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"disqusTitle": "Two Soda Stories: Richmond Tax Post-Mortem, New Ally in NYC Ban",
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"content": "\u003cfigure id=\"attachment_6672\" class=\"wp-caption alignleft\" style=\"max-width: 250px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2012/06/21/beverage-companies-blur-the-line-between-philanthropy-marketing/soda/\" rel=\"attachment wp-att-6672\">\u003cimg class=\"size-full wp-image-6672\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/06/soda.jpg\" alt=\" (La Piazza Pizzeria/Flickr)\" width=\"250\" height=\"250\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2012/06/soda.jpg 250w, https://ww2.kqed.org/app/uploads/sites/27/2012/06/soda-32x32.jpg 32w, https://ww2.kqed.org/app/uploads/sites/27/2012/06/soda-64x64.jpg 64w, https://ww2.kqed.org/app/uploads/sites/27/2012/06/soda-96x96.jpg 96w, https://ww2.kqed.org/app/uploads/sites/27/2012/06/soda-128x128.jpg 128w, https://ww2.kqed.org/app/uploads/sites/27/2012/06/soda-75x75.jpg 75w\" sizes=\"(max-width: 250px) 100vw, 250px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(La Piazza Pizzeria/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>The East Bay Express chose one heckuva startling headline for its article examining the fight over Measure N -- Richmond's penny-per-ounce tax on soda and sugar sweetened beverages that was defeated last November. \"\u003ca href=\"http://www.eastbayexpress.com/ebx/race-baiting-in-richmond/Content?oid=3441871&showFullText=true\" target=\"_blank\">Race Baiting in Richmond\u003c/a>\" alleges that big business used race to fracture Richmond's progressive community in its ultimately successful campaign to defeat the tax.\u003c/p>\n\u003cp>The lengthy and detailed article makes clear that race was already a factor in the anti-soda tax movement before the soda industry -- and its dollars -- arrived in Richmond last summer. From the East Bay Express:\u003c/p>\n\u003cblockquote>\u003cp>Some opponents of the tax had alleged that it was racist, arguing that it would unfairly harm low-income residents in the city. And the No on Measure N campaign, bankrolled by large corporations that make a fortune from selling cheap soda to low-income consumers, nurtured that sentiment. Indeed, there is evidence that the beverage association helped keep race at the forefront of the campaign as part of a strategy that exploited Richmond's existing tensions. And after spending at least $2.7 million — believed to be a record in East Bay politics — against Measure N, the beverage industry emerged victorious as the soda tax was beaten soundly.\u003c/p>\u003c/blockquote>\n\u003cp>\u003c!--more-->Meanwhile, proponents of the tax made arguments about how the tax would fund better health programs for Richmond low income children and teens, including plans to build more sports fields, but to little avail, says the Express:\u003c/p>\n\u003cblockquote>\u003cp>... (T)he health debate was ultimately drowned out in the election by arguments related to race and class. And that's not unusual for Richmond: It might be one of the few cities in the country that has a history of black leaders calling white liberals \"racists\" and of contending that progressive ideas hurt people of color. For example, black politicians in town, like Councilman Nat Bates, have fought for years against environmentalists who oppose Chevron's plans to expand its massive refinery. Bates and other black leaders in the city have contended that blocking Chevron could cost African-Americans jobs and hurt Richmond's economy.\u003c/p>\u003c/blockquote>\n\u003cp>From there, the Express examines individual members of the Richmond City Council and their positions on Measure N in detail -- and relates those positions to the larger political picture in the community. It's a fascinating read. In its wrap up, the Express sounds a cautionary note:\u003c/p>\n\u003cblockquote>\u003cp>... (T)he beverage industry discovered a winning formula in Richmond last year that it might be able to replicate elsewhere — an argument that the costs associated with taxes or governmental regulation on Big Business are \"regressive\" because they will merely be passed onto to low-income residents. And if that were to happen, it could drive a wedge through traditional Democratic constituencies in many communities, with blacks and Latinos opposing their longtime political allies — progressives and environmentalists — just like they did in Richmond.\u003c/p>\u003c/blockquote>\n\u003cp>It is with some irony then, that we look to news from New York City today. The beverage industry has filed suit against the city's limit on sizes of sugar sweetened beverages, which is set to go into effect in March. Yesterday, \u003ca href=\"http://ww2.kqed.org/stateofhealth/jp/quick-read-fight-over-bloombergs-soda-ban-reaches-courtroom/\" target=\"_blank\">the parties were in court\u003c/a> with the beverage industry asking a judge for a stay on the ban until the lawsuit can be resolved.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Now we learn that the beverage industry has a surprising friend in this fight: the NAACP. The civil rights group has filed an amicus brief in support of the lawsuit. From the \u003ca href=\"http://www.nytimes.com/2013/01/24/nyregion/fight-over-bloombergs-soda-ban-reaches-courtroom.html?ref=health\" target=\"_blank\">New York Times\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>In its brief, the N.A.A.C.P. conceded that obesity was a significant problem among blacks and Hispanics. But the group urged the city to create a more holistic program to attack the problem, including an increase in financing for physical education programs in public schools.\u003c/p>\n\u003cp>Mr. Bloomberg’s plan, the brief argued, would disproportionately hurt minority-owned small businesses, which faced competition from larger convenience stores like 7-Eleven that would be exempt from the soda restrictions because of a quirk in New York’s regulatory structure.\u003c/p>\n\u003cp>“At its worst, the ban arbitrarily discriminates against citizens and small-business owners in African-American and Hispanic communities,” the brief said.\u003c/p>\u003c/blockquote>\n\u003cp>\u003c/p>\n\u003cp>Public health advocates say \u003ca href=\"http://ww2.kqed.org/stateofhealth/2012/01/09/soda-tax-what-can-a-penny-do/\" target=\"_blank\">a soda tax is one useful lever\u003c/a> in the fight against obesity. Back in Richmond, the Express says now-retired Richmond city councilman Jeff Ritterman, who led the Measure N charge, is undeterred and talking about a possible statewide initiative.\u003c/p>\n\n",
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"excerpt": "The East Bay Express chose one heckuva startling headline for its article examining the fight over Measure N -- Richmond's penny-per-ounce tax on soda and sugar sweetened beverages that was defeated last November. \"Race Baiting in Richmond\" alleges that big business used race to fracture Richmond's progressive community in its ultimately successful campaign to defeat the tax.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_6672\" class=\"wp-caption alignleft\" style=\"max-width: 250px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2012/06/21/beverage-companies-blur-the-line-between-philanthropy-marketing/soda/\" rel=\"attachment wp-att-6672\">\u003cimg class=\"size-full wp-image-6672\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/06/soda.jpg\" alt=\" (La Piazza Pizzeria/Flickr)\" width=\"250\" height=\"250\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2012/06/soda.jpg 250w, https://ww2.kqed.org/app/uploads/sites/27/2012/06/soda-32x32.jpg 32w, https://ww2.kqed.org/app/uploads/sites/27/2012/06/soda-64x64.jpg 64w, https://ww2.kqed.org/app/uploads/sites/27/2012/06/soda-96x96.jpg 96w, https://ww2.kqed.org/app/uploads/sites/27/2012/06/soda-128x128.jpg 128w, https://ww2.kqed.org/app/uploads/sites/27/2012/06/soda-75x75.jpg 75w\" sizes=\"(max-width: 250px) 100vw, 250px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(La Piazza Pizzeria/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>The East Bay Express chose one heckuva startling headline for its article examining the fight over Measure N -- Richmond's penny-per-ounce tax on soda and sugar sweetened beverages that was defeated last November. \"\u003ca href=\"http://www.eastbayexpress.com/ebx/race-baiting-in-richmond/Content?oid=3441871&showFullText=true\" target=\"_blank\">Race Baiting in Richmond\u003c/a>\" alleges that big business used race to fracture Richmond's progressive community in its ultimately successful campaign to defeat the tax.\u003c/p>\n\u003cp>The lengthy and detailed article makes clear that race was already a factor in the anti-soda tax movement before the soda industry -- and its dollars -- arrived in Richmond last summer. From the East Bay Express:\u003c/p>\n\u003cblockquote>\u003cp>Some opponents of the tax had alleged that it was racist, arguing that it would unfairly harm low-income residents in the city. And the No on Measure N campaign, bankrolled by large corporations that make a fortune from selling cheap soda to low-income consumers, nurtured that sentiment. Indeed, there is evidence that the beverage association helped keep race at the forefront of the campaign as part of a strategy that exploited Richmond's existing tensions. And after spending at least $2.7 million — believed to be a record in East Bay politics — against Measure N, the beverage industry emerged victorious as the soda tax was beaten soundly.\u003c/p>\u003c/blockquote>\n\u003cp>\u003c!--more-->Meanwhile, proponents of the tax made arguments about how the tax would fund better health programs for Richmond low income children and teens, including plans to build more sports fields, but to little avail, says the Express:\u003c/p>\n\u003cblockquote>\u003cp>... (T)he health debate was ultimately drowned out in the election by arguments related to race and class. And that's not unusual for Richmond: It might be one of the few cities in the country that has a history of black leaders calling white liberals \"racists\" and of contending that progressive ideas hurt people of color. For example, black politicians in town, like Councilman Nat Bates, have fought for years against environmentalists who oppose Chevron's plans to expand its massive refinery. Bates and other black leaders in the city have contended that blocking Chevron could cost African-Americans jobs and hurt Richmond's economy.\u003c/p>\u003c/blockquote>\n\u003cp>From there, the Express examines individual members of the Richmond City Council and their positions on Measure N in detail -- and relates those positions to the larger political picture in the community. It's a fascinating read. In its wrap up, the Express sounds a cautionary note:\u003c/p>\n\u003cblockquote>\u003cp>... (T)he beverage industry discovered a winning formula in Richmond last year that it might be able to replicate elsewhere — an argument that the costs associated with taxes or governmental regulation on Big Business are \"regressive\" because they will merely be passed onto to low-income residents. And if that were to happen, it could drive a wedge through traditional Democratic constituencies in many communities, with blacks and Latinos opposing their longtime political allies — progressives and environmentalists — just like they did in Richmond.\u003c/p>\u003c/blockquote>\n\u003cp>It is with some irony then, that we look to news from New York City today. The beverage industry has filed suit against the city's limit on sizes of sugar sweetened beverages, which is set to go into effect in March. Yesterday, \u003ca href=\"http://ww2.kqed.org/stateofhealth/jp/quick-read-fight-over-bloombergs-soda-ban-reaches-courtroom/\" target=\"_blank\">the parties were in court\u003c/a> with the beverage industry asking a judge for a stay on the ban until the lawsuit can be resolved.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Now we learn that the beverage industry has a surprising friend in this fight: the NAACP. The civil rights group has filed an amicus brief in support of the lawsuit. From the \u003ca href=\"http://www.nytimes.com/2013/01/24/nyregion/fight-over-bloombergs-soda-ban-reaches-courtroom.html?ref=health\" target=\"_blank\">New York Times\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>In its brief, the N.A.A.C.P. conceded that obesity was a significant problem among blacks and Hispanics. But the group urged the city to create a more holistic program to attack the problem, including an increase in financing for physical education programs in public schools.\u003c/p>\n\u003cp>Mr. Bloomberg’s plan, the brief argued, would disproportionately hurt minority-owned small businesses, which faced competition from larger convenience stores like 7-Eleven that would be exempt from the soda restrictions because of a quirk in New York’s regulatory structure.\u003c/p>\n\u003cp>“At its worst, the ban arbitrarily discriminates against citizens and small-business owners in African-American and Hispanic communities,” the brief said.\u003c/p>\u003c/blockquote>\n\u003cp>\u003c/p>\n\u003cp>Public health advocates say \u003ca href=\"http://ww2.kqed.org/stateofhealth/2012/01/09/soda-tax-what-can-a-penny-do/\" target=\"_blank\">a soda tax is one useful lever\u003c/a> in the fight against obesity. Back in Richmond, the Express says now-retired Richmond city councilman Jeff Ritterman, who led the Measure N charge, is undeterred and talking about a possible statewide initiative.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Rural Husband and Wife Doctor Team Reflect on Careers in Medicine and Public Service",
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"content": "\u003cp>For more than three decades, Drs. Marcia and Oscar Sablan have served the tiny Central Valley town of Firebaugh. In an affectionate portrait today, the \u003cem>Los Angeles Times\u003c/em> describes a couple who made a plan to work for three years in a rural area and walk away from all their medical school debt. As Marcia Sablan mentioned last week in \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/01/17/in-fresno-the-road-to-health-reform-is-bumpy/\" target=\"_blank\">a panel discussion in Fresno\u003c/a>, she and her husband moved from Hawaii and arrived in Firebaugh in July on what turned out to be the hottest day of the year.\u003c/p>\n\u003cp>The couple never left Firebaugh, and today they are fixtures in the community. But what I found particularly interesting was the couple's recognition that medicine only goes so far, as reporter Anna Gorman describes in the \u003cem>Times\u003c/em> article:\u003c/p>\n\u003cblockquote>\u003cp>... (A)s they built up their medical practice, the Sablans say, they realized that they could do only so much in the exam room. For example, they would tell their diabetic patients to exercise, but there were few places to do so. So they turned to politics. \"I just saw that was the only way change could be made,\" says Marcia Sablan, who is still on the city council.\u003c!--more-->\u003c/p>\n\u003cp>During her time in city government, Sablan has helped get more affordable housing, parks and a walking path in the city. She also spearheaded the opening of a child care center. Her husband, who is also still on the school board, helped get sidewalks built near the schools so students could walk to campus.\u003c/p>\n\u003cp>\"What I do there is just as important but more far-reaching in terms of health outcomes,\" he says, \"than what I do taking care of the day-to-day patients.\"\u003c/p>\u003c/blockquote>\n\u003cp>Sidewalks, parks, walking paths. These are what policy types call the \"\u003ca href=\"http://ww2.kqed.org/stateofhealth/2012/01/31/if-we-build-it-will-people-be-more-healthy/\" target=\"_blank\">built environment\u003c/a>.\" And as the Sablans have found, what we build can contribute immeasurably to our overall health.\u003c/p>\n\u003cp> \u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n",
