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"content": "\u003cfigure id=\"attachment_5315\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/veteran.gif\">\u003cimg class=\"size-full wp-image-5315\" title=\"veteran\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/veteran.gif\" alt=\"\" width=\"300\" height=\"300\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2012/04/veteran.gif 300w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/veteran-32x32.gif 32w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/veteran-64x64.gif 64w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/veteran-96x96.gif 96w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/veteran-128x128.gif 128w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/veteran-75x75.gif 75w\" sizes=\"(max-width: 300px) 100vw, 300px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The need for mental health services among veterans has increased 35% since 2007. (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>The Department of Veterans Affairs \u003ca href=\"http://www.va.gov/opa/pressrel/pressrelease.cfm?id=2302\">has announced \u003c/a>that it will add 1,600 mental health clinicians and 300 support staff to veterans hospitals across the country to help contend with the rising demand for mental health care among returning veterans. That's an almost 10% increase in mental health staff and is sorely needed at hospitals that can't keep up with the requests for appointments. In some places, wait time for care is much longer than the VA's 14 day policy, the subject of a report by the department's inspector general to be released next week.\u003c/p>\n\u003cp>Northern California may be faring slightly better than the rest of the country on mental health issues. “In Northern California we have many veterans coming back. We also have a lot of staff,\" said Robin Jackson, a spokeswoman for the \u003ca href=\"http://www.northerncalifornia.va.gov/\">Department of Veterans Affairs Northern California Health Care System\u003c/a>. \"We’ve tripled our mental health staff in the last 4 years. So we many be ahead of the curve,” she added. Jackson said that staff in Northern California realized that traumatic brain injury and other mental trauma would be the most common illnesses in returning Iraq and Afghanistan veterans, so they ramped up their staffing to meet the need.\u003c!--more-->\u003c/p>\n\u003cp>Northern California VA's are meeting the department's 14 day timeline to see veterans in need of mental health treatment, according to Jackson. She also said they've been doing some innovative things to help veterans feel comfortable using the VA, and to diagnosis them early. “We do a post deployment health reassessment,” Jackson said, citing the recent return of a National Guard unit where all members were given the health assessment. \"They get familiar with what we have to offer and feel comfortable to come back,” she added. Jackson says California has always been at the forefront of practices like these because of the state's large veterans population, especially in Southern California.\u003c/p>\n\u003caside class=\"pullquote alignright\">\"We’ve tripled our mental health staff in the last 4 years. So we many be ahead of the curve.\"\u003c/aside>\n\u003cp>Southern California has seen a sharp increase in mental health need, almost doubling the number of patients between 2006 to the present. Dr. Peter Hauser, mental health program coordinator for the Southern California network of VA health care facilities, estimates that 20 to 30 percent of returning veterans from Iraq will have Post Traumatic Stress Disorder (PTSD). He added that the VA network expects more demand as former soldiers try to reintegrate into civilian life and experience employment difficulties that exacerbate existing traumas.\u003c/p>\n\u003cp>Dr. Hauser expects his region to get 111 new mental health professionals. \"We are working hard to fill all existing vacancies and ramp up recruiting to hire new staff and create outpatient mental health teams that enhance continuity of care,\" he wrote in an email. Southern California has had a \u003ca href=\"http://www.usatoday.com/news/military/story/2012-04-19/veterans-hiring-mental-health-workers/54418514/1\">hard time filling vacancies\u003c/a> on its mental health staff that already exist. Dr. Hauser cited high cost of living in Southern California, salary competition from private networks and overal budgetary contraints as reasons why recruiting and filling psychiatrist positions has been difficult.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The Department of Veterans Affairs as whole has \u003ca href=\"http://www.nytimes.com/2012/04/20/us/veterans-affairs-dept-to-increase-mental-health-staffing.html?_r=1\">come under fire\u003c/a> for long wait times and inadequate care, problems the new staff are meant to address. \"History shows that the costs of war will continue to grow for a decade or more after the operational missions in Iraq and Afghanistan have ended,\" Department Secretary \u003ca href=\"http://www.va.gov/opa/bios/secretary.asp\">Eric Shinseki\u003c/a> said in a statement. \"As more veterans return home, we must ensure that all veterans have access to quality mental health care.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The VA treats 1.3 million veterans for mental health problems nationwide, 400,000 of whom are returning from Iraq and Afghanistan. Since 2009, the VA has increased the mental health budget by 39%, but that may not be enough. The number of veterans seeking mental health help has increased 35% since 2007. The new staff will be paid for out of the VA's existing budget.\u003c/p>\n\n",
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"description": "The Department of Veterans Affairs has announced that it will add 1,600 mental health clinicians and 300 support staff to veterans hospitals across the country to help contend with the rising demand for mental health care among returning veterans. That's an almost 10% increase in mental health staff and is sorely needed at hospitals that",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_5315\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/veteran.gif\">\u003cimg class=\"size-full wp-image-5315\" title=\"veteran\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/veteran.gif\" alt=\"\" width=\"300\" height=\"300\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2012/04/veteran.gif 300w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/veteran-32x32.gif 32w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/veteran-64x64.gif 64w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/veteran-96x96.gif 96w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/veteran-128x128.gif 128w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/veteran-75x75.gif 75w\" sizes=\"(max-width: 300px) 100vw, 300px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The need for mental health services among veterans has increased 35% since 2007. (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>The Department of Veterans Affairs \u003ca href=\"http://www.va.gov/opa/pressrel/pressrelease.cfm?id=2302\">has announced \u003c/a>that it will add 1,600 mental health clinicians and 300 support staff to veterans hospitals across the country to help contend with the rising demand for mental health care among returning veterans. That's an almost 10% increase in mental health staff and is sorely needed at hospitals that can't keep up with the requests for appointments. In some places, wait time for care is much longer than the VA's 14 day policy, the subject of a report by the department's inspector general to be released next week.\u003c/p>\n\u003cp>Northern California may be faring slightly better than the rest of the country on mental health issues. “In Northern California we have many veterans coming back. We also have a lot of staff,\" said Robin Jackson, a spokeswoman for the \u003ca href=\"http://www.northerncalifornia.va.gov/\">Department of Veterans Affairs Northern California Health Care System\u003c/a>. \"We’ve tripled our mental health staff in the last 4 years. So we many be ahead of the curve,” she added. Jackson said that staff in Northern California realized that traumatic brain injury and other mental trauma would be the most common illnesses in returning Iraq and Afghanistan veterans, so they ramped up their staffing to meet the need.\u003c!--more-->\u003c/p>\n\u003cp>Northern California VA's are meeting the department's 14 day timeline to see veterans in need of mental health treatment, according to Jackson. She also said they've been doing some innovative things to help veterans feel comfortable using the VA, and to diagnosis them early. “We do a post deployment health reassessment,” Jackson said, citing the recent return of a National Guard unit where all members were given the health assessment. \"They get familiar with what we have to offer and feel comfortable to come back,” she added. Jackson says California has always been at the forefront of practices like these because of the state's large veterans population, especially in Southern California.\u003c/p>\n\u003caside class=\"pullquote alignright\">\"We’ve tripled our mental health staff in the last 4 years. So we many be ahead of the curve.\"\u003c/aside>\n\u003cp>Southern California has seen a sharp increase in mental health need, almost doubling the number of patients between 2006 to the present. Dr. Peter Hauser, mental health program coordinator for the Southern California network of VA health care facilities, estimates that 20 to 30 percent of returning veterans from Iraq will have Post Traumatic Stress Disorder (PTSD). He added that the VA network expects more demand as former soldiers try to reintegrate into civilian life and experience employment difficulties that exacerbate existing traumas.\u003c/p>\n\u003cp>Dr. Hauser expects his region to get 111 new mental health professionals. \"We are working hard to fill all existing vacancies and ramp up recruiting to hire new staff and create outpatient mental health teams that enhance continuity of care,\" he wrote in an email. Southern California has had a \u003ca href=\"http://www.usatoday.com/news/military/story/2012-04-19/veterans-hiring-mental-health-workers/54418514/1\">hard time filling vacancies\u003c/a> on its mental health staff that already exist. Dr. Hauser cited high cost of living in Southern California, salary competition from private networks and overal budgetary contraints as reasons why recruiting and filling psychiatrist positions has been difficult.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The Department of Veterans Affairs as whole has \u003ca href=\"http://www.nytimes.com/2012/04/20/us/veterans-affairs-dept-to-increase-mental-health-staffing.html?_r=1\">come under fire\u003c/a> for long wait times and inadequate care, problems the new staff are meant to address. \"History shows that the costs of war will continue to grow for a decade or more after the operational missions in Iraq and Afghanistan have ended,\" Department Secretary \u003ca href=\"http://www.va.gov/opa/bios/secretary.asp\">Eric Shinseki\u003c/a> said in a statement. \"As more veterans return home, we must ensure that all veterans have access to quality mental health care.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The VA treats 1.3 million veterans for mental health problems nationwide, 400,000 of whom are returning from Iraq and Afghanistan. Since 2009, the VA has increased the mental health budget by 39%, but that may not be enough. The number of veterans seeking mental health help has increased 35% since 2007. The new staff will be paid for out of the VA's existing budget.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "California Prison Medical Costs Higher Than Average",
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"content": "\u003cp>\u003cstrong>By KQED Staff and Wires\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_5305\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/prisoner.gif\">\u003cimg class=\"size-full wp-image-5305\" title=\"prisoner\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/prisoner.gif\" alt=\"\" width=\"300\" height=\"300\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2012/04/prisoner.gif 300w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/prisoner-32x32.gif 32w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/prisoner-64x64.gif 64w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/prisoner-96x96.gif 96w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/prisoner-128x128.gif 128w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/prisoner-75x75.gif 75w\" sizes=\"(max-width: 300px) 100vw, 300px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">California spends three times the national average on inmate medical care. (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>As the state prepares to resume control of inmate medical care, it must find ways to reduce costs that are triple the national average, the nonpartisan \u003ca href=\"http://www.lao.ca.gov/laoapp/\">Legislative Analyst's Office\u003c/a> said Thursday.\u003c/p>\n\u003cp>The federal receivership that has been in place since 2006 has greatly improved the medical care of state prison inmates but also has caused costs to soar, according to \u003ca href=\"http://www.lao.ca.gov/reports/2012/crim/inmate-medical-care/inmate-medical-care-041912.pdf\">the report\u003c/a>. California spends $16,000 per inmate for health care services, compared to an average of $5,000 in other states.\u003c/p>\n\u003cp>The analysis was released less than two weeks before the state and attorneys representing inmates must report to a federal judge with recommendations on when the receivership should end and whether it should maintain some oversight role.\u003c/p>\n\u003cp>The Legislature should create an independent board to monitor prison medical care to make sure conditions do not deteriorate once the state retakes control, the report said. It also recommends that the state experiment with contracting for medical services to cut costs.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The state should rely more on \u003ca href=\"http://www.americantelemed.org/i4a/pages/index.cfm?pageID=3331\">telemedicine \u003c/a>so physicians in urban medical facilities can treat inmates without physically traveling to remote prisons. The analysis also found that the receivership has not been consistent in using management safeguards that are designed to hold down medical spending.\u003c/p>\n\u003caside class=\"pullquote alignright\">\"Eighty cents of every dollar is spent on inmate direct care. Everything he's done is done with an eye to increasing efficiency.\"\u003c/aside>\n\u003cp>The receivership already is following many of the recommendations outlined in the report, said Nancy Kincaid, spokeswoman for the receiver's office.\u003c/p>\n\u003cp>The receivership began emphasizing telemedicine a year ago, Kincaid said. She acknowledged that while medical staff in some prisons follow the receivership's uniform policy for controlling medical costs, those in other prisons must do a better job.\u003c/p>\n\u003cp>The receiver, \u003ca href=\"http://www.capitolweekly.net/article.php?xid=ylta91g5empdw5\">J. Clark Kelso\u003c/a>, uses private contractors when they are cheaper, she said, but is limited by a prohibition in the state constitution on using a contractor if a state employee can do the job.\u003c/p>\n\u003cp>She disputed the report's comparisons with costs in other states, contending that many others don't count their administrative, information technology or contract costs in their accounting.\u003c/p>\n\u003cp>\"Eighty cents of every dollar is spent on inmate direct care. Everything he's done is done with an eye to increasing efficiency ... and saving taxpayers' money wherever he can,\" Kincaid said.\u003c/p>\n\u003cp>The legislative analyst called a recent 7 percent decline in inmate health care costs \"encouraging,\" but said the proposed prison medical budget for the fiscal year beginning July 1 is still 42 percent higher than it was before the receivership began.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Ending the receivership could save money in the \"low tens of millions of dollars annually,\" the analysis estimated, because the state could consolidate what currently are two duplicate bureaucracies overseeing the prison medical system ‚ one for the court-appointed receiver and the other for the \u003ca href=\"http://www.cdcr.ca.gov/\">California Department of Corrections and Rehabilitation.\u003c/a>\u003c/p>\n\n",
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"description": "By KQED Staff and Wires As the state prepares to resume control of inmate medical care, it must find ways to reduce costs that are triple the national average, the nonpartisan Legislative Analyst's Office said Thursday. The federal receivership that has been in place since 2006 has greatly improved the medical care of state prison",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>By KQED Staff and Wires\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_5305\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/prisoner.gif\">\u003cimg class=\"size-full wp-image-5305\" title=\"prisoner\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/prisoner.gif\" alt=\"\" width=\"300\" height=\"300\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2012/04/prisoner.gif 300w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/prisoner-32x32.gif 32w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/prisoner-64x64.gif 64w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/prisoner-96x96.gif 96w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/prisoner-128x128.gif 128w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/prisoner-75x75.gif 75w\" sizes=\"(max-width: 300px) 100vw, 300px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">California spends three times the national average on inmate medical care. (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>As the state prepares to resume control of inmate medical care, it must find ways to reduce costs that are triple the national average, the nonpartisan \u003ca href=\"http://www.lao.ca.gov/laoapp/\">Legislative Analyst's Office\u003c/a> said Thursday.\u003c/p>\n\u003cp>The federal receivership that has been in place since 2006 has greatly improved the medical care of state prison inmates but also has caused costs to soar, according to \u003ca href=\"http://www.lao.ca.gov/reports/2012/crim/inmate-medical-care/inmate-medical-care-041912.pdf\">the report\u003c/a>. California spends $16,000 per inmate for health care services, compared to an average of $5,000 in other states.\u003c/p>\n\u003cp>The analysis was released less than two weeks before the state and attorneys representing inmates must report to a federal judge with recommendations on when the receivership should end and whether it should maintain some oversight role.\u003c/p>\n\u003cp>The Legislature should create an independent board to monitor prison medical care to make sure conditions do not deteriorate once the state retakes control, the report said. It also recommends that the state experiment with contracting for medical services to cut costs.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The state should rely more on \u003ca href=\"http://www.americantelemed.org/i4a/pages/index.cfm?pageID=3331\">telemedicine \u003c/a>so physicians in urban medical facilities can treat inmates without physically traveling to remote prisons. The analysis also found that the receivership has not been consistent in using management safeguards that are designed to hold down medical spending.\u003c/p>\n\u003caside class=\"pullquote alignright\">\"Eighty cents of every dollar is spent on inmate direct care. Everything he's done is done with an eye to increasing efficiency.\"\u003c/aside>\n\u003cp>The receivership already is following many of the recommendations outlined in the report, said Nancy Kincaid, spokeswoman for the receiver's office.\u003c/p>\n\u003cp>The receivership began emphasizing telemedicine a year ago, Kincaid said. She acknowledged that while medical staff in some prisons follow the receivership's uniform policy for controlling medical costs, those in other prisons must do a better job.\u003c/p>\n\u003cp>The receiver, \u003ca href=\"http://www.capitolweekly.net/article.php?xid=ylta91g5empdw5\">J. Clark Kelso\u003c/a>, uses private contractors when they are cheaper, she said, but is limited by a prohibition in the state constitution on using a contractor if a state employee can do the job.\u003c/p>\n\u003cp>She disputed the report's comparisons with costs in other states, contending that many others don't count their administrative, information technology or contract costs in their accounting.\u003c/p>\n\u003cp>\"Eighty cents of every dollar is spent on inmate direct care. Everything he's done is done with an eye to increasing efficiency ... and saving taxpayers' money wherever he can,\" Kincaid said.\u003c/p>\n\u003cp>The legislative analyst called a recent 7 percent decline in inmate health care costs \"encouraging,\" but said the proposed prison medical budget for the fiscal year beginning July 1 is still 42 percent higher than it was before the receivership began.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Ending the receivership could save money in the \"low tens of millions of dollars annually,\" the analysis estimated, because the state could consolidate what currently are two duplicate bureaucracies overseeing the prison medical system ‚ one for the court-appointed receiver and the other for the \u003ca href=\"http://www.cdcr.ca.gov/\">California Department of Corrections and Rehabilitation.\u003c/a>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Report: Fewer Unhealthy Air Days in California",
