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"content": "\u003cp>By Alice Daniel, KQED\u003c/p>\n\u003cfigure id=\"attachment_6253\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/06/CentralValleyPollution_Smog_Getty_.gif\">\u003cimg class=\"size-full wp-image-6253\" title=\"Farming in California's Central Valley is a source of smog, a major contributor to the region's high asthma rates. (Getty Images)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/06/CentralValleyPollution_Smog_Getty_.gif\" alt=\"\" width=\"300\" height=\"300\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2012/06/CentralValleyPollution_Smog_Getty_.gif 300w, https://ww2.kqed.org/app/uploads/sites/27/2012/06/CentralValleyPollution_Smog_Getty_-32x32.gif 32w, https://ww2.kqed.org/app/uploads/sites/27/2012/06/CentralValleyPollution_Smog_Getty_-64x64.gif 64w, https://ww2.kqed.org/app/uploads/sites/27/2012/06/CentralValleyPollution_Smog_Getty_-96x96.gif 96w, https://ww2.kqed.org/app/uploads/sites/27/2012/06/CentralValleyPollution_Smog_Getty_-128x128.gif 128w, https://ww2.kqed.org/app/uploads/sites/27/2012/06/CentralValleyPollution_Smog_Getty_-75x75.gif 75w\" sizes=\"(max-width: 300px) 100vw, 300px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Farming in California's Central Valley is a source of smog, a major contributor to the region's high asthma rates. (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>The latest new thing in social policy circles is the social impact bond, and now Fresno is set to become the first city in the nation to test the idea of using this social bond idea to improve the health of the community.\u003c/p>\n\u003cp>Municipal bonds allow investors to put money into building roads or constructing schools. Health impact bonds aren’t much different, says Kevin Hamilton of the Fresno nonprofit health agency Clinica Sierra Vista. Instead of infrastructure, the investment is in public health, in this case asthma prevention.\u003c/p>\n\u003cp>\"There’s no reason to think of the public health in any different way than you do the public transportation system or the public school system,\" Hamilton says, \"all of which are things that have benefited from bond issues over time. No reason not to think of this in the same fashion.\"\u003c/p>\n\u003cp>The California Endowment is paying for Fresno's pilot project. The concept was developed by a Connecticut firm called Collective Health. The goal is to show that a systematic asthma prevention program can save enough money to entice private investors. One in six Fresno residents suffers from asthma. Hamilton says about 20 asthma patients go to the ER every day and of those, three are hospitalized.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"In this situation the return on investment comes from the health insurance companies who make money when people are well and lose money when they’re sick,\" Hamilton says. \"So you have that same sort of incentive to invest.\"\u003c/p>\n\u003cp>Starting in January, Clinica Sierra Vista will work with 200 low-income asthma patients on asthma intervention. Studies already show that symptoms are reduced with indoor air filters, clean or removed carpets and safe cleaning agents like vinegar and baking soda. But clinicians will also work with the patients to make sure they are using their medications correctly and keeping medical appointments. Cost savings will be documented by public and private insurers, says Hamilton.\u003c/p>\n\u003cp>On average, these 200 patients rack up costs of about $16,000 a year for ER visits and hospital stays. The goal is trim those costs by close to $8,000 by educating and training patients to manage asthma correctly.\u003c/p>\n\u003cp>\"It’s a way for a health insurance company to continue to make money, survive as an entity, and yet put money back into people’s health in a really, really positive way that has a chance of really changing their lives significantly,\" Hamilton says.\u003c/p>\n\u003cp>The pilot project hopes to save about a million dollars in the first year and cut ER visits by 30 percent. If it’s successful, investors would provide intervention funding for about 1100 patients the following year.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Listen to Daniel's story:\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/R201211140850c.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/R201211140850c.xml\">\u003c/embed>\u003c/object>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>By Alice Daniel, KQED\u003c/p>\n\u003cfigure id=\"attachment_6253\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/06/CentralValleyPollution_Smog_Getty_.gif\">\u003cimg class=\"size-full wp-image-6253\" title=\"Farming in California's Central Valley is a source of smog, a major contributor to the region's high asthma rates. (Getty Images)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/06/CentralValleyPollution_Smog_Getty_.gif\" alt=\"\" width=\"300\" height=\"300\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2012/06/CentralValleyPollution_Smog_Getty_.gif 300w, https://ww2.kqed.org/app/uploads/sites/27/2012/06/CentralValleyPollution_Smog_Getty_-32x32.gif 32w, https://ww2.kqed.org/app/uploads/sites/27/2012/06/CentralValleyPollution_Smog_Getty_-64x64.gif 64w, https://ww2.kqed.org/app/uploads/sites/27/2012/06/CentralValleyPollution_Smog_Getty_-96x96.gif 96w, https://ww2.kqed.org/app/uploads/sites/27/2012/06/CentralValleyPollution_Smog_Getty_-128x128.gif 128w, https://ww2.kqed.org/app/uploads/sites/27/2012/06/CentralValleyPollution_Smog_Getty_-75x75.gif 75w\" sizes=\"(max-width: 300px) 100vw, 300px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Farming in California's Central Valley is a source of smog, a major contributor to the region's high asthma rates. (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>The latest new thing in social policy circles is the social impact bond, and now Fresno is set to become the first city in the nation to test the idea of using this social bond idea to improve the health of the community.\u003c/p>\n\u003cp>Municipal bonds allow investors to put money into building roads or constructing schools. Health impact bonds aren’t much different, says Kevin Hamilton of the Fresno nonprofit health agency Clinica Sierra Vista. Instead of infrastructure, the investment is in public health, in this case asthma prevention.\u003c/p>\n\u003cp>\"There’s no reason to think of the public health in any different way than you do the public transportation system or the public school system,\" Hamilton says, \"all of which are things that have benefited from bond issues over time. No reason not to think of this in the same fashion.\"\u003c/p>\n\u003cp>The California Endowment is paying for Fresno's pilot project. The concept was developed by a Connecticut firm called Collective Health. The goal is to show that a systematic asthma prevention program can save enough money to entice private investors. One in six Fresno residents suffers from asthma. Hamilton says about 20 asthma patients go to the ER every day and of those, three are hospitalized.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"In this situation the return on investment comes from the health insurance companies who make money when people are well and lose money when they’re sick,\" Hamilton says. \"So you have that same sort of incentive to invest.\"\u003c/p>\n\u003cp>Starting in January, Clinica Sierra Vista will work with 200 low-income asthma patients on asthma intervention. Studies already show that symptoms are reduced with indoor air filters, clean or removed carpets and safe cleaning agents like vinegar and baking soda. But clinicians will also work with the patients to make sure they are using their medications correctly and keeping medical appointments. Cost savings will be documented by public and private insurers, says Hamilton.\u003c/p>\n\u003cp>On average, these 200 patients rack up costs of about $16,000 a year for ER visits and hospital stays. The goal is trim those costs by close to $8,000 by educating and training patients to manage asthma correctly.\u003c/p>\n\u003cp>\"It’s a way for a health insurance company to continue to make money, survive as an entity, and yet put money back into people’s health in a really, really positive way that has a chance of really changing their lives significantly,\" Hamilton says.\u003c/p>\n\u003cp>The pilot project hopes to save about a million dollars in the first year and cut ER visits by 30 percent. If it’s successful, investors would provide intervention funding for about 1100 patients the following year.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Listen to Daniel's story:\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/R201211140850c.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/R201211140850c.xml\">\u003c/embed>\u003c/object>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Valley Fever Cases Soar, Harm Remains Hidden",
"title": "Valley Fever Cases Soar, Harm Remains Hidden",
"headTitle": "State of Health | KQED News",
"content": "\u003cp>\u003cem>Editor's Note: This story is part of \u003ca title=\"http://www.reportingonhealth.org/content/just-one-breath-valley-fever-cases-reach-epidemic-levels-harm-remains-hidden\" href=\"http://www.reportingonhealth.org/content/just-one-breath-valley-fever-cases-reach-epidemic-levels-harm-remains-hidden\" target=\"_blank\">Just One Breath\u003c/a> an initiative on valley fever from reporters with The California Endowment Health Journalism Fellowships at the USC Annenberg School for Communication and Journalism. \u003c/em>\u003c/p>\n\u003cp>By \u003ca href=\"https://www.reportingonhealth.org/users/kschmitt-0\">Kellie Schmitt\u003c/a>, \u003ca href=\"https://www.reportingonhealth.org/users/rebeccaplevin\">Rebecca Plevin\u003c/a> and \u003ca href=\"https://www.reportingonhealth.org/users/tracy\">Tracy Wood\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_8392\" class=\"wp-caption alignright\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/09/ValleyFever_Dust-Storm_CraigKohlruss_FresnoBee.jpg\">\u003cimg class=\"size-medium wp-image-8392\" title=\"Dust storm. (Craig Kohlruss: FresnoBee)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/09/ValleyFever_Dust-Storm_CraigKohlruss_FresnoBee-300x192.jpg\" alt=\"Dust storm. (Craig Kohlruss: FresnoBee)\" width=\"300\" height=\"192\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A man struggles through heavy winds and dust blowing in downtown Fresno. (Craig Kohlruss: FresnoBee)\u003c/figcaption>\u003c/figure>\n\u003cp>Valley fever starts with the simple act of breathing.\u003c/p>\n\u003cp>The fungal spores, lifted from the dry dirt by the wind, pass through your nostrils or down your throat, so tiny they don’t even trigger a cough. They lodge in your lungs. If you’re fortunate – and most people are – they go no further.\u003c/p>\n\u003cp>But if you are one of the more than 150,000 people stricken with coccidioidomycosis every year nationwide, it’s because the spores have sent roots into the moist tissue of your lungs.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>They start to feed, and, over time, they can rob you of your health. In serious cases, your muscles waste away. Your bones become brittle. Pustules appear on your arms, neck and face and then erupt.\u003c/p>\n\u003caside class=\"pullquote alignleft\">“Valley fever is not occurring in D.C., it’s not occurring in Atlanta, and it’s not occurring in Bethesda, Maryland. It’s invisible to the most important policymakers when it comes to health funding.\u003c/aside>\n\u003cp>Once the fungus takes root, it never leaves you. In about 100 cases every year nationally the fever kills. That’s more deaths than those caused by hantavirus, whooping cough, and salmonella poisoning combined, yet all of these conditions receive far more attention from public health officials and are more widely known.\u003c/p>\n\u003cp>As horrible as the disease can be, people in Bakersfield, Fresno, Merced, Stockton and other parts of California's San Joaquín Valley have come to accept it as a way of life. Everyone knows somebody who has had valley fever, and most have survived.\u003c!--more-->\u003c/p>\n\u003cp>But talk to the people who deal with the disease every day – epidemiologists, clinicians, and the patients themselves – and you’ll hear a sense of urgency. Valley fever numbers are soaring so high that health experts call it an epidemic.\u003c/p>\n\u003cp>\"Only few diseases have increased like this in my career,\" Gregg Pullen, the infection control manager for Children's Hospital Central California in Madera, said at a recent public health gathering in Hanford. \"I can't remember ever seeing cocci like we have in the past two years.\"\u003c/p>\n\u003cp>The cocci fungus is common in much of the southwest and in northwestern Mexico, especially in the dry earth of California’s Central Valley and in the areas around Phoenix and Tucson in Arizona. It can be found, however, in soils of the beach haven of San Diego, the wine country of Sonoma County and inland in the Sierra foothills.\u003c/p>\n\u003cp>But you don’t have to live in one of those areas to catch the disease. Millions of people drive through the heart of valley fever country every year on Interstate 5 and can inhale the fungus with just one unlucky breath.\u003c/p>\n\u003cfigure id=\"attachment_8410\" class=\"wp-caption alignright\" style=\"max-width: 300px\">\u003ca href=\"http://www.reportingonhealth.org/content/just-one-breath-valley-fever-cases-reach-epidemic-levels-harm-remains-hidden\">\u003cimg class=\"size-medium wp-image-8410\" title=\"Read other stories in the series by clicking on the image above.\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/09/ATT00261-300x257.jpg\" alt=\"Read other stories in the series by clicking on the image above.\" width=\"300\" height=\"257\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Read other stories in the series by clicking on the image above.\u003c/figcaption>\u003c/figure>\n\u003cp>Efforts to stem the tide and to prevent new infections are hampered by widespread misdiagnosis, a lack of research funding, and decades of neglect by state and federal policymakers. Misdiagnosis is so pervasive, experts say, that some suffer and even die from valley fever without knowing they had the disease.\u003c/p>\n\u003cp>Just this summer, the small pool of funding for a potential vaccine dried up, leaving little hope of conquering the disease. Higher profile illnesses like West Nile virus command 20 times as much in federal funding. Yet valley fever harms far more people and is far more costly, according to National Institutes of Health data and a series of academic studies.\u003c/p>\n\u003cp>“Valley fever is not occurring in D.C., it’s not occurring in Atlanta, and it’s not occurring in Bethesda, Maryland. It’s invisible to the most important policymakers when it comes to health funding,” said valley fever researcher Dr. George Rutherford at the University of California San Francisco. “And that won’t change unless the need for a vaccine is elevated in some way.”\u003c/p>\n\u003cp>\u003cstrong>A hidden menace\u003c/strong>\u003c/p>\n\u003cp>By many measures, valley fever should be a disease that prompts an aggressive public health response. For nearly two decades, statistics from the U.S. Centers for Disease Control and Prevention show coccidioidomycosis doing more and more harm every year, with the rate of infection rising faster than most diseases reported to the CDC.\u003c/p>\n\u003cp>Some of that rise is due to an uptick in diagnosis and better disease reporting to state and federal agencies. But the trend can’t be explained by better reporting alone.\u003c/p>\n\u003cp>In 2000, cocci wasn’t even among the nation’s top diseases, as ranked by the rate of infection. There were fewer than four cases for every 100,000 people. By 2009, though, the rate of cocci had more than quadrupled to 13.24 for every 100,000 people, meaning that people in states that report the disease to the CDC had a higher likelihood of catching cocci than AIDS, hepatitis, or chickenpox.\u003c/p>\n\u003cp>While cases of tuberculosis and AIDS fell by half between 1995 and 2009, cocci rose 12-fold, according to CDC data. And the numbers continue to climb. In 2011, more than 13,200 people were diagnosed. But most cases are not diagnosed, and researchers estimate that the fungus infects more than 150,000 people every year who either suffer serious ailments without knowing the cause or who have mild cases that escape detection.\u003c/p>\n\u003cp>Most of the cases are concentrated in two states: Arizona and California. Arizona’s rate of valley fever jumped from 31 cases for every 100,000 people in 1999 to 157 cases in 2011. California officials did not provide similar data.\u003c/p>\n\u003cp>\u003cstrong>California cases jump annually\u003c/strong>\u003c/p>\n\u003cp>Alarmed by the rise in cases along the state’s main north-south corridor, Interstate 5, California county health officials called a meeting this past June in Hanford. Every participating county – except Tulare — reported an increase in valley fever cases.\u003c/p>\n\u003cp>\"If you're driving up and down I-5, hold your breath,” Kern County epidemiologist Kirt Emery said, half-jokingly.\u003c/p>\n\u003cp>Kern County is a good case study for the rest of the state. The county’s history of strong health department reporting shows a relatively constant trend in cases over the past three decades with two exceptions: a dramatic spike in the mid-1990s, which observers have dubbed the “Great Epidemic,” and another significant climb now, which some call “The Second Epidemic.”\u003c/p>\n\u003cp>An epidemic occurs when growth in cases far exceeds what has become the baseline rate over time.\u003c/p>\n\u003cp>Kern’s numbers more than tripled from 2009 to 2010, for a total of 2,051 that year. In 2011, they jumped to 2,734. So far, this year is following a similar trend.\u003c/p>\n\u003cp>Emery, the Kern County epidemiologist, was concerned that the uptick could be the result of more labs being required to report the disease because of a 2010 change in state law. So he removed the data from those labs from his analysis. Even with that new data excluded, there was still enough of a leap to call the rise an epidemic, Emery said.\u003c/p>\n\u003cp>“We’ve been reporting the exact same way since the 1980s, so it doesn’t across the board explain the increase we’re seeing,” Emery said. “In most counties, they’re pretty much doing the same thing they’ve always done.”\u003c/p>\n\u003cp>\u003cstrong>A little understood disease\u003c/strong>\u003c/p>\n\u003cp>Even though the first known case of valley fever was discovered more than a century ago, scientists continue to puzzle over exactly how the disease spreads and how to prevent it.\u003c/p>\n\u003cp>No one knows how much cocci needs to be breathed in to contract the disease. Computerized air screening systems can detect a wide range of spores for diseases such as anthrax, one of the most worrisome bioterrorism threats. But no one knows how to screen the air adequately for cocci during windy days. No one knows why some people die and others never know they are walking around with spores in their lungs.\u003c/p>\n\u003cp>People who work outside – farm workers and construction workers – are most likely to get it. The disease hits blacks and Filipinos harder than the rest of the population, and people with compromised immune systems and older people are more likely to suffer complications.