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"excerpt": "For more than three decades, Drs. Marcia and Oscar Sablan have served the tiny Central Valley town of Firebaugh. In an affectionate portrait today, the Los Angeles Times describes a couple who made a plan to work for three years in a rural area and walk away from all their medical school debt. As Marcia Sablan mentioned last week in a panel discussion in Fresno, the couple moved from Hawaii and arrived in Firebaugh in July on what turned out to be the hottest day of the year.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>For more than three decades, Drs. Marcia and Oscar Sablan have served the tiny Central Valley town of Firebaugh. In an affectionate portrait today, the \u003cem>Los Angeles Times\u003c/em> describes a couple who made a plan to work for three years in a rural area and walk away from all their medical school debt. As Marcia Sablan mentioned last week in \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/01/17/in-fresno-the-road-to-health-reform-is-bumpy/\" target=\"_blank\">a panel discussion in Fresno\u003c/a>, she and her husband moved from Hawaii and arrived in Firebaugh in July on what turned out to be the hottest day of the year.\u003c/p>\n\u003cp>The couple never left Firebaugh, and today they are fixtures in the community. But what I found particularly interesting was the couple's recognition that medicine only goes so far, as reporter Anna Gorman describes in the \u003cem>Times\u003c/em> article:\u003c/p>\n\u003cblockquote>\u003cp>... (A)s they built up their medical practice, the Sablans say, they realized that they could do only so much in the exam room. For example, they would tell their diabetic patients to exercise, but there were few places to do so. So they turned to politics. \"I just saw that was the only way change could be made,\" says Marcia Sablan, who is still on the city council.\u003c!--more-->\u003c/p>\n\u003cp>During her time in city government, Sablan has helped get more affordable housing, parks and a walking path in the city. She also spearheaded the opening of a child care center. Her husband, who is also still on the school board, helped get sidewalks built near the schools so students could walk to campus.\u003c/p>\n\u003cp>\"What I do there is just as important but more far-reaching in terms of health outcomes,\" he says, \"than what I do taking care of the day-to-day patients.\"\u003c/p>\u003c/blockquote>\n\u003cp>Sidewalks, parks, walking paths. These are what policy types call the \"\u003ca href=\"http://ww2.kqed.org/stateofhealth/2012/01/31/if-we-build-it-will-people-be-more-healthy/\" target=\"_blank\">built environment\u003c/a>.\" And as the Sablans have found, what we build can contribute immeasurably to our overall health.\u003c/p>\n\u003cp> \u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Assembly Bill Seeks to Increase Number of Abortion Providers",
"title": "Assembly Bill Seeks to Increase Number of Abortion Providers",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_10098\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/01/22/assembly-bill-seeks-to-increase-number-of-abortion-providers/screen-shot-2013-01-22-at-4-08-57-pm/\" rel=\"attachment wp-att-10098\">\u003cimg class=\"size-large wp-image-10098\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/01/Screen-Shot-2013-01-22-at-4.08.57-PM-620x324.png\" alt=\"Regulations around abortion providers in the U.S. (American Journal of Public Health)\" width=\"620\" height=\"324\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Regulations around abortion providers in the U.S. (American Journal of Public Health)\u003c/figcaption>\u003c/figure>\n\u003cp>Tuesday afternoon, on the 40th anniversary of Roe v. Wade, a group of state lawmakers and women's advocates announced the introduction of a bill in the California Legislature aimed at expanding a woman's access to abortion. Currently in California, only physicians are authorized to conduct early abortions. This new bill, AB 154, would authorize other clinicians -- specially-trained nurse practitioners, certified nurse midwives and physician assistants -- to perform early abortions.\u003c/p>\n\u003cp>\"As a former administrator of a health clinic, I know how important timely care is for women,\" Assemblymember Toni Atkins (D-San Diego), author of AB 154, said in a statement. \"This bill will ensure that early abortion care will be available for women in California who need it.\"\u003c/p>\n\u003cp>Four other states permit nonphysician clinicians to perform early abortions. Still, clinical evidence of safety had been lacking. Last week, a \u003ca href=\"http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2012.301159\" target=\"_blank\">new study\u003c/a> led by researchers at UCSF showed that early abortions performed by trained nurse practitioners, certified nurse midwives and physician assistants are \"clinically equivalent\" to those performed by physicians.\u003c/p>\n\u003cp>\"Early abortion is safer than we thought overall, and there's no difference in the complication rate between the two groups,\" said lead author Tracy Weitz, UCSF professor of obstetrics and gynecology. The research team found a two percent complication rate -- below the four percent rate they had expected. Complications were mostly minor.\u003c/p>\n\u003cp>In the study, published online by the American Journal of Public Health, researchers received a waiver from the state of California to permit training of nurse practitioners, certified nurse midwives and physician assistants to perform what are called surgical or aspiration abortions. Altogether, researchers analyzed more than 11,000 procedures.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>These nonphysician providers are already authorized in California to prescribe medications that can induce an abortion.\u003c/p>\n\u003cp>Access to an abortion provider is a significant issue across much of the country. \u003ca href=\"http://onlinelibrary.wiley.com/doi/10.1363/4304111/abstract\" target=\"_blank\">According to the Guttmacher Institute\u003c/a>, 87 percent of counties in the U.S. lack an abortion provider. In California, 22 percent of counties lack a provider, but only about one percent of women of reproductive age live in those counties. Overall, 54 of California's 58 counties lack what Guttmacher calls a \"regular provider\" of abortions. The institute defined \"regular\" as a facility where 400 or more abortions are performed annually. \"Facilities that do fewer than 400 abortions per year are less likely to advertise, and women may not know that abortion services are available at these facilities,\" says Rachel Jones, the Guttmacher researcher who crunched the California numbers.\u003c/p>\n\u003cp>Amy Everitt, executive director of NARAL Pro-Choice California, an advocacy group promoting the bill, says some women may have to travel five hours to seek care. \"These barriers to accessing care can force women to delay abortions into advanced stages of pregnancy which can result in a more complicated procedure,\" she said.\u003c/p>\n\u003cp>Nationally, 92 percent of abortions take place in the first trimester. In California, among women who receive Medi-Cal, the health insurance program for the poor, the first trimester abortion rate falls to 87 percent, meaning that many women delay getting an abortion putting them at risk of higher complication rates. Researchers believe that increasing providers is one way to alleviate the disparity.\u003c/p>\n\u003cp>The language of AB 154 will be worked out in the coming weeks. The \"spot bill\" language is brief: \"It is the intent of the legislature to enact legislation that would expand access to reproductive health care in CA by allowing qualified health care professionals to perform early abortions, provided that the functions are within the scope of their licenses.\"\u003c/p>\n\u003cp>Weitz, the UCSF author of the study, pointed out that while abortion is a socially complicated question, it is not a \u003cem>medically\u003c/em> complicated one. \"We often want to regulate abortion as if we want to solve its social complexity,\" she told me. \"The take home from our study is it's incredibly safe and that it can be offered in an outpatient facility by either physicians, nurse practitioners, certified nurse midwives or physician assistants. Women can feel safe that the care is high quality.\"\u003c/p>\n\u003cp>Everitt acknowledged that a social goal is for California to be a \"harbinger\" for change. \"We do hope that other states will pay attention and will broaden access to care.\"\u003c/p>\n\u003cp>\u003cem>This post was updated to clarify why 400 abortions per year is the study's threshold to be defined as a \"regular provider\" of abortions.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Learn More\u003c/strong>: \u003ca href=\"http://www.sacbee.com/2013/01/23/5133981/democratic-lawmakers-revive-california.html\" target=\"_blank\">Democratic Lawmakers Revive California Bill on Early Abortion Providers \u003c/a>(Sacramento Bee)\u003c/p>\n\n",
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"excerpt": "Tuesday afternoon, on the 40th anniversary of Roe vs. Wade, a group of state lawmakers and women's advocates announced the introduction of a bill in the California legislature aimed at expanding a woman's access to abortion. Currently in California, only physicians are authorized to conduct early abortions. This new bill, AB 154, would authorize other clinicians -- specially-trained nurse practitioners, certified nurse midwives and physician assistants -- to perform early abortions.\r\n\r\n\"As a former administrator of a health clinic, I know how important timely care is for women,\" Assemblymember Toni Atkins (D-San Diego), author of AB 154, said in a statement. \"This bill will ensure that early abortion care will be available for women in California who need it.\"",
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"description": "Tuesday afternoon, on the 40th anniversary of Roe vs. Wade, a group of state lawmakers and women's advocates announced the introduction of a bill in the California legislature aimed at expanding a woman's access to abortion. Currently in California, only physicians are authorized to conduct early abortions. This new bill, AB 154, would authorize other clinicians -- specially-trained nurse practitioners, certified nurse midwives and physician assistants -- to perform early abortions.\r\n\r\n"As a former administrator of a health clinic, I know how important timely care is for women," Assemblymember Toni Atkins (D-San Diego), author of AB 154, said in a statement. "This bill will ensure that early abortion care will be available for women in California who need it."",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_10098\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/01/22/assembly-bill-seeks-to-increase-number-of-abortion-providers/screen-shot-2013-01-22-at-4-08-57-pm/\" rel=\"attachment wp-att-10098\">\u003cimg class=\"size-large wp-image-10098\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/01/Screen-Shot-2013-01-22-at-4.08.57-PM-620x324.png\" alt=\"Regulations around abortion providers in the U.S. (American Journal of Public Health)\" width=\"620\" height=\"324\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Regulations around abortion providers in the U.S. (American Journal of Public Health)\u003c/figcaption>\u003c/figure>\n\u003cp>Tuesday afternoon, on the 40th anniversary of Roe v. Wade, a group of state lawmakers and women's advocates announced the introduction of a bill in the California Legislature aimed at expanding a woman's access to abortion. Currently in California, only physicians are authorized to conduct early abortions. This new bill, AB 154, would authorize other clinicians -- specially-trained nurse practitioners, certified nurse midwives and physician assistants -- to perform early abortions.\u003c/p>\n\u003cp>\"As a former administrator of a health clinic, I know how important timely care is for women,\" Assemblymember Toni Atkins (D-San Diego), author of AB 154, said in a statement. \"This bill will ensure that early abortion care will be available for women in California who need it.\"\u003c/p>\n\u003cp>Four other states permit nonphysician clinicians to perform early abortions. Still, clinical evidence of safety had been lacking. Last week, a \u003ca href=\"http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2012.301159\" target=\"_blank\">new study\u003c/a> led by researchers at UCSF showed that early abortions performed by trained nurse practitioners, certified nurse midwives and physician assistants are \"clinically equivalent\" to those performed by physicians.\u003c/p>\n\u003cp>\"Early abortion is safer than we thought overall, and there's no difference in the complication rate between the two groups,\" said lead author Tracy Weitz, UCSF professor of obstetrics and gynecology. The research team found a two percent complication rate -- below the four percent rate they had expected. Complications were mostly minor.\u003c/p>\n\u003cp>In the study, published online by the American Journal of Public Health, researchers received a waiver from the state of California to permit training of nurse practitioners, certified nurse midwives and physician assistants to perform what are called surgical or aspiration abortions. Altogether, researchers analyzed more than 11,000 procedures.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>These nonphysician providers are already authorized in California to prescribe medications that can induce an abortion.\u003c/p>\n\u003cp>Access to an abortion provider is a significant issue across much of the country. \u003ca href=\"http://onlinelibrary.wiley.com/doi/10.1363/4304111/abstract\" target=\"_blank\">According to the Guttmacher Institute\u003c/a>, 87 percent of counties in the U.S. lack an abortion provider. In California, 22 percent of counties lack a provider, but only about one percent of women of reproductive age live in those counties. Overall, 54 of California's 58 counties lack what Guttmacher calls a \"regular provider\" of abortions. The institute defined \"regular\" as a facility where 400 or more abortions are performed annually. \"Facilities that do fewer than 400 abortions per year are less likely to advertise, and women may not know that abortion services are available at these facilities,\" says Rachel Jones, the Guttmacher researcher who crunched the California numbers.\u003c/p>\n\u003cp>Amy Everitt, executive director of NARAL Pro-Choice California, an advocacy group promoting the bill, says some women may have to travel five hours to seek care. \"These barriers to accessing care can force women to delay abortions into advanced stages of pregnancy which can result in a more complicated procedure,\" she said.\u003c/p>\n\u003cp>Nationally, 92 percent of abortions take place in the first trimester. In California, among women who receive Medi-Cal, the health insurance program for the poor, the first trimester abortion rate falls to 87 percent, meaning that many women delay getting an abortion putting them at risk of higher complication rates. Researchers believe that increasing providers is one way to alleviate the disparity.\u003c/p>\n\u003cp>The language of AB 154 will be worked out in the coming weeks. The \"spot bill\" language is brief: \"It is the intent of the legislature to enact legislation that would expand access to reproductive health care in CA by allowing qualified health care professionals to perform early abortions, provided that the functions are within the scope of their licenses.\"\u003c/p>\n\u003cp>Weitz, the UCSF author of the study, pointed out that while abortion is a socially complicated question, it is not a \u003cem>medically\u003c/em> complicated one. \"We often want to regulate abortion as if we want to solve its social complexity,\" she told me. \"The take home from our study is it's incredibly safe and that it can be offered in an outpatient facility by either physicians, nurse practitioners, certified nurse midwives or physician assistants. Women can feel safe that the care is high quality.\"\u003c/p>\n\u003cp>Everitt acknowledged that a social goal is for California to be a \"harbinger\" for change. \"We do hope that other states will pay attention and will broaden access to care.\"\u003c/p>\n\u003cp>\u003cem>This post was updated to clarify why 400 abortions per year is the study's threshold to be defined as a \"regular provider\" of abortions.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Learn More\u003c/strong>: \u003ca href=\"http://www.sacbee.com/2013/01/23/5133981/democratic-lawmakers-revive-california.html\" target=\"_blank\">Democratic Lawmakers Revive California Bill on Early Abortion Providers \u003c/a>(Sacramento Bee)\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "In Fresno, the Road to Health Reform Is Bumpy",
