window.__IS_SSR__=true
window.__INITIAL_STATE__={
"attachmentsReducer": {
"audio_0": {
"type": "attachments",
"id": "audio_0",
"imgSizes": {
"kqedFullSize": {
"file": "https://ww2.kqed.org/news/wp-content/themes/KQED-unified/img/audio_bgs/background0.jpg"
}
}
},
"audio_1": {
"type": "attachments",
"id": "audio_1",
"imgSizes": {
"kqedFullSize": {
"file": "https://ww2.kqed.org/news/wp-content/themes/KQED-unified/img/audio_bgs/background1.jpg"
}
}
},
"audio_2": {
"type": "attachments",
"id": "audio_2",
"imgSizes": {
"kqedFullSize": {
"file": "https://ww2.kqed.org/news/wp-content/themes/KQED-unified/img/audio_bgs/background2.jpg"
}
}
},
"audio_3": {
"type": "attachments",
"id": "audio_3",
"imgSizes": {
"kqedFullSize": {
"file": "https://ww2.kqed.org/news/wp-content/themes/KQED-unified/img/audio_bgs/background3.jpg"
}
}
},
"audio_4": {
"type": "attachments",
"id": "audio_4",
"imgSizes": {
"kqedFullSize": {
"file": "https://ww2.kqed.org/news/wp-content/themes/KQED-unified/img/audio_bgs/background4.jpg"
}
}
},
"placeholder": {
"type": "attachments",
"id": "placeholder",
"imgSizes": {
"thumbnail": {
"file": "https://cdn.kqed.org/wp-content/uploads/2024/12/KQED-Default-Image-816638274-2000x1333-1-160x107.jpg",
"width": 160,
"height": 107,
"mimeType": "image/jpeg"
},
"medium": {
"file": "https://cdn.kqed.org/wp-content/uploads/2024/12/KQED-Default-Image-816638274-2000x1333-1-800x533.jpg",
"width": 800,
"height": 533,
"mimeType": "image/jpeg"
},
"medium_large": {
"file": "https://cdn.kqed.org/wp-content/uploads/2024/12/KQED-Default-Image-816638274-2000x1333-1-768x512.jpg",
"width": 768,
"height": 512,
"mimeType": "image/jpeg"
},
"large": {
"file": "https://cdn.kqed.org/wp-content/uploads/2024/12/KQED-Default-Image-816638274-2000x1333-1-1020x680.jpg",
"width": 1020,
"height": 680,
"mimeType": "image/jpeg"
},
"1536x1536": {
"file": "https://cdn.kqed.org/wp-content/uploads/2024/12/KQED-Default-Image-816638274-2000x1333-1-1536x1024.jpg",
"width": 1536,
"height": 1024,
"mimeType": "image/jpeg"
},
"fd-lrg": {
"file": "https://cdn.kqed.org/wp-content/uploads/2024/12/KQED-Default-Image-816638274-2000x1333-1-1536x1024.jpg",
"width": 1536,
"height": 1024,
"mimeType": "image/jpeg"
},
"fd-med": {
"file": "https://cdn.kqed.org/wp-content/uploads/2024/12/KQED-Default-Image-816638274-2000x1333-1-1020x680.jpg",
"width": 1020,
"height": 680,
"mimeType": "image/jpeg"
},
"fd-sm": {
"file": "https://cdn.kqed.org/wp-content/uploads/2024/12/KQED-Default-Image-816638274-2000x1333-1-800x533.jpg",
"width": 800,
"height": 533,
"mimeType": "image/jpeg"
},
"post-thumbnail": {
"file": "https://cdn.kqed.org/wp-content/uploads/2024/12/KQED-Default-Image-816638274-2000x1333-1-672x372.jpg",
"width": 672,
"height": 372,
"mimeType": "image/jpeg"
},
"twentyfourteen-full-width": {
"file": "https://cdn.kqed.org/wp-content/uploads/2024/12/KQED-Default-Image-816638274-2000x1333-1-1038x576.jpg",
"width": 1038,
"height": 576,
"mimeType": "image/jpeg"
},
"xxsmall": {
"file": "https://cdn.kqed.org/wp-content/uploads/2024/12/KQED-Default-Image-816638274-2000x1333-1-160x107.jpg",
"width": 160,
"height": 107,
"mimeType": "image/jpeg"
},
"xsmall": {
"file": "https://cdn.kqed.org/wp-content/uploads/2024/12/KQED-Default-Image-816638274-2000x1333-1-672x372.jpg",
"width": 672,
"height": 372,
"mimeType": "image/jpeg"
},
"small": {
"file": "https://cdn.kqed.org/wp-content/uploads/2024/12/KQED-Default-Image-816638274-2000x1333-1-672x372.jpg",
"width": 672,
"height": 372,
"mimeType": "image/jpeg"
},
"xlarge": {
"file": "https://cdn.kqed.org/wp-content/uploads/2024/12/KQED-Default-Image-816638274-2000x1333-1-1020x680.jpg",
"width": 1020,
"height": 680,
"mimeType": "image/jpeg"
},
"full-width": {
"file": "https://cdn.kqed.org/wp-content/uploads/2024/12/KQED-Default-Image-816638274-2000x1333-1-1920x1280.jpg",
"width": 1920,
"height": 1280,
"mimeType": "image/jpeg"
},
"guest-author-32": {
"file": "https://cdn.kqed.org/wp-content/uploads/2025/01/KQED-Default-Image-816638274-1333x1333-1-160x160.jpg",
"width": 32,
"height": 32,
"mimeType": "image/jpeg"
},
"guest-author-50": {
"file": "https://cdn.kqed.org/wp-content/uploads/2025/01/KQED-Default-Image-816638274-1333x1333-1-160x160.jpg",
"width": 50,
"height": 50,
"mimeType": "image/jpeg"
},
"guest-author-64": {
"file": "https://cdn.kqed.org/wp-content/uploads/2025/01/KQED-Default-Image-816638274-1333x1333-1-160x160.jpg",
"width": 64,
"height": 64,
"mimeType": "image/jpeg"
},
"guest-author-96": {
"file": "https://cdn.kqed.org/wp-content/uploads/2025/01/KQED-Default-Image-816638274-1333x1333-1-160x160.jpg",
"width": 96,
"height": 96,
"mimeType": "image/jpeg"
},
"guest-author-128": {
"file": "https://cdn.kqed.org/wp-content/uploads/2025/01/KQED-Default-Image-816638274-1333x1333-1-160x160.jpg",
"width": 128,
"height": 128,
"mimeType": "image/jpeg"
},
"detail": {
"file": "https://cdn.kqed.org/wp-content/uploads/2025/01/KQED-Default-Image-816638274-1333x1333-1-160x160.jpg",
"width": 160,
"height": 160,
"mimeType": "image/jpeg"
},
"kqedFullSize": {
"file": "https://cdn.kqed.org/wp-content/uploads/2024/12/KQED-Default-Image-816638274-2000x1333-1.jpg",
"width": 2000,
"height": 1333
}
}
},
"stateofhealth_39047": {
"type": "attachments",
"id": "stateofhealth_39047",
"meta": {
"index": "attachments_1716263798",
"site": "stateofhealth",
"id": "39047",
"found": true
},
"parent": 39028,
"imgSizes": {
"twentyfourteen-full-width": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/06/autism.jpg-1038x576.png",
"width": 1038,
"mimeType": "image/png",
"height": 576
},
"thumbnail": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/06/autism.jpg-400x225.png",
"width": 400,
"mimeType": "image/png",
"height": 225
},
"fd-sm": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/06/autism.jpg-960x540.png",
"width": 960,
"mimeType": "image/png",
"height": 540
},
"post-thumbnail": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/06/autism.jpg-672x372.png",
"width": 672,
"mimeType": "image/png",
"height": 372
},
"kqedFullSize": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/06/autism.jpg.png",
"width": 1920,
"height": 1080
},
"large": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/06/autism.jpg-1440x810.png",
"width": 1440,
"mimeType": "image/png",
"height": 810
},
"guest-author-96": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/06/autism.jpg-96x96.png",
"width": 96,
"mimeType": "image/png",
"height": 96
},
"medium": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/06/autism.jpg-800x450.png",
"width": 800,
"mimeType": "image/png",
"height": 450
},
"guest-author-64": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/06/autism.jpg-64x64.png",
"width": 64,
"mimeType": "image/png",
"height": 64
},
"guest-author-32": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/06/autism.jpg-32x32.png",
"width": 32,
"mimeType": "image/png",
"height": 32
},
"fd-med": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/06/autism.jpg-1180x664.png",
"width": 1180,
"mimeType": "image/png",
"height": 664
},
"detail": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/06/autism.jpg-75x75.png",
"width": 75,
"mimeType": "image/png",
"height": 75
},
"guest-author-128": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/06/autism.jpg-128x128.png",
"width": 128,
"mimeType": "image/png",
"height": 128
}
},
"publishDate": 1435004869,
"modified": 1435005074,
"caption": "Jazzmon Wilson with her son Timothy, 6, who has autism. In 2014, Medi-Cal expanded access to applied behavioral analysis therapy, the standard of care for autism. But actual access to treatment has been limited.",
"description": null,
"title": "autism.jpg",
"credit": "Jeremy Raff/KQED",
"status": "inherit",
"isLoading": false,
"fetchFailed": false
},
"stateofhealth_35624": {
"type": "attachments",
"id": "stateofhealth_35624",
"meta": {
"index": "attachments_1716263798",
"site": "stateofhealth",
"id": "35624",
"found": true
},
"parent": 35574,
"imgSizes": {
"twentyfourteen-full-width": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/06/iStock_000017435404_Large-1038x576.jpg",
"width": 1038,
"mimeType": "image/jpeg",
"height": 576
},
"thumbnail": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/06/iStock_000017435404_Large-400x293.jpg",
"width": 400,
"mimeType": "image/jpeg",
"height": 293
},
"fd-sm": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/06/iStock_000017435404_Large-960x703.jpg",
"width": 960,
"mimeType": "image/jpeg",
"height": 703
},
"post-thumbnail": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/06/iStock_000017435404_Large-672x372.jpg",
"width": 672,
"mimeType": "image/jpeg",
"height": 372
},
"kqedFullSize": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/06/iStock_000017435404_Large.jpg",
"width": 2591,
"height": 1897
},
"large": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/06/iStock_000017435404_Large-1440x1054.jpg",
"width": 1440,
"mimeType": "image/jpeg",
"height": 1054
},
"guest-author-96": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/06/iStock_000017435404_Large-96x96.jpg",
"width": 96,
"mimeType": "image/jpeg",
"height": 96
},
"medium": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/06/iStock_000017435404_Large-800x586.jpg",
"width": 800,
"mimeType": "image/jpeg",
"height": 586
},
"guest-author-64": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/06/iStock_000017435404_Large-64x64.jpg",
"width": 64,
"mimeType": "image/jpeg",
"height": 64
},
"guest-author-32": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/06/iStock_000017435404_Large-32x32.jpg",
"width": 32,
"mimeType": "image/jpeg",
"height": 32
},
"fd-med": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/06/iStock_000017435404_Large-1180x864.jpg",
"width": 1180,
"mimeType": "image/jpeg",
"height": 864
},
"detail": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/06/iStock_000017435404_Large-75x75.jpg",
"width": 75,
"mimeType": "image/jpeg",
"height": 75
},
"guest-author-128": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/06/iStock_000017435404_Large-128x128.jpg",
"width": 128,
"mimeType": "image/jpeg",
"height": 128
}
},
"publishDate": 1433969935,
"modified": 1433978237,
"caption": "Prilosec is one of several medications in a class of drugs called proton pump inhibitors associated with an increased risk of heart attack.",
"description": "One of the drugs in question is Prilosec, which is available over the counter. ",
"title": "Prilosec OTC on white background",
"credit": "Getty Images",
"status": "inherit",
"isLoading": false,
"fetchFailed": false
},
"stateofhealth_35559": {
"type": "attachments",
"id": "stateofhealth_35559",
"meta": {
"index": "attachments_1716263798",
"site": "stateofhealth",
"id": "35559",
"found": true
},
"parent": 35558,
"imgSizes": {
"twentyfourteen-full-width": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/06/How-Docs-Die001-copy-1038x576.jpg",
"width": 1038,
"mimeType": "image/jpeg",
"height": 576
},
"thumbnail": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/06/How-Docs-Die001-copy-400x267.jpg",
"width": 400,
"mimeType": "image/jpeg",
"height": 267
},
"fd-sm": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/06/How-Docs-Die001-copy-960x640.jpg",
"width": 960,
"mimeType": "image/jpeg",
"height": 640
},
"post-thumbnail": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/06/How-Docs-Die001-copy-672x372.jpg",
"width": 672,
"mimeType": "image/jpeg",
"height": 372
},
"kqedFullSize": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/06/How-Docs-Die001-copy-e1433955694106.jpg",
"width": 1920,
"height": 1280
},
"large": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/06/How-Docs-Die001-copy-1440x960.jpg",
"width": 1440,
"mimeType": "image/jpeg",
"height": 960
},
"guest-author-96": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/06/How-Docs-Die001-copy-96x96.jpg",
"width": 96,
"mimeType": "image/jpeg",
"height": 96
},
"medium": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/06/How-Docs-Die001-copy-800x533.jpg",
"width": 800,
"mimeType": "image/jpeg",
"height": 533
},
"guest-author-64": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/06/How-Docs-Die001-copy-64x64.jpg",
"width": 64,
"mimeType": "image/jpeg",
"height": 64
},
"guest-author-32": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/06/How-Docs-Die001-copy-32x32.jpg",
"width": 32,
"mimeType": "image/jpeg",
"height": 32
},
"fd-med": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/06/How-Docs-Die001-copy-1180x787.jpg",
"width": 1180,
"mimeType": "image/jpeg",
"height": 787
},
"detail": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/06/How-Docs-Die001-copy-75x75.jpg",
"width": 75,
"mimeType": "image/jpeg",
"height": 75
},
"guest-author-128": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/06/How-Docs-Die001-copy-128x128.jpg",
"width": 128,
"mimeType": "image/jpeg",
"height": 128
}
},
"publishDate": 1433955677,
"modified": 1433955724,
"caption": "Nora Zamichow says if she and her husband, Mark Saylor, had known how doctors die, they may have made different treatment decisions for him at the end of his life.",
"description": null,
"title": "How Docs Die - 1",
"credit": "Maya Sugarman/KPCC",
"status": "inherit",
"isLoading": false,
"fetchFailed": false
},
"stateofhealth_34968": {
"type": "attachments",
"id": "stateofhealth_34968",
"meta": {
"index": "attachments_1716263798",
"site": "stateofhealth",
"id": "34968",
"found": true
},
"parent": 34965,
"imgSizes": {
"twentyfourteen-full-width": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/06/iStock_000020174658_Large-1038x576.jpg",
"width": 1038,
"mimeType": "image/jpeg",
"height": 576
},
"thumbnail": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/06/iStock_000020174658_Large-400x267.jpg",
"width": 400,
"mimeType": "image/jpeg",
"height": 267
},
"fd-sm": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/06/iStock_000020174658_Large-960x640.jpg",
"width": 960,
"mimeType": "image/jpeg",
"height": 640
},
"post-thumbnail": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/06/iStock_000020174658_Large-672x372.jpg",
"width": 672,
"mimeType": "image/jpeg",
"height": 372
},
"kqedFullSize": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/06/iStock_000020174658_Large-e1433797001574.jpg",
"width": 1921,
"height": 1280
},
"large": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/06/iStock_000020174658_Large-1440x960.jpg",
"width": 1440,
"mimeType": "image/jpeg",
"height": 960
},
"guest-author-96": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/06/iStock_000020174658_Large-96x96.jpg",
"width": 96,
"mimeType": "image/jpeg",
"height": 96
},
"medium": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/06/iStock_000020174658_Large-800x533.jpg",
"width": 800,
"mimeType": "image/jpeg",
"height": 533
},
"guest-author-64": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/06/iStock_000020174658_Large-64x64.jpg",
"width": 64,
"mimeType": "image/jpeg",
"height": 64
},
"guest-author-32": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/06/iStock_000020174658_Large-32x32.jpg",
"width": 32,
"mimeType": "image/jpeg",
"height": 32
},
"fd-med": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/06/iStock_000020174658_Large-1180x786.jpg",
"width": 1180,
"mimeType": "image/jpeg",
"height": 786
},
"detail": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/06/iStock_000020174658_Large-75x75.jpg",
"width": 75,
"mimeType": "image/jpeg",
"height": 75
},
"guest-author-128": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/06/iStock_000020174658_Large-128x128.jpg",
"width": 128,
"mimeType": "image/jpeg",
"height": 128
}
},
"publishDate": 1433796980,
"modified": 1433796997,
"caption": null,
"description": "Alarm clock in the middle of the night isolated on black concept for insomnia",
"title": "Alarm clock insomnia",
"credit": "Getty Images",
"status": "inherit",
"isLoading": false,
"fetchFailed": false
},
"stateofhealth_33186": {
"type": "attachments",
"id": "stateofhealth_33186",
"meta": {
"index": "attachments_1716263798",
"site": "stateofhealth",
"id": "33186",
"found": true
},
"parent": 33185,
"imgSizes": {
"twentyfourteen-full-width": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/06/breast-cancer_enl-1d5bd6754844715ebd41468740167c4e8af30a53-1038x576.jpg",
"width": 1038,
"mimeType": "image/jpeg",
"height": 576
},
"thumbnail": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/06/breast-cancer_enl-1d5bd6754844715ebd41468740167c4e8af30a53-400x266.jpg",
"width": 400,
"mimeType": "image/jpeg",
"height": 266
},
"fd-sm": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/06/breast-cancer_enl-1d5bd6754844715ebd41468740167c4e8af30a53-960x639.jpg",
"width": 960,
"mimeType": "image/jpeg",
"height": 639
},
"post-thumbnail": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/06/breast-cancer_enl-1d5bd6754844715ebd41468740167c4e8af30a53-672x372.jpg",
"width": 672,
"mimeType": "image/jpeg",
"height": 372
},
"kqedFullSize": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/06/breast-cancer_enl-1d5bd6754844715ebd41468740167c4e8af30a53.jpg",
"width": 2000,
"height": 1332
},
"large": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/06/breast-cancer_enl-1d5bd6754844715ebd41468740167c4e8af30a53-1440x959.jpg",
"width": 1440,
"mimeType": "image/jpeg",
"height": 959
},
"guest-author-96": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/06/breast-cancer_enl-1d5bd6754844715ebd41468740167c4e8af30a53-96x96.jpg",
"width": 96,
"mimeType": "image/jpeg",
"height": 96
},
"medium": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/06/breast-cancer_enl-1d5bd6754844715ebd41468740167c4e8af30a53-800x533.jpg",
"width": 800,
"mimeType": "image/jpeg",
"height": 533
},
"guest-author-64": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/06/breast-cancer_enl-1d5bd6754844715ebd41468740167c4e8af30a53-64x64.jpg",
"width": 64,
"mimeType": "image/jpeg",
"height": 64
},
"guest-author-32": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/06/breast-cancer_enl-1d5bd6754844715ebd41468740167c4e8af30a53-32x32.jpg",
"width": 32,
"mimeType": "image/jpeg",
"height": 32
},
"fd-med": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/06/breast-cancer_enl-1d5bd6754844715ebd41468740167c4e8af30a53-1180x786.jpg",
"width": 1180,
"mimeType": "image/jpeg",
"height": 786
},
"detail": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/06/breast-cancer_enl-1d5bd6754844715ebd41468740167c4e8af30a53-75x75.jpg",
"width": 75,
"mimeType": "image/jpeg",
"height": 75
},
"guest-author-128": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/06/breast-cancer_enl-1d5bd6754844715ebd41468740167c4e8af30a53-128x128.jpg",
"width": 128,
"mimeType": "image/jpeg",
"height": 128
}
},
"publishDate": 1433355791,
"modified": 1433355791,
"caption": null,
"description": "Women with the earliest form of ductal carcinoma in situ didn't need surgery to get a good survival advantage.",
"title": "Women with the earliest form of ductal carcinoma in situ didn't need surgery to get a good survival advantage.",
"credit": null,
"status": "inherit",
"isLoading": false,
"fetchFailed": false
},
"stateofhealth_27308": {
"type": "attachments",
"id": "stateofhealth_27308",
"meta": {
"index": "attachments_1716263798",
"site": "stateofhealth",
"id": "27308",
"found": true
},
"parent": 27292,
"imgSizes": {
"twentyfourteen-full-width": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/462294288-1038x576.jpg",
"width": 1038,
"mimeType": "image/jpeg",
"height": 576
},
"thumbnail": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/462294288-400x276.jpg",
"width": 400,
"mimeType": "image/jpeg",
"height": 276
},
"fd-sm": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/462294288-960x662.jpg",
"width": 960,
"mimeType": "image/jpeg",
"height": 662
},
"post-thumbnail": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/462294288-672x372.jpg",
"width": 672,
"mimeType": "image/jpeg",
"height": 372
},
"kqedFullSize": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/462294288-e1431629128325.jpg",
"width": 1920,
"height": 1324
},
"large": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/462294288-1440x993.jpg",
"width": 1440,
"mimeType": "image/jpeg",
"height": 993
},
"guest-author-96": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/462294288-96x96.jpg",
"width": 96,
"mimeType": "image/jpeg",
"height": 96
},
"medium": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/462294288-800x552.jpg",
"width": 800,
"mimeType": "image/jpeg",
"height": 552
},
"guest-author-64": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/462294288-64x64.jpg",
"width": 64,
"mimeType": "image/jpeg",
"height": 64
},
"guest-author-32": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/462294288-32x32.jpg",
"width": 32,
"mimeType": "image/jpeg",
"height": 32
},
"fd-med": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/462294288-1180x814.jpg",
"width": 1180,
"mimeType": "image/jpeg",
"height": 814
},
"detail": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/462294288-75x75.jpg",
"width": 75,
"mimeType": "image/jpeg",
"height": 75
},
"guest-author-128": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/462294288-128x128.jpg",
"width": 128,
"mimeType": "image/jpeg",
"height": 128
}
},
"publishDate": 1431629119,
"modified": 1437323370,
"caption": null,
"description": "Measles, vaccine, MMR",
"title": "Large Outbreak Of Measles Reported In California",
"credit": "Justin Sullivan/Getty Images",
"status": "inherit",
"isLoading": false,
"fetchFailed": false
},
"stateofhealth_31084": {
"type": "attachments",
"id": "stateofhealth_31084",
"meta": {
"index": "attachments_1716263798",
"site": "stateofhealth",
"id": "31084",
"found": true
