Sharlach says, there are some caveats.\u003c/p>\n\u003cp>People in the study self-reported big gains in social connections — knowing more people, getting out of the house more, and interacting with people more than they used to.\u003c/p>\n\u003cp>But when the researchers looked at data from the 133 people they followed over the course of 12 months, there was no evidence that the number of interactions or social connections these people had, had actually changed.\u003c/p>\n\u003cp>“If you ask, the first day of the village, ‘How many people do you know? How often do you get out of the house? How many social activities are you participating in?’ and then you come back a year later and ask the exact same questions,” says Sharlach, “there’s not a significant difference.”\u003c/p>\n\u003cp>He says it’s possible one year may be too soon to see significant changes in numbers, or the questions may not be capturing the growth areas for people. Another possibility is that people join the village during transitions in life and their social circle doesn’t grow, it just shifts.\u003c/p>\n\u003cp>Village participants’ health outcomes are another area policy experts are eager for data about. Sharlach’s team is looking at changes over time in incidents of falls, emergency department visits and hospital admissions. But he says that data is still being processed.\u003c/p>\n\u003cp>The weakest points the study found were around diversity and sustainability.\u003c/p>\n\u003cp>Villages are 94 percent white, according to studies. If they are going to be a model to serve a greater aging population, Sharlach says, the challenges that communities have reflecting the whole population need to be addressed.\u003c/p>\n\u003cp>He says those could include some cultural barriers. The village model is aimed at helping individuals age in place, but in some cultures families and other communities are inextricably linked to their elders. That means adapting the model to serve existing communities.\u003c/p>\n\u003cp>Right now, though, given that they are largely white, Sharlach says that raises questions. “invite someone who is African-American, or Latino or Asian Pacific Islander to join a village,” he says. “And they come to a meeting that is based on social connections and these aren’t people who are naturally part of their social connections, are they going to want to join this club?”\u003c/p>\n\u003cp>Another challenge the study found was the sustainability of Villages.\u003c/p>\n\u003cp>Nationally, and also in California, about 50 percent of the budgets are covered by membership dues, but the other 50 percent has to be raised.\u003c/p>\n\u003cp>“Whether that’s through contracts and grants or through the government, [in order to succeed for the long term] that’s the area that really needs to be figured out,” says Sharlach.\u003c/p>\n\u003cp>The city of San Francisco stands out as a government that has supported its two villages. In February 2013 the city gave $50,000 each to the San Francisco Village and the NEXT Village. But these grants are the exception, not the rule.\u003c/p>\n\u003cp>Sharlach says the study shows there are great benefits to be had from the Village model, but the challenges suggest the model really needs to be models, plural, to serve the many communities that could take advantage of them.\u003c/p>\n\u003cp>The UC Berkeley study followed residents at nine communities in California. Most were suburban but it included the rural Community Connections program in Plumas County and the urban San Francisco Village were also included. The remaining study sites were Ashby Village (Berkeley), Avenidas (Palo Alto), Santa Barbara Village, Wise Connections (Santa Monica), Westchester Playa Village, Real Connections (Claremont-Pomona), and Tierra Santa in San Diego.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Rachel Dornhelm wrote this story through a Fellowship from New America Media and the Gerontological Society of America, supported by AARP.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_22472\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/11/iStock_000016939839_Large-e1415663541743.jpg\">\u003cimg class=\"size-large wp-image-22472\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/11/iStock_000016939839_Large-640x420.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"420\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Elaine Korry\u003c/strong>\u003c/p>\n\u003cp>The Joslyn Center in Burbank is a place where older adults come for low-cost healthy meals and activities ranging from fitness and computer classes to music lessons.\u003c/p>\n\u003cp>But several times lately, the normally placid environment of the center has been disrupted. One client who uses the services was showing signs of mental illness. Renee Crawford coordinates social services at the Center.\u003c/p>\n\u003cp>“She gets very loud, very aggressive and very anxious,\" Crawford said, in reference to the troubled client. \"And then we have to go in and tell her, 'Calm down, relax, you can’t be this loud,' Then she gets very upset and very irate.”\u003c/p>\n\u003cp>The woman seemed to be suffering from paranoid delusions, and Crawford says the workers here aren’t trained to help her.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"Staff gets very uncomfortable with it. We have called the police. We have asked her to leave the building.”\u003c/p>\n\u003cp>Until recently, there were few places for Crawford to go for help. But \u003ca title=\"http://www.treasurer.ca.gov/chffa/imhwa/\" href=\"http://www.treasurer.ca.gov/chffa/imhwa/\" target=\"_blank\">legislation passed last year\u003c/a> in Sacramento provides more than $140 million in grant funds for, among other things, mobile crisis support teams.\u003c/p>\n\u003cp>Because Crawford was worried her client might become violent, she turned to a service of the Burbank Police Department, called a Mental Health Evaluation Team. The team pairs a clinical psychologist and a patrol officer, who respond together to mental health crises. Psychologist Jennifer Hunt says the goal is to assess people and, if appropriate, connect them with mental health services. The team seeks to head off a confrontation that could land a person, like Crawford's client, either in the hospital or jail.\u003c/p>\n\u003cp>“We would want to make sure not only that we are addressing the needs that she continues to present,\" says Hunt, \"but also to make sure that everybody’s safe.”\u003c/p>\n\u003cp>Back in the patrol car, Kristiana Sanchez, the police officer who works with Hunt, says units like this one free up other patrols to focus on their primary mission -- fighting crime. Before crisis teams were in use, she says police officers wasted valuable time in waiting rooms.\u003c/p>\n\u003cp>“It took many officers out of the field to deal with transporting someone who was in a mental health crisis to the hospital and then sitting there for multiple hours,\" Sanchez says. \"And that took two officers for just one person.”\u003c/p>\n\u003cp>Now, says Sanchez, specially-trained officers like her are able to recognize the symptoms of mental disorders.\u003c/p>\n\u003cp>Linda Boyd, who started the emergency outreach bureau for Los Angeles County, says responding to mental illness requires very different skills from disarming criminals.\u003c/p>\n\u003cp>“We treat people with respect,\" Boyd says. \"We don’t rush in. … We give the person time to calm down. With folks who have a mental illness, you really have to slow down.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Mobile crisis teams are expensive, and were only available in parts of the Los Angeles County until last year when lawmakers approved the Investment in Mental Health Wellness Act. It restored badly needed funding for psychiatric services. Now, with the new grant money, Los Angeles has more than a dozen new mobile crisis teams, and is doubling the number of its urgent care units -- places where people in a psychiatric emergency can go for help, instead of the hospital or jail.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_22472\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/11/iStock_000016939839_Large-e1415663541743.jpg\">\u003cimg class=\"size-large wp-image-22472\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/11/iStock_000016939839_Large-640x420.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"420\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Elaine Korry\u003c/strong>\u003c/p>\n\u003cp>The Joslyn Center in Burbank is a place where older adults come for low-cost healthy meals and activities ranging from fitness and computer classes to music lessons.\u003c/p>\n\u003cp>But several times lately, the normally placid environment of the center has been disrupted. One client who uses the services was showing signs of mental illness. Renee Crawford coordinates social services at the Center.\u003c/p>\n\u003cp>“She gets very loud, very aggressive and very anxious,\" Crawford said, in reference to the troubled client. \"And then we have to go in and tell her, 'Calm down, relax, you can’t be this loud,' Then she gets very upset and very irate.”\u003c/p>\n\u003cp>The woman seemed to be suffering from paranoid delusions, and Crawford says the workers here aren’t trained to help her.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"Staff gets very uncomfortable with it. We have called the police. We have asked her to leave the building.”\u003c/p>\n\u003cp>Until recently, there were few places for Crawford to go for help. But \u003ca title=\"http://www.treasurer.ca.gov/chffa/imhwa/\" href=\"http://www.treasurer.ca.gov/chffa/imhwa/\" target=\"_blank\">legislation passed last year\u003c/a> in Sacramento provides more than $140 million in grant funds for, among other things, mobile crisis support teams.\u003c/p>\n\u003cp>Because Crawford was worried her client might become violent, she turned to a service of the Burbank Police Department, called a Mental Health Evaluation Team. The team pairs a clinical psychologist and a patrol officer, who respond together to mental health crises. Psychologist Jennifer Hunt says the goal is to assess people and, if appropriate, connect them with mental health services. The team seeks to head off a confrontation that could land a person, like Crawford's client, either in the hospital or jail.\u003c/p>\n\u003cp>“We would want to make sure not only that we are addressing the needs that she continues to present,\" says Hunt, \"but also to make sure that everybody’s safe.”\u003c/p>\n\u003cp>Back in the patrol car, Kristiana Sanchez, the police officer who works with Hunt, says units like this one free up other patrols to focus on their primary mission -- fighting crime. Before crisis teams were in use, she says police officers wasted valuable time in waiting rooms.\u003c/p>\n\u003cp>“It took many officers out of the field to deal with transporting someone who was in a mental health crisis to the hospital and then sitting there for multiple hours,\" Sanchez says. \"And that took two officers for just one person.”\u003c/p>\n\u003cp>Now, says Sanchez, specially-trained officers like her are able to recognize the symptoms of mental disorders.\u003c/p>\n\u003cp>Linda Boyd, who started the emergency outreach bureau for Los Angeles County, says responding to mental illness requires very different skills from disarming criminals.\u003c/p>\n\u003cp>“We treat people with respect,\" Boyd says. \"We don’t rush in. … We give the person time to calm down. With folks who have a mental illness, you really have to slow down.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Mobile crisis teams are expensive, and were only available in parts of the Los Angeles County until last year when lawmakers approved the Investment in Mental Health Wellness Act. It restored badly needed funding for psychiatric services. Now, with the new grant money, Los Angeles has more than a dozen new mobile crisis teams, and is doubling the number of its urgent care units -- places where people in a psychiatric emergency can go for help, instead of the hospital or jail.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Study Shows Childhood Trauma a ‘Hidden Crisis’ Across California",
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"content": "\u003cfigure id=\"attachment_22400\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/11/iStock_000011627266_LargeCROP-e1415297090876.jpg\">\u003cimg class=\"size-large wp-image-22400\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/11/iStock_000011627266_LargeCROP-640x473.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"473\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Sara Hossaini\u003c/strong>\u003c/p>\n\u003cp>A first-of-its kind report released Wednesday suggests Californians are facing a hidden public health crisis that stems from childhood trauma.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"People sometimes assume this is a low-income issue. This is everybody's burden.\" \u003c/aside>\n\u003cp>Researchers from the San Francisco-based Center for Youth Wellness and Public Health Institute in Oakland aim to shed light on how early adverse experiences, such as abuse, neglect, and household dysfunction -- including divorce and parental incarceration -- might impact a child's health for a lifetime.\u003c/p>\n\u003cp>Dr. Nadine Burke Harris is a pediatrician and founder of the Center for Youth Wellness. She says\u003ca title=\"https://chronicleofsocialchange.org/xpanel/wp-content/uploads/2014/11/Embrgoed_CYW_HiddenCrisis_Report_1014.pdf\" href=\"https://chronicleofsocialchange.org/xpanel/wp-content/uploads/2014/11/Embrgoed_CYW_HiddenCrisis_Report_1014.pdf\" target=\"_blank\"> the study \u003c/a>looked at data from more than 27,000 surveys conducted by the\u003ca title=\"http://www.cdph.ca.gov/data/surveys/Pages/BRFSS.aspx\" href=\"http://www.cdph.ca.gov/data/surveys/Pages/BRFSS.aspx\" target=\"_blank\"> California Behavioral Risk Factor Surveillance System\u003c/a> over four years between 2008 and 2013. \u003c!--more-->\u003c/p>\n\u003cp>She says the results surprised even her. For starters, so-called \u003ca title=\"http://www.cdc.gov/violenceprevention/acestudy/\" href=\"http://www.cdc.gov/violenceprevention/acestudy/\" target=\"_blank\">adverse childhood experiences, or ACEs\u003c/a>, are common across race, income, education and geography. Nearly 62 percent of Californians reported at least one traumatic childhood event, and one in six had experienced four or more. People in the northern rural counties of Humboldt and Butte reported the most ACEs. The lowest numbers came from Santa Clara and San Mateo counties, where just over half of respondents reported such experiences.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"People sometimes assume this is a low-income issue,\" says Burke Harris, \"This is everybody's burden, every taxpayer.\"\u003c/p>\n\u003cp>In part, she says this is because traumatic childhood experiences can make a child's natural response to stress go haywire and cause lasting damage. This is known as childhood toxic stress, a concept Burke Harris says has just begun to gain traction over the past five years.\u003c/p>\n\u003cp>\"Toxic stress affects the entire developmental trajectory of the child,\" Burke Harris says, \"the changes to your DNA, the changes to your hormonal systems, as well as the changes to your immune system and neuro-development.\"\u003c/p>\n\u003cp>High doses of such adversity increase risk of chronic diseases, heart disease, asthma, even Alzheimer's disease. People with four or more ACEs are poorer, less likely to get a college degree and are nearly 40 percent more likely to be unemployed later in life.