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"content": "\u003cfigure id=\"attachment_10049\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/01/FresnoSign_CharlesNadeau_Flickr.jpg\">\u003cimg class=\"size-medium wp-image-10049\" title=\"Fresno Sign (Charles Nadeau/Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/01/FresnoSign_CharlesNadeau_Flickr-300x198.jpg\" alt=\"\" width=\"300\" height=\"198\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Charles Nadeau/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>The greater Fresno area may be the most challenging region in California to implement the health care overhaul. Earlier this week a panel of experts gathered at Fresno State to review the issues and consider a path forward. Funding is always a problem, and Fresno is no exception. But in Fresno, collaboration seems to be an even bigger stumbling block.\u003c/p>\n\u003cp>Peter Cunningham, with the Center for Studying Health Systems Change, first outlined findings from a \u003ca href=\"http://www.chcf.org/publications/2012/12/regional-market-fresno\" target=\"_blank\">regional study\u003c/a>. For starters, the region encompasses a huge geographic area: five counties (Fresno, Tulare, Kings, Madera and Mariposa) stretch across 16,000 square miles and comprise both urban and very remote rural areas.\u003c/p>\n\u003cp>In addition to this geographic challenge, the region also faces:\u003c/p>\n\u003cul>\n\u003cli>High poverty and high uninsurance rates -- as well as a high number of undocumented residents -- people who are excluded from the benefits of Affordable Care Act, but will still need health care\u003c/li>\n\u003cli>Severe, chronic physician shortages\u003c/li>\n\u003cli>Structural or bureaucratic barriers to reform, specifically a 30-year contract between one hospital and Fresno County to provide care for the poor\u003c/li>\n\u003c/ul>\n\u003caside class=\"pullquote alignright\">\"There is no health care policy in Fresno County. We're in a position of haphazardly approaching this.\"\u003c/aside>\n\u003cp>After Cunningham's presentation, the discussion started off on a note everyone could agree on: more doctors are urgently needed. The region has 118 doctors per 100,000 people, about one-third below the state average of 174.\u003c/p>\n\u003cp> \u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>\"We need to recruit in the triple digits,\" said Stacy Vaillancourt, with St. Agnes Medical Center. \"People turn to the ER. They don't have primary care. There is a huge access problem.\"\u003c/p>\n\u003cp>To get to triple-digit recruiting, you need to start somewhere. One emphasis is recruiting graduating medical students for residency training in Fresno, because physicians often stay in the communities where they complete their residencies. The Fresno Health Community Access Partners (FHCAP) has received federal approval to start a program to train family practice residents.\u003c/p>\n\u003cp>The group is approved to recruit four doctors for each of the next three years. That sounds like a start -- 12 doctors coming to Fresno in the near future. Yet the program is only funded for three years while a medical residency typically runs three or four years.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"We can tell these kids today that they'll get their full three years,\" said Stephen Schilling, CEO of Clinica Sierra Vista. \"I don't know what we'll them them next year.\"\u003c/p>\n\u003cdiv>\n\u003cp>Then in a line that got a laugh from the audience, Schilling added, \"We'll be coming after you -- all you hospitals, all you practices, we'll be coming to you to help pony up for to help fund this for the long haul.\"\u003c/p>\n\u003cp>But once the physician supply discussion was dispensed with, tension started to build. Fresno is one of just three counties in California to decline to set up a \u003ca href=\"http://ww2.kqed.org/stateofhealth/2012/11/05/sacramento-county-expands-medi-cal-but-only-the-poorest-will-benefit/\" target=\"_blank\">Low Income Health Program\u003c/a>. The LIHP program gives counties access to federal funds ahead of the Medicaid expansion coming with the Affordable Care Act next January 1.\u003c/p>\n\u003cp>But even with the federal funds, money is needed at the county level. Dr. Edward Moreno, director of the Fresno County Department of Public Health, said that the county passed on the LIHP because it could allocate $20 million, and it \"wasn't enough to cover costs.\"\u003c/p>\n\u003cp>On this point, Norma Forbes of Fresno Health Community Access Partners promptly disagreed with Moreno. \"There is no health care policy in Fresno County,\" Forbes pointedly said. \"We're in a position of haphazardly approaching this. It's not an organized, not a collaborative approach.\"\u003c/p>\n\u003cp>One of the most obvious places where collaboration has been a challenge is the 30-year contract between Community Medical Centers (CMC) and Fresno County to provide indigent care. That contract still has more than a decade remaining on it. Cunningham's report identified a \"stalemate\" between CMC and Fresno County over modifying the contract which \"stymied\" LIHP development.\u003c/p>\n\u003cp>\"Each side has a position on the 30-year contract,\" Schilling said. \"It's just unfortunate that the parties that needed to ... couldn't come up with an agreement.\"\u003c/p>\n\u003cp>And that lack of collaboration is hampering overall efforts to plan for reform, as noted in Cunningham's report, which was prepared for the California HealthCare Foundation, one of the sponsors of the Fresno event:\u003c/p>\n\u003cblockquote>\u003cp>County governments and providers were doing little coordinated community-wide planning for health reform despite the importance of coverage expansions for this region and the large number of undocumented immigrants who will be ineligible to transition into Medi-Cal in 2014.\u003c/p>\u003c/blockquote>\n\u003cp>As the discussion wrapped up, Cunningham pointed out that even with the expansion of Medi-Cal, California's version of Medicaid, the Fresno area will still have a lot of uninsured, and he estimates one-third to one-half of those uninsured will be undocumented immigrants.\u003c/p>\n\u003cp>\"The county is still going to have that responsibility of caring for the indigent who do not qualify for the ACA expansions,\" Cunningham said. \"The challenge will be trying to fold them in within the changes that are happening in the Medi-Cal expansion.\"\u003c/p>\n\u003cp>Schilling, who is from Kern County, encouraged Fresno to \"get moving down the highway, so you're not left behind the 8-ball come next year.\"\u003c/p>\n\u003c/div>\n\n",
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"excerpt": "The greater Fresno area may be the most challenging region in California to implement the health care overhaul. Earlier this week a panel of experts gathered at Fresno State to review the issues and consider a path forward. Funding is always a problem, and Fresno is no exception. But in Fresno, collaboration seems to be an even bigger stumbling block.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_10049\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/01/FresnoSign_CharlesNadeau_Flickr.jpg\">\u003cimg class=\"size-medium wp-image-10049\" title=\"Fresno Sign (Charles Nadeau/Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/01/FresnoSign_CharlesNadeau_Flickr-300x198.jpg\" alt=\"\" width=\"300\" height=\"198\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Charles Nadeau/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>The greater Fresno area may be the most challenging region in California to implement the health care overhaul. Earlier this week a panel of experts gathered at Fresno State to review the issues and consider a path forward. Funding is always a problem, and Fresno is no exception. But in Fresno, collaboration seems to be an even bigger stumbling block.\u003c/p>\n\u003cp>Peter Cunningham, with the Center for Studying Health Systems Change, first outlined findings from a \u003ca href=\"http://www.chcf.org/publications/2012/12/regional-market-fresno\" target=\"_blank\">regional study\u003c/a>. For starters, the region encompasses a huge geographic area: five counties (Fresno, Tulare, Kings, Madera and Mariposa) stretch across 16,000 square miles and comprise both urban and very remote rural areas.\u003c/p>\n\u003cp>In addition to this geographic challenge, the region also faces:\u003c/p>\n\u003cul>\n\u003cli>High poverty and high uninsurance rates -- as well as a high number of undocumented residents -- people who are excluded from the benefits of Affordable Care Act, but will still need health care\u003c/li>\n\u003cli>Severe, chronic physician shortages\u003c/li>\n\u003cli>Structural or bureaucratic barriers to reform, specifically a 30-year contract between one hospital and Fresno County to provide care for the poor\u003c/li>\n\u003c/ul>\n\u003caside class=\"pullquote alignright\">\"There is no health care policy in Fresno County. We're in a position of haphazardly approaching this.\"\u003c/aside>\n\u003cp>After Cunningham's presentation, the discussion started off on a note everyone could agree on: more doctors are urgently needed. The region has 118 doctors per 100,000 people, about one-third below the state average of 174.\u003c/p>\n\u003cp> \u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>\"We need to recruit in the triple digits,\" said Stacy Vaillancourt, with St. Agnes Medical Center. \"People turn to the ER. They don't have primary care. There is a huge access problem.\"\u003c/p>\n\u003cp>To get to triple-digit recruiting, you need to start somewhere. One emphasis is recruiting graduating medical students for residency training in Fresno, because physicians often stay in the communities where they complete their residencies. The Fresno Health Community Access Partners (FHCAP) has received federal approval to start a program to train family practice residents.\u003c/p>\n\u003cp>The group is approved to recruit four doctors for each of the next three years. That sounds like a start -- 12 doctors coming to Fresno in the near future. Yet the program is only funded for three years while a medical residency typically runs three or four years.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"We can tell these kids today that they'll get their full three years,\" said Stephen Schilling, CEO of Clinica Sierra Vista. \"I don't know what we'll them them next year.\"\u003c/p>\n\u003cdiv>\n\u003cp>Then in a line that got a laugh from the audience, Schilling added, \"We'll be coming after you -- all you hospitals, all you practices, we'll be coming to you to help pony up for to help fund this for the long haul.\"\u003c/p>\n\u003cp>But once the physician supply discussion was dispensed with, tension started to build. Fresno is one of just three counties in California to decline to set up a \u003ca href=\"http://ww2.kqed.org/stateofhealth/2012/11/05/sacramento-county-expands-medi-cal-but-only-the-poorest-will-benefit/\" target=\"_blank\">Low Income Health Program\u003c/a>. The LIHP program gives counties access to federal funds ahead of the Medicaid expansion coming with the Affordable Care Act next January 1.\u003c/p>\n\u003cp>But even with the federal funds, money is needed at the county level. Dr. Edward Moreno, director of the Fresno County Department of Public Health, said that the county passed on the LIHP because it could allocate $20 million, and it \"wasn't enough to cover costs.\"\u003c/p>\n\u003cp>On this point, Norma Forbes of Fresno Health Community Access Partners promptly disagreed with Moreno. \"There is no health care policy in Fresno County,\" Forbes pointedly said. \"We're in a position of haphazardly approaching this. It's not an organized, not a collaborative approach.\"\u003c/p>\n\u003cp>One of the most obvious places where collaboration has been a challenge is the 30-year contract between Community Medical Centers (CMC) and Fresno County to provide indigent care. That contract still has more than a decade remaining on it. Cunningham's report identified a \"stalemate\" between CMC and Fresno County over modifying the contract which \"stymied\" LIHP development.\u003c/p>\n\u003cp>\"Each side has a position on the 30-year contract,\" Schilling said. \"It's just unfortunate that the parties that needed to ... couldn't come up with an agreement.\"\u003c/p>\n\u003cp>And that lack of collaboration is hampering overall efforts to plan for reform, as noted in Cunningham's report, which was prepared for the California HealthCare Foundation, one of the sponsors of the Fresno event:\u003c/p>\n\u003cblockquote>\u003cp>County governments and providers were doing little coordinated community-wide planning for health reform despite the importance of coverage expansions for this region and the large number of undocumented immigrants who will be ineligible to transition into Medi-Cal in 2014.\u003c/p>\u003c/blockquote>\n\u003cp>As the discussion wrapped up, Cunningham pointed out that even with the expansion of Medi-Cal, California's version of Medicaid, the Fresno area will still have a lot of uninsured, and he estimates one-third to one-half of those uninsured will be undocumented immigrants.\u003c/p>\n\u003cp>\"The county is still going to have that responsibility of caring for the indigent who do not qualify for the ACA expansions,\" Cunningham said. \"The challenge will be trying to fold them in within the changes that are happening in the Medi-Cal expansion.\"\u003c/p>\n\u003cp>Schilling, who is from Kern County, encouraged Fresno to \"get moving down the highway, so you're not left behind the 8-ball come next year.\"\u003c/p>\n\u003c/div>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_10013\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/01/Gun-Violence_Caheri-Gutierrez.jpg\">\u003cimg class=\"size-medium wp-image-10013\" title=\"Gun-Violence_Caheri-Gutierrez\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/01/Gun-Violence_Caheri-Gutierrez-300x225.jpg\" alt=\"Caheri Gutierrez, before the shooting.\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Caheri Gutierrez, before the shooting.\u003c/figcaption>\u003c/figure>\n\u003cp>Last weekend was an especially violent one, even for Oakland. On Friday, four people were killed, and over the rest of the weekend, 11 people were shot, though not fatally. There were \u003ca href=\"http://www2.oaklandnet.com/oakca1/groups/police/documents/webcontent/oak039293.pdf\" target=\"_blank\">126 homicides\u003c/a> [PDF] in Oakland last year, cementing the city's distinction as one of California's more violent urban centers. Oakland certainly doesn't have a lock on gun violence. Other cities like Stockton are struggling, too. But the situation in Oakland has been going on for some time now, and locals are giving a lot of thought to what it means to live under the constant threat of violence.\u003c/p>\n\u003cp>As part of KQED's occasional series, \"\u003ca href=\"http://www.californiareport.org/specialcoverage/whatsyourstory/index.jsp\" target=\"_blank\">What's Your Story\u003c/a>,\" Oakland native Caheri Gutierrez (pronounced \"Carrie\") shares her story about working with at-risk high schools students after she herself was shot in the face as a teenager. Guiterrez is a Violence Prevention Educator for \u003ca href=\"http://www.youthalive.org/\" target=\"_blank\">Youth Alive\u003c/a>, an Oakland non-profit with a mission to prevent youth violence. Below are excerpts of my conversation with her:\u003c/p>\n\u003caside class=\"pullquote alignright\">\"'They shot you. They shot you.’ I touched my face and my hand just went inside of my face.\"\u003c/aside>\n\u003cp>\"I was just in the car and all of a sudden I started to feel like I was getting electrified. It was really intense shocks from the top of my head to the bottom of my feet. The guy that was driving, my friend, starts screaming that he’s been shot.\u003c!--more-->\u003c/p>\n\u003cp>I reached over to him to try to help his hand and that’s when he looked at me, and he was like, ‘Oh my God, Caheri. It’s you. They shot you. They shot you.’ I touched my face and my hand just went inside of my face.\u003c/p>\n\u003cp>Five days later, I wake up at Highland Hospital and my hands are tied to the hospital bed. I have tubes coming in and out of my nose and out of my mouth. It was hard.\u003c/p>\n\u003cfigure id=\"attachment_10014\" class=\"wp-caption alignright\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/01/Caheri-Guiterrez-xray.jpg\">\u003cimg class=\"size-medium wp-image-10014\" title=\"Caheri-Guiterrez-xray\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/01/Caheri-Guiterrez-xray-300x240.jpg\" alt=\"An x-ray of Caheri Guiterrez's jaw soon after she was admitted to Oakland's Highland Hospital.\" width=\"300\" height=\"240\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">An x-ray of Caheri Guiterrez's jaw soon after she was admitted to Oakland's Highland Hospital.\u003c/figcaption>\u003c/figure>\n\u003cp>Some of my family members are, you know, gang-related, and so is my brother. And I remember my uncle asking my brother, ‘Who did it? Where are they from? What are we going to do? Are we going to get them?’And things like that. I couldn’t talk but I was just like, ‘NO. This cannot happen to anybody else.’\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>While I was at the hospital I was connected with an intervention specialist. Her name was Tammy Cloud. I got out of the hospital a month later. And Tammy comes to my house and she was like, ‘I think you should come to this program and talk to the high school students about getting shot and how you think about life now.’\u003c/p>\n\u003cp>Besides my personal story, I teach them a curriculum about violence. It makes me feel like I make a difference. It makes me feel very hopeful because I am a victim to the violence that happens in Oakland. And I’m one of the many victims. And when you talk to someone and you can give them an example of what can happen, I think they really soak that in and they think twice about hanging out with people who are gang-related, or even picking up a gun. Ever since then, honestly, I feel like getting shot happened for a reason.\"\u003c/p>\n\u003cp>\u003cstrong>MORE:\u003c/strong>\u003c/p>\n\u003cp>\u003cem>Listen to Caheri Gutierrez's story:\u003c/em>\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/R201301140850b.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/R201301140850b.xml\">\u003c/embed>\u003c/object>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>You can also read\u003c/em> \u003ca href=\"http://caherigtz.blogspot.com/\" target=\"_blank\">Caheri Guiterrez's blog\u003c/a>.\u003c/p>\n\n",
