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"disqusTitle": "Last Phase of Transition: Rural Californians Move to Medi-Cal Managed Care ",
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"content": "\u003cfigure id=\"attachment_5429\" class=\"wp-caption alignnone\" 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 href=\"http://www.californiahealthline.org/insight/2013/as-healthy-families-shift-goes-so-goes-rural-expansion-of-medical-managed-care\" target=\"_blank\">California Healthline\u003c/a>\u003c/p>\n\u003cp>Rural Californians already have challenges accessing health care and changes to Medi-Cal, the state's Medicaid program, could further complicate matters.\u003c/p>\n\u003cp>Rural areas have fewer physicians and facilities and services are spread out over greater distances than they are in urban and suburban areas. Rural areas also have a disproportionately high number of lower-income, Medi-Cal-eligible residents which creates a challenging situation for state health officials charged with providing medical coverage in rural settings.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"The rollout has gone relatively smoothly, but the access to providers -- that's a real question still.\"\u003c/aside>\n\u003cp>On Nov. 1, the state launched an ambitious plan to transition Medi-Cal beneficiaries in rural areas from fee-for-service care arrangements to managed care plans. The move shifts 28 rural counties to the financial model the state is using throughout the rest of the state.\u003c/p>\n\u003cp>Also on Nov. 1, the state launched the last phase of its Healthy Families transition -- moving children in rural counties to Medi-Cal managed care. Healthy Families is California's Children's Health Insurance Program.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>There have been scattered, anecdotal reports that parents can't find available physicians for their children because some doctors who had participated in Healthy Families won't be making the switch to the Medi-Cal managed care model, which pays lower rates.\u003c/p>\n\u003cp>\u003cstrong>Half the State's Children Eligible for Medi-Cal\u003c/strong>\u003c/p>\n\u003cp>Kelly Hardy has long been concerned about children. As director of health policy for Children Now, Hardy has kept a careful eye on the transition of 860,000 children from Healthy Families to Medi-Cal managed care.\u003c/p>\n\u003cp>\"I do think [state health officials] deserve some credit. The rollout has gone relatively smoothly,\" Hardy said. \"But the access to providers, especially in rural and underserved areas, that's a real question still.\"\u003c/p>\n\u003cp>Children are the proverbial canary in the coal mine of rural counties' shift to Medi-Cal managed care, she said. Healthy Families offered providers higher reimbursement rates than Medi-Cal, and physicians now stand to lose significant money by caring for Medi-Cal children.\u003c/p>\n\u003cp>And there are a lot of them.\u003c/p>\n\u003cp>State health officials estimate roughly 4.5 million children are in Medi-Cal. About half of all births in California are covered through Medi-Cal.\u003c/p>\n\u003cp>\"We're at a new point where about half of the kids in the state are Medi-Cal kids. It speaks to the stakes we're talking about, that we better get this right,\" Hardy said.\u003c/p>\n\u003cp>The potential for problems is greater in rural areas with a higher percentage of lower-income Californians, she said.\u003c/p>\n\u003cp>\"I am just amazed by the numbers we're talking about,\" Hardy said. \"That speaks to the dedication of the providers, that all of those children get care, and it speaks to the level of outreach by the Department of Health Care Services, as well,\" to make sure kids can get care.\u003c/p>\n\u003cp>\"But really, at the root, they just need to pay more for the care,\" Hardy said.\u003c/p>\n\u003cp>\u003cstrong>Access Issues in Some Rural Counties?\u003cstrong>\u003c/strong>\u003c/strong>\u003c/p>\n\u003cp>Hardy and other children's advocates say it's too early to provide big-picture statistics, but they've heard reports of provider network inadequacy in Lassen, Placer and Imperial counties so far.\u003c/p>\n\u003cp>\"In some counties, especially those served by Partnership HealthPlan, things seem to be going well,\" said Suzie Shupe, executive director of California Coverage and Health Initiatives, a not-for-profit children's advocacy group. Partnership HealthPlan, based in Fairfield, is one of six nonprofit, county-organized health systems in the state. It serves 14 counties in Northern California.\u003c/p>\n\u003cp>In other parts of the state, there have been reports of access issues, Shupe said. But it's impossible to know the extent of the problem \"because the information available to families about how to get help and how to report such problems has been so thin,\" she said.\u003c/p>\n\u003cp>\"I think what we're seeing now is a lack of providers,\" Hardy noted. \"It looks like few or no providers switched from Healthy Families over to Medi-Cal managed care. That's what we're hearing, rather than confusion.\u003c/p>\n\u003cp>People are saying there's a non-existent network here.\"\u003c/p>\n\u003cp>That is news to Jane Ogle, deputy director at DHCS. \"We haven't heard of any problems in Placer or Lassen [counties] at all.\"\u003c/p>\n\u003cp>DHCS officials are monitoring rural counties especially carefully right now, looking for complaints or trouble, and they haven't received many negative reports, Ogle said.\u003c/p>\n\u003cp>There was concern in Imperial County, Ogle said, where one plan's provider network wasn't up in time for the transition rollout.\u003c/p>\n\u003cp>\"In Imperial County we only had one plan, so Molina (Healthcare) agreed to be another provider for us,\" Ogle said. \"So for them it was a tight timeline to line up that provider network.\"\u003c/p>\n\u003cp>Once the provider network contracts were signed, Molina bought full-page advertisements in the local newspaper to alert residents, Ogle said.\u003c/p>\n\u003cp>\"From our point of view, it has gone very well,\" Ogle said.\u003c/p>\n\u003cp>\u003cstrong>Two Transition Efforts Are Linked\u003cstrong>\u003c/strong>\u003c/strong>\u003c/p>\n\u003cp>Ogle said both transitions -- the rural expansion into Medi-Cal managed care and the shift of Healthy Families children -- had to be done at the same time and be completed before January, when the Affordable Care Act will be fully implemented and the state's expands Medi-Cal eligibility.\u003c/p>\n\u003cp>\"We wanted to transition Healthy Families in the counties that have never had any managed care, and we wanted to open up managed care in rural counties at the same time,\" Ogle said. \"To allow for that expansion, we wanted to do it at the same time. If we only moved the relatively small population of Healthy Families children in rural areas, we would not have had the numbers to do it.\"\u003c/p>\n\u003cp>When you add in the rural expansion of the adult population, she said, \"then there are sufficient numbers to do it.\"\u003c/p>\n\u003cp>Under managed care, Californians should have access to more services, Ogle said. \"Making sure they get ... immunizations done, ... and having access standards, that kind of thing,\" she said, \"none of which is in fee-for-service.\"\u003c/p>\n\u003cp>Given the size and scope of the Healthy Families transition this year, the overall smoothness and success so far has been remarkable, Ogle said.\u003c/p>\n\u003cp>\"We know there will always be individual and anecdotal issues,\" Ogle said. \"But we transitioned 900,000 children, and by and large it's been a good, smooth transition for them, and they're now well-placed for the [ACA and Medi-Cal] expansion to occur.\"\u003c/p>\n\u003cp>Hardy agreed that the rollout has gone well, and she gives DHCS officials a lot of praise for that. The children in rural areas, though, may encounter problems in the months ahead, she said. Because children use medical services less often than adults, the effect on access might not be immediately clear, she added.\u003c/p>\n\u003cp>\"We haven't seen a big smoking gun, and we're really thankful we haven't seen a big smoking gun,\" Hardy said, \"but we're still concerned about sneaky issues like continuity of care and network adequacy.\"\u003c/p>\n\u003cp>In Lassen County, for instance, there's only one federally qualified health center in the entire county, she said, so the wiggle room for network inadequacy is razor-thin.\u003c/p>\n\u003cp>If a high percentage of children in the transition is able to maintain access to their preferred primary care physician, that's great, she said. However, that still leaves a group of children who did not get to remain with their physician.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\"Access to care is still a huge concern,\" Hardy said. \"So if you think this is a great result for California's kids, your standards are way too low.\"\u003c/p>\n\n",
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"excerpt": "Rural Californians already have challenges accessing health care and changes to Medi-Cal, the state's Medicaid program, could further complicate matters.\r\n\r\nRural areas have fewer physicians and facilities and services are spread out over greater distances than they are in urban and suburban areas. Rural areas also have a disproportionately high number of lower-income, Medi-Cal-eligible residents which creates a challenging situation for state health officials charged with providing medical coverage in rural settings.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_5429\" class=\"wp-caption alignnone\" 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 href=\"http://www.californiahealthline.org/insight/2013/as-healthy-families-shift-goes-so-goes-rural-expansion-of-medical-managed-care\" target=\"_blank\">California Healthline\u003c/a>\u003c/p>\n\u003cp>Rural Californians already have challenges accessing health care and changes to Medi-Cal, the state's Medicaid program, could further complicate matters.\u003c/p>\n\u003cp>Rural areas have fewer physicians and facilities and services are spread out over greater distances than they are in urban and suburban areas. Rural areas also have a disproportionately high number of lower-income, Medi-Cal-eligible residents which creates a challenging situation for state health officials charged with providing medical coverage in rural settings.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"The rollout has gone relatively smoothly, but the access to providers -- that's a real question still.\"\u003c/aside>\n\u003cp>On Nov. 1, the state launched an ambitious plan to transition Medi-Cal beneficiaries in rural areas from fee-for-service care arrangements to managed care plans. The move shifts 28 rural counties to the financial model the state is using throughout the rest of the state.\u003c/p>\n\u003cp>Also on Nov. 1, the state launched the last phase of its Healthy Families transition -- moving children in rural counties to Medi-Cal managed care. Healthy Families is California's Children's Health Insurance Program.\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 have been scattered, anecdotal reports that parents can't find available physicians for their children because some doctors who had participated in Healthy Families won't be making the switch to the Medi-Cal managed care model, which pays lower rates.\u003c/p>\n\u003cp>\u003cstrong>Half the State's Children Eligible for Medi-Cal\u003c/strong>\u003c/p>\n\u003cp>Kelly Hardy has long been concerned about children. As director of health policy for Children Now, Hardy has kept a careful eye on the transition of 860,000 children from Healthy Families to Medi-Cal managed care.\u003c/p>\n\u003cp>\"I do think [state health officials] deserve some credit. The rollout has gone relatively smoothly,\" Hardy said. \"But the access to providers, especially in rural and underserved areas, that's a real question still.\"\u003c/p>\n\u003cp>Children are the proverbial canary in the coal mine of rural counties' shift to Medi-Cal managed care, she said. Healthy Families offered providers higher reimbursement rates than Medi-Cal, and physicians now stand to lose significant money by caring for Medi-Cal children.\u003c/p>\n\u003cp>And there are a lot of them.\u003c/p>\n\u003cp>State health officials estimate roughly 4.5 million children are in Medi-Cal. About half of all births in California are covered through Medi-Cal.\u003c/p>\n\u003cp>\"We're at a new point where about half of the kids in the state are Medi-Cal kids. It speaks to the stakes we're talking about, that we better get this right,\" Hardy said.\u003c/p>\n\u003cp>The potential for problems is greater in rural areas with a higher percentage of lower-income Californians, she said.\u003c/p>\n\u003cp>\"I am just amazed by the numbers we're talking about,\" Hardy said. \"That speaks to the dedication of the providers, that all of those children get care, and it speaks to the level of outreach by the Department of Health Care Services, as well,\" to make sure kids can get care.\u003c/p>\n\u003cp>\"But really, at the root, they just need to pay more for the care,\" Hardy said.\u003c/p>\n\u003cp>\u003cstrong>Access Issues in Some Rural Counties?\u003cstrong>\u003c/strong>\u003c/strong>\u003c/p>\n\u003cp>Hardy and other children's advocates say it's too early to provide big-picture statistics, but they've heard reports of provider network inadequacy in Lassen, Placer and Imperial counties so far.\u003c/p>\n\u003cp>\"In some counties, especially those served by Partnership HealthPlan, things seem to be going well,\" said Suzie Shupe, executive director of California Coverage and Health Initiatives, a not-for-profit children's advocacy group. Partnership HealthPlan, based in Fairfield, is one of six nonprofit, county-organized health systems in the state. It serves 14 counties in Northern California.\u003c/p>\n\u003cp>In other parts of the state, there have been reports of access issues, Shupe said. But it's impossible to know the extent of the problem \"because the information available to families about how to get help and how to report such problems has been so thin,\" she said.\u003c/p>\n\u003cp>\"I think what we're seeing now is a lack of providers,\" Hardy noted. \"It looks like few or no providers switched from Healthy Families over to Medi-Cal managed care. That's what we're hearing, rather than confusion.\u003c/p>\n\u003cp>People are saying there's a non-existent network here.\"\u003c/p>\n\u003cp>That is news to Jane Ogle, deputy director at DHCS. \"We haven't heard of any problems in Placer or Lassen [counties] at all.\"\u003c/p>\n\u003cp>DHCS officials are monitoring rural counties especially carefully right now, looking for complaints or trouble, and they haven't received many negative reports, Ogle said.\u003c/p>\n\u003cp>There was concern in Imperial County, Ogle said, where one plan's provider network wasn't up in time for the transition rollout.\u003c/p>\n\u003cp>\"In Imperial County we only had one plan, so Molina (Healthcare) agreed to be another provider for us,\" Ogle said. \"So for them it was a tight timeline to line up that provider network.\"\u003c/p>\n\u003cp>Once the provider network contracts were signed, Molina bought full-page advertisements in the local newspaper to alert residents, Ogle said.\u003c/p>\n\u003cp>\"From our point of view, it has gone very well,\" Ogle said.\u003c/p>\n\u003cp>\u003cstrong>Two Transition Efforts Are Linked\u003cstrong>\u003c/strong>\u003c/strong>\u003c/p>\n\u003cp>Ogle said both transitions -- the rural expansion into Medi-Cal managed care and the shift of Healthy Families children -- had to be done at the same time and be completed before January, when the Affordable Care Act will be fully implemented and the state's expands Medi-Cal eligibility.\u003c/p>\n\u003cp>\"We wanted to transition Healthy Families in the counties that have never had any managed care, and we wanted to open up managed care in rural counties at the same time,\" Ogle said. \"To allow for that expansion, we wanted to do it at the same time. If we only moved the relatively small population of Healthy Families children in rural areas, we would not have had the numbers to do it.\"\u003c/p>\n\u003cp>When you add in the rural expansion of the adult population, she said, \"then there are sufficient numbers to do it.\"\u003c/p>\n\u003cp>Under managed care, Californians should have access to more services, Ogle said. \"Making sure they get ... immunizations done, ... and having access standards, that kind of thing,\" she said, \"none of which is in fee-for-service.\"\u003c/p>\n\u003cp>Given the size and scope of the Healthy Families transition this year, the overall smoothness and success so far has been remarkable, Ogle said.\u003c/p>\n\u003cp>\"We know there will always be individual and anecdotal issues,\" Ogle said. \"But we transitioned 900,000 children, and by and large it's been a good, smooth transition for them, and they're now well-placed for the [ACA and Medi-Cal] expansion to occur.\"\u003c/p>\n\u003cp>Hardy agreed that the rollout has gone well, and she gives DHCS officials a lot of praise for that. The children in rural areas, though, may encounter problems in the months ahead, she said. Because children use medical services less often than adults, the effect on access might not be immediately clear, she added.\u003c/p>\n\u003cp>\"We haven't seen a big smoking gun, and we're really thankful we haven't seen a big smoking gun,\" Hardy said, \"but we're still concerned about sneaky issues like continuity of care and network adequacy.\"\u003c/p>\n\u003cp>In Lassen County, for instance, there's only one federally qualified health center in the entire county, she said, so the wiggle room for network inadequacy is razor-thin.\u003c/p>\n\u003cp>If a high percentage of children in the transition is able to maintain access to their preferred primary care physician, that's great, she said. However, that still leaves a group of children who did not get to remain with their physician.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"Access to care is still a huge concern,\" Hardy said. \"So if you think this is a great result for California's kids, your standards are way too low.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Study Finds Girls Entering Puberty Younger; Obesity Implicated",