"title": "Report: Fewer Unhealthy Air Days in California",
"headTitle": "State of Health | KQED News",
"content": "\u003cp>\u003cstrong>By \u003ca title=\"View user profile.\" href=\"http://californiawatch.org/user/bernice-yeung\">Bernice Yeung\u003c/a>, \u003ca title=\"http://californiawatch.org/dailyreport/report-finds-fewer-unhealthy-air-days-california-15849\" href=\"http://californiawatch.org/dailyreport/report-finds-fewer-unhealthy-air-days-california-15849\" target=\"_blank\">California Watch\u003c/a>\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_5284\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/smokestack.gif\">\u003cimg class=\"size-full wp-image-5284\" title=\"smokestack\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/smokestack.gif\" alt=\"\" width=\"300\" height=\"300\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2012/04/smokestack.gif 300w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/smokestack-32x32.gif 32w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/smokestack-64x64.gif 64w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/smokestack-96x96.gif 96w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/smokestack-128x128.gif 128w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/smokestack-75x75.gif 75w\" sizes=\"(max-width: 300px) 100vw, 300px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">California logged fewer unhealthy air days in 2011 than a decade ago, giving hope that air quality is improving. (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>California air pollution reached unhealthy levels less often in 2011 than a decade ago, according to a report released this week by a state association of regional air district officers.\u003c/p>\n\u003cp>Compared with 2000, there were about 74 percent fewer days of “unhealthy air” statewide last year, data from the \u003ca href=\"http://www.capcoa.org/wp-content/uploads/downloads/2012/04/CAPCOA-Progress-Toward-Clean-Air-2012.pdf\" target=\"_blank\">report [PDF]\u003c/a> showed. Air quality can range from “good” to “very unhealthy,” and it is \u003ca href=\"http://www.airnow.gov/index.cfm?action=aqibasics.aqi\" target=\"_blank\">calculated\u003c/a> based on local monitoring of four air pollutants regulated by the federal \u003ca href=\"http://www.epa.gov/air/caa/\" target=\"_blank\">Clean Air Act\u003c/a>.\u003c/p>\n\u003cp>The report found that ozone pollution has decreased statewide between 1980 and 2011; there have been smaller and more limited reductions in particulate matter emissions during the same time frame.\u003c/p>\n\u003cp>Dr. John Balmes, a professor of medicine at UC San Francisco, said California is “ahead of the pack with regard to air quality and greenhouse gas control.” He said any reductions in ozone and particulate emissions could have positive effects on public health because these pollutants have been associated with cardiovascular or respiratory disease health risks.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The new report acknowledged that “despite significant improvements, air quality remains a major source of public health concern in large metropolitan areas throughout California,” especially in the San Joaquin Valley and the southern coast area surrounding Los Angeles. California has 35 regional air districts, which regulate businesses and industrial facilities.\u003c!--more-->\u003c/p>\n\u003cp>“We recognize that we have a long way to go in some of these air districts, but we have made a lot of progress,” said Kenneth Koyama, executive director of the California Air Pollution Control Officers Association, which published the report. “Some districts have gone down to one unhealthy day in the past year for air-quality purposes, and others have actually had zero unhealthy days.”\u003c/p>\n\u003cp>The report also outlines the local conditions that create air-quality problems and some ongoing efforts to address them. In the Great Basin Unified Air Pollution Control District, for example, water diversion to Los Angeles from tributaries of the Owens and Mono lakes have resulted in exposed lake beds that contribute to particulate matter pollution in the region. The district is spending $6.5 million on clean air projects.\u003c/p>\n\u003cp>Koyama said the air district association’s report was issued in part as a counterpoint to the American Lung Association’s \u003ca href=\"http://www.stateoftheair.org/2011/states/california/\" target=\"_blank\">State of the Air\u003c/a> analysis, which has been published since 2000. In 2011, the American Lung Association gave 36 California counties an F grade for ozone exposure based on the number of unhealthy ozone days, and 19 California counties received an F for particulate pollution.\u003c/p>\n\u003cp>“Giving a grade of F suggests to me that whatever the air district has done has failed, and that’s certainly not the case,” Koyama said. “We’ve introduced programs that we believe have been very innovative to reduce emissions and improve air quality in the state. We believe we’ve done a lot to protect public health.”\u003c/p>\n\u003cp>Bonnie Holmes-Gen, executive director for air quality and public health for the American Lung Association in California, said her organization’s report offers a complex picture of the state’s air quality.\u003c/p>\n\u003cp>“We think the grades provide a good snapshot as to what people are breathing, and the report also tracks trends over time for each region,” she said. “California has shown tremendous progress in healthy air, which we attribute to California’s groundbreaking regulations” related to vehicle emissions and clean fuels.\u003c/p>\n\u003cp>The 2012 State of the Air findings will be released Wednesday.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“After next week’s report, we will have 13 years of data on unhealthy air days in California, and just as we’ve shown tremendous progress in most areas of the state over the past 12 years,\" Holmes-Gen said, the latest analysis will \"show continued progress despite the serious challenges we still have.”\u003c/p>\n\n",
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"description": "By Bernice Yeung, California Watch California air pollution reached unhealthy levels less often in 2011 than a decade ago, according to a report released this week by a state association of regional air district officers. Compared with 2000, there were about 74 percent fewer days of “unhealthy air” statewide last year, data from the report showed. Air quality",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>By \u003ca title=\"View user profile.\" href=\"http://californiawatch.org/user/bernice-yeung\">Bernice Yeung\u003c/a>, \u003ca title=\"http://californiawatch.org/dailyreport/report-finds-fewer-unhealthy-air-days-california-15849\" href=\"http://californiawatch.org/dailyreport/report-finds-fewer-unhealthy-air-days-california-15849\" target=\"_blank\">California Watch\u003c/a>\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_5284\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/smokestack.gif\">\u003cimg class=\"size-full wp-image-5284\" title=\"smokestack\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/smokestack.gif\" alt=\"\" width=\"300\" height=\"300\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2012/04/smokestack.gif 300w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/smokestack-32x32.gif 32w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/smokestack-64x64.gif 64w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/smokestack-96x96.gif 96w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/smokestack-128x128.gif 128w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/smokestack-75x75.gif 75w\" sizes=\"(max-width: 300px) 100vw, 300px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">California logged fewer unhealthy air days in 2011 than a decade ago, giving hope that air quality is improving. (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>California air pollution reached unhealthy levels less often in 2011 than a decade ago, according to a report released this week by a state association of regional air district officers.\u003c/p>\n\u003cp>Compared with 2000, there were about 74 percent fewer days of “unhealthy air” statewide last year, data from the \u003ca href=\"http://www.capcoa.org/wp-content/uploads/downloads/2012/04/CAPCOA-Progress-Toward-Clean-Air-2012.pdf\" target=\"_blank\">report [PDF]\u003c/a> showed. Air quality can range from “good” to “very unhealthy,” and it is \u003ca href=\"http://www.airnow.gov/index.cfm?action=aqibasics.aqi\" target=\"_blank\">calculated\u003c/a> based on local monitoring of four air pollutants regulated by the federal \u003ca href=\"http://www.epa.gov/air/caa/\" target=\"_blank\">Clean Air Act\u003c/a>.\u003c/p>\n\u003cp>The report found that ozone pollution has decreased statewide between 1980 and 2011; there have been smaller and more limited reductions in particulate matter emissions during the same time frame.\u003c/p>\n\u003cp>Dr. John Balmes, a professor of medicine at UC San Francisco, said California is “ahead of the pack with regard to air quality and greenhouse gas control.” He said any reductions in ozone and particulate emissions could have positive effects on public health because these pollutants have been associated with cardiovascular or respiratory disease health risks.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The new report acknowledged that “despite significant improvements, air quality remains a major source of public health concern in large metropolitan areas throughout California,” especially in the San Joaquin Valley and the southern coast area surrounding Los Angeles. California has 35 regional air districts, which regulate businesses and industrial facilities.\u003c!--more-->\u003c/p>\n\u003cp>“We recognize that we have a long way to go in some of these air districts, but we have made a lot of progress,” said Kenneth Koyama, executive director of the California Air Pollution Control Officers Association, which published the report. “Some districts have gone down to one unhealthy day in the past year for air-quality purposes, and others have actually had zero unhealthy days.”\u003c/p>\n\u003cp>The report also outlines the local conditions that create air-quality problems and some ongoing efforts to address them. In the Great Basin Unified Air Pollution Control District, for example, water diversion to Los Angeles from tributaries of the Owens and Mono lakes have resulted in exposed lake beds that contribute to particulate matter pollution in the region. The district is spending $6.5 million on clean air projects.\u003c/p>\n\u003cp>Koyama said the air district association’s report was issued in part as a counterpoint to the American Lung Association’s \u003ca href=\"http://www.stateoftheair.org/2011/states/california/\" target=\"_blank\">State of the Air\u003c/a> analysis, which has been published since 2000. In 2011, the American Lung Association gave 36 California counties an F grade for ozone exposure based on the number of unhealthy ozone days, and 19 California counties received an F for particulate pollution.\u003c/p>\n\u003cp>“Giving a grade of F suggests to me that whatever the air district has done has failed, and that’s certainly not the case,” Koyama said. “We’ve introduced programs that we believe have been very innovative to reduce emissions and improve air quality in the state. We believe we’ve done a lot to protect public health.”\u003c/p>\n\u003cp>Bonnie Holmes-Gen, executive director for air quality and public health for the American Lung Association in California, said her organization’s report offers a complex picture of the state’s air quality.\u003c/p>\n\u003cp>“We think the grades provide a good snapshot as to what people are breathing, and the report also tracks trends over time for each region,” she said. “California has shown tremendous progress in healthy air, which we attribute to California’s groundbreaking regulations” related to vehicle emissions and clean fuels.\u003c/p>\n\u003cp>The 2012 State of the Air findings will be released Wednesday.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“After next week’s report, we will have 13 years of data on unhealthy air days in California, and just as we’ve shown tremendous progress in most areas of the state over the past 12 years,\" Holmes-Gen said, the latest analysis will \"show continued progress despite the serious challenges we still have.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Smoking or Schools: Which is More Important to Your Health?",
"title": "Smoking or Schools: Which is More Important to Your Health?",
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"content": "\u003cfigure id=\"attachment_5157\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/Cigarette_RaulLieberwirth_Flickr_04172012.jpg\">\u003cimg class=\"size-medium wp-image-5157 \" title=\"(Raul Lieberwirth: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/Cigarette_RaulLieberwirth_Flickr_04172012-300x237.jpg\" alt=\"(Raul Lieberwirth: Flickr)\" width=\"300\" height=\"237\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Sorry, cigarettes are still terrible for you, but can a good school system lead to better health? (Raul Lieberwirth: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Too often, we confuse health with health care. Health care comes from a doctor or hospital. But \u003cem>health\u003c/em> comes from many places we don't normally think of as health at all -- things like good schools, safe neighborhoods and access to a variety of jobs. In other words, if you live in places without those things, you have a lower likelihood of enjoying good health.\u003c/p>\n\u003cp>Today, a new study from researchers at Stanford's School of Medicine confirms that health disparities across the country have more to do with social factors than the color of your skin or where you live. In fact, the researchers say that some of these social factors even outweigh -- gasp -- the effect of cigarette smoking. (More on that later).\u003c/p>\n\u003cp>The study, \u003cem>\u003ca title=\"http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0032930\" href=\"http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0032930\" target=\"_blank\">Geographic and Racial Variation in Premature Mortality in the US\u003c/a>\u003c/em>, looked at counties across the United States and the likelihood of people living to age 70. Lead author \u003ca title=\"http://med.stanford.edu/profiles/Mark_Cullen\" href=\"http://med.stanford.edu/profiles/Mark_Cullen\" target=\"_blank\">Dr. Mark Cullen\u003c/a> says this measure is a good alternative to looking at life expectancy, because it shifts attention to events that occur earlier in life. In particular, researchers found that educational opportunities, distribution of income and a mix of jobs accounted for better health outcomes across the population of a county. These \"social determinants of health\" as public health professionals call them, also explain health disparities between African-Americans and caucasians. \"In most parts of the country,\" Cullen says, \"if African-Americans had the same advantages that their white counterparts had, almost ALL of the racial disparity would go away.\"\u003c!--more-->\u003c/p>\n\u003cp>The study is national in scope. Here in California, Cullen says that people who live along the coast up to about Mendocino enjoy the best health statistics. But head east to the Central Valley and the health outcomes are much worse.\u003c/p>\n\u003cp>\"It's not surprising,\" Cullen says, \"the dominant theme there is these are regions of relatively lower socioeconomic status, relatively lower levels of educational attainment. We're not talking about individuals here, we're talking about populations at the county level.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Cullen stresses that all policy avenues lead back to health. \"ALL policy is health policy,\" he says, \"which is to say that every time at the state level or the county level or the federal level, there's a debate about expenditures on housing or job training or education, those frankly are health debates. One of the biggest consequences of either cutting out programs or strengthening programs are the health consequences to the population. You don't see them in a day or a week, you see them over decades.\"\u003c/p>\n\u003cp>One person who sees policy outcomes up close is KQED's Community Correspondent \u003ca title=\"http://blogs.kqed.org/ourxperience/author/xwest/\" href=\"http://blogs.kqed.org/ourxperience/author/xwest/\" target=\"_blank\">Xan West\u003c/a>. She writes for KQED's blog \u003ca title=\"http://blogs.kqed.org/ourxperience/\" href=\"http://blogs.kqed.org/ourxperience/\" target=\"_blank\">ouRXperience\u003c/a> from her neighborhood of West Oakland, which is primarily African-American, low income and high crime. Responding to questions about today's study, she described not only West Oakland's lack of jobs and school closures, but also its run down playgrounds.\u003c/p>\n\u003cp>\"You see a lot of decrepit and broken down play structures, that kids would hurt themselves on,\" she told me. \"Neighborhoods are not safe for kids to be outside in West Oakland. It effects how much being outside, being a kid, being able to play is important to childhood, as well as .. important to obesity, important to hypertension. You see heightened rates of obesity in West Oakland and other inner city places and part of that is the inability of people to go outside and play.\"\u003c/p>\n\u003cp>\u003ca title=\"http://tcenews.calendow.org/pr/tce/tony-iton-bio.aspx\" href=\"http://tcenews.calendow.org/pr/tce/tony-iton-bio.aspx\" target=\"_blank\">Dr. Anthony Iton\u003c/a>, now at The California Endowment, served for six years as Health Officer of Alameda County. While there, he \u003ca title=\"http://www.jointcenter.org/hpi/sites/all/files/Toni%20Iton-Public%20Health%20Practice%20to%20Health%20Equity%20DL8.pdf\" href=\"http://www.jointcenter.org/hpi/sites/all/files/Toni%20Iton-Public%20Health%20Practice%20to%20Health%20Equity%20DL8.pdf\" target=\"_blank\">published research\u003c/a> about Alameda County's social determinants of health. He called today's report a \"great study.\" Like Cullen, he countered the idea that simply being African-American doomed someone to poorer health. \"That is one of the great misperceptions,\" he told me. People need to understand \"the difference between race and racism. \u003cem>Race\u003c/em> doesn't matter, rac\u003cem>ism \u003c/em>does matter because it constrains people's access to ... high educational attainment, high income, high employment.\"\u003c/p>\n\u003cp>And finally, what of cigarettes? By no means is anyone suggesting smoking is good for you, but Cullen's research showed the power of these social determinants of health. \"Some counties have higher rates of smoking,\" he explained. \"Some counties have higher rates of obesity. But it was dwarfed by the social environment that was already measured. In fact, when you added it into the equation, it added very little. Now that's not to say that being obese or smoking is individually a good thing. But it turns out when you look at large swaths of the population, that the underlying factor of education and wealth and occupation and so forth dominate.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Editor's Note: The California Endowment is a funder of KQED.\u003c/em>\u003c/p>\n\n",