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"excerpt": "As part of KQED's occasional series, \"What's Your Story,\" Oakland native Caheri Gutierrez shares her story about working with at-risk high schools students after she herself was shot in the face as a teenager. Guiterrez is a Violence Prevention Educator for Youth Alive, an Oakland non-profit with a mission to prevent youth violence. Below are excerpts of our conversation:",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_10013\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/01/Gun-Violence_Caheri-Gutierrez.jpg\">\u003cimg class=\"size-medium wp-image-10013\" title=\"Gun-Violence_Caheri-Gutierrez\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/01/Gun-Violence_Caheri-Gutierrez-300x225.jpg\" alt=\"Caheri Gutierrez, before the shooting.\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Caheri Gutierrez, before the shooting.\u003c/figcaption>\u003c/figure>\n\u003cp>Last weekend was an especially violent one, even for Oakland. On Friday, four people were killed, and over the rest of the weekend, 11 people were shot, though not fatally. There were \u003ca href=\"http://www2.oaklandnet.com/oakca1/groups/police/documents/webcontent/oak039293.pdf\" target=\"_blank\">126 homicides\u003c/a> [PDF] in Oakland last year, cementing the city's distinction as one of California's more violent urban centers. Oakland certainly doesn't have a lock on gun violence. Other cities like Stockton are struggling, too. But the situation in Oakland has been going on for some time now, and locals are giving a lot of thought to what it means to live under the constant threat of violence.\u003c/p>\n\u003cp>As part of KQED's occasional series, \"\u003ca href=\"http://www.californiareport.org/specialcoverage/whatsyourstory/index.jsp\" target=\"_blank\">What's Your Story\u003c/a>,\" Oakland native Caheri Gutierrez (pronounced \"Carrie\") shares her story about working with at-risk high schools students after she herself was shot in the face as a teenager. Guiterrez is a Violence Prevention Educator for \u003ca href=\"http://www.youthalive.org/\" target=\"_blank\">Youth Alive\u003c/a>, an Oakland non-profit with a mission to prevent youth violence. Below are excerpts of my conversation with her:\u003c/p>\n\u003caside class=\"pullquote alignright\">\"'They shot you. They shot you.’ I touched my face and my hand just went inside of my face.\"\u003c/aside>\n\u003cp>\"I was just in the car and all of a sudden I started to feel like I was getting electrified. It was really intense shocks from the top of my head to the bottom of my feet. The guy that was driving, my friend, starts screaming that he’s been shot.\u003c!--more-->\u003c/p>\n\u003cp>I reached over to him to try to help his hand and that’s when he looked at me, and he was like, ‘Oh my God, Caheri. It’s you. They shot you. They shot you.’ I touched my face and my hand just went inside of my face.\u003c/p>\n\u003cp>Five days later, I wake up at Highland Hospital and my hands are tied to the hospital bed. I have tubes coming in and out of my nose and out of my mouth. It was hard.\u003c/p>\n\u003cfigure id=\"attachment_10014\" class=\"wp-caption alignright\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/01/Caheri-Guiterrez-xray.jpg\">\u003cimg class=\"size-medium wp-image-10014\" title=\"Caheri-Guiterrez-xray\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/01/Caheri-Guiterrez-xray-300x240.jpg\" alt=\"An x-ray of Caheri Guiterrez's jaw soon after she was admitted to Oakland's Highland Hospital.\" width=\"300\" height=\"240\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">An x-ray of Caheri Guiterrez's jaw soon after she was admitted to Oakland's Highland Hospital.\u003c/figcaption>\u003c/figure>\n\u003cp>Some of my family members are, you know, gang-related, and so is my brother. And I remember my uncle asking my brother, ‘Who did it? Where are they from? What are we going to do? Are we going to get them?’And things like that. I couldn’t talk but I was just like, ‘NO. This cannot happen to anybody else.’\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>While I was at the hospital I was connected with an intervention specialist. Her name was Tammy Cloud. I got out of the hospital a month later. And Tammy comes to my house and she was like, ‘I think you should come to this program and talk to the high school students about getting shot and how you think about life now.’\u003c/p>\n\u003cp>Besides my personal story, I teach them a curriculum about violence. It makes me feel like I make a difference. It makes me feel very hopeful because I am a victim to the violence that happens in Oakland. And I’m one of the many victims. And when you talk to someone and you can give them an example of what can happen, I think they really soak that in and they think twice about hanging out with people who are gang-related, or even picking up a gun. Ever since then, honestly, I feel like getting shot happened for a reason.\"\u003c/p>\n\u003cp>\u003cstrong>MORE:\u003c/strong>\u003c/p>\n\u003cp>\u003cem>Listen to Caheri Gutierrez's story:\u003c/em>\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/R201301140850b.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/R201301140850b.xml\">\u003c/embed>\u003c/object>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>You can also read\u003c/em> \u003ca href=\"http://caherigtz.blogspot.com/\" target=\"_blank\">Caheri Guiterrez's blog\u003c/a>.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "UCLA Researchers Find Links Between Parkinson's Disease and Pesticides",
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"content": "\u003cp>By Sasha Khokha, KQED News Central Valley Bureau Chief\u003c/p>\n\u003cp>A \u003ca href=\"http://www.pnas.org/content/early/2012/12/19/1220399110.abstract\" target=\"_blank\">new study\u003c/a> from UCLA is the latest addition to a growing body of research linking pesticides and Parkinson’s disease.\u003c/p>\n\u003cp>UCLA neurologists examined hundreds of Parkinson’s patients in the Central Valley, where rural residents may have been exposed to a fungicide called benomyl. It was widely used on crops like almonds, apples, and berries before the EPA banned it a decade ago.\u003c/p>\n\u003cp>The study finds the pesticide triggered cellular changes, preventing a key enzyme from keeping check on a naturally occurring toxin that damages neurons in the brain.\u003c/p>\n\u003cp>But more importantly, researchers found that process may be at play even in Parkinson’s patients who have \u003cem>not\u003c/em> been exposed to pesticides. \"So it’s really the mechanism by which it works that is of particular interest to us,\" UCLA neurology professor Dr. Jeff Bronstein told me, \"because we think there are going to be other things in the environment -- and other genetic variations -- that may lead us to one of the causes of Parkinson’s disease.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Here's more from the \u003ca href=\"http://newsroom.ucla.edu/portal/ucla/pesticides-and-parkinson-s-more-242364.aspx\" target=\"_blank\">UCLA press release\u003c/a>:\u003c/p>\n\u003cblockquote>\n\u003cdiv>Benomyl exposure, they say, starts a cascade of cellular events that may lead to Parkinson's. The pesticide prevents an enzyme called ALDH (aldehyde dehydrogenase) from keeping a lid on DOPAL, a toxin that naturally occurs in the brain. When left unchecked by ALDH, DOPAL accumulates, damages neurons and increases an individual's risk of developing Parkinson's.\u003c/div>\n\u003cdiv>\u003c/div>\n\u003cdiv>The investigators believe their findings concerning benomyl may be generalized to all Parkinson's patients. Developing new drugs to protect ALDH activity, they say, may eventually help slow the progression of the disease, whether or not an individual has been exposed to pesticides.\u003c/div>\n\u003c/blockquote>\n\u003cdiv>\n\u003cp>Bronstein’s team tested the pesticide on transparent zebrafish in the lab, where they could watch its impact on neurons tinted with a fluorescent dye.\u003c/p>\n\u003c/div>\n\u003cp>The new study appears in the latest online edition of the Proceedings of the National Academy of Sciences.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cstrong>\u003cem>Listen to Sasha Khokha's story:\u003c/em>\u003c/strong>\u003cbr>\n\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/R201301150850b.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/R201301150850b.xml\">\u003c/embed>\u003c/object>\u003c/p>\n\n",
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"excerpt": "A new study from UCLA is the latest addition to a growing body of research linking pesticides and Parkinson’s disease.\r\n\r\nUCLA neurologists examined hundreds of Parkinson’s patients in the Central Valley, where rural residents may have been exposed to a fungicide called benomyl. It was widely used on crops like almonds, apples, and berries before the EPA banned it a decade ago.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>By Sasha Khokha, KQED News Central Valley Bureau Chief\u003c/p>\n\u003cp>A \u003ca href=\"http://www.pnas.org/content/early/2012/12/19/1220399110.abstract\" target=\"_blank\">new study\u003c/a> from UCLA is the latest addition to a growing body of research linking pesticides and Parkinson’s disease.\u003c/p>\n\u003cp>UCLA neurologists examined hundreds of Parkinson’s patients in the Central Valley, where rural residents may have been exposed to a fungicide called benomyl. It was widely used on crops like almonds, apples, and berries before the EPA banned it a decade ago.\u003c/p>\n\u003cp>The study finds the pesticide triggered cellular changes, preventing a key enzyme from keeping check on a naturally occurring toxin that damages neurons in the brain.\u003c/p>\n\u003cp>But more importantly, researchers found that process may be at play even in Parkinson’s patients who have \u003cem>not\u003c/em> been exposed to pesticides. \"So it’s really the mechanism by which it works that is of particular interest to us,\" UCLA neurology professor Dr. Jeff Bronstein told me, \"because we think there are going to be other things in the environment -- and other genetic variations -- that may lead us to one of the causes of Parkinson’s disease.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Here's more from the \u003ca href=\"http://newsroom.ucla.edu/portal/ucla/pesticides-and-parkinson-s-more-242364.aspx\" target=\"_blank\">UCLA press release\u003c/a>:\u003c/p>\n\u003cblockquote>\n\u003cdiv>Benomyl exposure, they say, starts a cascade of cellular events that may lead to Parkinson's. The pesticide prevents an enzyme called ALDH (aldehyde dehydrogenase) from keeping a lid on DOPAL, a toxin that naturally occurs in the brain. When left unchecked by ALDH, DOPAL accumulates, damages neurons and increases an individual's risk of developing Parkinson's.\u003c/div>\n\u003cdiv>\u003c/div>\n\u003cdiv>The investigators believe their findings concerning benomyl may be generalized to all Parkinson's patients. Developing new drugs to protect ALDH activity, they say, may eventually help slow the progression of the disease, whether or not an individual has been exposed to pesticides.\u003c/div>\n\u003c/blockquote>\n\u003cdiv>\n\u003cp>Bronstein’s team tested the pesticide on transparent zebrafish in the lab, where they could watch its impact on neurons tinted with a fluorescent dye.\u003c/p>\n\u003c/div>\n\u003cp>The new study appears in the latest online edition of the Proceedings of the National Academy of Sciences.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cstrong>\u003cem>Listen to Sasha Khokha's story:\u003c/em>\u003c/strong>\u003cbr>\n\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/R201301150850b.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/R201301150850b.xml\">\u003c/embed>\u003c/object>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>By Sarah Varney, \u003ca href=\"http://www.kaiserhealthnews.org/Stories/2013/January/13/Varney-Clinicas.aspx\" target=\"_blank\">Kaiser Health News\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_9953\" class=\"wp-caption alignleft\" style=\"max-width: 320px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/01/photo-2.jpg\">\u003cimg class=\"size-full wp-image-9953\" title=\"photo-2\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/01/photo-2.jpg\" alt=\"\" width=\"320\" height=\"240\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Sarah Varney/Kaiser Health News)\u003c/figcaption>\u003c/figure>\n\u003cp>The so-called bodega clinicas that line the streets of Los Angeles’ immigrant neighborhoods blend into a dense forest of commerce. Wedged between money order kiosks and pawn shops, these storefront doctors’ offices treat ailments for cash: a doctor’s visit is $20 to $40, a podiatry exam is $120 and at one bustling clinica, a colonoscopy is advertised on an erasable white board for $700.\u003c/p>\n\u003cp>County health officials describe the clinicas as a parallel health care system, servicing a vast number of uninsured Latino residents, yet the officials say they have little understanding of who owns and operates them, how they are regulated and the quality of the medical care they provide. Staffed with Spanish speaking medical providers, few of these low-rent clinics accept private insurance or participate in Medicaid managed care plans.\u003c/p>\n\u003cp>“Someone has to figure out if there’s a basic level of competence,” said Dr. Patrick Dowling, professor and chair of the department of family medicine at the David Geffen School of Medicine at the University of California, Los Angeles.\u003c/p>\n\u003cp>Not that researchers haven’t tried. Dr. Dowling, for one, has canvassed the local clinicas for years as part of his research for the state to document physician shortages. What he and others have found, however, is that clinca owners were reluctant to answer their questions.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>What is certain, though, is that despite their name, many of these clinicas are actually private doctor’s offices, not licensed clinics which are required to report regularly to federal and state oversight bodies. It is a distinction that deeply concerns Kimberly Wyard, chief executive of Northeast Valley Health Corporation, a non-profit group which runs 13 accredited health clinics for low-income Southern Californians. “They are off the radar screen,” said Wyard of the clinicas, “and it’s unclear what they’re doing.”\u003c/p>\n\u003cp>But driven by fast-approaching deadlines set by the Affordable Care Act, health officials in Los Angeles are vexed over whether to embrace bodega clinicas and bring them –- selectively and gingerly –- into the network of tightly regulated public and non-profit health centers that are driven more by mission than by profit to serve the uninsured.