"title": "Study Finds Girls Entering Puberty Younger; Obesity Implicated",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_16054\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/11/50781677-2-e1383511143227.jpg\">\u003cimg class=\"size-large wp-image-16054\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/11/50781677-2-640x427.jpg\" alt=\"Retailer J.C. Penney features a Girls Plus clothing department tailored to overweight girls in this April, 2004 photo. (Scott Olson/Getty Images)\" width=\"640\" height=\"427\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Retailer J.C. Penney features a Girls Plus clothing department tailored to overweight girls. (Scott Olson/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Building on earlier research a major new study has found that girls are starting puberty at even younger ages. The most significant changes were seen in Caucasian girls and in girls who are overweight or obese. Still, girls who were not overweight were also entering puberty younger, the study found.\u003c/p>\n\u003cp>Researchers at three sites around the country -- including the San Francisco Bay Area -- followed 1,239 ethnically diverse girls from 2004 to 2011. They looked at breast development, a key marker for the start of puberty.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Girls who mature earlier are at risk for lower self-esteem and higher rates of depression.\u003c/aside>\n\u003cp>Earlier studies had shown that African-American girls had reached this milestone at younger ages. \"Now it looks like it's happening earlier for Caucasian girls,\" said Dr. Louise Greenspan, a pediatric endocrinologist with Kaiser San Francisco and one of the authors of the study. \"Particularly, the overweight Caucasian girls are developing earlier than they have in the past.\"\u003c/p>\n\u003cp>Researchers looked at a number of factors, but the \"obesity epidemic appears to be a prime driver in the decrease in age at onset of breast development,\" the authors wrote. \u003c!--more-->\u003c/p>\n\u003cp>Researchers cannot say that being overweight or obese actually causes the earlier development, but there are biological reasons to suggest how body fat could contribute to the change. \"Fat makes hormones,\" Greenspan noted, \"and the hormones that are being made by the fat might also be generating high enough levels to make true breast development.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Greenspan specified \"true\" breast development, because their research was based on examining girls at least annually during the 7-year study period as opposed to other studies which had relied on observation. \"That's been a major criticism of prior studies,\" Greenspan said. \"Because when you look at a girl's chest, you can't tell whether there's fat tissue or true breast development, and our study was different because we examined the girls physically and were able to feel the difference between fat and real breast tissue.\"\u003c/p>\n\u003cp>The study, \u003ca href=\"http://pediatrics.aappublications.org/content/future/132/6#MONTHLYFEATURE\" target=\"_blank\">Onset of Breast Development in a Longitudinal Cohort\u003c/a>, was published online Monday in the journal Pediatrics. It was funded by the National Cancer Institute and the National Institute of Environmental Health Sciences.\u003c/p>\n\u003cp>\u003cstrong>Differences noted by ethnicity and race\u003c/strong>\u003c/p>\n\u003cp>\u003ca href=\"http://children.webmd.com/tc/growth-and-development-ages-11-to-14-years-what-to-expect\" target=\"_blank\">Common sources\u003c/a> for health information often list puberty as starting around age 11 for girls. But in 1997, a \u003ca href=\"http://pediatrics.aappublications.org/content/99/4/505.abstract\" target=\"_blank\">landmark study \u003c/a>concluded that puberty was starting earlier, and African-American girls in particular were entering puberty younger than their peers. This study found average ages for the even-earlier breast development as follows:\u003c/p>\n\u003cul>\n\u003cli>8.76 years for African-American girls\u003c/li>\n\u003cli>9.23 years for Hispanic girls\u003c/li>\n\u003cli>9.62 years for Caucasian\u003c/li>\n\u003c/ul>\n\u003cul>\n\u003cli>9.92 years for Asian-American girls\u003c/li>\n\u003c/ul>\n\u003cp>This study is essentially the first to determine onset of puberty for Asian-American girls, although their study sample was still small. \"Previous studies have largely focused on the white/black difference,\" said Lawrence Kushi, Directory of Scientific Policy at Kaiser's Division of Research and the principal investigator for the \u003ca href=\"https://www.cygnetstudy.com/component/content/category/8-about-cygnet\" target=\"_blank\">San Francisco site\u003c/a> in this report. Hispanic girls have been somewhat more represented in prior studies than Asian-American girls, and Hispanic girls have \"shifted to somewhat younger ages,\" Kushi said.\u003c/p>\n\u003cp>The big difference is in Caucasian girls. The average age of breast development for them was four months earlier than seen in the 1997 study, and that's \"a pretty significant reduction\" on a percentage basis, says Greenspan, since puberty only lasts two to three years. But that's the average. The more obese girls had a \"greater shift,\" Kushi said. Some of these heavier girls were entering puberty close to a year earlier than previously reported.\u003c/p>\n\u003cp>African-American girls appeared to be \"holding steady\" compared to earlier studies, said Greenspan.\u003c/p>\n\u003cp>What's not clear from this study is if girls are also having their first period at a younger age. The research team has been following this group of girls since they were ages 6 to 8. Now they are 14 to 16. The researchers plan to analyze ages of the girls' first period once all the girls in the study have reached that milestone. \"One question we have,\" Greenspan said, \"is puberty starting earlier and ending earlier so there's an entire shift to an earlier age; or is puberty starting earlier and ending at the same time?\"\u003c/p>\n\u003cp>\u003cstrong>Psychological and physical health risks\u003c/strong>\u003c/p>\n\u003cp>This earlier onset of puberty puts girls at risk for certain mental and physical health issues. From the study:\u003c/p>\n\u003cblockquote>\u003cp>Girls with earlier maturation are at risk for lower self-esteem and higher rates of depression. They are more likely to be influenced by older peers and more deviant peers, and initiate intercourse, substance use and other norm-breaking behaviors at younger ages.\u003c/p>\u003c/blockquote>\n\u003cp>Many schools include classes about puberty and sexuality in 5th or 6th grade, Greenspan noted. But according to this new data, many girls are entering puberty in 3rd or 4th grade. This creates a \"real disconnect between the timing of girls' puberty and the timing of the education they receive about the puberty and their bodies in general.\" She argued for splitting the subject matter and teaching girls about puberty in the earlier grades and leaving sexuality for the later grades.\u003c/p>\n\u003cp>Girls who enter puberty younger are at higher risk for developing certain cancers as adults, including breast cancer -- possibly because earlier puberty increases exposure to estrogen, a known breast cancer risk. Greenspan hopes that the researchers will continue to receive funding to follow the girls into adulthood, which could yield better understanding of breast cancer risk.\u003c/p>\n\u003cp>The researchers also collected blood and urine samples from the girls at the beginning of the study and are analyzing certain chemicals to see what associations there may be between chemicals and breast development. They are looking at \u003ca href=\"http://www.npr.org/templates/archives/archive.php?thingId=141118712\" target=\"_blank\">Bisphenol A \u003c/a>(BPA), flame retardants, \u003ca href=\"http://www.cdc.gov/biomonitoring/Phthalates_FactSheet.html\" target=\"_blank\">phthalates\u003c/a>, heavy metals and chemicals used in nonstick cookware.\u003c/p>\n\u003cp>Karuna Jagger, executive director of Breast Cancer Action, a San Francisco-based advocacy group, called the study \"very important\" especially since causes of breast cancer are not fully understood, she said. She wants to know if chemical exposure means \"creating breasts that are susceptible to future insult and higher risk of breast cancer.\"\u003c/p>\n\u003cp>\u003cstrong>Living with uncertainty\u003c/strong>\u003c/p>\n\u003cp>In an \u003ca href=\"http://pediatrics.aappublications.org/content/future/132/6#COMMENTARIES\" target=\"_blank\">accompanying commentary\u003c/a> in Pediatrics, Marcia Herman-Giddens, lead researcher in the 1997 study, said that we may have to \"live with uncertainty\" for a long time, since the \"exact trigger for pubertal initiation is still unknown.\"\u003c/p>\n\u003cp>Herman-Giddens agreed that \"considerable research\" implicates obesity as a factor in the declining age of onset of puberty, but also points to other complex changes:\u003c/p>\n\u003cblockquote>\u003cp>Extensive interacting variables are known to be associated with earlier development in addition to weight and genetics: certain intrauterine conditions and exposures, preschool high-meat diets, dairy products, low fiber intake, isoflavones, high-stress families, absent fathers, certain endocrine disruptors, the microbiome as it influences weight, epigenetics, light exposure, hormone-laced hair products, insulin resistance, activity level, geographical location, and others.\u003c/p>\u003c/blockquote>\n\u003cp>This study did not look at boys. Greenspan noted there's \"mixed data\" for them, some suggesting boys are going through puberty earlier, some not. Further investigation needs to be done on boys, she said. \"The issue is that the chemicals or even fat may have a different effect on boys' puberty because [boys] have a different set of hormones.\"\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This post has been updated with additional information about the range in onset of puberty for Caucasian girls.\u003c/em>\u003c/p>\n\n",
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"excerpt": "Building on earlier research a major new study has found that girls are starting puberty at even younger ages. The most significant changes were seen in Caucasian girls and in girls who are overweight or obese. Still, girls who were not overweight were also entering puberty younger, the study found.\r\n\r\nResearchers at three sites around the country -- including the San Francisco Bay Area -- followed 1,239 ethnically diverse girls from 2004 to 2011. They looked at breast development, a key marker for the start of puberty.",
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"description": "Building on earlier research a major new study has found that girls are starting puberty at even younger ages. The most significant changes were seen in Caucasian girls and in girls who are overweight or obese. Still, girls who were not overweight were also entering puberty younger, the study found.\r\n\r\nResearchers at three sites around the country -- including the San Francisco Bay Area -- followed 1,239 ethnically diverse girls from 2004 to 2011. They looked at breast development, a key marker for the start of puberty.",
"title": "Study Finds Girls Entering Puberty Younger; Obesity Implicated | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_16054\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/11/50781677-2-e1383511143227.jpg\">\u003cimg class=\"size-large wp-image-16054\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/11/50781677-2-640x427.jpg\" alt=\"Retailer J.C. Penney features a Girls Plus clothing department tailored to overweight girls in this April, 2004 photo. (Scott Olson/Getty Images)\" width=\"640\" height=\"427\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Retailer J.C. Penney features a Girls Plus clothing department tailored to overweight girls. (Scott Olson/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Building on earlier research a major new study has found that girls are starting puberty at even younger ages. The most significant changes were seen in Caucasian girls and in girls who are overweight or obese. Still, girls who were not overweight were also entering puberty younger, the study found.\u003c/p>\n\u003cp>Researchers at three sites around the country -- including the San Francisco Bay Area -- followed 1,239 ethnically diverse girls from 2004 to 2011. They looked at breast development, a key marker for the start of puberty.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Girls who mature earlier are at risk for lower self-esteem and higher rates of depression.\u003c/aside>\n\u003cp>Earlier studies had shown that African-American girls had reached this milestone at younger ages. \"Now it looks like it's happening earlier for Caucasian girls,\" said Dr. Louise Greenspan, a pediatric endocrinologist with Kaiser San Francisco and one of the authors of the study. \"Particularly, the overweight Caucasian girls are developing earlier than they have in the past.\"\u003c/p>\n\u003cp>Researchers looked at a number of factors, but the \"obesity epidemic appears to be a prime driver in the decrease in age at onset of breast development,\" the authors wrote. \u003c!--more-->\u003c/p>\n\u003cp>Researchers cannot say that being overweight or obese actually causes the earlier development, but there are biological reasons to suggest how body fat could contribute to the change. \"Fat makes hormones,\" Greenspan noted, \"and the hormones that are being made by the fat might also be generating high enough levels to make true breast development.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Greenspan specified \"true\" breast development, because their research was based on examining girls at least annually during the 7-year study period as opposed to other studies which had relied on observation. \"That's been a major criticism of prior studies,\" Greenspan said. \"Because when you look at a girl's chest, you can't tell whether there's fat tissue or true breast development, and our study was different because we examined the girls physically and were able to feel the difference between fat and real breast tissue.\"\u003c/p>\n\u003cp>The study, \u003ca href=\"http://pediatrics.aappublications.org/content/future/132/6#MONTHLYFEATURE\" target=\"_blank\">Onset of Breast Development in a Longitudinal Cohort\u003c/a>, was published online Monday in the journal Pediatrics. It was funded by the National Cancer Institute and the National Institute of Environmental Health Sciences.\u003c/p>\n\u003cp>\u003cstrong>Differences noted by ethnicity and race\u003c/strong>\u003c/p>\n\u003cp>\u003ca href=\"http://children.webmd.com/tc/growth-and-development-ages-11-to-14-years-what-to-expect\" target=\"_blank\">Common sources\u003c/a> for health information often list puberty as starting around age 11 for girls. But in 1997, a \u003ca href=\"http://pediatrics.aappublications.org/content/99/4/505.abstract\" target=\"_blank\">landmark study \u003c/a>concluded that puberty was starting earlier, and African-American girls in particular were entering puberty younger than their peers. This study found average ages for the even-earlier breast development as follows:\u003c/p>\n\u003cul>\n\u003cli>8.76 years for African-American girls\u003c/li>\n\u003cli>9.23 years for Hispanic girls\u003c/li>\n\u003cli>9.62 years for Caucasian\u003c/li>\n\u003c/ul>\n\u003cul>\n\u003cli>9.92 years for Asian-American girls\u003c/li>\n\u003c/ul>\n\u003cp>This study is essentially the first to determine onset of puberty for Asian-American girls, although their study sample was still small. \"Previous studies have largely focused on the white/black difference,\" said Lawrence Kushi, Directory of Scientific Policy at Kaiser's Division of Research and the principal investigator for the \u003ca href=\"https://www.cygnetstudy.com/component/content/category/8-about-cygnet\" target=\"_blank\">San Francisco site\u003c/a> in this report. Hispanic girls have been somewhat more represented in prior studies than Asian-American girls, and Hispanic girls have \"shifted to somewhat younger ages,\" Kushi said.