\u003c/p>\n\u003cp>For Bakersfield physician Dr. Yakdan Al Qaisi, the fight with the fungus began with a fever that drenched his pillow at night. No medications would reduce it. He lost his appetite. By the time his health improved, he had spent time in the hospital with pneumonia, lost 30 pounds and missed work for nearly six weeks.\u003c/p>\n\u003cp>“If I had known I would get this, I wouldn’t have come here and exposed my family to this,” Al Qaisi said. “It was a very scary time.”\u003c/p>\n\u003cp>In a small percent of cases, the fungus spreads beyond the lungs. This is called disseminated valley fever, and the effects can be devastating. Doctors compare the illness to tuberculosis because of its ability to damage so many distinct areas of the body. The fungus can enter the bones, skin and other organs, leading to brain swelling, lung failure, and, eventually, death.\u003c/p>\n\u003cp>“Disseminated cocci can be terrible,” said Dr. Navin Amin, the chair of the family practice department at Kern Medical Center. “We need to catch it earlier and start treating it aggressively.”\u003c/p>\n\u003cp>Treatments usually include several rounds of antifungal medications and, at times, surgeries to remove infected bone or skin. If it is caught early, physicians have a better chance of keeping the disease at bay. Without treatment, a person who develops a brain infection from the disease is much more likely to die. But physicians don’t often catch it early. Researchers say that most cases are misdiagnosed or missed entirely, in part because of a lack of training and attention in the medical community, in part because the symptoms are so varied.\u003c/p>\n\u003cp>When the disease causes unsightly abscesses on the skin, doctors think first of bacterial infections like staphylococcus. When the fungus invades the joints and leads to swelling and excruciating pain, doctors think of arthritis or cancer.\u003c/p>\n\u003cp>In January 2011, 12-year-old Tyler Bridgewater of Oildale died after doctors in Bakersfield treated him for viral meningitis instead of valley fever, his mother said.\u003c/p>\n\u003cp>Even if the disease is treated, some patients with cocci could be on anti-fungal treatments for the rest of their lives, often with troublesome side effects. Most patients with healthy immune systems who beat the disease are able to wall away the valley fever fungus and never be sickened by it again. In some cases, though, it resurfaces when the immune system is weakened by another disease, or when a patient takes medications that lower the body’s defenses.\u003c/p>\n\u003cp>\u003cstrong>Valley fever a low priority\u003c/strong>\u003c/p>\n\u003cp>Cocci has never had the high profile of diseases that affect far fewer people. The CDC didn’t even track valley fever until 1995. In 2007, it stopped gathering data about deaths from the disease.\u003c/p>\n\u003cp>In 2009, there were 720 cases of West Nile virus and 12,926 cases of cocci nationwide, meaning fewer people were stricken by West Nile virus over the entire year than by cocci every month. Yet, the agency has a whole campaign dedicated to West Nile and it publishes information about it in 11 languages. It provides an online map that shows data as current as three days earlier.\u003c/p>\n\u003cp>Federal agencies also have paid little attention to valley fever on the research side. The National Institutes of Health has neglected research funding on valley fever for decades.\u003c/p>\n\u003cp>Since 2000, 1,287 projects received a total of $585 million from the National Institutes of Health for work involving West Nile. Valley fever projects have received about 4 percent of that amount – $25 million over the past 12 years. The impact on human health is nearly the reverse. Valley fever has stricken about four times more people than West Nile virus, with thousands more going undiagnosed. It has killed many more people, too.\u003c/p>\n\u003cp>States have had very different responses to the disease.\u003c/p>\n\u003cp>In 1997, Arizona required all physicians and testing laboratories to report any cases of valley fever to the state so it could accurately track it. After repeated studies showed that most valley fever cases were not being diagnosed, Arizona policymakers changed the guidelines to encourage better diagnosis and tracking of the disease in 2008.\u003c/p>\n\u003cp>California did not make the change in reporting requirements until 2010, and the state has yet to change the diagnosis guidelines or develop a surveillance system that allows it to follow trends in the disease easily. Dr. Gil Chavez, the state’s chief epidemiologist, explained that the state only has access to data on valley fever as far back as 1990. And those are just paper records. From 2000 forward, the state started making annual compilations of electronic data, but none of the databases are linked.\u003c/p>\n\u003cp>“I don't have a single dataset that I can query and give me everything for the last 20 years,” Chavez said. “I would have to go through every year, and every one of those queries requires a lot of staff time. It’s just something that we don’t do very often.”\u003c/p>\n\u003cp>Reporters tried to interview state researchers who apparently are working on a valley fever project funded by the CDC but were sent a form email from the California Department of Public Health that said: “CDPH does not discuss studies that are ongoing.”\u003c/p>\n\u003cp>Perhaps it’s not surprising that the state health department has not issued any warnings or press releases about valley fever in the previous five years. No major political figure in California has sounded the alarm about the rise in cases, either.\u003c/p>\n\u003cp>In August, the mayor of Dallas, Mike Rawlings, declared a state of emergency in Texas because of West Nile virus. There have been 43 deaths in the state, the most on record. “I cannot have any more deaths on my conscience because we did not take action,” he said.\u003c/p>\n\u003cp>Unlike West Nile, though, no one is keeping a careful count of valley fever cases.\u003c/p>\n\u003cp>“For the areas affected, the impact of this disease is every bit as important as polio before the vaccine or chicken pox before the vaccine,” said John Galgiani, the director of the Valley Fever Center for Excellence in Arizona. “The numbers are going up and no one’s talking about it. Those communities hurting the most should be pushing the hardest for action to be taken.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Yesenia Amaro and Joe Goldeen contributed to this report.\u003c/em>\u003c/p>\n\n",
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"excerpt": "Valley fever starts with the simple act of breathing.\r\n\r\nThe fungal spores, lifted from the dry dirt by the wind, pass through your nostrils or down your throat, so tiny they don’t even trigger a cough. They lodge in your lungs. If you’re fortunate – and most people are – they go no further.\r\n\r\nBut if you are one of the more than 150,000 people stricken with coccidioidomycosis every year nationwide, it’s because the spores have sent roots into the moist tissue of your lungs.\r\n\r\nThey start to feed, and, over time, they can rob you of your health. In serious cases, your muscles waste away. Your bones become brittle. Pustules appear on your arms, neck and face and then erupt.",
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"description": "Valley fever starts with the simple act of breathing.\r\n\r\nThe fungal spores, lifted from the dry dirt by the wind, pass through your nostrils or down your throat, so tiny they don’t even trigger a cough. They lodge in your lungs. If you’re fortunate – and most people are – they go no further.\r\n\r\nBut if you are one of the more than 150,000 people stricken with coccidioidomycosis every year nationwide, it’s because the spores have sent roots into the moist tissue of your lungs.\r\n\r\nThey start to feed, and, over time, they can rob you of your health. In serious cases, your muscles waste away. Your bones become brittle. Pustules appear on your arms, neck and face and then erupt.",
"title": "Valley Fever Cases Soar, Harm Remains Hidden | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>Editor's Note: This story is part of \u003ca title=\"http://www.reportingonhealth.org/content/just-one-breath-valley-fever-cases-reach-epidemic-levels-harm-remains-hidden\" href=\"http://www.reportingonhealth.org/content/just-one-breath-valley-fever-cases-reach-epidemic-levels-harm-remains-hidden\" target=\"_blank\">Just One Breath\u003c/a> an initiative on valley fever from reporters with The California Endowment Health Journalism Fellowships at the USC Annenberg School for Communication and Journalism. \u003c/em>\u003c/p>\n\u003cp>By \u003ca href=\"https://www.reportingonhealth.org/users/kschmitt-0\">Kellie Schmitt\u003c/a>, \u003ca href=\"https://www.reportingonhealth.org/users/rebeccaplevin\">Rebecca Plevin\u003c/a> and \u003ca href=\"https://www.reportingonhealth.org/users/tracy\">Tracy Wood\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_8392\" class=\"wp-caption alignright\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/09/ValleyFever_Dust-Storm_CraigKohlruss_FresnoBee.jpg\">\u003cimg class=\"size-medium wp-image-8392\" title=\"Dust storm. (Craig Kohlruss: FresnoBee)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/09/ValleyFever_Dust-Storm_CraigKohlruss_FresnoBee-300x192.jpg\" alt=\"Dust storm. (Craig Kohlruss: FresnoBee)\" width=\"300\" height=\"192\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A man struggles through heavy winds and dust blowing in downtown Fresno. (Craig Kohlruss: FresnoBee)\u003c/figcaption>\u003c/figure>\n\u003cp>Valley fever starts with the simple act of breathing.\u003c/p>\n\u003cp>The fungal spores, lifted from the dry dirt by the wind, pass through your nostrils or down your throat, so tiny they don’t even trigger a cough. They lodge in your lungs. If you’re fortunate – and most people are – they go no further.\u003c/p>\n\u003cp>But if you are one of the more than 150,000 people stricken with coccidioidomycosis every year nationwide, it’s because the spores have sent roots into the moist tissue of your lungs.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>They start to feed, and, over time, they can rob you of your health. In serious cases, your muscles waste away. Your bones become brittle. Pustules appear on your arms, neck and face and then erupt.\u003c/p>\n\u003caside class=\"pullquote alignleft\">“Valley fever is not occurring in D.C., it’s not occurring in Atlanta, and it’s not occurring in Bethesda, Maryland. It’s invisible to the most important policymakers when it comes to health funding.\u003c/aside>\n\u003cp>Once the fungus takes root, it never leaves you. In about 100 cases every year nationally the fever kills. That’s more deaths than those caused by hantavirus, whooping cough, and salmonella poisoning combined, yet all of these conditions receive far more attention from public health officials and are more widely known.\u003c/p>\n\u003cp>As horrible as the disease can be, people in Bakersfield, Fresno, Merced, Stockton and other parts of California's San Joaquín Valley have come to accept it as a way of life. Everyone knows somebody who has had valley fever, and most have survived.\u003c!--more-->\u003c/p>\n\u003cp>But talk to the people who deal with the disease every day – epidemiologists, clinicians, and the patients themselves – and you’ll hear a sense of urgency. Valley fever numbers are soaring so high that health experts call it an epidemic.\u003c/p>\n\u003cp>\"Only few diseases have increased like this in my career,\" Gregg Pullen, the infection control manager for Children's Hospital Central California in Madera, said at a recent public health gathering in Hanford. \"I can't remember ever seeing cocci like we have in the past two years.\"\u003c/p>\n\u003cp>The cocci fungus is common in much of the southwest and in northwestern Mexico, especially in the dry earth of California’s Central Valley and in the areas around Phoenix and Tucson in Arizona. It can be found, however, in soils of the beach haven of San Diego, the wine country of Sonoma County and inland in the Sierra foothills.\u003c/p>\n\u003cp>But you don’t have to live in one of those areas to catch the disease. Millions of people drive through the heart of valley fever country every year on Interstate 5 and can inhale the fungus with just one unlucky breath.\u003c/p>\n\u003cfigure id=\"attachment_8410\" class=\"wp-caption alignright\" style=\"max-width: 300px\">\u003ca href=\"http://www.reportingonhealth.org/content/just-one-breath-valley-fever-cases-reach-epidemic-levels-harm-remains-hidden\">\u003cimg class=\"size-medium wp-image-8410\" title=\"Read other stories in the series by clicking on the image above.\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/09/ATT00261-300x257.jpg\" alt=\"Read other stories in the series by clicking on the image above.\" width=\"300\" height=\"257\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Read other stories in the series by clicking on the image above.\u003c/figcaption>\u003c/figure>\n\u003cp>Efforts to stem the tide and to prevent new infections are hampered by widespread misdiagnosis, a lack of research funding, and decades of neglect by state and federal policymakers. Misdiagnosis is so pervasive, experts say, that some suffer and even die from valley fever without knowing they had the disease.\u003c/p>\n\u003cp>Just this summer, the small pool of funding for a potential vaccine dried up, leaving little hope of conquering the disease. Higher profile illnesses like West Nile virus command 20 times as much in federal funding. Yet valley fever harms far more people and is far more costly, according to National Institutes of Health data and a series of academic studies.\u003c/p>\n\u003cp>“Valley fever is not occurring in D.C., it’s not occurring in Atlanta, and it’s not occurring in Bethesda, Maryland. It’s invisible to the most important policymakers when it comes to health funding,” said valley fever researcher Dr. George Rutherford at the University of California San Francisco. “And that won’t change unless the need for a vaccine is elevated in some way.”\u003c/p>\n\u003cp>\u003cstrong>A hidden menace\u003c/strong>\u003c/p>\n\u003cp>By many measures, valley fever should be a disease that prompts an aggressive public health response. For nearly two decades, statistics from the U.S. Centers for Disease Control and Prevention show coccidioidomycosis doing more and more harm every year, with the rate of infection rising faster than most diseases reported to the CDC.\u003c/p>\n\u003cp>Some of that rise is due to an uptick in diagnosis and better disease reporting to state and federal agencies. But the trend can’t be explained by better reporting alone.\u003c/p>\n\u003cp>In 2000, cocci wasn’t even among the nation’s top diseases, as ranked by the rate of infection. There were fewer than four cases for every 100,000 people. By 2009, though, the rate of cocci had more than quadrupled to 13.24 for every 100,000 people, meaning that people in states that report the disease to the CDC had a higher likelihood of catching cocci than AIDS, hepatitis, or chickenpox.\u003c/p>\n\u003cp>While cases of tuberculosis and AIDS fell by half between 1995 and 2009, cocci rose 12-fold, according to CDC data. And the numbers continue to climb. In 2011, more than 13,200 people were diagnosed. But most cases are not diagnosed, and researchers estimate that the fungus infects more than 150,000 people every year who either suffer serious ailments without knowing the cause or who have mild cases that escape detection.\u003c/p>\n\u003cp>Most of the cases are concentrated in two states: Arizona and California. Arizona’s rate of valley fever jumped from 31 cases for every 100,000 people in 1999 to 157 cases in 2011. California officials did not provide similar data.\u003c/p>\n\u003cp>\u003cstrong>California cases jump annually\u003c/strong>\u003c/p>\n\u003cp>Alarmed by the rise in cases along the state’s main north-south corridor, Interstate 5, California county health officials called a meeting this past June in Hanford. Every participating county – except Tulare — reported an increase in valley fever cases.\u003c/p>\n\u003cp>\"If you're driving up and down I-5, hold your breath,” Kern County epidemiologist Kirt Emery said, half-jokingly.\u003c/p>\n\u003cp>Kern County is a good case study for the rest of the state. The county’s history of strong health department reporting shows a relatively constant trend in cases over the past three decades with two exceptions: a dramatic spike in the mid-1990s, which observers have dubbed the “Great Epidemic,” and another significant climb now, which some call “The Second Epidemic.”\u003c/p>\n\u003cp>An epidemic occurs when growth in cases far exceeds what has become the baseline rate over time.\u003c/p>\n\u003cp>Kern’s numbers more than tripled from 2009 to 2010, for a total of 2,051 that year. In 2011, they jumped to 2,734. So far, this year is following a similar trend.\u003c/p>\n\u003cp>Emery, the Kern County epidemiologist, was concerned that the uptick could be the result of more labs being required to report the disease because of a 2010 change in state law. So he removed the data from those labs from his analysis. Even with that new data excluded, there was still enough of a leap to call the rise an epidemic, Emery said.\u003c/p>\n\u003cp>“We’ve been reporting the exact same way since the 1980s, so it doesn’t across the board explain the increase we’re seeing,” Emery said. “In most counties, they’re pretty much doing the same thing they’ve always done.”\u003c/p>\n\u003cp>\u003cstrong>A little understood disease\u003c/strong>\u003c/p>\n\u003cp>Even though the first known case of valley fever was discovered more than a century ago, scientists continue to puzzle over exactly how the disease spreads and how to prevent it.\u003c/p>\n\u003cp>No one knows how much cocci needs to be breathed in to contract the disease. Computerized air screening systems can detect a wide range of spores for diseases such as anthrax, one of the most worrisome bioterrorism threats. But no one knows how to screen the air adequately for cocci during windy days. No one knows why some people die and others never know they are walking around with spores in their lungs.\u003c/p>\n\u003cp>People who work outside – farm workers and construction workers – are most likely to get it. The disease hits blacks and Filipinos harder than the rest of the population, and people with compromised immune systems and older people are more likely to suffer complications.\u003c/p>\n\u003cp>For Bakersfield physician Dr. Yakdan Al Qaisi, the fight with the fungus began with a fever that drenched his pillow at night. No medications would reduce it. He lost his appetite. By the time his health improved, he had spent time in the hospital with pneumonia, lost 30 pounds and missed work for nearly six weeks.\u003c/p>\n\u003cp>“If I had known I would get this, I wouldn’t have come here and exposed my family to this,” Al Qaisi said. “It was a very scary time.”\u003c/p>\n\u003cp>In a small percent of cases, the fungus spreads beyond the lungs. This is called disseminated valley fever, and the effects can be devastating. Doctors compare the illness to tuberculosis because of its ability to damage so many distinct areas of the body. The fungus can enter the bones, skin and other organs, leading to brain swelling, lung failure, and, eventually, death.\u003c/p>\n\u003cp>“Disseminated cocci can be terrible,” said Dr. Navin Amin, the chair of the family practice department at Kern Medical Center. “We need to catch it earlier and start treating it aggressively.”