\u003c/p>\n\u003cp>The term \"ACEs\" was first coined in the late 1990s after Vincent Felitti of Kaiser in conjunction with a Centers for Disease Control researchers \u003ca title=\"http://www.ncbi.nlm.nih.gov/pubmed/9635069?dopt=Abstract\" href=\"http://www.ncbi.nlm.nih.gov/pubmed/9635069?dopt=Abstract\" target=\"_blank\">published the original ACEs study\u003c/a>. But that study was in Kaiser members who were overwhelmingly caucasian and most had a college education. The \"Hidden Crisis\" report is the first to use sample size more representative of the demographics of California, Marta Induni, research director at the Public Health Institute, told the \u003ca title=\"https://chronicleofsocialchange.org/news/new-study-childhood-trauma-a-california-public-health-crisis/8521\" href=\"https://chronicleofsocialchange.org/news/new-study-childhood-trauma-a-california-public-health-crisis/8521\" target=\"_blank\">Chronicle of Social Change\u003c/a>.\u003c/p>\n\u003cp>Burke Harris is hopeful that momentum around early interventions will save lives and money. She's calling for ACE training for physicians, in-home screenings, and what she calls the gold standard: two-generational services that includes both parents and children, like that utilized by University of California San Francisco's Infant Parent Program and Child Trauma Research Program.\u003c/p>\n\u003cp>\"Where a child has a high ACE score, often times you have a parent with high ACE score and that often predisposes for the conditions the child is in,\" says Burke Harris, With two-generational services, \"we're seeing improved school functioning, and a reduction in chronic disease outcomes, like asthma hospitalizations, et cetera.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Burke Harris says more research is needed on the impact of other types of negative childhood experiences that the original surveys did not consider, including bullying, racism and community violence.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_22400\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/11/iStock_000011627266_LargeCROP-e1415297090876.jpg\">\u003cimg class=\"size-large wp-image-22400\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/11/iStock_000011627266_LargeCROP-640x473.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"473\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Sara Hossaini\u003c/strong>\u003c/p>\n\u003cp>A first-of-its kind report released Wednesday suggests Californians are facing a hidden public health crisis that stems from childhood trauma.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"People sometimes assume this is a low-income issue. This is everybody's burden.\" \u003c/aside>\n\u003cp>Researchers from the San Francisco-based Center for Youth Wellness and Public Health Institute in Oakland aim to shed light on how early adverse experiences, such as abuse, neglect, and household dysfunction -- including divorce and parental incarceration -- might impact a child's health for a lifetime.\u003c/p>\n\u003cp>Dr. Nadine Burke Harris is a pediatrician and founder of the Center for Youth Wellness. She says\u003ca title=\"https://chronicleofsocialchange.org/xpanel/wp-content/uploads/2014/11/Embrgoed_CYW_HiddenCrisis_Report_1014.pdf\" href=\"https://chronicleofsocialchange.org/xpanel/wp-content/uploads/2014/11/Embrgoed_CYW_HiddenCrisis_Report_1014.pdf\" target=\"_blank\"> the study \u003c/a>looked at data from more than 27,000 surveys conducted by the\u003ca title=\"http://www.cdph.ca.gov/data/surveys/Pages/BRFSS.aspx\" href=\"http://www.cdph.ca.gov/data/surveys/Pages/BRFSS.aspx\" target=\"_blank\"> California Behavioral Risk Factor Surveillance System\u003c/a> over four years between 2008 and 2013. \u003c!--more-->\u003c/p>\n\u003cp>She says the results surprised even her. For starters, so-called \u003ca title=\"http://www.cdc.gov/violenceprevention/acestudy/\" href=\"http://www.cdc.gov/violenceprevention/acestudy/\" target=\"_blank\">adverse childhood experiences, or ACEs\u003c/a>, are common across race, income, education and geography. Nearly 62 percent of Californians reported at least one traumatic childhood event, and one in six had experienced four or more. People in the northern rural counties of Humboldt and Butte reported the most ACEs. The lowest numbers came from Santa Clara and San Mateo counties, where just over half of respondents reported such experiences.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"People sometimes assume this is a low-income issue,\" says Burke Harris, \"This is everybody's burden, every taxpayer.\"\u003c/p>\n\u003cp>In part, she says this is because traumatic childhood experiences can make a child's natural response to stress go haywire and cause lasting damage. This is known as childhood toxic stress, a concept Burke Harris says has just begun to gain traction over the past five years.\u003c/p>\n\u003cp>\"Toxic stress affects the entire developmental trajectory of the child,\" Burke Harris says, \"the changes to your DNA, the changes to your hormonal systems, as well as the changes to your immune system and neuro-development.\"\u003c/p>\n\u003cp>High doses of such adversity increase risk of chronic diseases, heart disease, asthma, even Alzheimer's disease. People with four or more ACEs are poorer, less likely to get a college degree and are nearly 40 percent more likely to be unemployed later in life.\u003c/p>\n\u003cp>The term \"ACEs\" was first coined in the late 1990s after Vincent Felitti of Kaiser in conjunction with a Centers for Disease Control researchers \u003ca title=\"http://www.ncbi.nlm.nih.gov/pubmed/9635069?dopt=Abstract\" href=\"http://www.ncbi.nlm.nih.gov/pubmed/9635069?dopt=Abstract\" target=\"_blank\">published the original ACEs study\u003c/a>. But that study was in Kaiser members who were overwhelmingly caucasian and most had a college education. The \"Hidden Crisis\" report is the first to use sample size more representative of the demographics of California, Marta Induni, research director at the Public Health Institute, told the \u003ca title=\"https://chronicleofsocialchange.org/news/new-study-childhood-trauma-a-california-public-health-crisis/8521\" href=\"https://chronicleofsocialchange.org/news/new-study-childhood-trauma-a-california-public-health-crisis/8521\" target=\"_blank\">Chronicle of Social Change\u003c/a>.\u003c/p>\n\u003cp>Burke Harris is hopeful that momentum around early interventions will save lives and money. She's calling for ACE training for physicians, in-home screenings, and what she calls the gold standard: two-generational services that includes both parents and children, like that utilized by University of California San Francisco's Infant Parent Program and Child Trauma Research Program.\u003c/p>\n\u003cp>\"Where a child has a high ACE score, often times you have a parent with high ACE score and that often predisposes for the conditions the child is in,\" says Burke Harris, With two-generational services, \"we're seeing improved school functioning, and a reduction in chronic disease outcomes, like asthma hospitalizations, et cetera.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Burke Harris says more research is needed on the impact of other types of negative childhood experiences that the original surveys did not consider, including bullying, racism and community violence.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Berkeley Passes Soda Tax; San Francisco Effort Fails",
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"content": "\u003cfigure id=\"attachment_22337\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/11/RS11267_177844339-e1415059485967.jpg\">\u003cimg class=\"size-large wp-image-22337\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/11/RS11267_177844339-640x495.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"495\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Update: 2:30am 11/5/2014\u003c/strong>\u003c/p>\n\u003cp>Voters in Berkeley have passed the nation's first soda tax with a resounding 75 percent of the vote. More than 30 cities and states across the country have attempted such a tax, but have failed, at least in part because of big spending by the soda industry to defeat these measures.\u003c/p>\n\u003cp>But across the bay in San Francisco, a similar proposal failed to get the two-thirds supermajority it needed.\u003c/p>\n\u003cp>Berkeley's Measure D needed only a simple majority to pass. It will levy a penny-per-ounce tax on \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/10/29/heres-what-would-be-taxed-or-not-in-sf-berkeley-soda-tax-measures/#more-22233\" href=\"http://ww2.kqed.org/stateofhealth/2014/10/29/heres-what-would-be-taxed-or-not-in-sf-berkeley-soda-tax-measures/#more-22233\" target=\"_blank\">most sugar-sweetened beverages\u003c/a> and is estimated to raise more than a million dollars per year. Proceeds will go to the general fund; Measure D calls for the creation of a health panel to advise Berkeley's City Council on appropriate health programs to receive funding.\u003c!--more-->\u003c/p>\n\u003cp>Campaign co-chair Josh Daniels called Berkeley's win a tipping point. \"I think you will now see many, many other cities and communities around the country looking at this as a genuine public policy to address the diabetes and obesity crisis that we face,\" he said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>While the San Francisco proposition did not pass, supporters there declared a victory of their own: more than half the voters approved the tax despite millions spent by the American Beverage Association to defeat it. \"So the fact that we were able to overcome $10 million dollars,\" said Proposition E co-author Supervisor Scott Wiener, \"and it looks like a majority of San Franciscans -- despite that $10 million -- will vote 'yes,' is pretty extraordinary.\"\u003c/p>\n\u003cp>Roger Salazar, a spokesman for both opposition campaigns, funded primarily by the beverage association, called Berkeley \"an anomaly\" and said that to expect to pass such a tax elsewhere in California was \"foolhardy.\"\u003c/p>\n\u003cp>Advocates are convinced he's wrong. Harold Goldstein is executive director with the California Center for Public Health Advocacy, and called the measure's passage \"remarkable.\"\u003c/p>\n\u003cp>\"What we learned here in Berkeley,\" he said, \"is that when voters learn the truth about sugary beverages, when they learn that they are one of the central causes of the growing diabetes epidemic, they want to tax it, they want to regulate these products.\"\u003c/p>\n\u003cp>Indeed, sugar-sweetened beverages are the primary source of added sugar in the American diet, and that added sugar is linked to increasing rates of diabetes.\u003c/p>\n\u003cp>Berkeley has a history of being first to a new cause that's later embraced more broadly, said Lori Dorfman, executive director for the Berkeley Media Studies Group. She noted that Berkeley was the first city to pass a clean indoor air ordinance. \"In the mid-70's, Berkeley made the first 'curb cut,' and now people in wheelchairs all over the country are not trapped in their homes any more.\"\u003c/p>\n\u003cp>Mexico enacted a soda tax earlier this year on January 1, and by summer, consumption had dropped 10 percent.\u003c/p>\n\u003cp>Kelly Brownell, dean of Duke University's school of public policy \u003ca title=\"http://www.yaleruddcenter.org/resources/upload/docs/press/ruddnews/OpEdNYTimesTaxes1994.pdf\" href=\"http://www.yaleruddcenter.org/resources/upload/docs/press/ruddnews/OpEdNYTimesTaxes1994.pdf\" target=\"_blank\">first proposed a soda tax\u003c/a> in the early 1990's. He called the votes in both Berkeley and San Francisco \"historic\" and, like other advocates, predicted other cities will soon follow suit, despite what soda companies might say publicly.\u003c/p>\n\u003cp>\"My guess is that inside their boardrooms, they know very well these taxes are the beginning of the future,\" he said. \"This is a wave starting to crest.\"\u003c/p>\n\u003cp>Brownell said that half the costs of diabetes and obesity are born by taxpayers, through the government health insurance programs Medicare and Medicaid. Those public costs \"justify the government getting involved, just like tobacco taxes,\" he said.\u003c/p>\n\u003cp>\u003cstrong>Update: 12:25am 11/5\u003c/strong>\u003c/p>\n\u003cp>With 80 percent of precincts reported, Berkeley's Measure D has 75 percent \"yes\" to 25 percent \"no\" votes. It needs a simple majority to pass.\u003c/p>\n\u003cp>In San Francisco, 100 percent of precincts are now reporting. Proposition E needed a two-thirds supermajority to pass. It received 54.5 percent \"yes\" to 45.5 percent \"no.\"\u003c/p>\n\u003cp>\u003cstrong>Original Post:\u003c/strong>\u003c/p>\n\u003cp>Many have tried, but none has yet succeeded.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Would 'send shudders through the soft drink industry.' \u003c/aside>\n\u003cp>Tuesday, voters in San Francisco or Berkeley will decide whether to impose a tax on sugar-sweetened beverages, the so-called soda tax. Similar attempts have failed more than two dozen times nationwide, including in the California cities of Richmond and El Monte in 2012 and in Telluride, Colorado, last year.\u003c/p>\n\u003cp>Sugar-sweetened beverages account for \u003ca title=\"http://www.cdc.gov/nccdphp/dnpa/nutrition/pdf/r2p_sweetend_beverages.pdf\" href=\"http://www.cdc.gov/nccdphp/dnpa/nutrition/pdf/r2p_sweetend_beverages.pdf\" target=\"_blank\">one-third of the added sugar \u003c/a>in the average American's diet, and advocates say that increasing consumption of sugar is driving up rates of Type 2 diabetes, heart disease and other health ills.\u003c/p>\n\u003cp>Opponents insist that the tax would disproportionately hurt people who are low income and that taxing people for what they choose to eat or drink is just bad policy.\u003c/p>\n\u003cp>And the opponents are spending big to drive those messages home. The \"no\" campaigns in both cities are funded largely by the American Beverage Association, which has spent more than a whopping $11 million to defeat the two measures -- $9 million in San Francisco and more than $2 million in Berkeley. Proponents have spent a mere fraction of those amounts. The biggest donor by far to either campaign is former New York City mayor Michael Bloomberg, who gave more than $600,000 and \u003ca title=\"https://www.youtube.com/watch?v=fIC4KXjgQII\" href=\"https://www.youtube.com/watch?v=fIC4KXjgQII\" target=\"_blank\">funded a TV ad \u003c/a>that aired during the World Series.\u003c/p>\n\u003cp>[contextly_sidebar id=\"KVgksnAHQh4qGNYQaT88s4v51T0kBbxe\"]\u003c/p>\n\u003cp>San Francisco's Proposition E would levy a 2-cents-an-ounce tax, raising the price of a can of soda by 24 cents and a 12-pack almost $3. The revenue, estimated at $35 million to $54 million, is earmarked to be spent specifically on nutrition and physical activity programs. Because the tax is earmarked, it requires a two-thirds majority to pass.\u003c/p>\n\u003cp>That two-thirds majority is \"a very high hurdle,\" says Michael Jacobsen, executive director of the Washington, DC-based Center for Science in the Public Interest, but \"if San Francisco gets even 50 percent of the vote, that would be quite remarkable, and I think would send shudders through the soft drink industry.\"\u003c/p>\n\u003cp>Meanwhile, Berkeley's tax is 1-cent-an-ounce. The measure would raise more than $1 million, but the funds would go into the city's general fund -- which means it needs only a simple majority to pass.\u003c/p>\n\u003cp>Roger Salazar, spokesman for both anti-tax campaigns,\u003ca title=\"http://mashable.com/2014/11/03/bay-area-soda-tax/\" href=\"http://mashable.com/2014/11/03/bay-area-soda-tax/\" target=\"_blank\"> admits the race is tight\u003c/a>, but insists that Berkeley is no bellwether for the rest of the country.\u003c/p>\n\u003cp>Jacobsen disagrees. While Berkeley is a very progressive community, if the tax passes, \"it's a population accepting and taxing itself,\" he said. \"I think that will be an encouragement to other progressive cities and states. You can imagine Vermont, Madison, maybe Boston, thinking 'well, if they can do it in Berkeley, maybe we can do it here.'