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"excerpt": "Too often, we confuse health with health care. But health comes from many places we don't normally think of as health at all -- things like good schools, safe neighborhoods and access to a variety of jobs. In other words, if you live in places without those things, you have a lower likelihood of enjoying good health. Today, a new study from researchers at Stanford's School of Medicine confirms that health disparities across the country have more to do with a group of socioeconomic and environmental conditions than the color of your skin or where you live. In fact, the researchers say that some of these living conditions even outweigh -- gasp -- the effect of cigarette smoking. (More on that later).\r\n\r\nThe study, Geographic and Racial Variation in Premature Mortality in the US, looked at counties across the United States and the likelihood of people living to age 70. Lead author Dr. Mark Cullen says this measure is a good alternative to looking at life expectancy, because it shifts attention to events that occur earlier in life. In particular, researchers found that educational opportunities, distribution of income and a mix of jobs accounted for better health outcomes across the population of a county. These \"social determinants of health\" as public health professionals call them, also explain health disparities between African-Americans and caucasians. \"In most parts of the country,\" Cullen says, \"if African-Americans had the same advantages that their white counterparts had, almost ALL of the racial disparity would go away.\"",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_5157\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/Cigarette_RaulLieberwirth_Flickr_04172012.jpg\">\u003cimg class=\"size-medium wp-image-5157 \" title=\"(Raul Lieberwirth: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/Cigarette_RaulLieberwirth_Flickr_04172012-300x237.jpg\" alt=\"(Raul Lieberwirth: Flickr)\" width=\"300\" height=\"237\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Sorry, cigarettes are still terrible for you, but can a good school system lead to better health? (Raul Lieberwirth: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Too often, we confuse health with health care. Health care comes from a doctor or hospital. But \u003cem>health\u003c/em> comes from many places we don't normally think of as health at all -- things like good schools, safe neighborhoods and access to a variety of jobs. In other words, if you live in places without those things, you have a lower likelihood of enjoying good health.\u003c/p>\n\u003cp>Today, a new study from researchers at Stanford's School of Medicine confirms that health disparities across the country have more to do with social factors than the color of your skin or where you live. In fact, the researchers say that some of these social factors even outweigh -- gasp -- the effect of cigarette smoking. (More on that later).\u003c/p>\n\u003cp>The study, \u003cem>\u003ca title=\"http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0032930\" href=\"http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0032930\" target=\"_blank\">Geographic and Racial Variation in Premature Mortality in the US\u003c/a>\u003c/em>, looked at counties across the United States and the likelihood of people living to age 70. Lead author \u003ca title=\"http://med.stanford.edu/profiles/Mark_Cullen\" href=\"http://med.stanford.edu/profiles/Mark_Cullen\" target=\"_blank\">Dr. Mark Cullen\u003c/a> says this measure is a good alternative to looking at life expectancy, because it shifts attention to events that occur earlier in life. In particular, researchers found that educational opportunities, distribution of income and a mix of jobs accounted for better health outcomes across the population of a county. These \"social determinants of health\" as public health professionals call them, also explain health disparities between African-Americans and caucasians. \"In most parts of the country,\" Cullen says, \"if African-Americans had the same advantages that their white counterparts had, almost ALL of the racial disparity would go away.\"\u003c!--more-->\u003c/p>\n\u003cp>The study is national in scope. Here in California, Cullen says that people who live along the coast up to about Mendocino enjoy the best health statistics. But head east to the Central Valley and the health outcomes are much worse.\u003c/p>\n\u003cp>\"It's not surprising,\" Cullen says, \"the dominant theme there is these are regions of relatively lower socioeconomic status, relatively lower levels of educational attainment. We're not talking about individuals here, we're talking about populations at the county level.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Cullen stresses that all policy avenues lead back to health. \"ALL policy is health policy,\" he says, \"which is to say that every time at the state level or the county level or the federal level, there's a debate about expenditures on housing or job training or education, those frankly are health debates. One of the biggest consequences of either cutting out programs or strengthening programs are the health consequences to the population. You don't see them in a day or a week, you see them over decades.\"\u003c/p>\n\u003cp>One person who sees policy outcomes up close is KQED's Community Correspondent \u003ca title=\"http://blogs.kqed.org/ourxperience/author/xwest/\" href=\"http://blogs.kqed.org/ourxperience/author/xwest/\" target=\"_blank\">Xan West\u003c/a>. She writes for KQED's blog \u003ca title=\"http://blogs.kqed.org/ourxperience/\" href=\"http://blogs.kqed.org/ourxperience/\" target=\"_blank\">ouRXperience\u003c/a> from her neighborhood of West Oakland, which is primarily African-American, low income and high crime. Responding to questions about today's study, she described not only West Oakland's lack of jobs and school closures, but also its run down playgrounds.\u003c/p>\n\u003cp>\"You see a lot of decrepit and broken down play structures, that kids would hurt themselves on,\" she told me. \"Neighborhoods are not safe for kids to be outside in West Oakland. It effects how much being outside, being a kid, being able to play is important to childhood, as well as .. important to obesity, important to hypertension. You see heightened rates of obesity in West Oakland and other inner city places and part of that is the inability of people to go outside and play.\"\u003c/p>\n\u003cp>\u003ca title=\"http://tcenews.calendow.org/pr/tce/tony-iton-bio.aspx\" href=\"http://tcenews.calendow.org/pr/tce/tony-iton-bio.aspx\" target=\"_blank\">Dr. Anthony Iton\u003c/a>, now at The California Endowment, served for six years as Health Officer of Alameda County. While there, he \u003ca title=\"http://www.jointcenter.org/hpi/sites/all/files/Toni%20Iton-Public%20Health%20Practice%20to%20Health%20Equity%20DL8.pdf\" href=\"http://www.jointcenter.org/hpi/sites/all/files/Toni%20Iton-Public%20Health%20Practice%20to%20Health%20Equity%20DL8.pdf\" target=\"_blank\">published research\u003c/a> about Alameda County's social determinants of health. He called today's report a \"great study.\" Like Cullen, he countered the idea that simply being African-American doomed someone to poorer health. \"That is one of the great misperceptions,\" he told me. People need to understand \"the difference between race and racism. \u003cem>Race\u003c/em> doesn't matter, rac\u003cem>ism \u003c/em>does matter because it constrains people's access to ... high educational attainment, high income, high employment.\"\u003c/p>\n\u003cp>And finally, what of cigarettes? By no means is anyone suggesting smoking is good for you, but Cullen's research showed the power of these social determinants of health. \"Some counties have higher rates of smoking,\" he explained. \"Some counties have higher rates of obesity. But it was dwarfed by the social environment that was already measured. In fact, when you added it into the equation, it added very little. Now that's not to say that being obese or smoking is individually a good thing. But it turns out when you look at large swaths of the population, that the underlying factor of education and wealth and occupation and so forth dominate.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Editor's Note: The California Endowment is a funder of KQED.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cdiv>\n\u003cfigure id=\"attachment_5105\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/Sofa_Couch_FrankJania_Flickr_04162012.jpg\">\u003cimg class=\"size-medium wp-image-5105\" title=\"The average-sized couch contains up to two pounds of flame retardant chemicals. (Frank Jania: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/Sofa_Couch_FrankJania_Flickr_04162012-300x225.jpg\" alt=\"The average-sized couch contains up to two pounds of flame retardant chemicals. (Frank Jania: Flickr)\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The average-sized couch contains up to two pounds of flame retardant chemicals. (Frank Jania: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Back in 1975, a pioneering law was passed to help prevent upholstered furniture from burning, as \u003ca title=\"http://science.kqed.org/quest/audio/the-political-firestorm-inside-your-sofa/\" href=\"http://science.kqed.org/quest/audio/the-political-firestorm-inside-your-sofa/\" target=\"_blank\">KQED's Amy Standen reports\u003c/a>. Technical Bulletin 117-- or \u003ca title=\"http://www.bhfti.ca.gov/industry/bulletin.shtml\" href=\"http://www.bhfti.ca.gov/industry/bulletin.shtml\" target=\"_blank\">TB 117\u003c/a> as it's known -- is now the regret of many scientists. Call it the law of unintended consequences. From Standen's post:\u003c/p>\n\u003c/div>\n\u003cdiv>\n\u003cblockquote>\u003cp>Manufacturers meet this law by treating the foam with several different kinds of chemicals, up to two pounds of flame retardant chemicals in an average-size sofa, according to \u003ca href=\"http://eetd.lbl.gov/staff/donald-lucas\" target=\"_blank\">Don Lucas\u003c/a>, a flammability expert at Lawrence Berkeley National Laboratory.\u003c/p>\n\u003cp>Even though the law is specific to California, it affects furniture sold across the country. Major furniture dealers sell California-compliant products in all 50 states, and Canada.\u003c/p>\n\u003cp>The problem ... is that the chemicals don’t just stay inside the sofas. They turn up in \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/21239062\" target=\"_blank\">household dust\u003c/a> and can be detected in human blood and \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/20079522\" target=\"_blank\">breast milk\u003c/a>. \u003ca href=\"http://www.ewg.org/reports/pbdesintoddlers\" target=\"_blank\">Toddlers\u003c/a> often have \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/17035146\" target=\"_blank\">higher levels\u003c/a> of the chemicals in their bodies than adults do.\u003c!--more-->\u003c/p>\n\u003cp>\"One study found that the levels of PBDEs found in bodies of toddlers are similar to what you'd find in people who work in a recycling foam factory. That's two to ten times what you'd find in adults,\" says Ami Zota, a researcher with UCSF's \u003ca href=\"http://prhe.ucsf.edu/prhe/\" target=\"_blank\">Program on Reproductive Health and the Environment.\u003c/a>\u003c/p>\n\u003cp> \u003c/p>\u003c/blockquote>\n\u003cp>Standen has plenty more detail about the politics of trying to change this law. But I'm trying to stay focused on the health aspects of her piece. Suffice it to say that legislators have tried to change the law five times. Five times they have failed.\u003c/p>\n\u003cp>To me, the most jaw-dropping part of Standen's piece is that the chemicals \u003cem>don't even prevent fires.\u003c/em>\u003c/p>\n\u003cblockquote>\u003cp>“Our conclusions were that we really don’t need the flame retardants in the foam in home furnishing,\" said Lucas. We don’t think the TB 117 standard is very good.”\u003c/p>\n\u003cp>The chemicals don’t work, he says, because fires don’t start inside sofas. They start on the surface of the sofa, on the fabric. California's flammability law, TB 117 law says nothing about the fabric, just the foam.\u003c/p>\n\u003cp>“Once the fabric catches on fire, the flame that the foam is exposed to is much larger than the flame in the test,” says Lucas.\u003c/p>\u003c/blockquote>\n\u003c/div>\n\u003cp>So, now we have chemically-drenched foam on fire, and the anti-flame retardant folks have a new ally: firefighters.\u003c/p>\n\u003cblockquote>\u003cp>Tom O’Connor, a firefighter in San Francisco, says fires these days are a toxic soup of chemicals, thanks, in part, to chemically-treated furniture.\u003c/p>\n\u003cp>O'Connor, and others, believe they're seeing an epidemic of cancers among firefighters. San Francisco's Fire Department is one of several around the country participating in a \u003ca href=\"http://www.usfa.fema.gov/fireservice/research/safety/niosh_cancer_study.shtm\">study\u003c/a> of firefighters and cancer run by the \u003ca title=\"http://www.cdc.gov/niosh/\" href=\"http://www.cdc.gov/niosh/\" target=\"_blank\">National Institute for Occupational Safety and Health.\u003c/a>\u003c/p>\n\u003cp>If flame-retardant chemicals in furniture are part of the problem, says O'Connor, \"then obviously we want them out of the products of combustion, once we go into a burning building.\"\u003c/p>\u003c/blockquote>\n\u003cp>You can read or listen to Amy's complete story\u003ca title=\"http://science.kqed.org/quest/audio/the-political-firestorm-inside-your-sofa/\" href=\"http://science.kqed.org/quest/audio/the-political-firestorm-inside-your-sofa/\" target=\"_blank\"> here\u003c/a>.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n",
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"excerpt": "Back in 1975, a pioneering law was passed to help prevent upholstered furniture from burning, as KQED's Amy Standen reports. Technical Bulletin 117-- or TB 117 as it's known -- is now the regret of many scientists. Call it the law of unintended consequences. From Standen's post:\r\n\r\nManufacturers meet this law by treating the foam with several different kinds of chemicals, up to two pounds of flame retardant chemicals in an average-size sofa, according to Don Lucas, a flammability expert at Lawrence Berkeley National Laboratory.\r\n\r\nEven though the law is specific to California, it affects furniture sold across the country. Major furniture dealers sell California-compliant products in all 50 states, and Canada.",
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"description": "Back in 1975, a pioneering law was passed to help prevent upholstered furniture from burning, as KQED's Amy Standen reports. Technical Bulletin 117-- or TB 117 as it's known -- is now the regret of many scientists. Call it the law of unintended consequences. From Standen's post:\r\n\r\nManufacturers meet this law by treating the foam with several different kinds of chemicals, up to two pounds of flame retardant chemicals in an average-size sofa, according to Don Lucas, a flammability expert at Lawrence Berkeley National Laboratory.\r\n\r\nEven though the law is specific to California, it affects furniture sold across the country. Major furniture dealers sell California-compliant products in all 50 states, and Canada.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cdiv>\n\u003cfigure id=\"attachment_5105\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/Sofa_Couch_FrankJania_Flickr_04162012.jpg\">\u003cimg class=\"size-medium wp-image-5105\" title=\"The average-sized couch contains up to two pounds of flame retardant chemicals. (Frank Jania: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/Sofa_Couch_FrankJania_Flickr_04162012-300x225.jpg\" alt=\"The average-sized couch contains up to two pounds of flame retardant chemicals. (Frank Jania: Flickr)\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The average-sized couch contains up to two pounds of flame retardant chemicals. (Frank Jania: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Back in 1975, a pioneering law was passed to help prevent upholstered furniture from burning, as \u003ca title=\"http://science.kqed.org/quest/audio/the-political-firestorm-inside-your-sofa/\" href=\"http://science.kqed.org/quest/audio/the-political-firestorm-inside-your-sofa/\" target=\"_blank\">KQED's Amy Standen reports\u003c/a>. Technical Bulletin 117-- or \u003ca title=\"http://www.bhfti.ca.gov/industry/bulletin.shtml\" href=\"http://www.bhfti.ca.gov/industry/bulletin.shtml\" target=\"_blank\">TB 117\u003c/a> as it's known -- is now the regret of many scientists. Call it the law of unintended consequences. From Standen's post:\u003c/p>\n\u003c/div>\n\u003cdiv>\n\u003cblockquote>\u003cp>Manufacturers meet this law by treating the foam with several different kinds of chemicals, up to two pounds of flame retardant chemicals in an average-size sofa, according to \u003ca href=\"http://eetd.lbl.gov/staff/donald-lucas\" target=\"_blank\">Don Lucas\u003c/a>, a flammability expert at Lawrence Berkeley National Laboratory.\u003c/p>\n\u003cp>Even though the law is specific to California, it affects furniture sold across the country. Major furniture dealers sell California-compliant products in all 50 states, and Canada.\u003c/p>\n\u003cp>The problem ... is that the chemicals don’t just stay inside the sofas. They turn up in \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/21239062\" target=\"_blank\">household dust\u003c/a> and can be detected in human blood and \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/20079522\" target=\"_blank\">breast milk\u003c/a>. \u003ca href=\"http://www.ewg.org/reports/pbdesintoddlers\" target=\"_blank\">Toddlers\u003c/a> often have \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/17035146\" target=\"_blank\">higher levels\u003c/a> of the chemicals in their bodies than adults do.