\u003c/p>\n\u003cp>The big difference is in Caucasian girls. The average age of breast development for them was four months earlier than seen in the 1997 study, and that's \"a pretty significant reduction\" on a percentage basis, says Greenspan, since puberty only lasts two to three years. But that's the average. The more obese girls had a \"greater shift,\" Kushi said. Some of these heavier girls were entering puberty close to a year earlier than previously reported.\u003c/p>\n\u003cp>African-American girls appeared to be \"holding steady\" compared to earlier studies, said Greenspan.\u003c/p>\n\u003cp>What's not clear from this study is if girls are also having their first period at a younger age. The research team has been following this group of girls since they were ages 6 to 8. Now they are 14 to 16. The researchers plan to analyze ages of the girls' first period once all the girls in the study have reached that milestone. \"One question we have,\" Greenspan said, \"is puberty starting earlier and ending earlier so there's an entire shift to an earlier age; or is puberty starting earlier and ending at the same time?\"\u003c/p>\n\u003cp>\u003cstrong>Psychological and physical health risks\u003c/strong>\u003c/p>\n\u003cp>This earlier onset of puberty puts girls at risk for certain mental and physical health issues. From the study:\u003c/p>\n\u003cblockquote>\u003cp>Girls with earlier maturation are at risk for lower self-esteem and higher rates of depression. They are more likely to be influenced by older peers and more deviant peers, and initiate intercourse, substance use and other norm-breaking behaviors at younger ages.\u003c/p>\u003c/blockquote>\n\u003cp>Many schools include classes about puberty and sexuality in 5th or 6th grade, Greenspan noted. But according to this new data, many girls are entering puberty in 3rd or 4th grade. This creates a \"real disconnect between the timing of girls' puberty and the timing of the education they receive about the puberty and their bodies in general.\" She argued for splitting the subject matter and teaching girls about puberty in the earlier grades and leaving sexuality for the later grades.\u003c/p>\n\u003cp>Girls who enter puberty younger are at higher risk for developing certain cancers as adults, including breast cancer -- possibly because earlier puberty increases exposure to estrogen, a known breast cancer risk. Greenspan hopes that the researchers will continue to receive funding to follow the girls into adulthood, which could yield better understanding of breast cancer risk.\u003c/p>\n\u003cp>The researchers also collected blood and urine samples from the girls at the beginning of the study and are analyzing certain chemicals to see what associations there may be between chemicals and breast development. They are looking at \u003ca href=\"http://www.npr.org/templates/archives/archive.php?thingId=141118712\" target=\"_blank\">Bisphenol A \u003c/a>(BPA), flame retardants, \u003ca href=\"http://www.cdc.gov/biomonitoring/Phthalates_FactSheet.html\" target=\"_blank\">phthalates\u003c/a>, heavy metals and chemicals used in nonstick cookware.\u003c/p>\n\u003cp>Karuna Jagger, executive director of Breast Cancer Action, a San Francisco-based advocacy group, called the study \"very important\" especially since causes of breast cancer are not fully understood, she said. She wants to know if chemical exposure means \"creating breasts that are susceptible to future insult and higher risk of breast cancer.\"\u003c/p>\n\u003cp>\u003cstrong>Living with uncertainty\u003c/strong>\u003c/p>\n\u003cp>In an \u003ca href=\"http://pediatrics.aappublications.org/content/future/132/6#COMMENTARIES\" target=\"_blank\">accompanying commentary\u003c/a> in Pediatrics, Marcia Herman-Giddens, lead researcher in the 1997 study, said that we may have to \"live with uncertainty\" for a long time, since the \"exact trigger for pubertal initiation is still unknown.\"\u003c/p>\n\u003cp>Herman-Giddens agreed that \"considerable research\" implicates obesity as a factor in the declining age of onset of puberty, but also points to other complex changes:\u003c/p>\n\u003cblockquote>\u003cp>Extensive interacting variables are known to be associated with earlier development in addition to weight and genetics: certain intrauterine conditions and exposures, preschool high-meat diets, dairy products, low fiber intake, isoflavones, high-stress families, absent fathers, certain endocrine disruptors, the microbiome as it influences weight, epigenetics, light exposure, hormone-laced hair products, insulin resistance, activity level, geographical location, and others.\u003c/p>\u003c/blockquote>\n\u003cp>This study did not look at boys. Greenspan noted there's \"mixed data\" for them, some suggesting boys are going through puberty earlier, some not. Further investigation needs to be done on boys, she said. \"The issue is that the chemicals or even fat may have a different effect on boys' puberty because [boys] have a different set of hormones.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>This post has been updated with additional information about the range in onset of puberty for Caucasian girls.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Stanford Kissing Event: Fun for the Evening, But Now Students Have Stomach Flu",
"title": "Stanford Kissing Event: Fun for the Evening, But Now Students Have Stomach Flu",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_16022\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://www.flickr.com/photos/11863277@N00/2576355770/in/photolist-4VEuP5-uAzAm-fwxynu-dZoSVP-hHqoq-9T3Q2R-4Hf7AU-4PBjqd-5TQJMf-4CkYnv-asLYeP-dLFQxc-sogFv-5C4fLo-sogrW-apMDU4-apQn7m-dZusmd-6rVL69-9hpkA8-4Pvxvo-8Tc6mx-4PriGF-7vMuE-7vMtd-7vMA2-7vMy8-7vMvC-7vMwq-7vMzn-7vMxg-7vMxA-7vMyX-7vMtG-7vMu9-4PrjFH-agqrmm-agnL5F-agqphq-2NGfo-exgZjv-4t4pV2-tpiq9-942jpj-7dbSwP-bMTugX-6stDX-5LsjfK-6G8FJB-bkYEMP-6MeLsD\">\u003cimg class=\"size-large wp-image-16022\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/11/2576355770_4c78a887b8_b-640x480.jpg\" alt=\"Where the kissing event happens, just not during the day. (rolfkleef/Flickr)\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Where the kissing event happens, just not during the day. (rolfkleef/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>I've lived in the Bay Area for more than 20 years, but somehow missed this tradition at Stanford: \u003ca href=\"http://www.stanforddaily.com/2013/10/18/roxy-sass-full-moon-on-the-quad-cheat-sheet/\" target=\"_blank\">Full Moon on the Quad\u003c/a>.\u003c/p>\n\u003cp>As the New York Times \u003ca href=\"http://www.nytimes.com/2013/11/01/education/welcomed-with-kisses-stanford-freshmen-risk-the-kissing-disease.html?partner=rss&emc=rss&_r=1&\" target=\"_blank\">reported\u003c/a> Friday it's \"an event unique in American education: an orgy of interclass kissing reluctantly but officially sanctioned by the university.\"\u003c/p>\n\u003cp>How you respond to this might depend on your age.\u003c/p>\n\u003cp>My initial reaction was \"ewwww!\" But a (younger) colleague asked, \"Is it horrible to confess to you: I'd probably join in?!?!\"\u003c/p>\n\u003cp>The event was held last week, on Oct. 22. With thousands of students milling around waiting, the Times described what happened next:\u003c/p>\n\u003cblockquote>\u003cp>Finally, a male senior saunters over to a group of the youngest-looking women and asks: “Hey! You freshmen? Can I kiss you?”\u003c!--more-->\u003c/p>\n\u003cp>As the Stanford Band plays and a giant screen shows famous movie clutches, the bravest women step forward and receive the traditional welcome to one of the nation’s most prestigious universities: a big wet upperclassman smack.\u003c/p>\u003c/blockquote>\n\u003cp>I think you can guess why this is a health story.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"Days later, another tradition arrives: flu and mononucleosis, the 'kissing disease,' sweep the dorms,\" says the Times.\u003c/p>\n\u003cp>It's now been 10 days since Full Moon on the Quad or FMOTQ.\u003c/p>\n\u003cp>Just a few minutes after I read the Times' piece, a release from Stanford popped up in my inbox -- 52 students had come down with norovirus. That's the virus commonly called \"stomach flu\" and generally causes vomiting and diarrhea.\u003c/p>\n\u003cp>Norovirus spreads like wildfire and risk factors for contracting the virus include having \"close personal contact\" with an infected person, says \u003ca href=\"http://www.cdc.gov/norovirus/downloads/keyfacts.pdf\" target=\"_blank\">the CDC\u003c/a>.\u003c/p>\n\u003cp>While any reasonable person might think that \"an orgy of interclass kissing\" would qualify as \"close personal contact,\" it's also true that association does not equal causation, as a reader notes in the comments below.\u003c/p>\n\u003cp>The Stanford Daily is following the health story, from a different angle. On Friday the paper \u003ca href=\"http://www.stanforddaily.com/2013/11/01/five-campus-study-spots-ranked-by-coughing-awkwardness/\" target=\"_blank\">reported\u003c/a> \"there's no shortage of illness going around campus\" now that FMOTQ is over. And what's the \"worst, and probably most ubiquitous, symptom\" of post-FMOTQ sickness? Coughing, the Daily believes. So the paper \u003ca href=\"http://www.stanforddaily.com/2013/11/01/five-campus-study-spots-ranked-by-coughing-awkwardness/\" target=\"_blank\">helpfully ranks\u003c/a> five campus study spots by \"coughing awkwardness.\"\u003c/p>\n\u003cp>Yet there's a more serious health story, too. Not surprisingly, an event that involves kissing a bunch of strangers can make people nervous. That kind of social anxiety can lead to excess alcohol consumption. The Daily \u003ca href=\"http://www.stanforddaily.com/2013/10/24/fmotq-medical-transports-drop-to-two/\" target=\"_blank\">reported last week\u003c/a> that medical transports related to FMOTQ were down this year possibly due to attempts to emphasize \"safe drinking vs. unsafe drinking.\"\u003c/p>\n\u003cp>And yes, Stanford officials have tried to ban the event, The Times notes, but since they've been unsuccessful, the university is focusing on trying to make the event safer.\u003c/p>\n\u003cblockquote>\u003cp>The evening is overseen by student sobriety monitors and decorated with hand-drawn signs — of the ilk that usually say \"Beat Cal” — but bearing slogans like “Consent is Sexy.”\u003c/p>\u003c/blockquote>\n\u003cp>\u003c/p>\n\u003cp>\u003cstrong>This post has been updated with more information about norovirus.\u003c/strong>\u003c/p>\n\n",
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"excerpt": "I've lived in the Bay Area for more than 20 years, but somehow missed this tradition at Stanford: Full Moon on the Quad.\r\n\r\nAs the New York Times reported Friday it's \"an event unique in American education: an orgy of interclass kissing reluctantly but officially sanctioned by the university.\"\r\n\r\nHow you respond to this might depend on your age.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_16022\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://www.flickr.com/photos/11863277@N00/2576355770/in/photolist-4VEuP5-uAzAm-fwxynu-dZoSVP-hHqoq-9T3Q2R-4Hf7AU-4PBjqd-5TQJMf-4CkYnv-asLYeP-dLFQxc-sogFv-5C4fLo-sogrW-apMDU4-apQn7m-dZusmd-6rVL69-9hpkA8-4Pvxvo-8Tc6mx-4PriGF-7vMuE-7vMtd-7vMA2-7vMy8-7vMvC-7vMwq-7vMzn-7vMxg-7vMxA-7vMyX-7vMtG-7vMu9-4PrjFH-agqrmm-agnL5F-agqphq-2NGfo-exgZjv-4t4pV2-tpiq9-942jpj-7dbSwP-bMTugX-6stDX-5LsjfK-6G8FJB-bkYEMP-6MeLsD\">\u003cimg class=\"size-large wp-image-16022\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/11/2576355770_4c78a887b8_b-640x480.jpg\" alt=\"Where the kissing event happens, just not during the day. (rolfkleef/Flickr)\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Where the kissing event happens, just not during the day. (rolfkleef/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>I've lived in the Bay Area for more than 20 years, but somehow missed this tradition at Stanford: \u003ca href=\"http://www.stanforddaily.com/2013/10/18/roxy-sass-full-moon-on-the-quad-cheat-sheet/\" target=\"_blank\">Full Moon on the Quad\u003c/a>.\u003c/p>\n\u003cp>As the New York Times \u003ca href=\"http://www.nytimes.com/2013/11/01/education/welcomed-with-kisses-stanford-freshmen-risk-the-kissing-disease.html?partner=rss&emc=rss&_r=1&\" target=\"_blank\">reported\u003c/a> Friday it's \"an event unique in American education: an orgy of interclass kissing reluctantly but officially sanctioned by the university.\"\u003c/p>\n\u003cp>How you respond to this might depend on your age.\u003c/p>\n\u003cp>My initial reaction was \"ewwww!\" But a (younger) colleague asked, \"Is it horrible to confess to you: I'd probably join in?!?!\"\u003c/p>\n\u003cp>The event was held last week, on Oct. 22. With thousands of students milling around waiting, the Times described what happened next:\u003c/p>\n\u003cblockquote>\u003cp>Finally, a male senior saunters over to a group of the youngest-looking women and asks: “Hey! You freshmen? Can I kiss you?”\u003c!--more-->\u003c/p>\n\u003cp>As the Stanford Band plays and a giant screen shows famous movie clutches, the bravest women step forward and receive the traditional welcome to one of the nation’s most prestigious universities: a big wet upperclassman smack.\u003c/p>\u003c/blockquote>\n\u003cp>I think you can guess why this is a health story.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"Days later, another tradition arrives: flu and mononucleosis, the 'kissing disease,' sweep the dorms,\" says the Times.\u003c/p>\n\u003cp>It's now been 10 days since Full Moon on the Quad or FMOTQ.\u003c/p>\n\u003cp>Just a few minutes after I read the Times' piece, a release from Stanford popped up in my inbox -- 52 students had come down with norovirus. That's the virus commonly called \"stomach flu\" and generally causes vomiting and diarrhea.\u003c/p>\n\u003cp>Norovirus spreads like wildfire and risk factors for contracting the virus include having \"close personal contact\" with an infected person, says \u003ca href=\"http://www.cdc.gov/norovirus/downloads/keyfacts.pdf\" target=\"_blank\">the CDC\u003c/a>.\u003c/p>\n\u003cp>While any reasonable person might think that \"an orgy of interclass kissing\" would qualify as \"close personal contact,\" it's also true that association does not equal causation, as a reader notes in the comments below.\u003c/p>\n\u003cp>The Stanford Daily is following the health story, from a different angle. On Friday the paper \u003ca href=\"http://www.stanforddaily.com/2013/11/01/five-campus-study-spots-ranked-by-coughing-awkwardness/\" target=\"_blank\">reported\u003c/a> \"there's no shortage of illness going around campus\" now that FMOTQ is over. And what's the \"worst, and probably most ubiquitous, symptom\" of post-FMOTQ sickness? Coughing, the Daily believes. So the paper \u003ca href=\"http://www.stanforddaily.com/2013/11/01/five-campus-study-spots-ranked-by-coughing-awkwardness/\" target=\"_blank\">helpfully ranks\u003c/a> five campus study spots by \"coughing awkwardness.\"\u003c/p>\n\u003cp>Yet there's a more serious health story, too. Not surprisingly, an event that involves kissing a bunch of strangers can make people nervous. That kind of social anxiety can lead to excess alcohol consumption. The Daily \u003ca href=\"http://www.stanforddaily.com/2013/10/24/fmotq-medical-transports-drop-to-two/\" target=\"_blank\">reported last week\u003c/a> that medical transports related to FMOTQ were down this year possibly due to attempts to emphasize \"safe drinking vs. unsafe drinking.\"\u003c/p>\n\u003cp>And yes, Stanford officials have tried to ban the event, The Times notes, but since they've been unsuccessful, the university is focusing on trying to make the event safer.\u003c/p>\n\u003cblockquote>\u003cp>The evening is overseen by student sobriety monitors and decorated with hand-drawn signs — of the ilk that usually say \"Beat Cal” — but bearing slogans like “Consent is Sexy.”\u003c/p>\u003c/blockquote>\n\u003cp>\u003c/p>\n\u003cp>\u003cstrong>This post has been updated with more information about norovirus.\u003c/strong>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_15981\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://www.flickr.com/photos/83372564@N00/7936652796/in/photolist-d6kqnj-4wP9ng-2rBmvA-2rwZDe-2rBiWL-2rBjQj-2rBnEy-bW4xDZ-8o6s7M-8n48Py-6wnvYo-5AJqrW-5iJccz-5AJbqy-dNSQVu-dNSLR3-n6b3P-5rihJR-5tjGZo-yG7H9-49QsiT-49Qs8t-dXzK1G-dXv14v-dXvcZR-dXAWvw-dXvnLx-dXud6x-dXuRst-dXAV21-dXzP6N-dXzQEE-dXAAj5-dXvzba-dXujSe-dXAuPw-dXAPQb-dXzYc1-dXAHL7-dXv9bT-dXvhi2-dXzSrd-dXuYsM-dXv9Mx-dXzNAN-dXvyJa-dXuX3n-dXvaLk-dXuiEi-dXuXsR-dXBeFY\">\u003cimg class=\"size-large wp-image-15981\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/7936652796_45cc7ccde0_b-640x480.jpg\" alt=\"(J. Stephen Conn/Flickr)\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(J. Stephen Conn/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Nearly a thousand farmworker women will gather Friday in Tulare, one of California’s poorest counties, for the annual Farmworker Women's Conference. They'll learn about education, social services and have an opportunity to discuss their lives and the health challenges they face.