\u003c/p>\n\u003cp>Health officials see in the clinicas the tantalizing opportunity to fill persistent and profound gaps in the county’s strained safety net, including a chronic shortage of primary care physicians. By January 2014, up to 2 million currently uninsured Angelenos will need to enroll in Medicaid or buy insurance and find primary care. And the clinicas, public health officials note, are already well established in the county’s poorest neighborhoods where they are meeting the needs of Spanish-speaking residents. The clinicas also could continue to serve a market that the Affordable Care Act does not touch: undocumented immigrants who are prohibited from getting health insurance under the law.\u003c/p>\n\u003cp>Dr. Mark Ghaly, deputy director for Community Health at the Los Angeles County Department of Health Services, said bodega clinicas, a term he seems to have coined, that agree to some scrutiny could be a good way of addressing the physician shortage in these neighborhoods.\u003c/p>\n\u003cp>“Where are we going to find those providers?” he said. “One logical place to consider looking is these clinics.”\u003c/p>\n\u003cp>The waiting rooms at the bodega clinicas reflect the everyday maladies of peoples’ lives: a glassy-eyed child rests listlessly on his mother’s lap; a fit-looking young woman waits with a bag of ice on her wrist; a pensive middle-aged man in work boots stares straight ahead. For patients with ordinary complaints, the medical care at these bodega clinicas may be suitable, say county health officials and medical experts. But they say problems arise when the illness exceeds the boundaries of a physician’s skills or the patient’s ability to pay cash.\u003c/p>\n\u003cp>Dr. Raul Joaquin Bendana, who has been practicing general medicine since 1987 in South Los Angeles, said bodega clinicas will refer patients to him when, for example, they have uncontrolled diabetes. “They refer to me because they don’t know how to handle the situation,” he said. The clinica physicians by and large appear to have current medical licenses, a sample showed, but experts say they are unlikely to be board certified as specialists or have admitting privileges at area hospitals. That can mean some clinicas attempt to continue to treat patients who face serious illness.\u003c/p>\n\u003cp>Olivia Cardenas, a 40-year-old restaurant worker who lives in Woodland Hills got a free pap smear at a clinica that advertises “especialistas” including gynecology. The pap smear came back abnormal, and the doctor told Cardenas she had cervical cancer. “Come back in a week with $5,000 in cash, and I’ll operate on you,” Cardenas said the doctor told her. “Otherwise you could die.”\u003c/p>\n\u003cp>Although Ms. Cardenas had gone to the clinica for years, she was shocked by the directive. She declined to pay the $5,000. Instead, a family friend helped her apply for Medicaid and she went to a licensed hospital for treatment. The diagnosis, it turned out, was correct.\u003c/p>\n\u003cp>Health care experts say clinicas’ medical practices would come under greater scrutiny if they were brought closer into the fold. Howard Kahn, chief executive of L.A. Care Health Plan, the nation’s largest public health plan, which contracts with private managed care companies, said: “I’m big on the idea that connectedness breeds quality.” Some here hold an uneasy hope that the clinicas could learn from licensed health centers how to follow their patients’ diabetes, hypertension and asthma, adopt electronic medical records and employ medical assistants to keep patients on track.\u003c/p>\n\u003cp>But being connected would mean the clinicas’ cash-only business model would need to change. Dowling, the UCLA researcher, said the lure of newly insured patients in 2014 might draw them in: “To the extent there are payments available, the legitimate ones might step up to the plate.”\u003c/p>\n\u003cp>Calls to a half dozen such clinics were met with no comment or were unreturned. There is at least one early indication that the clinicas may sit this one out: Clinica Mi Pueblo, regarded as scrupulous and well-run, recently sold four of its 11 clinics to a health maintenance organization over concerns that when the Affordable Care Act takes hold next year, it will lose a significant portion of its cash business.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This story was produced by Kaiser Health News in collaboration with the New York Times.\u003c/em>\u003c/p>\n\n",
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"excerpt": "The so-called bodega clinicas that line the streets of Los Angeles’ immigrant neighborhoods blend into a dense forest of commerce. Wedged between money order kiosks and pawn shops, these storefront doctors’ offices treat ailments for cash: a doctor’s visit is $20 to $40, a podiatry exam is $120 and at one bustling clinica, a colonoscopy is advertised on an erasable white board for $700.\r\n\r\nCounty health officials describe the clinicas as a parallel health care system, servicing a vast number of uninsured Latino residents, yet the officials say they have little understanding of who owns and operates them, how they are regulated and the quality of the medical care they provide. Staffed with Spanish speaking medical providers, few of these low-rent clinics accept private insurance or participate in Medicaid managed care plans.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>By Sarah Varney, \u003ca href=\"http://www.kaiserhealthnews.org/Stories/2013/January/13/Varney-Clinicas.aspx\" target=\"_blank\">Kaiser Health News\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_9953\" class=\"wp-caption alignleft\" style=\"max-width: 320px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/01/photo-2.jpg\">\u003cimg class=\"size-full wp-image-9953\" title=\"photo-2\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/01/photo-2.jpg\" alt=\"\" width=\"320\" height=\"240\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Sarah Varney/Kaiser Health News)\u003c/figcaption>\u003c/figure>\n\u003cp>The so-called bodega clinicas that line the streets of Los Angeles’ immigrant neighborhoods blend into a dense forest of commerce. Wedged between money order kiosks and pawn shops, these storefront doctors’ offices treat ailments for cash: a doctor’s visit is $20 to $40, a podiatry exam is $120 and at one bustling clinica, a colonoscopy is advertised on an erasable white board for $700.\u003c/p>\n\u003cp>County health officials describe the clinicas as a parallel health care system, servicing a vast number of uninsured Latino residents, yet the officials say they have little understanding of who owns and operates them, how they are regulated and the quality of the medical care they provide. Staffed with Spanish speaking medical providers, few of these low-rent clinics accept private insurance or participate in Medicaid managed care plans.\u003c/p>\n\u003cp>“Someone has to figure out if there’s a basic level of competence,” said Dr. Patrick Dowling, professor and chair of the department of family medicine at the David Geffen School of Medicine at the University of California, Los Angeles.\u003c/p>\n\u003cp>Not that researchers haven’t tried. Dr. Dowling, for one, has canvassed the local clinicas for years as part of his research for the state to document physician shortages. What he and others have found, however, is that clinca owners were reluctant to answer their questions.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>What is certain, though, is that despite their name, many of these clinicas are actually private doctor’s offices, not licensed clinics which are required to report regularly to federal and state oversight bodies. It is a distinction that deeply concerns Kimberly Wyard, chief executive of Northeast Valley Health Corporation, a non-profit group which runs 13 accredited health clinics for low-income Southern Californians. “They are off the radar screen,” said Wyard of the clinicas, “and it’s unclear what they’re doing.”\u003c/p>\n\u003cp>But driven by fast-approaching deadlines set by the Affordable Care Act, health officials in Los Angeles are vexed over whether to embrace bodega clinicas and bring them –- selectively and gingerly –- into the network of tightly regulated public and non-profit health centers that are driven more by mission than by profit to serve the uninsured.\u003c/p>\n\u003cp>Health officials see in the clinicas the tantalizing opportunity to fill persistent and profound gaps in the county’s strained safety net, including a chronic shortage of primary care physicians. By January 2014, up to 2 million currently uninsured Angelenos will need to enroll in Medicaid or buy insurance and find primary care. And the clinicas, public health officials note, are already well established in the county’s poorest neighborhoods where they are meeting the needs of Spanish-speaking residents. The clinicas also could continue to serve a market that the Affordable Care Act does not touch: undocumented immigrants who are prohibited from getting health insurance under the law.\u003c/p>\n\u003cp>Dr. Mark Ghaly, deputy director for Community Health at the Los Angeles County Department of Health Services, said bodega clinicas, a term he seems to have coined, that agree to some scrutiny could be a good way of addressing the physician shortage in these neighborhoods.\u003c/p>\n\u003cp>“Where are we going to find those providers?” he said. “One logical place to consider looking is these clinics.”\u003c/p>\n\u003cp>The waiting rooms at the bodega clinicas reflect the everyday maladies of peoples’ lives: a glassy-eyed child rests listlessly on his mother’s lap; a fit-looking young woman waits with a bag of ice on her wrist; a pensive middle-aged man in work boots stares straight ahead. For patients with ordinary complaints, the medical care at these bodega clinicas may be suitable, say county health officials and medical experts. But they say problems arise when the illness exceeds the boundaries of a physician’s skills or the patient’s ability to pay cash.\u003c/p>\n\u003cp>Dr. Raul Joaquin Bendana, who has been practicing general medicine since 1987 in South Los Angeles, said bodega clinicas will refer patients to him when, for example, they have uncontrolled diabetes. “They refer to me because they don’t know how to handle the situation,” he said. The clinica physicians by and large appear to have current medical licenses, a sample showed, but experts say they are unlikely to be board certified as specialists or have admitting privileges at area hospitals. That can mean some clinicas attempt to continue to treat patients who face serious illness.\u003c/p>\n\u003cp>Olivia Cardenas, a 40-year-old restaurant worker who lives in Woodland Hills got a free pap smear at a clinica that advertises “especialistas” including gynecology. The pap smear came back abnormal, and the doctor told Cardenas she had cervical cancer. “Come back in a week with $5,000 in cash, and I’ll operate on you,” Cardenas said the doctor told her. “Otherwise you could die.”\u003c/p>\n\u003cp>Although Ms. Cardenas had gone to the clinica for years, she was shocked by the directive. She declined to pay the $5,000. Instead, a family friend helped her apply for Medicaid and she went to a licensed hospital for treatment. The diagnosis, it turned out, was correct.\u003c/p>\n\u003cp>Health care experts say clinicas’ medical practices would come under greater scrutiny if they were brought closer into the fold. Howard Kahn, chief executive of L.A. Care Health Plan, the nation’s largest public health plan, which contracts with private managed care companies, said: “I’m big on the idea that connectedness breeds quality.” Some here hold an uneasy hope that the clinicas could learn from licensed health centers how to follow their patients’ diabetes, hypertension and asthma, adopt electronic medical records and employ medical assistants to keep patients on track.\u003c/p>\n\u003cp>But being connected would mean the clinicas’ cash-only business model would need to change. Dowling, the UCLA researcher, said the lure of newly insured patients in 2014 might draw them in: “To the extent there are payments available, the legitimate ones might step up to the plate.”\u003c/p>\n\u003cp>Calls to a half dozen such clinics were met with no comment or were unreturned. There is at least one early indication that the clinicas may sit this one out: Clinica Mi Pueblo, regarded as scrupulous and well-run, recently sold four of its 11 clinics to a health maintenance organization over concerns that when the Affordable Care Act takes hold next year, it will lose a significant portion of its cash business.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>This story was produced by Kaiser Health News in collaboration with the New York Times.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "A Public Health Approach to Gun Violence",
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"content": "\u003cp>So now we've heard from the NRA which asserts that \u003ca href=\"http://www.nytimes.com/2012/12/22/us/nra-calls-for-armed-guards-at-schools.html?hp&_r=0\" target=\"_blank\">we need to put armed police in every school\u003c/a>, then \u003ca href=\"http://www.sacbee.com/2012/12/21/5069433/nra-returns-to-public-debate-to.html\" target=\"_blank\">adding\u003c/a>, \"The only thing that stops a bad guy with a gun is a good guy with a gun.\"\u003c/p>\n\u003cp>It sounds good, but as Josh Sugarmann of the Violence Policy Center said today in \u003ca href=\"http://www.vpc.org/press/1212nra.htm\" target=\"_blank\">a statement\u003c/a>, that's been tried already -- and it didn't work. \"There were TWO armed law enforcement agents present at Columbine High School during the assault by Eric Harris and Dylan Klebold that left 15 dead and 23 wounded. They twice engaged and fired at Eric Harris in an effort to stop the shooting, but were unsuccessful because they were outgunned by the assault weapons wielded by the two teens.”\u003c/p>\n\u003cp>And if you're thinking that having a gun protects you from guns, think again. After all, Rachel Davis, Managing Director of the Prevention Institute points out, in Newtown, Adam Lanza first killed his mother, a gun enthusiast. \"The first victim of this shooting was a gun owner who was not able to stop this from happening,\" Davis says. \"The problem of guns is they raise the risk of lethality.\"\u003c/p>\n\u003cp>We are a society that craves simple solutions, yet violence is a complex problem. That doesn't mean nothing can be done. While Davis favors an assault weapons ban, she says that's only one piece of a comprehensive approach. \"Another piece,\" she adds, \"is addressing mental health needs -- that includes access to high quality mental health services, reducing the trauma people are exposed to and then addressing the trauma.\"\u003c/p>\n\u003cp>Mass shootings in Newtown understandably capture widespread media attention, but remember that children are murdered every day by firearms. In 2010, according to CDC numbers, 1,260 children up to age 18 were killed by someone who used a gun. That's more than three children every day -- or 21 children in the week since Newtown.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Davis argues for broad community-based prevention programs. Davis points to \"GRYD\" -- the Gang Reduction Youth Development program which has been in place for several years in Los Angeles. GRYD is multi-pronged. \"It's not one single thing,\" Davis says, \"but a combination of strategies and efforts that are coordinated in the neighborhoods that are most affected by violence.\"\u003c/p>\n\u003cp>For example, in LA's successful \u003ca href=\"http://mayor.lacity.org/issues/gangreduction/summernightlights/index.htm\" target=\"_blank\">Summer Night Lights\u003c/a> program, parks are open after dark -- prime gang-activity time -- with free food and extra programs. Families flock there.\u003c/p>\n\u003cp>And it's effective. Here are some statistics from the Summer Night Lights website:\u003c/p>\n\u003cfigure id=\"attachment_9669\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003ca href=\"http://mayor.lacity.org/issues/gangreduction/summernightlights/index.htm\">\u003cimg class=\"size-large wp-image-9669\" title=\"Screen Shot 2012-12-21 at 9.17.32 AM\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/Screen-Shot-2012-12-21-at-9.17.32-AM-620x305.png\" alt=\"\" width=\"620\" height=\"305\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Image from Summer Night Lights website)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>Got that? \"Gang related homicide\" down 57 percent -- those are real lives saved.\u003c/p>\n\u003cp>In a profile, the \u003ca href=\"http://articles.latimes.com/2011/sep/12/opinion/la-oe-newton-column-gangs-20110912\" target=\"_blank\">LA Times\u003c/a> showed how GRYD also takes at-risk youngsters and not just stops violence but puts kids on a better path:\u003c/p>\n\u003cblockquote>\u003cp>According to a study by the Urban Institute, since GRYD began operating, gang crimes have fallen by 21.6%, faster than crime overall in the city; in the two years before it opened, they dropped 14.9%. Moreover, GRYD is reaching large numbers of at-risk youngsters: Young people enrolled in the program were 29% less likely to skip class, while those from the same neighborhoods not in the program increased the amount they cut class by 53%.\u003c/p>\u003c/blockquote>\n\u003cp>What all these statistics show is that violence is preventable. \"There's growing evidence for it,\" Davis concludes, \"but there's no simple solution for it. We need to put in comprehensive solutions that are working in places around the country.\"\u003c/p>\n\u003cp>\u003cstrong>Learn More:\u003c/strong>\u003c/p>\n\u003cp>KQED Forum:\u003cbr>\n\u003ca href=\"http://www.kqed.org/a/forum/R201212210900\" target=\"_blank\">Living with Gun Violence\u003c/a>\u003c/p>\n\u003cp>KQED Lowdown Blog:\u003cbr>\n\u003ca href=\"http://blogs.kqed.org/lowdown/2012/12/19/the-geography-of-u-s-gun-homicides/\" target=\"_blank\">The Geography of U.S. Gun Homicides\u003c/a>;\u003cbr>\n\u003ca href=\"http://blogs.kqed.org/lowdown/2012/12/14/the-united-states-of-firearms-americas-love-of-the-gun/\" target=\"_blank\">The United States of Firearms: America's Love Affair with the Gun\u003c/a>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Fresh Air:\u003cbr>\n\u003ca href=\"http://www.npr.org/2012/12/20/167694808/assault-style-weapons-in-the-civilian-market\" target=\"_blank\">Assault-Style Weapons in the Civilian Market\u003c/a>\u003c/p>\n\n",