\u003c/p>\n\u003cp>Treatments usually include several rounds of antifungal medications and, at times, surgeries to remove infected bone or skin. If it is caught early, physicians have a better chance of keeping the disease at bay. Without treatment, a person who develops a brain infection from the disease is much more likely to die. But physicians don’t often catch it early. Researchers say that most cases are misdiagnosed or missed entirely, in part because of a lack of training and attention in the medical community, in part because the symptoms are so varied.\u003c/p>\n\u003cp>When the disease causes unsightly abscesses on the skin, doctors think first of bacterial infections like staphylococcus. When the fungus invades the joints and leads to swelling and excruciating pain, doctors think of arthritis or cancer.\u003c/p>\n\u003cp>In January 2011, 12-year-old Tyler Bridgewater of Oildale died after doctors in Bakersfield treated him for viral meningitis instead of valley fever, his mother said.\u003c/p>\n\u003cp>Even if the disease is treated, some patients with cocci could be on anti-fungal treatments for the rest of their lives, often with troublesome side effects. Most patients with healthy immune systems who beat the disease are able to wall away the valley fever fungus and never be sickened by it again. In some cases, though, it resurfaces when the immune system is weakened by another disease, or when a patient takes medications that lower the body’s defenses.\u003c/p>\n\u003cp>\u003cstrong>Valley fever a low priority\u003c/strong>\u003c/p>\n\u003cp>Cocci has never had the high profile of diseases that affect far fewer people. The CDC didn’t even track valley fever until 1995. In 2007, it stopped gathering data about deaths from the disease.\u003c/p>\n\u003cp>In 2009, there were 720 cases of West Nile virus and 12,926 cases of cocci nationwide, meaning fewer people were stricken by West Nile virus over the entire year than by cocci every month. Yet, the agency has a whole campaign dedicated to West Nile and it publishes information about it in 11 languages. It provides an online map that shows data as current as three days earlier.\u003c/p>\n\u003cp>Federal agencies also have paid little attention to valley fever on the research side. The National Institutes of Health has neglected research funding on valley fever for decades.\u003c/p>\n\u003cp>Since 2000, 1,287 projects received a total of $585 million from the National Institutes of Health for work involving West Nile. Valley fever projects have received about 4 percent of that amount – $25 million over the past 12 years. The impact on human health is nearly the reverse. Valley fever has stricken about four times more people than West Nile virus, with thousands more going undiagnosed. It has killed many more people, too.\u003c/p>\n\u003cp>States have had very different responses to the disease.\u003c/p>\n\u003cp>In 1997, Arizona required all physicians and testing laboratories to report any cases of valley fever to the state so it could accurately track it. After repeated studies showed that most valley fever cases were not being diagnosed, Arizona policymakers changed the guidelines to encourage better diagnosis and tracking of the disease in 2008.\u003c/p>\n\u003cp>California did not make the change in reporting requirements until 2010, and the state has yet to change the diagnosis guidelines or develop a surveillance system that allows it to follow trends in the disease easily. Dr. Gil Chavez, the state’s chief epidemiologist, explained that the state only has access to data on valley fever as far back as 1990. And those are just paper records. From 2000 forward, the state started making annual compilations of electronic data, but none of the databases are linked.\u003c/p>\n\u003cp>“I don't have a single dataset that I can query and give me everything for the last 20 years,” Chavez said. “I would have to go through every year, and every one of those queries requires a lot of staff time. It’s just something that we don’t do very often.”\u003c/p>\n\u003cp>Reporters tried to interview state researchers who apparently are working on a valley fever project funded by the CDC but were sent a form email from the California Department of Public Health that said: “CDPH does not discuss studies that are ongoing.”\u003c/p>\n\u003cp>Perhaps it’s not surprising that the state health department has not issued any warnings or press releases about valley fever in the previous five years. No major political figure in California has sounded the alarm about the rise in cases, either.\u003c/p>\n\u003cp>In August, the mayor of Dallas, Mike Rawlings, declared a state of emergency in Texas because of West Nile virus. There have been 43 deaths in the state, the most on record. “I cannot have any more deaths on my conscience because we did not take action,” he said.\u003c/p>\n\u003cp>Unlike West Nile, though, no one is keeping a careful count of valley fever cases.\u003c/p>\n\u003cp>“For the areas affected, the impact of this disease is every bit as important as polio before the vaccine or chicken pox before the vaccine,” said John Galgiani, the director of the Valley Fever Center for Excellence in Arizona. “The numbers are going up and no one’s talking about it. Those communities hurting the most should be pushing the hardest for action to be taken.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"title": "Is AIDS Still A Critical Concern to the Gay Community?",
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"content": "\u003cfigure id=\"attachment_8364\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/09/aidsblackmen080411.jpg\">\u003cimg class=\"size-medium wp-image-8364 \" title=\"AIDS activists carry banners.\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/09/aidsblackmen080411-300x207.jpg\" alt=\"\" width=\"300\" height=\"207\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Private AIDS funding drops, while new HIV infections among African American men rise dramatically. (Mark Ralston: AFP/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Researchers, doctors, advocates and general attendees at this year's \u003ca title=\"http://aids2012.org\" href=\"http://aids2012.org\" target=\"_blank\">International AIDS Conference\u003c/a> were awash in enthusiasm that a cure to the AIDS epidemic is actually within reach, largely due to advances in treatments and improved prevention.\u003c/p>\n\u003cp>But to actually reach the cure takes money. And right at this moment, private funding is down.\u003c/p>\n\u003cp>Dramatically.\u003c/p>\n\u003cp>\u003ca title=\"http://www.fcaaids.org/OurWork/ResourceTracking/CurrentReport/tabid/218/Default.aspx\" href=\"http://www.fcaaids.org/OurWork/ResourceTracking/CurrentReport/tabid/218/Default.aspx\" target=\"_blank\">Funders Concerned About AIDS\u003c/a>, a philanthropy dedicated to ensuring the end of the epidemic, says both the number of grants from private foundations and actual dollars given have dropped by about one-third.\u003c/p>\n\u003caside class=\"pullquote alignright\">While the new infections are among people at the intersection of race and poverty, the traditional funders of HIV/AIDS ... look around at their friends and may get the sense AIDS is \"solved.\"\u003c/aside>\n\u003cp>At first blush, it would seem that a down economy would be a big driver, but Daniel Tietz, Executive Director of the\u003ca title=\"http://www.acria.org\" href=\"http://www.acria.org\" target=\"_blank\"> AIDS Community Research Initiative of America\u003c/a> (ACRIA), sees something else at work. He spoke with KQED's Rachael Myrow on \u003ca title=\"http://www.californiareport.org/archive/R201209070850/b\" href=\"http://www.californiareport.org/archive/R201209070850/b\" target=\"_blank\">The California Report\u003c/a> Friday morning and said that the downturn in funding predated the downturn in the economy.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"If you look back at 2006, 2007, the economy was booming, but the drops were starting even then, both in total grant numbers and total dollars.\" At the same time, funding to other lesbian, gay, bisexual and transgender giving such as marriage equality and the repeal of the military's \"Don't Ask, Don't Tell\" policy have gone up. \"It's also worth noting,\" Tietz continued, \"that many foundations do three year averages in terms of their investments, in terms of what they give, so we would just be seeing some of those decreases now if it were just a matter of the economy.\"\u003c/p>\n\u003cp>So, what \u003cem>is \u003c/em>going on? Tietz asserts it has to do with the success of HIV/AIDS treatments and what groups are -- and are not -- benefiting from them. Despite the success in the battle against AIDS, 50-thousand people are infected every year and a wildly disproportionate number of those \u003ca title=\"http://ww2.kqed.org/stateofhealth/2012/07/10/endgame-frontline-documentary-explores-aids-in-black-america/\" href=\"http://ww2.kqed.org/stateofhealth/2012/07/10/endgame-frontline-documentary-explores-aids-in-black-america/\" target=\"_blank\">new infections are in African-Americans\u003c/a>.\u003c/p>\n\u003cp>As Tietz wrote in a \u003ca title=\"http://www.washingtonpost.com/opinions/aids-remains-a-problem-but-is-it-still-a-priority-for-the-gay-community/2012/07/20/gJQADLvjyW_story.html\" href=\"http://www.washingtonpost.com/opinions/aids-remains-a-problem-but-is-it-still-a-priority-for-the-gay-community/2012/07/20/gJQADLvjyW_story.html\" target=\"_blank\">Washington Post\u003c/a> opinion piece last summer as the AIDS Conference kicked off:\u003c/p>\n\u003cblockquote>\u003cp>More than six in 10 new infections in the United States are among men who have sex with men, known in this field as MSM. Within that group, the hardest-hit are African American men ages 13 to 29. From 2006 to 2009, \u003ca href=\"https://docs.google.com/viewer?a=v&q=cache:CSadjznKWXEJ:www.cdc.gov/nchhstp/newsroom/docs/FastFacts-MSM-FINAL508COMP.pdf+aids+African+American+men+ages+13+to+29+%2248+percent+%22&hl=en&gl=us&pid=bl&srcid=ADGEESjwMeouatuSTqcsdMbI7dvz-foi4TKmOicNIaGx926A_Og275dCLkHimjLmV9rQ97qeESZdoEAt7c12xKr_sMx4BGWqF8q-EImUyv1X22F6X9DjLEtqADR5fvE3InF4XUcish-u&sig=AHIEtbTrNgQqtChvVn6Xq9O4H-CfXEdZPw\">CDC data show\u003c/a>, HIV infections rose by an appalling 48 percent among these young men — one of the largest increases of any demographic. New HIV cases among black MSM are nearly equal to those for their white counterparts, despite the former’s far smaller percentage of the population.\u003c/p>\u003c/blockquote>\n\u003cp>So, Tietz says, while the new infections are among people at the intersection of race and poverty, the traditional funders of HIV/AIDS -- wealthy, gay, white philanthropists -- look around at their friends and may get the sense AIDS is \"solved.\"\u003c/p>\n\u003cp>\"Today, you may not even know who has HIV,\" he says. \"They could have HIV, they can be in treatment. You don't see deaths, you don't see people in rapid decline. It can feel solved. It can feel like 'OK, I can move on, I can give my resources to marriage equality, I can give my resources to whatever else in the world.\"\u003c/p>\n\u003cp>But obviously AIDS is far from solved. Tietz says he has gotten some \"quiet thank yous\" from other advocates for bringing attention to this issue, but so far, no word from funders themselves.\u003c/p>\n\u003cp>\"There are lots of folks who are committed and even on my own board,\" Tietz told Myrow. \"I have white gay men who give and give and give. There are folks who are really doing their part. But the big picture has changed and not for the better.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cstrong>\u003cem>Listen to Rachael Myrow's interview with Daniel Tietz:\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/R201209070850b.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/R201209070850b.xml\">\u003c/embed>\u003c/object>\u003c/p>\n\n",
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"excerpt": "Researchers, doctors, advocates and general attendees at this year's International AIDS Conference were awash in enthusiasm that a cure to the epidemic is actually within reach, largely due to advances in treatments for people with AIDS and improved prevention.\r\n\r\nBut to actually reach the cure takes money. And right at this moment, private funding is down. Dramatically. Funders Concerned About AIDS, a philanthropy dedicated to ensuring the end of the epidemic, says both the number of grants from private foundations and actual dollars given have dropped by about one-third.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_8364\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/09/aidsblackmen080411.jpg\">\u003cimg class=\"size-medium wp-image-8364 \" title=\"AIDS activists carry banners.\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/09/aidsblackmen080411-300x207.jpg\" alt=\"\" width=\"300\" height=\"207\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Private AIDS funding drops, while new HIV infections among African American men rise dramatically. (Mark Ralston: AFP/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Researchers, doctors, advocates and general attendees at this year's \u003ca title=\"http://aids2012.org\" href=\"http://aids2012.org\" target=\"_blank\">International AIDS Conference\u003c/a> were awash in enthusiasm that a cure to the AIDS epidemic is actually within reach, largely due to advances in treatments and improved prevention.\u003c/p>\n\u003cp>But to actually reach the cure takes money. And right at this moment, private funding is down.\u003c/p>\n\u003cp>Dramatically.\u003c/p>\n\u003cp>\u003ca title=\"http://www.fcaaids.org/OurWork/ResourceTracking/CurrentReport/tabid/218/Default.aspx\" href=\"http://www.fcaaids.org/OurWork/ResourceTracking/CurrentReport/tabid/218/Default.aspx\" target=\"_blank\">Funders Concerned About AIDS\u003c/a>, a philanthropy dedicated to ensuring the end of the epidemic, says both the number of grants from private foundations and actual dollars given have dropped by about one-third.\u003c/p>\n\u003caside class=\"pullquote alignright\">While the new infections are among people at the intersection of race and poverty, the traditional funders of HIV/AIDS ... look around at their friends and may get the sense AIDS is \"solved.\"\u003c/aside>\n\u003cp>At first blush, it would seem that a down economy would be a big driver, but Daniel Tietz, Executive Director of the\u003ca title=\"http://www.acria.org\" href=\"http://www.acria.org\" target=\"_blank\"> AIDS Community Research Initiative of America\u003c/a> (ACRIA), sees something else at work. He spoke with KQED's Rachael Myrow on \u003ca title=\"http://www.californiareport.org/archive/R201209070850/b\" href=\"http://www.californiareport.org/archive/R201209070850/b\" target=\"_blank\">The California Report\u003c/a> Friday morning and said that the downturn in funding predated the downturn in the economy.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"If you look back at 2006, 2007, the economy was booming, but the drops were starting even then, both in total grant numbers and total dollars.\" At the same time, funding to other lesbian, gay, bisexual and transgender giving such as marriage equality and the repeal of the military's \"Don't Ask, Don't Tell\" policy have gone up. \"It's also worth noting,\" Tietz continued, \"that many foundations do three year averages in terms of their investments, in terms of what they give, so we would just be seeing some of those decreases now if it were just a matter of the economy.\"\u003c/p>\n\u003cp>So, what \u003cem>is \u003c/em>going on? Tietz asserts it has to do with the success of HIV/AIDS treatments and what groups are -- and are not -- benefiting from them. Despite the success in the battle against AIDS, 50-thousand people are infected every year and a wildly disproportionate number of those \u003ca title=\"http://ww2.kqed.org/stateofhealth/2012/07/10/endgame-frontline-documentary-explores-aids-in-black-america/\" href=\"http://ww2.kqed.org/stateofhealth/2012/07/10/endgame-frontline-documentary-explores-aids-in-black-america/\" target=\"_blank\">new infections are in African-Americans\u003c/a>.\u003c/p>\n\u003cp>As Tietz wrote in a \u003ca title=\"http://www.washingtonpost.com/opinions/aids-remains-a-problem-but-is-it-still-a-priority-for-the-gay-community/2012/07/20/gJQADLvjyW_story.html\" href=\"http://www.washingtonpost.com/opinions/aids-remains-a-problem-but-is-it-still-a-priority-for-the-gay-community/2012/07/20/gJQADLvjyW_story.html\" target=\"_blank\">Washington Post\u003c/a> opinion piece last summer as the AIDS Conference kicked off:\u003c/p>\n\u003cblockquote>\u003cp>More than six in 10 new infections in the United States are among men who have sex with men, known in this field as MSM. Within that group, the hardest-hit are African American men ages 13 to 29. From 2006 to 2009, \u003ca href=\"https://docs.google.com/viewer?a=v&q=cache:CSadjznKWXEJ:www.cdc.gov/nchhstp/newsroom/docs/FastFacts-MSM-FINAL508COMP.pdf+aids+African+American+men+ages+13+to+29+%2248+percent+%22&hl=en&gl=us&pid=bl&srcid=ADGEESjwMeouatuSTqcsdMbI7dvz-foi4TKmOicNIaGx926A_Og275dCLkHimjLmV9rQ97qeESZdoEAt7c12xKr_sMx4BGWqF8q-EImUyv1X22F6X9DjLEtqADR5fvE3InF4XUcish-u&sig=AHIEtbTrNgQqtChvVn6Xq9O4H-CfXEdZPw\">CDC data show\u003c/a>, HIV infections rose by an appalling 48 percent among these young men — one of the largest increases of any demographic. New HIV cases among black MSM are nearly equal to those for their white counterparts, despite the former’s far smaller percentage of the population.\u003c/p>\u003c/blockquote>\n\u003cp>So, Tietz says, while the new infections are among people at the intersection of race and poverty, the traditional funders of HIV/AIDS -- wealthy, gay, white philanthropists -- look around at their friends and may get the sense AIDS is \"solved.\"\u003c/p>\n\u003cp>\"Today, you may not even know who has HIV,\" he says. \"They could have HIV, they can be in treatment. You don't see deaths, you don't see people in rapid decline. It can feel solved. It can feel like 'OK, I can move on, I can give my resources to marriage equality, I can give my resources to whatever else in the world.\"\u003c/p>\n\u003cp>But obviously AIDS is far from solved. Tietz says he has gotten some \"quiet thank yous\" from other advocates for bringing attention to this issue, but so far, no word from funders themselves.\u003c/p>\n\u003cp>\"There are lots of folks who are committed and even on my own board,\" Tietz told Myrow. \"I have white gay men who give and give and give. There are folks who are really doing their part. But the big picture has changed and not for the better.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cstrong>\u003cem>Listen to Rachael Myrow's interview with Daniel Tietz:\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/R201209070850b.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/R201209070850b.xml\">\u003c/embed>\u003c/object>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Nurse-led Clinics Not New, But Point to the Future",
"title": "Nurse-led Clinics Not New, But Point to the Future",
"headTitle": "State of Health | KQED News",