\u003c/p>\n\u003cp>Lali Moheno of Visalia started this \u003ca href=\"http://www.fresnobee.com/2013/10/28/3577638/farmworker-womens-conference-set.html\" target=\"_blank\">San Joaquin Valley conference\u003c/a> 11 years ago because she wanted to help other women farmworkers. Moheno’s mother spent decades picking cotton and grapes. She died without any medical insurance to treat her leg injuries and diabetes. Moheno sought to help educate other women and share tactics to improve their lives.\u003c/p>\n\u003cp>\"You will be a better person, a better mom, a better voter, a better woman,\" Moheno said, \"if you learn to think on your own -- if you learn take control of your life and not let other people control your life.\"\u003c!--more-->\u003c/p>\n\u003cp>Moheno says the conference is a forum where farmworker women deal with topics considered taboo: domestic violence at home and, as I have \u003ca href=\"http://www.californiareport.org/archive/R201306280850/a\" target=\"_blank\">documented on The California Report\u003c/a>, sexual harassment and assault in the fields.\u003c/p>\n\u003cp>Undocumented women not surprisingly fear law enforcement, so the conference works to break through those by inviting dialogue with the local District Attorney and Sheriff’s Department to talk about sexual violence. Plus, health organizations will be on hand to let women know about the services they offer.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Moheno says women at the conference become empowered through sharing their stories. \"They are promoters of their own destiny,\" she says. \"They have legitimized farmworker women as human beings. As productive members of our community.\"\u003c/p>\n\u003cp>And as community members, they do much more than pick fruits and vegetables. They work in their children's schools, educate each other about pesticides and try to prevent gangs in their neighborhoods.\u003c/p>\n\u003cp>Earlier this month, the California Wellness Foundation awarded Moheno its \u003ca href=\"http://www.calwellness.org/leadership_recognition/ca_peace_prize/2013/news_release.htm\" target=\"_blank\">California Peace Prize\u003c/a> for her efforts to prevent violence against farmworker women.\u003c/p>\n\u003cp>Here's a short video about Moheno from the foundation:\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[youtube //www.youtube.com/watch?v=KmA-TRWsm44?list=PLdJfHWDUNKcYs01MxtdMD-cozqlzfu7Dp]\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Moheno says women at the conference become empowered through sharing their stories. \"They are promoters of their own destiny,\" she says. \"They have legitimized farmworker women as human beings. As productive members of our community.\"\u003c/p>\n\u003cp>And as community members, they do much more than pick fruits and vegetables. They work in their children's schools, educate each other about pesticides and try to prevent gangs in their neighborhoods.\u003c/p>\n\u003cp>Earlier this month, the California Wellness Foundation awarded Moheno its \u003ca href=\"http://www.calwellness.org/leadership_recognition/ca_peace_prize/2013/news_release.htm\" target=\"_blank\">California Peace Prize\u003c/a> for her efforts to prevent violence against farmworker women.\u003c/p>\n\u003cp>Here's a short video about Moheno from the foundation:\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutube'>\n \u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutubeInside'>\n \u003ciframe\n loading='lazy'\n class='utils-parseShortcode-shortcodes-__youtubeShortcode__youtubePlayer'\n type='text/html'\n src='//www.youtube.com/embed/KmA-TRWsm44?list=PLdJfHWDUNKcYs01MxtdMD-cozqlzfu7Dp'\n title='//www.youtube.com/embed/KmA-TRWsm44?list=PLdJfHWDUNKcYs01MxtdMD-cozqlzfu7Dp'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_15733\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/horizontal-j-and-j-e1381958603376.jpg\">\u003cimg class=\"size-large wp-image-15733\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/horizontal-j-and-j-640x426.jpg\" alt=\"horizontal j and j\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Juana Gomez (right) is a traditional Mixteca healer from Mexico. She lives with her daughter, Johanna Gomez (left), in Madera, Calif. and provides health care to many farm workers. (Sasha Khokha/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cem>\u003c/em>\u003cem>Editor's Note: Some recent immigrants avoid visits to western doctors. Instead, they call on traditional healers who speak their language, use familiar medicinal plants, and share their cultures. As part of our ongoing series of first-person health profiles called \"What’s Your Story?\" we hear from Juana Gomez, a Mixteca traditional healer from Oaxaca, Mexico. Gomez now lives in Madera, in California's Central Valley, where many of her patients are undocumented farm workers. Her daughter, Johanna Gomez, translates her story. Reporter: Sasha Khokha\u003cbr>\n\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>By Juana Gomez\u003c/strong>\u003c/p>\n\u003cp>We have the purple basil and we have the green basil. The basil is a very, very sacred plant from my ancestors.\u003c/p>\n\u003cp>It’s very important to know the classification of each plant because even though they are plants and they are natural and they have healing powers, they work just as medicine and you have to be really careful with them.\u003c/p>\n\u003cp>My mom says that the most she sees here are males that work on the fields. She says that it is very common for them to come because it’s a combination of not being able to have a restroom close enough, it's a combination of the heat, the long hours that they’re sitting, the vibration of the tractors. So, there are many, many factors.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Most of the people that come do have physical illness, but many times they are not sick with the physical illness. They are more sick of a spiritual need because of the sadness of leaving their people behind. Maybe they left their wife and their kids over in their native countries.\u003c!--more-->\u003c/p>\n\u003cp>And my mom gets very emotional when she sees that in people that come because she feels just the exact same way. My brother is in Mexico. She left him over there.\u003c/p>\n\u003cp>She has to detect those signs of depression or, you know, something that comes from that loneliness. She also has to understand their problems. Because sometimes people that's the only thing that they need. For someone to hear them: To hear their sorrows, and not judge them. And we are able to give them, if you may call it, therapy, within these walls.\u003c/p>\n\u003cp>\u003cstrong>Listen to Juana Gomez tell her story:\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ciframe src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/117640477\" frameborder=\"no\" scrolling=\"no\" width=\"100%\" height=\"166\">\u003c/iframe>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_15733\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/horizontal-j-and-j-e1381958603376.jpg\">\u003cimg class=\"size-large wp-image-15733\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/horizontal-j-and-j-640x426.jpg\" alt=\"horizontal j and j\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Juana Gomez (right) is a traditional Mixteca healer from Mexico. She lives with her daughter, Johanna Gomez (left), in Madera, Calif. and provides health care to many farm workers. (Sasha Khokha/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cem>\u003c/em>\u003cem>Editor's Note: Some recent immigrants avoid visits to western doctors. Instead, they call on traditional healers who speak their language, use familiar medicinal plants, and share their cultures. As part of our ongoing series of first-person health profiles called \"What’s Your Story?\" we hear from Juana Gomez, a Mixteca traditional healer from Oaxaca, Mexico. Gomez now lives in Madera, in California's Central Valley, where many of her patients are undocumented farm workers. Her daughter, Johanna Gomez, translates her story. Reporter: Sasha Khokha\u003cbr>\n\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>By Juana Gomez\u003c/strong>\u003c/p>\n\u003cp>We have the purple basil and we have the green basil. The basil is a very, very sacred plant from my ancestors.\u003c/p>\n\u003cp>It’s very important to know the classification of each plant because even though they are plants and they are natural and they have healing powers, they work just as medicine and you have to be really careful with them.\u003c/p>\n\u003cp>My mom says that the most she sees here are males that work on the fields. She says that it is very common for them to come because it’s a combination of not being able to have a restroom close enough, it's a combination of the heat, the long hours that they’re sitting, the vibration of the tractors. So, there are many, many factors.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cfigure id=\"attachment_15832\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/56292361-e1382588779517.jpg\">\u003cimg class=\"size-large wp-image-15832\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/56292361-640x417.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"417\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Only about one in four low-income Californians say they have easily comprehensible information for health decision-making, and 71 percent say they would like more. That's just one of the findings from a new\u003ca href=\"http://www.blueshieldcafoundation.org/programs/sub-program/innovation-and-performance/building-better-health-care-for-low-income-californians\" target=\"_blank\"> statewide survey\u003c/a> looking at \"opportunities and challenges\" in reaching this underserved population.\u003c/p>\n\u003cp>The report is the latest in \u003ca href=\"http://www.blueshieldcafoundation.org/programs/sub-program/innovation-and-performance\" target=\"_blank\">a series\u003c/a> from the Blue Shield of California Foundation and provides \"important insights for those working to reshape the system in California and for the rest of the country,\" foundation executive director Peter Long said at a briefing and panel discussion in Washington, D.C., on Wednesday.\u003c/p>\n\u003cp>When asked about their top source of health information, media sources (TV, internet, printed material) nudged out medical professionals, 39 percent to 38 percent. However, reliance on a medical provider for information goes up — by 22 percent — if the patient usually sees the same person.\u003c/p>\n\u003cp>From the report:\u003c!--more-->\u003c/p>\n\u003cblockquote>\u003cp>Patients are also more apt to reply on their provider for information when they feel someone at their healthcare facility knows them (the definition of connectedness), as well as when providers explain things clearly, invite questions and encourage patients to be involved in their own care.\u003c/p>\u003c/blockquote>\n\u003cp>\"People often dismiss populations of lower income because they're different,\" said Dr. Kavita Patel, managing director of Delivery System Reform at the Brookings Institution, at the briefing on Wednesday. \"This study illustrates that no matter what your income is, patient engagement matters.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The survey is based on phone interviews with 1,018 Californians ages 19-64 with household incomes less than 200 percent of the \u003ca href=\"http://aspe.hhs.gov/poverty/13poverty.cfm\" target=\"_blank\">federal poverty level\u003c/a> (or about $46,000 for a family of four).\u003c/p>\n\u003cp>The report found that people with the strongest connection to their providers speak English and have insurance — which points to the challenge ahead in a state as diverse as California, as the Affordable Care Act is fully implemented on Jan. 1.\u003c/p>\n\u003cp>Yet the report also pointed to steps providers and health centers can take to engage their patients. In particular, patients who perceive that their provider encourages them to be active in their own care and feel that they have as much say in their health decisions as they want are significantly more likely to feel a \"strong rapport\" with their provider. They also feel \"very informed\" about their health and trust the doctor's information, according to the report.\u003c/p>\n\u003cp>Sara Rosenbaum, professor of health policy at the George Washington University School of Public Health, pointed out that \"it was no surprise to me that poor people should value good health care (as much as) anyone else does.\"\u003c/p>\n\u003cp>\u003cstrong>Digital divide\u003c/strong>\u003c/p>\n\u003cp>Though much has been written of the \u003ca href=\"http://www.pewinternet.org/Topics/Demographics/Digital-Divide.aspx?typeFilter=5\" target=\"_blank\">digital divide\u003c/a>, this new report teased out information that surprised even the panel. Four in 10 low-income Californians lack Internet access, the survey found, but that number spikes to 67 percent of low-income Spanish speakers.\u003c/p>\n\u003cp>Dr. Ron Yee worked for 20 years at United Health Centers, a group of community clinics in the Central Valley.\u003cstrong> \u003c/strong>\"I knew our patients did not have access to the Internet,\" he said at the briefing, \"but I was surprised to see 67 percent of our Spanish speakers did not have access. That's a big number for us to understand.\"\u003c/p>\n\u003cp>Of the people in the survey who use the Internet, three-quarters are interested in access to a health center's Internet patient portal. Of the few who have access, \"virtually all find it useful,\" the report found.\u003c/p>\n\u003cp>A similar disparity was found in email or text messages from providers. While very few low-income Californians have access to the technology, of those who do, 87 percent found email or text messages from the clinic or provider useful.\u003c/p>\n\u003cp>\u003cstrong>Alternative approaches\u003c/strong>\u003c/p>\n\u003cp>While California faces a \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/09/12/the-primary-care-crunch-not-enough-doctors-and-more-patients-coming-engaged-patient/\" target=\"_blank\">shortage of primary care providers\u003c/a> at the moment when access to insurance is expanding, alternative approaches can help with access and communication. For example, team-based care where a patient may see a nurse practitioner or physician assistant or health navigators — people who help patients make their way through a hospital or clinic — can \"enhance, rather than diminish, the critical connection between patients and their providers,\" the report found.\u003c/p>\n\u003cp>\"Patients are ahead of policymakers here,\" Peter Long noted, adding that critics had said that expanding access would lead to greater demands on physicians. But low-income Californians \"are open to team care.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>We've heard a lot about mandates,\" Patel observed. \"This is the patient mandate. These folks were very clear about their aspirations. ... What they're willing to do if engaged to me is heartening.\"\u003c/p>\n\n",