\u003c!--more-->\u003c/p>\n\u003cp>\"One study found that the levels of PBDEs found in bodies of toddlers are similar to what you'd find in people who work in a recycling foam factory. That's two to ten times what you'd find in adults,\" says Ami Zota, a researcher with UCSF's \u003ca href=\"http://prhe.ucsf.edu/prhe/\" target=\"_blank\">Program on Reproductive Health and the Environment.\u003c/a>\u003c/p>\n\u003cp> \u003c/p>\u003c/blockquote>\n\u003cp>Standen has plenty more detail about the politics of trying to change this law. But I'm trying to stay focused on the health aspects of her piece. Suffice it to say that legislators have tried to change the law five times. Five times they have failed.\u003c/p>\n\u003cp>To me, the most jaw-dropping part of Standen's piece is that the chemicals \u003cem>don't even prevent fires.\u003c/em>\u003c/p>\n\u003cblockquote>\u003cp>“Our conclusions were that we really don’t need the flame retardants in the foam in home furnishing,\" said Lucas. We don’t think the TB 117 standard is very good.”\u003c/p>\n\u003cp>The chemicals don’t work, he says, because fires don’t start inside sofas. They start on the surface of the sofa, on the fabric. California's flammability law, TB 117 law says nothing about the fabric, just the foam.\u003c/p>\n\u003cp>“Once the fabric catches on fire, the flame that the foam is exposed to is much larger than the flame in the test,” says Lucas.\u003c/p>\u003c/blockquote>\n\u003c/div>\n\u003cp>So, now we have chemically-drenched foam on fire, and the anti-flame retardant folks have a new ally: firefighters.\u003c/p>\n\u003cblockquote>\u003cp>Tom O’Connor, a firefighter in San Francisco, says fires these days are a toxic soup of chemicals, thanks, in part, to chemically-treated furniture.\u003c/p>\n\u003cp>O'Connor, and others, believe they're seeing an epidemic of cancers among firefighters. San Francisco's Fire Department is one of several around the country participating in a \u003ca href=\"http://www.usfa.fema.gov/fireservice/research/safety/niosh_cancer_study.shtm\">study\u003c/a> of firefighters and cancer run by the \u003ca title=\"http://www.cdc.gov/niosh/\" href=\"http://www.cdc.gov/niosh/\" target=\"_blank\">National Institute for Occupational Safety and Health.\u003c/a>\u003c/p>\n\u003cp>If flame-retardant chemicals in furniture are part of the problem, says O'Connor, \"then obviously we want them out of the products of combustion, once we go into a burning building.\"\u003c/p>\u003c/blockquote>\n\u003cp>You can read or listen to Amy's complete story\u003ca title=\"http://science.kqed.org/quest/audio/the-political-firestorm-inside-your-sofa/\" href=\"http://science.kqed.org/quest/audio/the-political-firestorm-inside-your-sofa/\" target=\"_blank\"> here\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>\u003cstrong>By Kamal Menghrajani\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_5032\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/AdultDayCareMarin20120328.jpg\">\u003cimg class=\"size-medium wp-image-5032\" title=\"Proposed California Budget Cuts Threaten Adult Day Health Care\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/AdultDayCareMarin20120328-300x208.jpg\" alt=\"Some paid caregivers are barely making ends meet. (Getty Images: Justin Sullivan)\" width=\"300\" height=\"208\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Some paid caregivers are barely making ends meet. (Getty Images: Justin Sullivan)\u003c/figcaption>\u003c/figure>\n\u003cp>Some people who care for vulnerable older adults are in dire economic straits, according to a new \u003ca href=\"http://www.healthpolicy.ucla.edu/pubs/files/caregiversfsapr2012.pdf\">study\u003c/a> [PDF] from the \u003ca title=\"http://www.healthpolicy.ucla.edu/\" href=\"http://www.healthpolicy.ucla.edu/\" target=\"_blank\">UCLA Center for Health Policy Research\u003c/a>.\u003c/p>\n\u003cp>Hundreds of thousands of people provide care – from cooking and cleaning to bathing and dressing – for adults with disabilities or long-term illnesses who receive benefits from \u003ca href=\"http://www.dhcs.ca.gov/services/medi-cal/Pages/Medi-CalFAQs.aspx#whatismedi-cal\">Medi-Cal\u003c/a>. As it turns out, those who get paid for this work may not be pulling in enough money to make ends meet.\u003c/p>\n\u003cp>\u003ca href=\"http://www.healthpolicy.ucla.edu/AskExpertDetails.aspx?expertId=30\">Geoffrey Hoffman\u003c/a>, a researcher at the Center and lead author of the report said, “These paid Medi-Cal caregivers have incomes that are quite low compared to other Californians, about half as much monthly household income.”\u003c/p>\n\u003caside class=\"pullquote alignleft\">“This aging population [of caregivers] is going to lead to great burdens on the health care system.\"\u003c/aside>\n\u003cp>He continued, “A third of them do not have health insurance. A number of them live in poverty or near-poverty, and, among those, a third of them have what is called ‘food insecurity’ – not enough food to put on the table every month.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>At issue is the amount that Medi-Cal is paying these caregivers. Even if you add income from other jobs, they earn a little over $11 per hour on average -- close to minimum wage, and about two-thirds of the median income in California -- making it difficult for them to live on their earnings. Many believe that the value of the care they provide is much greater than what they earn, but monetary constraints have led California lawmakers to decrease financial support for these services.\u003c/p>\n\u003cp>\u003c!--more-->In 2011, the state budget cut the Medi-Cal caregiver reimbursement program – \u003ca title=\"http://www.dss.cahwnet.gov/cdssweb/PG139.htm\" href=\"http://www.dss.cahwnet.gov/cdssweb/PG139.htm\" target=\"_blank\">In-Home Supportive Services\u003c/a> – by 3.6 percent. State officials had also planned a 20 percent decrease in the number of hours a caregiver could work, but that cut has been blocked by a judge for now.\u003c/p>\n\u003cp>Hoffman worries these trends could affect the quality of care available to those who need assistance. “If the caregivers are having trouble putting food on their own table, then they’re not going to provide the type of care we want for our grandparents and our spouses in this state.\u003c/p>\n\u003cp>As these caregivers themselves begin to age, Hoffman said he is also concerned that those who are economically disadvantaged will end up costing the system more money later on, making it even more difficult for Medi-Cal and Medicare to stay solvent in years to come.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“This aging population [of caregivers] is going to lead to great burdens on the health care system. So the sooner we address the problem today, the better off we are for our older adults’ health ... in the future.\"\u003c/p>\n\n",
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"excerpt": "Some people who care for vulnerable older adults are in dire economic straits, according to a new study [PDF] from the UCLA Center for Health Policy Research.\r\n\r\nHundreds of thousands of people provide care – from cooking and cleaning to bathing and dressing – for adults with disabilities or long-term illnesses who receive benefits from Medi-Cal. As it turns out, those who get paid for this work may not be pulling in enough money to make ends meet.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>By Kamal Menghrajani\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_5032\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/AdultDayCareMarin20120328.jpg\">\u003cimg class=\"size-medium wp-image-5032\" title=\"Proposed California Budget Cuts Threaten Adult Day Health Care\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/AdultDayCareMarin20120328-300x208.jpg\" alt=\"Some paid caregivers are barely making ends meet. (Getty Images: Justin Sullivan)\" width=\"300\" height=\"208\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Some paid caregivers are barely making ends meet. (Getty Images: Justin Sullivan)\u003c/figcaption>\u003c/figure>\n\u003cp>Some people who care for vulnerable older adults are in dire economic straits, according to a new \u003ca href=\"http://www.healthpolicy.ucla.edu/pubs/files/caregiversfsapr2012.pdf\">study\u003c/a> [PDF] from the \u003ca title=\"http://www.healthpolicy.ucla.edu/\" href=\"http://www.healthpolicy.ucla.edu/\" target=\"_blank\">UCLA Center for Health Policy Research\u003c/a>.\u003c/p>\n\u003cp>Hundreds of thousands of people provide care – from cooking and cleaning to bathing and dressing – for adults with disabilities or long-term illnesses who receive benefits from \u003ca href=\"http://www.dhcs.ca.gov/services/medi-cal/Pages/Medi-CalFAQs.aspx#whatismedi-cal\">Medi-Cal\u003c/a>. As it turns out, those who get paid for this work may not be pulling in enough money to make ends meet.\u003c/p>\n\u003cp>\u003ca href=\"http://www.healthpolicy.ucla.edu/AskExpertDetails.aspx?expertId=30\">Geoffrey Hoffman\u003c/a>, a researcher at the Center and lead author of the report said, “These paid Medi-Cal caregivers have incomes that are quite low compared to other Californians, about half as much monthly household income.”\u003c/p>\n\u003caside class=\"pullquote alignleft\">“This aging population [of caregivers] is going to lead to great burdens on the health care system.\"\u003c/aside>\n\u003cp>He continued, “A third of them do not have health insurance. A number of them live in poverty or near-poverty, and, among those, a third of them have what is called ‘food insecurity’ – not enough food to put on the table every month.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>At issue is the amount that Medi-Cal is paying these caregivers. Even if you add income from other jobs, they earn a little over $11 per hour on average -- close to minimum wage, and about two-thirds of the median income in California -- making it difficult for them to live on their earnings. Many believe that the value of the care they provide is much greater than what they earn, but monetary constraints have led California lawmakers to decrease financial support for these services.\u003c/p>\n\u003cp>\u003c!--more-->In 2011, the state budget cut the Medi-Cal caregiver reimbursement program – \u003ca title=\"http://www.dss.cahwnet.gov/cdssweb/PG139.htm\" href=\"http://www.dss.cahwnet.gov/cdssweb/PG139.htm\" target=\"_blank\">In-Home Supportive Services\u003c/a> – by 3.6 percent. State officials had also planned a 20 percent decrease in the number of hours a caregiver could work, but that cut has been blocked by a judge for now.\u003c/p>\n\u003cp>Hoffman worries these trends could affect the quality of care available to those who need assistance. “If the caregivers are having trouble putting food on their own table, then they’re not going to provide the type of care we want for our grandparents and our spouses in this state.\u003c/p>\n\u003cp>As these caregivers themselves begin to age, Hoffman said he is also concerned that those who are economically disadvantaged will end up costing the system more money later on, making it even more difficult for Medi-Cal and Medicare to stay solvent in years to come.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“This aging population [of caregivers] is going to lead to great burdens on the health care system. So the sooner we address the problem today, the better off we are for our older adults’ health ... in the future.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Talking About Choices May Encourage Colon Cancer Screening",
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"content": "\u003cp>\u003cstrong>By: Kamal Menghrajani\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_4913\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/DoctorPatientPic_FlickrVicLawrence_April92012.jpg\">\u003cimg class=\"size-medium wp-image-4913\" title=\"Doctor greating patient\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/DoctorPatientPic_FlickrVicLawrence_April92012-300x200.jpg\" alt=\"Doctor greating patient\" width=\"300\" height=\"200\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Patient-doctor discussions about choices in colon cancer screening may encourage more people to follow through. (Vic Lawrence: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Although about 50,000 people in the U.S. \u003ca href=\"http://seer.cancer.gov/statfacts/html/colorect.html\">died from colorectal cancer\u003c/a> (CRC) last year, as many as half of those deaths could have been prevented by routine screening. That’s 25,000 lives that could have been saved using tools that are already widely available.\u003c/p>\n\u003cp>The problem is getting people to undergo screening can be a bit of a challenge. The \"ick\" factor of colonoscopies, concerns about paying for them, and other barriers get in the way of adequate screenings. \u003ca href=\"http://www.cancer.org/Cancer/ColonandRectumCancer/DetailedGuide/colorectal-cancer-detection\">Alternatives do exist\u003c/a>, such as the fecal occult blood test (FOBT) – a non-invasive test people can do at home and send into the lab. As reported here in the past, \u003ca href=\"../2012/02/23/avoiding-a-colonoscopy-youre-not-alone/\">new tools are also being developed\u003c/a> that use more advanced science to check for markers of cancer, though these are still gaining traction.\u003c/p>\n\u003cp>But now doctors are looking at the psychology of how they talk to patients to figure out what might get the most people to get on board with screening.\u003c/p>\n\u003cp>In a study published today in the \u003ca title=\"http://archinte.ama-assn.org/\" href=\"http://archinte.ama-assn.org/\" target=\"_blank\">Archives of Internal Medicine\u003c/a>, researchers from three medical schools, including \u003ca title=\"http://www.ucsf.edu/\" href=\"http://www.ucsf.edu/\" target=\"_blank\">UCSF\u003c/a>, focused on just colonoscopies and FOBT. The study was done in San Francisco through the\u003ca title=\"http://www.sfdph.org/dph/comupg/oservices/medSvs/\" href=\"http://www.sfdph.org/dph/comupg/oservices/medSvs/\" target=\"_blank\"> Community Health Network\u003c/a>, and randomized doctors into three study groups: one to recommend only FOBT, one to recommend only colonoscopy, and one to offer patients a choice between the two.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Researchers presumed that recommending just one or the other would send a clear signal and be more effective than giving patients a choice.\u003c/p>\n\u003cp>They were wrong.\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>What they found instead was that patients who were recommended to get a colonoscopy only followed through 38 percent of the time. Compare that to patients who got a recommendation for FOBT and got screened 67 percent of the time, or those given a choice between the two -- who underwent screening 69 percent of the time.\u003c/p>\n\u003cp>As the researchers say, “Giving choices through shared decision making can improve adherence by increasing patient engagement and allowing for individual patient preferences.”\u003c/p>\n\u003cp>The finding was surprising because previous studies had suggested that talking to patients about the wide range of available options often led them to do nothing at all. As the study authors put it, “[E]vidence also illustrates that providing options of similar value and characteristics can sometimes have a negative impact on adherence due to people defaulting to inertia, presumably because of confusion or indecision between choices.”\u003c/p>\n\u003cp>Dr. Theodore Levin, who heads up Colon Cancer Screening for Kaiser Permanente in Northern California, wrote a commentary in response to the publication. In his words:\u003c/p>\n\u003cblockquote>\u003cp> “If having too many choices leads to confusion, the study by Inadomi et al. demonstrates that not having enough choice may lead to inaction when the only choice is colonoscopy ... When it comes to CRC screening, providing an option other than colonoscopy for our patients is not overwhelming, but necessary.”\u003c/p>\n\u003cp>“What should physicians recommend when talking with patients about CRC? The psychology literature has noted that too much choice is a problem in current society. Patients may be overwhelmed by the options and feel that no option is perfect and therefore choose to do nothing out of confusion. However, every option for CRC screening has its own unique strengths and limitations. A patient-centered approach would take each patient’s perspective into account when designing a screening strategy.”\u003c/p>\u003c/blockquote>\n\u003cp>The study further looked at differences among groups of people to find barriers to screening. The authors wrote:\u003c/p>\n\u003cblockquote>\u003cp>“Prior studies reported low CRC screening rates among racial/ethnic minorities, especially among Asians, Latinos, and African Americans. While the present study confirms the disparity among African Americans, we observed higher adherence among Asians and Latinos than for whites. Our population had established access to health care, which may have reduced these racial differences.”\u003c/p>\u003c/blockquote>\n\u003cp>The study authors also found that people who did their patient-doctor visits in Spanish, Cantonese, or Mandarin were more likely to get screened than people of the same race/ethnicity who chose to do their visits in English.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>And, not surprisingly, patients with insurance (public or private) completed screening more often than those without insurance.\u003c/p>\n\n",