},
"parent": 31026,
"imgSizes": {
"twentyfourteen-full-width": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/iStock_000017412151_Large-1038x576.jpg",
"width": 1038,
"mimeType": "image/jpeg",
"height": 576
},
"thumbnail": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/iStock_000017412151_Large-400x267.jpg",
"width": 400,
"mimeType": "image/jpeg",
"height": 267
},
"fd-sm": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/iStock_000017412151_Large-960x640.jpg",
"width": 960,
"mimeType": "image/jpeg",
"height": 640
},
"post-thumbnail": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/iStock_000017412151_Large-672x372.jpg",
"width": 672,
"mimeType": "image/jpeg",
"height": 372
},
"kqedFullSize": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/iStock_000017412151_Large-e1432840758515.jpg",
"width": 1921,
"height": 1280
},
"large": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/iStock_000017412151_Large-1440x960.jpg",
"width": 1440,
"mimeType": "image/jpeg",
"height": 960
},
"guest-author-96": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/iStock_000017412151_Large-96x96.jpg",
"width": 96,
"mimeType": "image/jpeg",
"height": 96
},
"medium": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/iStock_000017412151_Large-800x533.jpg",
"width": 800,
"mimeType": "image/jpeg",
"height": 533
},
"guest-author-64": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/iStock_000017412151_Large-64x64.jpg",
"width": 64,
"mimeType": "image/jpeg",
"height": 64
},
"guest-author-32": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/iStock_000017412151_Large-32x32.jpg",
"width": 32,
"mimeType": "image/jpeg",
"height": 32
},
"fd-med": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/iStock_000017412151_Large-1180x786.jpg",
"width": 1180,
"mimeType": "image/jpeg",
"height": 786
},
"detail": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/iStock_000017412151_Large-75x75.jpg",
"width": 75,
"mimeType": "image/jpeg",
"height": 75
},
"guest-author-128": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/iStock_000017412151_Large-128x128.jpg",
"width": 128,
"mimeType": "image/jpeg",
"height": 128
}
},
"publishDate": 1432840742,
"modified": 1432840793,
"caption": "EpiPen 2-Pak box with one EpiPen displayed. EpiPen is a prescription medication manufactured by Meridian Medical Technologies, Inc., a subsidiary of King Pharmaceuticals, Inc.",
"description": "EpiPen, Epinephrine",
"title": "EpiPen Epinephrine Auto-Injector for Allergic Emergencies",
"credit": "Getty Images",
"status": "inherit",
"isLoading": false,
"fetchFailed": false
},
"stateofhealth_30722": {
"type": "attachments",
"id": "stateofhealth_30722",
"meta": {
"index": "attachments_1716263798",
"site": "stateofhealth",
"id": "30722",
"found": true
},
"parent": 30459,
"imgSizes": {
"twentyfourteen-full-width": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/RS10943_Facebook_Final-1038x576.jpg",
"width": 1038,
"mimeType": "image/jpeg",
"height": 576
},
"thumbnail": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/RS10943_Facebook_Final-400x147.jpg",
"width": 400,
"mimeType": "image/jpeg",
"height": 147
},
"fd-sm": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/RS10943_Facebook_Final-960x354.jpg",
"width": 960,
"mimeType": "image/jpeg",
"height": 354
},
"post-thumbnail": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/RS10943_Facebook_Final-672x372.jpg",
"width": 672,
"mimeType": "image/jpeg",
"height": 372
},
"kqedFullSize": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/RS10943_Facebook_Final-e1432753817294.jpg",
"width": 1920,
"height": 708
},
"large": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/RS10943_Facebook_Final-1440x531.jpg",
"width": 1440,
"mimeType": "image/jpeg",
"height": 531
},
"guest-author-96": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/RS10943_Facebook_Final-96x96.jpg",
"width": 96,
"mimeType": "image/jpeg",
"height": 96
},
"medium": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/RS10943_Facebook_Final-800x295.jpg",
"width": 800,
"mimeType": "image/jpeg",
"height": 295
},
"guest-author-64": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/RS10943_Facebook_Final-64x64.jpg",
"width": 64,
"mimeType": "image/jpeg",
"height": 64
},
"guest-author-32": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/RS10943_Facebook_Final-32x32.jpg",
"width": 32,
"mimeType": "image/jpeg",
"height": 32
},
"fd-med": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/RS10943_Facebook_Final-1180x435.jpg",
"width": 1180,
"mimeType": "image/jpeg",
"height": 435
},
"detail": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/RS10943_Facebook_Final-75x75.jpg",
"width": 75,
"mimeType": "image/jpeg",
"height": 75
},
"guest-author-128": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/RS10943_Facebook_Final-128x128.jpg",
"width": 128,
"mimeType": "image/jpeg",
"height": 128
}
},
"publishDate": 1432753809,
"modified": 1432753842,
"caption": null,
"description": null,
"title": "RS10943_Facebook_Final",
"credit": "Andy Warner/KQED",
"status": "inherit",
"isLoading": false,
"fetchFailed": false
},
"stateofhealth_30451": {
"type": "attachments",
"id": "stateofhealth_30451",
"meta": {
"index": "attachments_1716263798",
"site": "stateofhealth",
"id": "30451",
"found": true
},
"parent": 30382,
"imgSizes": {
"twentyfourteen-full-width": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/002-1038x576.jpg",
"width": 1038,
"mimeType": "image/jpeg",
"height": 576
},
"thumbnail": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/002-400x225.jpg",
"width": 400,
"mimeType": "image/jpeg",
"height": 225
},
"fd-sm": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/002-960x540.jpg",
"width": 960,
"mimeType": "image/jpeg",
"height": 540
},
"post-thumbnail": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/002-672x372.jpg",
"width": 672,
"mimeType": "image/jpeg",
"height": 372
},
"kqedFullSize": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/002-e1432678588614.jpg",
"width": 1919,
"height": 1080
},
"large": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/002-1440x810.jpg",
"width": 1440,
"mimeType": "image/jpeg",
"height": 810
},
"guest-author-96": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/002-96x96.jpg",
"width": 96,
"mimeType": "image/jpeg",
"height": 96
},
"medium": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/002-800x450.jpg",
"width": 800,
"mimeType": "image/jpeg",
"height": 450
},
"guest-author-64": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/002-64x64.jpg",
"width": 64,
"mimeType": "image/jpeg",
"height": 64
},
"guest-author-32": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/002-32x32.jpg",
"width": 32,
"mimeType": "image/jpeg",
"height": 32
},
"fd-med": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/002-1180x664.jpg",
"width": 1180,
"mimeType": "image/jpeg",
"height": 664
},
"detail": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/002-75x75.jpg",
"width": 75,
"mimeType": "image/jpeg",
"height": 75
},
"guest-author-128": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/002-128x128.jpg",
"width": 128,
"mimeType": "image/jpeg",
"height": 128
}
},
"publishDate": 1432678527,
"modified": 1432678598,
"caption": "Jetta'Mae Carlisle says she was assigned the male gender at birth, but identifies as a straight woman.",
"description": "Jetta'Mae Carlisle says she was assigned the male gender at birth, but identifies as a straight woman.",
"title": "002",
"credit": "Deborah Svoboda",
"status": "inherit",
"isLoading": false,
"fetchFailed": false
},
"stateofhealth_30429": {
"type": "attachments",
"id": "stateofhealth_30429",
"meta": {
"index": "attachments_1716263798",
"site": "stateofhealth",
"id": "30429",
"found": true
},
"parent": 30425,
"imgSizes": {
"twentyfourteen-full-width": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/Screen-Shot-2015-05-26-at-2.34.11-PM-1038x576.png",
"width": 1038,
"mimeType": "image/png",
"height": 576
},
"thumbnail": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/Screen-Shot-2015-05-26-at-2.34.11-PM-400x197.png",
"width": 400,
"mimeType": "image/png",
"height": 197
},
"fd-sm": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/Screen-Shot-2015-05-26-at-2.34.11-PM-960x473.png",
"width": 960,
"mimeType": "image/png",
"height": 473
},
"post-thumbnail": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/Screen-Shot-2015-05-26-at-2.34.11-PM-672x372.png",
"width": 672,
"mimeType": "image/png",
"height": 372
},
"kqedFullSize": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/Screen-Shot-2015-05-26-at-2.34.11-PM.png",
"width": 1904,
"height": 939
},
"large": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/Screen-Shot-2015-05-26-at-2.34.11-PM-1440x710.png",
"width": 1440,
"mimeType": "image/png",
"height": 710
},
"guest-author-96": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/Screen-Shot-2015-05-26-at-2.34.11-PM-96x96.png",
"width": 96,
"mimeType": "image/png",
"height": 96
},
"medium": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/Screen-Shot-2015-05-26-at-2.34.11-PM-800x395.png",
"width": 800,
"mimeType": "image/png",
"height": 395
},
"guest-author-64": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/Screen-Shot-2015-05-26-at-2.34.11-PM-64x64.png",
"width": 64,
"mimeType": "image/png",
"height": 64
},
"guest-author-32": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/Screen-Shot-2015-05-26-at-2.34.11-PM-32x32.png",
"width": 32,
"mimeType": "image/png",
"height": 32
},
"fd-med": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/Screen-Shot-2015-05-26-at-2.34.11-PM-1180x582.png",
"width": 1180,
"mimeType": "image/png",
"height": 582
},
"detail": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/Screen-Shot-2015-05-26-at-2.34.11-PM-75x75.png",
"width": 75,
"mimeType": "image/png",
"height": 75
},
"guest-author-128": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/Screen-Shot-2015-05-26-at-2.34.11-PM-128x128.png",
"width": 128,
"mimeType": "image/png",
"height": 128
}
},
"publishDate": 1432676079,
"modified": 1432676169,
"caption": "The Imperial Valley's first Planned Parenthood clinic is shown on May 5, 2015. The clinic is now open for business, but only on a limited basis.",
"description": "The Imperial Valley's first Planned Parenthood clinic is shown on May 5, 2015. The clinic is now open for business, but only on a limited basis.",
"title": "Screen Shot 2015-05-26 at 2.34.11 PM",
"credit": "Nic McVicker/KPBS",
"status": "inherit",
"isLoading": false,
"fetchFailed": false
},
"stateofhealth_30360": {
"type": "attachments",
"id": "stateofhealth_30360",
"meta": {
"index": "attachments_1716263798",
"site": "stateofhealth",
"id": "30360",
"found": true
},
"parent": 30359,
"imgSizes": {
"twentyfourteen-full-width": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/umbilical-cord_enl-8e29c0c12048fcb83219cc2bbc32cb323bd32d98-1038x576.jpg",
"width": 1038,
"mimeType": "image/jpeg",
"height": 576
},
"thumbnail": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/umbilical-cord_enl-8e29c0c12048fcb83219cc2bbc32cb323bd32d98-400x266.jpg",
"width": 400,
"mimeType": "image/jpeg",
"height": 266
},
"fd-sm": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/umbilical-cord_enl-8e29c0c12048fcb83219cc2bbc32cb323bd32d98-960x637.jpg",
"width": 960,
"mimeType": "image/jpeg",
"height": 637
},
"post-thumbnail": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/umbilical-cord_enl-8e29c0c12048fcb83219cc2bbc32cb323bd32d98-672x372.jpg",
"width": 672,
"mimeType": "image/jpeg",
"height": 372
},
"kqedFullSize": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/umbilical-cord_enl-8e29c0c12048fcb83219cc2bbc32cb323bd32d98.jpg",
"width": 2000,
"height": 1328
},
"large": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/umbilical-cord_enl-8e29c0c12048fcb83219cc2bbc32cb323bd32d98-1440x956.jpg",
"width": 1440,
"mimeType": "image/jpeg",
"height": 956
},
"guest-author-96": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/umbilical-cord_enl-8e29c0c12048fcb83219cc2bbc32cb323bd32d98-96x96.jpg",
"width": 96,
"mimeType": "image/jpeg",
"height": 96
},
"medium": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/umbilical-cord_enl-8e29c0c12048fcb83219cc2bbc32cb323bd32d98-800x531.jpg",
"width": 800,
"mimeType": "image/jpeg",
"height": 531
},
"guest-author-64": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/umbilical-cord_enl-8e29c0c12048fcb83219cc2bbc32cb323bd32d98-64x64.jpg",
"width": 64,
"mimeType": "image/jpeg",
"height": 64
},
"guest-author-32": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/umbilical-cord_enl-8e29c0c12048fcb83219cc2bbc32cb323bd32d98-32x32.jpg",
"width": 32,
"mimeType": "image/jpeg",
"height": 32
},
"fd-med": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/umbilical-cord_enl-8e29c0c12048fcb83219cc2bbc32cb323bd32d98-1180x784.jpg",
"width": 1180,
"mimeType": "image/jpeg",
"height": 784
},
"detail": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/umbilical-cord_enl-8e29c0c12048fcb83219cc2bbc32cb323bd32d98-75x75.jpg",
"width": 75,
"mimeType": "image/jpeg",
"height": 75
},
"guest-author-128": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/umbilical-cord_enl-8e29c0c12048fcb83219cc2bbc32cb323bd32d98-128x128.jpg",
"width": 128,
"mimeType": "image/jpeg",
"height": 128
}
},
"publishDate": 1432661071,
"modified": 1432661071,
"caption": null,
"description": "The World Health Organization has endorsed waiting to clamp the umbilical cord for at least one minute after a baby is born.",
"title": "The World Health Organization has endorsed waiting to clamp the umbilical cord for at least one minute after a baby is born.",
"credit": null,
"status": "inherit",
"isLoading": false,
"fetchFailed": false
},
"stateofhealth_29232": {
"type": "attachments",
"id": "stateofhealth_29232",
"meta": {
"index": "attachments_1716263798",
"site": "stateofhealth",
"id": "29232",
"found": true
},
"parent": 29198,
"imgSizes": {
"twentyfourteen-full-width": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/er-asthma-8-1038x576.jpg",
"width": 1038,
"mimeType": "image/jpeg",
"height": 576
},
"thumbnail": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/er-asthma-8-400x267.jpg",
"width": 400,
"mimeType": "image/jpeg",
"height": 267
},
"fd-sm": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/er-asthma-8-960x641.jpg",
"width": 960,
"mimeType": "image/jpeg",
"height": 641
},
"post-thumbnail": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/er-asthma-8-672x372.jpg",
"width": 672,
"mimeType": "image/jpeg",
"height": 372
},
"kqedFullSize": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/er-asthma-8-e1432336118626.jpg",
"width": 1919,
"height": 1281
},
"large": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/er-asthma-8-1440x961.jpg",
"width": 1440,
"mimeType": "image/jpeg",
"height": 961
},
"guest-author-96": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/er-asthma-8-96x96.jpg",
"width": 96,
"mimeType": "image/jpeg",
"height": 96
},
"medium": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/er-asthma-8-800x534.jpg",
"width": 800,
"mimeType": "image/jpeg",
"height": 534
},
"guest-author-64": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/er-asthma-8-64x64.jpg",
"width": 64,
"mimeType": "image/jpeg",
"height": 64
},
"guest-author-32": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/er-asthma-8-32x32.jpg",
"width": 32,
"mimeType": "image/jpeg",
"height": 32
},
"fd-med": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/er-asthma-8-1180x788.jpg",
"width": 1180,
"mimeType": "image/jpeg",
"height": 788
},
"detail": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/er-asthma-8-75x75.jpg",
"width": 75,
"mimeType": "image/jpeg",
"height": 75
},
"guest-author-128": {
"file": "https://ww2.kqed.org/app/uploads/sites/27/2015/05/er-asthma-8-128x128.jpg",
"width": 128,
"mimeType": "image/jpeg",
"height": 128
}
},
"publishDate": 1432336070,
"modified": 1432336110,
"caption": "Daniel Lee, 5, gets his airway checked during his appointment at the Childrens Hospital of Orange County Breathmobile. Lee’s asthma symptoms prohibit him from playing soccer ",
"description": null,
"title": "er-asthma-8",
"credit": "Heidi de Marco/KHN",
"status": "inherit",
"isLoading": false,
"fetchFailed": false
}
},
"audioPlayerReducer": {
"postId": "stream_live",
"isPaused": true,
"isPlaying": false,
"pfsActive": false,
"pledgeModalIsOpen": true,
"playerDrawerIsOpen": false,
"liveAudioPlayStartedAt": 0,
"liveAudioPlayContext": ""
},
"authorsReducer": {
"byline_stateofhealth_39028": {
"type": "authors",
"id": "byline_stateofhealth_39028",
"meta": {
"override": true
},
"slug": "byline_stateofhealth_39028",
"name": "David Gorn\u003cbr>\u003ca href=\"http://www.californiahealthline.org/insight/2015/getting-autism-therapy-benefit-doesnt-mean-getting-access-to-care\">California Healthline\u003c/a>",
"isLoading": false
},
"byline_stateofhealth_35558": {
"type": "authors",
"id": "byline_stateofhealth_35558",
"meta": {
"override": true
},
"slug": "byline_stateofhealth_35558",
"name": "Stephanie O'Neill, KPCC",
"isLoading": false
},
"byline_stateofhealth_34965": {
"type": "authors",
"id": "byline_stateofhealth_34965",
"meta": {
"override": true
},
"slug": "byline_stateofhealth_34965",
"name": "Liza Gross",
"isLoading": false
},
"byline_stateofhealth_33185": {
"type": "authors",
"id": "byline_stateofhealth_33185",
"meta": {
"override": true
},
"slug": "byline_stateofhealth_33185",
"name": "Katherine Hobson, NPR",
"isLoading": false
},
"byline_stateofhealth_31026": {
"type": "authors",
"id": "byline_stateofhealth_31026",
"meta": {
"override": true
},
"slug": "byline_stateofhealth_31026",
"name": "Jane Meredith Adams, EdSource Today",
"isLoading": false
},
"byline_stateofhealth_30382": {
"type": "authors",
"id": "byline_stateofhealth_30382",
"meta": {
"override": true
},
"slug": "byline_stateofhealth_30382",
"name": "Deborah Svoboda",
"isLoading": false
},
"byline_stateofhealth_30425": {
"type": "authors",
"id": "byline_stateofhealth_30425",
"meta": {
"override": true
},
"slug": "byline_stateofhealth_30425",
"name": "Kenny Goldberg, KPBS",
"isLoading": false
},
"byline_stateofhealth_30359": {
"type": "authors",
"id": "byline_stateofhealth_30359",
"meta": {
"override": true
},
"slug": "byline_stateofhealth_30359",
"name": "Tara Haelle, NPR",
"isLoading": false
},
"byline_stateofhealth_29198": {
"type": "authors",
"id": "byline_stateofhealth_29198",
"meta": {
"override": true
},
"slug": "byline_stateofhealth_29198",
"name": "\u003cstrong>Barbara Feder Ostrov\u003cbr />Kaiser Health News\u003c/strong>",
"isLoading": false
},
"lisaaliferis": {
"type": "authors",
"id": "240",
"meta": {
"index": "authors_1716337520",
"id": "240",
"found": true
},
"name": "Lisa Aliferis",
"firstName": "Lisa",
"lastName": "Aliferis",
"slug": "lisaaliferis",
"email": "laliferis@kqed.org",
"display_author_email": false,
"staff_mastheads": [],
"title": "KQED Contributor",
"bio": "Lisa Aliferis is the founding editor of KQED's \u003cem>State of Health\u003c/em> blog. Since 2011, she's been writing and editing stories for the site. Before taking up blogging, she toiled for many years (more than we can count) producing health stories for television, including\u003cem> Dateline NBC\u003c/em> and San Francisco's CBS affiliate, KPIX-TV. She also wrote up a \u003ca title=\"http://www.kqed.org/news/health/obamacare/obamacare-guide.jsp\" href=\"http://www.kqed.org/news/health/obamacare/obamacare-guide.jsp\">handy guide to the Affordable Care Act\u003c/a>, especially for Californians. Her work has been honored for many awards. Most recently she was a finalist for \"Best Topical Reporting\" from the Online News Association. You can follow her on Twitter: \u003ca title=\"https://twitter.com/laliferis\" href=\"https://twitter.com/laliferis\">@laliferis\u003c/a>",
"avatar": "https://secure.gravatar.com/avatar/86c339d5cdcb0dcd2b6cf5d7c3f5886b?s=600&d=mm&r=g",
"twitter": "laliferis",
"facebook": null,
"instagram": null,
"linkedin": null,
"sites": [
{
"site": "news",
"roles": [
"subscriber"
]
},
{
"site": "futureofyou",
"roles": [
"subscriber"
]
},
{
"site": "stateofhealth",
"roles": [
"subscriber"
]
},
{
"site": "science",
"roles": [
"subscriber"
]
},
{
"site": "food",
"roles": []
}
],
"headData": {
"title": "Lisa Aliferis | KQED",
"description": "KQED Contributor",
"ogImgSrc": "https://secure.gravatar.com/avatar/86c339d5cdcb0dcd2b6cf5d7c3f5886b?s=600&d=mm&r=g",
"twImgSrc": "https://secure.gravatar.com/avatar/86c339d5cdcb0dcd2b6cf5d7c3f5886b?s=600&d=mm&r=g"
},
"isLoading": false,
"link": "/author/lisaaliferis"
}
},
"pagesReducer": {
"stateofhealth_category_tests-treatments": {
"type": "terms",
"id": "stateofhealth_13",
"meta": {
"index": "terms_1716263798",
"site": "stateofhealth",
"id": "13",
"score": 14.407178
},
"featImg": null,
"name": "Tests & Treatments",
"description": "Information and new research about advances in discovering and treating diseases and conditions.",
"taxonomy": "category",
"headData": {
"twImgId": null,
"twTitle": null,
"ogTitle": null,
"ogImgId": null,
"twDescription": null,
"description": "Information and new research about advances in discovering and treating diseases and conditions.",
"title": "Tests & Treatments Archives | KQED Arts",
"ogDescription": null
},
"ttid": 13,
"slug": "tests-treatments",
"isLoading": false,
"title": "Tests & Treatments",
"pageMeta": {
"site": "stateofhealth",
"WpPageTemplate": "page-topic-editorial",
"currentPage": 16
},
"blocks": [
{
"blockName": "kqed/company-paragraph",
"content": "Information and new research about advances in discovering and treating diseases and conditions."