"content": "\u003cp>By Richard Kipling, \u003ca title=\"http://centerforhealthreporting.org/blog/nurse-led-clinics-may-not-be-new-they-may-be-future972\" href=\"http://centerforhealthreporting.org/blog/nurse-led-clinics-may-not-be-new-they-may-be-future972\" target=\"_blank\">CHCF Center for Health Reporting\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_8353\" class=\"wp-caption alignleft\" style=\"max-width: 185px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/09/Screen-Shot-2012-09-06-at-1.44.03-PM.png\">\u003cimg class=\"size-full wp-image-8353\" title=\"Screen Shot 2012-09-06 at 1.44.03 PM\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/09/Screen-Shot-2012-09-06-at-1.44.03-PM.png\" alt=\"\" width=\"185\" height=\"182\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2012/09/Screen-Shot-2012-09-06-at-1.44.03-PM.png 185w, https://ww2.kqed.org/app/uploads/sites/27/2012/09/Screen-Shot-2012-09-06-at-1.44.03-PM-32x32.png 32w, https://ww2.kqed.org/app/uploads/sites/27/2012/09/Screen-Shot-2012-09-06-at-1.44.03-PM-64x64.png 64w, https://ww2.kqed.org/app/uploads/sites/27/2012/09/Screen-Shot-2012-09-06-at-1.44.03-PM-75x75.png 75w\" sizes=\"(max-width: 185px) 100vw, 185px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Photo: Glide Health Services)\u003c/figcaption>\u003c/figure>\n\u003cp>Who doesn’t remember running to the school nurse’s office with a nosebleed or ear ache? But how many among us have gone to a nurse-managed clinic for our \u003cem>adult\u003c/em> health care?\u003c/p>\n\u003cp>In this era of experimentation in health delivery, the nurse-led clinic is part of the conversation about how best to medically serve us, particularly the poor and uninsured populations.\u003c/p>\n\u003cp>These safety net clinics fly pretty far beneath the general public’s radar, despite the fact most have been around for a decade or more. In California, there are now at least seven of them, mostly in the Bay Area.\u003c/p>\n\u003cp>To find out more about what they do and how they differ from a typical health clinic, I got in touch with Patricia Dennehy, director of \u003ca href=\"http://glide.org/health\" target=\"_blank\">Glide Health Services\u003c/a>, a pioneering nurse-led health center in San Francisco that promises “compassionate healthcare.” The clinic, located in the Tenderloin area of downtown, addresses such issues as hunger and housing as well as providing medical support. It partners with Saint Francis Memorial Hospital, which offers pharmacy and lab services at no cost.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Glide Health resembles other community-based health centers, she told me, “except the leadership is a nurse – typically a nurse practitioner -- instead of a physician or other health professional.”\u003c/p>\n\u003cp>The more important difference, though, is Glide’s “nursing model” approach, which contrasts with the “medical model” that governs most clinics, said Dennehy, who is also a \u003ca href=\"http://nursing.ucsf.edu/faculty/patricia-dennehy\" target=\"_blank\">clinical professor in the school of nursing at UCSF\u003c/a>.\u003c/p>\n\u003cp>“The nursing model puts the \u003cem>person\u003c/em> in the center instead of the disease,” Dennehy said. “In the nurse-led model, the patient is more than, say, a diabetic. It’s about all the social determinants of your health. Are you a victim of trauma? Depressed? We take time to get to know you. It’s less prescriptive and more of a partnership.”\u003c/p>\n\u003cp>Nurse-led centers developed out of “the service mission of schools of nursing,” she said. “The faculty wanted to provide service and educate their students.” The National Nursing Centers Consortium lists \u003ca href=\"http://www.nncc.us/site/index.php/about-nncc/member-clinics\" target=\"_blank\">128 nurse-led center members\u003c/a> across the country, and \u003ca href=\"http://www.phmc.org/site/index.php?option=com_content&view=article&id=451:health-care-reform-package-includes-unprecedented-investment-in-nurse-led-health-clinics&catid=29&Itemid=1575\" target=\"_blank\">more than 85 schools of nursing run such clinics\u003c/a>, which function as training centers as well.\u003c/p>\n\u003cp>In many cases, it’s a “marriage between the school, the community and a community hospital,” said Dennehy. “That’s not unusual and it’s the perfect triangle.”\u003c/p>\n\u003cp>The clinics may be nurse-run, but that doesn’t mean there isn’t a doctor in the house. Many of the clinics recruit doctors to come in on appointed days as part of their professional team. “We have a wonderful internist, a psychiatrist and a pharmacist for parts of the week,” she said.\u003c/p>\n\u003cp>How does all this play with patients? Is there a lot of explaining to do when a doctor is \u003cem>not\u003c/em> around? “If any patient wants to see a doctor, we give them a referral to our doctor or to another place,” said Dennehy. “It doesn’t happen with great frequency, but it does happen.”\u003c/p>\n\u003cp>The clinic’s bottom line, she said, is that “We think that everyone has the right to choose their care. We’ll do everything we can to help you find another place.”\u003c/p>\n\u003cp>Is there new momentum for more nurse-led clinics because of the Affordable Care Act?\u003c/p>\n\u003cp>“It’s very clear that we cannot doctor-up to meet the country’s primary care needs,” said Dennehy.\u003c/p>\n\u003cp>People are searching for different models, she said, particularly when the ACA is bringing so many new people into full insurance coverage.\u003c/p>\n\u003cp>Many more medical professionals will have to practice “at the full scope of their competency and their training,” she said.\u003c/p>\n\u003cp>So what about nurse-led clinics’ prospects?\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“There are plenty of new buds on the vine that are trying to get up and going,” Dennehy said. “I think there are going to be more.”\u003c/p>\n\n",
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"excerpt": "Who doesn’t remember running to the school nurse’s office with a nosebleed or ear ache? But how many among us have gone to a nurse-managed clinic for ouradult health care?\r\n\r\nIn this era of experimentation in health delivery, the nurse-led clinic is part of the conversation about how best to medically serve us, particularly the poor and uninsured populations.\r\n\r\nThese safety net clinics fly pretty far beneath the general public’s radar, despite the fact most have been around for a decade or more. In California, there are now at least seven of them, mostly in the Bay Area.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>By Richard Kipling, \u003ca title=\"http://centerforhealthreporting.org/blog/nurse-led-clinics-may-not-be-new-they-may-be-future972\" href=\"http://centerforhealthreporting.org/blog/nurse-led-clinics-may-not-be-new-they-may-be-future972\" target=\"_blank\">CHCF Center for Health Reporting\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_8353\" class=\"wp-caption alignleft\" style=\"max-width: 185px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/09/Screen-Shot-2012-09-06-at-1.44.03-PM.png\">\u003cimg class=\"size-full wp-image-8353\" title=\"Screen Shot 2012-09-06 at 1.44.03 PM\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/09/Screen-Shot-2012-09-06-at-1.44.03-PM.png\" alt=\"\" width=\"185\" height=\"182\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2012/09/Screen-Shot-2012-09-06-at-1.44.03-PM.png 185w, https://ww2.kqed.org/app/uploads/sites/27/2012/09/Screen-Shot-2012-09-06-at-1.44.03-PM-32x32.png 32w, https://ww2.kqed.org/app/uploads/sites/27/2012/09/Screen-Shot-2012-09-06-at-1.44.03-PM-64x64.png 64w, https://ww2.kqed.org/app/uploads/sites/27/2012/09/Screen-Shot-2012-09-06-at-1.44.03-PM-75x75.png 75w\" sizes=\"(max-width: 185px) 100vw, 185px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Photo: Glide Health Services)\u003c/figcaption>\u003c/figure>\n\u003cp>Who doesn’t remember running to the school nurse’s office with a nosebleed or ear ache? But how many among us have gone to a nurse-managed clinic for our \u003cem>adult\u003c/em> health care?\u003c/p>\n\u003cp>In this era of experimentation in health delivery, the nurse-led clinic is part of the conversation about how best to medically serve us, particularly the poor and uninsured populations.\u003c/p>\n\u003cp>These safety net clinics fly pretty far beneath the general public’s radar, despite the fact most have been around for a decade or more. In California, there are now at least seven of them, mostly in the Bay Area.\u003c/p>\n\u003cp>To find out more about what they do and how they differ from a typical health clinic, I got in touch with Patricia Dennehy, director of \u003ca href=\"http://glide.org/health\" target=\"_blank\">Glide Health Services\u003c/a>, a pioneering nurse-led health center in San Francisco that promises “compassionate healthcare.” The clinic, located in the Tenderloin area of downtown, addresses such issues as hunger and housing as well as providing medical support. It partners with Saint Francis Memorial Hospital, which offers pharmacy and lab services at no cost.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Glide Health resembles other community-based health centers, she told me, “except the leadership is a nurse – typically a nurse practitioner -- instead of a physician or other health professional.”\u003c/p>\n\u003cp>The more important difference, though, is Glide’s “nursing model” approach, which contrasts with the “medical model” that governs most clinics, said Dennehy, who is also a \u003ca href=\"http://nursing.ucsf.edu/faculty/patricia-dennehy\" target=\"_blank\">clinical professor in the school of nursing at UCSF\u003c/a>.\u003c/p>\n\u003cp>“The nursing model puts the \u003cem>person\u003c/em> in the center instead of the disease,” Dennehy said. “In the nurse-led model, the patient is more than, say, a diabetic. It’s about all the social determinants of your health. Are you a victim of trauma? Depressed? We take time to get to know you. It’s less prescriptive and more of a partnership.”\u003c/p>\n\u003cp>Nurse-led centers developed out of “the service mission of schools of nursing,” she said. “The faculty wanted to provide service and educate their students.” The National Nursing Centers Consortium lists \u003ca href=\"http://www.nncc.us/site/index.php/about-nncc/member-clinics\" target=\"_blank\">128 nurse-led center members\u003c/a> across the country, and \u003ca href=\"http://www.phmc.org/site/index.php?option=com_content&view=article&id=451:health-care-reform-package-includes-unprecedented-investment-in-nurse-led-health-clinics&catid=29&Itemid=1575\" target=\"_blank\">more than 85 schools of nursing run such clinics\u003c/a>, which function as training centers as well.\u003c/p>\n\u003cp>In many cases, it’s a “marriage between the school, the community and a community hospital,” said Dennehy. “That’s not unusual and it’s the perfect triangle.”\u003c/p>\n\u003cp>The clinics may be nurse-run, but that doesn’t mean there isn’t a doctor in the house. Many of the clinics recruit doctors to come in on appointed days as part of their professional team. “We have a wonderful internist, a psychiatrist and a pharmacist for parts of the week,” she said.\u003c/p>\n\u003cp>How does all this play with patients? Is there a lot of explaining to do when a doctor is \u003cem>not\u003c/em> around? “If any patient wants to see a doctor, we give them a referral to our doctor or to another place,” said Dennehy. “It doesn’t happen with great frequency, but it does happen.”\u003c/p>\n\u003cp>The clinic’s bottom line, she said, is that “We think that everyone has the right to choose their care. We’ll do everything we can to help you find another place.”\u003c/p>\n\u003cp>Is there new momentum for more nurse-led clinics because of the Affordable Care Act?\u003c/p>\n\u003cp>“It’s very clear that we cannot doctor-up to meet the country’s primary care needs,” said Dennehy.\u003c/p>\n\u003cp>People are searching for different models, she said, particularly when the ACA is bringing so many new people into full insurance coverage.\u003c/p>\n\u003cp>Many more medical professionals will have to practice “at the full scope of their competency and their training,” she said.\u003c/p>\n\u003cp>So what about nurse-led clinics’ prospects?\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“There are plenty of new buds on the vine that are trying to get up and going,” Dennehy said. “I think there are going to be more.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Hispanic Children Focus of New Study on Developmental Delay and Autism",
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"content": "\u003cp>Hispanic children have had a lower rate of autism than other children -- although their cases tend to be more severe. Researchers had wondered -- is there something protective about being Hispanic? Or is this a case of lack of access and lack of understanding of warning signs?\u003c/p>\n\u003cp>I think you can guess the answer. But proving it is generally better than guessing.\u003c/p>\n\u003cp>In one of the largest studies so far to compare development in Hispanic children and non-Hispanic children, researchers at the \u003ca title=\"http://www.ucdmc.ucdavis.edu/mindinstitute/\" href=\"http://www.ucdmc.ucdavis.edu/mindinstitute/\" target=\"_blank\">UC Davis MIND Institute\u003c/a> wrote that Hispanic children \"displayed more similarities than differences compared to non-Hispanics.\" In the case of autism, they found that rates of autism were actually roughly the same between Hispanic and non-Hispanic children.\u003c/p>\n\u003cp>The study's lead author, Virginia Chaidez, Ph.D. said the research filled in a piece of \"large puzzle\" and added \"autism is a spectrum and it's very similar across the board. So we're pretty confident in promoting outreach and trying to encourage the Hispanic community to learn the signs very early in life.\"\u003c!--more-->\u003c/p>\n\u003cp>Chaidez's paper \u003cem>\u003ca title=\"http://www.ncbi.nlm.nih.gov/pubmed/22399446\" href=\"http://www.ncbi.nlm.nih.gov/pubmed/22399446\" target=\"_blank\">Autism spectrum disorders in Hispanics and non-Hispanics\u003c/a>, \u003c/em>was published in the journal \u003cem>Autism. \u003c/em>Research was funded by government grants and the MIND Institute.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>MIND Institute researchers have been following more than 1,000 children since 2003 as part of the larger CHARGE study (Childhood Autism Risks from Genetics and the Environment). CHARGE children fall into three groups: children with autism, children with developmental delay, but not autism and children enrolled from the general population. While autism is much more about deficits in social interaction and communicating, developmental delay has to do with children who lag in meeting physical or intellectual milestones.\u003c/p>\n\u003cp>In addition to looking at rates of autism in Hispanic and non-Hispanic children, researchers also looked at comparisons in developmental delay and found some surprises. First, in both Hispanic and non-Hispanic children, nearly one in five children in the developmental delay group actually met the criteria for autism. If parents don't get the correct diagnosis, it's much less likely their children can get the correct treatment.\u003c/p>\n\u003cp>In addition, 16.5 percent of Hispanic children enrolled from the general population -- \"typically developing\" -- met criteria for either developmental delay or mixed development, compared with just 2.8 percent of non-Hispanic participants. That's more than a five-fold difference. In the published study, researchers explored many possibilities for this disparity.\u003c/p>\n\u003cp>One explanation is that children who speak two languages at home tend to test lower at young ages. (This is expected in bilingual or multilingual children -- they generally catch up later.) \"Test bias\" may have then accounted for some of the difference. On the other hand, researchers wrote that \"milder forms of developmental disabilities are more likely to go undetected in Hispanics.\" Finally, Hispanics may have cultural differences in expectations for child behavior and parenting practices, so diagnosis and treatment may not be sought out.\u003c/p>\n\u003cp>When Maribel Hernandez of Sacramento noticed something seemed not quite right with her young son, some family members told her not to worry and that he would be fine. Instead, she went to her pediatrician. Her son was diagnosed with autism. After her second son was born, he, too, was diagnosed with the disorder. Hernandez is bilingual and encourages parents -- in both English and Spanish -- to seek out diagnosis and treatment. \"They need to ask,\" she told me, \"they need to go and ask for help. If they don't have a chance to go and review what he's supposed to be doing at six months, 12 months, 18 months, if they don't have that chance, then they can't compare with the peers.\"\u003c/p>\n\u003cp>Chaidez also encourages parents to be aware of\u003ca title=\"http://www.cdc.gov/ncbddd/actearly/milestones/index.html\" href=\"http://www.cdc.gov/ncbddd/actearly/milestones/index.html\" target=\"_blank\"> developmental milestones\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n",
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"excerpt": "Hispanic children have had a lower rate of autism than other children -- although their cases tend to be more severe. Researchers wondered -- is there something protective about being Hispanic? Or is this a case of lack of access and lack of understanding of warning signs?\r\n\r\nI think you can guess the answer. But proving it is generally better than guessing.\r\n\r\nIn one of the largest studies so far to compare development in Hispanic children and non-Hispanic children, researchers at the UC Davis MIND Institute wrote that Hispanic children \"displayed more similarities than differences compared to non-Hispanics.\" In the case of autism, they found that rates of autism were about the same between Hispanic and non-Hispanic children.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Hispanic children have had a lower rate of autism than other children -- although their cases tend to be more severe. Researchers had wondered -- is there something protective about being Hispanic? Or is this a case of lack of access and lack of understanding of warning signs?\u003c/p>\n\u003cp>I think you can guess the answer. But proving it is generally better than guessing.\u003c/p>\n\u003cp>In one of the largest studies so far to compare development in Hispanic children and non-Hispanic children, researchers at the \u003ca title=\"http://www.ucdmc.ucdavis.edu/mindinstitute/\" href=\"http://www.ucdmc.ucdavis.edu/mindinstitute/\" target=\"_blank\">UC Davis MIND Institute\u003c/a> wrote that Hispanic children \"displayed more similarities than differences compared to non-Hispanics.\" In the case of autism, they found that rates of autism were actually roughly the same between Hispanic and non-Hispanic children.\u003c/p>\n\u003cp>The study's lead author, Virginia Chaidez, Ph.D. said the research filled in a piece of \"large puzzle\" and added \"autism is a spectrum and it's very similar across the board. So we're pretty confident in promoting outreach and trying to encourage the Hispanic community to learn the signs very early in life.\"\u003c!--more-->\u003c/p>\n\u003cp>Chaidez's paper \u003cem>\u003ca title=\"http://www.ncbi.nlm.nih.gov/pubmed/22399446\" href=\"http://www.ncbi.nlm.nih.gov/pubmed/22399446\" target=\"_blank\">Autism spectrum disorders in Hispanics and non-Hispanics\u003c/a>, \u003c/em>was published in the journal \u003cem>Autism. \u003c/em>Research was funded by government grants and the MIND Institute.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>MIND Institute researchers have been following more than 1,000 children since 2003 as part of the larger CHARGE study (Childhood Autism Risks from Genetics and the Environment). CHARGE children fall into three groups: children with autism, children with developmental delay, but not autism and children enrolled from the general population. While autism is much more about deficits in social interaction and communicating, developmental delay has to do with children who lag in meeting physical or intellectual milestones.\u003c/p>\n\u003cp>In addition to looking at rates of autism in Hispanic and non-Hispanic children, researchers also looked at comparisons in developmental delay and found some surprises. First, in both Hispanic and non-Hispanic children, nearly one in five children in the developmental delay group actually met the criteria for autism. If parents don't get the correct diagnosis, it's much less likely their children can get the correct treatment.\u003c/p>\n\u003cp>In addition, 16.5 percent of Hispanic children enrolled from the general population -- \"typically developing\" -- met criteria for either developmental delay or mixed development, compared with just 2.8 percent of non-Hispanic participants. That's more than a five-fold difference. In the published study, researchers explored many possibilities for this disparity.\u003c/p>\n\u003cp>One explanation is that children who speak two languages at home tend to test lower at young ages. (This is expected in bilingual or multilingual children -- they generally catch up later.) \"Test bias\" may have then accounted for some of the difference. On the other hand, researchers wrote that \"milder forms of developmental disabilities are more likely to go undetected in Hispanics.\" Finally, Hispanics may have cultural differences in expectations for child behavior and parenting practices, so diagnosis and treatment may not be sought out.\u003c/p>\n\u003cp>When Maribel Hernandez of Sacramento noticed something seemed not quite right with her young son, some family members told her not to worry and that he would be fine. Instead, she went to her pediatrician. Her son was diagnosed with autism. After her second son was born, he, too, was diagnosed with the disorder. Hernandez is bilingual and encourages parents -- in both English and Spanish -- to seek out diagnosis and treatment. \"They need to ask,\" she told me, \"they need to go and ask for help. If they don't have a chance to go and review what he's supposed to be doing at six months, 12 months, 18 months, if they don't have that chance, then they can't compare with the peers.\"\u003c/p>\n\u003cp>Chaidez also encourages parents to be aware of\u003ca title=\"http://www.cdc.gov/ncbddd/actearly/milestones/index.html\" href=\"http://www.cdc.gov/ncbddd/actearly/milestones/index.html\" target=\"_blank\"> developmental milestones\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "New Requirement for Vaccine Exemption Passed by Senate",