\"\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Mexico enacted a similar tax on January 1, and consumption of sugar-sweetened beverages dropped 10 percent by the summer.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_22337\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/11/RS11267_177844339-e1415059485967.jpg\">\u003cimg class=\"size-large wp-image-22337\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/11/RS11267_177844339-640x495.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"495\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Update: 2:30am 11/5/2014\u003c/strong>\u003c/p>\n\u003cp>Voters in Berkeley have passed the nation's first soda tax with a resounding 75 percent of the vote. More than 30 cities and states across the country have attempted such a tax, but have failed, at least in part because of big spending by the soda industry to defeat these measures.\u003c/p>\n\u003cp>But across the bay in San Francisco, a similar proposal failed to get the two-thirds supermajority it needed.\u003c/p>\n\u003cp>Berkeley's Measure D needed only a simple majority to pass. It will levy a penny-per-ounce tax on \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/10/29/heres-what-would-be-taxed-or-not-in-sf-berkeley-soda-tax-measures/#more-22233\" href=\"http://ww2.kqed.org/stateofhealth/2014/10/29/heres-what-would-be-taxed-or-not-in-sf-berkeley-soda-tax-measures/#more-22233\" target=\"_blank\">most sugar-sweetened beverages\u003c/a> and is estimated to raise more than a million dollars per year. Proceeds will go to the general fund; Measure D calls for the creation of a health panel to advise Berkeley's City Council on appropriate health programs to receive funding.\u003c!--more-->\u003c/p>\n\u003cp>Campaign co-chair Josh Daniels called Berkeley's win a tipping point. \"I think you will now see many, many other cities and communities around the country looking at this as a genuine public policy to address the diabetes and obesity crisis that we face,\" he said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>While the San Francisco proposition did not pass, supporters there declared a victory of their own: more than half the voters approved the tax despite millions spent by the American Beverage Association to defeat it. \"So the fact that we were able to overcome $10 million dollars,\" said Proposition E co-author Supervisor Scott Wiener, \"and it looks like a majority of San Franciscans -- despite that $10 million -- will vote 'yes,' is pretty extraordinary.\"\u003c/p>\n\u003cp>Roger Salazar, a spokesman for both opposition campaigns, funded primarily by the beverage association, called Berkeley \"an anomaly\" and said that to expect to pass such a tax elsewhere in California was \"foolhardy.\"\u003c/p>\n\u003cp>Advocates are convinced he's wrong. Harold Goldstein is executive director with the California Center for Public Health Advocacy, and called the measure's passage \"remarkable.\"\u003c/p>\n\u003cp>\"What we learned here in Berkeley,\" he said, \"is that when voters learn the truth about sugary beverages, when they learn that they are one of the central causes of the growing diabetes epidemic, they want to tax it, they want to regulate these products.\"\u003c/p>\n\u003cp>Indeed, sugar-sweetened beverages are the primary source of added sugar in the American diet, and that added sugar is linked to increasing rates of diabetes.\u003c/p>\n\u003cp>Berkeley has a history of being first to a new cause that's later embraced more broadly, said Lori Dorfman, executive director for the Berkeley Media Studies Group. She noted that Berkeley was the first city to pass a clean indoor air ordinance. \"In the mid-70's, Berkeley made the first 'curb cut,' and now people in wheelchairs all over the country are not trapped in their homes any more.\"\u003c/p>\n\u003cp>Mexico enacted a soda tax earlier this year on January 1, and by summer, consumption had dropped 10 percent.\u003c/p>\n\u003cp>Kelly Brownell, dean of Duke University's school of public policy \u003ca title=\"http://www.yaleruddcenter.org/resources/upload/docs/press/ruddnews/OpEdNYTimesTaxes1994.pdf\" href=\"http://www.yaleruddcenter.org/resources/upload/docs/press/ruddnews/OpEdNYTimesTaxes1994.pdf\" target=\"_blank\">first proposed a soda tax\u003c/a> in the early 1990's. He called the votes in both Berkeley and San Francisco \"historic\" and, like other advocates, predicted other cities will soon follow suit, despite what soda companies might say publicly.\u003c/p>\n\u003cp>\"My guess is that inside their boardrooms, they know very well these taxes are the beginning of the future,\" he said. \"This is a wave starting to crest.\"\u003c/p>\n\u003cp>Brownell said that half the costs of diabetes and obesity are born by taxpayers, through the government health insurance programs Medicare and Medicaid. Those public costs \"justify the government getting involved, just like tobacco taxes,\" he said.\u003c/p>\n\u003cp>\u003cstrong>Update: 12:25am 11/5\u003c/strong>\u003c/p>\n\u003cp>With 80 percent of precincts reported, Berkeley's Measure D has 75 percent \"yes\" to 25 percent \"no\" votes. It needs a simple majority to pass.\u003c/p>\n\u003cp>In San Francisco, 100 percent of precincts are now reporting. Proposition E needed a two-thirds supermajority to pass. It received 54.5 percent \"yes\" to 45.5 percent \"no.\"\u003c/p>\n\u003cp>\u003cstrong>Original Post:\u003c/strong>\u003c/p>\n\u003cp>Many have tried, but none has yet succeeded.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Would 'send shudders through the soft drink industry.' \u003c/aside>\n\u003cp>Tuesday, voters in San Francisco or Berkeley will decide whether to impose a tax on sugar-sweetened beverages, the so-called soda tax. Similar attempts have failed more than two dozen times nationwide, including in the California cities of Richmond and El Monte in 2012 and in Telluride, Colorado, last year.\u003c/p>\n\u003cp>Sugar-sweetened beverages account for \u003ca title=\"http://www.cdc.gov/nccdphp/dnpa/nutrition/pdf/r2p_sweetend_beverages.pdf\" href=\"http://www.cdc.gov/nccdphp/dnpa/nutrition/pdf/r2p_sweetend_beverages.pdf\" target=\"_blank\">one-third of the added sugar \u003c/a>in the average American's diet, and advocates say that increasing consumption of sugar is driving up rates of Type 2 diabetes, heart disease and other health ills.\u003c/p>\n\u003cp>Opponents insist that the tax would disproportionately hurt people who are low income and that taxing people for what they choose to eat or drink is just bad policy.\u003c/p>\n\u003cp>And the opponents are spending big to drive those messages home. The \"no\" campaigns in both cities are funded largely by the American Beverage Association, which has spent more than a whopping $11 million to defeat the two measures -- $9 million in San Francisco and more than $2 million in Berkeley. Proponents have spent a mere fraction of those amounts. The biggest donor by far to either campaign is former New York City mayor Michael Bloomberg, who gave more than $600,000 and \u003ca title=\"https://www.youtube.com/watch?v=fIC4KXjgQII\" href=\"https://www.youtube.com/watch?v=fIC4KXjgQII\" target=\"_blank\">funded a TV ad \u003c/a>that aired during the World Series.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>San Francisco's Proposition E would levy a 2-cents-an-ounce tax, raising the price of a can of soda by 24 cents and a 12-pack almost $3. The revenue, estimated at $35 million to $54 million, is earmarked to be spent specifically on nutrition and physical activity programs. Because the tax is earmarked, it requires a two-thirds majority to pass.\u003c/p>\n\u003cp>That two-thirds majority is \"a very high hurdle,\" says Michael Jacobsen, executive director of the Washington, DC-based Center for Science in the Public Interest, but \"if San Francisco gets even 50 percent of the vote, that would be quite remarkable, and I think would send shudders through the soft drink industry.\"\u003c/p>\n\u003cp>Meanwhile, Berkeley's tax is 1-cent-an-ounce. The measure would raise more than $1 million, but the funds would go into the city's general fund -- which means it needs only a simple majority to pass.\u003c/p>\n\u003cp>Roger Salazar, spokesman for both anti-tax campaigns,\u003ca title=\"http://mashable.com/2014/11/03/bay-area-soda-tax/\" href=\"http://mashable.com/2014/11/03/bay-area-soda-tax/\" target=\"_blank\"> admits the race is tight\u003c/a>, but insists that Berkeley is no bellwether for the rest of the country.\u003c/p>\n\u003cp>Jacobsen disagrees. While Berkeley is a very progressive community, if the tax passes, \"it's a population accepting and taxing itself,\" he said. \"I think that will be an encouragement to other progressive cities and states. You can imagine Vermont, Madison, maybe Boston, thinking 'well, if they can do it in Berkeley, maybe we can do it here.'\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Mexico enacted a similar tax on January 1, and consumption of sugar-sweetened beverages dropped 10 percent by the summer.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "For Families with Mixed-Immigration Status: Some Insured, Some Not",
"title": "For Families with Mixed-Immigration Status: Some Insured, Some Not",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_22318\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/11/Bravo-1-e1415038250334.jpg\">\u003cimg class=\"size-large wp-image-22318\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/11/Bravo-1-640x427.jpg\" alt=\"Jessica Bravo, 19, of Costa Mesa was granted DACA (Deferred Action for Childhood Arrivals) status, but didn’t know she could also qualify for Medi-Cal. (Heidi de Marco/Kaiser Health News).\" width=\"640\" height=\"427\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Jessica Bravo, 19, of Costa Mesa was granted DACA (Deferred Action for Childhood Arrivals) status, but didn’t know she could also qualify for Medi-Cal. (Heidi de Marco/Kaiser Health News).\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Heidi de Marco\u003c/strong>, \u003ca title=\"http://kaiserhealthnews.org/news/for-families-with-mixed-immigration-status-health-insurance-can-be-puzzling/\" href=\"http://kaiserhealthnews.org/news/for-families-with-mixed-immigration-status-health-insurance-can-be-puzzling/\" target=\"_blank\">Kaiser Health News\u003c/a>\u003c/p>\n\u003cp>Jessica Bravo walks house-to-house in the piercing Southern California heat. Over and over, at doorsteps around Orange County, she asks the same question: “Are you insured?”\u003c/p>\n\u003cp>Getting an answer isn’t always easy. Doors slam in her face. She gets shooed from porches. And sometimes people cut her off mid-spiel.\u003c/p>\n\u003cp>Bravo is a paid health outreach worker for the Orange County Congregation Community Organization, a faith-based nonprofit. Her job is to inform people about getting health insurance under the nation’s landmark health law, the Affordable Care Act.\u003c/p>\n\u003cp>“A lot of people don’t know about this new law … this opportunity for health insurance,” said Bravo, a 19-year old Costa Mesa resident.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Until a few months ago, Bravo didn’t actually know coverage was an opportunity for her, as well.\u003c/p>\n\u003cp>She is an undocumented immigrant from Mexico. Most people without papers can’t get health insurance under the ACA. But last year, Bravo and her 21-year-old brother Daniel qualified for the Deferred Action for Childhood Arrivals (DACA) program -– a 2012 initiative that grants temporary legal status to certain undocumented immigrants who were brought to the United States as children.\u003c/p>\n\u003cp>The law applies to people who came to the U.S. before turning 16, are in school or a high school graduate and are now under the age of 33.\u003c/p>\n\u003cp>They can obtain a work permit, a driver’s license, a Social Security number, a two-year reprieve from deportation and — as Bravo now realizes — the opportunity to get health insurance through Medi-Cal, California’s insurance program for poor and disabled people. Only a few other states offer similar options.\u003c/p>\n\u003cp>Now studying politics and ethnic studies full time at Golden West College in Huntington Beach, Bravo can’t work as much as she used to. Her monthly income of $960 likely would make her eligible for Medi-Cal.\u003c/p>\n\u003cp>Figuring out her options under the law was especially difficult for Bravo, whose family is of “mixed status.” That is, some have federal authorization to be in this country and others don’t. While anyone can buy insurance privately, people without legal status are not allowed to buy insurance on the exchange or participate in most government program such as Medicare, non-emergency Medicaid or the Children’s Health Insurance Program.\u003c/p>\n\u003cp>Her parents are in the country without permission, as is her older brother Luis, 22, who did not qualify for DACA. Her other brother Daniel, 21, was granted DACA status and qualifies for the same benefits she does. And her brother Alex, 11, is a U.S.-born citizen, covered through California Kids –- a nonprofit health insurance plan.\u003c/p>\n\u003cp>\u003cstrong>‘Stuck In The Middle’\u003c/strong>\u003c/p>\n\u003cp>The family’s history is complicated. After several failed visa attempts, her father Enrique Bravo crossed the border illegally in 1996. His wife, Virginia, tried to cross by hiding in a car but was caught by border patrol agents. Desperate to join her husband, she tried again and made it across six months later. Three-year-old Jessica and her older brothers later crossed with legal-resident relatives in a car.\u003c/p>\n\u003cp>“I’m 100 percent Mexican…but all my memories growing up are from the United States,” said Jessica. “It’s like I’m stuck in the middle…I’m neither from here or there.”\u003c/p>\n\u003cfigure id=\"attachment_22319\" class=\"wp-caption alignright\" style=\"max-width: 380px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/11/Bravos-e1415038674805.jpg\">\u003cimg class=\"size-full wp-image-22319\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/11/Bravos-e1415038674805.jpg\" alt=\"Photos of the Bravo family, Enrique, his wife, Virginia, and their children Jessica, Daniel and Luis, taken in 2001, five years after arriving in the United States (Photos Courtesy of the Bravo Family).\" width=\"380\" height=\"777\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2014/11/Bravos-e1415038674805.jpg 380w, https://ww2.kqed.org/app/uploads/sites/27/2014/11/Bravos-e1415038674805-320x654.jpg 320w\" sizes=\"(max-width: 380px) 100vw, 380px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Photos of the Bravo family, Enrique, his wife, Virginia, and their children Jessica, Daniel and Luis, taken in 2001, five years after arriving in the United States (Photos Courtesy of the Bravo Family).\u003c/figcaption>\u003c/figure>\n\u003cp>As the older children grew up, getting health care proved dicey. The family tried to stay below the radar. This meant visiting the doctor only when absolutely necessary -- and always paying cash.\u003c/p>\n\u003cp>They were, like many immigrants, fearful of exposing the family’s unauthorized status and risking deportation, for themselves and their children.\u003c/p>\n\u003cp>Eventually Enrique, an electrician, found a job that offered health insurance, and for several years the family was insured. But he got laid off in 2006. From then on, they were forced to rely on local community clinics that provide care on a sliding pay scale.\u003c/p>\n\u003cp>“I remember my parents telling me that I was no longer going to be insured under their plan,” said Jessica. “I just tried to eat healthy.”\u003c/p>\n\u003cp>Her biggest concern now, she says, is that one of the others will get sick and the family won’t be able to pay for care.