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"excerpt": "So now we've heard from the NRA which asserts that we need to put armed police in every school, then adding, \"The only thing that stops a bad guy with a gun is a good guy with a gun.\"\r\n\r\nIt sounds good, but as Josh Sugarmann of the Violence Policy Center said today in a statement, that's been tried already -- and it didn't work. \"There were TWO armed law enforcement agents present at Columbine High School during the assault by Eric Harris and Dylan Klebold that left 15 dead and 23 wounded. They twice engaged and fired at Eric Harris in an effort to stop the shooting, but were unsuccessful because they were outgunned by the assault weapons wielded by the two teens.”",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>So now we've heard from the NRA which asserts that \u003ca href=\"http://www.nytimes.com/2012/12/22/us/nra-calls-for-armed-guards-at-schools.html?hp&_r=0\" target=\"_blank\">we need to put armed police in every school\u003c/a>, then \u003ca href=\"http://www.sacbee.com/2012/12/21/5069433/nra-returns-to-public-debate-to.html\" target=\"_blank\">adding\u003c/a>, \"The only thing that stops a bad guy with a gun is a good guy with a gun.\"\u003c/p>\n\u003cp>It sounds good, but as Josh Sugarmann of the Violence Policy Center said today in \u003ca href=\"http://www.vpc.org/press/1212nra.htm\" target=\"_blank\">a statement\u003c/a>, that's been tried already -- and it didn't work. \"There were TWO armed law enforcement agents present at Columbine High School during the assault by Eric Harris and Dylan Klebold that left 15 dead and 23 wounded. They twice engaged and fired at Eric Harris in an effort to stop the shooting, but were unsuccessful because they were outgunned by the assault weapons wielded by the two teens.”\u003c/p>\n\u003cp>And if you're thinking that having a gun protects you from guns, think again. After all, Rachel Davis, Managing Director of the Prevention Institute points out, in Newtown, Adam Lanza first killed his mother, a gun enthusiast. \"The first victim of this shooting was a gun owner who was not able to stop this from happening,\" Davis says. \"The problem of guns is they raise the risk of lethality.\"\u003c/p>\n\u003cp>We are a society that craves simple solutions, yet violence is a complex problem. That doesn't mean nothing can be done. While Davis favors an assault weapons ban, she says that's only one piece of a comprehensive approach. \"Another piece,\" she adds, \"is addressing mental health needs -- that includes access to high quality mental health services, reducing the trauma people are exposed to and then addressing the trauma.\"\u003c/p>\n\u003cp>Mass shootings in Newtown understandably capture widespread media attention, but remember that children are murdered every day by firearms. In 2010, according to CDC numbers, 1,260 children up to age 18 were killed by someone who used a gun. That's more than three children every day -- or 21 children in the week since Newtown.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Davis argues for broad community-based prevention programs. Davis points to \"GRYD\" -- the Gang Reduction Youth Development program which has been in place for several years in Los Angeles. GRYD is multi-pronged. \"It's not one single thing,\" Davis says, \"but a combination of strategies and efforts that are coordinated in the neighborhoods that are most affected by violence.\"\u003c/p>\n\u003cp>For example, in LA's successful \u003ca href=\"http://mayor.lacity.org/issues/gangreduction/summernightlights/index.htm\" target=\"_blank\">Summer Night Lights\u003c/a> program, parks are open after dark -- prime gang-activity time -- with free food and extra programs. Families flock there.\u003c/p>\n\u003cp>And it's effective. Here are some statistics from the Summer Night Lights website:\u003c/p>\n\u003cfigure id=\"attachment_9669\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003ca href=\"http://mayor.lacity.org/issues/gangreduction/summernightlights/index.htm\">\u003cimg class=\"size-large wp-image-9669\" title=\"Screen Shot 2012-12-21 at 9.17.32 AM\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/Screen-Shot-2012-12-21-at-9.17.32-AM-620x305.png\" alt=\"\" width=\"620\" height=\"305\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Image from Summer Night Lights website)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>Got that? \"Gang related homicide\" down 57 percent -- those are real lives saved.\u003c/p>\n\u003cp>In a profile, the \u003ca href=\"http://articles.latimes.com/2011/sep/12/opinion/la-oe-newton-column-gangs-20110912\" target=\"_blank\">LA Times\u003c/a> showed how GRYD also takes at-risk youngsters and not just stops violence but puts kids on a better path:\u003c/p>\n\u003cblockquote>\u003cp>According to a study by the Urban Institute, since GRYD began operating, gang crimes have fallen by 21.6%, faster than crime overall in the city; in the two years before it opened, they dropped 14.9%. Moreover, GRYD is reaching large numbers of at-risk youngsters: Young people enrolled in the program were 29% less likely to skip class, while those from the same neighborhoods not in the program increased the amount they cut class by 53%.\u003c/p>\u003c/blockquote>\n\u003cp>What all these statistics show is that violence is preventable. \"There's growing evidence for it,\" Davis concludes, \"but there's no simple solution for it. We need to put in comprehensive solutions that are working in places around the country.\"\u003c/p>\n\u003cp>\u003cstrong>Learn More:\u003c/strong>\u003c/p>\n\u003cp>KQED Forum:\u003cbr>\n\u003ca href=\"http://www.kqed.org/a/forum/R201212210900\" target=\"_blank\">Living with Gun Violence\u003c/a>\u003c/p>\n\u003cp>KQED Lowdown Blog:\u003cbr>\n\u003ca href=\"http://blogs.kqed.org/lowdown/2012/12/19/the-geography-of-u-s-gun-homicides/\" target=\"_blank\">The Geography of U.S. Gun Homicides\u003c/a>;\u003cbr>\n\u003ca href=\"http://blogs.kqed.org/lowdown/2012/12/14/the-united-states-of-firearms-americas-love-of-the-gun/\" target=\"_blank\">The United States of Firearms: America's Love Affair with the Gun\u003c/a>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Fresh Air:\u003cbr>\n\u003ca href=\"http://www.npr.org/2012/12/20/167694808/assault-style-weapons-in-the-civilian-market\" target=\"_blank\">Assault-Style Weapons in the Civilian Market\u003c/a>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "California Faces Shortage of Primary Care Doctors",
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"content": "\u003cp>\u003cem>By Susan Valot\u003c/em>\u003c/p>\n\u003cfigure id=\"attachment_9160\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/11/CalifDocShortage.jpg\">\u003cimg class=\"size-medium wp-image-9160\" title=\"(Susan Valot/KQED)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/11/CalifDocShortage-300x169.jpg\" alt=\"(Susan Valot/KQED)\" width=\"300\" height=\"169\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Medical student gets information at the California Family Medicine Residency Fair. (Susan Valot/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>At a Los Angeles hotel meeting room dozens of medical students mill around booths set up by residency programs. They pick up literature and stop to ask questions.\u003c/p>\n\u003cp>It's the \u003ca href=\"http://www.familydocs.org/students-residents/cafps-family-medicine-summit/california-residency-fair.php\" target=\"_blank\">California Family Medicine Residency Fair\u003c/a>, put on by the California Academy of Family Physicians. Its goal is to bring more general practice doctors into the fold. Dr. Jeff Luther runs the family medicine residency program at Long Beach Memorial Medical Center.\u003c/p>\n\u003cp>\"There are benefits to living in California,\" Luther says. \"That’s why so many people do it and a lot of people want to come to California for training. It can be harder to attract people to practice in ... the more developed parts of California, because it’s expensive to live there. And if you’re coming out of medical school with $200,000 in debt off the ground and then thinking about trying to buy a home and raise a family, that part of it can be a little more difficult.\"\u003c/p>\n\u003cp>In general, specialists make a lot more money than general practitioners. \u003ca href=\"http://www.chcf.org/publications/2009/06/fewer-and-more-specialized--a-new-assessment-of-physician-supply-in-california\" target=\"_blank\">A study three years ago\u003c/a> by the California HealthCare Foundation found that only 16 of California’s 58 counties had enough primary care physicians, based on standards by the American Medical Association. Areas like San Bernardino and Riverside counties and the San Joaquin Valley fared the worst.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>UC Riverside next year plans to open California’s first new medical school in 40 years. That's a first step. Once medical school is completed, Dr. Luther says residency slots are key to keeping doctors in the state’s underserved areas.\u003c/p>\n\u003cp>\"People often go to train in an area where they hope to settle eventually or where they have some ties to begin with. And when you’re finishing training, it’s very comfortable to stay where you trained. You know the community. .. And to pick up and leave where you trained and go to a new community, it’s a little scarier.\"\u003c/p>\n\u003cp>Callie Langton of the California Academy of Family Physicians says the state government limits the number of family medicine residency slots, which also contributes to the shortage of family docs.\u003c/p>\n\u003cp>\"If you’re a new patient and you’re moving into the area,\" Langton says, \"it’s really hard to find somebody. And that shortage is only expected to get worse as more and more people become insured under healthcare reform.\"\u003c/p>\n\u003cp>Tucked away in a corner of the residency fair, Dr. Robert Allen is trying to attract medical students to a new family medicine residency program in the Central Valley town of Visalia. He’s in charge of it at Kaweah Delta Healthcare District Hospital, in an area that until now has had no general practice residency program.\u003c/p>\n\u003cp>\"We currently have an estimate of between 30 to 50 percent underserved in the area of primary care,\" Allen laments. \"If you look at the number of docs that are going to retire, we could probably place the next ten years of graduates of our program. We think we’ve probably got positions for about 50 to 60 doctors in the area.\"\u003c/p>\n\u003cp>Dr. Raul Ayala chose to do his residency at UCSF Fresno. Ayala this year created a networking program to help doctors share resources in his underserved area. Ayala says President Obama’s healthcare plan is another step in the right direction, but it won’t work without enough primary care physicians.\u003c/p>\n\u003cp>\"You have a great blueprint,\" Ayala says \"but you also forget about, okay, do we have enough wood? Do we have enough nails? Do we have enough sheet rock? ... It's a great monument, but if you don’t have the raw material, then I’m sorry, you’re not going to be able to build something with a great foundation.\"\u003c/p>\n\u003cp>Some state lawmakers want to strengthen that foundation by expanding the roles of lower level healthcare providers, such as pharmacists and nurses. Democratic State Senator Ed Hernandez of LA's San Gabriel Valley also wants to reintroduce a bill that died during the last legislative session to increase the number of California’s residency slots.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Listen to Susan Valot's story:\u003c/em>\u003cbr>\n\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/R201211280850b.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/R201211280850b.xml\">\u003c/embed>\u003c/object>\u003c/p>\n\n",
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"excerpt": "At a Los Angeles hotel meeting room dozens of medical students mill around booths set up by residency programs. They pick up literature and stop to ask questions.\r\n\r\nIt's the California Family Medicine Residency Fair, put on by the California Academy of Family Physicians. Its goal is to bring more general practice doctors into the fold. Dr. Jeff Luther runs the family medicine residency program at Long Beach Memorial Medical Center.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>By Susan Valot\u003c/em>\u003c/p>\n\u003cfigure id=\"attachment_9160\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/11/CalifDocShortage.jpg\">\u003cimg class=\"size-medium wp-image-9160\" title=\"(Susan Valot/KQED)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/11/CalifDocShortage-300x169.jpg\" alt=\"(Susan Valot/KQED)\" width=\"300\" height=\"169\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Medical student gets information at the California Family Medicine Residency Fair. (Susan Valot/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>At a Los Angeles hotel meeting room dozens of medical students mill around booths set up by residency programs. They pick up literature and stop to ask questions.\u003c/p>\n\u003cp>It's the \u003ca href=\"http://www.familydocs.org/students-residents/cafps-family-medicine-summit/california-residency-fair.php\" target=\"_blank\">California Family Medicine Residency Fair\u003c/a>, put on by the California Academy of Family Physicians. Its goal is to bring more general practice doctors into the fold. Dr. Jeff Luther runs the family medicine residency program at Long Beach Memorial Medical Center.\u003c/p>\n\u003cp>\"There are benefits to living in California,\" Luther says. \"That’s why so many people do it and a lot of people want to come to California for training. It can be harder to attract people to practice in ... the more developed parts of California, because it’s expensive to live there. And if you’re coming out of medical school with $200,000 in debt off the ground and then thinking about trying to buy a home and raise a family, that part of it can be a little more difficult.\"\u003c/p>\n\u003cp>In general, specialists make a lot more money than general practitioners. \u003ca href=\"http://www.chcf.org/publications/2009/06/fewer-and-more-specialized--a-new-assessment-of-physician-supply-in-california\" target=\"_blank\">A study three years ago\u003c/a> by the California HealthCare Foundation found that only 16 of California’s 58 counties had enough primary care physicians, based on standards by the American Medical Association. Areas like San Bernardino and Riverside counties and the San Joaquin Valley fared the worst.