},
{
"blockName": "kqed/post-list",
"attrs": {
"layout": "cardArticle2",
"query": "posts/stateofhealth?category=tests-treatments",
"seeMore": false,
"paginated": true,
"page": 16
}
},
{
"blockName": "kqed/ad"
}
]
}
},
"pfsSessionReducer": {},
"postsReducer": {
"stream_live": {
"type": "live",
"id": "stream_live",
"audioUrl": "https://hls.kqed.org/hls/kqed_app/playlist.m3u8",
"title": "Live Stream",
"excerpt": "Live Stream information currently unavailable.",
"link": "/radio",
"featImg": "",
"label": {
"name": "KQED Live",
"link": "/"
}
},
"stream_kqedNewscast": {
"type": "posts",
"id": "stream_kqedNewscast",
"audioUrl": "https://www.kqed.org/.stream/anon/radio/RDnews/newscast.mp3?_=1",
"title": "KQED Newscast",
"featImg": "",
"label": {
"name": "88.5 FM",
"link": "/"
}
},
"stateofhealth_39028": {
"type": "posts",
"id": "stateofhealth_39028",
"meta": {
"index": "posts_1716263798",
"site": "stateofhealth",
"id": "39028",
"score": null,
"sort": [
1435005889000
]
},
"parent": 0,
"labelTerm": {
"site": "stateofhealth"
},
"blocks": [],
"publishDate": 1435005889,
"format": "standard",
"disqusTitle": "Medi-Cal's Autism Therapy Benefit Doesn't Mean Access to Care",
"title": "Medi-Cal's Autism Therapy Benefit Doesn't Mean Access to Care",
"headTitle": "State of Health | KQED News",
"content": "\u003cp>When Tatiana Ciudac found out in January that Medi-Cal benefits included childhood autism therapy, she was ecstatic.\u003c/p>\n\u003cp>Ciudac, originally from Moldova (near Ukraine) and now living in San Francisco, is the mother of a six-year-old boy with autism spectrum disorder. Her son had been getting a type of autism treatment called applied behavior analysis -- known as ABA therapy -- through a program at her child's school. The ABA therapy ran out once he hit age five, though.\u003c/p>\n\u003cp>So when she discovered in January that the therapy was now part of her Medi-Cal coverage, she immediately contacted her Medi-Cal managed care plan -- and was told there were no in-network ABA providers in San Francisco.\u003c/p>\n\u003cp>\"They said they had not any providers of ABA,\" Ciudac said. She was directed to providers in San Jose, which would have required more than two hours of driving every day around the three-hour appointments. There were no providers at all available in San Francisco, she was told.\u003c/p>\n\u003cp>\"But that's not true, of course,\" she said. \"I started to search providers myself, and some of them said, 'Yes, we take Medi-Cal.'\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>So after cold-calling ABA providers and finding a couple who would accept Medi-Cal patients, Ciudac took that information to her Medi-Cal plan. Not good enough.\u003c/p>\n\u003cp>The insurer, she said, wouldn't accept a provider who wasn't in-network -- even though, within the network, they couldn't offer a provider.\u003c/p>\n\u003cp>\"If we have a provider they won't take, and the [insurance] officials say they don't have a provider, it's like this closed circle,\" Ciudac said. \"We couldn't get anywhere.\"\u003c/p>\n\u003cp>\u003cstrong>Delays and Uncertainty\u003c/strong>\u003c/p>\n\u003cp>Ciudac's story has a happy ending. After six months of fighting, dueling letters, emails and phone calls, her Medi-Cal managed care plan agreed to allow an ABA therapy provider Ciudac found to apply to join the network.\u003c/p>\n\u003cp>At the beginning of June, her six-year-old son began to receive ABA services.\u003c/p>\n\u003cp>That six-month odyssey to receive covered services is emblematic of the problems faced by many parents of autistic kids in California, children's advocates say.\u003c/p>\n\u003cp>According to state statistics released in May by the Department of Health Care Services, 1,123 children have received behavioral health treatment services, which included ABA therapy as of May 5. That's just 2 percent of the estimated 76,000 children under age 21 who are enrolled in Medi-Cal and have autism spectrum disorder.\u003c/p>\n\u003cp>State officials announced autism therapy as a Medi-Cal benefit on Sept. 15, 2014. The coverage is retroactive to July 7, 2014, when federal officials first issued guidance establishing autism therapy as a benefit.\u003c/p>\n\u003cp>Now, just under a year later, according to state statistics:\u003c/p>\n\u003cul>\n\u003cli>Almost half of California's counties (24 of 58) have provided no behavioral health treatment through Medi-Cal managed care plans.\u003c/li>\n\u003cli>18 counties have fewer than 11 autism cases per county (an exact number can't be released due to privacy issues).\u003c/li>\n\u003cli>The remaining 16 counties provide behavioral services to 943 Medi-Cal managed care children, an average of roughly 59 children per county.\u003c/li>\n\u003c/ul>\n\u003cp>Norman Williams, deputy director of public affairs for DHCS, gave California Healthline an updated estimate on June 10.\u003c/p>\n\u003cp>\"Between 1,500 and 2,000 Medi-Cal managed care members are currently receiving BHT (behavioral health treatment) services, and we expect to have updated numbers soon,\" Williams said in an email message. \"This does not include the approximately 9,000 members currently receiving services from regional centers. Medi-Cal managed care responsibility for BHT services for the majority of these members will occur later this year. The number of individuals accessing BHT services seem in line with other states based upon our discussions with them.\"\u003c/p>\n\u003cp>Beyond the rates of coverage, there is another issue plaguing implementation of the autism therapy benefit, according to Kristin Jacobson, executive director of Autism Deserves Equal Coverage. She said the state is insisting on conducting a long diagnostic evaluation of children being considered for coverage.\u003c/p>\n\u003cp>\"There's a long waiting list for that,\" Jacobson said. \"Families are waiting six months to get an evaluation. In some cases the wait time is a year.\"\u003c/p>\n\u003cp>Waiting half a year or more for ABA therapy can be crippling to an autistic child's development, Jacobson said.\u003c/p>\n\u003cp>In general, the earlier the intervention of ABA therapy, the better a child develops. Early intervention can shorten the time ABA therapy is needed, and absence of it can mean serious setbacks for children, she said.\u003c/p>\n\u003cp>\u003cstrong>ABA Therapy a Difference-Maker\u003c/strong>\u003c/p>\n\u003cp>Ciudac said she saw firsthand what lack of therapy meant when her son's ABA therapy stopped in April 2014.\u003c/p>\n\u003cp>\"We saw so much change in his behavior and progress,\" Ciudac said. \"His teachers all said it was now so difficult to teach him, he lost skills, he was more sensitive to noises.\"\u003c/p>\n\u003cp>In just the first two weeks after the start of ABA therapy this month, she said, she can see a huge change.\u003c/p>\n\u003cp>\"Now he's much better, he's starting to learn better how to communicate, so he can explain when he needs to go to the bathroom, when he's scared. It's only the beginning, but I see the difference.\"\u003c/p>\n\u003cp>Ciudac hopes this therapy could actually have a much greater effect than previous ABA therapy provided by the schools, because it had been limited by school hours and summers off, and now it will be more regular and consistent.\u003c/p>\n\u003cp>\"When his schedule is structured, it's much easier for him,\" Ciudac said. \"This year was very difficult, because we didn't have ABA therapy. We have had some cases of wandering. And he has no sense of danger, so that can be a problem. Now I know he's much safer.\"\u003c/p>\n\u003cp>Ironically for Ciudac, her Medi-Cal managed care plan sent her a letter in March informing her that autism therapy treatment is now a Medi-Cal benefit.\u003c/p>\n\u003cp>That's information she would have preferred to see last year, she said.\u003c/p>\n\u003cp>\"After I found out by myself. After I talked to the insurance. After all the phone calls and letters about it. After I found the provider. After all the times they said no,\" Ciudac said. \"After all this much, they sent me a letter in March.\"\u003c/p>\n\u003cp>That's a year her son will never have back, she said.\u003c/p>\n\u003cp>\"We lost about a year in his development,\" Ciudac said. \"Every day is counting.\"\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Children's advocates hope to convene a legislative hearing on the issue in mid-September, the first-year anniversary of the benefit's announcement.\u003c/p>\n\n",
"disqusIdentifier": "39028 http://ww2.kqed.org/stateofhealth/?p=39028",
"disqusUrl": "https://ww2.kqed.org/stateofhealth/2015/06/22/medi-cals-autism-therapy-benefit-doesnt-mean-access-to-care/",
"stats": {
"hasVideo": false,
"hasChartOrMap": false,
"hasAudio": false,
"hasPolis": false,
"wordCount": 1111,
"hasGoogleForm": false,
"hasGallery": false,
"hasHearkenModule": false,
"iframeSrcs": [],
"paragraphCount": 36
},
"modified": 1435005889,
"excerpt": "Small percentage of Medi-Cal youth with autism spectrum disorder receiving treatment they're entitled to.",
"headData": {
"twImgId": "",
"twTitle": "",
"ogTitle": "",
"ogImgId": "",
"twDescription": "",
"description": "Small percentage of Medi-Cal youth with autism spectrum disorder receiving treatment they're entitled to.",
"title": "Medi-Cal's Autism Therapy Benefit Doesn't Mean Access to Care | KQED",
"ogDescription": "",
"schema": {
"@context": "https://schema.org",
"@type": "Article",
"headline": "Medi-Cal's Autism Therapy Benefit Doesn't Mean Access to Care",
"datePublished": "2015-06-22T13:44:49-07:00",
"dateModified": "2015-06-22T13:44:49-07:00",
"image": "https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"
}
},
"guestAuthors": [],
"slug": "medi-cals-autism-therapy-benefit-doesnt-mean-access-to-care",
"status": "publish",
"nprByline": "David Gorn\u003cbr>\u003ca href=\"http://www.californiahealthline.org/insight/2015/getting-autism-therapy-benefit-doesnt-mean-getting-access-to-care\">California Healthline\u003c/a>",
"path": "/stateofhealth/39028/medi-cals-autism-therapy-benefit-doesnt-mean-access-to-care",
"audioTrackLength": null,
"parsedContent": [
{
"type": "contentString",
"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>When Tatiana Ciudac found out in January that Medi-Cal benefits included childhood autism therapy, she was ecstatic.\u003c/p>\n\u003cp>Ciudac, originally from Moldova (near Ukraine) and now living in San Francisco, is the mother of a six-year-old boy with autism spectrum disorder. Her son had been getting a type of autism treatment called applied behavior analysis -- known as ABA therapy -- through a program at her child's school. The ABA therapy ran out once he hit age five, though.\u003c/p>\n\u003cp>So when she discovered in January that the therapy was now part of her Medi-Cal coverage, she immediately contacted her Medi-Cal managed care plan -- and was told there were no in-network ABA providers in San Francisco.\u003c/p>\n\u003cp>\"They said they had not any providers of ABA,\" Ciudac said. She was directed to providers in San Jose, which would have required more than two hours of driving every day around the three-hour appointments. There were no providers at all available in San Francisco, she was told.\u003c/p>\n\u003cp>\"But that's not true, of course,\" she said. \"I started to search providers myself, and some of them said, 'Yes, we take Medi-Cal.'\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
"attributes": {
"named": {},
"numeric": []
}
},
{
"type": "component",
"content": "",
"name": "ad",
"attributes": {
"named": {
"label": "fullwidth"
},
"numeric": [
"fullwidth"
]
}
},
{
"type": "contentString",
"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>So after cold-calling ABA providers and finding a couple who would accept Medi-Cal patients, Ciudac took that information to her Medi-Cal plan. Not good enough.\u003c/p>\n\u003cp>The insurer, she said, wouldn't accept a provider who wasn't in-network -- even though, within the network, they couldn't offer a provider.\u003c/p>\n\u003cp>\"If we have a provider they won't take, and the [insurance] officials say they don't have a provider, it's like this closed circle,\" Ciudac said. \"We couldn't get anywhere.\"\u003c/p>\n\u003cp>\u003cstrong>Delays and Uncertainty\u003c/strong>\u003c/p>\n\u003cp>Ciudac's story has a happy ending. After six months of fighting, dueling letters, emails and phone calls, her Medi-Cal managed care plan agreed to allow an ABA therapy provider Ciudac found to apply to join the network.\u003c/p>\n\u003cp>At the beginning of June, her six-year-old son began to receive ABA services.\u003c/p>\n\u003cp>That six-month odyssey to receive covered services is emblematic of the problems faced by many parents of autistic kids in California, children's advocates say.\u003c/p>\n\u003cp>According to state statistics released in May by the Department of Health Care Services, 1,123 children have received behavioral health treatment services, which included ABA therapy as of May 5. That's just 2 percent of the estimated 76,000 children under age 21 who are enrolled in Medi-Cal and have autism spectrum disorder.\u003c/p>\n\u003cp>State officials announced autism therapy as a Medi-Cal benefit on Sept. 15, 2014. The coverage is retroactive to July 7, 2014, when federal officials first issued guidance establishing autism therapy as a benefit.\u003c/p>\n\u003cp>Now, just under a year later, according to state statistics:\u003c/p>\n\u003cul>\n\u003cli>Almost half of California's counties (24 of 58) have provided no behavioral health treatment through Medi-Cal managed care plans.\u003c/li>\n\u003cli>18 counties have fewer than 11 autism cases per county (an exact number can't be released due to privacy issues).\u003c/li>\n\u003cli>The remaining 16 counties provide behavioral services to 943 Medi-Cal managed care children, an average of roughly 59 children per county.\u003c/li>\n\u003c/ul>\n\u003cp>Norman Williams, deputy director of public affairs for DHCS, gave California Healthline an updated estimate on June 10.\u003c/p>\n\u003cp>\"Between 1,500 and 2,000 Medi-Cal managed care members are currently receiving BHT (behavioral health treatment) services, and we expect to have updated numbers soon,\" Williams said in an email message. \"This does not include the approximately 9,000 members currently receiving services from regional centers. Medi-Cal managed care responsibility for BHT services for the majority of these members will occur later this year. The number of individuals accessing BHT services seem in line with other states based upon our discussions with them.\"\u003c/p>\n\u003cp>Beyond the rates of coverage, there is another issue plaguing implementation of the autism therapy benefit, according to Kristin Jacobson, executive director of Autism Deserves Equal Coverage. She said the state is insisting on conducting a long diagnostic evaluation of children being considered for coverage.\u003c/p>\n\u003cp>\"There's a long waiting list for that,\" Jacobson said. \"Families are waiting six months to get an evaluation. In some cases the wait time is a year.\"\u003c/p>\n\u003cp>Waiting half a year or more for ABA therapy can be crippling to an autistic child's development, Jacobson said.\u003c/p>\n\u003cp>In general, the earlier the intervention of ABA therapy, the better a child develops. Early intervention can shorten the time ABA therapy is needed, and absence of it can mean serious setbacks for children, she said.\u003c/p>\n\u003cp>\u003cstrong>ABA Therapy a Difference-Maker\u003c/strong>\u003c/p>\n\u003cp>Ciudac said she saw firsthand what lack of therapy meant when her son's ABA therapy stopped in April 2014.\u003c/p>\n\u003cp>\"We saw so much change in his behavior and progress,\" Ciudac said. \"His teachers all said it was now so difficult to teach him, he lost skills, he was more sensitive to noises.\"\u003c/p>\n\u003cp>In just the first two weeks after the start of ABA therapy this month, she said, she can see a huge change.\u003c/p>\n\u003cp>\"Now he's much better, he's starting to learn better how to communicate, so he can explain when he needs to go to the bathroom, when he's scared. It's only the beginning, but I see the difference.\"\u003c/p>\n\u003cp>Ciudac hopes this therapy could actually have a much greater effect than previous ABA therapy provided by the schools, because it had been limited by school hours and summers off, and now it will be more regular and consistent.\u003c/p>\n\u003cp>\"When his schedule is structured, it's much easier for him,\" Ciudac said. \"This year was very difficult, because we didn't have ABA therapy. We have had some cases of wandering. And he has no sense of danger, so that can be a problem. Now I know he's much safer.\"\u003c/p>\n\u003cp>Ironically for Ciudac, her Medi-Cal managed care plan sent her a letter in March informing her that autism therapy treatment is now a Medi-Cal benefit.\u003c/p>\n\u003cp>That's information she would have preferred to see last year, she said.\u003c/p>\n\u003cp>\"After I found out by myself. After I talked to the insurance. After all the phone calls and letters about it. After I found the provider. After all the times they said no,\" Ciudac said. \"After all this much, they sent me a letter in March.\"\u003c/p>\n\u003cp>That's a year her son will never have back, she said.\u003c/p>\n\u003cp>\"We lost about a year in his development,\" Ciudac said. \"Every day is counting.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
"attributes": {
"named": {},
"numeric": []
}
},
{
"type": "component",
"content": "",
"name": "ad",
"attributes": {
"named": {
"label": "floatright"
},
"numeric": [
"floatright"
]
}
},
{
"type": "contentString",
"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Children's advocates hope to convene a legislative hearing on the issue in mid-September, the first-year anniversary of the benefit's announcement.\u003c/p>\n\n\u003c/div>\u003c/p>",
"attributes": {
"named": {},
"numeric": []
}
}
],
"link": "/stateofhealth/39028/medi-cals-autism-therapy-benefit-doesnt-mean-access-to-care",
"authors": [
"byline_stateofhealth_39028"
],
"categories": [
"stateofhealth_13"
],
"tags": [
"stateofhealth_155"
],
"featImg": "stateofhealth_39047",
"label": "stateofhealth"
},
"stateofhealth_35574": {
"type": "posts",
"id": "stateofhealth_35574",
"meta": {
"index": "posts_1716263798",
"site": "stateofhealth",
"id": "35574",
"score": null,
"sort": [
1433970553000
]
},
"parent": 0,
"labelTerm": {
"site": "stateofhealth"
},
"blocks": [],
"publishDate": 1433970553,
"format": "standard",
"disqusTitle": "Stanford 'Big Data' Study Links Common Heartburn Drugs with Heart Attack Risk",
"title": "Stanford 'Big Data' Study Links Common Heartburn Drugs with Heart Attack Risk",
"headTitle": "State of Health | KQED News",
"content": "\u003cp>Some of the most commonly used drugs in the world to treat heartburn are associated with a 16 to 20 percent increased risk of heart attack, a large data mining study of electronic health records from Stanford researchers shows.\u003c/p>\n\u003cp>The class of drugs, called proton pump inhibitors or PPIs, are sold under the name Prilosec and Nexium, among others. These drugs are available by prescription as well as over the counter and generate an estimated $13 billion in annual sales globally.\u003c/p>\n\u003cp>More than 20 million Americans use a PPI, according to the study, which was published online in \u003ca href=\"http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0124653\" target=\"_blank\">Plos One. \u003c/a>\u003c/p>\n\u003cp>Dr. Nick Leeper, a cardiologist at Stanford and senior author of the study, stressed the research could not prove causation, \"but I will say the association looks to be fairly compelling. What we have seen in this study is that PPI usage is very clearly associated with increased risk of heart attack.\" He said that only a randomized control trial, where patients either get the drug or a placebo, could prove causation.\u003c/p>\n\u003cp>Still, the increased risk is \"above baseline\" Leeper said. So if your personal risk is low -- let's use 1 in 1,000 as an example -- then increasing that risk 20 percent now makes your risk 1.2 in 1,000. The concern is that when that increased risk is multiplied across the millions of people taking the drug, some of whom are likely to be at higher risk of a heart attack.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cstrong>Combing Through Doctors' Notes\u003c/strong>\u003c/p>\n\u003cp>The researchers used a novel research technique. They designed algorithms to comb through the electronic health records (EHRs) of 3 million people across different data sets. This analysis looked beyond checked boxes that doctors often complain about when discussing EHRs.\u003c/p>\n\u003cp>\"We figured out a way to analyze the notes that doctors write about their patients during the course of care,\" said Nigam Shah, a study author and professor of bioinformatics at Stanford, \"and created a data structure which we (could) then analyze for associations that may have clinical significance.\"\u003c/p>\n\u003cp>Doctors have known that people who take a PPI and also take the anti-platelet drug clopidogrel, known commercially as Plavix, are at increased risk of heart attack. This study excluded those patients and found the association among people not taking the second drug. The study did not show increased risk of heart attack in people taking a drug that fights heartburn in a different way, called an H2 blocker. That drug is sold under the name Zantac or Pepcid, among others.\u003c/p>\n\u003cp>The authors theorize that PPIs alter the metabolism of nitric oxide, which helps to regulate blood vessel function. \"It's widely accepted that having reduced levels of nitric oxide is a bad thing and is associated with risks for cardiovascular events,\" Leeper said.\u003c/p>\n\u003cp>Still, he cautioned that the research can only generate a hypothesis, which needs to be confirmed through additional studies.\u003c/p>\n\u003cp>Barb Kochanowski is vice president of regulatory and scientific affairs with the Consumer Healthcare Products Association, a trade group for over-the-counter drug manufacturers. In a statement, she said that millions of consumers use these drugs. As with all over-the-counter medications, she said, \"consumers should read the label and follow directions closely to understand what the medicine is used for, to ensure appropriate dosing and to avoid drug interactions.\"\u003c/p>\n\u003cp>AstraZeneca, maker of Nexium, also issued a statement noting that all its medicines \"are generally safe and effective when used in accordance with the label. ... AstraZeneca was not consulted during the research and we cannot comment further on this data.\"\u003c/p>\n\u003cp>\u003cstrong>New Tool for Drug Safety Surveillance\u003c/strong>\u003c/p>\n\u003cp>Leeper stressed that this study should not be seen as critical of pharmaceutical companies, which \"simply can't identify every harm,\" he said. \"That's why we think these new approaches, where you can have post-approval surveillance, pharmacovigilance, this is where we really have the potential to figure out who's at risk, who's not, who's going to have an adverse outcome, who should be on different medicines.\"\u003c/p>\n\u003cp>Other industries such as banking and airlines have been \"learning from the behavior and response of their customers\" for years, Shah said.\u003c/p>\n\u003cp>\"Health care is one of the few areas of the economy where we don't learn from routine (visits). You go in with acid reflux. I go in with acid reflux, 50,000 people go in with acid reflux, but the evidence on which doctors are making decisions are based on the 500 or 1,000 people who were enrolled in the randomized control trial. Why would we not learn from the collective record of what patients had and what doctors did to them that we're already collecting in the electronic health record?\"\u003c/p>\n\u003cp>Dr. Bob Wachter is chief of the division of hospital medicine at UC San Francisco Medical Center and author of \"\u003ca href=\"http://www.amazon.com/The-Digital-Doctor-Medicines-Computer/dp/0071849467\" target=\"_blank\">The Digital Doctor\u003c/a>.\" He was not involved in the research.\u003c/p>\n\u003cp>He said the study \"is a big deal clinically\" and provides \"reasonably strong evidence\" that PPIs can cause harm.\u003c/p>\n\u003cp>He also had praise for the methods used -- sifting through doctors' actual notes from millions of patient encounters. \"It's a little surprising that this is novel in health care, when you think about Google's ability to read text or plagiarism detectors. It's now commonplace to sift through natural language and analyze it in the rest of our lives, but it's new in medicine.\"\u003c/p>\n\u003cp>Six years ago just 10 percent of doctors and hospitals used electronic health records, he said. Today, that number has shot up to 75 percent, after the federal government's stimulus package included $30 billion to incentivize providers to adapt electronic health records systems.\u003c/p>\n\u003cp>Wachter said the implementation of health records has \"been somewhat maligned.\" But, \"it's clear that the promise of computerization is real.\"\u003c/p>\n\u003cp>\u003cstrong>Check With Your Doctor\u003c/strong>\u003c/p>\n\u003cp>Yet Dr. Alan Go, director of the Comprehensive Clinical Research Unit at Kaiser's Division of Research in Oakland, found the association between PPIs and heart attack risk to be \"very weak overall\" in the study.\u003c/p>\n\u003cp>\"More rigorous data are needed before we make a clinical recommendation to stop using these medications,\" he said.\u003c/p>\n\u003cp>He cautioned that the study did not look at the full range of variables that could affect the result -- what researchers call \"confounders.\" For example, behavior and lifestyle of individual patients were not accounted for.\u003c/p>\n\u003cp>Still, all the doctors interviewed for this article agreed that this news provides a reminder that patients should check with their doctor about whether the need for a PPI is really there.\u003c/p>\n\u003cp>Study authors Shah and Leeper say that if this technology -- electronic health records combined with data-combing algorithms -- had been developed sooner, the association between PPIs and heart attack risk would have been identified in the year 2000.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\"And so we could have started a prospective study back then to figure out the truth,\" Leeper said.\u003c/p>\n\n",