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"excerpt": "Only about one in four low-income Californians say they have easily comprehensible information for health decision-making, and 71 percent say they would like more. That's just one of the findings from a new statewide survey looking at \"opportunities and challenges\" in reaching this underserved population.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_15832\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/56292361-e1382588779517.jpg\">\u003cimg class=\"size-large wp-image-15832\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/56292361-640x417.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"417\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Only about one in four low-income Californians say they have easily comprehensible information for health decision-making, and 71 percent say they would like more. That's just one of the findings from a new\u003ca href=\"http://www.blueshieldcafoundation.org/programs/sub-program/innovation-and-performance/building-better-health-care-for-low-income-californians\" target=\"_blank\"> statewide survey\u003c/a> looking at \"opportunities and challenges\" in reaching this underserved population.\u003c/p>\n\u003cp>The report is the latest in \u003ca href=\"http://www.blueshieldcafoundation.org/programs/sub-program/innovation-and-performance\" target=\"_blank\">a series\u003c/a> from the Blue Shield of California Foundation and provides \"important insights for those working to reshape the system in California and for the rest of the country,\" foundation executive director Peter Long said at a briefing and panel discussion in Washington, D.C., on Wednesday.\u003c/p>\n\u003cp>When asked about their top source of health information, media sources (TV, internet, printed material) nudged out medical professionals, 39 percent to 38 percent. However, reliance on a medical provider for information goes up — by 22 percent — if the patient usually sees the same person.\u003c/p>\n\u003cp>From the report:\u003c!--more-->\u003c/p>\n\u003cblockquote>\u003cp>Patients are also more apt to reply on their provider for information when they feel someone at their healthcare facility knows them (the definition of connectedness), as well as when providers explain things clearly, invite questions and encourage patients to be involved in their own care.\u003c/p>\u003c/blockquote>\n\u003cp>\"People often dismiss populations of lower income because they're different,\" said Dr. Kavita Patel, managing director of Delivery System Reform at the Brookings Institution, at the briefing on Wednesday. \"This study illustrates that no matter what your income is, patient engagement matters.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The survey is based on phone interviews with 1,018 Californians ages 19-64 with household incomes less than 200 percent of the \u003ca href=\"http://aspe.hhs.gov/poverty/13poverty.cfm\" target=\"_blank\">federal poverty level\u003c/a> (or about $46,000 for a family of four).\u003c/p>\n\u003cp>The report found that people with the strongest connection to their providers speak English and have insurance — which points to the challenge ahead in a state as diverse as California, as the Affordable Care Act is fully implemented on Jan. 1.\u003c/p>\n\u003cp>Yet the report also pointed to steps providers and health centers can take to engage their patients. In particular, patients who perceive that their provider encourages them to be active in their own care and feel that they have as much say in their health decisions as they want are significantly more likely to feel a \"strong rapport\" with their provider. They also feel \"very informed\" about their health and trust the doctor's information, according to the report.\u003c/p>\n\u003cp>Sara Rosenbaum, professor of health policy at the George Washington University School of Public Health, pointed out that \"it was no surprise to me that poor people should value good health care (as much as) anyone else does.\"\u003c/p>\n\u003cp>\u003cstrong>Digital divide\u003c/strong>\u003c/p>\n\u003cp>Though much has been written of the \u003ca href=\"http://www.pewinternet.org/Topics/Demographics/Digital-Divide.aspx?typeFilter=5\" target=\"_blank\">digital divide\u003c/a>, this new report teased out information that surprised even the panel. Four in 10 low-income Californians lack Internet access, the survey found, but that number spikes to 67 percent of low-income Spanish speakers.\u003c/p>\n\u003cp>Dr. Ron Yee worked for 20 years at United Health Centers, a group of community clinics in the Central Valley.\u003cstrong> \u003c/strong>\"I knew our patients did not have access to the Internet,\" he said at the briefing, \"but I was surprised to see 67 percent of our Spanish speakers did not have access. That's a big number for us to understand.\"\u003c/p>\n\u003cp>Of the people in the survey who use the Internet, three-quarters are interested in access to a health center's Internet patient portal. Of the few who have access, \"virtually all find it useful,\" the report found.\u003c/p>\n\u003cp>A similar disparity was found in email or text messages from providers. While very few low-income Californians have access to the technology, of those who do, 87 percent found email or text messages from the clinic or provider useful.\u003c/p>\n\u003cp>\u003cstrong>Alternative approaches\u003c/strong>\u003c/p>\n\u003cp>While California faces a \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/09/12/the-primary-care-crunch-not-enough-doctors-and-more-patients-coming-engaged-patient/\" target=\"_blank\">shortage of primary care providers\u003c/a> at the moment when access to insurance is expanding, alternative approaches can help with access and communication. For example, team-based care where a patient may see a nurse practitioner or physician assistant or health navigators — people who help patients make their way through a hospital or clinic — can \"enhance, rather than diminish, the critical connection between patients and their providers,\" the report found.\u003c/p>\n\u003cp>\"Patients are ahead of policymakers here,\" Peter Long noted, adding that critics had said that expanding access would lead to greater demands on physicians. But low-income Californians \"are open to team care.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>We've heard a lot about mandates,\" Patel observed. \"This is the patient mandate. These folks were very clear about their aspirations. ... What they're willing to do if engaged to me is heartening.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_15731\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/IMG_6494-2-e1381958343292.jpg\">\u003cimg class=\"size-large wp-image-15731\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/IMG_6494-2-640x480.jpg\" alt=\"IMG_6494 (2)\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Andrew Jolivette wants to start a family but because he is HIV-positive, he is having a hard time finding a place that will help him donate sperm to his friend. (Ryder Diaz/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cem>Editor’s note: Andrew Jolivette was diagnosed with AIDS eleven years ago. Back then, he didn’t think he could ever have a family, since it was illegal for HIV-positive men to donate sperm. California reversed that law in 2007. Now, Jolivette hopes to start a family with a friend. As part of our ongoing series of first-person health profiles called “What’s Your Story?” Jolivette tells us how some medical facilities still can't handle this kind of situation.\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>By Andrew Jolivette\u003c/strong>\u003c/p>\n\u003cp>You know, my mother passed away about a year ago and I think that that also, in all honesty, has had some impact on me saying: Well gosh, she was such a great mom and all these things she taught me, I want to be able to share that with someone, too.\u003c/p>\n\u003cp>Quite frankly, because [my viral load is] undetectable and there are measures they can take like sperm washing and the potential mother, can take anti-retrovirals beforehand to ensure that she nor the child will be infected, then why not?\u003c!--more-->\u003c/p>\n\u003cp>But the first response after we both did fertility tests, they said, well, as you know you’re HIV positive, so we don’t really have the capacity to do that here. So what they suggested, which I found rather insulting, was that we actually do insemination at home. I took that to mean -- that whole sort of outdated thing, it’s the stereotype when people say, you go get a turkey-baster type thing.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Really, if we're talking about people having equal rights to health care, if you're performing these services for other people who aren't (HIV) positive, then you should be performing these services for people who are positive.\u003c/p>\n\u003cp>They need to be prepared. If it’s been six years and you’re aware of the law, then why haven’t you done more to make this accessible to people who want to have children and raise families?\u003c/p>\n\u003cp>\u003cstrong>Related:\u003c/strong> \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/02/15/permission-to-forego-condoms-for-hiv-men-wanting-children/\" target=\"_blank\">Re-thinking Unprotected Sex for HIV-Positive Men Who Want Children\u003c/a>\u003c/p>\n\u003cp>\u003cstrong>Listen to Jolivette's story:\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cobject width=\"335\" height=\"85\" classid=\"d27cdb6e-ae6d-11cf-96b8-444553540000\" codebase=\"http://download.macromedia.com/pub/shockwave/cabs/flash/swflash.cab#version=6,0,40,0\">\u003cparam name=\"flashvars\" value=\"file=http://www.kqed.org/radio/archives/R201310170850c.xml\">\u003cparam name=\"src\" value=\"http://www.kqed.org/assets/flash/kqedplayer.swf\">\u003cembed width=\"335\" height=\"85\" type=\"application/x-shockwave-flash\" src=\"http://www.kqed.org/assets/flash/kqedplayer.swf\" flashvars=\"file=http://www.kqed.org/radio/archives/R201310170850c.xml\">\u003c/embed>\u003c/object>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_15731\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/IMG_6494-2-e1381958343292.jpg\">\u003cimg class=\"size-large wp-image-15731\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/IMG_6494-2-640x480.jpg\" alt=\"IMG_6494 (2)\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Andrew Jolivette wants to start a family but because he is HIV-positive, he is having a hard time finding a place that will help him donate sperm to his friend. (Ryder Diaz/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cem>Editor’s note: Andrew Jolivette was diagnosed with AIDS eleven years ago. Back then, he didn’t think he could ever have a family, since it was illegal for HIV-positive men to donate sperm. California reversed that law in 2007. Now, Jolivette hopes to start a family with a friend. As part of our ongoing series of first-person health profiles called “What’s Your Story?” Jolivette tells us how some medical facilities still can't handle this kind of situation.\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>By Andrew Jolivette\u003c/strong>\u003c/p>\n\u003cp>You know, my mother passed away about a year ago and I think that that also, in all honesty, has had some impact on me saying: Well gosh, she was such a great mom and all these things she taught me, I want to be able to share that with someone, too.\u003c/p>\n\u003cp>Quite frankly, because [my viral load is] undetectable and there are measures they can take like sperm washing and the potential mother, can take anti-retrovirals beforehand to ensure that she nor the child will be infected, then why not?\u003c!--more-->\u003c/p>\n\u003cp>But the first response after we both did fertility tests, they said, well, as you know you’re HIV positive, so we don’t really have the capacity to do that here. So what they suggested, which I found rather insulting, was that we actually do insemination at home. I took that to mean -- that whole sort of outdated thing, it’s the stereotype when people say, you go get a turkey-baster type thing.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Really, if we're talking about people having equal rights to health care, if you're performing these services for other people who aren't (HIV) positive, then you should be performing these services for people who are positive.\u003c/p>\n\u003cp>They need to be prepared. If it’s been six years and you’re aware of the law, then why haven’t you done more to make this accessible to people who want to have children and raise families?\u003c/p>\n\u003cp>\u003cstrong>Related:\u003c/strong> \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/02/15/permission-to-forego-condoms-for-hiv-men-wanting-children/\" target=\"_blank\">Re-thinking Unprotected Sex for HIV-Positive Men Who Want Children\u003c/a>\u003c/p>\n\u003cp>\u003cstrong>Listen to Jolivette's story:\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cobject width=\"335\" height=\"85\" classid=\"d27cdb6e-ae6d-11cf-96b8-444553540000\" codebase=\"http://download.macromedia.com/pub/shockwave/cabs/flash/swflash.cab#version=6,0,40,0\">\u003cparam name=\"flashvars\" value=\"file=http://www.kqed.org/radio/archives/R201310170850c.xml\">\u003cparam name=\"src\" value=\"http://www.kqed.org/assets/flash/kqedplayer.swf\">\u003cembed width=\"335\" height=\"85\" type=\"application/x-shockwave-flash\" src=\"http://www.kqed.org/assets/flash/kqedplayer.swf\" flashvars=\"file=http://www.kqed.org/radio/archives/R201310170850c.xml\">\u003c/embed>\u003c/object>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Lead-Based Paint Still a Hazard for California's Most Vulnerable Children",
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"content": "\u003cfigure id=\"attachment_15716\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/antonioncropped.png\">\u003cimg class=\"size-large wp-image-15716\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/antonioncropped-640x395.png\" alt=\"hree year old Antonio suffered hearing loss after eating lead-based paint chips as a toddler. (Lauren M. Whaley/CHCF Center for Health Reporting)\" width=\"640\" height=\"395\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Three year old Antonio suffered hearing loss after eating lead-based paint chips as a toddler. (Lauren M. Whaley/CHCF Center for Health Reporting)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Kelley Weiss\u003c/strong>, \u003ca href=\"http://centerforhealthreporting.org\" target=\"_blank\">CHCF Center for Health Reporting\u003c/a>\u003c/p>\n\u003cp>Children’s advocates are hoping for a big Christmas present this year – a billion dollars to remove toxic lead paint from homes. A Santa Clara Superior Court judge has until the end of the year to decide if paint companies should pay to get rid of lead paint still in thousands of older homes around the state.\u003c/p>\n\u003cp>While California’s lead poisoning cases have declined, especially over the last two decades, children's advocates say the most vulnerable children are still at risk because they don’t have enough money to reach the finish line.\u003c/p>\n\u003cp>Two counties are trying to fix the problem with the resources they have.\u003c/p>\n\u003cp>Alameda County is one of the ten counties and cities involved in the lawsuit.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Two years ago Nathaniel Stone was living in an East Oakland apartment with one-year-old Antonio. Stone is Antonio's legal guardian and is in the process of adopting him. The home they lived in had a lot of peeling paint.\u003c/p>\n\u003cp>One day when Stone was cooking in the kitchen from across the room he saw that Antonio seemed to be eating something. Stone checked it out and found Antonio with paint chips in his mouth.\u003c!--more-->\u003c/p>\n\u003cp>Stone had no idea the peeling paint was lead-based -- or that it's not so surprising that small children like to eat it. Lead paint tastes sweet. Soon, Stone noticed a change in Antonio's behavior.\u003c/p>\n\u003cp>“From there he was kind of a little sick and restless, sleeping bad at night and kind of crying and a mood that normally wasn’t him,” Stone says.\u003c/p>\n\u003cp>So Stone took Antonio to the doctor and discovered that Antonio had a high level of lead in his blood.\u003c/p>\n\u003cp>“From that he ended up with loss of hearing in his ear,” Stone says.\u003c/p>\n\u003cp>Immediately Alameda County stepped in to help Stone find a new place to live. Today they live in an apartment that is free of lead paint. But because of that early exposure to lead, Antonio, now three-years-old, has major hearing loss. He goes to a center for children with disabilities.\u003c/p>\n\u003cp>Stone says Antonio has a speech therapist, because his words are \"slow and twisted.\"\u003c/p>\n\u003cp>It takes a variety of county experts to handle a case like Antonio’s. This is easier for Alameda County because as part of its lead\u003cstrong> \u003c/strong>poisoning prevention\u003cstrong> \u003c/strong>program, the public health, environmental health and housing departments are integrated. The county program also has more resources than most.\u003c/p>\n\u003cp>Property owners of houses built before 1978 pay the county a $10 annual fee to respond to lead hazards. It’s one of the only assessments of its kind in California. With stable funding, the County tries to be more proactive.\u003c/p>\n\u003cp>Peter Belanger is a state certified lead project designer with the \u003ca href=\"http://www.achhd.org\">Alameda County Healthy Homes Department\u003c/a>.\u003c/p>\n\u003cp>To get a better understanding of the issues he drove me around West Oakland – an area with industrial factories, art studios and he says, “a lot of older homes.”\u003c/p>\n\u003cp>In Oakland, 90 percent of houses have lead paint. Belanger says it’s not cheap to remove with an average cost of $5,000 per unit.\u003c/p>\n\u003cp>If the lead can’t be removed he’ll help move the family out, as happened in Antonio’s case. But whatever the approach, Belanger says the key is getting the children away from the toxic lead.\u003c/p>\n\u003cp>But for many families in California that level of support isn't available.\u003c/p>\n\u003cp>Los Angeles County is also a plaintiff in the lead paint trial. But unlike in Alameda, in LA County, it can take six months to resolve a case like Antonio’s.\u003c/p>\n\u003cp>Dr. Jonathan Fielding, director of the Los Angeles County Public Health Department, points to three main reasons for this lag.\u003c/p>\n\u003cp>The first: the sheer size of the county and the problem.\u003c/p>\n\u003cp>“We have roughly one and a half million residences that have lead paint,” he says.\u003c/p>\n\u003cp>Second, unlike Alameda County, LA’s Public Health and Housing Departments are not integrated. Fielding says that lack of integration can delay action.\u003c/p>\n\u003cp>And, the third reason: money. LA County doesn’t have a dedicated property tax like Alameda County. It relies mainly on state funding and that amount has varied over the years. In addition, the county took a hit last year when \u003ca href=\"http://www.usatoday.com/story/news/nation/2013/09/16/lead-poisoning-prevention-cuts/2817329/\">Congress cut almost all of its funding for the Centers for Disease Control’s lead program\u003c/a>. That money goes out to county health departments for outreach and education.\u003c/p>\n\u003cp>Fielding says this resulted in LA County’s lead program losing about $600,000 a year.\u003c/p>\n\u003cp>At the same time the CDC reported that even \u003ca href=\"http://www.cdc.gov/nceh/lead/ACCLPP/blood_lead_levels.htm\">lower levels of lead can cause permanent brain damage\u003c/a> than had previously been known. Yet Fielding says there’s less and less funding to protect children from lead exposure.\u003c/p>\n\u003cp>“It is really catastrophic to see literally tens of thousands of kids having a level of poisoning that’s going to affect their ability to succeed in high school or to succeed in college,” he says.\u003c/p>\n\u003cp>\u003cstrong>Learn More:\u003c/strong>\u003c/p>\n\u003cp>[youtube //player.vimeo.com/video/74674216]\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"http://vimeo.com/74674216\">Lead poisoning in California's kids: Antonio's story\u003c/a> from \u003ca href=\"http://vimeo.com/user5638243\">CAhealthReport\u003c/a> on \u003ca href=\"https://vimeo.com\">Vimeo\u003c/a>.\u003c/p>\n\n",