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"excerpt": "Although about 50,000 people in the U.S. died from colorectal cancer (CRC) last year, as many as half of those deaths could have been prevented by routine screening. That’s 25,000 lives that could have been saved using tools that are already widely available.\r\n\r\nThe problem is getting people to undergo screening can be a bit of a challenge. The \"ick\" factor of colonoscopies, concerns about paying for them, and other barriers get in the way of adequate screenings. Alternatives do exist, such as the fecal occult blood test (FOBT) – a non-invasive test people can do at home and send into the lab. As reported here in the past, new tools are also being developed that use more advanced science to check for markers of cancer, though these are still gaining traction.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>By: Kamal Menghrajani\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_4913\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/DoctorPatientPic_FlickrVicLawrence_April92012.jpg\">\u003cimg class=\"size-medium wp-image-4913\" title=\"Doctor greating patient\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/DoctorPatientPic_FlickrVicLawrence_April92012-300x200.jpg\" alt=\"Doctor greating patient\" width=\"300\" height=\"200\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Patient-doctor discussions about choices in colon cancer screening may encourage more people to follow through. (Vic Lawrence: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Although about 50,000 people in the U.S. \u003ca href=\"http://seer.cancer.gov/statfacts/html/colorect.html\">died from colorectal cancer\u003c/a> (CRC) last year, as many as half of those deaths could have been prevented by routine screening. That’s 25,000 lives that could have been saved using tools that are already widely available.\u003c/p>\n\u003cp>The problem is getting people to undergo screening can be a bit of a challenge. The \"ick\" factor of colonoscopies, concerns about paying for them, and other barriers get in the way of adequate screenings. \u003ca href=\"http://www.cancer.org/Cancer/ColonandRectumCancer/DetailedGuide/colorectal-cancer-detection\">Alternatives do exist\u003c/a>, such as the fecal occult blood test (FOBT) – a non-invasive test people can do at home and send into the lab. As reported here in the past, \u003ca href=\"../2012/02/23/avoiding-a-colonoscopy-youre-not-alone/\">new tools are also being developed\u003c/a> that use more advanced science to check for markers of cancer, though these are still gaining traction.\u003c/p>\n\u003cp>But now doctors are looking at the psychology of how they talk to patients to figure out what might get the most people to get on board with screening.\u003c/p>\n\u003cp>In a study published today in the \u003ca title=\"http://archinte.ama-assn.org/\" href=\"http://archinte.ama-assn.org/\" target=\"_blank\">Archives of Internal Medicine\u003c/a>, researchers from three medical schools, including \u003ca title=\"http://www.ucsf.edu/\" href=\"http://www.ucsf.edu/\" target=\"_blank\">UCSF\u003c/a>, focused on just colonoscopies and FOBT. The study was done in San Francisco through the\u003ca title=\"http://www.sfdph.org/dph/comupg/oservices/medSvs/\" href=\"http://www.sfdph.org/dph/comupg/oservices/medSvs/\" target=\"_blank\"> Community Health Network\u003c/a>, and randomized doctors into three study groups: one to recommend only FOBT, one to recommend only colonoscopy, and one to offer patients a choice between the two.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Researchers presumed that recommending just one or the other would send a clear signal and be more effective than giving patients a choice.\u003c/p>\n\u003cp>They were wrong.\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>What they found instead was that patients who were recommended to get a colonoscopy only followed through 38 percent of the time. Compare that to patients who got a recommendation for FOBT and got screened 67 percent of the time, or those given a choice between the two -- who underwent screening 69 percent of the time.\u003c/p>\n\u003cp>As the researchers say, “Giving choices through shared decision making can improve adherence by increasing patient engagement and allowing for individual patient preferences.”\u003c/p>\n\u003cp>The finding was surprising because previous studies had suggested that talking to patients about the wide range of available options often led them to do nothing at all. As the study authors put it, “[E]vidence also illustrates that providing options of similar value and characteristics can sometimes have a negative impact on adherence due to people defaulting to inertia, presumably because of confusion or indecision between choices.”\u003c/p>\n\u003cp>Dr. Theodore Levin, who heads up Colon Cancer Screening for Kaiser Permanente in Northern California, wrote a commentary in response to the publication. In his words:\u003c/p>\n\u003cblockquote>\u003cp> “If having too many choices leads to confusion, the study by Inadomi et al. demonstrates that not having enough choice may lead to inaction when the only choice is colonoscopy ... When it comes to CRC screening, providing an option other than colonoscopy for our patients is not overwhelming, but necessary.”\u003c/p>\n\u003cp>“What should physicians recommend when talking with patients about CRC? The psychology literature has noted that too much choice is a problem in current society. Patients may be overwhelmed by the options and feel that no option is perfect and therefore choose to do nothing out of confusion. However, every option for CRC screening has its own unique strengths and limitations. A patient-centered approach would take each patient’s perspective into account when designing a screening strategy.”\u003c/p>\u003c/blockquote>\n\u003cp>The study further looked at differences among groups of people to find barriers to screening. The authors wrote:\u003c/p>\n\u003cblockquote>\u003cp>“Prior studies reported low CRC screening rates among racial/ethnic minorities, especially among Asians, Latinos, and African Americans. While the present study confirms the disparity among African Americans, we observed higher adherence among Asians and Latinos than for whites. Our population had established access to health care, which may have reduced these racial differences.”\u003c/p>\u003c/blockquote>\n\u003cp>The study authors also found that people who did their patient-doctor visits in Spanish, Cantonese, or Mandarin were more likely to get screened than people of the same race/ethnicity who chose to do their visits in English.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>And, not surprisingly, patients with insurance (public or private) completed screening more often than those without insurance.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "California Advocates For Healthy Food in U.S. Farm Bill",
"title": "California Advocates For Healthy Food in U.S. Farm Bill",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_4821\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/Farm_.gif\">\u003cimg class=\"size-full wp-image-4821\" title=\"Farm_\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/Farm_.gif\" alt=\"\" width=\"300\" height=\"300\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2012/04/Farm_.gif 300w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/Farm_-32x32.gif 32w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/Farm_-64x64.gif 64w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/Farm_-96x96.gif 96w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/Farm_-128x128.gif 128w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/Farm_-75x75.gif 75w\" sizes=\"(max-width: 300px) 100vw, 300px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">California food advocates are hoping to shift national farm policy to support healthier foods for all. (Liji Jinaraj:Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>The \u003ca href=\"http://www.usda.gov/wps/portal/usda/farmbill2008?navid=FARMBILL2008\" target=\"_blank\">U.S. Farm Bill\u003c/a> is up for reauthorization in Congress this year and California food and health advocates are eager to use the opportunity to shift national policy towards healthier eating, which would also benefit California farmers.\u003c/p>\n\u003cp>A panel of food experts that included \u003ca href=\"http://michaelpollan.com/\" target=\"_blank\">Michael Pollan\u003c/a>, author of bestseller \u003cem>Omnivore's Dilemma\u003c/em>, and \u003ca href=\"http://www.cdfa.ca.gov/SecretaryBio.html\">Karen Ross\u003c/a>, Secretary of the \u003ca href=\"http://www.cdfa.ca.gov/\" target=\"_blank\">California Department of Food and Agriculture\u003c/a> packed an auditorium at U.C. Berkeley Thursday evening.\u003c/p>\n\u003cp>Budget cuts in Washington D.C. emerged as a big theme. Every panelist recognized the need to play defense in order to keep money in the bill for important programs such as \u003ca title=\"http://www.fns.usda.gov/snap/rules/Legislation/about.htm\" href=\"http://www.fns.usda.gov/snap/rules/Legislation/about.htm\" target=\"_blank\">Supplemental Nutrition Assistance Program or SNAP\u003c/a>, formerly known as food stamps. Currently, 77 percent of the money in the Farm Bill goes to support food and nutrition programs like SNAP. \"One in five of our citizens find themselves food insecure in a month or a year,\" said Karen Ross referring to California specifically. \"And it’s ironic that we have that need in a state that’s the number one producer of so many of those crops,\" she continued.\u003c!--more-->\u003c/p>\n\u003cp>The problem is that California produces mostly \"specialty crops\" like fruits, vegetables, nuts and grapes. Those crops don't carry as much weight in Congress as the heavy hitting commodity crops like corn, soy and cotton that have long received cash subsidies from the government and are often the focus of the Farm Bill.\u003c/p>\n\u003cfigure id=\"attachment_4828\" class=\"wp-caption alignleft\" style=\"max-width: 200px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/MichaelPollan2.gif\">\u003cimg class=\"size-full wp-image-4828\" title=\"Author Michael Pollan said the Farm Bill needs to be changed radically to focus on people's health. (Photo: www.michaelpollan.com)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/MichaelPollan2.gif\" alt=\"Author Michael Pollan said the Farm Bill needs to be changed radically to focus on people's health. (Photo: www.michaelpollan.com)\" width=\"200\" height=\"200\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2012/04/MichaelPollan2.gif 200w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/MichaelPollan2-32x32.gif 32w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/MichaelPollan2-64x64.gif 64w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/MichaelPollan2-96x96.gif 96w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/MichaelPollan2-128x128.gif 128w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/MichaelPollan2-75x75.gif 75w\" sizes=\"(max-width: 200px) 100vw, 200px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Author Michael Pollan said the Farm Bill needs to be changed radically to focus on people's health. (Photo: www.michaelpollan.com)\u003c/figcaption>\u003c/figure>\n\u003cp>\"It has a lot to do with the kind of food that's in your supermarket and the kind of food that's not in your supermarket,\" Michael Pollan explained his interest in the Farm Bill to me. \"It really is the rules of the whole food game. And unfortunately it's decided by a small group of people who may not have an eater's interest firmly in view,\" he added. Pollan is concerned about access to fresh fruits and vegetables and wants to limit the amount of foods that have highly processed ingredients like high-fructose corn syrup in them. “We should seriously consider a federal definition of food,” he said to the hundreds of people who attended. “There are many things that we are supporting that are not food.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>While the Farm Bill doesn't put a lot of money into programs that support healthy eating, it could do a lot more, the panelists urged. Pollan wants to see more money go to support farmers' markets, to make it easier to get healthy food into school lunch programs and to help farmers transition to organic agriculture. He calls these efforts \"crumbs\" in the big money picture in D.C. and sees these programs as real ways to help avoid some of the chronic illnesses endemic to the U.S., most of which are diet related.\u003c/p>\n\u003caside class=\"pullquote alignright\">\"We should seriously consider a federal definition of food.\"\u003c/aside>\n\u003cp>Karen Ross is in charge of determining a unified message that California's congressional delegation could offer up in the Farm Bill debate. She says the three top priorities that have emerged from talks with 80 stakeholders up and down the state and five \u003ca title=\"http://www.cdfa.ca.gov/egov/Press_Releases/Press_Release.asp?PRnum=11-047\" href=\"http://www.cdfa.ca.gov/egov/Press_Releases/Press_Release.asp?PRnum=11-047\" target=\"_blank\">public listening sessions\u003c/a> are:\u003c/p>\n\u003cul>\n\u003cli>Protecting the state's agricultural assets from invasive species\u003c/li>\n\u003cli>Conservation practices\u003c/li>\n\u003cli>Access to healthy food\u003c/li>\n\u003c/ul>\n\u003cp>\u003c/p>\n\u003cp>\"We're hopeful that because we were able to bring together all the agencies within state government that have an interest that we can communicate in a way that will help our delegation vote collectively on some of the issues we care about,\" said Ross. The 2008 Farm Bill was a step in the right direction for California, she said, because a \u003ca href=\"http://www.ers.usda.gov/farmbill/2008/titles/titleXHorticulture.htm\" target=\"_blank\">specialty crop title\u003c/a> was inserted into the bill that allocates money to programs that more directly affect California specialty crop farmers, who currently get no subsidies from the government for their crops.\u003c/p>\n\n",
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"excerpt": "The U.S. Farm Bill is up for reauthorization in Congress this year and California food and health advocates are eager to use the opportunity to shift national policy towards healthier eating, which would also benefit California farmers.\r\n\r\nA panel of food experts that included Michael Pollan, author of bestseller Omnivore's Dilemma, and Karen Ross, Secretary of the California Department of Food and Agriculture packed Wheeler Auditorium at U.C. Berkeley Thursday evening.",
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"description": "The U.S. Farm Bill is up for reauthorization in Congress this year and California food and health advocates are eager to use the opportunity to shift national policy towards healthier eating, which would also benefit California farmers.\r\n\r\nA panel of food experts that included Michael Pollan, author of bestseller Omnivore's Dilemma, and Karen Ross, Secretary of the California Department of Food and Agriculture packed Wheeler Auditorium at U.C. Berkeley Thursday evening.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_4821\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/Farm_.gif\">\u003cimg class=\"size-full wp-image-4821\" title=\"Farm_\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/Farm_.gif\" alt=\"\" width=\"300\" height=\"300\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2012/04/Farm_.gif 300w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/Farm_-32x32.gif 32w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/Farm_-64x64.gif 64w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/Farm_-96x96.gif 96w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/Farm_-128x128.gif 128w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/Farm_-75x75.gif 75w\" sizes=\"(max-width: 300px) 100vw, 300px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">California food advocates are hoping to shift national farm policy to support healthier foods for all. (Liji Jinaraj:Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>The \u003ca href=\"http://www.usda.gov/wps/portal/usda/farmbill2008?navid=FARMBILL2008\" target=\"_blank\">U.S. Farm Bill\u003c/a> is up for reauthorization in Congress this year and California food and health advocates are eager to use the opportunity to shift national policy towards healthier eating, which would also benefit California farmers.\u003c/p>\n\u003cp>A panel of food experts that included \u003ca href=\"http://michaelpollan.com/\" target=\"_blank\">Michael Pollan\u003c/a>, author of bestseller \u003cem>Omnivore's Dilemma\u003c/em>, and \u003ca href=\"http://www.cdfa.ca.gov/SecretaryBio.html\">Karen Ross\u003c/a>, Secretary of the \u003ca href=\"http://www.cdfa.ca.gov/\" target=\"_blank\">California Department of Food and Agriculture\u003c/a> packed an auditorium at U.C. Berkeley Thursday evening.\u003c/p>\n\u003cp>Budget cuts in Washington D.C. emerged as a big theme. Every panelist recognized the need to play defense in order to keep money in the bill for important programs such as \u003ca title=\"http://www.fns.usda.gov/snap/rules/Legislation/about.htm\" href=\"http://www.fns.usda.gov/snap/rules/Legislation/about.htm\" target=\"_blank\">Supplemental Nutrition Assistance Program or SNAP\u003c/a>, formerly known as food stamps. Currently, 77 percent of the money in the Farm Bill goes to support food and nutrition programs like SNAP. \"One in five of our citizens find themselves food insecure in a month or a year,\" said Karen Ross referring to California specifically. \"And it’s ironic that we have that need in a state that’s the number one producer of so many of those crops,\" she continued.\u003c!--more-->\u003c/p>\n\u003cp>The problem is that California produces mostly \"specialty crops\" like fruits, vegetables, nuts and grapes. Those crops don't carry as much weight in Congress as the heavy hitting commodity crops like corn, soy and cotton that have long received cash subsidies from the government and are often the focus of the Farm Bill.\u003c/p>\n\u003cfigure id=\"attachment_4828\" class=\"wp-caption alignleft\" style=\"max-width: 200px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/MichaelPollan2.gif\">\u003cimg class=\"size-full wp-image-4828\" title=\"Author Michael Pollan said the Farm Bill needs to be changed radically to focus on people's health. (Photo: www.michaelpollan.com)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/MichaelPollan2.gif\" alt=\"Author Michael Pollan said the Farm Bill needs to be changed radically to focus on people's health. (Photo: www.michaelpollan.com)\" width=\"200\" height=\"200\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2012/04/MichaelPollan2.gif 200w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/MichaelPollan2-32x32.gif 32w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/MichaelPollan2-64x64.gif 64w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/MichaelPollan2-96x96.gif 96w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/MichaelPollan2-128x128.gif 128w, https://ww2.kqed.org/app/uploads/sites/27/2012/04/MichaelPollan2-75x75.gif 75w\" sizes=\"(max-width: 200px) 100vw, 200px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Author Michael Pollan said the Farm Bill needs to be changed radically to focus on people's health. (Photo: www.michaelpollan.com)\u003c/figcaption>\u003c/figure>\n\u003cp>\"It has a lot to do with the kind of food that's in your supermarket and the kind of food that's not in your supermarket,\" Michael Pollan explained his interest in the Farm Bill to me. \"It really is the rules of the whole food game. And unfortunately it's decided by a small group of people who may not have an eater's interest firmly in view,\" he added. Pollan is concerned about access to fresh fruits and vegetables and wants to limit the amount of foods that have highly processed ingredients like high-fructose corn syrup in them. “We should seriously consider a federal definition of food,” he said to the hundreds of people who attended. “There are many things that we are supporting that are not food.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>While the Farm Bill doesn't put a lot of money into programs that support healthy eating, it could do a lot more, the panelists urged. Pollan wants to see more money go to support farmers' markets, to make it easier to get healthy food into school lunch programs and to help farmers transition to organic agriculture. He calls these efforts \"crumbs\" in the big money picture in D.C. and sees these programs as real ways to help avoid some of the chronic illnesses endemic to the U.S., most of which are diet related.\u003c/p>\n\u003caside class=\"pullquote alignright\">\"We should seriously consider a federal definition of food.\"\u003c/aside>\n\u003cp>Karen Ross is in charge of determining a unified message that California's congressional delegation could offer up in the Farm Bill debate. She says the three top priorities that have emerged from talks with 80 stakeholders up and down the state and five \u003ca title=\"http://www.cdfa.ca.gov/egov/Press_Releases/Press_Release.asp?PRnum=11-047\" href=\"http://www.cdfa.ca.gov/egov/Press_Releases/Press_Release.asp?PRnum=11-047\" target=\"_blank\">public listening sessions\u003c/a> are:\u003c/p>\n\u003cul>\n\u003cli>Protecting the state's agricultural assets from invasive species\u003c/li>\n\u003cli>Conservation practices\u003c/li>\n\u003cli>Access to healthy food\u003c/li>\n\u003c/ul>\n\u003cp>\u003c/p>\n\u003cp>\"We're hopeful that because we were able to bring together all the agencies within state government that have an interest that we can communicate in a way that will help our delegation vote collectively on some of the issues we care about,\" said Ross. The 2008 Farm Bill was a step in the right direction for California, she said, because a \u003ca href=\"http://www.ers.usda.gov/farmbill/2008/titles/titleXHorticulture.htm\" target=\"_blank\">specialty crop title\u003c/a> was inserted into the bill that allocates money to programs that more directly affect California specialty crop farmers, who currently get no subsidies from the government for their crops.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "\"Model\" Dental Program Ultimately Painful for Children",