"disqusIdentifier": "35574 http://ww2.kqed.org/stateofhealth/?p=35574",
"disqusUrl": "https://ww2.kqed.org/stateofhealth/2015/06/10/stanford-big-data-study-links-common-heartburn-drugs-with-heart-attack-risk/",
"stats": {
"hasVideo": false,
"hasChartOrMap": false,
"hasAudio": false,
"hasPolis": false,
"wordCount": 1171,
"hasGoogleForm": false,
"hasGallery": false,
"hasHearkenModule": false,
"iframeSrcs": [],
"paragraphCount": 31
},
"modified": 1434576035,
"excerpt": "The drugs include some of the most commonly prescribed medications, such as Prilosec and Nexium.",
"headData": {
"twImgId": "",
"twTitle": "",
"ogTitle": "",
"ogImgId": "",
"twDescription": "",
"description": "The drugs include some of the most commonly prescribed medications, such as Prilosec and Nexium.",
"title": "Stanford 'Big Data' Study Links Common Heartburn Drugs with Heart Attack Risk | KQED",
"ogDescription": "",
"schema": {
"@context": "https://schema.org",
"@type": "Article",
"headline": "Stanford 'Big Data' Study Links Common Heartburn Drugs with Heart Attack Risk",
"datePublished": "2015-06-10T14:09:13-07:00",
"dateModified": "2015-06-17T14:20:35-07:00",
"image": "https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"
}
},
"guestAuthors": [],
"slug": "stanford-big-data-study-links-common-heartburn-drugs-with-heart-attack-risk",
"status": "publish",
"path": "/stateofhealth/35574/stanford-big-data-study-links-common-heartburn-drugs-with-heart-attack-risk",
"audioTrackLength": null,
"parsedContent": [
{
"type": "contentString",
"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Some of the most commonly used drugs in the world to treat heartburn are associated with a 16 to 20 percent increased risk of heart attack, a large data mining study of electronic health records from Stanford researchers shows.\u003c/p>\n\u003cp>The class of drugs, called proton pump inhibitors or PPIs, are sold under the name Prilosec and Nexium, among others. These drugs are available by prescription as well as over the counter and generate an estimated $13 billion in annual sales globally.\u003c/p>\n\u003cp>More than 20 million Americans use a PPI, according to the study, which was published online in \u003ca href=\"http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0124653\" target=\"_blank\">Plos One. \u003c/a>\u003c/p>\n\u003cp>Dr. Nick Leeper, a cardiologist at Stanford and senior author of the study, stressed the research could not prove causation, \"but I will say the association looks to be fairly compelling. What we have seen in this study is that PPI usage is very clearly associated with increased risk of heart attack.\" He said that only a randomized control trial, where patients either get the drug or a placebo, could prove causation.\u003c/p>\n\u003cp>Still, the increased risk is \"above baseline\" Leeper said. So if your personal risk is low -- let's use 1 in 1,000 as an example -- then increasing that risk 20 percent now makes your risk 1.2 in 1,000. The concern is that when that increased risk is multiplied across the millions of people taking the drug, some of whom are likely to be at higher risk of a heart attack.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
"attributes": {
"named": {},
"numeric": []
}
},
{
"type": "component",
"content": "",
"name": "ad",
"attributes": {
"named": {
"label": "fullwidth"
},
"numeric": [
"fullwidth"
]
}
},
{
"type": "contentString",
"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Combing Through Doctors' Notes\u003c/strong>\u003c/p>\n\u003cp>The researchers used a novel research technique. They designed algorithms to comb through the electronic health records (EHRs) of 3 million people across different data sets. This analysis looked beyond checked boxes that doctors often complain about when discussing EHRs.\u003c/p>\n\u003cp>\"We figured out a way to analyze the notes that doctors write about their patients during the course of care,\" said Nigam Shah, a study author and professor of bioinformatics at Stanford, \"and created a data structure which we (could) then analyze for associations that may have clinical significance.\"\u003c/p>\n\u003cp>Doctors have known that people who take a PPI and also take the anti-platelet drug clopidogrel, known commercially as Plavix, are at increased risk of heart attack. This study excluded those patients and found the association among people not taking the second drug. The study did not show increased risk of heart attack in people taking a drug that fights heartburn in a different way, called an H2 blocker. That drug is sold under the name Zantac or Pepcid, among others.\u003c/p>\n\u003cp>The authors theorize that PPIs alter the metabolism of nitric oxide, which helps to regulate blood vessel function. \"It's widely accepted that having reduced levels of nitric oxide is a bad thing and is associated with risks for cardiovascular events,\" Leeper said.\u003c/p>\n\u003cp>Still, he cautioned that the research can only generate a hypothesis, which needs to be confirmed through additional studies.\u003c/p>\n\u003cp>Barb Kochanowski is vice president of regulatory and scientific affairs with the Consumer Healthcare Products Association, a trade group for over-the-counter drug manufacturers. In a statement, she said that millions of consumers use these drugs. As with all over-the-counter medications, she said, \"consumers should read the label and follow directions closely to understand what the medicine is used for, to ensure appropriate dosing and to avoid drug interactions.\"\u003c/p>\n\u003cp>AstraZeneca, maker of Nexium, also issued a statement noting that all its medicines \"are generally safe and effective when used in accordance with the label. ... AstraZeneca was not consulted during the research and we cannot comment further on this data.\"\u003c/p>\n\u003cp>\u003cstrong>New Tool for Drug Safety Surveillance\u003c/strong>\u003c/p>\n\u003cp>Leeper stressed that this study should not be seen as critical of pharmaceutical companies, which \"simply can't identify every harm,\" he said. \"That's why we think these new approaches, where you can have post-approval surveillance, pharmacovigilance, this is where we really have the potential to figure out who's at risk, who's not, who's going to have an adverse outcome, who should be on different medicines.\"\u003c/p>\n\u003cp>Other industries such as banking and airlines have been \"learning from the behavior and response of their customers\" for years, Shah said.\u003c/p>\n\u003cp>\"Health care is one of the few areas of the economy where we don't learn from routine (visits). You go in with acid reflux. I go in with acid reflux, 50,000 people go in with acid reflux, but the evidence on which doctors are making decisions are based on the 500 or 1,000 people who were enrolled in the randomized control trial. Why would we not learn from the collective record of what patients had and what doctors did to them that we're already collecting in the electronic health record?\"\u003c/p>\n\u003cp>Dr. Bob Wachter is chief of the division of hospital medicine at UC San Francisco Medical Center and author of \"\u003ca href=\"http://www.amazon.com/The-Digital-Doctor-Medicines-Computer/dp/0071849467\" target=\"_blank\">The Digital Doctor\u003c/a>.\" He was not involved in the research.\u003c/p>\n\u003cp>He said the study \"is a big deal clinically\" and provides \"reasonably strong evidence\" that PPIs can cause harm.\u003c/p>\n\u003cp>He also had praise for the methods used -- sifting through doctors' actual notes from millions of patient encounters. \"It's a little surprising that this is novel in health care, when you think about Google's ability to read text or plagiarism detectors. It's now commonplace to sift through natural language and analyze it in the rest of our lives, but it's new in medicine.\"\u003c/p>\n\u003cp>Six years ago just 10 percent of doctors and hospitals used electronic health records, he said. Today, that number has shot up to 75 percent, after the federal government's stimulus package included $30 billion to incentivize providers to adapt electronic health records systems.\u003c/p>\n\u003cp>Wachter said the implementation of health records has \"been somewhat maligned.\" But, \"it's clear that the promise of computerization is real.\"\u003c/p>\n\u003cp>\u003cstrong>Check With Your Doctor\u003c/strong>\u003c/p>\n\u003cp>Yet Dr. Alan Go, director of the Comprehensive Clinical Research Unit at Kaiser's Division of Research in Oakland, found the association between PPIs and heart attack risk to be \"very weak overall\" in the study.\u003c/p>\n\u003cp>\"More rigorous data are needed before we make a clinical recommendation to stop using these medications,\" he said.\u003c/p>\n\u003cp>He cautioned that the study did not look at the full range of variables that could affect the result -- what researchers call \"confounders.\" For example, behavior and lifestyle of individual patients were not accounted for.\u003c/p>\n\u003cp>Still, all the doctors interviewed for this article agreed that this news provides a reminder that patients should check with their doctor about whether the need for a PPI is really there.\u003c/p>\n\u003cp>Study authors Shah and Leeper say that if this technology -- electronic health records combined with data-combing algorithms -- had been developed sooner, the association between PPIs and heart attack risk would have been identified in the year 2000.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
"attributes": {
"named": {},
"numeric": []
}
},
{
"type": "component",
"content": "",
"name": "ad",
"attributes": {
"named": {
"label": "floatright"
},
"numeric": [
"floatright"
]
}
},
{
"type": "contentString",
"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"And so we could have started a prospective study back then to figure out the truth,\" Leeper said.\u003c/p>\n\n\u003c/div>\u003c/p>",
"attributes": {
"named": {},
"numeric": []
}
}
],
"link": "/stateofhealth/35574/stanford-big-data-study-links-common-heartburn-drugs-with-heart-attack-risk",
"authors": [
"240"
],
"categories": [
"stateofhealth_2407",
"stateofhealth_13"
],
"tags": [
"stateofhealth_461"
],
"featImg": "stateofhealth_35624",
"label": "stateofhealth"
},
"stateofhealth_35558": {
"type": "posts",
"id": "stateofhealth_35558",
"meta": {
"index": "posts_1716263798",
"site": "stateofhealth",
"id": "35558",
"score": null,
"sort": [
1433956095000
]
},
"parent": 0,
"labelTerm": {
"site": "stateofhealth"
},
"blocks": [],
"publishDate": 1433956095,
"format": "standard",
"disqusTitle": "Knowing How Doctors Die May Help Patients at End of Life",
"title": "Knowing How Doctors Die May Help Patients at End of Life",
"headTitle": "State of Health | KQED News",
"content": "\u003cp class=\"inaugural\">Los Angeles doctor Ken Murray first started thinking about how doctors die roughly ten years ago, when a physician he knew passed away.\u003c/p>\n\u003cp>\"He had died at home and it occurred to me I couldn’t remember any of our colleagues...who had actually died in the hospital,\" he says. \"That struck me as quite odd because I know that most people do die in hospitals.\"\u003c/p>\n\u003cp>Murray then began talking about it with other doctors.\u003c/p>\n\u003cp>\"And I said, 'Have you noticed this phenomenon?'\" he recalls. \"They thought about it and they said, 'You know? You’re right.'\"\u003c/p>\n\u003cp>Five years later, the retired family practice physician shared his observations in an online article entitled, \u003ca href=\"http://www.zocalopublicsquare.org/2011/11/30/how-doctors-die/ideas/nexus/\" target=\"_blank\">\"How Doctors Die.\" \u003c/a>It quickly went viral. In it, Murray told the world that doctors don’t typically die like the rest of us and he doesn't plan to, either.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"I fit with the vast majority of physicians that want to have a gentle death and don’t want extraordinary measures taken when they have no meaning,\" he says.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ca title=\"http://www.scpr.org/blogs/health/2015/04/14/18020/terminally-ill-orange-county-mom-says-assisted-sui/\" href=\"http://www.scpr.org/news/2015/05/19/51633/knowing-how-doctors-die-may-help-patients-at-end-o/\" target=\"_blank\">Read the full story via KPCC. \u003c/a>\u003c/p>\n\n",
"disqusIdentifier": "35558 http://ww2.kqed.org/stateofhealth/?p=35558",
"disqusUrl": "https://ww2.kqed.org/stateofhealth/2015/06/10/knowing-how-doctors-die-may-help-patients-at-end-of-life/",
"stats": {
"hasVideo": false,
"hasChartOrMap": false,
"hasAudio": false,
"hasPolis": false,
"wordCount": 191,
"hasGoogleForm": false,
"hasGallery": false,
"hasHearkenModule": false,
"iframeSrcs": [],
"paragraphCount": 8
},
"modified": 1433956095,
"excerpt": "If most doctors prefer to die at home, without heroic measures, why do most patients die in the hospital?",
"headData": {
"twImgId": "",
"twTitle": "",
"ogTitle": "",
"ogImgId": "",
"twDescription": "",
"description": "If most doctors prefer to die at home, without heroic measures, why do most patients die in the hospital?",
"title": "Knowing How Doctors Die May Help Patients at End of Life | KQED",
"ogDescription": "",
"schema": {
"@context": "https://schema.org",
"@type": "Article",
"headline": "Knowing How Doctors Die May Help Patients at End of Life",
"datePublished": "2015-06-10T10:08:15-07:00",
"dateModified": "2015-06-10T10:08:15-07:00",
"image": "https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"
}
},
"guestAuthors": [],
"slug": "knowing-how-doctors-die-may-help-patients-at-end-of-life",
"status": "publish",
"nprByline": "Stephanie O'Neill, KPCC",
"path": "/stateofhealth/35558/knowing-how-doctors-die-may-help-patients-at-end-of-life",
"audioTrackLength": null,
"parsedContent": [
{
"type": "contentString",
"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp class=\"inaugural\">Los Angeles doctor Ken Murray first started thinking about how doctors die roughly ten years ago, when a physician he knew passed away.\u003c/p>\n\u003cp>\"He had died at home and it occurred to me I couldn’t remember any of our colleagues...who had actually died in the hospital,\" he says. \"That struck me as quite odd because I know that most people do die in hospitals.\"\u003c/p>\n\u003cp>Murray then began talking about it with other doctors.\u003c/p>\n\u003cp>\"And I said, 'Have you noticed this phenomenon?'\" he recalls. \"They thought about it and they said, 'You know? You’re right.'\"\u003c/p>\n\u003cp>Five years later, the retired family practice physician shared his observations in an online article entitled, \u003ca href=\"http://www.zocalopublicsquare.org/2011/11/30/how-doctors-die/ideas/nexus/\" target=\"_blank\">\"How Doctors Die.\" \u003c/a>It quickly went viral. In it, Murray told the world that doctors don’t typically die like the rest of us and he doesn't plan to, either.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
"attributes": {
"named": {},
"numeric": []
}
},
{
"type": "component",
"content": "",
"name": "ad",
"attributes": {
"named": {
"label": "fullwidth"
},
"numeric": [
"fullwidth"
]
}
},
{
"type": "contentString",
"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"I fit with the vast majority of physicians that want to have a gentle death and don’t want extraordinary measures taken when they have no meaning,\" he says.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ca title=\"http://www.scpr.org/blogs/health/2015/04/14/18020/terminally-ill-orange-county-mom-says-assisted-sui/\" href=\"http://www.scpr.org/news/2015/05/19/51633/knowing-how-doctors-die-may-help-patients-at-end-o/\" target=\"_blank\">Read the full story via KPCC. \u003c/a>\u003c/p>\n\n\u003c/div>\u003c/p>",
"attributes": {
"named": {},
"numeric": []
}
}
],
"link": "/stateofhealth/35558/knowing-how-doctors-die-may-help-patients-at-end-of-life",
"authors": [
"byline_stateofhealth_35558"
],
"categories": [
"stateofhealth_11",
"stateofhealth_13"
],
"tags": [
"stateofhealth_40"
],
"featImg": "stateofhealth_35559",
"label": "stateofhealth"
},
"stateofhealth_34965": {
"type": "posts",
"id": "stateofhealth_34965",
"meta": {
"index": "posts_1716263798",
"site": "stateofhealth",
"id": "34965",
"score": null,
"sort": [
1433798002000
]
},
"parent": 0,
"labelTerm": {
"site": "stateofhealth"
},
"blocks": [],
"publishDate": 1433798002,
"format": "standard",
"disqusTitle": "To Cure Insomnia, Skip the Drugs and Retrain Your Brain",
"title": "To Cure Insomnia, Skip the Drugs and Retrain Your Brain",
"headTitle": "State of Health | KQED News",
"content": "\u003cp>Most everyone has trouble sleeping from time to time. But missing the occasional night’s sleep bears little relation to chronic insomnia, when worries real and imagined rob rest from the night and dog the day as exhausted minds fixate on the haunted hours when sleep never comes.\u003c/p>\n\u003cp>Chronic insomnia affects \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/21652083\">10 to 15 percent of Americans\u003c/a>, \u003ca href=\"http://www.sciencedirect.com/science/article/pii/S0165032711002606\" target=\"_blank\">as many as 36 million adults\u003c/a>. Most people who seek treatment receive a prescription for sleeping pills. Medication can bring temporary relief but often at the cost of a \u003ca href=\"http://www.webmd.com/sleep-disorders/guide/understanding-the-side-effects-of-sleeping-pills\" target=\"_blank\">long list of side effects\u003c/a>, including a hangover that impairs judgment and coordination. The hangover associated with Ambien and other sleeping pills made with the medication zolpidem is so severe that the FDA required lower recommended doses for the pills in 2013, citing \u003ca href=\"http://www.fda.gov/Drugs/DrugSafety/ucm334041.htm\" target=\"_blank\">increased risk of car accidents\u003c/a>.\u003c/p>\n\u003cp>But, as a systematic analysis of multiple sleep studies \u003ca href=\"http://annals.org/article.aspx?articleid=2301405\" target=\"_blank\">published Monday in the Annals of Internal Medicine\u003c/a> shows, there’s a better way to help insomniacs tame those nighttime demons and get a good night’s sleep: retrain the mind and body to embrace sleep again. The treatment is based on cognitive behavioral therapy (CBT), a type of psychotherapy that has long been used to treat depression and other mental disorders by correcting self-destructive thoughts, feelings and behaviors. Cognitive behavioral therapy for insomnia (or CBTi) applies this approach while also drawing on the science of sleep to improve sleep patterns without drugs.\u003c/p>\n\u003cp>“People with chronic insomnia become very focused on sleep and fearful of the consequences of poor sleep,” says David Cunnington, director of the Melbourne Sleep Disorders Centre in Australia, who led the study.\u003c/p>\n\u003cp>Pills simply mask these anxieties, which can return with a vengeance when people stop taking medication. But CBTi targets the core problem of chronic insomnia, Cunnington says. “It’s the changed thinking and behavior around sleep that needs to be addressed to settle down symptoms.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>And because the therapy corrects the habits and thoughts that promote insomnia, he says, it helps people retain healthy sleep habits without the need for ongoing treatment.\u003c/p>\n\u003cp>According to the researchers, key elements of CBT-i include:\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>Cognitive therapy:\u003c/strong> Identify and replace dysfunctional beliefs and attitudes about sleep and insomnia.\u003c/li>\n\u003cli>\u003cstrong>Stimulus control\u003c/strong>: Strengthen the association between bed and sleep and instead of stimulating activities. For example, going to bed only when sleepy and getting up when awake for 15-20 minutes.\u003c/li>\n\u003cli>\u003cstrong>Sleep restriction\u003c/strong>: Limit time in bed to match perceived sleep duration in order to increase sleep drive and further reduce time awake in bed. Start by restricting allowed time in bed to the average time perceived as sleep per night, then adjust to reach over 85 percent sleep efficiency.\u003c/li>\n\u003cli>\u003cstrong>Sleep hygiene:\u003c/strong> Avoid visual access to a clock; set and keep a regular sleep schedule and avoid long daytime naps. Limit alcohol, caffeine, and nicotine intake, especially before bed.\u003c/li>\n\u003cli>\u003cstrong>Relaxation\u003c/strong>: Practice any technique that is relaxing including meditation, mindfulness, guided imagery, and breathing techniques.\u003c/li>\n\u003c/ul>\n\u003cp>The \u003ca href=\"http://www.nih.gov/news/pr/jun2005/od-15.htm%5d\" target=\"_blank\">National Institutes of Health recommended\u003c/a> the broader use of cognitive and behavioral therapies to treat chronic insomnia 10 years ago, but a gap still exists between the guidelines and clinical practice, partly due to a \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/22505869\" target=\"_blank\">lack of qualified therapists\u003c/a>.\u003c/p>\n\u003cp>Individual studies show that cognitive behavioral therapy works for chronic insomnia. But it’s tough to draw general conclusions from studies conducted in different countries by different health care professionals using slightly different treatments. Cunnington and his colleagues applied statistical methods to control for these differences in a meta-analysis of 20 published studies to provide a clearer picture of the true effect of treatments, and perhaps boost uptake of \u003ca href=\"http://www.medscape.com/viewarticle/727935\" target=\"_blank\">evidence-based guidelines\u003c/a>.\u003c/p>\n\u003cp>The studies used a combination of sleep diaries and polysomnography (a diagnostic machine that monitors brain and physiological activity during sleep) to assess patients’ sleep patterns. Overall, they showed that patients who underwent a short course of cognitive behavioral therapy – at least four face-to-face sessions -- fell sleep about 20 minutes faster and stayed awake about half an hour less throughout the night. Patients maintained these improvements after the treatments ended.\u003c/p>\n\u003cp>The findings support the “already strong evidence” that CBT-i is an effective treatment for chronic insomnia, notes Charles Morin, a sleep disorders expert who was not involved in the study, in an accompanying editorial.\u003c/p>\n\u003cp>Yet despite “robust scientific evidence” and “strong professional endorsements” of cognitive behavioral therapy’s value in treating chronic insomnia, Morin wrote, “a major gap exists between the current state of the science and actual clinical practice.”\u003c/p>\n\u003cp>Morin, who heads the Center for the Study of Sleep Disorders at Laval University in Quebec, acknowledged that CBT-i requires more time and effort for both clinician and patient than taking a pill. “Although we lack an easy-to-swallow ‘CBT pill’ for insomnia, the reality is that drug therapy alone does not address the underlying psychological and behavioral factors that perpetuate insomnia.”\u003c/p>\n\u003cp>Untreated insomnia can cause long-term health problems, including major depression and hypertension, though more research is needed to evaluate whether improved sleep alters the risk of later health problems.\u003c/p>\n\u003cp>What’s clear is that CBT-i can help patients regain control over their sleep and quality of life.\u003c/p>\n\u003cp>Over the past few months, Cunnington has been treating a 25-year-old veterinary surgeon whose sleep deteriorated as she worked long hours, often on-call, throughout the past year. She rearranged her schedule but it didn’t help. Her increasing anxiety about sleep soon bled into other aspects of her life until she found herself having panic attacks.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“She came to me after being so distressed one night that she called an ambulance to take her to the ER to just get ‘something to sleep,’ ” Cunnington recalls. “We’ve used CBT-i with her over the last few months, and she’s now back at work, feeling and sleeping reasonably well. She’s getting on with life.”\u003c/p>\n\n",