"title": "New Requirement for Vaccine Exemption Passed by Senate",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_8239\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/08/Vaccine_Baby_DanHatton_Flickr.jpg\">\u003cimg class=\"size-medium wp-image-8239\" title=\"Baby cries after receiving a vaccine. (Dan Hatton: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/08/Vaccine_Baby_DanHatton_Flickr-300x200.jpg\" alt=\"Baby cries after receiving a vaccine. (Dan Hatton: Flickr)\" width=\"300\" height=\"200\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Baby cries after receiving a vaccine. (Dan Hatton: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>\u003cem>Update: Gov. Jerry Brown\u003ca href=\"http://gov.ca.gov/docs/AB_2109_Signing_Message.pdf\" target=\"_blank\"> signed this bill\u003c/a> into law on Sept. 30, 2012. \u003c/em>\u003c/strong>\u003c/p>\n\u003cp>California has one of the more lenient approaches for parents who wish to opt out of vaccinations for their school-age children. While state law requires that children must be vaccinated against various illnesses (think polio, measles, tetanus) to enroll in school, California parents can opt out of vaccines simply by filing a short statement stating that immunizations are contrary to their beliefs. It's known as a personal belief exemption.\u003c/p>\n\u003cp>This week in Sacramento, the Senate passed\u003ca title=\"http://www.aroundthecapitol.com/billtrack/text.html?bvid=20110AB210996AMD\" href=\"http://www.aroundthecapitol.com/billtrack/text.html?bvid=20110AB210996AMD\" target=\"_blank\"> AB 2109\u003c/a>, a bill to make this exemption a little tougher. Under the bill, parents who don't wish to have their children vaccinated must meet with a health care provider to talk about risks and benefits of vaccines. The provider can be a doctor, nurse practitioner, physician assistant, osteopathic physician, naturopathic doctor or a credentialed school nurse. The provider must sign a form and the parent must still provide a written statement.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"This bill does not take away the parent’s right to make a decision.\"\u003c/aside>\n\u003cp>\u003ca title=\"http://asmdc.org/members/a05/\" href=\"http://asmdc.org/members/a05/\" target=\"_blank\">Assemblyman Richard Pan\u003c/a> of Sacramento, a pediatrician himself, sponsored the bill. He pointed to misinformation as a driver of parents opting out of vaccines. \"Parents become uncertain. They're not sure what they should do,\" he told me today in an interview. \"They’re being told their children should be immunized but at the same time, they’re seeing scary stuff out on the internet.\"\u003c!--more-->\u003c/p>\n\u003cp>Pan noted that the bill does not mandate vaccination of all children. \"This bill does not take away the parent’s right to make a decision about whether to get their child immunized or not. We just want to make sure it’s an informed decision.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Critics counter that parents who opt out are already informed. They say that this bill adds to health care costs by requiring extra medical appointments to discuss vaccines.\u003c/p>\n\u003cp>A similar bill passed 18 months ago in Washington state. After it took effect, the opt-out rate there dropped by about 25 percent. So at least some people are making a different decision after meeting with a health care provider. Public health officials expect the opt out rate will go down further this year.\u003c/p>\n\u003cp>The personal belief exemption rate in California is much lower than Washington's -- 2.3 percent for the 2010-2011 school year. But it's not an even distribution statewide. In Los Angeles county, for example, the rate is 1.58 percent. But several counties in northern California -- Trinity, Nevada, Siskiyou -- have opt-out rates exceeding 12 percent. Public health officials say when more than 10 percent of children are not vaccinated, it puts a community at risk. Of special concern are people with weakened immune systems, such as cancer patients or people with HIV. Another group at strong risk are newborn babies.\u003c/p>\n\u003cp>Babies cannot be vaccinated against some illnesses until they are six months old. In 2010, California had a\u003ca title=\"http://ww2.kqed.org/stateofhealth/2012/01/25/no-whooping-cough-deaths-last-year-in-california/\" href=\"http://ww2.kqed.org/stateofhealth/2012/01/25/no-whooping-cough-deaths-last-year-in-california/\" target=\"_blank\"> whooping cough epidemic\u003c/a>. There were 9.000 reported cases and 10 babies died.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>AB 2109 heads back to the Assembly for a final vote, which must happen before the end of the legislative session next Friday. From there, the governor will have 30 days to sign or veto the bill.\u003c/p>\n\n",
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"excerpt": "California has one of the more lenient approaches for parents who wish to opt out of vaccinations for their school-age children. While state law requires that children must be vaccinated against various illnesses (think polio, measles, tetanus) to enroll in school, California parents can opt out of vaccines simply by filing a short statement stating that immunizations are contrary to their beliefs. It's known as a personal belief exemption.\r\n\r\nThis week in Sacramento, the Senate passed AB 2109, a bill to make this exemption a little tougher. Under the bill, parents who don't wish to have their children vaccinated must meet with a health care provider to talk about risks and benefits of vaccines. The provider can be a doctor, nurse practitioner, physician assistant, osteopathic physician, naturopathic doctor or a credentialed school nurse. The provider must sign a form and the parent must still provide a written statement.",
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"description": "California has one of the more lenient approaches for parents who wish to opt out of vaccinations for their school-age children. While state law requires that children must be vaccinated against various illnesses (think polio, measles, tetanus) to enroll in school, California parents can opt out of vaccines simply by filing a short statement stating that immunizations are contrary to their beliefs. It's known as a personal belief exemption.\r\n\r\nThis week in Sacramento, the Senate passed AB 2109, a bill to make this exemption a little tougher. Under the bill, parents who don't wish to have their children vaccinated must meet with a health care provider to talk about risks and benefits of vaccines. The provider can be a doctor, nurse practitioner, physician assistant, osteopathic physician, naturopathic doctor or a credentialed school nurse. The provider must sign a form and the parent must still provide a written statement.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_8239\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/08/Vaccine_Baby_DanHatton_Flickr.jpg\">\u003cimg class=\"size-medium wp-image-8239\" title=\"Baby cries after receiving a vaccine. (Dan Hatton: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/08/Vaccine_Baby_DanHatton_Flickr-300x200.jpg\" alt=\"Baby cries after receiving a vaccine. (Dan Hatton: Flickr)\" width=\"300\" height=\"200\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Baby cries after receiving a vaccine. (Dan Hatton: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>\u003cem>Update: Gov. Jerry Brown\u003ca href=\"http://gov.ca.gov/docs/AB_2109_Signing_Message.pdf\" target=\"_blank\"> signed this bill\u003c/a> into law on Sept. 30, 2012. \u003c/em>\u003c/strong>\u003c/p>\n\u003cp>California has one of the more lenient approaches for parents who wish to opt out of vaccinations for their school-age children. While state law requires that children must be vaccinated against various illnesses (think polio, measles, tetanus) to enroll in school, California parents can opt out of vaccines simply by filing a short statement stating that immunizations are contrary to their beliefs. It's known as a personal belief exemption.\u003c/p>\n\u003cp>This week in Sacramento, the Senate passed\u003ca title=\"http://www.aroundthecapitol.com/billtrack/text.html?bvid=20110AB210996AMD\" href=\"http://www.aroundthecapitol.com/billtrack/text.html?bvid=20110AB210996AMD\" target=\"_blank\"> AB 2109\u003c/a>, a bill to make this exemption a little tougher. Under the bill, parents who don't wish to have their children vaccinated must meet with a health care provider to talk about risks and benefits of vaccines. The provider can be a doctor, nurse practitioner, physician assistant, osteopathic physician, naturopathic doctor or a credentialed school nurse. The provider must sign a form and the parent must still provide a written statement.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"This bill does not take away the parent’s right to make a decision.\"\u003c/aside>\n\u003cp>\u003ca title=\"http://asmdc.org/members/a05/\" href=\"http://asmdc.org/members/a05/\" target=\"_blank\">Assemblyman Richard Pan\u003c/a> of Sacramento, a pediatrician himself, sponsored the bill. He pointed to misinformation as a driver of parents opting out of vaccines. \"Parents become uncertain. They're not sure what they should do,\" he told me today in an interview. \"They’re being told their children should be immunized but at the same time, they’re seeing scary stuff out on the internet.\"\u003c!--more-->\u003c/p>\n\u003cp>Pan noted that the bill does not mandate vaccination of all children. \"This bill does not take away the parent’s right to make a decision about whether to get their child immunized or not. We just want to make sure it’s an informed decision.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Critics counter that parents who opt out are already informed. They say that this bill adds to health care costs by requiring extra medical appointments to discuss vaccines.\u003c/p>\n\u003cp>A similar bill passed 18 months ago in Washington state. After it took effect, the opt-out rate there dropped by about 25 percent. So at least some people are making a different decision after meeting with a health care provider. Public health officials expect the opt out rate will go down further this year.\u003c/p>\n\u003cp>The personal belief exemption rate in California is much lower than Washington's -- 2.3 percent for the 2010-2011 school year. But it's not an even distribution statewide. In Los Angeles county, for example, the rate is 1.58 percent. But several counties in northern California -- Trinity, Nevada, Siskiyou -- have opt-out rates exceeding 12 percent. Public health officials say when more than 10 percent of children are not vaccinated, it puts a community at risk. Of special concern are people with weakened immune systems, such as cancer patients or people with HIV. Another group at strong risk are newborn babies.\u003c/p>\n\u003cp>Babies cannot be vaccinated against some illnesses until they are six months old. In 2010, California had a\u003ca title=\"http://ww2.kqed.org/stateofhealth/2012/01/25/no-whooping-cough-deaths-last-year-in-california/\" href=\"http://ww2.kqed.org/stateofhealth/2012/01/25/no-whooping-cough-deaths-last-year-in-california/\" target=\"_blank\"> whooping cough epidemic\u003c/a>. There were 9.000 reported cases and 10 babies died.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>AB 2109 heads back to the Assembly for a final vote, which must happen before the end of the legislative session next Friday. From there, the governor will have 30 days to sign or veto the bill.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Hospital Policies Dramatically Improve Breastfeeding Rates",
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"content": "\u003cp>By Alice Daniel, \u003ca title=\"http://www.californiahealthline.org/features/2012/tulare-county-hospital-takes-big-steps-to-promote-breastfeeding.aspx\" href=\"http://www.californiahealthline.org/features/2012/tulare-county-hospital-takes-big-steps-to-promote-breastfeeding.aspx\" target=\"_blank\">California Healthline\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_8125\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/08/Breastfeeding_fikirbaz_flickr.jpg\">\u003cimg class=\"size-medium wp-image-8125\" title=\"(fikirbaz: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/08/Breastfeeding_fikirbaz_flickr-300x199.jpg\" alt=\"(fikirbaz: Flickr)\" width=\"300\" height=\"199\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(fikirbaz: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Patti McCowan was fairly new to her job as director of perinatal and pediatric services at Tulare Regional Medical Center when statistics came out showing the hospital had the worst rate in the county for exclusive breastfeeding.\u003c/p>\n\u003cp>That was four years ago and only 15 percent of new mothers were exclusively breastfeeding -- meaning they weren't giving their infants any supplemental formula -- while in the hospital. But 80 percent of women coming in to give birth said their goal was to breastfeed exclusively, McGowan says.\u003c/p>\n\u003cp>\"We were not doing something right,\" said McCowan. \"We were letting 65 percent [of babies] have a bottle. We realized something had to be done.\"\u003c/p>\n\u003cp>Jump ahead to 2012, and Tulare Regional Medical Center has one of the highest rates for exclusive breastfeeding in the Central Valley-- nearly 62 percent, according to the California Department of Public Health -- and the highest in Tulare County.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The county's other two hospitals had much lower exclusive breastfeeding rates; one was 27.9%, the other was 38.5%.\u003c!--more-->\u003c/p>\n\u003cp>\u003cstrong>Changing Policies and Procedures\u003c/strong>\u003c/p>\n\u003cp>Much of Tulare Regional Medical Center's increased rate is due to an overhaul in policies and procedures, said McCowan.\u003c/p>\n\u003cp>The hospital started by sending its obstetrics and gynecology team to a breastfeeding seminar called Birth and Beyond California. Once the medical staff all had the same training, they could offer uniform advice to mothers.\u003c/p>\n\u003cp>Previously, said McCowan, a nurse or a doctor might speak from personal experience instead of objectively offering information on breastfeeding. \"Now we all get the same education and we all educate in the same way,\" she said.\u003c/p>\n\u003cp>A quality assurance team also looked at hospital policies to see which ones needed to be changed or updated to better promote breastfeeding.\u003c/p>\n\u003cp>For instance, nurses no longer give out pacifiers or offer a bottle to a baby just because the mother wants to rest or take a nap. \"That's not the right reason to give a bottle,\" said McCowan. Pacifiers aren't handed out because \"you don't want new babies sucking on something artificial. Any baby awake enough to be sucking needs to be nursing.\"\u003c/p>\n\u003cp>One thing hospital staff members have learned, said McCowan, is \"if you give mothers the right information, they will make the right choice.\"\u003c/p>\n\u003cp>Another policy change was the establishment of skin-to-skin bonding during what is called the \"golden hour.\"\u003c/p>\n\u003cp>\"The first hour after a baby is born, we let the family in to say hello, then have them leave and put the baby on the mother skin-to-skin so they have that attachment and bonding that's so important,\" said McCowan. She said most infants, if allowed, will breastfeed on their own in an hour or two.\u003c/p>\n\u003cp>The Affordable Care Act also supports breastfeeding mothers. As of Aug. 1, new or renewing health insurance plans now must cover certain preventive services, including breastfeeding counseling, for women at no out-of-pocket cost.\u003c/p>\n\u003cp>The Tulare program already has two full-time lactation nurses on staff, a strong ratio for a smaller regional hospital delivering approximately 100 infants a month.\u003c/p>\n\u003cp>\u003cstrong>Partnerships\u003c/strong>\u003c/p>\n\u003cp>The hospital also partnered with First 5 Tulare County, a group focused on children's health, to increase its breastfeeding rates. The Tulare County Women, Infants and Children (WIC) program worked with Tulare Regional to help women continue to breastfeed after leaving the hospital.\u003c/p>\n\u003cp>\"Tulare Regional Medical Center has made amazing progress,\" said Linda Sward, a breastfeeding/nutrition education coordinator with Tulare WIC who also is the Tulare County Breastfeeding Coalition chairperson.\u003c/p>\n\u003cp>Sward said the medical center's program is effective because of the major policy shifts that took place to promote breastfeeding as well as the number of people, including the two lactation consultants, trained to assist in breastfeeding. \"They really help the mothers. There are people with real skills there six days a week,\" she said. \"It really, really has come a long way.\"\u003c/p>\n\u003cp>In January 2011, the California Women, Infants and Children Association recognized Tulare Regional Medical Center as a leader in promoting and improving breastfeeding rates in the state of California.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n",