\u003c/p>\n\u003cp>“Even though that fear is gone for me, it’s still very real for my family,” said Bravo, who is in the process of renewing her DACA status for another two years.\u003c/p>\n\u003cp>“It’s difficult to grasp that I have this privilege, yet my parents who worked twice as hard, don’t have anything.”\u003c/p>\n\u003cp>Recent events have compounded the family’s worries.\u003c/p>\n\u003cp>Jessica’s brother Luis was recently detained by agents from Immigration and Customs Enforcement as a result of a tip arising from a prior conviction for driving under the influence. It’s unclear what will happen until the immigration court hears his case and decides whether he can remain in the U.S.\u003c/p>\n\u003cp>“It all seems like a dream…it happened so fast,” said Jessica. “We’re doing everything we can to stop his deportation.”\u003c/p>\n\u003cp>\u003cstrong>One Fall Can Change Everything\u003c/strong>\u003c/p>\n\u003cp>Weeks ago, Jessica’s mother Virginia stumbled and fell to the ground in front of their Costa Mesa apartment, spilling the milk she’d just bought. The 48-year-old former hairstylist hurt her arm, but despite feeling a sharp pain she won’t be visiting the emergency room.\u003c/p>\n\u003cp>“We can’t afford it,” Virginia Bravo said. The mother of four has been unemployed for over a year and is more concerned about stocking the empty refrigerator than seeking treatment.\u003c/p>\n\u003cp>She knows all too well that without insurance an unexpected injury could leave them bankrupt.\u003c/p>\n\u003cp>Last year, Enrique had to be rushed to the emergency room. He woke up in the middle of the night with extreme paranoia, unable to catch his breath, and feeling numb.\u003c/p>\n\u003cp>He was having a panic attack. The bill for the two-hour hospital stay was about $6,000. Already struggling financially, the family had to find a way to pay cash.\u003c/p>\n\u003cp>“At first I refused to go to the hospital,” he said. “I knew it would be expensive.”\u003c/p>\n\u003cp>The 44-year-old says he struggles to earn at least $2,250 each month as a self-employed electrician –- the exact amount he needs to pay rent.\u003c/p>\n\u003cp>Any extra money is used to buy food and pay bills. Saving for an emergency is impossible, the family members said.\u003c/p>\n\u003cp>“We’re poor, but rich in health and family unity,” Virginia Bravo said.\u003c/p>\n\u003cp>Living in a mixed-status family has been challenging, but it has also brought them closer, she said. The whole family has been involved in campaigning for immigration reform and hopes the ACA will eventually include coverage for undocumented immigrants.\u003c/p>\n\u003cp>“People don’t know what we had to go through to get here,” said Virginia. “We made it across … we’re the lucky ones.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“We don’t want anything for free,” she said. “If we had an opportunity to buy health insurance, we would find a way to pay for it.”\u003c/p>\n\n",
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"excerpt": "Three of four siblings qualify for health insurance benefits, but their parents and an older brother do not.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_22318\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/11/Bravo-1-e1415038250334.jpg\">\u003cimg class=\"size-large wp-image-22318\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/11/Bravo-1-640x427.jpg\" alt=\"Jessica Bravo, 19, of Costa Mesa was granted DACA (Deferred Action for Childhood Arrivals) status, but didn’t know she could also qualify for Medi-Cal. (Heidi de Marco/Kaiser Health News).\" width=\"640\" height=\"427\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Jessica Bravo, 19, of Costa Mesa was granted DACA (Deferred Action for Childhood Arrivals) status, but didn’t know she could also qualify for Medi-Cal. (Heidi de Marco/Kaiser Health News).\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Heidi de Marco\u003c/strong>, \u003ca title=\"http://kaiserhealthnews.org/news/for-families-with-mixed-immigration-status-health-insurance-can-be-puzzling/\" href=\"http://kaiserhealthnews.org/news/for-families-with-mixed-immigration-status-health-insurance-can-be-puzzling/\" target=\"_blank\">Kaiser Health News\u003c/a>\u003c/p>\n\u003cp>Jessica Bravo walks house-to-house in the piercing Southern California heat. Over and over, at doorsteps around Orange County, she asks the same question: “Are you insured?”\u003c/p>\n\u003cp>Getting an answer isn’t always easy. Doors slam in her face. She gets shooed from porches. And sometimes people cut her off mid-spiel.\u003c/p>\n\u003cp>Bravo is a paid health outreach worker for the Orange County Congregation Community Organization, a faith-based nonprofit. Her job is to inform people about getting health insurance under the nation’s landmark health law, the Affordable Care Act.\u003c/p>\n\u003cp>“A lot of people don’t know about this new law … this opportunity for health insurance,” said Bravo, a 19-year old Costa Mesa resident.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Until a few months ago, Bravo didn’t actually know coverage was an opportunity for her, as well.\u003c/p>\n\u003cp>She is an undocumented immigrant from Mexico. Most people without papers can’t get health insurance under the ACA. But last year, Bravo and her 21-year-old brother Daniel qualified for the Deferred Action for Childhood Arrivals (DACA) program -– a 2012 initiative that grants temporary legal status to certain undocumented immigrants who were brought to the United States as children.\u003c/p>\n\u003cp>The law applies to people who came to the U.S. before turning 16, are in school or a high school graduate and are now under the age of 33.\u003c/p>\n\u003cp>They can obtain a work permit, a driver’s license, a Social Security number, a two-year reprieve from deportation and — as Bravo now realizes — the opportunity to get health insurance through Medi-Cal, California’s insurance program for poor and disabled people. Only a few other states offer similar options.\u003c/p>\n\u003cp>Now studying politics and ethnic studies full time at Golden West College in Huntington Beach, Bravo can’t work as much as she used to. Her monthly income of $960 likely would make her eligible for Medi-Cal.\u003c/p>\n\u003cp>Figuring out her options under the law was especially difficult for Bravo, whose family is of “mixed status.” That is, some have federal authorization to be in this country and others don’t. While anyone can buy insurance privately, people without legal status are not allowed to buy insurance on the exchange or participate in most government program such as Medicare, non-emergency Medicaid or the Children’s Health Insurance Program.\u003c/p>\n\u003cp>Her parents are in the country without permission, as is her older brother Luis, 22, who did not qualify for DACA. Her other brother Daniel, 21, was granted DACA status and qualifies for the same benefits she does. And her brother Alex, 11, is a U.S.-born citizen, covered through California Kids –- a nonprofit health insurance plan.\u003c/p>\n\u003cp>\u003cstrong>‘Stuck In The Middle’\u003c/strong>\u003c/p>\n\u003cp>The family’s history is complicated. After several failed visa attempts, her father Enrique Bravo crossed the border illegally in 1996. His wife, Virginia, tried to cross by hiding in a car but was caught by border patrol agents. Desperate to join her husband, she tried again and made it across six months later. Three-year-old Jessica and her older brothers later crossed with legal-resident relatives in a car.\u003c/p>\n\u003cp>“I’m 100 percent Mexican…but all my memories growing up are from the United States,” said Jessica. “It’s like I’m stuck in the middle…I’m neither from here or there.”\u003c/p>\n\u003cfigure id=\"attachment_22319\" class=\"wp-caption alignright\" style=\"max-width: 380px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/11/Bravos-e1415038674805.jpg\">\u003cimg class=\"size-full wp-image-22319\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/11/Bravos-e1415038674805.jpg\" alt=\"Photos of the Bravo family, Enrique, his wife, Virginia, and their children Jessica, Daniel and Luis, taken in 2001, five years after arriving in the United States (Photos Courtesy of the Bravo Family).\" width=\"380\" height=\"777\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2014/11/Bravos-e1415038674805.jpg 380w, https://ww2.kqed.org/app/uploads/sites/27/2014/11/Bravos-e1415038674805-320x654.jpg 320w\" sizes=\"(max-width: 380px) 100vw, 380px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Photos of the Bravo family, Enrique, his wife, Virginia, and their children Jessica, Daniel and Luis, taken in 2001, five years after arriving in the United States (Photos Courtesy of the Bravo Family).\u003c/figcaption>\u003c/figure>\n\u003cp>As the older children grew up, getting health care proved dicey. The family tried to stay below the radar. This meant visiting the doctor only when absolutely necessary -- and always paying cash.\u003c/p>\n\u003cp>They were, like many immigrants, fearful of exposing the family’s unauthorized status and risking deportation, for themselves and their children.\u003c/p>\n\u003cp>Eventually Enrique, an electrician, found a job that offered health insurance, and for several years the family was insured. But he got laid off in 2006. From then on, they were forced to rely on local community clinics that provide care on a sliding pay scale.\u003c/p>\n\u003cp>“I remember my parents telling me that I was no longer going to be insured under their plan,” said Jessica. “I just tried to eat healthy.”\u003c/p>\n\u003cp>Her biggest concern now, she says, is that one of the others will get sick and the family won’t be able to pay for care.\u003c/p>\n\u003cp>“Even though that fear is gone for me, it’s still very real for my family,” said Bravo, who is in the process of renewing her DACA status for another two years.\u003c/p>\n\u003cp>“It’s difficult to grasp that I have this privilege, yet my parents who worked twice as hard, don’t have anything.”\u003c/p>\n\u003cp>Recent events have compounded the family’s worries.\u003c/p>\n\u003cp>Jessica’s brother Luis was recently detained by agents from Immigration and Customs Enforcement as a result of a tip arising from a prior conviction for driving under the influence. It’s unclear what will happen until the immigration court hears his case and decides whether he can remain in the U.S.\u003c/p>\n\u003cp>“It all seems like a dream…it happened so fast,” said Jessica. “We’re doing everything we can to stop his deportation.”\u003c/p>\n\u003cp>\u003cstrong>One Fall Can Change Everything\u003c/strong>\u003c/p>\n\u003cp>Weeks ago, Jessica’s mother Virginia stumbled and fell to the ground in front of their Costa Mesa apartment, spilling the milk she’d just bought. The 48-year-old former hairstylist hurt her arm, but despite feeling a sharp pain she won’t be visiting the emergency room.\u003c/p>\n\u003cp>“We can’t afford it,” Virginia Bravo said. The mother of four has been unemployed for over a year and is more concerned about stocking the empty refrigerator than seeking treatment.\u003c/p>\n\u003cp>She knows all too well that without insurance an unexpected injury could leave them bankrupt.\u003c/p>\n\u003cp>Last year, Enrique had to be rushed to the emergency room. He woke up in the middle of the night with extreme paranoia, unable to catch his breath, and feeling numb.\u003c/p>\n\u003cp>He was having a panic attack. The bill for the two-hour hospital stay was about $6,000. Already struggling financially, the family had to find a way to pay cash.\u003c/p>\n\u003cp>“At first I refused to go to the hospital,” he said. “I knew it would be expensive.”\u003c/p>\n\u003cp>The 44-year-old says he struggles to earn at least $2,250 each month as a self-employed electrician –- the exact amount he needs to pay rent.\u003c/p>\n\u003cp>Any extra money is used to buy food and pay bills. Saving for an emergency is impossible, the family members said.\u003c/p>\n\u003cp>“We’re poor, but rich in health and family unity,” Virginia Bravo said.\u003c/p>\n\u003cp>Living in a mixed-status family has been challenging, but it has also brought them closer, she said. The whole family has been involved in campaigning for immigration reform and hopes the ACA will eventually include coverage for undocumented immigrants.\u003c/p>\n\u003cp>“People don’t know what we had to go through to get here,” said Virginia. “We made it across … we’re the lucky ones.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "In Oakland, Students Bite Back at Undead in Zombie Health Symposium",
"title": "In Oakland, Students Bite Back at Undead in Zombie Health Symposium",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_22295\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/15483368747_f5d1abe646_k-e1414733773219.jpg\">\u003cimg class=\"size-large wp-image-22295\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/15483368747_f5d1abe646_k-640x480.jpg\" alt=\"Craig Elliott, assistant VP of student services at Samuel Merritt University, encouraged grief counselors for families dealing with undead loved ones. (Courtesy: Samuel Merritt University)\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Craig Elliott, assistant VP of student services at Samuel Merritt University, encouraged grief counseling for families dealing with undead loved ones. (Courtesy: Samuel Merritt University)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Isabel Angell\u003c/strong>\u003c/p>\n\u003cp>Just in time for Halloween, health science students at Samuel Merritt University in Oakland were learning about an understudied demographic in health care: zombies.\u003c/p>\n\u003cp>That’s right, zombies.\u003c/p>\n\u003cp>Students packed the hall at the first-ever\u003ca title=\"https://www.samuelmerritt.edu/students/zombies\" href=\"https://www.samuelmerritt.edu/students/zombies\" target=\"_blank\"> Zombie Health Symposium\u003c/a> and learned some crucial information, should these \u003ca title=\"http://en.wikipedia.org/wiki/Zombie_(fictional)\" href=\"http://en.wikipedia.org/wiki/Zombie_(fictional)\" target=\"_blank\">fictional beings\u003c/a> ever show up in real life. In a presentation Dr. Sharon Gorman, a physical therapy professor, described which gait will improve your survivability during a zombie apocalypse. She said it’s important to realize there are different kinds of zombies.\u003c/p>\n\u003cp>“Use your observation skills that you’ve honed as health care providers, because those are key,\" she said. \"You need to determine what is the threat of that zombie and figure out quickly what your best evasive maneuver might be. If it’s a fast zombie, I suggest being quiet and running, very, very fast and very, very far away. If it’s a non-ambulatory zombie, just give it a wide berth.”\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Gorman translated data from scientific papers dealing with the alive -- and applied it to the undead.\u003c/p>\n\u003cp>“If it’s a slow zombie, you want to look for a gait speed for yourself of between 1.63 meters per second to 4.47 meters per second, and that should successfully get you away from zombies,” she said.\u003c/p>\n\u003cp>That’s between about 3.5 to 10 miles per hour. By comparison, the average person’s walking speed is just over three miles per hour. But 10 miles per hour would mean running at six minute miles. Good luck if you encounter a fast zombie.\u003c/p>\n\u003cp>\u003cstrong>Counseling is Key in Event of Zombie Apocalypse\u003c/strong>\u003c/p>\n\u003cp>Craig Elliott, assistant vice president of enrollment and student services, tackled the emotional side of a zombie apocalypse.\u003c/p>\n\u003cp>“How do you mourn that (a) zombie that represents your family member is not truly your daughter, wife, husband or son?”\u003c/p>\n\u003cp>Elliot said it’s important to remember that zombies were people too -- and that it’s okay to grieve.