"disqusIdentifier": "34965 http://ww2.kqed.org/stateofhealth/?p=34965",
"disqusUrl": "https://ww2.kqed.org/stateofhealth/2015/06/08/to-cure-insomnia-skip-the-drugs-and-retrain-your-mind/",
"stats": {
"hasVideo": false,
"hasChartOrMap": false,
"hasAudio": false,
"hasPolis": false,
"wordCount": 1018,
"hasGoogleForm": false,
"hasGallery": false,
"hasHearkenModule": false,
"iframeSrcs": [],
"paragraphCount": 19
},
"modified": 1433798110,
"excerpt": "Because this therapy corrects the habits and thoughts that promote insomnia, people retain healthy sleep habits.",
"headData": {
"twImgId": "",
"twTitle": "",
"ogTitle": "",
"ogImgId": "",
"twDescription": "",
"description": "Because this therapy corrects the habits and thoughts that promote insomnia, people retain healthy sleep habits.",
"title": "To Cure Insomnia, Skip the Drugs and Retrain Your Brain | KQED",
"ogDescription": "",
"schema": {
"@context": "https://schema.org",
"@type": "Article",
"headline": "To Cure Insomnia, Skip the Drugs and Retrain Your Brain",
"datePublished": "2015-06-08T14:13:22-07:00",
"dateModified": "2015-06-08T14:15:10-07:00",
"image": "https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"
}
},
"guestAuthors": [],
"slug": "to-cure-insomnia-skip-the-drugs-and-retrain-your-mind",
"status": "publish",
"nprByline": "Liza Gross",
"path": "/stateofhealth/34965/to-cure-insomnia-skip-the-drugs-and-retrain-your-mind",
"audioTrackLength": null,
"parsedContent": [
{
"type": "contentString",
"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Most everyone has trouble sleeping from time to time. But missing the occasional night’s sleep bears little relation to chronic insomnia, when worries real and imagined rob rest from the night and dog the day as exhausted minds fixate on the haunted hours when sleep never comes.\u003c/p>\n\u003cp>Chronic insomnia affects \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/21652083\">10 to 15 percent of Americans\u003c/a>, \u003ca href=\"http://www.sciencedirect.com/science/article/pii/S0165032711002606\" target=\"_blank\">as many as 36 million adults\u003c/a>. Most people who seek treatment receive a prescription for sleeping pills. Medication can bring temporary relief but often at the cost of a \u003ca href=\"http://www.webmd.com/sleep-disorders/guide/understanding-the-side-effects-of-sleeping-pills\" target=\"_blank\">long list of side effects\u003c/a>, including a hangover that impairs judgment and coordination. The hangover associated with Ambien and other sleeping pills made with the medication zolpidem is so severe that the FDA required lower recommended doses for the pills in 2013, citing \u003ca href=\"http://www.fda.gov/Drugs/DrugSafety/ucm334041.htm\" target=\"_blank\">increased risk of car accidents\u003c/a>.\u003c/p>\n\u003cp>But, as a systematic analysis of multiple sleep studies \u003ca href=\"http://annals.org/article.aspx?articleid=2301405\" target=\"_blank\">published Monday in the Annals of Internal Medicine\u003c/a> shows, there’s a better way to help insomniacs tame those nighttime demons and get a good night’s sleep: retrain the mind and body to embrace sleep again. The treatment is based on cognitive behavioral therapy (CBT), a type of psychotherapy that has long been used to treat depression and other mental disorders by correcting self-destructive thoughts, feelings and behaviors. Cognitive behavioral therapy for insomnia (or CBTi) applies this approach while also drawing on the science of sleep to improve sleep patterns without drugs.\u003c/p>\n\u003cp>“People with chronic insomnia become very focused on sleep and fearful of the consequences of poor sleep,” says David Cunnington, director of the Melbourne Sleep Disorders Centre in Australia, who led the study.\u003c/p>\n\u003cp>Pills simply mask these anxieties, which can return with a vengeance when people stop taking medication. But CBTi targets the core problem of chronic insomnia, Cunnington says. “It’s the changed thinking and behavior around sleep that needs to be addressed to settle down symptoms.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
"attributes": {
"named": {},
"numeric": []
}
},
{
"type": "component",
"content": "",
"name": "ad",
"attributes": {
"named": {
"label": "fullwidth"
},
"numeric": [
"fullwidth"
]
}
},
{
"type": "contentString",
"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>And because the therapy corrects the habits and thoughts that promote insomnia, he says, it helps people retain healthy sleep habits without the need for ongoing treatment.\u003c/p>\n\u003cp>According to the researchers, key elements of CBT-i include:\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>Cognitive therapy:\u003c/strong> Identify and replace dysfunctional beliefs and attitudes about sleep and insomnia.\u003c/li>\n\u003cli>\u003cstrong>Stimulus control\u003c/strong>: Strengthen the association between bed and sleep and instead of stimulating activities. For example, going to bed only when sleepy and getting up when awake for 15-20 minutes.\u003c/li>\n\u003cli>\u003cstrong>Sleep restriction\u003c/strong>: Limit time in bed to match perceived sleep duration in order to increase sleep drive and further reduce time awake in bed. Start by restricting allowed time in bed to the average time perceived as sleep per night, then adjust to reach over 85 percent sleep efficiency.\u003c/li>\n\u003cli>\u003cstrong>Sleep hygiene:\u003c/strong> Avoid visual access to a clock; set and keep a regular sleep schedule and avoid long daytime naps. Limit alcohol, caffeine, and nicotine intake, especially before bed.\u003c/li>\n\u003cli>\u003cstrong>Relaxation\u003c/strong>: Practice any technique that is relaxing including meditation, mindfulness, guided imagery, and breathing techniques.\u003c/li>\n\u003c/ul>\n\u003cp>The \u003ca href=\"http://www.nih.gov/news/pr/jun2005/od-15.htm%5d\" target=\"_blank\">National Institutes of Health recommended\u003c/a> the broader use of cognitive and behavioral therapies to treat chronic insomnia 10 years ago, but a gap still exists between the guidelines and clinical practice, partly due to a \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/22505869\" target=\"_blank\">lack of qualified therapists\u003c/a>.\u003c/p>\n\u003cp>Individual studies show that cognitive behavioral therapy works for chronic insomnia. But it’s tough to draw general conclusions from studies conducted in different countries by different health care professionals using slightly different treatments. Cunnington and his colleagues applied statistical methods to control for these differences in a meta-analysis of 20 published studies to provide a clearer picture of the true effect of treatments, and perhaps boost uptake of \u003ca href=\"http://www.medscape.com/viewarticle/727935\" target=\"_blank\">evidence-based guidelines\u003c/a>.\u003c/p>\n\u003cp>The studies used a combination of sleep diaries and polysomnography (a diagnostic machine that monitors brain and physiological activity during sleep) to assess patients’ sleep patterns. Overall, they showed that patients who underwent a short course of cognitive behavioral therapy – at least four face-to-face sessions -- fell sleep about 20 minutes faster and stayed awake about half an hour less throughout the night. Patients maintained these improvements after the treatments ended.\u003c/p>\n\u003cp>The findings support the “already strong evidence” that CBT-i is an effective treatment for chronic insomnia, notes Charles Morin, a sleep disorders expert who was not involved in the study, in an accompanying editorial.\u003c/p>\n\u003cp>Yet despite “robust scientific evidence” and “strong professional endorsements” of cognitive behavioral therapy’s value in treating chronic insomnia, Morin wrote, “a major gap exists between the current state of the science and actual clinical practice.”\u003c/p>\n\u003cp>Morin, who heads the Center for the Study of Sleep Disorders at Laval University in Quebec, acknowledged that CBT-i requires more time and effort for both clinician and patient than taking a pill. “Although we lack an easy-to-swallow ‘CBT pill’ for insomnia, the reality is that drug therapy alone does not address the underlying psychological and behavioral factors that perpetuate insomnia.”\u003c/p>\n\u003cp>Untreated insomnia can cause long-term health problems, including major depression and hypertension, though more research is needed to evaluate whether improved sleep alters the risk of later health problems.\u003c/p>\n\u003cp>What’s clear is that CBT-i can help patients regain control over their sleep and quality of life.\u003c/p>\n\u003cp>Over the past few months, Cunnington has been treating a 25-year-old veterinary surgeon whose sleep deteriorated as she worked long hours, often on-call, throughout the past year. She rearranged her schedule but it didn’t help. Her increasing anxiety about sleep soon bled into other aspects of her life until she found herself having panic attacks.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“She came to me after being so distressed one night that she called an ambulance to take her to the ER to just get ‘something to sleep,’ ” Cunnington recalls. “We’ve used CBT-i with her over the last few months, and she’s now back at work, feeling and sleeping reasonably well. She’s getting on with life.”\u003c/p>\n\n\u003c/div>\u003c/p>",
"attributes": {
"named": {},
"numeric": []
}
}
],
"link": "/stateofhealth/34965/to-cure-insomnia-skip-the-drugs-and-retrain-your-mind",
"authors": [
"byline_stateofhealth_34965"
],
"categories": [
"stateofhealth_12",
"stateofhealth_13"
],
"tags": [
"stateofhealth_461"
],
"featImg": "stateofhealth_34968",
"label": "stateofhealth"
},
"stateofhealth_33185": {
"type": "posts",
"id": "stateofhealth_33185",
"meta": {
"index": "posts_1716263798",
"site": "stateofhealth",
"id": "33185",
"score": null,
"sort": [
1433356362000
]
},
"parent": 0,
"labelTerm": {
"site": "stateofhealth"
},
"blocks": [],
"publishDate": 1433356362,
"format": "standard",
"disqusTitle": "Surgery Doesn't Help Women With Earliest-Stage Breast Cancer",
"title": "Surgery Doesn't Help Women With Earliest-Stage Breast Cancer",
"headTitle": "State of Health | KQED News",
"content": "\u003cp>What to do about the non-invasive breast lesions called ductal carcinoma in situ, or \"stage zero\" cancer, is one of the hottest debates in breast cancer care.\u003c/p>\n\u003cp>Because of more widespread screening, more and more women are being diagnosed with DCIS. The condition now makes up 20 percent of new breast cancer cases, \u003ca href=\"http://www.cancer.org/cancer/breastcancer/detailedguide/breast-cancer-breast-cancer-types\" target=\"_blank\">according to the American Cancer Society\u003c/a>.\u003c/p>\n\u003cp>DCIS doesn't always progress to invasive breast cancer, which is the life-threatening kind. In fact, some physicians and researchers, including a \u003ca href=\"http://jama.jamanetwork.com/article.aspx?articleid=1722196\" target=\"_blank\">working group convened by the National Cancer Institute\u003c/a>, say it's not accurate to call DCIS a form of cancer at all, and that the terminology is contributing to overly \u003ca href=\"http://www.npr.org/sections/health-shots/2013/08/05/208239545/when-treating-abnormal-breast-cells-sometimes-less-is-more\" target=\"_blank\">aggressive treatment\u003c/a>.\u003c/p>\n\u003cp>\"We are certainly overtreating this disease, but we haven't figured out who can get less treatment, no treatment or active surveillance,\" says Mehra Golshan, a breast surgeon at Brigham and Women's Hospital in Boston. Surgery (lumpectomy and in some cases mastectomy) is the standard of care, but a \u003ca href=\"http://archsurg.jamanetwork.com/article.aspx?articleid=2300045\" target=\"_blank\">study\u003c/a> by Golshan and his colleagues may support some women's decision to skip the surgery, which comes with physical, emotional and financial costs.\u003c/p>\n\u003cp>The study, published Wednesday in \u003cem>JAMA Surgery\u003c/em>, relied on a National Cancer Institute registry covering 57,222 cases of DCIS in women treated in nine U.S. states between 1988 and 2011. The researchers looked at what happened to women who had surgery and to the small minority of those who didn't. They found that for women whose DCIS was classified as low-grade by a pathologist looking at the cells under the microscope, surgery didn't offer a significant survival advantage over 10 years.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>For the women who had cells that were closer on the continuum to invasive cancer — those with intermediate- or high-grade DCIS — surgery did provide a significant benefit. After 10 years, 98.6 percent of women with intermediate-grade DCIS and who had surgery had survived breast cancer, compared to 94.6 percent of women who didn't have surgery. And with high-grade DCIS, 98.4 percent of those who had surgery survived, compared to 90.5 percent of those who didn't.\u003c/p>\n\u003cp>This study relied on the historical data available in a registry and can't tell us why some women didn't get surgery. (For example, some might have been too sick to tolerate it.) There may have been other differences between those who opted for surgery and those who did not that affected the results. So the researchers can't say for sure that women with low-grade DCIS should not have surgery. There are \u003ca href=\"http://www.cancerresearchuk.org/about-cancer/find-a-clinical-trial/a-trial-comparing-surgery-with-active-monitoring-for-low-risk-dcis-loris\" target=\"_blank\">randomized clinical trials\u003c/a> comparing active monitoring to surgery for lower-risk DCIS going on in Europe that may help answer the question.\u003c/p>\n\u003cp>A \u003ca href=\"http://archsurg.jamanetwork.com/article.aspx?articleid=2300040\">commentary\u003c/a> accompanying the study says that molecular markers being developed are more promising than the cell grading system for figuring out who will and won't benefit from surgery. That may be true, but those tests aren't yet available and will cost much more, says Golshan, whereas the cell pathology reports are already standard.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>For now, most doctors will still recommend surgery. But this research represents \"a first step in trying to tailor therapy to be in line with an individual patient's disease,\" says Golshan. He notes that women are already making a decision one way or the other. These results may make them and their physicians more comfortable with the idea of initially foregoing surgery for careful monitoring and possibly hormone therapy to block estrogen from fueling the growth of the abnormal cells.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2015 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Surgery+Doesn%27t+Help+Women+With+Early-Stage+Breast+Carcinoma&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n",
"disqusIdentifier": "33185 http://ww2.kqed.org/stateofhealth/?p=33185",
"disqusUrl": "https://ww2.kqed.org/stateofhealth/2015/06/03/surgery-doesnt-help-women-with-earliest-stage-breast-cancer/",
"stats": {
"hasVideo": false,
"hasChartOrMap": false,
"hasAudio": false,
"hasPolis": false,
"wordCount": 608,
"hasGoogleForm": false,
"hasGallery": false,
"hasHearkenModule": false,
"iframeSrcs": [],
"paragraphCount": 11
},
"modified": 1433356362,
"excerpt": "Only women with more advanced cases of ductal carcinoma in situ -- also called Stage 0 breast cancer -- benefited from lumpectomy, a study found. ",
"headData": {
"twImgId": "",
"twTitle": "",
"ogTitle": "",
"ogImgId": "",
"twDescription": "",
"description": "Only women with more advanced cases of ductal carcinoma in situ -- also called Stage 0 breast cancer -- benefited from lumpectomy, a study found. ",
"title": "Surgery Doesn't Help Women With Earliest-Stage Breast Cancer | KQED",
"ogDescription": "",
"schema": {
"@context": "https://schema.org",
"@type": "Article",
"headline": "Surgery Doesn't Help Women With Earliest-Stage Breast Cancer",
"datePublished": "2015-06-03T11:32:42-07:00",
"dateModified": "2015-06-03T11:32:42-07:00",
"image": "https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"
}
},
"guestAuthors": [],
"slug": "surgery-doesnt-help-women-with-earliest-stage-breast-cancer",
"status": "publish",
"nprApiLink": "http://api.npr.org/query?id=411698622&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004",
"nprByline": "Katherine Hobson, NPR",
"nprStoryDate": "Wed, 03 Jun 2015 12:21:00 -0400",
"nprLastModifiedDate": "Wed, 03 Jun 2015 12:24:05 -0400",
"nprHtmlLink": "http://www.npr.org/sections/health-shots/2015/06/03/411698622/surgery-doesnt-help-women-with-early-stage-breast-carcinoma?ft=nprml&f=411698622",
"nprStoryId": "411698622",
"nprRetrievedStory": "1",
"nprPubDate": "Wed, 03 Jun 2015 12:21:00 -0400",
"path": "/stateofhealth/33185/surgery-doesnt-help-women-with-earliest-stage-breast-cancer",
"audioTrackLength": null,
"parsedContent": [
{
"type": "contentString",
"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>What to do about the non-invasive breast lesions called ductal carcinoma in situ, or \"stage zero\" cancer, is one of the hottest debates in breast cancer care.\u003c/p>\n\u003cp>Because of more widespread screening, more and more women are being diagnosed with DCIS. The condition now makes up 20 percent of new breast cancer cases, \u003ca href=\"http://www.cancer.org/cancer/breastcancer/detailedguide/breast-cancer-breast-cancer-types\" target=\"_blank\">according to the American Cancer Society\u003c/a>.\u003c/p>\n\u003cp>DCIS doesn't always progress to invasive breast cancer, which is the life-threatening kind. In fact, some physicians and researchers, including a \u003ca href=\"http://jama.jamanetwork.com/article.aspx?articleid=1722196\" target=\"_blank\">working group convened by the National Cancer Institute\u003c/a>, say it's not accurate to call DCIS a form of cancer at all, and that the terminology is contributing to overly \u003ca href=\"http://www.npr.org/sections/health-shots/2013/08/05/208239545/when-treating-abnormal-breast-cells-sometimes-less-is-more\" target=\"_blank\">aggressive treatment\u003c/a>.\u003c/p>\n\u003cp>\"We are certainly overtreating this disease, but we haven't figured out who can get less treatment, no treatment or active surveillance,\" says Mehra Golshan, a breast surgeon at Brigham and Women's Hospital in Boston. Surgery (lumpectomy and in some cases mastectomy) is the standard of care, but a \u003ca href=\"http://archsurg.jamanetwork.com/article.aspx?articleid=2300045\" target=\"_blank\">study\u003c/a> by Golshan and his colleagues may support some women's decision to skip the surgery, which comes with physical, emotional and financial costs.\u003c/p>\n\u003cp>The study, published Wednesday in \u003cem>JAMA Surgery\u003c/em>, relied on a National Cancer Institute registry covering 57,222 cases of DCIS in women treated in nine U.S. states between 1988 and 2011. The researchers looked at what happened to women who had surgery and to the small minority of those who didn't. They found that for women whose DCIS was classified as low-grade by a pathologist looking at the cells under the microscope, surgery didn't offer a significant survival advantage over 10 years.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
"attributes": {
"named": {},
"numeric": []
}
},
{
"type": "component",
"content": "",
"name": "ad",
"attributes": {
"named": {
"label": "fullwidth"
},
"numeric": [
"fullwidth"
]
}
},
{
"type": "contentString",
"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>For the women who had cells that were closer on the continuum to invasive cancer — those with intermediate- or high-grade DCIS — surgery did provide a significant benefit. After 10 years, 98.6 percent of women with intermediate-grade DCIS and who had surgery had survived breast cancer, compared to 94.6 percent of women who didn't have surgery. And with high-grade DCIS, 98.4 percent of those who had surgery survived, compared to 90.5 percent of those who didn't.\u003c/p>\n\u003cp>This study relied on the historical data available in a registry and can't tell us why some women didn't get surgery. (For example, some might have been too sick to tolerate it.) There may have been other differences between those who opted for surgery and those who did not that affected the results. So the researchers can't say for sure that women with low-grade DCIS should not have surgery. There are \u003ca href=\"http://www.cancerresearchuk.org/about-cancer/find-a-clinical-trial/a-trial-comparing-surgery-with-active-monitoring-for-low-risk-dcis-loris\" target=\"_blank\">randomized clinical trials\u003c/a> comparing active monitoring to surgery for lower-risk DCIS going on in Europe that may help answer the question.\u003c/p>\n\u003cp>A \u003ca href=\"http://archsurg.jamanetwork.com/article.aspx?articleid=2300040\">commentary\u003c/a> accompanying the study says that molecular markers being developed are more promising than the cell grading system for figuring out who will and won't benefit from surgery. That may be true, but those tests aren't yet available and will cost much more, says Golshan, whereas the cell pathology reports are already standard.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>For now, most doctors will still recommend surgery. But this research represents \"a first step in trying to tailor therapy to be in line with an individual patient's disease,\" says Golshan. He notes that women are already making a decision one way or the other. These results may make them and their physicians more comfortable with the idea of initially foregoing surgery for careful monitoring and possibly hormone therapy to block estrogen from fueling the growth of the abnormal cells.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2015 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Surgery+Doesn%27t+Help+Women+With+Early-Stage+Breast+Carcinoma&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n\u003c/div>\u003c/p>",
"attributes": {
"named": {},
"numeric": []
}
}
],
"link": "/stateofhealth/33185/surgery-doesnt-help-women-with-earliest-stage-breast-cancer",
"authors": [
"byline_stateofhealth_33185"
],
"categories": [
"stateofhealth_13"
],
"tags": [
"stateofhealth_46",
"stateofhealth_235"
],
"featImg": "stateofhealth_33186",
"label": "stateofhealth"
},
"stateofhealth_31444": {
"type": "posts",
"id": "stateofhealth_31444",
"meta": {
"index": "posts_1716263798",
"site": "stateofhealth",
"id": "31444",
"score": null,
"sort": [
1433132869000
]
},
"parent": 0,
"labelTerm": {
"site": "stateofhealth"
},
"blocks": [],
"publishDate": 1433132869,
"format": "standard",
"disqusTitle": "Training Doctors to Talk about Vaccines Fails to Sway Parents",
"title": "Training Doctors to Talk about Vaccines Fails to Sway Parents",
"headTitle": "State of Health | KQED News",