"title": "\"Model\" Dental Program Ultimately Painful for Children",
"headTitle": "State of Health | KQED News",
"content": "\u003cp>By Kelley Weiss, \u003ca title=\"http://centerforhealthreporting.org/\" href=\"http://centerforhealthreporting.org/\" target=\"_blank\">Center for Health Reporting\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_4802\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/ChildatDentist_EthanDenney_Flickr_04062012.jpg\">\u003cimg class=\"size-medium wp-image-4802\" title=\"(Ethan Denney: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/ChildatDentist_EthanDenney_Flickr_04062012-300x225.jpg\" alt=\"(Ethan Denney: Flickr)\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Ethan Denney: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Since February, reports from the \u003ca href=\"http://centerforhealthreporting.org/article/model-dental-program-proves-painful-kids785\" target=\"_blank\">CHCF Center for Health Reporting\u003c/a> and \u003ca title=\"http://www.sacbee.com/2012/02/12/4256975/model-dental-program-proves-painful.html\" href=\"http://www.sacbee.com/2012/02/12/4256975/model-dental-program-proves-painful.html\" target=\"_blank\">The Sacramento Bee\u003c/a> have painted a grim picture of low-income children waiting for months or even years to see a dentist in Sacramento. And now some state lawmakers are calling for immediate action.\u003c/p>\n\u003cp>Almost two decades ago the state started a managed care pilot program in Sacramento County for children’s dental care. Since then, several families have described harrowing instances of long wait times and unsuccessful attempts to get through the red tape.\u003c/p>\n\u003cp>Alisa Erickson testified at the state Capitol on March 15th about her 18-year-old daughter’s struggle to get dental care in Sacramento.\u003c/p>\n\u003cp>“Her cheek was actually swollen and she was in so much pain, that she missed school, she could not sleep because every time she laid down … her tooth would throb so bad she’d start crying,” Erickson says.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>Erickson’s daughter, Stephanie, has coverage through Medi-Cal -- a program for low-income Californians. But Erickson says it took three years to get a broken tooth pulled. That’s because through her coverage, she couldn’t find any dentists to see her daughter. By the time she got treatment, it had gotten much worse.\u003c/p>\n\u003cp>“My daughter, the damage has been done,” Erickson testified. “All her teeth have been pulled.”\u003c/p>\n\u003cp>Last year less than a third of Sacramento’s 100,000 children with Medi-Cal saw a dentist. That’s compared to a state average of nearly 50 percent, which makes Sacramento one of the worst counties for kids to access public dental benefits.\u003c/p>\n\u003cp>Ongoing issues with Sacramento’s dental program were documented in a \u003ca title=\"http://www.first5sacramento.net/coswcms/groups/public/@wcm/@pub/@first5/@inter/documents/webcontent/sac_022976.pdf\" href=\"http://www.first5sacramento.net/coswcms/groups/public/@wcm/@pub/@first5/@inter/documents/webcontent/sac_022976.pdf\" target=\"_blank\">First 5 Sacramento report [PDF]\u003c/a> presented to government officials in 2010.\u003c/p>\n\u003cp>And \u003ca href=\"http://sd06.senate.ca.gov/news/2012-02-13-steinberg-calls-state-review-children-s-dental-care-program\" target=\"_blank\">Senate President Pro Tem Darrell Steinberg\u003c/a>, D-Sacramento, says children from low-income families shouldn’t be suffering like this.\u003c/p>\n\u003cp>He’s trying to change what’s called \u003ca href=\"http://www.denti-cal.ca.gov/WSI/ManagedCare.jsp?fname=ManagedCareOverview\" target=\"_blank\">Dental Geographic Managed Care,\u003c/a> or GMC, in Sacramento County. It’s a closed network of providers that get paid a flat monthly rate of about $12 for each child enrolled in the program. That’s whether they see them or not. But around the state, most children with Medi-Cal are not enrolled in dental managed care. But in Sacramento, that’s not the case: it’s the only county where kids have to be in this kind of program.\u003c/p>\n\u003cp>\u003ca href=\"http://centerforhealthreporting.org/article/senate-panel-backs-change-kids-dental-coverage832\" target=\"_blank\">Steinberg recently introduced a bill\u003c/a> to even the playing field for children in his district of Sacramento.\u003c/p>\n\u003cp>“We want to push for a voluntary program where there is some choice here, because when there is more choice more likely kids will get the access quickly,” Steinberg says.\u003c/p>\n\u003cp>Steinberg’s bill still has a long way to go. It needs lawmakers’ approval and then Governor Brown’s signature. The bill calls for much greater oversight of the health plans. And for regular reports to the Legislature about progress.\u003c/p>\n\u003cp>But California’s Department of Health Care Services director, \u003ca title=\"http://www.dhcs.ca.gov/Pages/DirectorsBiography.aspx\" href=\"http://www.dhcs.ca.gov/Pages/DirectorsBiography.aspx\" target=\"_blank\">Toby Douglas\u003c/a>, says he wants to stick with the current mandatory dental program.\u003c/p>\n\u003cp>“We strongly believe that managed care done right with really, really strong accountability, and working with our plans to make sure that providers are providing the right care, that it can be the right model,” Douglas says.\u003c/p>\n\u003cp>At the same time \u003ca href=\"http://centerforhealthreporting.org/article/state-health-chief-vows-changes-sacramento-county-dental-program802\">Toby Douglas is responding to the public scrutiny\u003c/a> of the program now. He says audits of the health plans in Sacramento are underway. And Douglas says the state will pay providers more if they see more children. If they don’t, Douglas says they won’t get paid.\u003c/p>\n\u003cp>But \u003ca href=\"http://www.barbaraavedassociates.com/\">health care consultant Barbara Aved\u003c/a> is skeptical this will actually happen. She points to the state’s failing record with Sacramento’s Geographic Managed Care dental program saying, “very little attention is paid to the GMC side, very little oversight, very little enforcement.”\u003c/p>\n\u003cp>Aved says the root of the problem is the low payments to dentists. She says for every dollar dentists spend on care for Medi-Cal patients, they get reimbursed 10 to 20 cents. And this has led many to drop out of the program altogether.\u003c/p>\n\u003cp>“Quite honestly, and I know this is the wrong economic environment to say this, but you have to pay an equitable rate,” Aved says.\u003c/p>\n\u003cp>Aved says without increasing payments you can’t fully fix Sacramento’s program. And she says there’s a bigger picture here – these same problems could come up if a current state budget proposal is approved. It would expand dental managed care into 30 counties across the state.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Listen to the story:\u003c/strong>\u003cbr>\n\u003cobject width=\"335\" height=\"85\" classid=\"d27cdb6e-ae6d-11cf-96b8-444553540000\" codebase=\"http://download.macromedia.com/pub/shockwave/cabs/flash/swflash.cab#version=6,0,40,0\">\u003cparam name=\"flashvars\" value=\"file=http://www.kqed.org/radio/archives/R201204060850b.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/R201204060850b.xml\">\u003c/embed>\u003c/object>\u003c/p>\n\n",
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"excerpt": "Since February, reports from the CHCF Center for Health Reporting and The Sacramento Bee have painted a grim picture of low-income children waiting for months or even years to see a dentist in Sacramento. And now some state lawmakers are calling for immediate action.\r\n\r\nAlmost two decades ago the state started a managed care pilot program in Sacramento County for children’s dental care. Since then several families have described harrowing instances of long wait times and unsuccessful attempts to get through the red tape.\r\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>By Kelley Weiss, \u003ca title=\"http://centerforhealthreporting.org/\" href=\"http://centerforhealthreporting.org/\" target=\"_blank\">Center for Health Reporting\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_4802\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/ChildatDentist_EthanDenney_Flickr_04062012.jpg\">\u003cimg class=\"size-medium wp-image-4802\" title=\"(Ethan Denney: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/ChildatDentist_EthanDenney_Flickr_04062012-300x225.jpg\" alt=\"(Ethan Denney: Flickr)\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Ethan Denney: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Since February, reports from the \u003ca href=\"http://centerforhealthreporting.org/article/model-dental-program-proves-painful-kids785\" target=\"_blank\">CHCF Center for Health Reporting\u003c/a> and \u003ca title=\"http://www.sacbee.com/2012/02/12/4256975/model-dental-program-proves-painful.html\" href=\"http://www.sacbee.com/2012/02/12/4256975/model-dental-program-proves-painful.html\" target=\"_blank\">The Sacramento Bee\u003c/a> have painted a grim picture of low-income children waiting for months or even years to see a dentist in Sacramento. And now some state lawmakers are calling for immediate action.\u003c/p>\n\u003cp>Almost two decades ago the state started a managed care pilot program in Sacramento County for children’s dental care. Since then, several families have described harrowing instances of long wait times and unsuccessful attempts to get through the red tape.\u003c/p>\n\u003cp>Alisa Erickson testified at the state Capitol on March 15th about her 18-year-old daughter’s struggle to get dental care in Sacramento.\u003c/p>\n\u003cp>“Her cheek was actually swollen and she was in so much pain, that she missed school, she could not sleep because every time she laid down … her tooth would throb so bad she’d start crying,” Erickson says.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>Erickson’s daughter, Stephanie, has coverage through Medi-Cal -- a program for low-income Californians. But Erickson says it took three years to get a broken tooth pulled. That’s because through her coverage, she couldn’t find any dentists to see her daughter. By the time she got treatment, it had gotten much worse.\u003c/p>\n\u003cp>“My daughter, the damage has been done,” Erickson testified. “All her teeth have been pulled.”\u003c/p>\n\u003cp>Last year less than a third of Sacramento’s 100,000 children with Medi-Cal saw a dentist. That’s compared to a state average of nearly 50 percent, which makes Sacramento one of the worst counties for kids to access public dental benefits.\u003c/p>\n\u003cp>Ongoing issues with Sacramento’s dental program were documented in a \u003ca title=\"http://www.first5sacramento.net/coswcms/groups/public/@wcm/@pub/@first5/@inter/documents/webcontent/sac_022976.pdf\" href=\"http://www.first5sacramento.net/coswcms/groups/public/@wcm/@pub/@first5/@inter/documents/webcontent/sac_022976.pdf\" target=\"_blank\">First 5 Sacramento report [PDF]\u003c/a> presented to government officials in 2010.\u003c/p>\n\u003cp>And \u003ca href=\"http://sd06.senate.ca.gov/news/2012-02-13-steinberg-calls-state-review-children-s-dental-care-program\" target=\"_blank\">Senate President Pro Tem Darrell Steinberg\u003c/a>, D-Sacramento, says children from low-income families shouldn’t be suffering like this.\u003c/p>\n\u003cp>He’s trying to change what’s called \u003ca href=\"http://www.denti-cal.ca.gov/WSI/ManagedCare.jsp?fname=ManagedCareOverview\" target=\"_blank\">Dental Geographic Managed Care,\u003c/a> or GMC, in Sacramento County. It’s a closed network of providers that get paid a flat monthly rate of about $12 for each child enrolled in the program. That’s whether they see them or not. But around the state, most children with Medi-Cal are not enrolled in dental managed care. But in Sacramento, that’s not the case: it’s the only county where kids have to be in this kind of program.\u003c/p>\n\u003cp>\u003ca href=\"http://centerforhealthreporting.org/article/senate-panel-backs-change-kids-dental-coverage832\" target=\"_blank\">Steinberg recently introduced a bill\u003c/a> to even the playing field for children in his district of Sacramento.\u003c/p>\n\u003cp>“We want to push for a voluntary program where there is some choice here, because when there is more choice more likely kids will get the access quickly,” Steinberg says.\u003c/p>\n\u003cp>Steinberg’s bill still has a long way to go. It needs lawmakers’ approval and then Governor Brown’s signature. The bill calls for much greater oversight of the health plans. And for regular reports to the Legislature about progress.\u003c/p>\n\u003cp>But California’s Department of Health Care Services director, \u003ca title=\"http://www.dhcs.ca.gov/Pages/DirectorsBiography.aspx\" href=\"http://www.dhcs.ca.gov/Pages/DirectorsBiography.aspx\" target=\"_blank\">Toby Douglas\u003c/a>, says he wants to stick with the current mandatory dental program.\u003c/p>\n\u003cp>“We strongly believe that managed care done right with really, really strong accountability, and working with our plans to make sure that providers are providing the right care, that it can be the right model,” Douglas says.\u003c/p>\n\u003cp>At the same time \u003ca href=\"http://centerforhealthreporting.org/article/state-health-chief-vows-changes-sacramento-county-dental-program802\">Toby Douglas is responding to the public scrutiny\u003c/a> of the program now. He says audits of the health plans in Sacramento are underway. And Douglas says the state will pay providers more if they see more children. If they don’t, Douglas says they won’t get paid.\u003c/p>\n\u003cp>But \u003ca href=\"http://www.barbaraavedassociates.com/\">health care consultant Barbara Aved\u003c/a> is skeptical this will actually happen. She points to the state’s failing record with Sacramento’s Geographic Managed Care dental program saying, “very little attention is paid to the GMC side, very little oversight, very little enforcement.”\u003c/p>\n\u003cp>Aved says the root of the problem is the low payments to dentists. She says for every dollar dentists spend on care for Medi-Cal patients, they get reimbursed 10 to 20 cents. And this has led many to drop out of the program altogether.\u003c/p>\n\u003cp>“Quite honestly, and I know this is the wrong economic environment to say this, but you have to pay an equitable rate,” Aved says.\u003c/p>\n\u003cp>Aved says without increasing payments you can’t fully fix Sacramento’s program. And she says there’s a bigger picture here – these same problems could come up if a current state budget proposal is approved. It would expand dental managed care into 30 counties across the state.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Listen to the story:\u003c/strong>\u003cbr>\n\u003cobject width=\"335\" height=\"85\" classid=\"d27cdb6e-ae6d-11cf-96b8-444553540000\" codebase=\"http://download.macromedia.com/pub/shockwave/cabs/flash/swflash.cab#version=6,0,40,0\">\u003cparam name=\"flashvars\" value=\"file=http://www.kqed.org/radio/archives/R201204060850b.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/R201204060850b.xml\">\u003c/embed>\u003c/object>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Please, Don't Call It Rationing",
"title": "Please, Don't Call It Rationing",
"headTitle": "State of Health | KQED News",
"content": "\u003cp>\u003cstrong>New Campaign Urges Doctors to Avoid Unnecessary Tests\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_4778\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/MRI_Machine_JustUs3_Flickr.jpg\">\u003cimg class=\"size-medium wp-image-4778\" title=\"MRI_Machine_JustUs3_Flickr\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/MRI_Machine_JustUs3_Flickr-300x230.jpg\" alt=\"\" width=\"300\" height=\"230\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Just Us 3: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>To many patients, it may seem unbelievable that their doctors would recommend something that is completely unnecessary. But by \u003ca title=\"http://www.rand.org/pubs/research_briefs/RB4522/index1.html\" href=\"http://www.rand.org/pubs/research_briefs/RB4522/index1.html\" target=\"_blank\">some estimates\u003c/a>, that's exactly what happens a third of the time.\u003c/p>\n\u003cp>Yesterday a broad coalition of medical specialty groups -- including cardiologists and family practitioners -- as well as \u003ca title=\"http://web.consumerreports.org/test/SEM/version5.htm?EXTKEY=SG72CR0&CMP=KNC-CROBRANDG&HBX_OU=50&HBX_PK=consumer_reports\" href=\"http://web.consumerreports.org/test/SEM/version5.htm?EXTKEY=SG72CR0&CMP=KNC-CROBRANDG&HBX_OU=50&HBX_PK=consumer_reports\" target=\"_blank\">Consumer Reports\u003c/a> announced a new campaign, \u003ca title=\"http://choosingwisely.org/\" href=\"http://choosingwisely.org/\" target=\"_blank\">Choosing Wisely\u003c/a>. It's a list of 45 tests and procedures that doctors should do much less often for one simple reason: the items on the list are unlikely to be of benefit to the patient.\u003c/p>\n\u003cp>The idea immediately raised questions of rationing and that's exactly where \u003ca title=\"http://www.kqed.org/a/forum/R201204050900\" href=\"http://www.kqed.org/a/forum/R201204050900\" target=\"_blank\">KQED's Forum\u003c/a> started off this morning in discussing the new campaign. UCSF's \u003ca title=\"http://profiles.ucsf.edu/ProfileDetails.aspx?Person=4577990\" href=\"http://profiles.ucsf.edu/ProfileDetails.aspx?Person=4577990\" target=\"_blank\">Dr. Catherine Lucey\u003c/a>, who helped to spearhead the Choosing Wisely campaign, swatted that misconception away.\u003c/p>\n\u003cp>\"It's not rationing,\" she explained. \"Rationing of health care is when you deny needed care to patients. ... Rationing of health care means patients could get better being given a particular drug of subject to a particular test. This is about tests that in many circumstances do not improve quality of life, do not improve quantity of life and potentially could harm patients.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>Among the 45 tests and procedures the campaign says to \"question\" are: annual EKGs for patients at low risk of heart disease; MRIs for back pain; and antibiotics for mild-to-moderate sinusitis. The operative word here is \"question.\" Some callers to Forum worried insurance companies would use this information to deny payment, depriving those who might need the test or procedure of something that would be helpful. But Dr. Lucey explained that this is a campaign that was developed by physicians. She said insurance companies had not been involved in the process at all.