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"description": "By Kelley Weiss, CHCF Center for Health Reporting Children’s advocates are hoping for a big Christmas present this year – a billion dollars to remove toxic lead paint from homes. A Santa Clara Superior Court judge has until the end of the year to decide if paint companies should pay to get rid of lead paint",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Two years ago Nathaniel Stone was living in an East Oakland apartment with one-year-old Antonio. Stone is Antonio's legal guardian and is in the process of adopting him. The home they lived in had a lot of peeling paint.\u003c/p>\n\u003cp>One day when Stone was cooking in the kitchen from across the room he saw that Antonio seemed to be eating something. Stone checked it out and found Antonio with paint chips in his mouth.\u003c!--more-->\u003c/p>\n\u003cp>Stone had no idea the peeling paint was lead-based -- or that it's not so surprising that small children like to eat it. Lead paint tastes sweet. Soon, Stone noticed a change in Antonio's behavior.\u003c/p>\n\u003cp>“From there he was kind of a little sick and restless, sleeping bad at night and kind of crying and a mood that normally wasn’t him,” Stone says.\u003c/p>\n\u003cp>So Stone took Antonio to the doctor and discovered that Antonio had a high level of lead in his blood.\u003c/p>\n\u003cp>“From that he ended up with loss of hearing in his ear,” Stone says.\u003c/p>\n\u003cp>Immediately Alameda County stepped in to help Stone find a new place to live. Today they live in an apartment that is free of lead paint. But because of that early exposure to lead, Antonio, now three-years-old, has major hearing loss. He goes to a center for children with disabilities.\u003c/p>\n\u003cp>Stone says Antonio has a speech therapist, because his words are \"slow and twisted.\"\u003c/p>\n\u003cp>It takes a variety of county experts to handle a case like Antonio’s. This is easier for Alameda County because as part of its lead\u003cstrong> \u003c/strong>poisoning prevention\u003cstrong> \u003c/strong>program, the public health, environmental health and housing departments are integrated. The county program also has more resources than most.\u003c/p>\n\u003cp>Property owners of houses built before 1978 pay the county a $10 annual fee to respond to lead hazards. It’s one of the only assessments of its kind in California. With stable funding, the County tries to be more proactive.\u003c/p>\n\u003cp>Peter Belanger is a state certified lead project designer with the \u003ca href=\"http://www.achhd.org\">Alameda County Healthy Homes Department\u003c/a>.\u003c/p>\n\u003cp>To get a better understanding of the issues he drove me around West Oakland – an area with industrial factories, art studios and he says, “a lot of older homes.”\u003c/p>\n\u003cp>In Oakland, 90 percent of houses have lead paint. Belanger says it’s not cheap to remove with an average cost of $5,000 per unit.\u003c/p>\n\u003cp>If the lead can’t be removed he’ll help move the family out, as happened in Antonio’s case. But whatever the approach, Belanger says the key is getting the children away from the toxic lead.\u003c/p>\n\u003cp>But for many families in California that level of support isn't available.\u003c/p>\n\u003cp>Los Angeles County is also a plaintiff in the lead paint trial. But unlike in Alameda, in LA County, it can take six months to resolve a case like Antonio’s.\u003c/p>\n\u003cp>Dr. Jonathan Fielding, director of the Los Angeles County Public Health Department, points to three main reasons for this lag.\u003c/p>\n\u003cp>The first: the sheer size of the county and the problem.\u003c/p>\n\u003cp>“We have roughly one and a half million residences that have lead paint,” he says.\u003c/p>\n\u003cp>Second, unlike Alameda County, LA’s Public Health and Housing Departments are not integrated. Fielding says that lack of integration can delay action.\u003c/p>\n\u003cp>And, the third reason: money. LA County doesn’t have a dedicated property tax like Alameda County. It relies mainly on state funding and that amount has varied over the years. In addition, the county took a hit last year when \u003ca href=\"http://www.usatoday.com/story/news/nation/2013/09/16/lead-poisoning-prevention-cuts/2817329/\">Congress cut almost all of its funding for the Centers for Disease Control’s lead program\u003c/a>. That money goes out to county health departments for outreach and education.\u003c/p>\n\u003cp>Fielding says this resulted in LA County’s lead program losing about $600,000 a year.\u003c/p>\n\u003cp>At the same time the CDC reported that even \u003ca href=\"http://www.cdc.gov/nceh/lead/ACCLPP/blood_lead_levels.htm\">lower levels of lead can cause permanent brain damage\u003c/a> than had previously been known. Yet Fielding says there’s less and less funding to protect children from lead exposure.\u003c/p>\n\u003cp>“It is really catastrophic to see literally tens of thousands of kids having a level of poisoning that’s going to affect their ability to succeed in high school or to succeed in college,” he says.\u003c/p>\n\u003cp>\u003cstrong>Learn More:\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\u003cp>null\u003c/p>\u003cp>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"http://vimeo.com/74674216\">Lead poisoning in California's kids: Antonio's story\u003c/a> from \u003ca href=\"http://vimeo.com/user5638243\">CAhealthReport\u003c/a> on \u003ca href=\"https://vimeo.com\">Vimeo\u003c/a>.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Empathizing with the Homeless: San Francisco Woman Goes a Week Without A Shower",
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"content": "\u003cfigure id=\"attachment_15614\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/RS718_homeless-20120221-scr.jpg\">\u003cimg class=\"size-large wp-image-15614\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/RS718_homeless-20120221-scr-640x480.jpg\" alt=\"A man roots through the garbage at the 16th street BART stop in San Francisco. (Keith Menconi/KQED)\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A man roots through the garbage at the 16th street BART stop in San Francisco. (Keith Menconi/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Polly Stryker\u003c/strong>\u003c/p>\n\u003cp>You know how you feel when you've been camping and haven't showered? After a couple days, your body feels sweaty and ripe; your hair feels greasy. As you start to head home, you begin craving a shower -- the soap, the hot water, the clean towel. It's likely the first thing you do when you get home.\u003c/p>\n\u003cp>But homeless people live a different reality every day. For them, cleaning up depends on making it to a public shower somewhere across town, with a long line, only open during certain hours. Keeping clean is a nearly impossible challenge.\u003c/p>\n\u003cp>San Franciscan Doniece Sandoval started thinking deeply about this question one day two years ago when she was walking near the Design Center in San Francisco. She saw a homeless woman under the 101 overpass crying, terribly upset that she would never be clean. Sandoval had always felt moved and saddened when she saw people who were homeless. Seeing the woman gave her an idea. Since clean bathrooms and showers are so hard for homeless people to get to, why not bring showers to them?\u003c/p>\n\u003cp>And so Sandoval created a nonprofit \u003ca href=\"http://www.lavamae.org/\" target=\"_blank\">Lava Mae\u003c/a>, a play on the Spanish word for \"wash me,\" to help the homeless.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/news/2013/09/09/san-francisco-homeless-showers\" target=\"_blank\">Sandoval recently described her mission to KQED's Joshua Johnson\u003c/a>. San Francisco's 3,400 homeless people have access to just 16 shower stalls, at different places around the city. Just getting to them can be tough. Also, not all homeless shelters have showers. Surprisingly, some emergency family and winter shelters don't have showers.\u003c!--more-->\u003c/p>\n\u003cp>But how to go about it? Sandoval knew church groups had converted mobile homes or horse trailers into mobile showers. Sandoval had a different idea -- what about old Muni busses?\u003c/p>\n\u003cp>In early 2012, Sandoval began working with various city departments which ultimately donated four decommissioned Muni busses. She plans to retrofit the busses with two showers and two toilets each. The idea is that the busses will pull up to homeless service agencies, hook up to water via fire hydrants, and start \"delivering dignity, one shower at a time,\" as Sandoval puts it. The first bus should be ready to roll in early 2014.\u003c/p>\n\u003cp>That's her project's blueprint, but Sandoval wanted to take things one step further. She felt she needed to get some sense of what it's like to go without bathing for an extended period. She issued herself a \"No Shower Challenge\" -- a week without a shower. Sure, it was a way to draw attention to her cause. But it was also a way to try and walk the walk, even if Sandoval isn't homeless.\u003c/p>\n\u003cp>Sandoval has been a neat-freak ever since her childhood in Texas. \"When I was a little girl, I would go out and play, and if I got dirty, my mother would bring me back in the house, and I might get tossed in the bathtub.” Sandoval's mother sometimes changed her daughter's clothes three times a day. In other words, going without a shower for an extended period of time was going to be tough.\u003c/p>\n\u003cp>I stayed in touch with her throughout the week. Her ground rules? No showers. No rinsing off in her sink. “I'm using wipes as best I can. I'm using a lot of deodorant and body lotion,\" she told me. Day one was no problem.\u003c/p>\n\u003cp>On day two, she began to feel sticky. She brushed her teeth at home and in public places, but otherwise she only cleaned up in public restrooms -- for example patting her hair down with water to try and give it a bit of shape. On day three, Sandoval started sleeping in a sleep sack, \"to spare my husband my dirty sheets.\" Her six-year-old daughter told her she smelled. On day five, Sandoval thought about wearing a hat, because her hair felt so nasty. By day six, she began obsessing about sweat glands and germs.\u003c/p>\n\u003cp>While she used a lot of wipes, they weren't much help. \"Everybody talks about how great wipes are. I have friends who go camping. And I think that compared to being out in the wilderness and having nothing else, it's really satisfactory. But when you're around people who are cleaning themselves up in a shower or bath, and you're using wipes, it's just not the same. It's like a layer of something that stays on you.\"\u003c/p>\n\u003cp>Later in the week, she said she felt like the wipes were just smearing dirt around her body. She felt increasingly itchy and oily. By day six, Sandoval couldn't wait to wash her hair and told me that she felt like she was walking around with \"a shelacked thing of grime on my scalp.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Doniece took a shower at midnight on the seventh day. She washed her hair four times. She says she would do it again, if it helped her to raise funds. But, \"from an empathy perspective, I think this one experience gave me a sole sense of how hard and demoralizing it is to be dirty.\"\u003c/p>\n\u003cfigure id=\"attachment_15617\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/donice.jpg\">\u003cimg class=\"size-large wp-image-15617\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/donice-640x530.jpg\" alt='A clean and happy Doniece Sandoval after completing her \"No Shower Challenge.\" (Photo: Sadik Huseny)' width=\"640\" height=\"530\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A clean and happy Doniece Sandoval after completing her \"No Shower Challenge.\" (Photo: Sadik Huseny)\u003c/figcaption>\u003c/figure>\n\u003cdiv>\u003c/div>\n\n",
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"excerpt": "You know how you feel when you've been camping and haven't showered? After a couple days, your body feels sweaty and ripe, and your hair feels greasy. As you start to head home, you start craving a shower -- the soap, the hot water, the clean towel. \r\n\r\nBut what if cleaning up depended on making it to a public shower somewhere across town, with a long line, only open during certain hours, and you had no car? In other words, what if you were homeless? How do you keep clean then?",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_15614\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/RS718_homeless-20120221-scr.jpg\">\u003cimg class=\"size-large wp-image-15614\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/RS718_homeless-20120221-scr-640x480.jpg\" alt=\"A man roots through the garbage at the 16th street BART stop in San Francisco. (Keith Menconi/KQED)\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A man roots through the garbage at the 16th street BART stop in San Francisco. (Keith Menconi/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Polly Stryker\u003c/strong>\u003c/p>\n\u003cp>You know how you feel when you've been camping and haven't showered? After a couple days, your body feels sweaty and ripe; your hair feels greasy. As you start to head home, you begin craving a shower -- the soap, the hot water, the clean towel. It's likely the first thing you do when you get home.\u003c/p>\n\u003cp>But homeless people live a different reality every day. For them, cleaning up depends on making it to a public shower somewhere across town, with a long line, only open during certain hours. Keeping clean is a nearly impossible challenge.\u003c/p>\n\u003cp>San Franciscan Doniece Sandoval started thinking deeply about this question one day two years ago when she was walking near the Design Center in San Francisco. She saw a homeless woman under the 101 overpass crying, terribly upset that she would never be clean. Sandoval had always felt moved and saddened when she saw people who were homeless. Seeing the woman gave her an idea. Since clean bathrooms and showers are so hard for homeless people to get to, why not bring showers to them?\u003c/p>\n\u003cp>And so Sandoval created a nonprofit \u003ca href=\"http://www.lavamae.org/\" target=\"_blank\">Lava Mae\u003c/a>, a play on the Spanish word for \"wash me,\" to help the homeless.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/news/2013/09/09/san-francisco-homeless-showers\" target=\"_blank\">Sandoval recently described her mission to KQED's Joshua Johnson\u003c/a>. San Francisco's 3,400 homeless people have access to just 16 shower stalls, at different places around the city. Just getting to them can be tough. Also, not all homeless shelters have showers. Surprisingly, some emergency family and winter shelters don't have showers.\u003c!--more-->\u003c/p>\n\u003cp>But how to go about it? Sandoval knew church groups had converted mobile homes or horse trailers into mobile showers. Sandoval had a different idea -- what about old Muni busses?\u003c/p>\n\u003cp>In early 2012, Sandoval began working with various city departments which ultimately donated four decommissioned Muni busses. She plans to retrofit the busses with two showers and two toilets each. The idea is that the busses will pull up to homeless service agencies, hook up to water via fire hydrants, and start \"delivering dignity, one shower at a time,\" as Sandoval puts it. The first bus should be ready to roll in early 2014.