"content": "\u003cp>After years of \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/09/11/vaccine-opt-out-rate-doubled-in-7-years-look-up-your-school-online/\" target=\"_blank\">increasing rates\u003c/a> of parents voluntarily choosing to skip vaccinations for their children, public health professionals and researchers have been looking at new ways to ease the concerns of parents who are vaccine hesitant.\u003c/p>\n\u003cp>But that turns out to be tough to do. Simply educating parents about the safety and efficacy of vaccines \u003ca href=\"http://pediatrics.aappublications.org/content/early/2014/02/25/peds.2013-2365.abstract?sid=4c82b05f-5ad9-4ab5-b91e-b187e909c237\" target=\"_blank\">doesn't increase \u003c/a>their likelihood of vaccinating their children.\u003c/p>\n\u003cp>Group Health Research Institute in Seattle tried a different approach. Since \u003ca href=\"http://www.researchgate.net/publication/6716211_Association_between_health_care_providers'_influence_on_parents_who_have_concerns_about_vaccine_safety_and_vaccination_coverage\" target=\"_blank\">numerous studies\u003c/a> show that doctors are the most trusted communicators of information about vaccines, researchers tried an intervention aimed at improving how doctors and other providers communicate with vaccine-hesitant mothers about vaccines.\u003c/p>\n\u003cp>\"The intervention was designed to involve parents and respect where they were coming from, respect that they wanted what was best for their child, and the provider wanted that, too,\" said the study's lead author, Nora Henrikson, Ph.D., a research associate with the institute. The goal, she said, was to help doctors address parents' concerns, but \"still make a strong recommendation for vaccines.\"\u003c/p>\n\u003cp>It was a lofty goal, but the upshot is this: It didn't work.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>There was no sign that what the researchers did in the study helped to reduce vaccine hesitancy.\u003c/p>\n\u003cp>But that's not the end of this approach.\u003c/p>\n\u003cp>Scientists like to say that finding out something doesn't work can be just as important as finding out when something does. Not only researchers involved with the study -- but also those who had nothing to do with it -- say that's the case here.\u003c/p>\n\u003cp>Let's look first at what Group Health Research did in its study, which they say is the first randomized trial to test improving hesitancy about vaccination -- by directly targeting doctors.\u003c/p>\n\u003cp>The centerpiece of the new approach was a 45-minute training of a \"novel communication strategy\" with doctors and providers, It was based on \"best practices in physican-patient communication, adapted to vaccine conversations,\" the authors wrote. Doctors also received written support material, monthly emails and assistance upon request.\u003c/p>\n\u003cp>The parents themselves did not receive training. The goal was to see if giving doctors better tools in communicating about vaccines would reduce hesitancy in mothers.\u003c/p>\n\u003cp>In the study, 347 mothers of healthy newborn babies were randomized into two groups: Some received care in clinics where doctors had received the training, and the rest went to clinics that did not.\u003c/p>\n\u003cp>The study lasted six months, and vaccine hesitancy declined somewhat in both groups, but there was no statistically significant difference between the two. During the study period, there was a whooping cough outbreak in Washington, as well as a new law requiring a doctor's note before opting out of vaccines. The decline in vaccine hesitancy may have been related to those events, rather than anything in the study.\u003c/p>\n\u003cp>The study was published in the journal Pediatrics and was funded by the Group Health Foundation and the Bill and Melinda Gates Foundation.\u003c/p>\n\u003cp>\"Obviously, we were hopeful that it would improve vaccine hesitancy, so we would have preferred to see a different effect,\" Henrikson said, \"but it really raised more questions about what other projects we could do moving forward.\"\u003c/p>\n\u003cp>Brendan Nyhan, a professor of government at Dartmouth, has been looking at vaccines and testing different approaches of educating parents. He was also positive about the research.\u003c/p>\n\u003cp>\"We're headed in the right direction,\" he told State of Health. \"We're starting to ask better questions, and part of real science is that sometimes our experiments don't work out the way we expect.\"\u003c/p>\n\u003cp>In any accompanying editorial, Julie Leask, Ph.D., with the University of Sydney's School of Public Health, and Paul Kinnersley, M.D., at the Institute of Medical Education at the University of Cardiff in Wales, said the study \"required careful consideration and should be seen as the start, not the end of the story.\" It pointed to a \"clear need to develop new approaches to vaccine consultation.\"\u003c/p>\n\u003cp>One of Henrikson's big questions was whether the 45-minute training was \"a big enough dose of the intervention. It's not a bad intervention,\" she said, \"but a more intense version of it might be able to make a difference.\"\u003c/p>\n\u003cp>Since the overwhelming majority of parents do vaccinate their children, Henrikson said another area for future research could be identifying ways to \"help providers make time for parents who do have more questions and need more time.\"\u003c/p>\n\u003cp>She pointed out that concerns about vaccines are not an all-or-nothing proposition. It's a continuum, she says. On one end are people who support vaccines and ensure their children receive all recommended vaccinations. On the other end are people who refuse all vaccines.\u003c/p>\n\u003cp>\"Then there are people in between,\" Henrikson said, \"and we're still understanding that. And at what point do people really have all the information they need?\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"What we want to do is build a body of evidence about how doctors can communicate about vaccines,\" Nyhan said. \"Each time we do this, we'll learn more.\"\u003c/p>\n\n",
"disqusIdentifier": "31444 http://ww2.kqed.org/stateofhealth/?p=31444",
"disqusUrl": "https://ww2.kqed.org/stateofhealth/2015/05/31/study-looks-at-new-ways-to-address-parents-vaccine-fears/",
"stats": {
"hasVideo": false,
"hasChartOrMap": false,
"hasAudio": false,
"hasPolis": false,
"wordCount": 854,
"hasGoogleForm": false,
"hasGallery": false,
"hasHearkenModule": false,
"iframeSrcs": [],
"paragraphCount": 25
},
"modified": 1433206205,
"excerpt": "But researchers say this attempt was just a first try at a worthy concept. \r\n\r\n",
"headData": {
"twImgId": "",
"twTitle": "",
"ogTitle": "",
"ogImgId": "",
"twDescription": "",
"description": "But researchers say this attempt was just a first try at a worthy concept. \r\n\r\n",
"title": "Training Doctors to Talk about Vaccines Fails to Sway Parents | KQED",
"ogDescription": "",
"schema": {
"@context": "https://schema.org",
"@type": "Article",
"headline": "Training Doctors to Talk about Vaccines Fails to Sway Parents",
"datePublished": "2015-05-31T21:27:49-07:00",
"dateModified": "2015-06-01T17:50:05-07:00",
"image": "https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"
}
},
"guestAuthors": [],
"slug": "study-looks-at-new-ways-to-address-parents-vaccine-fears",
"status": "publish",
"path": "/stateofhealth/31444/study-looks-at-new-ways-to-address-parents-vaccine-fears",
"audioTrackLength": null,
"parsedContent": [
{
"type": "contentString",
"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>After years of \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/09/11/vaccine-opt-out-rate-doubled-in-7-years-look-up-your-school-online/\" target=\"_blank\">increasing rates\u003c/a> of parents voluntarily choosing to skip vaccinations for their children, public health professionals and researchers have been looking at new ways to ease the concerns of parents who are vaccine hesitant.\u003c/p>\n\u003cp>But that turns out to be tough to do. Simply educating parents about the safety and efficacy of vaccines \u003ca href=\"http://pediatrics.aappublications.org/content/early/2014/02/25/peds.2013-2365.abstract?sid=4c82b05f-5ad9-4ab5-b91e-b187e909c237\" target=\"_blank\">doesn't increase \u003c/a>their likelihood of vaccinating their children.\u003c/p>\n\u003cp>Group Health Research Institute in Seattle tried a different approach. Since \u003ca href=\"http://www.researchgate.net/publication/6716211_Association_between_health_care_providers'_influence_on_parents_who_have_concerns_about_vaccine_safety_and_vaccination_coverage\" target=\"_blank\">numerous studies\u003c/a> show that doctors are the most trusted communicators of information about vaccines, researchers tried an intervention aimed at improving how doctors and other providers communicate with vaccine-hesitant mothers about vaccines.\u003c/p>\n\u003cp>\"The intervention was designed to involve parents and respect where they were coming from, respect that they wanted what was best for their child, and the provider wanted that, too,\" said the study's lead author, Nora Henrikson, Ph.D., a research associate with the institute. The goal, she said, was to help doctors address parents' concerns, but \"still make a strong recommendation for vaccines.\"\u003c/p>\n\u003cp>It was a lofty goal, but the upshot is this: It didn't work.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
"attributes": {
"named": {},
"numeric": []
}
},
{
"type": "component",
"content": "",
"name": "ad",
"attributes": {
"named": {
"label": "fullwidth"
},
"numeric": [
"fullwidth"
]
}
},
{
"type": "contentString",
"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>There was no sign that what the researchers did in the study helped to reduce vaccine hesitancy.\u003c/p>\n\u003cp>But that's not the end of this approach.\u003c/p>\n\u003cp>Scientists like to say that finding out something doesn't work can be just as important as finding out when something does. Not only researchers involved with the study -- but also those who had nothing to do with it -- say that's the case here.\u003c/p>\n\u003cp>Let's look first at what Group Health Research did in its study, which they say is the first randomized trial to test improving hesitancy about vaccination -- by directly targeting doctors.\u003c/p>\n\u003cp>The centerpiece of the new approach was a 45-minute training of a \"novel communication strategy\" with doctors and providers, It was based on \"best practices in physican-patient communication, adapted to vaccine conversations,\" the authors wrote. Doctors also received written support material, monthly emails and assistance upon request.\u003c/p>\n\u003cp>The parents themselves did not receive training. The goal was to see if giving doctors better tools in communicating about vaccines would reduce hesitancy in mothers.\u003c/p>\n\u003cp>In the study, 347 mothers of healthy newborn babies were randomized into two groups: Some received care in clinics where doctors had received the training, and the rest went to clinics that did not.\u003c/p>\n\u003cp>The study lasted six months, and vaccine hesitancy declined somewhat in both groups, but there was no statistically significant difference between the two. During the study period, there was a whooping cough outbreak in Washington, as well as a new law requiring a doctor's note before opting out of vaccines. The decline in vaccine hesitancy may have been related to those events, rather than anything in the study.\u003c/p>\n\u003cp>The study was published in the journal Pediatrics and was funded by the Group Health Foundation and the Bill and Melinda Gates Foundation.\u003c/p>\n\u003cp>\"Obviously, we were hopeful that it would improve vaccine hesitancy, so we would have preferred to see a different effect,\" Henrikson said, \"but it really raised more questions about what other projects we could do moving forward.\"\u003c/p>\n\u003cp>Brendan Nyhan, a professor of government at Dartmouth, has been looking at vaccines and testing different approaches of educating parents. He was also positive about the research.\u003c/p>\n\u003cp>\"We're headed in the right direction,\" he told State of Health. \"We're starting to ask better questions, and part of real science is that sometimes our experiments don't work out the way we expect.\"\u003c/p>\n\u003cp>In any accompanying editorial, Julie Leask, Ph.D., with the University of Sydney's School of Public Health, and Paul Kinnersley, M.D., at the Institute of Medical Education at the University of Cardiff in Wales, said the study \"required careful consideration and should be seen as the start, not the end of the story.\" It pointed to a \"clear need to develop new approaches to vaccine consultation.\"\u003c/p>\n\u003cp>One of Henrikson's big questions was whether the 45-minute training was \"a big enough dose of the intervention. It's not a bad intervention,\" she said, \"but a more intense version of it might be able to make a difference.\"\u003c/p>\n\u003cp>Since the overwhelming majority of parents do vaccinate their children, Henrikson said another area for future research could be identifying ways to \"help providers make time for parents who do have more questions and need more time.\"\u003c/p>\n\u003cp>She pointed out that concerns about vaccines are not an all-or-nothing proposition. It's a continuum, she says. On one end are people who support vaccines and ensure their children receive all recommended vaccinations. On the other end are people who refuse all vaccines.\u003c/p>\n\u003cp>\"Then there are people in between,\" Henrikson said, \"and we're still understanding that. And at what point do people really have all the information they need?\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"What we want to do is build a body of evidence about how doctors can communicate about vaccines,\" Nyhan said. \"Each time we do this, we'll learn more.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
"attributes": {
"named": {},
"numeric": []
}
}
],
"link": "/stateofhealth/31444/study-looks-at-new-ways-to-address-parents-vaccine-fears",
"authors": [
"240"
],
"categories": [
"stateofhealth_13"
],
"tags": [
"stateofhealth_461",
"stateofhealth_31"
],
"featImg": "stateofhealth_27308",
"label": "stateofhealth"
},
"stateofhealth_31026": {
"type": "posts",
"id": "stateofhealth_31026",
"meta": {
"index": "posts_1716263798",
"site": "stateofhealth",
"id": "31026",
"score": null,
"sort": [
1432841074000
]
},
"parent": 0,
"labelTerm": {
"site": "stateofhealth"
},
"blocks": [],
"publishDate": 1432841074,
"format": "standard",
"disqusTitle": "Schools Require Emergency Allergy Medicine, But Doctors Balk",
"title": "Schools Require Emergency Allergy Medicine, But Doctors Balk",
"headTitle": "State of Health | KQED News",
"content": "\u003cp>When a Murietta Valley Unified School District elementary student bit into a cupcake made with peanut butter in April, she quickly struggled to breathe. A school health aide grabbed a pre-loaded syringe of adrenaline from the supply cabinet, injected the girl and contained the girls' allergic reaction to peanuts until she got to the emergency room. This is exactly as a \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140SB1266\" target=\"_blank\">new California law\u003c/a> intended –- but not, in fact, how the law is playing out in many districts.\u003c/p>\n\u003caside class=\"pullquote alignright\">\"The law indemnified everybody except the doctor.\"\u003cbr>\n\u003ccite> Dr. Brett Curtis, consultant with Oakland Unified School District\u003c/cite>\u003cbr>\n\u003c/aside>\n\u003cp>Six months after the Jan. 1 law required schools to stock these pre-loaded syringes – known as \u003ca class=\"\" href=\"http://www.nlm.nih.gov/medlineplus/druginfo/meds/a603002.html\" target=\"_blank\">epinephrine automatic injectors\u003c/a> and considered the \u003ca class=\"\" href=\"https://escholarship.org/uc/item/64f526r6#page-1\" target=\"_blank\">first line treatment\u003c/a> for potentially life-threatening allergic reactions – many districts have been unable to obtain what Riverside County's Murietta Unified has: a doctor’s prescription for the devices.\u003c/p>\n\u003cp>Up and down the state, doctors have declined to write prescriptions for epinephrine auto-injectors for districts, citing liability concerns and derailing the promise of the law. A February survey of 408 school nurses by the California School Nurses Organization found that 57 percent had been unable to obtain epinephrine auto-injectors for their district, calling the inability to find a doctor to write a prescription a major obstacle.\u003c/p>\n\u003cp>Many districts have turned to city and county public health doctors as the logical prescription writers, only to be rebuffed. “They are being asked to sign these orders, but are being told by their county counsel and their risk managers that the liability risks are real,” said Kat DeBurgh, executive director of the Health Officers Association of California, a Sacramento-based membership group for city and county public health doctors.\u003c/p>\n\u003cp>The impasse has prompted the author of the law, state Sen. Robert Huff, R-Diamond Bar, to introduce follow-up legislation designed to protect physicians from prosecution if they write these prescriptions. The bill, \u003ca class=\"\" href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160SB738\" target=\"_blank\">Senate Bill 738\u003c/a>, passed the Senate this month and is in the Assembly.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Brett Curtis, a consulting physician for the Oakland Unified School District, is all for it. “The standard is to prescribe on the basis of a good faith exam,” he said. But the law asks doctors to write a prescription naming the school district as the patient, with the injectors to be used to treat a student or adult as needed – which means “a patient I’ve never seen,” Curtis said.\u003c/p>\n\u003cp>“The law indemnified everybody except the doctor,” he said.\u003c/p>\n\u003cp>His medical liability insurance company agreed. In order to write a prescription to bring Oakland Unified into compliance with the new law, Curtis took out additional liability insurance. Now he writes prescriptions for stock epinephrine auto-injectors for all 86 schools in Oakland.\u003c/p>\n\u003cp>About\u003ca href=\"http://pediatrics.aappublications.org/content/early/2011/06/16/peds.2011-0204.abstract\" target=\"_blank\"> 8 percent of children nationwide \u003c/a>have food allergies, and of those, nearly 40 percent have had a severe reaction known as \u003ca href=\"http://edsource.org/wp-admin/post.php?post=80214&action=edit\" target=\"_blank\">anaphylaxis\u003c/a>, where blood pressure drops and airways constrict. Other symptoms include hives, a swollen tongue and vomiting.\u003c/p>\n\u003cp>Severe food allergies have become an issue in schools across the state and the nation as the percentage of children who are allergic to nuts, milk, wheat and other substances has \u003ca class=\"\" href=\"http://www.cdc.gov/media/pressrel/2008/r081022.htm\" target=\"_blank\">increased\u003c/a>, according to the Centers for Disease Control, for reasons researchers \u003ca class=\"\" href=\"https://ncchildrenshospital.org/enews/foodallergyqa\" target=\"_blank\">can’t definitively explain.\u003c/a>\u003c/p>\n\u003cp>Some schools have introduced nut-free zones in school cafeterias and ingredient inspections for classroom birthday treats. But enforcement can be difficult.\u003c/p>\n\u003cp>For instance, just days before the Murietta Valley student took a bite of the peanut butter-filled cupcake, Cathy Owens, a school nurse, sent a memo to teachers stating that parents must give advance permission for their child to eat food brought in for school events. But at the classroom cupcake party, that notification never happened, Owens said.\u003c/p>\n\u003cp>The result is a lot of anxiety for parents and for school nurses like Martha Wallis, who said she has given at least four emergency epinephrine injections in the past five years in the unified districts of Moreno Valley and Lake Elsinore. A local physician was willing to write a prescription for stock epinephrine even before the law required schools to have it, she said.\u003c/p>\n\u003cp>While many students with severe allergies carry their own epinephrine auto-injectors or keep one at the school office, others don’t. And 20 percent of severe allergic reactions at school happen to children who have never been diagnosed with a severe allergy, said Dr. Marc Lerner, medical officer for the Orange County Department of Education.\u003c/p>\n\u003cp>As a school district employee, Lerner says he is covered by the district’s risk insurance. So he’s written prescriptions for epinephrine auto-injectors for 600 schools in 28 districts in Orange County, using the website \u003ca class=\"\" href=\"https://www.epipen4schools.com/\" target=\"_blank\">EpiPen4Schools.com\u003c/a>, which offers free and reduced price epinephrine auto-injectors to schools across the country.\u003c/p>\n\u003cp>Lerner is one of a group of doctors who have stepped up to write prescriptions for districts.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>At a hearing of the state Senate Judiciary Committee earlier this month, school nurse Melissa Locketz urged passage of the new legislation to dispatch physicians’ liability worries. She read five statements from fellow school nurses, including this one: “It does not seem fair that some schools are lucky to have relationships with physicians, while others can’t comply because no one will sign.”\u003c/p>\n\n",
"disqusIdentifier": "31026 http://ww2.kqed.org/stateofhealth/?p=31026",
"disqusUrl": "https://ww2.kqed.org/stateofhealth/2015/05/28/schools-require-emergency-allergy-medicine-but-doctors-balk/",
"stats": {
"hasVideo": false,
"hasChartOrMap": false,
"hasAudio": false,
"hasPolis": false,
"wordCount": 913,
"hasGoogleForm": false,
"hasGallery": false,
"hasHearkenModule": false,
"iframeSrcs": [],
"paragraphCount": 19
},
"modified": 1432851279,
"excerpt": "Proposed law would protect doctors from liability in prescribing epinephrine.",
"headData": {
"twImgId": "",
"twTitle": "",
"ogTitle": "",
"ogImgId": "",
"twDescription": "",
"description": "Proposed law would protect doctors from liability in prescribing epinephrine.",
"title": "Schools Require Emergency Allergy Medicine, But Doctors Balk | KQED",
"ogDescription": "",
"schema": {
"@context": "https://schema.org",
"@type": "Article",
"headline": "Schools Require Emergency Allergy Medicine, But Doctors Balk",
"datePublished": "2015-05-28T12:24:34-07:00",
"dateModified": "2015-05-28T15:14:39-07:00",
"image": "https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"
}
},
"guestAuthors": [],
"slug": "schools-require-emergency-allergy-medicine-but-doctors-balk",
"status": "publish",
"nprByline": "Jane Meredith Adams, EdSource Today",
"path": "/stateofhealth/31026/schools-require-emergency-allergy-medicine-but-doctors-balk",
"audioTrackLength": null,
"parsedContent": [
{
"type": "contentString",
"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>When a Murietta Valley Unified School District elementary student bit into a cupcake made with peanut butter in April, she quickly struggled to breathe. A school health aide grabbed a pre-loaded syringe of adrenaline from the supply cabinet, injected the girl and contained the girls' allergic reaction to peanuts until she got to the emergency room. This is exactly as a \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140SB1266\" target=\"_blank\">new California law\u003c/a> intended –- but not, in fact, how the law is playing out in many districts.\u003c/p>\n\u003caside class=\"pullquote alignright\">\"The law indemnified everybody except the doctor.\"\u003cbr>\n\u003ccite> Dr. Brett Curtis, consultant with Oakland Unified School District\u003c/cite>\u003cbr>\n\u003c/aside>\n\u003cp>Six months after the Jan. 1 law required schools to stock these pre-loaded syringes – known as \u003ca class=\"\" href=\"http://www.nlm.nih.gov/medlineplus/druginfo/meds/a603002.html\" target=\"_blank\">epinephrine automatic injectors\u003c/a> and considered the \u003ca class=\"\" href=\"https://escholarship.org/uc/item/64f526r6#page-1\" target=\"_blank\">first line treatment\u003c/a> for potentially life-threatening allergic reactions – many districts have been unable to obtain what Riverside County's Murietta Unified has: a doctor’s prescription for the devices.\u003c/p>\n\u003cp>Up and down the state, doctors have declined to write prescriptions for epinephrine auto-injectors for districts, citing liability concerns and derailing the promise of the law. A February survey of 408 school nurses by the California School Nurses Organization found that 57 percent had been unable to obtain epinephrine auto-injectors for their district, calling the inability to find a doctor to write a prescription a major obstacle.\u003c/p>\n\u003cp>Many districts have turned to city and county public health doctors as the logical prescription writers, only to be rebuffed. “They are being asked to sign these orders, but are being told by their county counsel and their risk managers that the liability risks are real,” said Kat DeBurgh, executive director of the Health Officers Association of California, a Sacramento-based membership group for city and county public health doctors.\u003c/p>\n\u003cp>The impasse has prompted the author of the law, state Sen. Robert Huff, R-Diamond Bar, to introduce follow-up legislation designed to protect physicians from prosecution if they write these prescriptions. The bill, \u003ca class=\"\" href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160SB738\" target=\"_blank\">Senate Bill 738\u003c/a>, passed the Senate this month and is in the Assembly.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
"attributes": {
"named": {},
"numeric": []
}
},
{
"type": "component",
"content": "",
"name": "ad",
"attributes": {
"named": {