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"excerpt": "Patti McCowan was fairly new to her job as director of perinatal and pediatric services at Tulare Regional Medical Center when statistics came out showing the hospital had the worst rate in the county for exclusive breastfeeding.\r\n\r\nThat was four years ago and only 15 percent of new mothers were exclusively breastfeeding -- meaning they weren't giving their infants any supplemental formula -- while in the hospital. But 80 percent of women coming in to give birth said their goal was to breastfeed exclusively, McGowan says.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>By Alice Daniel, \u003ca title=\"http://www.californiahealthline.org/features/2012/tulare-county-hospital-takes-big-steps-to-promote-breastfeeding.aspx\" href=\"http://www.californiahealthline.org/features/2012/tulare-county-hospital-takes-big-steps-to-promote-breastfeeding.aspx\" target=\"_blank\">California Healthline\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_8125\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/08/Breastfeeding_fikirbaz_flickr.jpg\">\u003cimg class=\"size-medium wp-image-8125\" title=\"(fikirbaz: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/08/Breastfeeding_fikirbaz_flickr-300x199.jpg\" alt=\"(fikirbaz: Flickr)\" width=\"300\" height=\"199\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(fikirbaz: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Patti McCowan was fairly new to her job as director of perinatal and pediatric services at Tulare Regional Medical Center when statistics came out showing the hospital had the worst rate in the county for exclusive breastfeeding.\u003c/p>\n\u003cp>That was four years ago and only 15 percent of new mothers were exclusively breastfeeding -- meaning they weren't giving their infants any supplemental formula -- while in the hospital. But 80 percent of women coming in to give birth said their goal was to breastfeed exclusively, McGowan says.\u003c/p>\n\u003cp>\"We were not doing something right,\" said McCowan. \"We were letting 65 percent [of babies] have a bottle. We realized something had to be done.\"\u003c/p>\n\u003cp>Jump ahead to 2012, and Tulare Regional Medical Center has one of the highest rates for exclusive breastfeeding in the Central Valley-- nearly 62 percent, according to the California Department of Public Health -- and the highest in Tulare County.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The county's other two hospitals had much lower exclusive breastfeeding rates; one was 27.9%, the other was 38.5%.\u003c!--more-->\u003c/p>\n\u003cp>\u003cstrong>Changing Policies and Procedures\u003c/strong>\u003c/p>\n\u003cp>Much of Tulare Regional Medical Center's increased rate is due to an overhaul in policies and procedures, said McCowan.\u003c/p>\n\u003cp>The hospital started by sending its obstetrics and gynecology team to a breastfeeding seminar called Birth and Beyond California. Once the medical staff all had the same training, they could offer uniform advice to mothers.\u003c/p>\n\u003cp>Previously, said McCowan, a nurse or a doctor might speak from personal experience instead of objectively offering information on breastfeeding. \"Now we all get the same education and we all educate in the same way,\" she said.\u003c/p>\n\u003cp>A quality assurance team also looked at hospital policies to see which ones needed to be changed or updated to better promote breastfeeding.\u003c/p>\n\u003cp>For instance, nurses no longer give out pacifiers or offer a bottle to a baby just because the mother wants to rest or take a nap. \"That's not the right reason to give a bottle,\" said McCowan. Pacifiers aren't handed out because \"you don't want new babies sucking on something artificial. Any baby awake enough to be sucking needs to be nursing.\"\u003c/p>\n\u003cp>One thing hospital staff members have learned, said McCowan, is \"if you give mothers the right information, they will make the right choice.\"\u003c/p>\n\u003cp>Another policy change was the establishment of skin-to-skin bonding during what is called the \"golden hour.\"\u003c/p>\n\u003cp>\"The first hour after a baby is born, we let the family in to say hello, then have them leave and put the baby on the mother skin-to-skin so they have that attachment and bonding that's so important,\" said McCowan. She said most infants, if allowed, will breastfeed on their own in an hour or two.\u003c/p>\n\u003cp>The Affordable Care Act also supports breastfeeding mothers. As of Aug. 1, new or renewing health insurance plans now must cover certain preventive services, including breastfeeding counseling, for women at no out-of-pocket cost.\u003c/p>\n\u003cp>The Tulare program already has two full-time lactation nurses on staff, a strong ratio for a smaller regional hospital delivering approximately 100 infants a month.\u003c/p>\n\u003cp>\u003cstrong>Partnerships\u003c/strong>\u003c/p>\n\u003cp>The hospital also partnered with First 5 Tulare County, a group focused on children's health, to increase its breastfeeding rates. The Tulare County Women, Infants and Children (WIC) program worked with Tulare Regional to help women continue to breastfeed after leaving the hospital.\u003c/p>\n\u003cp>\"Tulare Regional Medical Center has made amazing progress,\" said Linda Sward, a breastfeeding/nutrition education coordinator with Tulare WIC who also is the Tulare County Breastfeeding Coalition chairperson.\u003c/p>\n\u003cp>Sward said the medical center's program is effective because of the major policy shifts that took place to promote breastfeeding as well as the number of people, including the two lactation consultants, trained to assist in breastfeeding. \"They really help the mothers. There are people with real skills there six days a week,\" she said. \"It really, really has come a long way.\"\u003c/p>\n\u003cp>In January 2011, the California Women, Infants and Children Association recognized Tulare Regional Medical Center as a leader in promoting and improving breastfeeding rates in the state of California.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_8050\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/08/RichmondRefineryFire_DanielParks_Flickr_08062012.jpg\">\u003cimg class=\"size-medium wp-image-8050\" title=\"Monday night's Chevron Refinery fire as seen from the Berkeley Hills. (Daniel Parks: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/08/RichmondRefineryFire_DanielParks_Flickr_08062012-300x185.jpg\" alt=\"Monday night's Chevron Refinery fire as seen from the Berkeley Hills. (Daniel Parks: Flickr)\" width=\"300\" height=\"185\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Monday night's Chevron Refinery fire as seen from the Berkeley Hills. (Daniel Parks: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Contra Costa Health Services has posted a succinct \"\u003ca title=\"http://cchealth.org/special/pdf/FAQ-Chevron-Fire.pdf\" href=\"http://cchealth.org/special/pdf/FAQ-Chevron-Fire.pdf\" target=\"_blank\">Frequently Asked Questions Related to the Chevron Fire on August 6, 2012\u003c/a>.\" [PDF] It's good information -- cleaning fruits, vegetables, avoiding groundwater, health impact, etc.\u003c/p>\n\u003cp>I republish it here, in its entirety:\u003c/p>\n\u003cdiv>\n\u003cblockquote>\u003cp>1. What are the health impacts from the refinery fire?\u003c/p>\n\u003cp>Smoke can cause throat and eye irritation, though it generally is not serious\u003cbr>\nif the exposure is limited. These symptoms should resolve on their own after a few days for most people. Exposure to smoke can be more serious for people with pre-existing lung disease, such as asthma, and they may experience wheezing or have trouble breathing. As of August 8, more than 1,700 people have gone to the emergency room with nose, throat or eye irritation or respiratory issues, although none have been hospitalized.\u003c/p>\n\u003cp>2. What chemicals were released into the air and how dangerous are they?\u003c!--more-->\u003c/p>\n\u003cp>A variety of chemicals were released during the Chevron Richmond refinery fire. (See list of chemicals from each sample location.) Smoke particulates, which are what makes smoke black, were the major concern during this fire. Smoke particulates can irritate the throat, lungs and eyes particularly in those with pre-existing lung disease, such as asthma. Benzene, a chemical that can cause cancer, and other toxic chemicals can also be present in smoke. Test results from air samples that were taken by Contra Costa Hazardous Materials Response Team and staff from the Bay Area Air Quality Management District (BAAQMD) were analyzed by BAAQMD and show the level of benzene and other toxic chemicals was below harmful levels during the fire and poses no risk of cancer. We do not have good measurements of the smoke particulates that impacted the community.\u003c/p>\n\u003cp>3. Is it safe to eat fruits and vegetables from my garden?\u003c/p>\n\u003cp>Yes, it’s safe. It’s always a good idea to wash fruits and vegetables before eating. If you live in an area that was affected by the refinery fire, you can wash fruits and vegetables from your garden with soap and a mild detergent (like liquid dish soap). Washing your fruits and vegetables will remove any particulates that might have been on the surface from smoke. You also can peel off the outer layer of lettuce or peel your fruit if you are concerned.\u003c/p>\n\u003cp>4. Is our water safe for drinking?\u003c/p>\n\u003cp>The tap water in Richmond is one of the best waters in the country and it is safe for you to drink and to give to your pets. The ground water from local wells in Richmond should not be used for drinking by you or your pets.\u003c/p>\n\u003cp>5. What should I do if there is soot on my car, patio furniture or outdoor play structures?\u003c/p>\n\u003cp>If there is residue on your car, patio furniture or outdoor play structure wash it with a mild detergent and water.\u003c/p>\n\u003cp>6. Why was shelter-in-place lifted if the air sample results aren't in yet?\u003c/p>\n\u003cp>The shelter-in-place was lifted because the fire at Chevron was under control and our hazardous materials monitors confirmed there was no ongoing exposure.\u003c/p>\n\u003cp>7. What should I do if I am having trouble breathing or have burning eyes and a sore throat?\u003c/p>\n\u003cp>People who are experiencing trouble breathing should seek medical attention. If you have burning eyes and a sore throat contact your health care provider.\u003c/p>\n\u003cp>8. Is there any assistance in paying for my medical expenses related to this incident?\u003c/p>\n\u003cp>Contact Chevron for information regarding payment of medical expenses or claims. You can reach them at 510-242-2000 for general information or at 1-866-260-7881 for claim information.\u003c/p>\u003c/blockquote>\n\u003c/div>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n",
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"excerpt": "Contra Costa Health Services has posted a succinct \"Frequently Asked Questions Related to the Chevron Fire on August 6, 2012.\" [PDF] It's good information -- cleaning fruits, vegetables, avoiding groundwater, health impact, etc.\r\n\r\nI republish it here, in its entirety:\r\n\r\n1. What are the health impacts from the refinery fire?",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_8050\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/08/RichmondRefineryFire_DanielParks_Flickr_08062012.jpg\">\u003cimg class=\"size-medium wp-image-8050\" title=\"Monday night's Chevron Refinery fire as seen from the Berkeley Hills. (Daniel Parks: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/08/RichmondRefineryFire_DanielParks_Flickr_08062012-300x185.jpg\" alt=\"Monday night's Chevron Refinery fire as seen from the Berkeley Hills. (Daniel Parks: Flickr)\" width=\"300\" height=\"185\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Monday night's Chevron Refinery fire as seen from the Berkeley Hills. (Daniel Parks: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Contra Costa Health Services has posted a succinct \"\u003ca title=\"http://cchealth.org/special/pdf/FAQ-Chevron-Fire.pdf\" href=\"http://cchealth.org/special/pdf/FAQ-Chevron-Fire.pdf\" target=\"_blank\">Frequently Asked Questions Related to the Chevron Fire on August 6, 2012\u003c/a>.\" [PDF] It's good information -- cleaning fruits, vegetables, avoiding groundwater, health impact, etc.\u003c/p>\n\u003cp>I republish it here, in its entirety:\u003c/p>\n\u003cdiv>\n\u003cblockquote>\u003cp>1. What are the health impacts from the refinery fire?\u003c/p>\n\u003cp>Smoke can cause throat and eye irritation, though it generally is not serious\u003cbr>\nif the exposure is limited. These symptoms should resolve on their own after a few days for most people. Exposure to smoke can be more serious for people with pre-existing lung disease, such as asthma, and they may experience wheezing or have trouble breathing. As of August 8, more than 1,700 people have gone to the emergency room with nose, throat or eye irritation or respiratory issues, although none have been hospitalized.\u003c/p>\n\u003cp>2. What chemicals were released into the air and how dangerous are they?\u003c!--more-->\u003c/p>\n\u003cp>A variety of chemicals were released during the Chevron Richmond refinery fire. (See list of chemicals from each sample location.) Smoke particulates, which are what makes smoke black, were the major concern during this fire. Smoke particulates can irritate the throat, lungs and eyes particularly in those with pre-existing lung disease, such as asthma. Benzene, a chemical that can cause cancer, and other toxic chemicals can also be present in smoke. Test results from air samples that were taken by Contra Costa Hazardous Materials Response Team and staff from the Bay Area Air Quality Management District (BAAQMD) were analyzed by BAAQMD and show the level of benzene and other toxic chemicals was below harmful levels during the fire and poses no risk of cancer. We do not have good measurements of the smoke particulates that impacted the community.\u003c/p>\n\u003cp>3. Is it safe to eat fruits and vegetables from my garden?\u003c/p>\n\u003cp>Yes, it’s safe. It’s always a good idea to wash fruits and vegetables before eating. If you live in an area that was affected by the refinery fire, you can wash fruits and vegetables from your garden with soap and a mild detergent (like liquid dish soap). Washing your fruits and vegetables will remove any particulates that might have been on the surface from smoke. You also can peel off the outer layer of lettuce or peel your fruit if you are concerned.\u003c/p>\n\u003cp>4. Is our water safe for drinking?\u003c/p>\n\u003cp>The tap water in Richmond is one of the best waters in the country and it is safe for you to drink and to give to your pets. The ground water from local wells in Richmond should not be used for drinking by you or your pets.\u003c/p>\n\u003cp>5. What should I do if there is soot on my car, patio furniture or outdoor play structures?\u003c/p>\n\u003cp>If there is residue on your car, patio furniture or outdoor play structure wash it with a mild detergent and water.\u003c/p>\n\u003cp>6. Why was shelter-in-place lifted if the air sample results aren't in yet?\u003c/p>\n\u003cp>The shelter-in-place was lifted because the fire at Chevron was under control and our hazardous materials monitors confirmed there was no ongoing exposure.\u003c/p>\n\u003cp>7. What should I do if I am having trouble breathing or have burning eyes and a sore throat?\u003c/p>\n\u003cp>People who are experiencing trouble breathing should seek medical attention. If you have burning eyes and a sore throat contact your health care provider.\u003c/p>\n\u003cp>8. Is there any assistance in paying for my medical expenses related to this incident?\u003c/p>\n\u003cp>Contact Chevron for information regarding payment of medical expenses or claims. You can reach them at 510-242-2000 for general information or at 1-866-260-7881 for claim information.\u003c/p>\u003c/blockquote>\n\u003c/div>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "California Heats Up and That Means Health Risks",
"title": "California Heats Up and That Means Health Risks",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_8034\" class=\"wp-caption alignleft\" style=\"max-width: 293px\">\u003ca href=\"www.weather.gov\">\u003cimg class=\"size-medium wp-image-8034\" title=\"Map from the National Weather Service shows the areas of 'excessive heat' alerts in California.\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/08/Screen-Shot-2012-08-09-at-11.29.07-AM-300x307.png\" alt=\"Map from the National Weather Service shows the areas of 'excessive heat' alerts in California.\" width=\"293\" height=\"300\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Map from the National Weather Service shows the areas of 'excessive heat' alerts in California.\u003c/figcaption>\u003c/figure>\n\u003cp>The rest of the nation has sweltered this summer, but California has escaped extreme heat -- until now. The \u003ca title=\"http://www.weather.gov\" href=\"http://www.weather.gov\" target=\"_blank\">National Weather Service\u003c/a> may not have high-end graphics, but its map tells the story. The San Joaquin Valley, starting south of Modesto, is colored a brownish-red and that means excessive heat warning. Temperatures are expected to exceed 100 degrees every day until Tuesday. The bright pink areas indicate a heat \"watch\" (click \u003ca title=\"http://www.crh.noaa.gov/lmk/spotter_reference/spotter_slideshow/slide9.php\" href=\"http://www.crh.noaa.gov/lmk/spotter_reference/spotter_slideshow/slide9.php\" target=\"_blank\">here\u003c/a> if you don't know the difference). This kind of heat is not just a weather story, it's a significant health and environment story too.\u003c/p>\n\u003cp>High heat is hazardous to people, pets and livestock.\u003ca title=\"http://www.sjcphs.org/Disease/Heat_Emergencies.aspx\" href=\"http://www.sjcphs.org/Disease/Heat_Emergencies.aspx\" target=\"_blank\"> San Joaquin County Public Health Services\u003c/a> warns people to drink plenty of water, stay cool in an air-conditioned room and wear loose-fitting clothing. And, please, do not leave children, seniors or pets in a parked car for any period of time, even with windows cracked. The interior of the car can heat up very fast -- to deadly levels -- within minutes.\u003c/p>\n\u003cp>Those at highest risk for heat stress are children under age 4, adults with disabilities, anyone with a chronic illness and the elderly.\u003c!--more-->\u003c/p>\n\u003cp>With high heat generally comes higher pollution which puts people with respiratory conditions at risk as well. Kevin Hall, Director of the \u003ca title=\"http://www.calcleanair.org\" href=\"http://www.calcleanair.org\" target=\"_blank\">Central Valley Air Quality Coalition\u003c/a> emailed me that the worst air is likely to be in the Fresno metropolitan area and \"presumably, up against and into the Sierra Nevada -- but we only have the forest service monitors at 1500 and 5500 feet in eastern Tulare County.\" He also pointed out that the Valley Air Board suspended issuing \"Spare the Air\" days three years ago, so air quality warnings will not be issued.\u003c/p>\n\u003cp>Indeed, when I checked the Valley Air Board's website, it showed today's \u003ca title=\"http://www.valleyair.org/Home.htm\" href=\"http://www.valleyair.org/Home.htm\" target=\"_blank\">air quality forecast\u003c/a> as \"moderate\" even though numbers from the state \u003ca title=\"http://www.arb.ca.gov/aqmis2/display.php?param=OZONE&units=007&year=2012&mon=8&day=8&hours=midday&report=7DAY&statistic=DMOL8&o3area=&o3pa8=SJV&county_name=&latitude=&basin=&order=&ptype=aqd\" href=\"http://www.arb.ca.gov/aqmis2/display.php?param=OZONE&units=007&year=2012&mon=8&day=8&hours=midday&report=7DAY&statistic=DMOL8&o3area=&o3pa8=SJV&county_name=&latitude=&basin=&order=&ptype=aqd\" target=\"_blank\">Air Resources Board\u003c/a> show that yesterday's 8-hour ozone levels exceeded both state and federal standards in many areas in and around Fresno.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Finally, this kind of heat stressed humans and the state's power grid. The \u003ca title=\"http://www.caiso.com/Pages/default.aspx?gclid=CI--zNqZ27ECFYIaQgod6gwAyw\" href=\"http://www.caiso.com/Pages/default.aspx?gclid=CI--zNqZ27ECFYIaQgod6gwAyw\" target=\"_blank\">California Independent System Operator\u003c/a> has issued a \u003ca title=\"http://www.caiso.com/Documents/CaliforniaISO-DeclaresFlex-AlertStatewide.pdf\" href=\"http://www.caiso.com/Documents/CaliforniaISO-DeclaresFlex-AlertStatewide.pdf\" target=\"_blank\">Flex Alert\u003c/a> starting tomorrow and running through Sunday. People are encouraged to reduce their energy use, especially in the afternoon. As Steven Greene told KPBS, \"During the 4 to 6 p.m. period, we like to call that the 'air conditioning rush hour.' Many people come home and they have been out in the weather and want to cool down fairly quickly. So they go over their thermostat to do that.\"\u003c/p>\n\u003cp>Greene says a setting of of between 70 and 80 degrees provides enough cooling and helps lessen the energy strain.\u003c/p>\n\u003cp> \u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n",