\u003c/p>\n\u003cp>That's her project's blueprint, but Sandoval wanted to take things one step further. She felt she needed to get some sense of what it's like to go without bathing for an extended period. She issued herself a \"No Shower Challenge\" -- a week without a shower. Sure, it was a way to draw attention to her cause. But it was also a way to try and walk the walk, even if Sandoval isn't homeless.\u003c/p>\n\u003cp>Sandoval has been a neat-freak ever since her childhood in Texas. \"When I was a little girl, I would go out and play, and if I got dirty, my mother would bring me back in the house, and I might get tossed in the bathtub.” Sandoval's mother sometimes changed her daughter's clothes three times a day. In other words, going without a shower for an extended period of time was going to be tough.\u003c/p>\n\u003cp>I stayed in touch with her throughout the week. Her ground rules? No showers. No rinsing off in her sink. “I'm using wipes as best I can. I'm using a lot of deodorant and body lotion,\" she told me. Day one was no problem.\u003c/p>\n\u003cp>On day two, she began to feel sticky. She brushed her teeth at home and in public places, but otherwise she only cleaned up in public restrooms -- for example patting her hair down with water to try and give it a bit of shape. On day three, Sandoval started sleeping in a sleep sack, \"to spare my husband my dirty sheets.\" Her six-year-old daughter told her she smelled. On day five, Sandoval thought about wearing a hat, because her hair felt so nasty. By day six, she began obsessing about sweat glands and germs.\u003c/p>\n\u003cp>While she used a lot of wipes, they weren't much help. \"Everybody talks about how great wipes are. I have friends who go camping. And I think that compared to being out in the wilderness and having nothing else, it's really satisfactory. But when you're around people who are cleaning themselves up in a shower or bath, and you're using wipes, it's just not the same. It's like a layer of something that stays on you.\"\u003c/p>\n\u003cp>Later in the week, she said she felt like the wipes were just smearing dirt around her body. She felt increasingly itchy and oily. By day six, Sandoval couldn't wait to wash her hair and told me that she felt like she was walking around with \"a shelacked thing of grime on my scalp.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Doniece took a shower at midnight on the seventh day. She washed her hair four times. She says she would do it again, if it helped her to raise funds. But, \"from an empathy perspective, I think this one experience gave me a sole sense of how hard and demoralizing it is to be dirty.\"\u003c/p>\n\u003cfigure id=\"attachment_15617\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/donice.jpg\">\u003cimg class=\"size-large wp-image-15617\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/donice-640x530.jpg\" alt='A clean and happy Doniece Sandoval after completing her \"No Shower Challenge.\" (Photo: Sadik Huseny)' width=\"640\" height=\"530\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A clean and happy Doniece Sandoval after completing her \"No Shower Challenge.\" (Photo: Sadik Huseny)\u003c/figcaption>\u003c/figure>\n\u003cdiv>\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Vaccine Refusals Fueled California Whooping Cough Epidemic",
"title": "Vaccine Refusals Fueled California Whooping Cough Epidemic",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_15266\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg class=\"size-large wp-image-15266\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/09/149948672-640x452.jpg\" alt=\"Students leaving a vaccine clinic after being vaccinated against whooping cough at a middle school in Los Angeles. (Kevork Djansezian/Getty Images)\" width=\"640\" height=\"452\">\u003cfigcaption class=\"wp-caption-text\">Student leaves a vaccine clinic at a Los Angeles middle school after being immunized against whooping cough. (Kevork Djansezian/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Nancy Shute\u003c/strong>, \u003ca href=\"http://www.npr.org/blogs/health/2013/09/25/226147147/vaccine-refusals-fueled-californias-whooping-cough-epidemic\" target=\"_blank\">NPR\u003c/a>\u003c/p>\n\u003cp>When the whooping cough vaccine was invented in the 1940s, doctors thought they had finally licked the illness, which is especially dangerous for babies. But then it came roaring back.\u003c/p>\n\u003cp>In 2010, a whooping cough outbreak in California sickened 9,120 people, more than in any year since 1947. Ten infants died; babies are too young to be vaccinated.\u003c/p>\n\u003cp>Public health officials suspected that the increased numbers of parents who refused to vaccinate their children played a role, but they couldn't be sure.\u003c/p>\n\u003cp>Vaccine refusal was indeed a factor, researchers now say. They compared the location and number of whooping cough, or pertussis, cases in that outbreak with the \u003ca href=\"http://ww2.kqed.org/news/2013/08/21/marin-vaccinations/\" target=\"_blank\">personal belief exemptions\u003c/a> filed by parents who chose not to vaccinate for reasons other than a child's health. (Some children with compromised immune systems aren't able to be vaccinated.)\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Pertussis is very contagious, spreading quickly through a community. So the researchers had to map not only the location of outbreak clusters, but also when they appeared.\u003c!--more-->\u003c/p>\n\u003cp>They found that people who lived in areas with high rates of personal belief exemptions were 2 1/2 times more likely to live in a place with lots of pertussis cases. \"The exemptions clustered spatially and were associated with clusters of cases,\" Jessica Atwell, a graduate student at Johns Hopkins Bloomberg School of Public Health and lead author on the study, told NPR. It was \u003ca href=\"http://pediatrics.aappublications.org/content/early/2013/09/24/peds.2013-0878.abstract\">published online\u003c/a> in the journal \u003cem>Pediatrics\u003c/em>.\u003c/p>\n\u003cp>Both exemptions and clusters of pertussis cases tended to be in neighborhoods with higher levels of education and income. Statewide about 2 percent of parents file an exemption, but the number varied hugely from one community to the text. In some schools more than three-quarters of the families filed exemptions.\u003c/p>\n\u003cp style=\"text-align: center\">\u003cstrong>[Related: \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/09/06/more-california-parents-opting-out-of-vaccines-look-up-your-school-online/\" target=\"_blank\">More California Parents Opt Out of Vaccines; Look Up Your School Online\u003c/a>]\u003c/strong>\u003c/p>\n\u003cp>When the number of people vaccinated drops below 95 percent, a community loses\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/08/23/5-things-you-should-know-about-vaccines/\" target=\"_blank\"> herd immunity \u003c/a>to highly contagious germs like pertussis, and babies and other unvaccinated people can get sick. In 2010, 91 percent of kindergarteners were up to date on their shots in California.\u003c/p>\n\u003cp>Vaccine refusal wasn't the only factor fueling the California outbreak. Pertussis is a cyclical disease. Protection from the current version of pertussis vaccine appears to fade \u003ca href=\"http://www.npr.org/blogs/health/2012/09/13/161062792/whooping-cough-vaccines-protection-fades-quickly\">more quickly than doctors originally thought\u003c/a>, so many older children vaccinated as youngsters were no longer immune to the bacterium. And many adults had never gotten a booster.\u003c/p>\n\u003cp>Finally, this study couldn't tell if the parents who filed exemptions had vaccinated their children against some diseases, or which ones.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>California has since launched a statewide campaign to get both children and adults vaccinated, with a booster required for attendance at middle school. While parents can still file a personal belief exemption, \u003ca href=\"http://ww2.kqed.org/stateofhealth/2012/08/23/new-requirement-for-vaccine-exemption-passed-by-senate/\" target=\"_blank\">a new state law \u003c/a>taking effect Jan. 1, 2014 will require them to meet with a health care provider first.\u003c/p>\n\n",
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"excerpt": "In 2010, a whooping cough outbreak in California sickened 9,120 people, more than in any year since 1947. Ten infants died; babies are too young to be vaccinated.\r\n\r\nPublic health officials suspected that the increased numbers of parents who refused to vaccinate their children played a role, but they couldn't be sure.\r\n\r\nVaccine refusal was indeed a factor, researchers now say. ",
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"headline": "Vaccine Refusals Fueled California Whooping Cough Epidemic",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_15266\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg class=\"size-large wp-image-15266\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/09/149948672-640x452.jpg\" alt=\"Students leaving a vaccine clinic after being vaccinated against whooping cough at a middle school in Los Angeles. (Kevork Djansezian/Getty Images)\" width=\"640\" height=\"452\">\u003cfigcaption class=\"wp-caption-text\">Student leaves a vaccine clinic at a Los Angeles middle school after being immunized against whooping cough. (Kevork Djansezian/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Nancy Shute\u003c/strong>, \u003ca href=\"http://www.npr.org/blogs/health/2013/09/25/226147147/vaccine-refusals-fueled-californias-whooping-cough-epidemic\" target=\"_blank\">NPR\u003c/a>\u003c/p>\n\u003cp>When the whooping cough vaccine was invented in the 1940s, doctors thought they had finally licked the illness, which is especially dangerous for babies. But then it came roaring back.\u003c/p>\n\u003cp>In 2010, a whooping cough outbreak in California sickened 9,120 people, more than in any year since 1947. Ten infants died; babies are too young to be vaccinated.\u003c/p>\n\u003cp>Public health officials suspected that the increased numbers of parents who refused to vaccinate their children played a role, but they couldn't be sure.\u003c/p>\n\u003cp>Vaccine refusal was indeed a factor, researchers now say. They compared the location and number of whooping cough, or pertussis, cases in that outbreak with the \u003ca href=\"http://ww2.kqed.org/news/2013/08/21/marin-vaccinations/\" target=\"_blank\">personal belief exemptions\u003c/a> filed by parents who chose not to vaccinate for reasons other than a child's health. (Some children with compromised immune systems aren't able to be vaccinated.)\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Pertussis is very contagious, spreading quickly through a community. So the researchers had to map not only the location of outbreak clusters, but also when they appeared.\u003c!--more-->\u003c/p>\n\u003cp>They found that people who lived in areas with high rates of personal belief exemptions were 2 1/2 times more likely to live in a place with lots of pertussis cases. \"The exemptions clustered spatially and were associated with clusters of cases,\" Jessica Atwell, a graduate student at Johns Hopkins Bloomberg School of Public Health and lead author on the study, told NPR. It was \u003ca href=\"http://pediatrics.aappublications.org/content/early/2013/09/24/peds.2013-0878.abstract\">published online\u003c/a> in the journal \u003cem>Pediatrics\u003c/em>.\u003c/p>\n\u003cp>Both exemptions and clusters of pertussis cases tended to be in neighborhoods with higher levels of education and income. Statewide about 2 percent of parents file an exemption, but the number varied hugely from one community to the text. In some schools more than three-quarters of the families filed exemptions.\u003c/p>\n\u003cp style=\"text-align: center\">\u003cstrong>[Related: \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/09/06/more-california-parents-opting-out-of-vaccines-look-up-your-school-online/\" target=\"_blank\">More California Parents Opt Out of Vaccines; Look Up Your School Online\u003c/a>]\u003c/strong>\u003c/p>\n\u003cp>When the number of people vaccinated drops below 95 percent, a community loses\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/08/23/5-things-you-should-know-about-vaccines/\" target=\"_blank\"> herd immunity \u003c/a>to highly contagious germs like pertussis, and babies and other unvaccinated people can get sick. In 2010, 91 percent of kindergarteners were up to date on their shots in California.\u003c/p>\n\u003cp>Vaccine refusal wasn't the only factor fueling the California outbreak. Pertussis is a cyclical disease. Protection from the current version of pertussis vaccine appears to fade \u003ca href=\"http://www.npr.org/blogs/health/2012/09/13/161062792/whooping-cough-vaccines-protection-fades-quickly\">more quickly than doctors originally thought\u003c/a>, so many older children vaccinated as youngsters were no longer immune to the bacterium. And many adults had never gotten a booster.\u003c/p>\n\u003cp>Finally, this study couldn't tell if the parents who filed exemptions had vaccinated their children against some diseases, or which ones.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>California has since launched a statewide campaign to get both children and adults vaccinated, with a booster required for attendance at middle school. While parents can still file a personal belief exemption, \u003ca href=\"http://ww2.kqed.org/stateofhealth/2012/08/23/new-requirement-for-vaccine-exemption-passed-by-senate/\" target=\"_blank\">a new state law \u003c/a>taking effect Jan. 1, 2014 will require them to meet with a health care provider first.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Food Stamps Cuts Would Harm Vulnerable Californians, Advocates Say",
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"content": "\u003cp>\u003cstrong>By Elaine Korry\u003c/strong>\u003c/p>\n\u003cp>Thousands of Californians could lose food stamp benefits under a plan approved by congressional Republicans last week cutting the federal program by approximately $40 billion over ten years. California already has the lowest food stamp participation rate in the nation. Advocates for the poor are alarmed, and they say the GOP plan would hurt veterans and former foster youth, among others.\u003c/p>\n\u003cp style=\"text-align: justify\">An estimated four million Californians receive food assistance through a state-administered program called CalFresh. \u003ca href=\"http://www.govtrack.us/congress/votes/113-2013/h476\" target=\"_blank\">The bill\u003c/a>, which passed by a 217-210 margin, would protect benefits for the poorest households with children (who comprise about 80 percent of food stamp recipients in California), but restrict benefits for unemployed childless adults after three months.\u003c/p>\n\u003cp style=\"text-align: justify\">GOP Rep. Tom McClintock, who represents a district stretching from Truckee to the Sequoia National Forest, says he voted on behalf of every California household that pays $720 a year in taxes to support CalFresh. “I think they’ve got a right to ask in return that those who are on the program make a good faith effort to get off it, and that’s what this bill does,” he said.\u003c/p>\n\u003cp>More than 360,000 out-of-work Californians could lose CalFresh benefits, unless they enroll in vocational courses or a county jobs program. “The bill restores a requirement that able-bodied adults work, or look for work, or at least be training for work in order to receive this assistance,” said McClintock.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>But there’s just one catch, according to Jessica Bartholow, a legislative advocate at the nonprofit Western Center on Law and Poverty. “Our counties and our state administrators all say that they don't have the capacity to absorb those individuals into a job search and a job training program,” she said.\u003c/p>\n\u003cp>The House GOP cuts could also hurt one vulnerable group state lawmakers have been actively trying to help: jobless veterans. Bartholow says the House plan reverses a newly passed state law giving special benefits to returning vets. “The bill passed by the House of Representatives would put that policy in jeopardy,” said Bartholow.\u003c/p>\n\u003cp>The federal government pays for food stamps, formally called the Supplemental Nutrition Assistance Program or SNAP. Bartholow believes that instead of eliminating people from the food stamp rolls, California should be working to enroll more of the estimated 4 million residents who are eligible for but do not receive food assistance. Because of that low participation rate, California leaves about $4.7 billion in federal money earmarked for SNAP on the table each year.\u003c/p>\n\u003cp>According to Bartholow, past Republican governors oversaw tough requirements that helped keep the state’s SNAP participation rate low. “We were one of the first states to have a finger image requirement for the program,” said Bartholow. “We were one of the last states to allow for phone interviews when people couldn't come into the office, and we were the last state to change reporting requirements for income and assets from quarterly to semiannually.”\u003c/p>\n\u003cp>Some of those barriers to enrollment have been lifted through legislation signed by Gov. Brown, but according to a U.S. Dept. of Agriculture survey earlier this year, approximately one-half of Californians entitled to federal nutrition assistance do not receive it.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>All California’s Democratic representatives voted against the bill. Republican representatives Gary Miller and David Valadao also voted no.\u003c/p>\n\n",