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>UC Riverside next year plans to open California’s first new medical school in 40 years. That's a first step. Once medical school is completed, Dr. Luther says residency slots are key to keeping doctors in the state’s underserved areas.\u003c/p>\n\u003cp>\"People often go to train in an area where they hope to settle eventually or where they have some ties to begin with. And when you’re finishing training, it’s very comfortable to stay where you trained. You know the community. .. And to pick up and leave where you trained and go to a new community, it’s a little scarier.\"\u003c/p>\n\u003cp>Callie Langton of the California Academy of Family Physicians says the state government limits the number of family medicine residency slots, which also contributes to the shortage of family docs.\u003c/p>\n\u003cp>\"If you’re a new patient and you’re moving into the area,\" Langton says, \"it’s really hard to find somebody. And that shortage is only expected to get worse as more and more people become insured under healthcare reform.\"\u003c/p>\n\u003cp>Tucked away in a corner of the residency fair, Dr. Robert Allen is trying to attract medical students to a new family medicine residency program in the Central Valley town of Visalia. He’s in charge of it at Kaweah Delta Healthcare District Hospital, in an area that until now has had no general practice residency program.\u003c/p>\n\u003cp>\"We currently have an estimate of between 30 to 50 percent underserved in the area of primary care,\" Allen laments. \"If you look at the number of docs that are going to retire, we could probably place the next ten years of graduates of our program. We think we’ve probably got positions for about 50 to 60 doctors in the area.\"\u003c/p>\n\u003cp>Dr. Raul Ayala chose to do his residency at UCSF Fresno. Ayala this year created a networking program to help doctors share resources in his underserved area. Ayala says President Obama’s healthcare plan is another step in the right direction, but it won’t work without enough primary care physicians.\u003c/p>\n\u003cp>\"You have a great blueprint,\" Ayala says \"but you also forget about, okay, do we have enough wood? Do we have enough nails? Do we have enough sheet rock? ... It's a great monument, but if you don’t have the raw material, then I’m sorry, you’re not going to be able to build something with a great foundation.\"\u003c/p>\n\u003cp>Some state lawmakers want to strengthen that foundation by expanding the roles of lower level healthcare providers, such as pharmacists and nurses. Democratic State Senator Ed Hernandez of LA's San Gabriel Valley also wants to reintroduce a bill that died during the last legislative session to increase the number of California’s residency slots.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Listen to Susan Valot's story:\u003c/em>\u003cbr>\n\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/R201211280850b.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/R201211280850b.xml\">\u003c/embed>\u003c/object>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "New Mapping Finds More Breast Cancer 'Areas of Concern'",
"title": "New Mapping Finds More Breast Cancer 'Areas of Concern'",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_9025\" class=\"wp-caption alignleft\" style=\"max-width: 299px\">\u003ca href=\"http://cehtp.org/resources/breast_cancer_mapping/CBCMP_Report_FINAL.pdf\">\u003cimg class=\"size-medium wp-image-9025\" title='Map of breast cancer \"areas of concern\" in the Bay Area. (Image: California Breast Cancer Mapping Project)' src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/11/Screen-Shot-2012-11-27-at-9.11.24-AM-300x301.png\" alt='Map of breast cancer \"areas of concern\" in the Bay Area. (Image: California Breast Cancer Mapping Project)' width=\"299\" height=\"300\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Map of breast cancer \"areas of concern\" in the Bay Area. (Image: California Breast Cancer Mapping Project)\u003c/figcaption>\u003c/figure>\n\u003cp>A new study finds Marin County isn't the only part of the Bay Area where breast cancer rates are higher than the state average.\u003c/p>\n\u003cp>Researchers with the California Breast Cancer Mapping Project say they've also found a higher rate of breast cancer -- defined as 10 to 20 percent above statewide average -- in parts of Alameda, Sonoma, Napa, Solano and Contra Costa Counties.\u003c/p>\n\u003cp>Researchers looked at breast cancer rates by census tract, a more targeted approach than other numbers which are collected county-wide.\u003c/p>\n\u003cp>“This is an opportunity for us to think about communities affected by breast cancer in new ways,” said Dr. Eric Roberts, of Oakland's Public Health Institute and principal investigator for \u003ca title=\"http://cehtp.org/resources/breast_cancer_mapping/CBCMP_Report_FINAL.pdf\" href=\"http://cehtp.org/resources/breast_cancer_mapping/CBCMP_Report_FINAL.pdf\" target=\"_blank\">the study\u003c/a> [PDF]. “And one of them is that -- although no one argues that there isn't an excess of breast cancer in Marin County -- when you look at it this way, it appears more that Marin County is part of an extended area.”\u003c!--more-->\u003c/p>\n\u003cp>The study also found portions of the South Bay have higher than average breast cancer rates. Those areas include communities in San Mateo County, northern Santa Clara and southern Alameda Counties.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Roberts says the maps are not designed to determine the causes of breast cancer rates or detect specific environmental triggers, but will point researchers in new directions. As the\u003ca href=\"http://www.sfgate.com/health/article/Bay-Area-breast-cancer-clusters-seen-4068698.php\" target=\"_blank\"> San Francisco Chronicle reports\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>(T)he study is an important tool for further research, said \u003ca href=\"http://www.sfgate.com/?controllerName=search&action=search&channel=health&search=1&inlineLink=1&query=%22Janice+Barlow%22\">Janice Barlow\u003c/a>, executive director of Zero Breast Cancer, a nonprofit advocacy group based in Marin County. She served on the project's advisory group.\u003c/p>\n\u003cp>\"This opens up whole new areas to look at and explore,\" Barlow said. \"It's an opportunity to advance our understanding of why there are such geographic variations in breast cancer incidence.\"\u003c/p>\n\u003cp>About 26,300 new cases of breast cancer are diagnosed in women in California each year, leading to about 4,175 deaths annually.\u003c/p>\n\u003cp>Marin County has long been studied for its high rates of breast cancer, but many questions remain unanswered. Risk factors for the disease include having a family history of breast cancer, being white, hormone use after menopause, being an older mother or never having children, alcohol consumption, and having higher socioeconomic status. Still, many health experts say those factors don't explain the rate disparities along geographic lines.\u003c/p>\n\u003cp>\"We can say definitively that breast cancer is caused by a combination of genetics, behavioral risk factors and the environment,\" said Dr. \u003ca href=\"http://www.sfgate.com/?controllerName=search&action=search&channel=health&search=1&inlineLink=1&query=%22Eric+Roberts%22\">Eric Roberts\u003c/a>, a research scientist at Public Health Institute and principal investigator of the California Breast Cancer Mapping Project. \"The state of the science is that we really don't know what the mix is.\"\u003c/p>\n\u003cp>While the new study doesn't delve into the reasons behind the clusters, it offers a more specific geographic picture of the problem. Its authors suggest the results may be used by lawmakers and local health officials to redirect \u003ca href=\"http://www.sfgate.com/education-guide/\">education\u003c/a>, outreach and screening efforts.\u003c/p>\u003c/blockquote>\n\u003cp>The study also found that parts of Los Angeles County, Orange County and a small portion of western Riverside County are also seeing higher rates of breast cancer.\u003c/p>\n\u003cp>\u003cstrong>Learn More\u003c/strong>:\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"http://www.kqed.org/news/story/2012/11/27/111741/study_finds_higher_rates_of_breast_cancer_in_bay_area?category=bay+area\" target=\"_blank\">Listen to KQED Health Editor discuss the study with KQED News Anchor Stephanie Martin\u003c/a>\u003c/p>\n\n",
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"description": "A new study finds Marin County isn't the only part of the Bay Area where breast cancer rates are higher than the state average. Researchers with the California Breast Cancer Mapping Project say they've also found a higher rate of breast cancer -- defined as 10 to 20 percent above statewide average -- in parts",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_9025\" class=\"wp-caption alignleft\" style=\"max-width: 299px\">\u003ca href=\"http://cehtp.org/resources/breast_cancer_mapping/CBCMP_Report_FINAL.pdf\">\u003cimg class=\"size-medium wp-image-9025\" title='Map of breast cancer \"areas of concern\" in the Bay Area. (Image: California Breast Cancer Mapping Project)' src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/11/Screen-Shot-2012-11-27-at-9.11.24-AM-300x301.png\" alt='Map of breast cancer \"areas of concern\" in the Bay Area. (Image: California Breast Cancer Mapping Project)' width=\"299\" height=\"300\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Map of breast cancer \"areas of concern\" in the Bay Area. (Image: California Breast Cancer Mapping Project)\u003c/figcaption>\u003c/figure>\n\u003cp>A new study finds Marin County isn't the only part of the Bay Area where breast cancer rates are higher than the state average.\u003c/p>\n\u003cp>Researchers with the California Breast Cancer Mapping Project say they've also found a higher rate of breast cancer -- defined as 10 to 20 percent above statewide average -- in parts of Alameda, Sonoma, Napa, Solano and Contra Costa Counties.\u003c/p>\n\u003cp>Researchers looked at breast cancer rates by census tract, a more targeted approach than other numbers which are collected county-wide.\u003c/p>\n\u003cp>“This is an opportunity for us to think about communities affected by breast cancer in new ways,” said Dr. Eric Roberts, of Oakland's Public Health Institute and principal investigator for \u003ca title=\"http://cehtp.org/resources/breast_cancer_mapping/CBCMP_Report_FINAL.pdf\" href=\"http://cehtp.org/resources/breast_cancer_mapping/CBCMP_Report_FINAL.pdf\" target=\"_blank\">the study\u003c/a> [PDF]. “And one of them is that -- although no one argues that there isn't an excess of breast cancer in Marin County -- when you look at it this way, it appears more that Marin County is part of an extended area.”\u003c!--more-->\u003c/p>\n\u003cp>The study also found portions of the South Bay have higher than average breast cancer rates. Those areas include communities in San Mateo County, northern Santa Clara and southern Alameda Counties.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Roberts says the maps are not designed to determine the causes of breast cancer rates or detect specific environmental triggers, but will point researchers in new directions. As the\u003ca href=\"http://www.sfgate.com/health/article/Bay-Area-breast-cancer-clusters-seen-4068698.php\" target=\"_blank\"> San Francisco Chronicle reports\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>(T)he study is an important tool for further research, said \u003ca href=\"http://www.sfgate.com/?controllerName=search&action=search&channel=health&search=1&inlineLink=1&query=%22Janice+Barlow%22\">Janice Barlow\u003c/a>, executive director of Zero Breast Cancer, a nonprofit advocacy group based in Marin County. She served on the project's advisory group.\u003c/p>\n\u003cp>\"This opens up whole new areas to look at and explore,\" Barlow said. \"It's an opportunity to advance our understanding of why there are such geographic variations in breast cancer incidence.\"\u003c/p>\n\u003cp>About 26,300 new cases of breast cancer are diagnosed in women in California each year, leading to about 4,175 deaths annually.\u003c/p>\n\u003cp>Marin County has long been studied for its high rates of breast cancer, but many questions remain unanswered. Risk factors for the disease include having a family history of breast cancer, being white, hormone use after menopause, being an older mother or never having children, alcohol consumption, and having higher socioeconomic status. Still, many health experts say those factors don't explain the rate disparities along geographic lines.\u003c/p>\n\u003cp>\"We can say definitively that breast cancer is caused by a combination of genetics, behavioral risk factors and the environment,\" said Dr. \u003ca href=\"http://www.sfgate.com/?controllerName=search&action=search&channel=health&search=1&inlineLink=1&query=%22Eric+Roberts%22\">Eric Roberts\u003c/a>, a research scientist at Public Health Institute and principal investigator of the California Breast Cancer Mapping Project. \"The state of the science is that we really don't know what the mix is.\"\u003c/p>\n\u003cp>While the new study doesn't delve into the reasons behind the clusters, it offers a more specific geographic picture of the problem. Its authors suggest the results may be used by lawmakers and local health officials to redirect \u003ca href=\"http://www.sfgate.com/education-guide/\">education\u003c/a>, outreach and screening efforts.\u003c/p>\u003c/blockquote>\n\u003cp>The study also found that parts of Los Angeles County, Orange County and a small portion of western Riverside County are also seeing higher rates of breast cancer.\u003c/p>\n\u003cp>\u003cstrong>Learn More\u003c/strong>:\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"http://www.kqed.org/news/story/2012/11/27/111741/study_finds_higher_rates_of_breast_cancer_in_bay_area?category=bay+area\" target=\"_blank\">Listen to KQED Health Editor discuss the study with KQED News Anchor Stephanie Martin\u003c/a>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>By Lauren Whaley, \u003ca title=\"http://centerforhealthreporting.org/blog/clinics-will-continue-surging-prepping-january-20141022\" href=\"http://centerforhealthreporting.org/blog/clinics-will-continue-surging-prepping-january-20141022\" target=\"_blank\">CHCF Center for Health Reporting\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_8908\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/11/CommunityHealthCenterSign_LaurenWhaley_CHCFCenterForHealthReporting.jpg\">\u003cimg class=\"size-medium wp-image-8908\" title=\"(LaurenWhaley/CHCF Center for Health Reporting)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/11/CommunityHealthCenterSign_LaurenWhaley_CHCFCenterForHealthReporting-300x224.jpg\" alt=\"\" width=\"300\" height=\"224\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(LaurenWhaley/CHCF Center for Health Reporting)\u003c/figcaption>\u003c/figure>\n\u003cp>Dr. Paul Gregerson says November 7, the day after the election, was a “very good day in my life.”\u003c/p>\n\u003cp>“The Obama election is very good news, let me tell you,” he says. “I couldn’t be happier.”\u003c/p>\n\u003cp>Gregerson’s joy -- and relief -- stems from his role as chief medical officer at the \u003ca href=\"http://jwchinstitute.org/\" target=\"_blank\">John Wesley Community Health Institute\u003c/a> in Los Angeles. Gregerson sees patients daily at the Institute’s \u003ca href=\"http://jwchinstitute.org/primary-medical-care/cch-downtown/\" target=\"_blank\">clinic in downtown LA’s Skid Row\u003c/a> neighborhood.\u003c/p>\n\u003cp>He sees Obamacare (and \u003ca href=\"http://centerforhealthreporting.org/article/%E2%80%98last-distraction%E2%80%99-removed-california-moves-ahead-health-reform1015\">California’s full-steam ahead movement on it\u003c/a>) as a way to increase quality health care to his patients. About 20 percent of them are currently enrolled in Medi-Cal. Come January 2014, when the president’s Affordable Care Act goes into full effect, about 80 percent will qualify, he says.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Under the new law, the clinic will get reimbursed for more of the patients it already sees -- and for many of the new patients it expects to see. About a million more Angelenos are expected to get health insurance. Studies show that people visit the doctor more often when they’re insured. Community health centers have been planning for an explosion of new patients for several years.