"label": "fullwidth"
},
"numeric": [
"fullwidth"
]
}
},
{
"type": "contentString",
"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Brett Curtis, a consulting physician for the Oakland Unified School District, is all for it. “The standard is to prescribe on the basis of a good faith exam,” he said. But the law asks doctors to write a prescription naming the school district as the patient, with the injectors to be used to treat a student or adult as needed – which means “a patient I’ve never seen,” Curtis said.\u003c/p>\n\u003cp>“The law indemnified everybody except the doctor,” he said.\u003c/p>\n\u003cp>His medical liability insurance company agreed. In order to write a prescription to bring Oakland Unified into compliance with the new law, Curtis took out additional liability insurance. Now he writes prescriptions for stock epinephrine auto-injectors for all 86 schools in Oakland.\u003c/p>\n\u003cp>About\u003ca href=\"http://pediatrics.aappublications.org/content/early/2011/06/16/peds.2011-0204.abstract\" target=\"_blank\"> 8 percent of children nationwide \u003c/a>have food allergies, and of those, nearly 40 percent have had a severe reaction known as \u003ca href=\"http://edsource.org/wp-admin/post.php?post=80214&action=edit\" target=\"_blank\">anaphylaxis\u003c/a>, where blood pressure drops and airways constrict. Other symptoms include hives, a swollen tongue and vomiting.\u003c/p>\n\u003cp>Severe food allergies have become an issue in schools across the state and the nation as the percentage of children who are allergic to nuts, milk, wheat and other substances has \u003ca class=\"\" href=\"http://www.cdc.gov/media/pressrel/2008/r081022.htm\" target=\"_blank\">increased\u003c/a>, according to the Centers for Disease Control, for reasons researchers \u003ca class=\"\" href=\"https://ncchildrenshospital.org/enews/foodallergyqa\" target=\"_blank\">can’t definitively explain.\u003c/a>\u003c/p>\n\u003cp>Some schools have introduced nut-free zones in school cafeterias and ingredient inspections for classroom birthday treats. But enforcement can be difficult.\u003c/p>\n\u003cp>For instance, just days before the Murietta Valley student took a bite of the peanut butter-filled cupcake, Cathy Owens, a school nurse, sent a memo to teachers stating that parents must give advance permission for their child to eat food brought in for school events. But at the classroom cupcake party, that notification never happened, Owens said.\u003c/p>\n\u003cp>The result is a lot of anxiety for parents and for school nurses like Martha Wallis, who said she has given at least four emergency epinephrine injections in the past five years in the unified districts of Moreno Valley and Lake Elsinore. A local physician was willing to write a prescription for stock epinephrine even before the law required schools to have it, she said.\u003c/p>\n\u003cp>While many students with severe allergies carry their own epinephrine auto-injectors or keep one at the school office, others don’t. And 20 percent of severe allergic reactions at school happen to children who have never been diagnosed with a severe allergy, said Dr. Marc Lerner, medical officer for the Orange County Department of Education.\u003c/p>\n\u003cp>As a school district employee, Lerner says he is covered by the district’s risk insurance. So he’s written prescriptions for epinephrine auto-injectors for 600 schools in 28 districts in Orange County, using the website \u003ca class=\"\" href=\"https://www.epipen4schools.com/\" target=\"_blank\">EpiPen4Schools.com\u003c/a>, which offers free and reduced price epinephrine auto-injectors to schools across the country.\u003c/p>\n\u003cp>Lerner is one of a group of doctors who have stepped up to write prescriptions for districts.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>At a hearing of the state Senate Judiciary Committee earlier this month, school nurse Melissa Locketz urged passage of the new legislation to dispatch physicians’ liability worries. She read five statements from fellow school nurses, including this one: “It does not seem fair that some schools are lucky to have relationships with physicians, while others can’t comply because no one will sign.”\u003c/p>\n\n\u003c/div>\u003c/p>",
"attributes": {
"named": {},
"numeric": []
}
}
],
"link": "/stateofhealth/31026/schools-require-emergency-allergy-medicine-but-doctors-balk",
"authors": [
"byline_stateofhealth_31026"
],
"categories": [
"stateofhealth_14",
"stateofhealth_13"
],
"tags": [
"stateofhealth_96"
],
"featImg": "stateofhealth_31084",
"label": "stateofhealth"
},
"stateofhealth_30459": {
"type": "posts",
"id": "stateofhealth_30459",
"meta": {
"index": "posts_1716263798",
"site": "stateofhealth",
"id": "30459",
"score": null,
"sort": [
1432755370000
]
},
"parent": 0,
"labelTerm": {
"site": "stateofhealth",
"term": 2492
},
"blocks": [],
"publishDate": 1432755370,
"format": "image",
"disqusTitle": "PriceCheck: How Much Does A Colonoscopy Cost?",
"title": "PriceCheck: How Much Does A Colonoscopy Cost?",
"headTitle": "Price Check | State of Health | KQED News",
"content": "\u003cp>The colonoscopy: it may be the most dreaded screening test out there, and it's the next procedure we're covering as part of \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">PriceCheck\u003c/a>.\u003c/p>\n\u003cp>On PriceCheck, we're crowdsourcing prices of common health tests and procedures. KQED, along with our colleagues at \u003ca href=\"http://www.scpr.org/price-check\" target=\"_blank\">KPCC in LA\u003c/a>, and \u003ca href=\"http://clearhealthcosts.com\" target=\"_blank\">ClearHealthCosts.com,\u003c/a> a health cost transparency start up in New York, are shining a light on health care costs by asking you --members of our community -- to share what you've paid for various health care procedures.\u003c/p>\n\u003cp>We turned to crowdsourcing because health care prices are wildly variable and opaque. It sometimes stuns people to find out there is no central database of prices. Gag clauses in contracts between doctors and insurers forbid both parties to disclose prices.\u003c/p>\n\u003cp>But you can use \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">our form\u003c/a> to help bring prices into the open. Just get the \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/07/18/explaining-the-health-insurance-explanation-of-benefits/\" target=\"_blank\">explanation of benefits\u003c/a> your insurance company sent for the colonoscopy, and enter price charged, price the insurance company paid and your co-pay (which should be zero for a screening colonoscopy -- more on that below.)\u003c/p>\n\u003cp>[contextly_sidebar id=\"puvCWmnJOc4fK0T9WeE3LJOSU6tZE7it\"]Our PriceCheck database already contains entries for colonoscopy prices -- they range from $1,000-$5000 in the Bay Area. Surprised by that range? It's in line with the price variation reported both by policy experts and our community on PriceCheck for other procedures.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>After we get more shared prices (usually in a few weeks), we'll report them back to you on State of Health.\u003c/p>\n\u003cp>Under the Affordable Care Act (ACA), certain screening tests --including the colonoscopy -- are mandated to be covered at no cost to the patient. But we should all care about the wild variation in prices because as health care costs rise, health insurance premiums go up. If you have employer-sponsored health insurance, that can mean \u003ca href=\"http://www.nber.org/digest/aug05/w11063.html\" target=\"_blank\">your own part of the premium\u003c/a> will go up. Public insurance programs like Medicare and Medicaid get more expensive, too, and those are paid for through taxes.\u003c/p>\n\u003cp>Colonoscopy is \"a messy one\" for other reasons, too, says Maribeth Shannon with some irony. She specializes in market transparency and accountability at the California HealthCare Foundation.\u003c/p>\n\u003cp>She's not just referring to the procedure itself. Colonoscopy is messy because of the way it's billed. Here are some things to ask about before you go in for the procedure:\u003c/p>\n\u003cp>\u003cstrong>Screening or diagnostic\u003c/strong>: In a screening colonoscopy, a doctor threads a flexible tube with an attached camera into the colon to look for abnormalities, like a polyp. If a polyp is found, it can be removed during the procedure. After the ACA first took effect, patients who had polyps removed discovered that this action changed the colonoscopy from a \"free\" screening test to a diagnostic test, and they were \u003ca href=\"http://khn.org/news/michelle-andrews-q-and-a-on-insurance-coverage-costs/\" target=\"_blank\">on the hook for a big bill\u003c/a>.\u003c/p>\n\u003cp>\u003ca href=\"http://www.dol.gov/ebsa/faqs/faq-aca12.html\" target=\"_blank\">Federal rules\u003c/a> about the free screening colonoscopy have since been updated. \"(P)olyp removal is an integral part of a colonoscopy,\" says the federal government, and must be included at no cost to the patient. Still, Maribeth Shannon says that \"consumers should check with their health plan and ask 'what happens if a polyp is found -- you're going to treat that as preventive, right?'\"\u003c/p>\n\u003cp>\u003cstrong>[contextly_sidebar id=\"Rb89uD7TSagofaKysPbEsJRMKO4UX3rU\"]Anesthesia: \u003c/strong>You might think that anesthesia would be included with the price of a colonoscopy. After all, it's not surprising that many patients would want to be anesthetized when they are having a colonoscopy. But for quite awhile, patients were being billed for anesthesia, which by itself can run be $1,000 or more.\u003c/p>\n\u003cp>That's what happened to Gareth Tyrnauer of Sebastopol. He was delighted when his insurer sent him a letter that said a colonoscopy would be covered 100 percent. \"I'd be a fool not to do this,\" he recalls thinking. But, after the procedure, he got a $1,200 bill -- just for the anesthesia. He called his insurer's customer service to fight the bill, saying he told the representative, \"I've got a piece of paper right here and it says 'it's 100 percent covered. What part of 100 percent don't I understand?'\" He ultimately won.\u003c/p>\n\u003cp>\u003ca href=\"http://www.npr.org/sections/health-shots/2015/05/15/406969802/feds-tell-insurers-to-pay-for-anesthesia-during-screening-colonoscopies\" target=\"_blank\">Earlier this month\u003c/a>, the federal government stepped in again and \u003ca href=\"http://www.cms.gov/CCIIO/Resources/Fact-Sheets-and-FAQs/Downloads/aca_implementation_faqs26.pdf\" target=\"_blank\">issued a clarification \u003c/a>that insurers may not charge for anesthesia used in connection with a preventive colonoscopy.\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/207652658\" params=\"color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" iframe=\"true\" /]\u003c/p>\n\u003cp>\u003cstrong>In-network is key: \u003c/strong>Make sure you know in advance who is involved in the procedure, warns Dena Mendelsohn, a health policy analyst with Consumers Union in San Francisco. \"Consumers should be sure to confirm that the facility where they're going is in-network and the provider they will have is in-network.\"\u003c/p>\n\u003cp>\u003cstrong>Quality:\u003c/strong> In health care, determining quality of a procedure can be as difficult as determining how much it might cost. A strong predictor of quality is volume of procedures. A doctor or facility that has high volume is likely to be doing a higher quality job. Mendelsohn says many health insurance plans have tools for their customers on their websites and sometimes that includes volume. How much is the right amount? Hard to know, she says, but consumers could compare \"hundreds or thousands versus dozens.\"\u003c/p>\n\u003cp>Mendelsohn also recommends avoiding a large university medical center for a colonoscopy. \"Large universities are tailored toward more complicated procedures,\" she says. \"Since a screening colonoscopy is more routine, it's not necessarily the case that going to a large university will get you a better colonoscopy.\"\u003c/p>\n\u003cp>\u003cstrong>Other options: \u003c/strong>If you've been dreading have a colonoscopy, you're not alone. But there are other \u003ca href=\"http://healthfinder.gov/HealthTopics/Category/doctor-visits/screening-tests/get-tested-for-colorectal-cancer\" target=\"_blank\">non-invasive options\u003c/a> for colon cancer screening, including the fecal-occult blood test. If you've been \u003ca href=\"http://ww2.kqed.org/stateofhealth/2012/02/23/avoiding-a-colonoscopy-youre-not-alone/\" target=\"_blank\">avoiding a colonoscopy\u003c/a>, you may want to learn more about this option.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>An earlier version of this story misstated how screening and diagnostic colonoscopies were billed after some aspects of the Affordable Care Act went into effect. We regret the error.\u003c/em>\u003c/p>\n\n",
"disqusIdentifier": "30459 http://ww2.kqed.org/stateofhealth/?p=30459",
"disqusUrl": "https://ww2.kqed.org/stateofhealth/2015/05/27/pricecheck-how-much-does-a-colonoscopy-cost/",
"stats": {
"hasVideo": false,
"hasChartOrMap": false,
"hasAudio": false,
"hasPolis": false,
"wordCount": 1022,
"hasGoogleForm": false,
"hasGallery": false,
"hasHearkenModule": false,
"iframeSrcs": [],
"paragraphCount": 22
},
"modified": 1434054977,
"excerpt": "Health care prices are wildly variable. KQED is crowdsourcing prices to show exactly what procedures cost.",
"headData": {
"twImgId": "",
"twTitle": "",
"ogTitle": "",
"ogImgId": "",
"twDescription": "",
"description": "Health care prices are wildly variable. KQED is crowdsourcing prices to show exactly what procedures cost.",
"title": "PriceCheck: How Much Does A Colonoscopy Cost? | KQED",
"ogDescription": "",
"schema": {
"@context": "https://schema.org",
"@type": "Article",
"headline": "PriceCheck: How Much Does A Colonoscopy Cost?",
"datePublished": "2015-05-27T12:36:10-07:00",
"dateModified": "2015-06-11T13:36:17-07:00",
"image": "https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"
}
},
"guestAuthors": [],
"slug": "pricecheck-how-much-does-a-colonoscopy-cost",
"status": "publish",
"path": "/stateofhealth/30459/pricecheck-how-much-does-a-colonoscopy-cost",
"audioTrackLength": null,
"parsedContent": [
{
"type": "contentString",
"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The colonoscopy: it may be the most dreaded screening test out there, and it's the next procedure we're covering as part of \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">PriceCheck\u003c/a>.\u003c/p>\n\u003cp>On PriceCheck, we're crowdsourcing prices of common health tests and procedures. KQED, along with our colleagues at \u003ca href=\"http://www.scpr.org/price-check\" target=\"_blank\">KPCC in LA\u003c/a>, and \u003ca href=\"http://clearhealthcosts.com\" target=\"_blank\">ClearHealthCosts.com,\u003c/a> a health cost transparency start up in New York, are shining a light on health care costs by asking you --members of our community -- to share what you've paid for various health care procedures.\u003c/p>\n\u003cp>We turned to crowdsourcing because health care prices are wildly variable and opaque. It sometimes stuns people to find out there is no central database of prices. Gag clauses in contracts between doctors and insurers forbid both parties to disclose prices.\u003c/p>\n\u003cp>But you can use \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/23/share-your-bill-make-health-costs-transparent-in-california/\" target=\"_blank\">our form\u003c/a> to help bring prices into the open. Just get the \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/07/18/explaining-the-health-insurance-explanation-of-benefits/\" target=\"_blank\">explanation of benefits\u003c/a> your insurance company sent for the colonoscopy, and enter price charged, price the insurance company paid and your co-pay (which should be zero for a screening colonoscopy -- more on that below.)\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>Our PriceCheck database already contains entries for colonoscopy prices -- they range from $1,000-$5000 in the Bay Area. Surprised by that range? It's in line with the price variation reported both by policy experts and our community on PriceCheck for other procedures.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
"attributes": {
"named": {},
"numeric": []
}
},
{
"type": "component",
"content": "",
"name": "ad",
"attributes": {
"named": {
"label": "fullwidth"
},
"numeric": [
"fullwidth"
]
}
},
{
"type": "contentString",
"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>After we get more shared prices (usually in a few weeks), we'll report them back to you on State of Health.\u003c/p>\n\u003cp>Under the Affordable Care Act (ACA), certain screening tests --including the colonoscopy -- are mandated to be covered at no cost to the patient. But we should all care about the wild variation in prices because as health care costs rise, health insurance premiums go up. If you have employer-sponsored health insurance, that can mean \u003ca href=\"http://www.nber.org/digest/aug05/w11063.html\" target=\"_blank\">your own part of the premium\u003c/a> will go up. Public insurance programs like Medicare and Medicaid get more expensive, too, and those are paid for through taxes.\u003c/p>\n\u003cp>Colonoscopy is \"a messy one\" for other reasons, too, says Maribeth Shannon with some irony. She specializes in market transparency and accountability at the California HealthCare Foundation.\u003c/p>\n\u003cp>She's not just referring to the procedure itself. Colonoscopy is messy because of the way it's billed. Here are some things to ask about before you go in for the procedure:\u003c/p>\n\u003cp>\u003cstrong>Screening or diagnostic\u003c/strong>: In a screening colonoscopy, a doctor threads a flexible tube with an attached camera into the colon to look for abnormalities, like a polyp. If a polyp is found, it can be removed during the procedure. After the ACA first took effect, patients who had polyps removed discovered that this action changed the colonoscopy from a \"free\" screening test to a diagnostic test, and they were \u003ca href=\"http://khn.org/news/michelle-andrews-q-and-a-on-insurance-coverage-costs/\" target=\"_blank\">on the hook for a big bill\u003c/a>.\u003c/p>\n\u003cp>\u003ca href=\"http://www.dol.gov/ebsa/faqs/faq-aca12.html\" target=\"_blank\">Federal rules\u003c/a> about the free screening colonoscopy have since been updated. \"(P)olyp removal is an integral part of a colonoscopy,\" says the federal government, and must be included at no cost to the patient. Still, Maribeth Shannon says that \"consumers should check with their health plan and ask 'what happens if a polyp is found -- you're going to treat that as preventive, right?'\"\u003c/p>\n\u003cp>\u003cstrong>\u003c/p>\u003cp>\u003c/p>\u003cp>Anesthesia: \u003c/strong>You might think that anesthesia would be included with the price of a colonoscopy. After all, it's not surprising that many patients would want to be anesthetized when they are having a colonoscopy. But for quite awhile, patients were being billed for anesthesia, which by itself can run be $1,000 or more.\u003c/p>\n\u003cp>That's what happened to Gareth Tyrnauer of Sebastopol. He was delighted when his insurer sent him a letter that said a colonoscopy would be covered 100 percent. \"I'd be a fool not to do this,\" he recalls thinking. But, after the procedure, he got a $1,200 bill -- just for the anesthesia. He called his insurer's customer service to fight the bill, saying he told the representative, \"I've got a piece of paper right here and it says 'it's 100 percent covered. What part of 100 percent don't I understand?'\" He ultimately won.\u003c/p>\n\u003cp>\u003ca href=\"http://www.npr.org/sections/health-shots/2015/05/15/406969802/feds-tell-insurers-to-pay-for-anesthesia-during-screening-colonoscopies\" target=\"_blank\">Earlier this month\u003c/a>, the federal government stepped in again and \u003ca href=\"http://www.cms.gov/CCIIO/Resources/Fact-Sheets-and-FAQs/Downloads/aca_implementation_faqs26.pdf\" target=\"_blank\">issued a clarification \u003c/a>that insurers may not charge for anesthesia used in connection with a preventive colonoscopy.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cdiv class='utils-parseShortcode-shortcodes-__shortcodes__shortcodeWrapper'>\n \u003ciframe width='100%' height='166'\n scrolling='no' frameborder='no'\n src='https://w.soundcloud.com/player/?url=https://api.soundcloud.com/tracks/207652658&visual=true&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false'\n title='https://api.soundcloud.com/tracks/207652658'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\u003cstrong>In-network is key: \u003c/strong>Make sure you know in advance who is involved in the procedure, warns Dena Mendelsohn, a health policy analyst with Consumers Union in San Francisco. \"Consumers should be sure to confirm that the facility where they're going is in-network and the provider they will have is in-network.\"\u003c/p>\n\u003cp>\u003cstrong>Quality:\u003c/strong> In health care, determining quality of a procedure can be as difficult as determining how much it might cost. A strong predictor of quality is volume of procedures. A doctor or facility that has high volume is likely to be doing a higher quality job. Mendelsohn says many health insurance plans have tools for their customers on their websites and sometimes that includes volume. How much is the right amount? Hard to know, she says, but consumers could compare \"hundreds or thousands versus dozens.\"\u003c/p>\n\u003cp>Mendelsohn also recommends avoiding a large university medical center for a colonoscopy. \"Large universities are tailored toward more complicated procedures,\" she says. \"Since a screening colonoscopy is more routine, it's not necessarily the case that going to a large university will get you a better colonoscopy.\"\u003c/p>\n\u003cp>\u003cstrong>Other options: \u003c/strong>If you've been dreading have a colonoscopy, you're not alone. But there are other \u003ca href=\"http://healthfinder.gov/HealthTopics/Category/doctor-visits/screening-tests/get-tested-for-colorectal-cancer\" target=\"_blank\">non-invasive options\u003c/a> for colon cancer screening, including the fecal-occult blood test. If you've been \u003ca href=\"http://ww2.kqed.org/stateofhealth/2012/02/23/avoiding-a-colonoscopy-youre-not-alone/\" target=\"_blank\">avoiding a colonoscopy\u003c/a>, you may want to learn more about this option.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>An earlier version of this story misstated how screening and diagnostic colonoscopies were billed after some aspects of the Affordable Care Act went into effect. We regret the error.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
"attributes": {
"named": {},
"numeric": []
}
}
],
"link": "/stateofhealth/30459/pricecheck-how-much-does-a-colonoscopy-cost",
"authors": [
"240"
],
"series": [
"stateofhealth_2492"
],
"categories": [
"stateofhealth_13"
],
"tags": [
"stateofhealth_482",
"stateofhealth_841"
],
"featImg": "stateofhealth_30722",
"label": "stateofhealth_2492"
},
"stateofhealth_30382": {
"type": "posts",
"id": "stateofhealth_30382",
"meta": {
"index": "posts_1716263798",
"site": "stateofhealth",
"id": "30382",
"score": null,
"sort": [
1432744771000
]
},
"parent": 0,
"labelTerm": {
"site": "stateofhealth",
"term": 2363
},
"blocks": [],
"publishDate": 1432744771,
"format": "video",
"disqusTitle": "Follow Two Transgender People Through a Year of Transitioning (Video)",
"title": "Follow Two Transgender People Through a Year of Transitioning (Video)",
"headTitle": "Vital Signs | State of Health | KQED News",
"content": "\u003cp>\"Over the moon excited, terrified, scared, emotional.\"\u003c/p>\n\u003cp>That's how Jetta'Mae Carlisle described feeling as her sexual re-assignment surgery got closer. Carlisle says she was assigned as male at birth, but felt like she was female since she was a child. She identifies as a straight woman.\u003c/p>\n\u003cp>Jamie Nelson says he identifies \"as a transgender male who is queer.\" When I met him, he had already been taking testosterone and was getting ready for top surgery.\u003c/p>\n\u003cp>I followed Carlisle and Nelson over a year as they transitioned -- which is about much more than surgery. Watch their stories unfold and hear their dreams for their lives going forward.\u003c/p>\n\u003cp>\u003cem>This story is part of KQED’s ongoing health series \u003ca title=\"Vital Signs\" href=\"http://ww2.kqed.org/stateofhealth/series/vital-signs/\" target=\"_blank\">Vital Signs\u003c/a>.\u003c/em>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n",
"disqusIdentifier": "30382 http://ww2.kqed.org/stateofhealth/?p=30382",
"disqusUrl": "https://ww2.kqed.org/stateofhealth/2015/05/27/follow-two-transgender-people-through-a-year-of-transitioning-video/",