\u003c/p>\n\u003cp>“In those unexpected times, we have a greater sense of vulnerability and heightened anxiety about it,\" Elliott said. \"We’ve got to deal with what that means for us and who we are and how we’re feeling.”\u003c/p>\n\u003cp>Elliott recommends counseling to help overcome the grief associated with a loved one turning into a zombie.\u003c/p>\n\u003cp>In a video, basic sciences professor Barb Puder held up a model of a brain and explained exactly what’s going on in a zombie’s head. The cortex, the front part of the brain where feeling and thinking goes on, is no longer functional in zombies, she said. Instead, when looking at zombie brains, scientists look at the brain stem.\u003c/p>\n\u003cp>“That is activated in the zombie,\" Puder said. \"That’s the part that controls ... internal organs, allows for movement, but not really personality and speech and behaviors. And this is the part of the brain that we need to destroy to get rid of our zombie population.\"\u003c/p>\n\u003cp>\u003cstrong>Crowbar best weapon\u003c/strong>\u003c/p>\n\u003cp>The big question is how. How do we rid ourselves of the zombie population?\u003c/p>\n\u003cp>Puder had specific advice on the best weapons to kill a zombie. She suggested aiming for the eyes or lower— anything higher won’t damage the brain stem. Longer weapons are more effective. Short screwdrivers, for example, might not reach far enough back.\u003c/p>\n\u003cp>Her weapon of choice? A crow bar.\u003c/p>\n\u003cp>Dr. Drew Smith, who runs the university’s Motion Analysis Research Center, reviewed a case where a young woman appeared to be having trouble walking. When researchers played music in the lab, the patient’s gait changed from an ungainly lurching motion to something surprisingly like Michael Jackson’s Thriller dance.\u003c/p>\n\u003cp>Occupational therapy professor Gordon Giles took issue with calling these afflicted people “zombies.” He reminded students never to call patients by their diagnosis.\u003c/p>\n\u003cp>“We don’t stay ‘the schizophrenic,’” he said. “We don’t stay ‘the femoral fracture in the end bed.’ So I really think that we need to use person-first language. And I would really suggest that.\"\u003c/p>\n\u003cp>\"Except of course, they’re not actually people.”\u003c/p>\n\u003cp>Giles instead urged student to use the term “animated dead.”\u003c/p>\n\u003cp>“Like many people who have severe cognitive impairments, the animated dead do not follow directions,\" Giles said, \"but they will follow you. Rapidly.”\u003c/p>\n\u003cp>“I just want to say maintaining a therapeutic relationship is really important for us as occupational therapists,\" Giles said. \"But it’s difficult with the animated dead. So I want you all to remember that they do love us for what’s on the inside.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Cue collective groan. Or, make that a collective zombie moan. Aarrrghhhh.\u003c/p>\n\n",
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"excerpt": "Students pack hall at tongue-in-cheek symposium where professors reminded them that \"zombies were people too.\"",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_22295\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/15483368747_f5d1abe646_k-e1414733773219.jpg\">\u003cimg class=\"size-large wp-image-22295\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/15483368747_f5d1abe646_k-640x480.jpg\" alt=\"Craig Elliott, assistant VP of student services at Samuel Merritt University, encouraged grief counselors for families dealing with undead loved ones. (Courtesy: Samuel Merritt University)\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Craig Elliott, assistant VP of student services at Samuel Merritt University, encouraged grief counseling for families dealing with undead loved ones. (Courtesy: Samuel Merritt University)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Isabel Angell\u003c/strong>\u003c/p>\n\u003cp>Just in time for Halloween, health science students at Samuel Merritt University in Oakland were learning about an understudied demographic in health care: zombies.\u003c/p>\n\u003cp>That’s right, zombies.\u003c/p>\n\u003cp>Students packed the hall at the first-ever\u003ca title=\"https://www.samuelmerritt.edu/students/zombies\" href=\"https://www.samuelmerritt.edu/students/zombies\" target=\"_blank\"> Zombie Health Symposium\u003c/a> and learned some crucial information, should these \u003ca title=\"http://en.wikipedia.org/wiki/Zombie_(fictional)\" href=\"http://en.wikipedia.org/wiki/Zombie_(fictional)\" target=\"_blank\">fictional beings\u003c/a> ever show up in real life. In a presentation Dr. Sharon Gorman, a physical therapy professor, described which gait will improve your survivability during a zombie apocalypse. She said it’s important to realize there are different kinds of zombies.\u003c/p>\n\u003cp>“Use your observation skills that you’ve honed as health care providers, because those are key,\" she said. \"You need to determine what is the threat of that zombie and figure out quickly what your best evasive maneuver might be. If it’s a fast zombie, I suggest being quiet and running, very, very fast and very, very far away. If it’s a non-ambulatory zombie, just give it a wide berth.”\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Gorman translated data from scientific papers dealing with the alive -- and applied it to the undead.\u003c/p>\n\u003cp>“If it’s a slow zombie, you want to look for a gait speed for yourself of between 1.63 meters per second to 4.47 meters per second, and that should successfully get you away from zombies,” she said.\u003c/p>\n\u003cp>That’s between about 3.5 to 10 miles per hour. By comparison, the average person’s walking speed is just over three miles per hour. But 10 miles per hour would mean running at six minute miles. Good luck if you encounter a fast zombie.\u003c/p>\n\u003cp>\u003cstrong>Counseling is Key in Event of Zombie Apocalypse\u003c/strong>\u003c/p>\n\u003cp>Craig Elliott, assistant vice president of enrollment and student services, tackled the emotional side of a zombie apocalypse.\u003c/p>\n\u003cp>“How do you mourn that (a) zombie that represents your family member is not truly your daughter, wife, husband or son?”\u003c/p>\n\u003cp>Elliot said it’s important to remember that zombies were people too -- and that it’s okay to grieve.\u003c/p>\n\u003cp>“In those unexpected times, we have a greater sense of vulnerability and heightened anxiety about it,\" Elliott said. \"We’ve got to deal with what that means for us and who we are and how we’re feeling.”\u003c/p>\n\u003cp>Elliott recommends counseling to help overcome the grief associated with a loved one turning into a zombie.\u003c/p>\n\u003cp>In a video, basic sciences professor Barb Puder held up a model of a brain and explained exactly what’s going on in a zombie’s head. The cortex, the front part of the brain where feeling and thinking goes on, is no longer functional in zombies, she said. Instead, when looking at zombie brains, scientists look at the brain stem.\u003c/p>\n\u003cp>“That is activated in the zombie,\" Puder said. \"That’s the part that controls ... internal organs, allows for movement, but not really personality and speech and behaviors. And this is the part of the brain that we need to destroy to get rid of our zombie population.\"\u003c/p>\n\u003cp>\u003cstrong>Crowbar best weapon\u003c/strong>\u003c/p>\n\u003cp>The big question is how. How do we rid ourselves of the zombie population?\u003c/p>\n\u003cp>Puder had specific advice on the best weapons to kill a zombie. She suggested aiming for the eyes or lower— anything higher won’t damage the brain stem. Longer weapons are more effective. Short screwdrivers, for example, might not reach far enough back.\u003c/p>\n\u003cp>Her weapon of choice? A crow bar.\u003c/p>\n\u003cp>Dr. Drew Smith, who runs the university’s Motion Analysis Research Center, reviewed a case where a young woman appeared to be having trouble walking. When researchers played music in the lab, the patient’s gait changed from an ungainly lurching motion to something surprisingly like Michael Jackson’s Thriller dance.\u003c/p>\n\u003cp>Occupational therapy professor Gordon Giles took issue with calling these afflicted people “zombies.” He reminded students never to call patients by their diagnosis.\u003c/p>\n\u003cp>“We don’t stay ‘the schizophrenic,’” he said. “We don’t stay ‘the femoral fracture in the end bed.’ So I really think that we need to use person-first language. And I would really suggest that.\"\u003c/p>\n\u003cp>\"Except of course, they’re not actually people.”\u003c/p>\n\u003cp>Giles instead urged student to use the term “animated dead.”\u003c/p>\n\u003cp>“Like many people who have severe cognitive impairments, the animated dead do not follow directions,\" Giles said, \"but they will follow you. Rapidly.”\u003c/p>\n\u003cp>“I just want to say maintaining a therapeutic relationship is really important for us as occupational therapists,\" Giles said. \"But it’s difficult with the animated dead. So I want you all to remember that they do love us for what’s on the inside.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Cue collective groan. Or, make that a collective zombie moan. Aarrrghhhh.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Here's What Would Be Taxed -- or Not -- in SF, Berkeley Soda Tax Measures",
"title": "Here's What Would Be Taxed -- or Not -- in SF, Berkeley Soda Tax Measures",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_11293\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003cimg class=\"wp-image-11293 size-large\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/03/Soda_Flickr_KJM-427-620x412.jpg\" alt=\"(KJM-427/Flickr)\" width=\"620\" height=\"412\">\u003cfigcaption class=\"wp-caption-text\">(KJM-427/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Both San Francisco and Berkeley have \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/10/15/election-2014-san-francisco-berkeley-consider-soda-taxes/\" href=\"http://ww2.kqed.org/stateofhealth/2014/10/15/election-2014-san-francisco-berkeley-consider-soda-taxes/\" target=\"_blank\">measures on their November ballots \u003c/a>that would institute a tax on sugar-sweetened beverages. With less than a week to go until Election Day, we're getting down to the nitty-gritty. People want to know exactly what will be taxed -- and what won't.\u003c/p>\n\u003cp>First things first: The tax is on sugar-sweetened beverages, so diet sodas would not be taxed. After all, they do not have sugar or any other sweetener that has calories. Maybe the moniker \"soda tax\" is misleading here.\u003c/p>\n\u003cp>To find out if your favorite beverage would be taxed, ask yourself the following:\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>Does this drink contain added sugar\u003c/strong> (or another caloric sweetener such as high-fructose corn syrup)?\u003c/li>\n\u003cli>\u003cstrong>Does this drink have significant nutritional value\u003c/strong> (such as, say, milk does)?\u003c/li>\n\u003c/ul>\n\u003cp>If you answer \"yes\" to the first question and \"no\" to the second, your beverage is most likely subject to the proposed tax.\u003c/p>\n\u003cp>Here are drinks that are subject to the tax (farther down are exempt drinks):\u003c/p>\n\u003cfigure id=\"attachment_22244\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"https://www.flickr.com/photos/kalebdf/517315536/in/photolist-MHnTo-57sm4r-auQ5u1-8BaTH2-7uy9Vn-7QfxsV-3jZk2D-bvJeAP-5njkwx-7YABEo-6eXTk4-xJ8Le-h3sMLv-7h9bj4-4ECKjf-bvmvt5-7Qde5Y-8LssN2-9ZYJCb-5nAKXL-oLF3Bp-8N6CeH-oLF3Be-8CRKqm-8m2bPN-5ZHacu-hjMsM6-57PtFj-7sm6bo-6f36vu-6EdH1P-dkScku-28Ck1M-GVq4B-6Ab35o-xHoHv-z5hyD-95bcnr-auMq7M-o7MHJu-op8q9N-5bkmdM-aYXygt-a3sk3i-6f3ebE-6eY1zn-bJ15Jt-9wAxH3-nJhhUX-9497i1\">\u003cimg class=\"size-large wp-image-22244\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/517315536_9197f1aee4_oREV-640x571.jpg\" alt=\"(Kaleb Fulgham/Flickr)\" width=\"640\" height=\"571\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Kaleb Fulgham/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Sodas\u003c/strong> -- such as regular Coke, Pepsi, 7 Up, etc. (But not diet sodas.) This includes sodas in bottles and cans, as well as fountain drinks. Both the Berkeley and San Francisco measures call for taxing the syrup used to make fountain drinks. The syrup is taxed according to the largest volume, in fluid ounces, that could be produced from the sugar-sweetened syrup. For example, if a distributor sells a 12-ounce bottle of syrup and that syrup can be used to make 144 ounces of beverage, the tax is levied on the 144 ounces of beverage.\u003c!--more-->\u003c/p>\n\u003chr>\n\u003cfigure id=\"attachment_20568\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/13556198874_fdf70c448e_z.jpg\">\u003cimg class=\"size-full wp-image-20568\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/13556198874_fdf70c448e_z.jpg\" alt=\"Gatorade was one of the 21 beverages analyzed in the study. (Mike Mozart/Flickr)\" width=\"640\" height=\"478\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2014/08/13556198874_fdf70c448e_z.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2014/08/13556198874_fdf70c448e_z-400x299.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2014/08/13556198874_fdf70c448e_z-320x239.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Mike Mozart/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Sports drinks\u003c/strong>, such as Gatorade. While the Gatorade label says that there are 14 grams of sugar in each 8-ounce serving, the bottles above are 20-ounces each. That means there are 35 grams of sugar in the bottle -- the equivalent of almost nine teaspoons of sugar. Energy drinks often are sugar-sweetened as well. Ditto, Vitamin Water.\u003c/p>\n\u003chr>\n\u003cfigure id=\"attachment_15792\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/oak-tech-ice-tea.jpg\">\u003cimg class=\"size-full wp-image-15792\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/oak-tech-ice-tea.jpg\" alt=\"Arizona Green Tea is popular with teens, but this 23.5 ounce can has 51 grams -- or more than one-third of a cup -- of sugar.(Jane Meredith Adams/EdSource)\" width=\"640\" height=\"427\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2013/10/oak-tech-ice-tea.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2013/10/oak-tech-ice-tea-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2013/10/oak-tech-ice-tea-320x214.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Jane Meredith Adams/EdSource)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Sweetened teas \u003c/strong>are especially popular with teens. The 23.5-ounce can of Arizona Green Tea pictured above contains 51 grams of sugar -- that's more than one-third of a cup. It would be subject to the tax.\u003c/p>\n\u003chr>\n\u003cfigure id=\"attachment_22258\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"https://www.flickr.com/photos/allison_taylor/3307487000/in/photolist-63gJDW-5vPrAu-btqGXR-CUVTd-5DZgGN-CUVUm-8bRiqi-4rSwxW-6UZuVy-5nvvoL-fzvxsH-fzKRB3-5nre8F-Dd2Nr-6ybZ2z-4r4eDb-Czkfd-pc6t1W-dD5hy-6geTcA-dS68Yj-4s6cfN-4HiB6W-cNUx5W-e2dYas-94xiiR-9Rapr-33UurF-6eymr2-6ki4NZ-87hAP-6v3MMh-5nrexp-5nvvvQ-9QEpPd-ceSzom-pTifC-4xZdru-cUY7W-uvQ6P-iB6tw-6taomm-oFNSfz-BzFfB-J3bGJ-7RUnW6-7EN4HY-5anW1j-6wxjBy-6mojej\">\u003cimg class=\"size-large wp-image-22258\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/3307487000_ae79cac0b2_oCROP-640x515.jpg\" alt=\"(Allison Richards/Flickr)\" width=\"640\" height=\"515\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Allison Richards/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>While 100 percent juice drinks are exempt from the tax (see further below), drinks that contain less than that are subject to the tax. For example, according to the \u003ca title=\"http://commons.wikimedia.org/wiki/File:SunnyD_Nutrition_Facts_02.jpg\" href=\"http://commons.wikimedia.org/wiki/File:SunnyD_Nutrition_Facts_02.jpg\" target=\"_blank\">Sunny D nutrition label\u003c/a>, the product contains 5 percent juice -- and added high-fructose corn syrup. The added corn syrup triggers the tax.