\u003c/p>\n\u003cp>\"This is not about denying these tests. This is not saying that these tests don't make a difference for some patients,\" Dr. Lucey said. \"It's saying many times they don't. For instance, nuclear cardiologists said 45 percent of routine screening cardiac procedures, stress tests using nuclear radiology, are done for people who don't benefit from those tests, so why do them?\"\u003c/p>\n\u003cp>It was about this time that Forum welcomed \u003ca title=\"http://www.consumerreports.org/health/health-experts/index.htm\" href=\"http://www.consumerreports.org/health/health-experts/index.htm\" target=\"_blank\">Dr. John Santa\u003c/a> to the program. He's director of the \u003ca title=\"http://www.consumerreports.org/health/home.htm\" href=\"http://www.consumerreports.org/health/home.htm\" target=\"_blank\">Health Ratings Center\u003c/a> of Consumer Reports which partnered with the doctor's groups in developing this campaign. (Note: Consumer Reports is generally not a group I associate with supporting rationing).\u003c/p>\n\u003cp>At the heart of the Choosing Wisely campaign is an acknowledgment that patients and doctors need to share in the \u003ca title=\"http://informedmedicaldecisions.org/\" href=\"http://informedmedicaldecisions.org/\" target=\"_blank\">decision making\u003c/a> about a patient's treatment. If a patient wants a test or treatment that is unlikely to benefit them, the doctor needs to explain that. Conversely, if your doctor recommends something to you, you should ask questions. As Dr. Santa noted, Consumer Reports has 75 years of history telling consumers about virtually every industry, including what products work well and what products don't. Now, they find the same desire for information in health care.\u003c/p>\n\u003cp>\"Our surveys of consumers overwhelmingly say they want to have\u003ca title=\"http://ww2.kqed.org/stateofhealth/2011/12/08/how-much-do-elderly-patients-want-to-know-and-should-doctors-tell-them/\" href=\"http://ww2.kqed.org/stateofhealth/2011/12/08/how-much-do-elderly-patients-want-to-know-and-should-doctors-tell-them/\" target=\"_blank\"> those kinds of conversations\u003c/a>,\" Santa explained. \"They are more and more concerned about cost. They're concerned about safety.\"\u003c/p>\n\u003cp>But this is where I need to digress from \u003cem>Forum\u003c/em> (although I think the entire show is worth a listen; the embedded player is below). I fully support avoiding treatments that are not going to benefit a patient. I also support the concept of shared decision making. The problem is that patients, in general, have so much less knowledge and expertise than doctors.\u003c/p>\n\u003cp>And this brings me to the story of my good friend Saskia van Dijl, someone who is both smart and forceful. She recently developed a severe kidney infection and was hospitalized at a well-respected Bay Area hospital. When I visited her in the middle of her three day stay -- a Saturday -- she looked awful. She was receiving IV antibiotics. And she was concerned. While her doctor had not told her directly, the nurses told her they had found an order for a \"PICC\" line -- a peripherally inserted central catheter. It would be inserted in Saskia's arm, to access a major vein for administration of drugs, like the antibiotics Saskia was receiving.\u003c/p>\n\u003cp>But PICC lines are prone to infection, and Saskia knew that. She wanted to switch to oral antibiotics when she went home. When the doctor came later, Saskia was clear with her doctor. \"I asked point blank,\" she told me. \"'Are you absolutely sure there's not an oral antibiotic that would be as effective?' ... I asked that question three times in three different ways. Lisa, I can't even tell you, I really did not want the PICC line. I felt like it was way too much.\" But the doctor was clear. Saskia got the PICC line -- and had to stay in the hospital another night.\u003c/p>\n\u003cp>The next day, a new doctor was on duty. She took another look and saw a new option, based on Saskia's bacterial culture. There \u003cem>was \u003c/em>an oral antibiotic that could work for her. Saskia asked if the first doctor could have known this, and the answer was 'yes.' Within twenty minutes the PICC line was out, and Saskia went home with oral antibiotics. She has recovered fully.\u003c/p>\n\u003cp>Add the cost of Saskia's PICC line to that one-third of unnecessary health care in this country.\u003c/p>\n\u003cp>I caught up with Dr. Lucey after \u003cem>Forum\u003c/em> and told her Saskia's story. She said when a patient pushes back as strongly as Saskia had, it should prompt the doctor to take a second look at the options. \"Stop, let's re-think this,\" she said. Of course, Saskia could have demanded a second opinion. But by the time the first doctor got back to her, it was Sunday--not a great day for looking for doctors for second opinions. It's also hard to rebut a doctor who is telling you \"this is your only option\" when you're quite sick and lying in a hospital bed.\u003c/p>\n\u003cp>I've watched the discussion back and forth for years. Patients say doctors never explained all the risks. Doctors say, \"Patients walk into my office and demand all these tests.\" The \u003cem>Choosing Wisely\u003c/em> campaign which explicitly acknowledges doctors' role in overtreatment is a step forward. Still, if groups of specialists could come up with 45 tests that are generally unnecessary, one might wonder why they didn't come up with the list a long time ago.\u003c/p>\n\u003cp>Dr. Lucey told \u003cem>Forum\u003c/em> listeners, \"Like any other individuals, sometimes we fall into habits. And this campaign is suggesting we need to critically evaluate those habits.\"\u003c/p>\n\u003cp>Hundreds of billions of dollars could be saved if those habits are changed.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Listen to Forum:\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/R201204050900.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/R201204050900.xml\">\u003c/embed>\u003c/object>\u003c/p>\n\n",
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"excerpt": "To many patients, it may seem unbelievable that their doctors would recommend something that is completely unnecessary. But by some estimates, that's exactly what happens a third of the time.\r\n\r\nYesterday a broad coalition of medical specialty groups -- including cardiologists and family practitioners -- as well as Consumer Reports announced a new campaign, Choosing Wisely. It's a list of 45 tests and procedures that doctors should do much less often for one simple reason: the items on the list are unlikely to be of benefit to the patient.\r\n\r\nThe idea immediately raised questions of rationing and that's exactly where KQED's Forum started off this morning in discussing the new campaign. UCSF's Dr. Catherine Lucey, who helped to spearhead the Choosing Wisely campaign, swatted that misconception away.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>New Campaign Urges Doctors to Avoid Unnecessary Tests\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_4778\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/MRI_Machine_JustUs3_Flickr.jpg\">\u003cimg class=\"size-medium wp-image-4778\" title=\"MRI_Machine_JustUs3_Flickr\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/MRI_Machine_JustUs3_Flickr-300x230.jpg\" alt=\"\" width=\"300\" height=\"230\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Just Us 3: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>To many patients, it may seem unbelievable that their doctors would recommend something that is completely unnecessary. But by \u003ca title=\"http://www.rand.org/pubs/research_briefs/RB4522/index1.html\" href=\"http://www.rand.org/pubs/research_briefs/RB4522/index1.html\" target=\"_blank\">some estimates\u003c/a>, that's exactly what happens a third of the time.\u003c/p>\n\u003cp>Yesterday a broad coalition of medical specialty groups -- including cardiologists and family practitioners -- as well as \u003ca title=\"http://web.consumerreports.org/test/SEM/version5.htm?EXTKEY=SG72CR0&CMP=KNC-CROBRANDG&HBX_OU=50&HBX_PK=consumer_reports\" href=\"http://web.consumerreports.org/test/SEM/version5.htm?EXTKEY=SG72CR0&CMP=KNC-CROBRANDG&HBX_OU=50&HBX_PK=consumer_reports\" target=\"_blank\">Consumer Reports\u003c/a> announced a new campaign, \u003ca title=\"http://choosingwisely.org/\" href=\"http://choosingwisely.org/\" target=\"_blank\">Choosing Wisely\u003c/a>. It's a list of 45 tests and procedures that doctors should do much less often for one simple reason: the items on the list are unlikely to be of benefit to the patient.\u003c/p>\n\u003cp>The idea immediately raised questions of rationing and that's exactly where \u003ca title=\"http://www.kqed.org/a/forum/R201204050900\" href=\"http://www.kqed.org/a/forum/R201204050900\" target=\"_blank\">KQED's Forum\u003c/a> started off this morning in discussing the new campaign. UCSF's \u003ca title=\"http://profiles.ucsf.edu/ProfileDetails.aspx?Person=4577990\" href=\"http://profiles.ucsf.edu/ProfileDetails.aspx?Person=4577990\" target=\"_blank\">Dr. Catherine Lucey\u003c/a>, who helped to spearhead the Choosing Wisely campaign, swatted that misconception away.\u003c/p>\n\u003cp>\"It's not rationing,\" she explained. \"Rationing of health care is when you deny needed care to patients. ... Rationing of health care means patients could get better being given a particular drug of subject to a particular test. This is about tests that in many circumstances do not improve quality of life, do not improve quantity of life and potentially could harm patients.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>Among the 45 tests and procedures the campaign says to \"question\" are: annual EKGs for patients at low risk of heart disease; MRIs for back pain; and antibiotics for mild-to-moderate sinusitis. The operative word here is \"question.\" Some callers to Forum worried insurance companies would use this information to deny payment, depriving those who might need the test or procedure of something that would be helpful. But Dr. Lucey explained that this is a campaign that was developed by physicians. She said insurance companies had not been involved in the process at all.\u003c/p>\n\u003cp>\"This is not about denying these tests. This is not saying that these tests don't make a difference for some patients,\" Dr. Lucey said. \"It's saying many times they don't. For instance, nuclear cardiologists said 45 percent of routine screening cardiac procedures, stress tests using nuclear radiology, are done for people who don't benefit from those tests, so why do them?\"\u003c/p>\n\u003cp>It was about this time that Forum welcomed \u003ca title=\"http://www.consumerreports.org/health/health-experts/index.htm\" href=\"http://www.consumerreports.org/health/health-experts/index.htm\" target=\"_blank\">Dr. John Santa\u003c/a> to the program. He's director of the \u003ca title=\"http://www.consumerreports.org/health/home.htm\" href=\"http://www.consumerreports.org/health/home.htm\" target=\"_blank\">Health Ratings Center\u003c/a> of Consumer Reports which partnered with the doctor's groups in developing this campaign. (Note: Consumer Reports is generally not a group I associate with supporting rationing).\u003c/p>\n\u003cp>At the heart of the Choosing Wisely campaign is an acknowledgment that patients and doctors need to share in the \u003ca title=\"http://informedmedicaldecisions.org/\" href=\"http://informedmedicaldecisions.org/\" target=\"_blank\">decision making\u003c/a> about a patient's treatment. If a patient wants a test or treatment that is unlikely to benefit them, the doctor needs to explain that. Conversely, if your doctor recommends something to you, you should ask questions. As Dr. Santa noted, Consumer Reports has 75 years of history telling consumers about virtually every industry, including what products work well and what products don't. Now, they find the same desire for information in health care.\u003c/p>\n\u003cp>\"Our surveys of consumers overwhelmingly say they want to have\u003ca title=\"http://ww2.kqed.org/stateofhealth/2011/12/08/how-much-do-elderly-patients-want-to-know-and-should-doctors-tell-them/\" href=\"http://ww2.kqed.org/stateofhealth/2011/12/08/how-much-do-elderly-patients-want-to-know-and-should-doctors-tell-them/\" target=\"_blank\"> those kinds of conversations\u003c/a>,\" Santa explained. \"They are more and more concerned about cost. They're concerned about safety.\"\u003c/p>\n\u003cp>But this is where I need to digress from \u003cem>Forum\u003c/em> (although I think the entire show is worth a listen; the embedded player is below). I fully support avoiding treatments that are not going to benefit a patient. I also support the concept of shared decision making. The problem is that patients, in general, have so much less knowledge and expertise than doctors.\u003c/p>\n\u003cp>And this brings me to the story of my good friend Saskia van Dijl, someone who is both smart and forceful. She recently developed a severe kidney infection and was hospitalized at a well-respected Bay Area hospital. When I visited her in the middle of her three day stay -- a Saturday -- she looked awful. She was receiving IV antibiotics. And she was concerned. While her doctor had not told her directly, the nurses told her they had found an order for a \"PICC\" line -- a peripherally inserted central catheter. It would be inserted in Saskia's arm, to access a major vein for administration of drugs, like the antibiotics Saskia was receiving.\u003c/p>\n\u003cp>But PICC lines are prone to infection, and Saskia knew that. She wanted to switch to oral antibiotics when she went home. When the doctor came later, Saskia was clear with her doctor. \"I asked point blank,\" she told me. \"'Are you absolutely sure there's not an oral antibiotic that would be as effective?' ... I asked that question three times in three different ways. Lisa, I can't even tell you, I really did not want the PICC line. I felt like it was way too much.\" But the doctor was clear. Saskia got the PICC line -- and had to stay in the hospital another night.\u003c/p>\n\u003cp>The next day, a new doctor was on duty. She took another look and saw a new option, based on Saskia's bacterial culture. There \u003cem>was \u003c/em>an oral antibiotic that could work for her. Saskia asked if the first doctor could have known this, and the answer was 'yes.' Within twenty minutes the PICC line was out, and Saskia went home with oral antibiotics. She has recovered fully.\u003c/p>\n\u003cp>Add the cost of Saskia's PICC line to that one-third of unnecessary health care in this country.\u003c/p>\n\u003cp>I caught up with Dr. Lucey after \u003cem>Forum\u003c/em> and told her Saskia's story. She said when a patient pushes back as strongly as Saskia had, it should prompt the doctor to take a second look at the options. \"Stop, let's re-think this,\" she said. Of course, Saskia could have demanded a second opinion. But by the time the first doctor got back to her, it was Sunday--not a great day for looking for doctors for second opinions. It's also hard to rebut a doctor who is telling you \"this is your only option\" when you're quite sick and lying in a hospital bed.\u003c/p>\n\u003cp>I've watched the discussion back and forth for years. Patients say doctors never explained all the risks. Doctors say, \"Patients walk into my office and demand all these tests.\" The \u003cem>Choosing Wisely\u003c/em> campaign which explicitly acknowledges doctors' role in overtreatment is a step forward. Still, if groups of specialists could come up with 45 tests that are generally unnecessary, one might wonder why they didn't come up with the list a long time ago.\u003c/p>\n\u003cp>Dr. Lucey told \u003cem>Forum\u003c/em> listeners, \"Like any other individuals, sometimes we fall into habits. And this campaign is suggesting we need to critically evaluate those habits.\"\u003c/p>\n\u003cp>Hundreds of billions of dollars could be saved if those habits are changed.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Listen to Forum:\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/R201204050900.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/R201204050900.xml\">\u003c/embed>\u003c/object>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Opposition to the Federal Health Law: Tea Party, Republicans and ... the Green Party",
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"content": "\u003cp>\u003cstrong>Green Party Backs A Single-Payer System\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_4714\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/SupremeCourt_NoObamacare_Getty_MarkWilson_03272012.jpg\">\u003cimg class=\"size-medium wp-image-4714 \" title=\"The Green Party opposes the federal health law, but for different reasons than you might think. (Mark Wilson: Getty Images)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/SupremeCourt_NoObamacare_Getty_MarkWilson_03272012-300x212.jpg\" alt=\"The Green Party opposes the federal health law, but for different reasons than you might think. (Mark Wilson: Getty Images)\" width=\"300\" height=\"212\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The Green Party opposes the federal health law, because it doesn't go far enough. (Mark Wilson: Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>The platform of California’s third largest political party -- the Green Party -- includes legalizing marijuana, ending the death penalty and offering free, community bicycles. Now, add this to the Party’s list of solemn commitments:\u003c/p>\n\u003cp>\"We’re hoping the individual mandate will be struck down,\" says Barry Hermanson, the Green Party's candidate for California's 12th Congressional District. \"It is extraordinary that now Congress is saying individuals must purchase a product from a private company. There’s no precedent for this.\"\u003c/p>\n\u003cp>For Hermanson, and other Greens, being compelled to buy a product from an industry they find repugnant is a bit like a school requiring kids to hand over their lunch money to the playground bullies.\u003c/p>\n\u003cp>\"I have no trust they have my best interest and the general populace interest in mind,\" he said.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>For most opponents, the federal health law presents a test of federal power versus individual liberty. But for the Greens, who have 34 local elected officials in California -- that’s more than any other state -- the law doesn’t go far enough.\u003c/p>\n\u003caside class=\"pullquote alignright\">It would take a seismic shift in the nation’s political make-up to advance the idea.\u003c/aside>\n\u003cp>The Green Party wants Congress to pass a Medicare-For-All health plan, a tax-funded, federally-administered program like Medicare and Social Security.\u003c/p>\n\u003cp>\"That is in the direction of where we need to go with health care. Medicare-For-All is something that would solve our issue,\" says Laura Wells. She ran for governor as the Green Party candidate in California in 2010. She’s still bitter that Congressional leaders, when crafting the federal health law, refused to allow debate on a Medicare-for-All program.\u003c/p>\n\u003cp>In 2009, nearly a dozen advocates for a so-called single-payer system were arrested for disrupting committee hearings. They haven’t gotten much attention since then.\u003c/p>\n\u003cp>But Green Party officials say if the Supreme Court strikes down the federal health law -- and the ranks of the uninsured swell beyond 50 million, as most health policy experts predict -- their views might finally come into favor.\u003c/p>\n\u003cp>Chris Lehane is a California democratic political consultant. He says while there is potential if the Court throws out the individual mandate or the federal health law s a whole that health care overhaul could be revisited in a different way, but sees a tough road. \"It’s a hard battle and it will be a very uphill fight,\" he says \"but you can certainly see the potential if the President’s plan is thrown out, for people to revisit how they approach this.\"\u003c/p>\n\u003cp>Lehane says there are some Democrats who also support a single payer system, but it would take a seismic shift in the nation’s political make-up to advance the idea. \"The question really becomes,\" he points out, \"Can you really begin to convince independent voters that this is really the way to go?\"\u003c/p>\n\u003cp>In the meantime, the best bet for the Green Party and other single payer advocates may rest with the states. Vermont has started to put a single payer system in place.\u003c/p>\n\u003cp>In California, Democratic lawmakers twice passed bills establishing a single payer system which were later vetoed by former Governor Arnold Schwarzenegger. Earlier this year, a single payer bill stalled in the California Senate, but its sponsors have vowed, as they do every year, to bring it back again.\u003c/p>\n\u003cp>As for the Supreme Court, a decision from the justices is expected by the end of June.\u003c/p>\n\u003cp>\u003cstrong>Listen to the story:\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cobject width=\"335\" height=\"85\">\u003cparam name=\"movie\" value=\"http://www.kqed.org/assets/flash/kqedplayer.swf\">\u003cparam name=\"flashvars\" value=\"file=http://www.kqed.org/radio/archives/R201204040850c.xml\">\u003cembed src=\"http://www.kqed.org/assets/flash/kqedplayer.swf\" type=\"application/x-shockwave-flash\" width=\"335\" height=\"85\" flashvars=\"file=http://www.kqed.org/radio/archives/R201204040850c.xml\">\u003c/embed>\u003c/object>\u003c/p>\n\n",