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"excerpt": "The rest of the nation has sweltered this summer, but California has escaped extreme heat -- until now. The National Weather Service may not have high-end graphics, but its map tells the story. The San Joaquin Valley, starting south of Modesto, is colored a brownish-red and that means excessive heat warning. Temperatures are expected to exceed 100 degrees every day until Tuesday. The bright pink areas indicate a heat \"watch\" (click here if you don't know the difference). This kind of heat is not just a weather story, it's a significant health and environment story too.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_8034\" class=\"wp-caption alignleft\" style=\"max-width: 293px\">\u003ca href=\"www.weather.gov\">\u003cimg class=\"size-medium wp-image-8034\" title=\"Map from the National Weather Service shows the areas of 'excessive heat' alerts in California.\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/08/Screen-Shot-2012-08-09-at-11.29.07-AM-300x307.png\" alt=\"Map from the National Weather Service shows the areas of 'excessive heat' alerts in California.\" width=\"293\" height=\"300\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Map from the National Weather Service shows the areas of 'excessive heat' alerts in California.\u003c/figcaption>\u003c/figure>\n\u003cp>The rest of the nation has sweltered this summer, but California has escaped extreme heat -- until now. The \u003ca title=\"http://www.weather.gov\" href=\"http://www.weather.gov\" target=\"_blank\">National Weather Service\u003c/a> may not have high-end graphics, but its map tells the story. The San Joaquin Valley, starting south of Modesto, is colored a brownish-red and that means excessive heat warning. Temperatures are expected to exceed 100 degrees every day until Tuesday. The bright pink areas indicate a heat \"watch\" (click \u003ca title=\"http://www.crh.noaa.gov/lmk/spotter_reference/spotter_slideshow/slide9.php\" href=\"http://www.crh.noaa.gov/lmk/spotter_reference/spotter_slideshow/slide9.php\" target=\"_blank\">here\u003c/a> if you don't know the difference). This kind of heat is not just a weather story, it's a significant health and environment story too.\u003c/p>\n\u003cp>High heat is hazardous to people, pets and livestock.\u003ca title=\"http://www.sjcphs.org/Disease/Heat_Emergencies.aspx\" href=\"http://www.sjcphs.org/Disease/Heat_Emergencies.aspx\" target=\"_blank\"> San Joaquin County Public Health Services\u003c/a> warns people to drink plenty of water, stay cool in an air-conditioned room and wear loose-fitting clothing. And, please, do not leave children, seniors or pets in a parked car for any period of time, even with windows cracked. The interior of the car can heat up very fast -- to deadly levels -- within minutes.\u003c/p>\n\u003cp>Those at highest risk for heat stress are children under age 4, adults with disabilities, anyone with a chronic illness and the elderly.\u003c!--more-->\u003c/p>\n\u003cp>With high heat generally comes higher pollution which puts people with respiratory conditions at risk as well. Kevin Hall, Director of the \u003ca title=\"http://www.calcleanair.org\" href=\"http://www.calcleanair.org\" target=\"_blank\">Central Valley Air Quality Coalition\u003c/a> emailed me that the worst air is likely to be in the Fresno metropolitan area and \"presumably, up against and into the Sierra Nevada -- but we only have the forest service monitors at 1500 and 5500 feet in eastern Tulare County.\" He also pointed out that the Valley Air Board suspended issuing \"Spare the Air\" days three years ago, so air quality warnings will not be issued.\u003c/p>\n\u003cp>Indeed, when I checked the Valley Air Board's website, it showed today's \u003ca title=\"http://www.valleyair.org/Home.htm\" href=\"http://www.valleyair.org/Home.htm\" target=\"_blank\">air quality forecast\u003c/a> as \"moderate\" even though numbers from the state \u003ca title=\"http://www.arb.ca.gov/aqmis2/display.php?param=OZONE&units=007&year=2012&mon=8&day=8&hours=midday&report=7DAY&statistic=DMOL8&o3area=&o3pa8=SJV&county_name=&latitude=&basin=&order=&ptype=aqd\" href=\"http://www.arb.ca.gov/aqmis2/display.php?param=OZONE&units=007&year=2012&mon=8&day=8&hours=midday&report=7DAY&statistic=DMOL8&o3area=&o3pa8=SJV&county_name=&latitude=&basin=&order=&ptype=aqd\" target=\"_blank\">Air Resources Board\u003c/a> show that yesterday's 8-hour ozone levels exceeded both state and federal standards in many areas in and around Fresno.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Finally, this kind of heat stressed humans and the state's power grid. The \u003ca title=\"http://www.caiso.com/Pages/default.aspx?gclid=CI--zNqZ27ECFYIaQgod6gwAyw\" href=\"http://www.caiso.com/Pages/default.aspx?gclid=CI--zNqZ27ECFYIaQgod6gwAyw\" target=\"_blank\">California Independent System Operator\u003c/a> has issued a \u003ca title=\"http://www.caiso.com/Documents/CaliforniaISO-DeclaresFlex-AlertStatewide.pdf\" href=\"http://www.caiso.com/Documents/CaliforniaISO-DeclaresFlex-AlertStatewide.pdf\" target=\"_blank\">Flex Alert\u003c/a> starting tomorrow and running through Sunday. People are encouraged to reduce their energy use, especially in the afternoon. As Steven Greene told KPBS, \"During the 4 to 6 p.m. period, we like to call that the 'air conditioning rush hour.' Many people come home and they have been out in the weather and want to cool down fairly quickly. So they go over their thermostat to do that.\"\u003c/p>\n\u003cp>Greene says a setting of of between 70 and 80 degrees provides enough cooling and helps lessen the energy strain.\u003c/p>\n\u003cp> \u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Soda Industry Spending Big to Defeat Richmond Beverage Tax",
"title": "Soda Industry Spending Big to Defeat Richmond Beverage Tax",
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"content": "\u003cfigure id=\"attachment_8019\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/08/RichmondSoda_20120806b.jpg\">\u003cimg class=\"size-medium wp-image-8019\" title=\"Rosa Lara talks with Alejandra Nava at La Raza market. Lara is a paid organizer for the Community Coalition Against Beverage Taxes. (Photo: Mina Kim)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/08/RichmondSoda_20120806b-300x225.jpg\" alt=\"Rosa Lara talks with Alejandra Nava at La Raza market. Lara is a paid organizer for the community coalition against beverage taxes.\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Rosa Lara talks with Alejandra Nava at La Raza market in Richmond. Lara is a paid organizer for the community coalition against beverage taxes.\u003c/figcaption>\u003c/figure>\n\u003cp>Earlier this week, KQED's Mina Kim looked at \u003ca title=\"http://ww2.kqed.org/stateofhealth/2012/08/06/the-soda-tax-campaign-in-full-swing-in-richmond/\" href=\"http://ww2.kqed.org/stateofhealth/2012/08/06/the-soda-tax-campaign-in-full-swing-in-richmond/\" target=\"_blank\">the ongoing soda tax campaign\u003c/a> in Richmond. In November, voters there will decide whether to impose a penny-an-ounce fee on sweetened drinks. Today, William Harless at \u003ca title=\"http://californiawatch.org/dailyreport/soda-industry-outspends-beverage-tax-supporters-10-1-richmond-17454\" href=\"http://californiawatch.org/dailyreport/soda-industry-outspends-beverage-tax-supporters-10-1-richmond-17454\" target=\"_blank\">California Watch\u003c/a> drilled down into newly-released campaign finance disclosures and learned that -- not surprisingly -- tax opponents are outspending tax supporters.\u003c/p>\n\u003cp>What might be more surprising is that the margin is 10 to 1. Harless reports that the \u003ca href=\"http://www.ameribev.org/\" target=\"_blank\">American Beverage Association\u003c/a>, based in Washington and representing Coca Cola, PepsiCo et. al. has spent $150,000 since June. (Note that the City Council \u003ca title=\"http://ww2.kqed.org/stateofhealth/2012/05/16/richmond-voters-will-decide-on-soda-tax/\" href=\"http://ww2.kqed.org/stateofhealth/2012/05/16/richmond-voters-will-decide-on-soda-tax/\" target=\"_blank\">voted to put the tax on the ballot \u003c/a>on May 15.)\u003c/p>\n\u003cp>Harless \u003ca title=\"http://californiawatch.org/dailyreport/beverage-lobbyist-funds-community-campaign-against-soda-tax-16585\" href=\"http://californiawatch.org/dailyreport/beverage-lobbyist-funds-community-campaign-against-soda-tax-16585\" target=\"_blank\">earlier reported\u003c/a> that the beverage association is funding the \u003ca href=\"http://www.norichmondbeveragetax.com/\" target=\"_blank\">Community Coalition Against Beverage Taxes\u003c/a>. To date, that organization has spent an additional $200,000, again according to campaign finance records.\u003c/p>\n\u003cp>While dramatically outspent, more organizations are also joining the campaign to support the tax. \u003c!--more-->From California Watch:\u003c/p>\n\u003cblockquote>\u003cp>The \u003ca href=\"http://www.publichealthadvocacy.org/\" target=\"_blank\">California Center for Public Health Advocacy\u003c/a>, a nonprofit group with offices in Oakland, Davis and Los Angeles, has spent about $21,600 on polling and focus groups.\u003c/p>\n\u003cp>Richmond City Council Member Jeff Ritterman, a cardiologist who is leading the campaign for the sweetened-beverage tax, said he believes soda drinkers will start to turn to tap water, saving money and drinking something healthier. He said the American Beverage Association is worried that Richmond will set a trend.\u003c/p>\n\u003cp>“I think they’re quite aware that if these dominoes begin to fall, a lot more will,” he said, referring to the two California cities, Richmond and \u003ca href=\"http://articles.latimes.com/2012/jul/24/local/la-me-el-monte-20120724\" target=\"_blank\">El Monte\u003c/a>, in Los Angeles County, that are considering penny-per-ounce sweetened-beverage taxes, which would be the first of their kind in the United States.\u003c/p>\n\u003cp>Ritterman and a handful of Bay Area residents have raised about $10,400 for their own campaign, dubbed \u003ca href=\"http://www.fit-for-life.org/\" target=\"_blank\">Richmond Fit for Life\u003c/a>, and have sent out brochures and mailers advocating for the tax, outlining obesity statistics and describing how it and a companion health measure are phrased on the November ballot.\u003c/p>\u003c/blockquote>\n\u003cp>Ritterman believes the tax could raise $3 million annually. A non-binding resolution passed by City Council the same night it voted to put the tax on the ballot recommends that the money be spent on obesity prevention programs. Opponents say they think the money would end up in the general fund.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n",
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"excerpt": "Earlier this week, KQED's Mina Kim looked at the ongoing soda tax campaign in Richmond. In November, voters will decide whether to impose a penny an ounce fee on sweetened drinks. Today, William Harless at California Watch drilled down into newly released campaign finance disclosures and learned that -- not surprisingly -- tax opponents are outspending tax supporters. \r\n\r\nWhat might be somewhat more surprising is that the margin is 10 to 1. Harless reports that the American Beverage Association, based in Washington and representing Coca Cola, PepsiCo et. a. has spent $150,000 since June. (Note that the City Council voted to put the tax on the ballot on May 15.)",
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"description": "Earlier this week, KQED's Mina Kim looked at the ongoing soda tax campaign in Richmond. In November, voters will decide whether to impose a penny an ounce fee on sweetened drinks. Today, William Harless at California Watch drilled down into newly released campaign finance disclosures and learned that -- not surprisingly -- tax opponents are outspending tax supporters. \r\n\r\nWhat might be somewhat more surprising is that the margin is 10 to 1. Harless reports that the American Beverage Association, based in Washington and representing Coca Cola, PepsiCo et. a. has spent $150,000 since June. (Note that the City Council voted to put the tax on the ballot on May 15.)",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_8019\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/08/RichmondSoda_20120806b.jpg\">\u003cimg class=\"size-medium wp-image-8019\" title=\"Rosa Lara talks with Alejandra Nava at La Raza market. Lara is a paid organizer for the Community Coalition Against Beverage Taxes. (Photo: Mina Kim)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/08/RichmondSoda_20120806b-300x225.jpg\" alt=\"Rosa Lara talks with Alejandra Nava at La Raza market. Lara is a paid organizer for the community coalition against beverage taxes.\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Rosa Lara talks with Alejandra Nava at La Raza market in Richmond. Lara is a paid organizer for the community coalition against beverage taxes.\u003c/figcaption>\u003c/figure>\n\u003cp>Earlier this week, KQED's Mina Kim looked at \u003ca title=\"http://ww2.kqed.org/stateofhealth/2012/08/06/the-soda-tax-campaign-in-full-swing-in-richmond/\" href=\"http://ww2.kqed.org/stateofhealth/2012/08/06/the-soda-tax-campaign-in-full-swing-in-richmond/\" target=\"_blank\">the ongoing soda tax campaign\u003c/a> in Richmond. In November, voters there will decide whether to impose a penny-an-ounce fee on sweetened drinks. Today, William Harless at \u003ca title=\"http://californiawatch.org/dailyreport/soda-industry-outspends-beverage-tax-supporters-10-1-richmond-17454\" href=\"http://californiawatch.org/dailyreport/soda-industry-outspends-beverage-tax-supporters-10-1-richmond-17454\" target=\"_blank\">California Watch\u003c/a> drilled down into newly-released campaign finance disclosures and learned that -- not surprisingly -- tax opponents are outspending tax supporters.\u003c/p>\n\u003cp>What might be more surprising is that the margin is 10 to 1. Harless reports that the \u003ca href=\"http://www.ameribev.org/\" target=\"_blank\">American Beverage Association\u003c/a>, based in Washington and representing Coca Cola, PepsiCo et. al. has spent $150,000 since June. (Note that the City Council \u003ca title=\"http://ww2.kqed.org/stateofhealth/2012/05/16/richmond-voters-will-decide-on-soda-tax/\" href=\"http://ww2.kqed.org/stateofhealth/2012/05/16/richmond-voters-will-decide-on-soda-tax/\" target=\"_blank\">voted to put the tax on the ballot \u003c/a>on May 15.)\u003c/p>\n\u003cp>Harless \u003ca title=\"http://californiawatch.org/dailyreport/beverage-lobbyist-funds-community-campaign-against-soda-tax-16585\" href=\"http://californiawatch.org/dailyreport/beverage-lobbyist-funds-community-campaign-against-soda-tax-16585\" target=\"_blank\">earlier reported\u003c/a> that the beverage association is funding the \u003ca href=\"http://www.norichmondbeveragetax.com/\" target=\"_blank\">Community Coalition Against Beverage Taxes\u003c/a>. To date, that organization has spent an additional $200,000, again according to campaign finance records.\u003c/p>\n\u003cp>While dramatically outspent, more organizations are also joining the campaign to support the tax. \u003c!--more-->From California Watch:\u003c/p>\n\u003cblockquote>\u003cp>The \u003ca href=\"http://www.publichealthadvocacy.org/\" target=\"_blank\">California Center for Public Health Advocacy\u003c/a>, a nonprofit group with offices in Oakland, Davis and Los Angeles, has spent about $21,600 on polling and focus groups.\u003c/p>\n\u003cp>Richmond City Council Member Jeff Ritterman, a cardiologist who is leading the campaign for the sweetened-beverage tax, said he believes soda drinkers will start to turn to tap water, saving money and drinking something healthier. He said the American Beverage Association is worried that Richmond will set a trend.\u003c/p>\n\u003cp>“I think they’re quite aware that if these dominoes begin to fall, a lot more will,” he said, referring to the two California cities, Richmond and \u003ca href=\"http://articles.latimes.com/2012/jul/24/local/la-me-el-monte-20120724\" target=\"_blank\">El Monte\u003c/a>, in Los Angeles County, that are considering penny-per-ounce sweetened-beverage taxes, which would be the first of their kind in the United States.\u003c/p>\n\u003cp>Ritterman and a handful of Bay Area residents have raised about $10,400 for their own campaign, dubbed \u003ca href=\"http://www.fit-for-life.org/\" target=\"_blank\">Richmond Fit for Life\u003c/a>, and have sent out brochures and mailers advocating for the tax, outlining obesity statistics and describing how it and a companion health measure are phrased on the November ballot.\u003c/p>\u003c/blockquote>\n\u003cp>Ritterman believes the tax could raise $3 million annually. A non-binding resolution passed by City Council the same night it voted to put the tax on the ballot recommends that the money be spent on obesity prevention programs. Opponents say they think the money would end up in the general fund.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Could Marin County's High Breast Cancer Rate Have a Genetic Link?",