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"excerpt": "Thousands of Californians could lose food stamp benefits under a plan approved by congressional Republicans last week cutting the federal program by approximately $40 billion over ten years. Advocates for the poor are alarmed; California already has the lowest food stamp participation rate in the nation, and they say the GOP plan would hurt veterans and former foster youth, among others.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>By Elaine Korry\u003c/strong>\u003c/p>\n\u003cp>Thousands of Californians could lose food stamp benefits under a plan approved by congressional Republicans last week cutting the federal program by approximately $40 billion over ten years. California already has the lowest food stamp participation rate in the nation. Advocates for the poor are alarmed, and they say the GOP plan would hurt veterans and former foster youth, among others.\u003c/p>\n\u003cp style=\"text-align: justify\">An estimated four million Californians receive food assistance through a state-administered program called CalFresh. \u003ca href=\"http://www.govtrack.us/congress/votes/113-2013/h476\" target=\"_blank\">The bill\u003c/a>, which passed by a 217-210 margin, would protect benefits for the poorest households with children (who comprise about 80 percent of food stamp recipients in California), but restrict benefits for unemployed childless adults after three months.\u003c/p>\n\u003cp style=\"text-align: justify\">GOP Rep. Tom McClintock, who represents a district stretching from Truckee to the Sequoia National Forest, says he voted on behalf of every California household that pays $720 a year in taxes to support CalFresh. “I think they’ve got a right to ask in return that those who are on the program make a good faith effort to get off it, and that’s what this bill does,” he said.\u003c/p>\n\u003cp>More than 360,000 out-of-work Californians could lose CalFresh benefits, unless they enroll in vocational courses or a county jobs program. “The bill restores a requirement that able-bodied adults work, or look for work, or at least be training for work in order to receive this assistance,” said McClintock.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But there’s just one catch, according to Jessica Bartholow, a legislative advocate at the nonprofit Western Center on Law and Poverty. “Our counties and our state administrators all say that they don't have the capacity to absorb those individuals into a job search and a job training program,” she said.\u003c/p>\n\u003cp>The House GOP cuts could also hurt one vulnerable group state lawmakers have been actively trying to help: jobless veterans. Bartholow says the House plan reverses a newly passed state law giving special benefits to returning vets. “The bill passed by the House of Representatives would put that policy in jeopardy,” said Bartholow.\u003c/p>\n\u003cp>The federal government pays for food stamps, formally called the Supplemental Nutrition Assistance Program or SNAP. Bartholow believes that instead of eliminating people from the food stamp rolls, California should be working to enroll more of the estimated 4 million residents who are eligible for but do not receive food assistance. Because of that low participation rate, California leaves about $4.7 billion in federal money earmarked for SNAP on the table each year.\u003c/p>\n\u003cp>According to Bartholow, past Republican governors oversaw tough requirements that helped keep the state’s SNAP participation rate low. “We were one of the first states to have a finger image requirement for the program,” said Bartholow. “We were one of the last states to allow for phone interviews when people couldn't come into the office, and we were the last state to change reporting requirements for income and assets from quarterly to semiannually.”\u003c/p>\n\u003cp>Some of those barriers to enrollment have been lifted through legislation signed by Gov. Brown, but according to a U.S. Dept. of Agriculture survey earlier this year, approximately one-half of Californians entitled to federal nutrition assistance do not receive it.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>All California’s Democratic representatives voted against the bill. Republican representatives Gary Miller and David Valadao also voted no.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Federal Health Officials to Launch Study of Valley Fever",
"title": "Federal Health Officials to Launch Study of Valley Fever",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_15170\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg class=\"size-large wp-image-15170\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/09/81030094-640x426.jpg\" alt=\"A bull kicks up dust on a farm south of Bakersfield. Valley fever spores are carried by the wind in the dry, desert southwest, including California's Central Valley. (David McNew/Getty Images)\" width=\"640\" height=\"426\">\u003cfigcaption class=\"wp-caption-text\">A bull kicks up dust on a farm south of Bakersfield. Valley fever spores are carried by the wind in the dry, desert southwest, including California's Central Valley. (David McNew/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Rachel Cook,\u003c/strong> \u003ca href=\"http://www.reportingonhealth.org/valleyfever/story\" target=\"_blank\">Reporting on Health Collaborative\u003c/a>\u003c/p>\n\u003cp>The leaders of the Centers for Disease Control and the National Institutes of Health announced they will launch a clinical trial to get a better understanding of how to treat valley fever. The announcement was made Monday as part of a two-day symposium on valley fever being held in Bakersfield.\u003c/p>\n\u003cp>The randomized control trial will cost millions of dollars and involve roughly 1,000 patients, and it could help determine the best practices for treating the fungal infection.\u003c/p>\n\u003cp>“It will take some time to mount this trial, to plan it, to put it forward,\" said Dr. Francis Collins, director of the NIH. \"But I just want to assure all of you from this part of California that we’re serious about trying to get some of those answers even in the face of difficult budget times,” Collins said.\u003c/p>\n\u003cp>California's San Joaquin Valley is\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/03/29/valley-fever-cases-skyrocketing-says-cdc/\" target=\"_blank\"> a valley fever hot spot\u003c/a>.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“What we’ve seen is a steady increase in the number of diagnosed cases of valley fever, or coccidioidomycosis,” said Dr. Thomas Frieden, director of the CDC. “We don’t know why that’s happened and there’s a lot that we need to learn.”\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>Symposium participants called the announcement a major development in the fight against valley fever. The news comes after U.S. Rep. Kevin McCarthy, (R-Bakersfield), who spearheaded the symposium, courted the leaders of the CDC and NIH for months about valley fever.\u003c/p>\n\u003cp>The trial will involve some 1,000 people diagnosed with community-acquired pneumonia, the most common presentation of valley fever. Half will be randomly chosen to receive either a traditional antibiotic used to treat bacterial pneumonia or placebo; the other half will be treated with the antibiotic plus fluconazole, an anti-fungal medication frequently used to treat valley fever.\u003c/p>\n\u003cp>The patients will be tested immediately and then every two weeks to see if they have valley fever and which treatments prove most effective. Collins said the trial will spread awareness about the disease and educate people about diagnostics and treatment.\u003c/p>\n\u003cp>“We all recognize that there’s more that needs to be done. There’s so many unknowns (about valley fever),” Collins said. “We don’t know exactly what the right treatment is for people who become infected with this fungus.”\u003c/p>\n\u003cp>Dr. Royce Johnson, Kern Medical Center’s chief of infectious disease, called the trial exciting news.\u003c/p>\n\u003cp>“There is a real difference of opinion about who should be treated, when they should be treated and how much they should be treated with,” Johnson said. “It would answer some of those questions.”\u003c/p>\n\u003cp>After the trial was announced to reporters, about 200 people attended a public forum. The gathering brought together people battling the disease, doctors working to developed a vaccine, and past and present politicians.\u003c/p>\n\u003cp>“This is a particularly unusual (event) because this is not as common a condition as many of the things that Dr. Frieden and I spend our time worrying about,” Collins said. “But it is a compelling situation because of the rise in (reported cases) and the fact that there’s so many unknowns that could be answers so it seems like the right time to get all of the smart people together and see what we can do.”\u003c/p>\n\u003cp>Men, women and one little girl shared their stories of living with valley fever. Many asked specific questions about their own condition and symptoms, telling stories of misdiagnosis and uncertainty.\u003c/p>\n\u003cp>Darrin Blackmon, Sr., of Buttonwillow brought a plastic bag filled with medications and bills he has accrued while dealing with the disease for one year.\u003c/p>\n\u003cp>“It’s an honor, it’s a privilege to still be living,” Blackmon said after briefly meeting Frieden. “When I first got it, oh your body (makes) you feel like you (are) dying already.”\u003c/p>\n\u003cp>Lisa Limbeck of Rosamond has lived with valley fever for five years, and the virus has settled in her brain. She says she's had several brain operations and takes daily antifungal treatments. She copes with chronic pain which she compared to a day-long severe migraine.\u003c/p>\n\u003cp>“I just wanted to hear other stories of people who’ve battled what I’ve gone through and how they’re coping and how they’re living and how it’s changed their world because I know it’s changed mine,” she said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>She said she hoped public health leaders would be open to new ideas for advancing testing and technologies to understand valley fever.\u003c/p>\n\n",
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"excerpt": "The leaders of the Centers for Disease Control and the National Institutes of Health announced they will launch a clinical trial to get a better understanding of how to treat valley fever, they announced in Bakersfield Monday.\r\n\r\nThe endeavour, announced as part of a two-day valley fever symposium, will cost millions of dollars and involve roughly 1,000 patients. The randomized control trial could help determine the best practices for treating the fungal infection.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_15170\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg class=\"size-large wp-image-15170\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/09/81030094-640x426.jpg\" alt=\"A bull kicks up dust on a farm south of Bakersfield. Valley fever spores are carried by the wind in the dry, desert southwest, including California's Central Valley. (David McNew/Getty Images)\" width=\"640\" height=\"426\">\u003cfigcaption class=\"wp-caption-text\">A bull kicks up dust on a farm south of Bakersfield. Valley fever spores are carried by the wind in the dry, desert southwest, including California's Central Valley. (David McNew/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Rachel Cook,\u003c/strong> \u003ca href=\"http://www.reportingonhealth.org/valleyfever/story\" target=\"_blank\">Reporting on Health Collaborative\u003c/a>\u003c/p>\n\u003cp>The leaders of the Centers for Disease Control and the National Institutes of Health announced they will launch a clinical trial to get a better understanding of how to treat valley fever. The announcement was made Monday as part of a two-day symposium on valley fever being held in Bakersfield.\u003c/p>\n\u003cp>The randomized control trial will cost millions of dollars and involve roughly 1,000 patients, and it could help determine the best practices for treating the fungal infection.\u003c/p>\n\u003cp>“It will take some time to mount this trial, to plan it, to put it forward,\" said Dr. Francis Collins, director of the NIH. \"But I just want to assure all of you from this part of California that we’re serious about trying to get some of those answers even in the face of difficult budget times,” Collins said.\u003c/p>\n\u003cp>California's San Joaquin Valley is\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/03/29/valley-fever-cases-skyrocketing-says-cdc/\" target=\"_blank\"> a valley fever hot spot\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“What we’ve seen is a steady increase in the number of diagnosed cases of valley fever, or coccidioidomycosis,” said Dr. Thomas Frieden, director of the CDC. “We don’t know why that’s happened and there’s a lot that we need to learn.”\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>Symposium participants called the announcement a major development in the fight against valley fever. The news comes after U.S. Rep. Kevin McCarthy, (R-Bakersfield), who spearheaded the symposium, courted the leaders of the CDC and NIH for months about valley fever.\u003c/p>\n\u003cp>The trial will involve some 1,000 people diagnosed with community-acquired pneumonia, the most common presentation of valley fever. Half will be randomly chosen to receive either a traditional antibiotic used to treat bacterial pneumonia or placebo; the other half will be treated with the antibiotic plus fluconazole, an anti-fungal medication frequently used to treat valley fever.\u003c/p>\n\u003cp>The patients will be tested immediately and then every two weeks to see if they have valley fever and which treatments prove most effective. Collins said the trial will spread awareness about the disease and educate people about diagnostics and treatment.\u003c/p>\n\u003cp>“We all recognize that there’s more that needs to be done. There’s so many unknowns (about valley fever),” Collins said. “We don’t know exactly what the right treatment is for people who become infected with this fungus.”\u003c/p>\n\u003cp>Dr. Royce Johnson, Kern Medical Center’s chief of infectious disease, called the trial exciting news.\u003c/p>\n\u003cp>“There is a real difference of opinion about who should be treated, when they should be treated and how much they should be treated with,” Johnson said. “It would answer some of those questions.”\u003c/p>\n\u003cp>After the trial was announced to reporters, about 200 people attended a public forum. The gathering brought together people battling the disease, doctors working to developed a vaccine, and past and present politicians.\u003c/p>\n\u003cp>“This is a particularly unusual (event) because this is not as common a condition as many of the things that Dr. Frieden and I spend our time worrying about,” Collins said. “But it is a compelling situation because of the rise in (reported cases) and the fact that there’s so many unknowns that could be answers so it seems like the right time to get all of the smart people together and see what we can do.”\u003c/p>\n\u003cp>Men, women and one little girl shared their stories of living with valley fever. Many asked specific questions about their own condition and symptoms, telling stories of misdiagnosis and uncertainty.\u003c/p>\n\u003cp>Darrin Blackmon, Sr., of Buttonwillow brought a plastic bag filled with medications and bills he has accrued while dealing with the disease for one year.\u003c/p>\n\u003cp>“It’s an honor, it’s a privilege to still be living,” Blackmon said after briefly meeting Frieden. “When I first got it, oh your body (makes) you feel like you (are) dying already.”\u003c/p>\n\u003cp>Lisa Limbeck of Rosamond has lived with valley fever for five years, and the virus has settled in her brain. She says she's had several brain operations and takes daily antifungal treatments. She copes with chronic pain which she compared to a day-long severe migraine.\u003c/p>\n\u003cp>“I just wanted to hear other stories of people who’ve battled what I’ve gone through and how they’re coping and how they’re living and how it’s changed their world because I know it’s changed mine,” she said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>She said she hoped public health leaders would be open to new ideas for advancing testing and technologies to understand valley fever.\u003c/p>\n\n\u003c/div>\u003c/p>",
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