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"excerpt": "The platform of California’s third largest political party -- the Green Party -- includes legalizing marijuana, ending the death penalty and offering free, community bicycles. Now, add this to the Party’s list of solemn commitments:\r\n\r\n\"We’re hoping the individual mandate will be struck down,\" says Barry Hermanson, the Green Party's candidate for California's 12th Congressional District. \"It is extraordinary that now Congress is saying individuals must purchase a product from a private company. There’s no precedent for this.\"\r\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>Green Party Backs A Single-Payer System\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_4714\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/SupremeCourt_NoObamacare_Getty_MarkWilson_03272012.jpg\">\u003cimg class=\"size-medium wp-image-4714 \" title=\"The Green Party opposes the federal health law, but for different reasons than you might think. (Mark Wilson: Getty Images)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/SupremeCourt_NoObamacare_Getty_MarkWilson_03272012-300x212.jpg\" alt=\"The Green Party opposes the federal health law, but for different reasons than you might think. (Mark Wilson: Getty Images)\" width=\"300\" height=\"212\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The Green Party opposes the federal health law, because it doesn't go far enough. (Mark Wilson: Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>The platform of California’s third largest political party -- the Green Party -- includes legalizing marijuana, ending the death penalty and offering free, community bicycles. Now, add this to the Party’s list of solemn commitments:\u003c/p>\n\u003cp>\"We’re hoping the individual mandate will be struck down,\" says Barry Hermanson, the Green Party's candidate for California's 12th Congressional District. \"It is extraordinary that now Congress is saying individuals must purchase a product from a private company. There’s no precedent for this.\"\u003c/p>\n\u003cp>For Hermanson, and other Greens, being compelled to buy a product from an industry they find repugnant is a bit like a school requiring kids to hand over their lunch money to the playground bullies.\u003c/p>\n\u003cp>\"I have no trust they have my best interest and the general populace interest in mind,\" he said.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>For most opponents, the federal health law presents a test of federal power versus individual liberty. But for the Greens, who have 34 local elected officials in California -- that’s more than any other state -- the law doesn’t go far enough.\u003c/p>\n\u003caside class=\"pullquote alignright\">It would take a seismic shift in the nation’s political make-up to advance the idea.\u003c/aside>\n\u003cp>The Green Party wants Congress to pass a Medicare-For-All health plan, a tax-funded, federally-administered program like Medicare and Social Security.\u003c/p>\n\u003cp>\"That is in the direction of where we need to go with health care. Medicare-For-All is something that would solve our issue,\" says Laura Wells. She ran for governor as the Green Party candidate in California in 2010. She’s still bitter that Congressional leaders, when crafting the federal health law, refused to allow debate on a Medicare-for-All program.\u003c/p>\n\u003cp>In 2009, nearly a dozen advocates for a so-called single-payer system were arrested for disrupting committee hearings. They haven’t gotten much attention since then.\u003c/p>\n\u003cp>But Green Party officials say if the Supreme Court strikes down the federal health law -- and the ranks of the uninsured swell beyond 50 million, as most health policy experts predict -- their views might finally come into favor.\u003c/p>\n\u003cp>Chris Lehane is a California democratic political consultant. He says while there is potential if the Court throws out the individual mandate or the federal health law s a whole that health care overhaul could be revisited in a different way, but sees a tough road. \"It’s a hard battle and it will be a very uphill fight,\" he says \"but you can certainly see the potential if the President’s plan is thrown out, for people to revisit how they approach this.\"\u003c/p>\n\u003cp>Lehane says there are some Democrats who also support a single payer system, but it would take a seismic shift in the nation’s political make-up to advance the idea. \"The question really becomes,\" he points out, \"Can you really begin to convince independent voters that this is really the way to go?\"\u003c/p>\n\u003cp>In the meantime, the best bet for the Green Party and other single payer advocates may rest with the states. Vermont has started to put a single payer system in place.\u003c/p>\n\u003cp>In California, Democratic lawmakers twice passed bills establishing a single payer system which were later vetoed by former Governor Arnold Schwarzenegger. Earlier this year, a single payer bill stalled in the California Senate, but its sponsors have vowed, as they do every year, to bring it back again.\u003c/p>\n\u003cp>As for the Supreme Court, a decision from the justices is expected by the end of June.\u003c/p>\n\u003cp>\u003cstrong>Listen to the story:\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cobject width=\"335\" height=\"85\">\u003cparam name=\"movie\" value=\"http://www.kqed.org/assets/flash/kqedplayer.swf\">\u003cparam name=\"flashvars\" value=\"file=http://www.kqed.org/radio/archives/R201204040850c.xml\">\u003cembed src=\"http://www.kqed.org/assets/flash/kqedplayer.swf\" type=\"application/x-shockwave-flash\" width=\"335\" height=\"85\" flashvars=\"file=http://www.kqed.org/radio/archives/R201204040850c.xml\">\u003c/embed>\u003c/object>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Autism on the Rise: But Why?",
"title": "Autism on the Rise: But Why?",
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"content": "\u003cp>\u003cstrong>By Kamal Menghrajani\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_4597\" class=\"wp-caption alignleft\" style=\"max-width: 248px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/03/BoyProfileAutism.jpg\">\u003cimg class=\"size-full wp-image-4597 \" title=\"BoyProfileAutism\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/03/BoyProfileAutism.jpg\" alt=\"Profile Picture of a Boy\" width=\"248\" height=\"140\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>It was news that startled many. A \u003ca title=\"http://www.cdc.gov/mmwr/preview/mmwrhtml/ss6103a1.htm?s_cid=ss6103a1_w\" href=\"http://www.cdc.gov/mmwr/preview/mmwrhtml/ss6103a1.htm?s_cid=ss6103a1_w\" target=\"_blank\">new study\u003c/a> from the \u003ca title=\"http://www.cdc.gov/ncbddd/AboutUs/biographies/Boyle.html\" href=\"http://www.cdc.gov/ncbddd/AboutUs/biographies/Boyle.html\" target=\"_blank\">Centers for Diseases Control and Prevention\u003c/a> suggests that the prevalence of the disorder is much higher than previously thought. Up to 1 in 88 children is expected to develop autism or a related disorder, which is a 23 percent jump from the rate the CDC found just 2 years ago. Perhaps one million children and teens across the country are affected.\u003c/p>\n\u003cp>This morning on \u003ca href=\"http://www.kqed.org/a/forum/R201203300900\">KQED’s Forum\u003c/a>, autism experts discussed the significance of the new numbers and what progress is being made in the field of autism research.\u003c/p>\n\u003cp>The first question on everybody’s mind was whether the new number represents a true rise in the rate of autism – or is simply a reflection of the fact that more doctors are recognizing it.\u003c/p>\n\u003cp>“We’re not sure what the increase is due to. We do know that better identification, better diagnosis, and availability of services is contributing,” said \u003ca href=\"http://www.cdc.gov/ncbddd/AboutUs/biographies/Boyle.html\">Coleen Boyle\u003c/a>, Director of the National Center on Birth Defects and Developmental Disabilities at the CDC.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003ca href=\"http://www.doctornewmark.com/\">Sanford Newmark\u003c/a>, head of the Pediatric Integrative Neurodevelopmental Program at UCSF, says that doctors are also at a loss to explain the increased rate of autism.\u003c/p>\n\u003cp>“I don’t think we know,” he said. “It’s certainly partly better diagnosis, but it’s possible that there are more kids out there who have autism.”\u003c/p>\n\u003cp>One factor that may have led to the rise in autism diagnosis is that doctors are now more attuned to the early signs of autism. Newmark says that kids who are developing normally will begin to babble by eight months of age, but that kids with autism don’t. Another difference is that most kids will try to get their parents’ attention by pointing to something, but that kids with autism don’t have the same impulse to be social.\u003c/p>\n\u003cp>That is something that \u003ca title=\"http://www.squidalicious.com/\" href=\"http://www.squidalicious.com/\" target=\"_blank\">Shannon Des Roches Rosa\u003c/a>, an author and blogger, said that she saw in her autistic son when he was an infant. She described him at 18 months as having what she called a lack of “joint attention” – he was not interested in looking at the same things all the grown-ups were. “He was not responding to his name, and he was not responding to a lot of social cues,” she said.\u003c/p>\n\u003cp>Newmark added that when the parents smile or laugh, a young child should smile in response. “A warning sign is if the child just doesn’t pay any attention to that,” he said.\u003c/p>\n\u003cp>If parents suspect their child is showing early signs of autism, Newmark says they should seek support. “That is, to me, the most important part of what could come out of this [CDC study] -- is early screening.”\u003c/p>\n\u003cp>Both he and Des Roches Rosa think that parents should find a pediatrician they are comfortable with, one who they trust. If parents and their doctor find signs that a child may have autism, the next step is to get a formal evaluation at a state-run center. From there, children with autism or developmental delay can get access to speech, occupational, physical and most important, behavioral therapy.\u003c/p>\n\u003cp>Newmark says that researchers are continuing to look for treatment options beyond therapy that may help kids with autism, but that's not easy.\u003c/p>\n\u003cp>“We certainly don’t know the cause of autism, and that does make it more difficult to find a really great treatment,” he said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Both he and Des Roches Rosa caution that parents should not try new treatments just because they feel they must do something. They recommend that parents should critically evaluate any treatment options they come across and be sure that they are safe and worth the risk.\u003c/p>\n\n",
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"excerpt": "Many parents fear that their young children will be diagnosed with autism. And now, a new study from the Centers for Diseases Control and Prevention suggests that the prevalence of the disorder is much higher than previously thought. As many as 1 in 88 kids is expected to develop autism or a related disorder, which is a 23% jump from the rate the CDC found just 2 years ago.\r\n\r\nThis morning on KQED’s Forum, autism experts discussed the significance of the new numbers and what progress is being made in the field of autism research.\r\n",
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"description": "Many parents fear that their young children will be diagnosed with autism. And now, a new study from the Centers for Diseases Control and Prevention suggests that the prevalence of the disorder is much higher than previously thought. As many as 1 in 88 kids is expected to develop autism or a related disorder, which is a 23% jump from the rate the CDC found just 2 years ago.\r\n\r\nThis morning on KQED’s Forum, autism experts discussed the significance of the new numbers and what progress is being made in the field of autism research.\r\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"http://www.doctornewmark.com/\">Sanford Newmark\u003c/a>, head of the Pediatric Integrative Neurodevelopmental Program at UCSF, says that doctors are also at a loss to explain the increased rate of autism.\u003c/p>\n\u003cp>“I don’t think we know,” he said. “It’s certainly partly better diagnosis, but it’s possible that there are more kids out there who have autism.”\u003c/p>\n\u003cp>One factor that may have led to the rise in autism diagnosis is that doctors are now more attuned to the early signs of autism. Newmark says that kids who are developing normally will begin to babble by eight months of age, but that kids with autism don’t. Another difference is that most kids will try to get their parents’ attention by pointing to something, but that kids with autism don’t have the same impulse to be social.\u003c/p>\n\u003cp>That is something that \u003ca title=\"http://www.squidalicious.com/\" href=\"http://www.squidalicious.com/\" target=\"_blank\">Shannon Des Roches Rosa\u003c/a>, an author and blogger, said that she saw in her autistic son when he was an infant. She described him at 18 months as having what she called a lack of “joint attention” – he was not interested in looking at the same things all the grown-ups were. “He was not responding to his name, and he was not responding to a lot of social cues,” she said.\u003c/p>\n\u003cp>Newmark added that when the parents smile or laugh, a young child should smile in response. “A warning sign is if the child just doesn’t pay any attention to that,” he said.\u003c/p>\n\u003cp>If parents suspect their child is showing early signs of autism, Newmark says they should seek support. “That is, to me, the most important part of what could come out of this [CDC study] -- is early screening.”\u003c/p>\n\u003cp>Both he and Des Roches Rosa think that parents should find a pediatrician they are comfortable with, one who they trust. If parents and their doctor find signs that a child may have autism, the next step is to get a formal evaluation at a state-run center. From there, children with autism or developmental delay can get access to speech, occupational, physical and most important, behavioral therapy.\u003c/p>\n\u003cp>Newmark says that researchers are continuing to look for treatment options beyond therapy that may help kids with autism, but that's not easy.\u003c/p>\n\u003cp>“We certainly don’t know the cause of autism, and that does make it more difficult to find a really great treatment,” he said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Both he and Des Roches Rosa caution that parents should not try new treatments just because they feel they must do something. They recommend that parents should critically evaluate any treatment options they come across and be sure that they are safe and worth the risk.\u003c/p>\n\n\u003c/div>\u003c/p>",
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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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"marketplace": {
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"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
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},
"mindshift": {
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"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
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"order": 12
},
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5",
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"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
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"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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"pbs-newshour": {
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},
"perspectives": {
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"order": 14
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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.",
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"politicalbreakdown": {
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"title": "Political Breakdown",
"tagline": "Politics from a personal perspective",
"info": "Political Breakdown is a new series that explores the political intersection of California and the nation. Each week hosts Scott Shafer and Marisa Lagos are joined with a new special guest to unpack politics -- with personality — and offer an insider’s glimpse at how politics happens.",
"airtime": "THU 6:30pm-7pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Political-Breakdown-2024-Podcast-Tile-703x703-1.jpg",
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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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},
"pri-the-world": {
"id": "pri-the-world",
"title": "PRI's The World: Latest Edition",
"info": "Each weekday, host Marco Werman and his team of producers bring you the world's most interesting stories in an hour of radio that reminds us just how small our planet really is.",
"airtime": "MON-FRI 2pm-3pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-World-Podcast-Tile-360x360-1.jpg",
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},
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},
"radiolab": {
"id": "radiolab",
"title": "Radiolab",
"info": "A two-time Peabody Award-winner, Radiolab is an investigation told through sounds and stories, and centered around one big idea. In the Radiolab world, information sounds like music and science and culture collide. Hosted by Jad Abumrad and Robert Krulwich, the show is designed for listeners who demand skepticism, but appreciate wonder. WNYC Studios is the producer of other leading podcasts including Freakonomics Radio, Death, Sex & Money, On the Media and many more.",
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