"title": "Could Marin County's High Breast Cancer Rate Have a Genetic Link?",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_7997\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/08/MtTam_SteveMohundro_Flickr.jpg\">\u003cimg class=\"size-medium wp-image-7997\" title=\"View of Marin County from Mt. Tamalpais. (Flickr: Steve Mohundro)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/08/MtTam_SteveMohundro_Flickr-300x225.jpg\" alt=\"View of Marin County from Mt. Tamalpais. (Flickr: Steve Mohundro)\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">View of Marin County from Mt. Tamalpais. (Flickr: Steve Mohundro)\u003c/figcaption>\u003c/figure>\n\u003cp>Let's start out with the disclaimers -- first, this small study -- just 338 samples -- has to be proven in a larger study. Second, even if true, we are years away from seeing new treatments.\u003c/p>\n\u003cp>Still this new research from UCSF is intriguing to say the least. Researchers at UC San Francisco looked at cell samples from women shown through previous testing to be at higher risk of breast cancer. They found that those women were almost twice as likely to have a genetic variation involving a vitamin D receptor. The research was \u003ca title=\"http://www.journalacs.org/article/S1072-7515(12)00892-7/abstract\" href=\"http://www.journalacs.org/article/S1072-7515(12)00892-7/abstract\" target=\"_blank\">published online\u003c/a> earlier this week and will be in the November print edition of the Journal of the American College of Surgeons.\u003c/p>\n\u003cp>Marin County has one of the highest rates of breast cancer in the world. \u003ca title=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC314435/\" href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC314435/\" target=\"_blank\">A 2003 study\u003c/a> found that the land in Marin was not a factor -- a woman's risk of developing cancer did not go up if she lived longer in Marin County. In conducting that study, researchers had used cell samples taken from the mouths of women -- half the women had breast cancer, half did not. Those samples were kept frozen after the study was complete.\u003c!--more-->\u003c/p>\n\u003cp>This new study used technology developed by \u003ca title=\"http://www.intergenetics.com/cms/\" href=\"http://www.intergenetics.com/cms/\" target=\"_blank\">InterGenetics\u003c/a> in Oklahoma City. The new technology scores breast cancer risk based on genetic variations within the vitamin D receptor and other genes, according to a press release from UCSF.\u003c/p>\n\u003cp>As the\u003ca title=\"http://www.sfgate.com/health/article/Marin-breast-cancer-linked-to-vitamin-D-receptor-3770785.php\" href=\"http://www.sfgate.com/health/article/Marin-breast-cancer-linked-to-vitamin-D-receptor-3770785.php\" target=\"_blank\"> San Francisco Chronicle\u003c/a> reports:\u003c/p>\n\u003cblockquote>\u003cp>\"A lot of people have been doing analyses of vitamin D levels and breast cancer risk, but there haven't been a lot of studies addressing the vitamin D receptor itself,\" said Dr. Kathie Dalessandri, a surgeon scientist in Point Reyes Station and primary author of the study.\u003c/p>\n\u003cp>\"I think this is just the tip of the iceberg,\" she said, adding that the findings need to be validated in a larger study.\u003c/p>\u003c/blockquote>\n\u003cp>Yes, there's that \"larger study needed\" disclaimer mentioned above. From the UCSF release:\u003c/p>\n\u003cblockquote>\u003cp>If genetic variations in the vitamin D receptor prove to be causally linked to breast cancer, that may help pave the way for new ways to prevent or treat the disease through vitamin D supplementation—though any such approaches would have to prove safe and effective in clinical trials, which can take years to reveal impact.\u003c/p>\u003c/blockquote>\n\u003cp>Studies of vitamin D supplementation to prevent breast cancer are going on now, Dr. Dalessandri says. Women whose alcohol consumption is more than two drinks each day are at increased risk for breast cancer. That alcohol can be associated with vitamin deficiency, which includes vitamin D deficiency. In Marin County, about 25 percent of the breast cases were in women who also had alcohol consumption above two drinks per day. Dr. Dalessandri believes the the vitamin D genetic variation is \"potentially interacting\" with the effects of the alcohol to increase breast cancer risk.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Again, it will take more research to prove this connection.\u003c/p>\n\n",
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"excerpt": "Let's start out with the disclaimers -- first, this small study -- just 338 samples -- has to be proven in a larger study. Second, even if true, we are years away from seeing new treatments.\r\n\r\nStill this new research from UCSF is intriguing to say the least. Researchers at UC San Francisco looked at cell samples from women shown through previous testing to be at higher risk of breast cancer. They found that those women were almost twice as likely to have a genetic variation involving, of all things, a vitamin D receptor.\r\n",
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"description": "Let's start out with the disclaimers -- first, this small study -- just 338 samples -- has to be proven in a larger study. Second, even if true, we are years away from seeing new treatments.\r\n\r\nStill this new research from UCSF is intriguing to say the least. Researchers at UC San Francisco looked at cell samples from women shown through previous testing to be at higher risk of breast cancer. They found that those women were almost twice as likely to have a genetic variation involving, of all things, a vitamin D receptor.\r\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_7997\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/08/MtTam_SteveMohundro_Flickr.jpg\">\u003cimg class=\"size-medium wp-image-7997\" title=\"View of Marin County from Mt. Tamalpais. (Flickr: Steve Mohundro)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/08/MtTam_SteveMohundro_Flickr-300x225.jpg\" alt=\"View of Marin County from Mt. Tamalpais. (Flickr: Steve Mohundro)\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">View of Marin County from Mt. Tamalpais. (Flickr: Steve Mohundro)\u003c/figcaption>\u003c/figure>\n\u003cp>Let's start out with the disclaimers -- first, this small study -- just 338 samples -- has to be proven in a larger study. Second, even if true, we are years away from seeing new treatments.\u003c/p>\n\u003cp>Still this new research from UCSF is intriguing to say the least. Researchers at UC San Francisco looked at cell samples from women shown through previous testing to be at higher risk of breast cancer. They found that those women were almost twice as likely to have a genetic variation involving a vitamin D receptor. The research was \u003ca title=\"http://www.journalacs.org/article/S1072-7515(12)00892-7/abstract\" href=\"http://www.journalacs.org/article/S1072-7515(12)00892-7/abstract\" target=\"_blank\">published online\u003c/a> earlier this week and will be in the November print edition of the Journal of the American College of Surgeons.\u003c/p>\n\u003cp>Marin County has one of the highest rates of breast cancer in the world. \u003ca title=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC314435/\" href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC314435/\" target=\"_blank\">A 2003 study\u003c/a> found that the land in Marin was not a factor -- a woman's risk of developing cancer did not go up if she lived longer in Marin County. In conducting that study, researchers had used cell samples taken from the mouths of women -- half the women had breast cancer, half did not. Those samples were kept frozen after the study was complete.\u003c!--more-->\u003c/p>\n\u003cp>This new study used technology developed by \u003ca title=\"http://www.intergenetics.com/cms/\" href=\"http://www.intergenetics.com/cms/\" target=\"_blank\">InterGenetics\u003c/a> in Oklahoma City. The new technology scores breast cancer risk based on genetic variations within the vitamin D receptor and other genes, according to a press release from UCSF.\u003c/p>\n\u003cp>As the\u003ca title=\"http://www.sfgate.com/health/article/Marin-breast-cancer-linked-to-vitamin-D-receptor-3770785.php\" href=\"http://www.sfgate.com/health/article/Marin-breast-cancer-linked-to-vitamin-D-receptor-3770785.php\" target=\"_blank\"> San Francisco Chronicle\u003c/a> reports:\u003c/p>\n\u003cblockquote>\u003cp>\"A lot of people have been doing analyses of vitamin D levels and breast cancer risk, but there haven't been a lot of studies addressing the vitamin D receptor itself,\" said Dr. Kathie Dalessandri, a surgeon scientist in Point Reyes Station and primary author of the study.\u003c/p>\n\u003cp>\"I think this is just the tip of the iceberg,\" she said, adding that the findings need to be validated in a larger study.\u003c/p>\u003c/blockquote>\n\u003cp>Yes, there's that \"larger study needed\" disclaimer mentioned above. From the UCSF release:\u003c/p>\n\u003cblockquote>\u003cp>If genetic variations in the vitamin D receptor prove to be causally linked to breast cancer, that may help pave the way for new ways to prevent or treat the disease through vitamin D supplementation—though any such approaches would have to prove safe and effective in clinical trials, which can take years to reveal impact.\u003c/p>\u003c/blockquote>\n\u003cp>Studies of vitamin D supplementation to prevent breast cancer are going on now, Dr. Dalessandri says. Women whose alcohol consumption is more than two drinks each day are at increased risk for breast cancer. That alcohol can be associated with vitamin deficiency, which includes vitamin D deficiency. In Marin County, about 25 percent of the breast cases were in women who also had alcohol consumption above two drinks per day. Dr. Dalessandri believes the the vitamin D genetic variation is \"potentially interacting\" with the effects of the alcohol to increase breast cancer risk.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cfigure id=\"attachment_7967\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/08/Wendy-Georges-Planning-Session.jpg\">\u003cimg class=\"size-medium wp-image-7967\" title=\"Wendy Georges Planning Session\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/08/Wendy-Georges-Planning-Session-300x225.jpg\" alt=\"\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Wendy Georges (second from the left) leads a planning session for the new TRUST Clinic (Photo: David Modersbach)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Alvin Tran \u003c/strong>\u003c/p>\n\u003cp>Alameda County has new plans in store for its homeless population – it intends to open an integrated medical clinic in downtown Oakland.\u003c/p>\n\u003cp>The TRUST Clinic is one of the county's newest projects and involves the collaboration of several agencies including Alameda County’s \u003ca href=\"http://www.acphd.org/hchp.aspx\" target=\"_blank\">Health Care for the Homeless Program\u003c/a>, \u003ca href=\"http://alamedasocialservices.org/public/index.cfm\" target=\"_blank\">Social Services Agency\u003c/a> and \u003ca href=\"http://www.acbhcs.org/\" target=\"_blank\">Behavioral Health Services\u003c/a>.\u003c/p>\n\u003cp>But unlike other clinics in Alameda County, TRUST will be one of just two which will offer integrated health services, including primary care, behavioral health, case management with housing assistance, and medical-legal partnerships.\u003c/p>\n\u003cp>“This clinic is a very innovative idea. It’s not something that’s being done in very many places,” said Dr. Michael Boroff, a clinical psychologist who will be working at the clinic. “It embraces the integrated health care ... with medical and mental health and all of these different aspects of services combining and working together as a team.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>“I’d be hard-pressed to identify the population who needs these services more than the homeless population that we’re going to be serving,” Boroff added. And that population is large -- more than 4,000 people in 2011, according to a report by \u003ca href=\"http://www.everyonehome.org/resources_homeless_count11.html\" target=\"_blank\">EveryOne Home\u003c/a>, an advocacy group.\u003c/p>\n\u003cp>Wendy Georges, the TRUST Clinic Manager, said many homeless people deal with a variety of health and behavioral problems. Homeless individuals might have mental illness and substance abuse issues, they may have difficulty keeping track of their medical appointments, and might struggle in social settings.\u003c/p>\n\u003cp>The TRUST Clinic is intended to be a place where people can get a variety of services for up to 24 months. The hope is that during this time, patients will achieve financial and housing stability and be prepared to transition to other permanent clinics in Oakland.\u003c/p>\n\u003cp>“What we’re hoping to do in the TRUST Clinic is to address all of those problems across a spectrum -- stabilize their health, stabilize their mental health, offer effective substance abuse and interventions for addiction, provide legal advocacy to people so that they can successfully transition off of (General Assistance), get on to insurance which will then increase their access to medical care, mental health care,” Georges explained.\u003c/p>\n\u003cp>While many homeless individuals are current recipients of \u003ca href=\"http://www.alamedasocialservices.org/public/services/financial_assistance/general_assistance/index.cfm\" target=\"_blank\">General Assistance\u003c/a>, also known as welfare, Georges said that many of them are still unable to obtain adequate health services. TRUST will help enroll individuals in other areas of assistance.\u003c/p>\n\u003cp>“If they get on to Social Security, Supplemental Security Income -- SSI -- or SSDI, they'll have access, automatic access, then to Medi-Cal and, in some instances, to Medicare,” Georges said.\u003c/p>\n\u003cp>But when more people become insured, there will be other challenges to face.\u003c/p>\n\u003cp>According to Georges, more than 56,000 people in Alameda County will become eligible for health insurance once President Obama's \u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-admin/www.healthcare.gov\" target=\"_blank\">Affordable Care Act\u003c/a> takes full effect in California.\u003c/p>\n\u003cp>“The demand outweighs the supply,” Georges said, adding that the current community clinic system in Alameda County will continue to be overburdened with patients from the safety net population –- a population in need which lacks health insurance.\u003c/p>\n\u003cp>This is where the TRUST Clinic comes into play. Georges describes the clinic as the “safety net for the safety net.”\u003c/p>\n\u003cp>“By redirecting the homeless population to the TRUST Clinic we relieve the burden on our community health network and enhance an already inadequate safety net system in Alameda County,” Georges explained later in an email. “Our clients/patients already have difficulties gaining access to the system and fitting in even when they do. We are establishing the (clinic) with just such clients/patients in mind, so truly to function as a safety net for the safety net.”\u003c/p>\n\u003cp>While the bricks and mortar clinic opens in 2013, Alameda’s homeless population does not have to wait until then to begin receiving the TRUST Clinic’s integrated health services. Starting Tuesday staff members of the clinic, including a nurse practitioner and a clinical psychologist, began offering part-time, interim mental health services at two locations in Oakland.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“We’re going to start with mental health and we’re going to begin this building up process, get our mechanisms in place,” Georges said. “It’s a little bit of a practice run for a ramp up to full scale services.\"\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": "The Political Mind of Jerry Brown brings listeners the wisdom of the former Governor, Mayor, and presidential candidate. Scott Shafer interviewed Brown for more than 40 hours, covering the former governor's life and half-century in the political game – and Brown has some lessons he'd like to share. ",
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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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"masters-of-scale": {
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},
"mindshift": {
"id": "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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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5",
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"morning-edition": {
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"info": "\u003cem>Morning Edition\u003c/em> takes listeners around the country and the world with multi-faceted stories and commentaries every weekday. Hosts Steve Inskeep, David Greene and Rachel Martin bring you the latest breaking news and features to prepare you for the day.",
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"onourwatch": {
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"title": "On Our Watch",
"tagline": "Deeply-reported investigative journalism",
"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
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"order": 11
},
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"on-the-media": {
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"title": "On The Media",
"info": "Our weekly podcast explores how the media 'sausage' is made, casts an incisive eye on fluctuations in the marketplace of ideas, and examines threats to the freedom of information and expression in America and abroad. For one hour a week, the show tries to lift the veil from the process of \"making media,\" especially news media, because it's through that lens that we see the world and the world sees us",
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"link": "/radio/program/on-the-media",
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},
"pbs-newshour": {
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"tuneIn": "https://tunein.com/radio/PBS-NewsHour---Full-Show-p425698/",
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},
"perspectives": {
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"order": 14
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"planet-money": {
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"info": "The economy explained. Imagine you could call up a friend and say, Meet me at the bar and tell me what's going on with the economy. Now imagine that's actually a fun evening.",
"airtime": "SUN 3pm-4pm",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/planetmoney.jpg",
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"link": "/radio/program/planet-money",
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"apple": "https://itunes.apple.com/us/podcast/planet-money/id290783428?mt=2",
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},
"politicalbreakdown": {
"id": "politicalbreakdown",
"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",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Political-Breakdown-2024-Podcast-Tile-703x703-1.jpg",
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"order": 5
},
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"amazon": "https://music.amazon.com/podcasts/e0c2d153-ad36-4c8d-901d-f1da6a724824/political-breakdown",
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"possible": {
"id": "possible",
"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",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Possible-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.possible.fm/",
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"source": "Possible"
},
"link": "/radio/program/possible",
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"spotify": "https://open.spotify.com/show/730YpdUSNlMyPQwNnyjp4k"
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},
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