\u003c!--more-->\u003c/p>\n\u003cp>With more reimbursements for newly insured patients, Gregerson and his team will be able to hire more employees, which, in turn, will allow his clinic to serve more patients. He also expects clinics to deliver a higher level of service and higher quality of care because of increased competition for patients.\u003c/p>\n\u003cp>“For the health center, the things that we’ve already put in motion will continue to run the course,” he says. “The creating of new programs, money that’s been spent on remodeling and hiring new people, will move forward and will even accelerate.”\u003c/p>\n\u003cp>As I reported in a story for \u003ca href=\"http://centerforhealthreporting.org/article/community-health-centers-rise-california1011\">KPCC Southern California Public Radio\u003c/a>, Federally-Qualified Health Centers (FQHCs) like this one have already been ramping up their services and sites. They have become the darlings of the Affordable Care Act, with their \u003ca href=\"http://www.ncqa.org/Programs/Recognition/PatientCenteredMedicalHomePCMH.aspx\" target=\"_blank\">patient-centered medical home\u003c/a> team approach.\u003c/p>\n\u003cp>“It improves their attachment to the clinic because they’re not only attaching to a physician, they’re attaching to a whole team,” says Al Ballesteros, CEO at \u003ca href=\"http://jwchinstitute.org/about-us/\" target=\"_blank\">JWCH Institute\u003c/a>. “Their mental health, physical health, their nursing needs, their laboratory needs, their specialty referral needs, their needs for benefits, their needs for housing access, (are) all handled by a team.”\u003c/p>\n\u003cp>Ballesteros says community health centers help monitor chronic diseases, focus on preventive care and keep people away from expensive emergency room visits.\u003c/p>\n\u003cp>The JWCH Institute hasn’t been the only FQHC ramping up. Advocates say that the recession has introduced middle class Americans to community health centers.\u003c/p>\n\u003cp>In California, the number of patients seen at FQHCs rose from \u003ca href=\"http://www.nachc.com/client/documents/Primary_Care_Revolution_Final_8_16.pdf\" target=\"_blank\">2.7 million in 2009\u003c/a> to \u003ca href=\"http://www.nachc.com/client/2012%20Key%20data.pdf\" target=\"_blank\">3.1 million in 2011\u003c/a>.\u003c/p>\n\u003cp>Nationwide, patient numbers are expected to jump from the current \u003ca href=\"http://www.nachc.com/client/HCR_New_Patients_Final.pdf\" target=\"_blank\">20 million to 40 million by 2015\u003c/a>.\u003c/p>\n\u003cp>As for JWCH, its centers have been bombarded. In 2009, JWCH clinics provided 59 thousand primary care visits. They expect to have almost twice that number by year’s end.\u003c/p>\n\u003cp>“We started out here eight years ago with a clinic down here,” says Gregerson of the Skid Row location. “And just because of the demand, we’ve added a clinic in Bell Gardens, in Norwalk, in Lynwood. We just opened one in Bellflower about six or eight months ago.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>We’re all human,” he says. “Everybody deserves to be taken care of.”\u003c/p>\n\n",
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"excerpt": "Dr. Paul Gregerson says November 7, the day after the election, was a “very good day in my life.”\r\n\r\n“The Obama election is very good news, let me tell you,” he says. “I couldn’t be happier.”\r\n\r\nGregerson’s joy -- and relief -- stems from his role as chief medical officer at the John Wesley Community Health Institute in Los Angeles. Gregerson sees patients daily at the Institute’s clinic in downtown LA’s Skid Row neighborhood.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>By Lauren Whaley, \u003ca title=\"http://centerforhealthreporting.org/blog/clinics-will-continue-surging-prepping-january-20141022\" href=\"http://centerforhealthreporting.org/blog/clinics-will-continue-surging-prepping-january-20141022\" target=\"_blank\">CHCF Center for Health Reporting\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_8908\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/11/CommunityHealthCenterSign_LaurenWhaley_CHCFCenterForHealthReporting.jpg\">\u003cimg class=\"size-medium wp-image-8908\" title=\"(LaurenWhaley/CHCF Center for Health Reporting)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/11/CommunityHealthCenterSign_LaurenWhaley_CHCFCenterForHealthReporting-300x224.jpg\" alt=\"\" width=\"300\" height=\"224\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(LaurenWhaley/CHCF Center for Health Reporting)\u003c/figcaption>\u003c/figure>\n\u003cp>Dr. Paul Gregerson says November 7, the day after the election, was a “very good day in my life.”\u003c/p>\n\u003cp>“The Obama election is very good news, let me tell you,” he says. “I couldn’t be happier.”\u003c/p>\n\u003cp>Gregerson’s joy -- and relief -- stems from his role as chief medical officer at the \u003ca href=\"http://jwchinstitute.org/\" target=\"_blank\">John Wesley Community Health Institute\u003c/a> in Los Angeles. Gregerson sees patients daily at the Institute’s \u003ca href=\"http://jwchinstitute.org/primary-medical-care/cch-downtown/\" target=\"_blank\">clinic in downtown LA’s Skid Row\u003c/a> neighborhood.\u003c/p>\n\u003cp>He sees Obamacare (and \u003ca href=\"http://centerforhealthreporting.org/article/%E2%80%98last-distraction%E2%80%99-removed-california-moves-ahead-health-reform1015\">California’s full-steam ahead movement on it\u003c/a>) as a way to increase quality health care to his patients. About 20 percent of them are currently enrolled in Medi-Cal. Come January 2014, when the president’s Affordable Care Act goes into full effect, about 80 percent will qualify, he says.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Under the new law, the clinic will get reimbursed for more of the patients it already sees -- and for many of the new patients it expects to see. About a million more Angelenos are expected to get health insurance. Studies show that people visit the doctor more often when they’re insured. Community health centers have been planning for an explosion of new patients for several years.\u003c!--more-->\u003c/p>\n\u003cp>With more reimbursements for newly insured patients, Gregerson and his team will be able to hire more employees, which, in turn, will allow his clinic to serve more patients. He also expects clinics to deliver a higher level of service and higher quality of care because of increased competition for patients.\u003c/p>\n\u003cp>“For the health center, the things that we’ve already put in motion will continue to run the course,” he says. “The creating of new programs, money that’s been spent on remodeling and hiring new people, will move forward and will even accelerate.”\u003c/p>\n\u003cp>As I reported in a story for \u003ca href=\"http://centerforhealthreporting.org/article/community-health-centers-rise-california1011\">KPCC Southern California Public Radio\u003c/a>, Federally-Qualified Health Centers (FQHCs) like this one have already been ramping up their services and sites. They have become the darlings of the Affordable Care Act, with their \u003ca href=\"http://www.ncqa.org/Programs/Recognition/PatientCenteredMedicalHomePCMH.aspx\" target=\"_blank\">patient-centered medical home\u003c/a> team approach.\u003c/p>\n\u003cp>“It improves their attachment to the clinic because they’re not only attaching to a physician, they’re attaching to a whole team,” says Al Ballesteros, CEO at \u003ca href=\"http://jwchinstitute.org/about-us/\" target=\"_blank\">JWCH Institute\u003c/a>. “Their mental health, physical health, their nursing needs, their laboratory needs, their specialty referral needs, their needs for benefits, their needs for housing access, (are) all handled by a team.”\u003c/p>\n\u003cp>Ballesteros says community health centers help monitor chronic diseases, focus on preventive care and keep people away from expensive emergency room visits.\u003c/p>\n\u003cp>The JWCH Institute hasn’t been the only FQHC ramping up. Advocates say that the recession has introduced middle class Americans to community health centers.\u003c/p>\n\u003cp>In California, the number of patients seen at FQHCs rose from \u003ca href=\"http://www.nachc.com/client/documents/Primary_Care_Revolution_Final_8_16.pdf\" target=\"_blank\">2.7 million in 2009\u003c/a> to \u003ca href=\"http://www.nachc.com/client/2012%20Key%20data.pdf\" target=\"_blank\">3.1 million in 2011\u003c/a>.\u003c/p>\n\u003cp>Nationwide, patient numbers are expected to jump from the current \u003ca href=\"http://www.nachc.com/client/HCR_New_Patients_Final.pdf\" target=\"_blank\">20 million to 40 million by 2015\u003c/a>.\u003c/p>\n\u003cp>As for JWCH, its centers have been bombarded. In 2009, JWCH clinics provided 59 thousand primary care visits. They expect to have almost twice that number by year’s end.\u003c/p>\n\u003cp>“We started out here eight years ago with a clinic down here,” says Gregerson of the Skid Row location. “And just because of the demand, we’ve added a clinic in Bell Gardens, in Norwalk, in Lynwood. We just opened one in Bellflower about six or eight months ago.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>We’re all human,” he says. “Everybody deserves to be taken care of.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>\u003cstrong>By Mina Kim, KQED\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_8897\" class=\"wp-caption alignleft\" style=\"max-width: 248px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/11/couch0409.jpg\">\u003cimg class=\"size-full wp-image-8897\" title=\"A sofa may contain up to two pounds of flame retardants. (Dan Buczynski/Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/11/couch0409.jpg\" alt=\"A sofa may contain up to two pounds of flame retardants. (Dan Buczynski/Flickr)\" width=\"248\" height=\"140\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A sofa may contain up to two pounds of flame retardants. (Dan Buczynski/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>A new study finds flame retardants -- chemicals used to make household items more fire resistant -- are linked to lower IQs and poorer coordination in children.\u003c/p>\n\u003cp>The\u003ca href=\"http://ehp.niehs.nih.gov/2012/11/1205597/\" target=\"_blank\"> UC Berkeley study\u003c/a> focuses on the effects of Polybrominated Diphenyl Ethers (PBDEs). That's a class of chemicals that was widely used in California in furniture, baby products and electronics, until they were phased out in 2004 out of concerns they were toxic.\u003c/p>\n\u003cp>Still, the flame retardant continues to leech out of older household products said the study's lead author Brenda Eskanazi. She's a professor of maternal and child health at UC Berkeley.\u003c/p>\n\u003cp>“The couch that I own was purchased before 2004,” Eskanazi said. “As the foam in the couch disintegrates, the PBDEs will enter into the dust particles, and if I had a child that was crawling on the floor, that child will be exposed to that dust.”\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Eskanzi recommends mopping, vacuuming and washing hands frequently to help reduce exposure to PBDEs.\u003c/p>\n\u003cp>Today's research comes from the \u003ca href=\"http://cerch.org/research-programs/chamacos/\" target=\"_blank\">CHAMACOS study\u003c/a> -- a study based in Salinas Valley of hundreds of pregnant women and their children, born since 1999. For the flame retardants study, researchers took blood samples of more than 270 children when they were in their mothers' wombs and again seven years later. The children received a battery of tests to gauge their attention span, fine motor skills and IQ.\u003c/p>\n\u003cp>“What we saw was that children had more problems in relationship to the amount of PBDEs in their mothers' or their (own) blood,” Eskanazi said.\u003c/p>\n\u003cp>Officials with the American Chemistry Council which represents the chemical industry said in a statement that they “will need time to more thoroughly analyze the findings” and noted that a link is not clear evidence of a cause-and-effect relationship.\u003c/p>\n\u003cp>The study appears in Thursday’s issue of the journal \u003ca title=\"http://ehp.niehs.nih.gov\" href=\"http://ehp.niehs.nih.gov\" target=\"_blank\">Environmental Health Perspectives\u003c/a>, published by the National Institute of Environmental Health Sciences, part of the NIH.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Listen to Mina Kim's story:\u003c/strong>\u003cbr>\n\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/R201211150850b.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/R201211150850b.xml\">\u003c/embed>\u003c/object>\u003c/p>\n\n",
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"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
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"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
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"mindshift": {
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"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
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"order": 12
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"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
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"politicalbreakdown": {
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"title": "Political Breakdown",
"tagline": "Politics from a personal perspective",
"info": "Political Breakdown is a new series that explores the political intersection of California and the nation. Each week hosts Scott Shafer and Marisa Lagos are joined with a new special guest to unpack politics -- with personality — and offer an insider’s glimpse at how politics happens.",
"airtime": "THU 6:30pm-7pm",
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"possible": {
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"title": "Possible",
"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
"airtime": "SUN 2pm",
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"pri-the-world": {
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"title": "PRI's The World: Latest Edition",
"info": "Each weekday, host Marco Werman and his team of producers bring you the world's most interesting stories in an hour of radio that reminds us just how small our planet really is.",
"airtime": "MON-FRI 2pm-3pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-World-Podcast-Tile-360x360-1.jpg",
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},
"radiolab": {
"id": "radiolab",
"title": "Radiolab",
"info": "A two-time Peabody Award-winner, Radiolab is an investigation told through sounds and stories, and centered around one big idea. In the Radiolab world, information sounds like music and science and culture collide. Hosted by Jad Abumrad and Robert Krulwich, the show is designed for listeners who demand skepticism, but appreciate wonder. WNYC Studios is the producer of other leading podcasts including Freakonomics Radio, Death, Sex & Money, On the Media and many more.",
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},
"reveal": {
"id": "reveal",
"title": "Reveal",
"info": "Created by The Center for Investigative Reporting and PRX, Reveal is public radios first one-hour weekly radio show and podcast dedicated to investigative reporting. Credible, fact based and without a partisan agenda, Reveal combines the power and artistry of driveway moment storytelling with data-rich reporting on critically important issues. The result is stories that inform and inspire, arming our listeners with information to right injustices, hold the powerful accountable and improve lives.Reveal is hosted by Al Letson and showcases the award-winning work of CIR and newsrooms large and small across the nation. In a radio and podcast market crowded with choices, Reveal focuses on important and often surprising stories that illuminate the world for our listeners.",
"airtime": "SAT 4pm-5pm",
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"officialWebsiteLink": "https://www.revealnews.org/episodes/",
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"link": "/radio/program/reveal",
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"rss": "http://feeds.revealradio.org/revealpodcast"
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},
"rightnowish": {
"id": "rightnowish",
"title": "Rightnowish",
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