\u003c/p>\n\u003chr>\n\u003cp>\u003ca title=\"http://sfgov2.org/ftp/uploadedfiles/elections/candidates/Nov2014/Nov2014_SugarSweetenedBeverages.pdf\" href=\"http://sfgov2.org/ftp/uploadedfiles/elections/candidates/Nov2014/Nov2014_SugarSweetenedBeverages.pdf\" target=\"_blank\">San Francisco's Proposition E\u003c/a> would levy a 2-cents-per-ounce tax on sugar-sweetened beverages that have at least 25 calories per 12-ounce drink. The tax revenue generated is earmarked to be spent on health programs. Since the tax is earmarked, it needs a two-thirds supermajority to pass.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003ca title=\"http://www.cityofberkeley.info/Clerk/Elections/Election__2014_Ballot_Measure_Page.aspx\" href=\"http://www.cityofberkeley.info/Clerk/Elections/Election__2014_Ballot_Measure_Page.aspx\" target=\"_blank\">Berkeley's Measure D\u003c/a> would levy a penny-per-ounce tax. Berkeley's tax would be levied on sugar-sweetened beverages that contain at least two calories per ounce. The tax revenue generated would go into the general fund, but Measure D also mandates the creation of a health panel to advise the city on health programs to fund. Because the tax is not earmarked for specific programs, it requires a simple majority to pass -- 50 percent plus one vote.\u003c/p>\n\u003cp>Both taxes are levied on the distributor of the beverages. The presumption its that the tax would ultimately be paid by consumers.\u003c/p>\n\u003chr>\n\u003cp>The San Francisco and Berkeley measures exempt certain categories of drinks from the tax. Those exempted products are as follows:\u003c/p>\n\u003cfigure id=\"attachment_22237\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/iStock_000009686784_Large-e1414537072213.jpg\">\u003cimg class=\"size-large wp-image-22237\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/iStock_000009686784_Large-640x425.jpg\" alt=\"(iStock/Getty Images)\" width=\"640\" height=\"425\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(iStock/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Infant formula. \u003c/strong>Full disclaimer that I have no idea whether that bottle actually contains infant formula or breast milk. But you get the idea. Infant formula is not subject to a sugar-sweetened beverage tax.\u003c/p>\n\u003chr>\n\u003cfigure id=\"attachment_22238\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/iStock_000008600386_Large-e1414537672703.jpg\">\u003cimg class=\"size-large wp-image-22238\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/iStock_000008600386_Large-640x426.jpg\" alt=\"(iStock/Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(iStock/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>100 percent fruit juices\u003c/strong> are not subject to the tax. Neither are 100 percent vegetable juice or 100 percent fruit and vegetable drinks. Why? They do not have added sugar or other caloric sweeteners.\u003c/p>\n\u003chr>\n\u003cfigure id=\"attachment_22239\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/iStock_000019087382_Large.jpg\">\u003cimg class=\"size-large wp-image-22239\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/iStock_000019087382_Large-640x427.jpg\" alt=\"(iStock/Getty Images)\" width=\"640\" height=\"427\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(iStock/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>All milk products\u003c/strong>, including milk alternatives such as soy milk or almond milk. Yes, this includes flavored milk, including chocolate milk. All milk products would be exempt from the tax.\u003c/p>\n\u003chr>\n\u003cfigure id=\"attachment_22240\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/iStock_000020963753_Large-e1414538405773.jpg\">\u003cimg class=\"size-large wp-image-22240\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/iStock_000020963753_Large-640x426.jpg\" alt=\"(iStock/Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(iStock/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Meal replacement drinks \u003c/strong>and so-called medical foods, as well as weight-loss products, are exempt from the tax.\u003c/p>\n\u003chr>\n\u003cfigure id=\"attachment_22260\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/RS5905_167439444-lpr-e1414600313492.jpg\">\u003cimg class=\"size-large wp-image-22260\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/RS5905_167439444-lpr-640x426.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Alcohol would be exempt from the tax. The state of California \u003ca title=\"http://www.boe.ca.gov/sptaxprog/alcoholfaq.htm\" href=\"http://www.boe.ca.gov/sptaxprog/alcoholfaq.htm\" target=\"_blank\">already taxes alcohol\u003c/a>, and according to the state board of equalization, \u003ca title=\"http://www.boe.ca.gov/lawguides/business/current/btlg/vol3/abtl/abtl-32010.html\" href=\"http://www.boe.ca.gov/lawguides/business/current/btlg/vol3/abtl/abtl-32010.html\" target=\"_blank\">state law prohibits local jurisdictions\u003c/a> from imposing excise taxes on alcohol.\u003c/p>\n\u003chr>\n\u003cfigure id=\"attachment_22241\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/1433444783_5ba3b955c6_oREV-e1414538691262.jpg\">\u003cimg class=\"size-large wp-image-22241\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/1433444783_5ba3b955c6_oREV-640x429.jpg\" alt=\"(Kyle Wilson/Flickr)\" width=\"640\" height=\"429\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Kyle Wilson/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Flavored coffee drinks. \u003c/strong>This category of beverages is the only one I've found that is somewhat tricky. If the drinks are pre-bottled and have added sugar, they are subject to the tax. But if they are made by a barista at, say, Starbucks, then the Berkeley and San Francisco measures handle coffee drinks differently.\u003c/p>\n\u003cp>In San Francisco, drinks prepared one by one (in other words, not pre-packaged) would not be taxed. The campaign manager for Yes on Proposition E told me that trying to assess the number of pumps of sweetener for each drink would pose an administrative burden on businesses.\u003c/p>\n\u003cp>But Berkeley would tax flavored coffee drinks made individually. The distributor would pay a tax based on the quantity of sweetener used according to the printed instructions. For example, Starbucks likely provides instruction about how many pumps of sweetener to put in each drink. The distributor would pay a tax according to that calculation.\u003c/p>\n\u003cp>If you buy an unsweetened coffee and then add the sweetener yourself, that additional sweetener is not taxed. In fact, if you buy any drink and add sugar or other caloric sweetener to it after you have purchased it, the additional sweetener will not be taxed. The tax is on the beverage, not on the sugar an individual adds to it.\u003c/p>\n\u003chr>\n\u003cp>People can debate the merits of a sugar-sweetened beverage tax. The American Beverage Association\u003ca title=\"http://ww2.kqed.org/news/2014/10/10/beverage-industry-spends-big-to-defeat-berkeley-measure-d\" href=\"http://ww2.kqed.org/news/2014/10/10/beverage-industry-spends-big-to-defeat-berkeley-measure-d\" target=\"_blank\"> is spending big\u003c/a> to defeat these taxes. One of its strategies, especially in Berkeley, is to insist that Measure D contains \"loopholes,\" and that it's confusing.\u003c/p>\n\u003cp>I frankly don't find it confusing. If your favorite drink contains added sugar and has little other nutritional value, then more than likely it is subject to the tax. If it has nutritional value, such as milk or meal replacement drinks, it is not.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp> \u003c/p>\n\n",
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"excerpt": "If a drink contains added sugar and lacks nutritional value, it will likely be subject to the tax. ",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_11293\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003cimg class=\"wp-image-11293 size-large\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/03/Soda_Flickr_KJM-427-620x412.jpg\" alt=\"(KJM-427/Flickr)\" width=\"620\" height=\"412\">\u003cfigcaption class=\"wp-caption-text\">(KJM-427/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Both San Francisco and Berkeley have \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/10/15/election-2014-san-francisco-berkeley-consider-soda-taxes/\" href=\"http://ww2.kqed.org/stateofhealth/2014/10/15/election-2014-san-francisco-berkeley-consider-soda-taxes/\" target=\"_blank\">measures on their November ballots \u003c/a>that would institute a tax on sugar-sweetened beverages. With less than a week to go until Election Day, we're getting down to the nitty-gritty. People want to know exactly what will be taxed -- and what won't.\u003c/p>\n\u003cp>First things first: The tax is on sugar-sweetened beverages, so diet sodas would not be taxed. After all, they do not have sugar or any other sweetener that has calories. Maybe the moniker \"soda tax\" is misleading here.\u003c/p>\n\u003cp>To find out if your favorite beverage would be taxed, ask yourself the following:\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>Does this drink contain added sugar\u003c/strong> (or another caloric sweetener such as high-fructose corn syrup)?\u003c/li>\n\u003cli>\u003cstrong>Does this drink have significant nutritional value\u003c/strong> (such as, say, milk does)?\u003c/li>\n\u003c/ul>\n\u003cp>If you answer \"yes\" to the first question and \"no\" to the second, your beverage is most likely subject to the proposed tax.\u003c/p>\n\u003cp>Here are drinks that are subject to the tax (farther down are exempt drinks):\u003c/p>\n\u003cfigure id=\"attachment_22244\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"https://www.flickr.com/photos/kalebdf/517315536/in/photolist-MHnTo-57sm4r-auQ5u1-8BaTH2-7uy9Vn-7QfxsV-3jZk2D-bvJeAP-5njkwx-7YABEo-6eXTk4-xJ8Le-h3sMLv-7h9bj4-4ECKjf-bvmvt5-7Qde5Y-8LssN2-9ZYJCb-5nAKXL-oLF3Bp-8N6CeH-oLF3Be-8CRKqm-8m2bPN-5ZHacu-hjMsM6-57PtFj-7sm6bo-6f36vu-6EdH1P-dkScku-28Ck1M-GVq4B-6Ab35o-xHoHv-z5hyD-95bcnr-auMq7M-o7MHJu-op8q9N-5bkmdM-aYXygt-a3sk3i-6f3ebE-6eY1zn-bJ15Jt-9wAxH3-nJhhUX-9497i1\">\u003cimg class=\"size-large wp-image-22244\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/517315536_9197f1aee4_oREV-640x571.jpg\" alt=\"(Kaleb Fulgham/Flickr)\" width=\"640\" height=\"571\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Kaleb Fulgham/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Sodas\u003c/strong> -- such as regular Coke, Pepsi, 7 Up, etc. (But not diet sodas.) This includes sodas in bottles and cans, as well as fountain drinks. Both the Berkeley and San Francisco measures call for taxing the syrup used to make fountain drinks. The syrup is taxed according to the largest volume, in fluid ounces, that could be produced from the sugar-sweetened syrup. For example, if a distributor sells a 12-ounce bottle of syrup and that syrup can be used to make 144 ounces of beverage, the tax is levied on the 144 ounces of beverage.\u003c!--more-->\u003c/p>\n\u003chr>\n\u003cfigure id=\"attachment_20568\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/13556198874_fdf70c448e_z.jpg\">\u003cimg class=\"size-full wp-image-20568\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/13556198874_fdf70c448e_z.jpg\" alt=\"Gatorade was one of the 21 beverages analyzed in the study. (Mike Mozart/Flickr)\" width=\"640\" height=\"478\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2014/08/13556198874_fdf70c448e_z.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2014/08/13556198874_fdf70c448e_z-400x299.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2014/08/13556198874_fdf70c448e_z-320x239.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Mike Mozart/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Sports drinks\u003c/strong>, such as Gatorade. While the Gatorade label says that there are 14 grams of sugar in each 8-ounce serving, the bottles above are 20-ounces each. That means there are 35 grams of sugar in the bottle -- the equivalent of almost nine teaspoons of sugar. Energy drinks often are sugar-sweetened as well. Ditto, Vitamin Water.\u003c/p>\n\u003chr>\n\u003cfigure id=\"attachment_15792\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/oak-tech-ice-tea.jpg\">\u003cimg class=\"size-full wp-image-15792\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/oak-tech-ice-tea.jpg\" alt=\"Arizona Green Tea is popular with teens, but this 23.5 ounce can has 51 grams -- or more than one-third of a cup -- of sugar.(Jane Meredith Adams/EdSource)\" width=\"640\" height=\"427\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2013/10/oak-tech-ice-tea.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2013/10/oak-tech-ice-tea-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2013/10/oak-tech-ice-tea-320x214.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Jane Meredith Adams/EdSource)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Sweetened teas \u003c/strong>are especially popular with teens. The 23.5-ounce can of Arizona Green Tea pictured above contains 51 grams of sugar -- that's more than one-third of a cup. It would be subject to the tax.\u003c/p>\n\u003chr>\n\u003cfigure id=\"attachment_22258\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"https://www.flickr.com/photos/allison_taylor/3307487000/in/photolist-63gJDW-5vPrAu-btqGXR-CUVTd-5DZgGN-CUVUm-8bRiqi-4rSwxW-6UZuVy-5nvvoL-fzvxsH-fzKRB3-5nre8F-Dd2Nr-6ybZ2z-4r4eDb-Czkfd-pc6t1W-dD5hy-6geTcA-dS68Yj-4s6cfN-4HiB6W-cNUx5W-e2dYas-94xiiR-9Rapr-33UurF-6eymr2-6ki4NZ-87hAP-6v3MMh-5nrexp-5nvvvQ-9QEpPd-ceSzom-pTifC-4xZdru-cUY7W-uvQ6P-iB6tw-6taomm-oFNSfz-BzFfB-J3bGJ-7RUnW6-7EN4HY-5anW1j-6wxjBy-6mojej\">\u003cimg class=\"size-large wp-image-22258\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/3307487000_ae79cac0b2_oCROP-640x515.jpg\" alt=\"(Allison Richards/Flickr)\" width=\"640\" height=\"515\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Allison Richards/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>While 100 percent juice drinks are exempt from the tax (see further below), drinks that contain less than that are subject to the tax. For example, according to the \u003ca title=\"http://commons.wikimedia.org/wiki/File:SunnyD_Nutrition_Facts_02.jpg\" href=\"http://commons.wikimedia.org/wiki/File:SunnyD_Nutrition_Facts_02.jpg\" target=\"_blank\">Sunny D nutrition label\u003c/a>, the product contains 5 percent juice -- and added high-fructose corn syrup. The added corn syrup triggers the tax.\u003c/p>\n\u003chr>\n\u003cp>\u003ca title=\"http://sfgov2.org/ftp/uploadedfiles/elections/candidates/Nov2014/Nov2014_SugarSweetenedBeverages.pdf\" href=\"http://sfgov2.org/ftp/uploadedfiles/elections/candidates/Nov2014/Nov2014_SugarSweetenedBeverages.pdf\" target=\"_blank\">San Francisco's Proposition E\u003c/a> would levy a 2-cents-per-ounce tax on sugar-sweetened beverages that have at least 25 calories per 12-ounce drink. The tax revenue generated is earmarked to be spent on health programs. Since the tax is earmarked, it needs a two-thirds supermajority to pass.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003ca title=\"http://www.cityofberkeley.info/Clerk/Elections/Election__2014_Ballot_Measure_Page.aspx\" href=\"http://www.cityofberkeley.info/Clerk/Elections/Election__2014_Ballot_Measure_Page.aspx\" target=\"_blank\">Berkeley's Measure D\u003c/a> would levy a penny-per-ounce tax. Berkeley's tax would be levied on sugar-sweetened beverages that contain at least two calories per ounce. The tax revenue generated would go into the general fund, but Measure D also mandates the creation of a health panel to advise the city on health programs to fund. Because the tax is not earmarked for specific programs, it requires a simple majority to pass -- 50 percent plus one vote.\u003c/p>\n\u003cp>Both taxes are levied on the distributor of the beverages. The presumption its that the tax would ultimately be paid by consumers.\u003c/p>\n\u003chr>\n\u003cp>The San Francisco and Berkeley measures exempt certain categories of drinks from the tax. Those exempted products are as follows:\u003c/p>\n\u003cfigure id=\"attachment_22237\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/iStock_000009686784_Large-e1414537072213.jpg\">\u003cimg class=\"size-large wp-image-22237\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/iStock_000009686784_Large-640x425.jpg\" alt=\"(iStock/Getty Images)\" width=\"640\" height=\"425\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(iStock/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Infant formula. \u003c/strong>Full disclaimer that I have no idea whether that bottle actually contains infant formula or breast milk. But you get the idea. Infant formula is not subject to a sugar-sweetened beverage tax.\u003c/p>\n\u003chr>\n\u003cfigure id=\"attachment_22238\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/iStock_000008600386_Large-e1414537672703.jpg\">\u003cimg class=\"size-large wp-image-22238\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/iStock_000008600386_Large-640x426.jpg\" alt=\"(iStock/Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(iStock/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>100 percent fruit juices\u003c/strong> are not subject to the tax. Neither are 100 percent vegetable juice or 100 percent fruit and vegetable drinks. Why? They do not have added sugar or other caloric sweeteners.\u003c/p>\n\u003chr>\n\u003cfigure id=\"attachment_22239\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/iStock_000019087382_Large.jpg\">\u003cimg class=\"size-large wp-image-22239\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/iStock_000019087382_Large-640x427.jpg\" alt=\"(iStock/Getty Images)\" width=\"640\" height=\"427\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(iStock/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>All milk products\u003c/strong>, including milk alternatives such as soy milk or almond milk. Yes, this includes flavored milk, including chocolate milk. All milk products would be exempt from the tax.\u003c/p>\n\u003chr>\n\u003cfigure id=\"attachment_22240\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/iStock_000020963753_Large-e1414538405773.jpg\">\u003cimg class=\"size-large wp-image-22240\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/iStock_000020963753_Large-640x426.jpg\" alt=\"(iStock/Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(iStock/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Meal replacement drinks \u003c/strong>and so-called medical foods, as well as weight-loss products, are exempt from the tax.\u003c/p>\n\u003chr>\n\u003cfigure id=\"attachment_22260\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/RS5905_167439444-lpr-e1414600313492.jpg\">\u003cimg class=\"size-large wp-image-22260\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/RS5905_167439444-lpr-640x426.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Alcohol would be exempt from the tax. The state of California \u003ca title=\"http://www.boe.ca.gov/sptaxprog/alcoholfaq.htm\" href=\"http://www.boe.ca.gov/sptaxprog/alcoholfaq.htm\" target=\"_blank\">already taxes alcohol\u003c/a>, and according to the state board of equalization, \u003ca title=\"http://www.boe.ca.gov/lawguides/business/current/btlg/vol3/abtl/abtl-32010.html\" href=\"http://www.boe.ca.gov/lawguides/business/current/btlg/vol3/abtl/abtl-32010.html\" target=\"_blank\">state law prohibits local jurisdictions\u003c/a> from imposing excise taxes on alcohol.\u003c/p>\n\u003chr>\n\u003cfigure id=\"attachment_22241\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/1433444783_5ba3b955c6_oREV-e1414538691262.jpg\">\u003cimg class=\"size-large wp-image-22241\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/10/1433444783_5ba3b955c6_oREV-640x429.jpg\" alt=\"(Kyle Wilson/Flickr)\" width=\"640\" height=\"429\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Kyle Wilson/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Flavored coffee drinks. \u003c/strong>This category of beverages is the only one I've found that is somewhat tricky. If the drinks are pre-bottled and have added sugar, they are subject to the tax. But if they are made by a barista at, say, Starbucks, then the Berkeley and San Francisco measures handle coffee drinks differently.\u003c/p>\n\u003cp>In San Francisco, drinks prepared one by one (in other words, not pre-packaged) would not be taxed. The campaign manager for Yes on Proposition E told me that trying to assess the number of pumps of sweetener for each drink would pose an administrative burden on businesses.\u003c/p>\n\u003cp>But Berkeley would tax flavored coffee drinks made individually. The distributor would pay a tax based on the quantity of sweetener used according to the printed instructions. For example, Starbucks likely provides instruction about how many pumps of sweetener to put in each drink. The distributor would pay a tax according to that calculation.\u003c/p>\n\u003cp>If you buy an unsweetened coffee and then add the sweetener yourself, that additional sweetener is not taxed. In fact, if you buy any drink and add sugar or other caloric sweetener to it after you have purchased it, the additional sweetener will not be taxed. The tax is on the beverage, not on the sugar an individual adds to it.\u003c/p>\n\u003chr>\n\u003cp>People can debate the merits of a sugar-sweetened beverage tax. The American Beverage Association\u003ca title=\"http://ww2.kqed.org/news/2014/10/10/beverage-industry-spends-big-to-defeat-berkeley-measure-d\" href=\"http://ww2.kqed.org/news/2014/10/10/beverage-industry-spends-big-to-defeat-berkeley-measure-d\" target=\"_blank\"> is spending big\u003c/a> to defeat these taxes. One of its strategies, especially in Berkeley, is to insist that Measure D contains \"loopholes,\" and that it's confusing.\u003c/p>\n\u003cp>I frankly don't find it confusing. If your favorite drink contains added sugar and has little other nutritional value, then more than likely it is subject to the tax. If it has nutritional value, such as milk or meal replacement drinks, it is not.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "State Set to Move Rural Seniors, Disabled to Medi-Cal Managed Care",
"title": "State Set to Move Rural Seniors, Disabled to Medi-Cal Managed Care",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_5429\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/Redwoods_BenRamirez_Flickr_04262012-e1383937340166.jpg\">\u003cimg class=\"size-large wp-image-5429\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/Redwoods_BenRamirez_Flickr_04262012-620x465.jpg\" alt=\"(Ben Ramirez: Flickr)\" width=\"620\" height=\"465\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Ben Ramirez/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By David Gorn,\u003c/strong>\u003ca title=\"http://www.californiahealthline.org/capitol-desk/2014/10/state-gearing-up-to-move-rural-seniors-disabled-into-medical-managed-care\" href=\"http://www.californiahealthline.org/capitol-desk/2014/10/state-gearing-up-to-move-rural-seniors-disabled-into-medical-managed-care\" target=\"_blank\"> California Healthline\u003c/a>\u003c/p>\n\u003cp>About one month from now, the state is launching a program to shift a new set of Medi-Cal beneficiaries into Medi-Cal managed care plans. This time, the state is focusing on a shift in care for some of the frailest patients in rural counties.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Among many of these frail beneficiaries, there is deep fear about what's about to happen.\u003c/aside>\n\u003cp>On Dec. 1, about \u003ca title=\"http://www.dhcs.ca.gov/provgovpart/Documents/Waiver%20Renewal/Rural_SPD_1115_2014-08-04.pdf\" href=\"http://www.dhcs.ca.gov/provgovpart/Documents/Waiver%20Renewal/Rural_SPD_1115_2014-08-04.pdf\" target=\"_blank\">20,000 Medi-Cal seniors and persons with disabilities\u003c/a> in 28 rural counties will make the switch to managed care plans. It's a continuation of an extended effort by the state to expand Medi-Cal managed care to rural areas, said Mari Cantwell, chief deputy director of health care programs at the Department of Health Care Services, which oversees Medi-Cal.\u003c/p>\n\u003cp>\"We started the rural expansion about a year ago, starting with non-disabled adults and children in 28 counties,\" Cantwell said. \"Still pending are the population of seniors and persons with disabilities (SPD's). That's not a very large number of people in comparison, about 20,000 people.\"\u003c!--more-->\u003c/p>\n\u003cp>However, it is a population with some big challenges, Cantwell said -- people with multiple conditions, medications and providers. That makes the transition tricky -- and also points out its importance, she said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"From our perspective, our managed care plans are able to provide better integrated care, they are doing risk assessments to see where the gaps in care might be,\" Cantwell said.\u003c/p>\n\u003cp>\"It is really about improving care so they can have their health plan help them navigate the system,\" she said.\u003c/p>\n\u003cp>Among many of these frail beneficiaries, though, there is deep fear about what's about to happen, said Steve Barrow, president and CEO of Advocates for Health, Economics and Development, a not-for-profit advocacy group for underserved areas, including rural California counties.\u003c/p>\n\u003cp>\"Just put yourself in their place,\" Barrow said. \"You establish specialty care in some place like Redding or Reno, and if you can't go to the same place, it would be pretty scary.\"\u003c/p>\n\u003cp>Rural counties have an alarming lack of specialty providers, Barrow said, so people might have difficulty finding one who treats their particular problem -- or set of problems -- within a manageable distance. And it's not just beneficiaries who have concerns about this particular transition, he said.\u003c/p>\n\u003cp>\"For the provider, it's scary because you're not sure you can handle all of these patients' problems [at managed care reimbursement rates]. And for health plans it's scary taking on these complex patients, because they're wondering now, \"How do we not lose our shirts on these patients?,\" Barrow said. \"There's plenty of fear to go around.\"\u003c/p>\n\u003cp>Rural care is more challenging because of the distances involved, on top of the scarcity of providers, Barrow said.\u003c/p>\n\u003cp>\"In rural areas you have extreme difficulties to establish specialists in the first place. There's also a huge shortage of primary care physicians in rural areas,\" Barrow said. \"I mean, the landscape is already difficult for people who are healthy.\"\u003c/p>\n\u003cp>Add in the inexperience of rural counties in dealing with managed care and you have a situation that's more difficult than any other state transition to Medi-Cal managed care, Barrow said.\u003cbr>\n\"They call it a safety net for a reason,\" Barrow said. \"It's very thin. It may be a small number of people, but this is big impact.\"\u003c/p>\n\u003cp>Cantwell said the department is aware of all of these concerns and officials hope to make this transition smoother than some of the others have been.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"We certainly have applied lessons learned,\" Cantwell said. \"We are making sure health plans have data on people in advance of being enrolled in the plans. We are making sure there is more clarity on the continuity-of-care provision.\"\u003c/p>\n\n",
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"excerpt": "The goal is better coordinated care for these frail patients, but advocates worry about the disruption.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_5429\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/Redwoods_BenRamirez_Flickr_04262012-e1383937340166.jpg\">\u003cimg class=\"size-large wp-image-5429\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/Redwoods_BenRamirez_Flickr_04262012-620x465.jpg\" alt=\"(Ben Ramirez: Flickr)\" width=\"620\" height=\"465\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Ben Ramirez/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By David Gorn,\u003c/strong>\u003ca title=\"http://www.californiahealthline.org/capitol-desk/2014/10/state-gearing-up-to-move-rural-seniors-disabled-into-medical-managed-care\" href=\"http://www.californiahealthline.org/capitol-desk/2014/10/state-gearing-up-to-move-rural-seniors-disabled-into-medical-managed-care\" target=\"_blank\"> California Healthline\u003c/a>\u003c/p>\n\u003cp>About one month from now, the state is launching a program to shift a new set of Medi-Cal beneficiaries into Medi-Cal managed care plans. This time, the state is focusing on a shift in care for some of the frailest patients in rural counties.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Among many of these frail beneficiaries, there is deep fear about what's about to happen.\u003c/aside>\n\u003cp>On Dec. 1, about \u003ca title=\"http://www.dhcs.ca.gov/provgovpart/Documents/Waiver%20Renewal/Rural_SPD_1115_2014-08-04.pdf\" href=\"http://www.dhcs.ca.gov/provgovpart/Documents/Waiver%20Renewal/Rural_SPD_1115_2014-08-04.pdf\" target=\"_blank\">20,000 Medi-Cal seniors and persons with disabilities\u003c/a> in 28 rural counties will make the switch to managed care plans. It's a continuation of an extended effort by the state to expand Medi-Cal managed care to rural areas, said Mari Cantwell, chief deputy director of health care programs at the Department of Health Care Services, which oversees Medi-Cal.\u003c/p>\n\u003cp>\"We started the rural expansion about a year ago, starting with non-disabled adults and children in 28 counties,\" Cantwell said. \"Still pending are the population of seniors and persons with disabilities (SPD's). That's not a very large number of people in comparison, about 20,000 people.\"\u003c!--more-->\u003c/p>\n\u003cp>However, it is a population with some big challenges, Cantwell said -- people with multiple conditions, medications and providers. That makes the transition tricky -- and also points out its importance, she said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"From our perspective, our managed care plans are able to provide better integrated care, they are doing risk assessments to see where the gaps in care might be,\" Cantwell said.\u003c/p>\n\u003cp>\"It is really about improving care so they can have their health plan help them navigate the system,\" she said.\u003c/p>\n\u003cp>Among many of these frail beneficiaries, though, there is deep fear about what's about to happen, said Steve Barrow, president and CEO of Advocates for Health, Economics and Development, a not-for-profit advocacy group for underserved areas, including rural California counties.\u003c/p>\n\u003cp>\"Just put yourself in their place,\" Barrow said. \"You establish specialty care in some place like Redding or Reno, and if you can't go to the same place, it would be pretty scary.\"\u003c/p>\n\u003cp>Rural counties have an alarming lack of specialty providers, Barrow said, so people might have difficulty finding one who treats their particular problem -- or set of problems -- within a manageable distance. And it's not just beneficiaries who have concerns about this particular transition, he said.\u003c/p>\n\u003cp>\"For the provider, it's scary because you're not sure you can handle all of these patients' problems [at managed care reimbursement rates]. And for health plans it's scary taking on these complex patients, because they're wondering now, \"How do we not lose our shirts on these patients?,\" Barrow said. \"There's plenty of fear to go around.\"\u003c/p>\n\u003cp>Rural care is more challenging because of the distances involved, on top of the scarcity of providers, Barrow said.\u003c/p>\n\u003cp>\"In rural areas you have extreme difficulties to establish specialists in the first place. There's also a huge shortage of primary care physicians in rural areas,\" Barrow said. \"I mean, the landscape is already difficult for people who are healthy.\"\u003c/p>\n\u003cp>Add in the inexperience of rural counties in dealing with managed care and you have a situation that's more difficult than any other state transition to Medi-Cal managed care, Barrow said.\u003cbr>\n\"They call it a safety net for a reason,\" Barrow said. \"It's very thin. It may be a small number of people, but this is big impact.\"\u003c/p>\n\u003cp>Cantwell said the department is aware of all of these concerns and officials hope to make this transition smoother than some of the others have been.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"We certainly have applied lessons learned,\" Cantwell said. \"We are making sure health plans have data on people in advance of being enrolled in the plans. We are making sure there is more clarity on the continuity-of-care provision.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"officialWebsiteLink": "/californiareportmagazine",
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"order": 10
},
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM3NjkwNjk1OTAz",
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},
"city-arts": {
"id": "city-arts",
"title": "City Arts & Lectures",
"info": "A one-hour radio program to hear celebrated writers, artists and thinkers address contemporary ideas and values, often discussing the creative process. Please note: tapes or transcripts are not available",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/05/cityartsandlecture-300x300.jpg",
"officialWebsiteLink": "https://www.cityarts.net/",
"airtime": "SUN 1pm-2pm, TUE 10pm, WED 1am",
"meta": {
"site": "news",
"source": "City Arts & Lectures"
},
"link": "https://www.cityarts.net",
"subscribe": {
"tuneIn": "https://tunein.com/radio/City-Arts-and-Lectures-p692/",
"rss": "https://www.cityarts.net/feed/"
}
},
"closealltabs": {
"id": "closealltabs",
"title": "Close All Tabs",
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"info": "Close All Tabs breaks down how digital culture shapes our world through thoughtful insights and irreverent humor.",
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"officialWebsiteLink": "/podcasts/closealltabs",
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"order": 1
},
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"id": "code-switch-life-kit",
"title": "Code Switch / Life Kit",
"info": "\u003cem>Code Switch\u003c/em>, which listeners will hear in the first part of the hour, has fearless and much-needed conversations about race. Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />",
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"meta": {
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly93d3cubnByLm9yZy9yc3MvcG9kY2FzdC5waHA_aWQ9NTEwMzEy",
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"id": "commonwealth-club",
"title": "Commonwealth Club of California Podcast",
"info": "The Commonwealth Club of California is the nation's oldest and largest public affairs forum. As a non-partisan forum, The Club brings to the public airwaves diverse viewpoints on important topics. The Club's weekly radio broadcast - the oldest in the U.S., dating back to 1924 - is carried across the nation on public radio stations and is now podcasting. Our website archive features audio of our recent programs, as well as selected speeches from our long and distinguished history. This podcast feed is usually updated twice a week and is always un-edited.",
"airtime": "THU 10pm, FRI 1am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Commonwealth-Club-Podcast-Tile-360x360-1.jpg",
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"meta": {
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"source": "Commonwealth Club of California"
},
"link": "/radio/program/commonwealth-club",
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"google": "https://podcasts.google.com/feed/aHR0cDovL3d3dy5jb21tb253ZWFsdGhjbHViLm9yZy9hdWRpby9wb2RjYXN0L3dlZWtseS54bWw",
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},
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"id": "forum",
"title": "Forum",
"tagline": "The conversation starts here",
"info": "KQED’s live call-in program discussing local, state, national and international issues, as well as in-depth interviews.",
"airtime": "MON-FRI 9am-11am, 10pm-11pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Forum-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED Forum with Mina Kim and Alexis Madrigal",
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"meta": {
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"source": "kqed",
"order": 9
},
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM5NTU3MzgxNjMz",
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"id": "freakonomics-radio",
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"imageSrc": "https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/05/freakonomicsRadio.png",
"officialWebsiteLink": "http://freakonomics.com/",
"airtime": "SUN 1am-2am, SAT 3pm-4pm",
"meta": {
"site": "radio",
"source": "WNYC"
},
"link": "/radio/program/freakonomics-radio",
"subscribe": {
"npr": "https://rpb3r.app.goo.gl/4s8b",
"apple": "https://itunes.apple.com/us/podcast/freakonomics-radio/id354668519",
"tuneIn": "https://tunein.com/podcasts/WNYC-Podcasts/Freakonomics-Radio-p272293/",
"rss": "https://feeds.feedburner.com/freakonomicsradio"
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},
"fresh-air": {
"id": "fresh-air",
"title": "Fresh Air",
"info": "Hosted by Terry Gross, \u003cem>Fresh Air from WHYY\u003c/em> is the Peabody Award-winning weekday magazine of contemporary arts and issues. One of public radio's most popular programs, Fresh Air features intimate conversations with today's biggest luminaries.",
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"link": "/radio/program/fresh-air",
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"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=214089682&at=11l79Y&ct=nprdirectory",
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"rss": "https://feeds.npr.org/381444908/podcast.xml"
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"info": "A live production of NPR and WBUR Boston, in collaboration with stations across the country, Here & Now reflects the fluid world of news as it's happening in the middle of the day, with timely, in-depth news, interviews and conversation. Hosted by Robin Young, Jeremy Hobson and Tonya Mosley.",
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"rss": "https://feeds.npr.org/510051/podcast.xml"
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},
"hidden-brain": {
"id": "hidden-brain",
"title": "Hidden Brain",
"info": "Shankar Vedantam uses science and storytelling to reveal the unconscious patterns that drive human behavior, shape our choices and direct our relationships.",
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"officialWebsiteLink": "https://www.npr.org/series/423302056/hidden-brain",
"airtime": "SUN 7pm-8pm",
"meta": {
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"source": "NPR"
},
"link": "/radio/program/hidden-brain",
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},
"how-i-built-this": {
"id": "how-i-built-this",
"title": "How I Built This with Guy Raz",
"info": "Guy Raz dives into the stories behind some of the world's best known companies. How I Built This weaves a narrative journey about innovators, entrepreneurs and idealists—and the movements they built.",
"imageSrc": "https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/05/howIBuiltThis.png",
"officialWebsiteLink": "https://www.npr.org/podcasts/510313/how-i-built-this",
"airtime": "SUN 7:30pm-8pm",
"meta": {
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"source": "npr"
},
"link": "/radio/program/how-i-built-this",
"subscribe": {
"npr": "https://rpb3r.app.goo.gl/3zxy",
"apple": "https://itunes.apple.com/us/podcast/how-i-built-this-with-guy-raz/id1150510297?mt=2",
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"rss": "https://feeds.npr.org/510313/podcast.xml"
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},
"hyphenacion": {
"id": "hyphenacion",
"title": "Hyphenación",
"tagline": "Where conversation and cultura meet",
"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2025/03/Hyphenacion_FinalAssets_PodcastTile.png",
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"officialWebsiteLink": "/podcasts/hyphenacion",
"meta": {
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"source": "kqed",
"order": 15
},
"link": "/podcasts/hyphenacion",
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"spotify": "https://open.spotify.com/show/2p3Fifq96nw9BPcmFdIq0o?si=39209f7b25774f38",
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"rss": "https://feeds.megaphone.fm/KQINC2275451163"
}
},
"jerrybrown": {
"id": "jerrybrown",
"title": "The Political Mind of Jerry Brown",
"tagline": "Lessons from a lifetime in politics",
"info": "The Political Mind of Jerry Brown brings listeners the wisdom of the former Governor, Mayor, and presidential candidate. Scott Shafer interviewed Brown for more than 40 hours, covering the former governor's life and half-century in the political game – and Brown has some lessons he'd like to share. ",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-Political-Mind-of-Jerry-Brown-Podcast-Tile-703x703-1.jpg",
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"officialWebsiteLink": "/podcasts/jerrybrown",
"meta": {
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"source": "kqed",
"order": 18
},
"link": "/podcasts/jerrybrown",
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"apple": "https://itunes.apple.com/us/podcast/id1492194549",
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}
},
"latino-usa": {
"id": "latino-usa",
"title": "Latino USA",
"airtime": "MON 1am-2am, SUN 6pm-7pm",
"info": "Latino USA, the radio journal of news and culture, is the only national, English-language radio program produced from a Latino perspective.",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/latinoUsa.jpg",
"officialWebsiteLink": "http://latinousa.org/",
"meta": {
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"source": "npr"
},
"link": "/radio/program/latino-usa",
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"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=79681317&at=11l79Y&ct=nprdirectory",
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"rss": "https://feeds.npr.org/510016/podcast.xml"
}
},
"marketplace": {
"id": "marketplace",
"title": "Marketplace",
"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
"airtime": "MON-FRI 4pm-4:30pm, MON-WED 6:30pm-7pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Marketplace-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.marketplace.org/",
"meta": {
"site": "news",
"source": "American Public Media"
},
"link": "/radio/program/marketplace",
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"rss": "https://feeds.publicradio.org/public_feeds/marketplace-pm/rss/rss"
}
},
"masters-of-scale": {
"id": "masters-of-scale",
"title": "Masters of Scale",
"info": "Masters of Scale is an original podcast in which LinkedIn co-founder and Greylock Partner Reid Hoffman sets out to describe and prove theories that explain how great entrepreneurs take their companies from zero to a gazillion in ingenious fashion.",
"airtime": "Every other Wednesday June 12 through October 16 at 8pm (repeats Thursdays at 2am)",
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"officialWebsiteLink": "https://mastersofscale.com/",
"meta": {
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"source": "WaitWhat"
},
"link": "/radio/program/masters-of-scale",
"subscribe": {
"apple": "http://mastersofscale.app.link/",
"rss": "https://rss.art19.com/masters-of-scale"
}
},
"mindshift": {
"id": "mindshift",
"title": "MindShift",
"tagline": "A podcast about the future of learning and how we raise our kids",
"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Mindshift-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED MindShift: How We Will Learn",
"officialWebsiteLink": "/mindshift/",
"meta": {
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"source": "kqed",
"order": 12
},
"link": "/podcasts/mindshift",
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5",
"npr": "https://www.npr.org/podcasts/464615685/mind-shift-podcast",
"stitcher": "https://www.stitcher.com/podcast/kqed/stories-teachers-share",
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}
},
"morning-edition": {
"id": "morning-edition",
"title": "Morning Edition",
"info": "\u003cem>Morning Edition\u003c/em> takes listeners around the country and the world with multi-faceted stories and commentaries every weekday. Hosts Steve Inskeep, David Greene and Rachel Martin bring you the latest breaking news and features to prepare you for the day.",
"airtime": "MON-FRI 3am-9am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Morning-Edition-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.npr.org/programs/morning-edition/",
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"link": "/radio/program/morning-edition"
},
"onourwatch": {
"id": "onourwatch",
"title": "On Our Watch",
"tagline": "Deeply-reported investigative journalism",
"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/On-Our-Watch-Podcast-Tile-703x703-1.jpg",
"imageAlt": "On Our Watch from NPR and KQED",
"officialWebsiteLink": "/podcasts/onourwatch",
"meta": {
"site": "news",
"source": "kqed",
"order": 11
},
"link": "/podcasts/onourwatch",
"subscribe": {
"apple": "https://podcasts.apple.com/podcast/id1567098962",
"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5ucHIub3JnLzUxMDM2MC9wb2RjYXN0LnhtbD9zYz1nb29nbGVwb2RjYXN0cw",
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"rss": "https://feeds.npr.org/510360/podcast.xml"
}
},
"on-the-media": {
"id": "on-the-media",
"title": "On The Media",
"info": "Our weekly podcast explores how the media 'sausage' is made, casts an incisive eye on fluctuations in the marketplace of ideas, and examines threats to the freedom of information and expression in America and abroad. For one hour a week, the show tries to lift the veil from the process of \"making media,\" especially news media, because it's through that lens that we see the world and the world sees us",
"airtime": "SUN 2pm-3pm, MON 12am-1am",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/onTheMedia.png",
"officialWebsiteLink": "https://www.wnycstudios.org/shows/otm",
"meta": {
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"source": "wnyc"
},
"link": "/radio/program/on-the-media",
"subscribe": {
"apple": "https://itunes.apple.com/us/podcast/on-the-media/id73330715?mt=2",
"tuneIn": "https://tunein.com/radio/On-the-Media-p69/",
"rss": "http://feeds.wnyc.org/onthemedia"
}
},
"pbs-newshour": {
"id": "pbs-newshour",
"title": "PBS NewsHour",
"info": "Analysis, background reports and updates from the PBS NewsHour putting today's news in context.",
"airtime": "MON-FRI 3pm-4pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/PBS-News-Hour-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.pbs.org/newshour/",
"meta": {
"site": "news",
"source": "pbs"
},
"link": "/radio/program/pbs-newshour",
"subscribe": {
"apple": "https://itunes.apple.com/us/podcast/pbs-newshour-full-show/id394432287?mt=2",
"tuneIn": "https://tunein.com/radio/PBS-NewsHour---Full-Show-p425698/",
"rss": "https://www.pbs.org/newshour/feeds/rss/podcasts/show"
}
},
"perspectives": {
"id": "perspectives",
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