"stats": {
"hasVideo": false,
"hasChartOrMap": false,
"hasAudio": false,
"hasPolis": false,
"wordCount": 125,
"hasGoogleForm": false,
"hasGallery": false,
"hasHearkenModule": false,
"iframeSrcs": [],
"paragraphCount": 7
},
"modified": 1433450257,
"excerpt": "Watch their stories unfold as they transition, and hear their dreams for their lives going forward.",
"headData": {
"twImgId": "",
"twTitle": "",
"ogTitle": "",
"ogImgId": "",
"twDescription": "",
"description": "Watch their stories unfold as they transition, and hear their dreams for their lives going forward.",
"title": "Follow Two Transgender People Through a Year of Transitioning (Video) | KQED",
"ogDescription": "",
"schema": {
"@context": "https://schema.org",
"@type": "Article",
"headline": "Follow Two Transgender People Through a Year of Transitioning (Video)",
"datePublished": "2015-05-27T09:39:31-07:00",
"dateModified": "2015-06-04T13:37:37-07:00",
"image": "https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"
}
},
"guestAuthors": [],
"slug": "follow-two-transgender-people-through-a-year-of-transitioning-video",
"status": "publish",
"videoEmbed": "https://vimeo.com/128523924",
"nprByline": "Deborah Svoboda",
"path": "/stateofhealth/30382/follow-two-transgender-people-through-a-year-of-transitioning-video",
"audioTrackLength": null,
"parsedContent": [
{
"type": "contentString",
"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\"Over the moon excited, terrified, scared, emotional.\"\u003c/p>\n\u003cp>That's how Jetta'Mae Carlisle described feeling as her sexual re-assignment surgery got closer. Carlisle says she was assigned as male at birth, but felt like she was female since she was a child. She identifies as a straight woman.\u003c/p>\n\u003cp>Jamie Nelson says he identifies \"as a transgender male who is queer.\" When I met him, he had already been taking testosterone and was getting ready for top surgery.\u003c/p>\n\u003cp>I followed Carlisle and Nelson over a year as they transitioned -- which is about much more than surgery. Watch their stories unfold and hear their dreams for their lives going forward.\u003c/p>\n\u003cp>\u003cem>This story is part of KQED’s ongoing health series \u003ca title=\"Vital Signs\" href=\"http://ww2.kqed.org/stateofhealth/series/vital-signs/\" target=\"_blank\">Vital Signs\u003c/a>.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
"attributes": {
"named": {},
"numeric": []
}
},
{
"type": "component",
"content": "",
"name": "ad",
"attributes": {
"named": {
"label": "fullwidth"
},
"numeric": [
"fullwidth"
]
}
},
{
"type": "contentString",
"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
"attributes": {
"named": {},
"numeric": []
}
}
],
"link": "/stateofhealth/30382/follow-two-transgender-people-through-a-year-of-transitioning-video",
"authors": [
"byline_stateofhealth_30382"
],
"series": [
"stateofhealth_2363"
],
"categories": [
"stateofhealth_12",
"stateofhealth_13"
],
"tags": [
"stateofhealth_783"
],
"featImg": "stateofhealth_30451",
"label": "stateofhealth_2363"
},
"stateofhealth_30425": {
"type": "posts",
"id": "stateofhealth_30425",
"meta": {
"index": "posts_1716263798",
"site": "stateofhealth",
"id": "30425",
"score": null,
"sort": [
1432676458000
]
},
"parent": 0,
"labelTerm": {
"site": "stateofhealth"
},
"blocks": [],
"publishDate": 1432676458,
"format": "standard",
"disqusTitle": "Imperial County Divided Over Region's First Planned Parenthood Clinic",
"title": "Imperial County Divided Over Region's First Planned Parenthood Clinic",
"headTitle": "State of Health | KQED News",
"content": "\u003cp>The vast majority of Californians support unrestricted access to abortion and comprehensive sex education in schools.\u003c/p>\n\u003cp>But not in Imperial County, where religious groups have tried to prevent the region’s first Planned Parenthood clinic from opening.\u003c/p>\n\u003cp>Despite considerable opposition, the clinic is now providing care, but only on a limited basis.\u003c/p>\n\u003cp>\u003cstrong>New Clinic Opens\u003c/strong>\u003c/p>\n\u003cp>The new Planned Parenthood clinic sits right next to a Thai restaurant in El Centro, a city of 43,000 people 100 miles east of San Diego, near the Mexico border. Its waiting room is decorated in pastel colors, and all of the signs are in English and Spanish.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The clinic has six exam rooms and offers testing for HIV and other sexually transmitted diseases.\u003c/p>\n\u003cp>Maykent Salazar, who works as a promotora, or health educator, for Planned Parenthood, goes door-to-door in Imperial County telling people about the services that are available.\u003c/p>\n\u003cp>Salazar said family planning isn’t usually discussed around here.\u003c/p>\n\u003cp>“ ‘Cause there’s no access,\" she said. \"I mean, we have no clinics where people can talk about what they feel or what they think. It’s just taboo. It’s there, but no one talks about it.”\u003c/p>\n\u003cp>Salazar said people in Imperial County should have the same access to care as any other Californian.\u003c/p>\n\u003cp>“I think we in the Valley all deserve the right to choose what we want to do with our bodies and with our lives — that involves choosing what contraceptives we want to use, choosing if we want to have a baby or if we don’t want to have a baby, and when do we want to have him,\" she said.\u003c/p>\n\u003cp>\u003cstrong>Block That Clinic\u003c/strong>\u003c/p>\n\u003cp>But Planned Parenthood opponents have a totally different view.\u003c/p>\n\u003cp>At a meeting earlier this month of the El Centro City Council, opponents gathered outside and made their voices heard loud and clear.\u003c/p>\n\u003cp>Religious groups held what they called a “baby shower for life.” They collected donations of diapers, baby clothes, and set up anti-abortion displays.\u003c/p>\n\u003cp>Lisa Owens, who works with a Christian ministry called Woven, says she knows that some people believe in a woman’s right to choose to have an abortion.\u003c/p>\n\u003cp>“But that’s not what the Bible says,\" Owens said. \"The Bible says that God gives life and he takes life. And he’s the only one that can, and should.\"\u003c/p>\n\u003cp>\"Amen to that,\" said Chris Nunn. He’s a minister at El Centro’s Christ Community Church.\u003c/p>\n\u003cp>Nunn has urged local lawmakers to keep Planned Parenthood out of the area.\u003c/p>\n\u003cp>He said there’s nothing wrong with a new clinic coming to town.\u003c/p>\n\u003cp>“But Planned Parenthood kind of disguises itself as a clinic, and tries to come in under the guise of a clinic, in order to perform abortions, and prey on our young women,\" Nunn said. \"And that’s really what we have a problem with.”\u003c/p>\n\u003cp>Opponents like Nunn want the El Centro City Council to nullify a recently approved transfer agreement between the clinic and El Centro Regional Medical Center. Such agreements are standard between clinics and hospitals. They allow clinic patients and their records to be transferred should they suddenly need a higher level of care.\u003c/p>\n\u003cp>Nunn said the agreement is discretionary.\u003c/p>\n\u003cp>“That’s what we’re saying -- is that here in the community, that is 70 percent pro-life, is it prudent for our city-owned hospital to agree to a transfer agreement, that their constituents, by and large, would not agree with?\" Nunn said.\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/207305268\" params=\"color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" iframe=\"true\" /]\u003c/p>\n\u003cp>\u003cstrong>City Says It's Doing the Right Thing\u003c/strong>\u003c/p>\n\u003cp>Opponents may not agree with it, but El Centro has no legal right to deny the transfer agreement. That’s the opinion of an independent legal review the city recently obtained.\u003c/p>\n\u003cp>El Centro city manager Ruben Duran said he’s familiar with opponents’ views. After all, in such a small town, he knows most Planned Parenthood critics personally.\u003c/p>\n\u003cp>Nonetheless, Duran said he and other city officials are doing the right thing.\u003c/p>\n\u003cp>“Actually, this goes back to the \u003ca href=\"ftp://www.leginfo.ca.gov/pub/01-02/bill/sen/sb_1301-1350/sb_1301_bill_20020906_chaptered.html\" target=\"_blank\">Reproductive Protection Act\u003c/a>,\" Duran said. \"It says that abortions are allowed in this state, and they are a protected right in this state. We’re following the law.”\u003c/p>\n\u003cp>\u003cstrong>Planned Parenthood Sues City\u003c/strong>\u003c/p>\n\u003cp>But not exactly, argues Planned Parenthood.\u003c/p>\n\u003cp>For now, the clinic can offer all of its services in El Centro except abortions, and the clinic is only allowed to operate 20 hours a week.\u003c/p>\n\u003cp>That’s because while the city has issued an occupancy permit, the city’s fire chief has refused to sign off on the clinic’s final fire safety clearance. The chief said it should be reclassified as an outpatient surgery center, which would require a pricey fire suppression system.\u003c/p>\n\u003cp>The city says it’s seeking guidance from the state on this issue.\u003c/p>\n\u003cp>But Planned Parenthood said it's fed up and is suing the chief and the city. It’s asking a judge to compel the chief to issue the final permit.\u003c/p>\n\u003cp>\u003cstrong>Teen Pregnancy Problem\u003c/strong>\u003c/p>\n\u003cp>In the meantime, 21-year-old Ariana Gonzalez believes Imperial Valley really needs Planned Parenthood.\u003c/p>\n\u003cp>She grew up in El Centro. Gonzalez is expecting her second child; she had her first when she was 16 and still in high school.\u003c/p>\n\u003cp>Gonzalez said it’s about time someone taught local teens the facts of life.\u003c/p>\n\u003cp>“I think education is the key factor in changing behaviors,\" she said. \"If you don’t know, then what’s to prevent you from going out and having unprotected sex?”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>That’s a big problem in Imperial County, where the teen pregnancy rate is 70 percent higher than the statewide average.\u003c/p>\n\n",
"disqusIdentifier": "30425 http://ww2.kqed.org/stateofhealth/?p=30425",
"disqusUrl": "https://ww2.kqed.org/stateofhealth/2015/05/26/imperial-county-divided-over-regions-first-planned-parenthood-clinic/",
"stats": {
"hasVideo": false,
"hasChartOrMap": false,
"hasAudio": false,
"hasPolis": false,
"wordCount": 1010,
"hasGoogleForm": false,
"hasGallery": false,
"hasHearkenModule": false,
"iframeSrcs": [],
"paragraphCount": 44
},
"modified": 1432677144,
"excerpt": "Despite opposition from religious groups, the clinic is now providing care, but only on a limited basis.",
"headData": {
"twImgId": "",
"twTitle": "",
"ogTitle": "",
"ogImgId": "",
"twDescription": "",
"description": "Despite opposition from religious groups, the clinic is now providing care, but only on a limited basis.",
"title": "Imperial County Divided Over Region's First Planned Parenthood Clinic | KQED",
"ogDescription": "",
"schema": {
"@context": "https://schema.org",
"@type": "Article",
"headline": "Imperial County Divided Over Region's First Planned Parenthood Clinic",
"datePublished": "2015-05-26T14:40:58-07:00",
"dateModified": "2015-05-26T14:52:24-07:00",
"image": "https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"
}
},
"guestAuthors": [],
"slug": "imperial-county-divided-over-regions-first-planned-parenthood-clinic",
"status": "publish",
"nprByline": "Kenny Goldberg, KPBS",
"path": "/stateofhealth/30425/imperial-county-divided-over-regions-first-planned-parenthood-clinic",
"audioTrackLength": null,
"parsedContent": [
{
"type": "contentString",
"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The vast majority of Californians support unrestricted access to abortion and comprehensive sex education in schools.\u003c/p>\n\u003cp>But not in Imperial County, where religious groups have tried to prevent the region’s first Planned Parenthood clinic from opening.\u003c/p>\n\u003cp>Despite considerable opposition, the clinic is now providing care, but only on a limited basis.\u003c/p>\n\u003cp>\u003cstrong>New Clinic Opens\u003c/strong>\u003c/p>\n\u003cp>The new Planned Parenthood clinic sits right next to a Thai restaurant in El Centro, a city of 43,000 people 100 miles east of San Diego, near the Mexico border. Its waiting room is decorated in pastel colors, and all of the signs are in English and Spanish.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
"attributes": {
"named": {},
"numeric": []
}
},
{
"type": "component",
"content": "",
"name": "ad",
"attributes": {
"named": {
"label": "fullwidth"
},
"numeric": [
"fullwidth"
]
}
},
{
"type": "contentString",
"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The clinic has six exam rooms and offers testing for HIV and other sexually transmitted diseases.\u003c/p>\n\u003cp>Maykent Salazar, who works as a promotora, or health educator, for Planned Parenthood, goes door-to-door in Imperial County telling people about the services that are available.\u003c/p>\n\u003cp>Salazar said family planning isn’t usually discussed around here.\u003c/p>\n\u003cp>“ ‘Cause there’s no access,\" she said. \"I mean, we have no clinics where people can talk about what they feel or what they think. It’s just taboo. It’s there, but no one talks about it.”\u003c/p>\n\u003cp>Salazar said people in Imperial County should have the same access to care as any other Californian.\u003c/p>\n\u003cp>“I think we in the Valley all deserve the right to choose what we want to do with our bodies and with our lives — that involves choosing what contraceptives we want to use, choosing if we want to have a baby or if we don’t want to have a baby, and when do we want to have him,\" she said.\u003c/p>\n\u003cp>\u003cstrong>Block That Clinic\u003c/strong>\u003c/p>\n\u003cp>But Planned Parenthood opponents have a totally different view.\u003c/p>\n\u003cp>At a meeting earlier this month of the El Centro City Council, opponents gathered outside and made their voices heard loud and clear.\u003c/p>\n\u003cp>Religious groups held what they called a “baby shower for life.” They collected donations of diapers, baby clothes, and set up anti-abortion displays.\u003c/p>\n\u003cp>Lisa Owens, who works with a Christian ministry called Woven, says she knows that some people believe in a woman’s right to choose to have an abortion.\u003c/p>\n\u003cp>“But that’s not what the Bible says,\" Owens said. \"The Bible says that God gives life and he takes life. And he’s the only one that can, and should.\"\u003c/p>\n\u003cp>\"Amen to that,\" said Chris Nunn. He’s a minister at El Centro’s Christ Community Church.\u003c/p>\n\u003cp>Nunn has urged local lawmakers to keep Planned Parenthood out of the area.\u003c/p>\n\u003cp>He said there’s nothing wrong with a new clinic coming to town.\u003c/p>\n\u003cp>“But Planned Parenthood kind of disguises itself as a clinic, and tries to come in under the guise of a clinic, in order to perform abortions, and prey on our young women,\" Nunn said. \"And that’s really what we have a problem with.”\u003c/p>\n\u003cp>Opponents like Nunn want the El Centro City Council to nullify a recently approved transfer agreement between the clinic and El Centro Regional Medical Center. Such agreements are standard between clinics and hospitals. They allow clinic patients and their records to be transferred should they suddenly need a higher level of care.\u003c/p>\n\u003cp>Nunn said the agreement is discretionary.\u003c/p>\n\u003cp>“That’s what we’re saying -- is that here in the community, that is 70 percent pro-life, is it prudent for our city-owned hospital to agree to a transfer agreement, that their constituents, by and large, would not agree with?\" Nunn said.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cdiv class='utils-parseShortcode-shortcodes-__shortcodes__shortcodeWrapper'>\n \u003ciframe width='100%' height='166'\n scrolling='no' frameborder='no'\n src='https://w.soundcloud.com/player/?url=https://api.soundcloud.com/tracks/207305268&visual=true&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false'\n title='https://api.soundcloud.com/tracks/207305268'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\u003cstrong>City Says It's Doing the Right Thing\u003c/strong>\u003c/p>\n\u003cp>Opponents may not agree with it, but El Centro has no legal right to deny the transfer agreement. That’s the opinion of an independent legal review the city recently obtained.\u003c/p>\n\u003cp>El Centro city manager Ruben Duran said he’s familiar with opponents’ views. After all, in such a small town, he knows most Planned Parenthood critics personally.\u003c/p>\n\u003cp>Nonetheless, Duran said he and other city officials are doing the right thing.\u003c/p>\n\u003cp>“Actually, this goes back to the \u003ca href=\"ftp://www.leginfo.ca.gov/pub/01-02/bill/sen/sb_1301-1350/sb_1301_bill_20020906_chaptered.html\" target=\"_blank\">Reproductive Protection Act\u003c/a>,\" Duran said. \"It says that abortions are allowed in this state, and they are a protected right in this state. We’re following the law.”\u003c/p>\n\u003cp>\u003cstrong>Planned Parenthood Sues City\u003c/strong>\u003c/p>\n\u003cp>But not exactly, argues Planned Parenthood.\u003c/p>\n\u003cp>For now, the clinic can offer all of its services in El Centro except abortions, and the clinic is only allowed to operate 20 hours a week.\u003c/p>\n\u003cp>That’s because while the city has issued an occupancy permit, the city’s fire chief has refused to sign off on the clinic’s final fire safety clearance. The chief said it should be reclassified as an outpatient surgery center, which would require a pricey fire suppression system.\u003c/p>\n\u003cp>The city says it’s seeking guidance from the state on this issue.\u003c/p>\n\u003cp>But Planned Parenthood said it's fed up and is suing the chief and the city. It’s asking a judge to compel the chief to issue the final permit.\u003c/p>\n\u003cp>\u003cstrong>Teen Pregnancy Problem\u003c/strong>\u003c/p>\n\u003cp>In the meantime, 21-year-old Ariana Gonzalez believes Imperial Valley really needs Planned Parenthood.\u003c/p>\n\u003cp>She grew up in El Centro. Gonzalez is expecting her second child; she had her first when she was 16 and still in high school.\u003c/p>\n\u003cp>Gonzalez said it’s about time someone taught local teens the facts of life.\u003c/p>\n\u003cp>“I think education is the key factor in changing behaviors,\" she said. \"If you don’t know, then what’s to prevent you from going out and having unprotected sex?”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>That’s a big problem in Imperial County, where the teen pregnancy rate is 70 percent higher than the statewide average.\u003c/p>\n\n\u003c/div>\u003c/p>",
"attributes": {
"named": {},
"numeric": []
}
}
],
"link": "/stateofhealth/30425/imperial-county-divided-over-regions-first-planned-parenthood-clinic",
"authors": [
"byline_stateofhealth_30425"
],
"categories": [
"stateofhealth_11",
"stateofhealth_13"
],
"tags": [
"stateofhealth_160"
],
"featImg": "stateofhealth_30429",
"label": "stateofhealth"
},
"stateofhealth_30359": {
"type": "posts",
"id": "stateofhealth_30359",
"meta": {
"index": "posts_1716263798",
"site": "stateofhealth",
"id": "30359",
"score": null,
"sort": [
1432661568000
]
},
"parent": 0,
"labelTerm": {
"site": "stateofhealth"
},
"blocks": [],
"publishDate": 1432661568,
"format": "standard",
"disqusTitle": "Delayed Umbilical Cord Clamping May Benefit Children Years Later",
"title": "Delayed Umbilical Cord Clamping May Benefit Children Years Later",
"headTitle": "State of Health | KQED News",
"content": "\u003cp>A couple extra minutes attached to the umbilical cord at birth may translate into a small boost in neurodevelopment several years later, a study suggests.\u003c/p>\n\u003cp>Children whose cords were cut more than three minutes after birth had slightly higher social skills and fine motor skills than those whose cords were cut within 10 seconds. The results showed no differences in IQ.\u003c/p>\n\u003cp>\"There is growing evidence from a number of studies that all infants, those born at term and those born early, benefit from receiving extra blood from the placenta at birth,\" said \u003ca href=\"http://www.sussex.ac.uk/profiles/197709\" target=\"_blank\">Dr. Heike Rabe\u003c/a>, a neonatologist at Brighton & Sussex Medical School in England. Rabe's editorial accompanied the \u003ca href=\"http://dx.doi.org/10.1001/jamapediatrics.2015.0358\" target=\"_blank\">study\u003c/a> published Tuesday in the journal \u003cem>JAMA Pediatrics\u003c/em>.\u003c/p>\n\u003cp>Delaying the clamping of the cord allows more blood to transfer from the placenta to the infant, sometimes increasing the infant's blood volume by up to a third. The iron in the blood increases infants' iron storage, and iron is essential for healthy brain development.\u003c/p>\n\u003cp>\"The extra blood at birth helps the baby to cope better with the transition from life in the womb, where everything is provided for them by the placenta and the mother, to the outside world,\" Rabe said. \"Their lungs get more blood so that the exchange of oxygen into the blood can take place smoothly.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Past studies have shown \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/25831651\" target=\"_blank\">higher levels of iron\u003c/a> and \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/23843134\" target=\"_blank\">other positive effects\u003c/a> later in infancy among babies whose cords were clamped after several minutes, but few studies have looked at results past infancy.\u003c/p>\n\u003cp>In this study, researchers randomly assigned half of 263 healthy Swedish full-term newborns to have their cords clamped more than three minutes after birth. The other half were clamped less than 10 seconds after birth.\u003c/p>\n\u003cp>Four years later, the children underwent a series of assessments for IQ, motor skills, social skills, problem-solving, communication skills and behavior. Those with delayed cord clamping showed modestly higher scores in social skills and fine motor skills. When separated by sex, only the boys showed statistically significant improvement.\u003c/p>\n\u003cp>\"We don't know exactly why, but speculate that girls receive extra protection through higher estrogen levels whilst being in the womb,\" Rabe said. \"The results in term infants are consistent with those of follow-up in preterm infants.\"\u003c/p>\n\u003cp>Delayed cord clamping has garnered more attention in the past few years for its potential benefits to the newborn. Until recently, clinicians believed early clamping reduced the risk of hemorrhaging in the mother, but \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/25404605\" target=\"_blank\">research hasn't borne\u003c/a> that out.\u003c/p>\n\u003cp>Much of the research has focused on \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/25984654\" target=\"_blank\">preterm infants,\u003c/a> who appear to \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/24901269\" target=\"_blank\">benefit most\u003c/a> from delayed cord clamping, Rabe said. Preemies who had delayed cord clamping tend to have better blood pressure in the days immediately after birth, need fewer drugs to support blood pressure, need fewer blood transfusions, have less bleeding into the brain and have a lower risk of \u003ca href=\"http://www.nlm.nih.gov/medlineplus/ency/article/001148.htm\" target=\"_blank\">necrotizing enterocolitis\u003c/a>, a life-threatening bowel injury, she said.\u003c/p>\n\u003cp>This study is among the few looking at healthy, full-term infants in a country high in resources, as opposed to developing countries where iron deficiency may be more likely.\u003c/p>\n\u003cp>The American Congress of Obstetricians and Gynecologists has \u003ca href=\"http://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Timing-of-Umbilical-Cord-Clamping-After-Birth\" target=\"_blank\">not yet endorsed the practice\u003c/a>, citing \u003ca href=\"http://www.acog.org/About-ACOG/News-Room/News-Releases/2012/Time-to-Clamp-the-Cord\">insufficient\u003c/a> evidence for full-term infants. The World Health Organization \u003ca href=\"http://www.who.int/elena/titles/full_recommendations/cord_clamping/en/\" target=\"_blank\">recommends delayed cord clamping\u003c/a> of not less than one minute.\u003c/p>\n\u003cp>It is unclear if the practice could harm infants' health. Some studies have found a \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/23843134\" target=\"_blank\">higher risk of jaundice\u003c/a>, a build-up of bilirubin in the blood from the breakdown of red blood cells. Jaundice is treated with blue light therapy and \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/25831651\" target=\"_blank\">rarely has serious complications\u003c/a>.\u003c/p>\n\u003cp>Another potential risk is a condition called polycythemia, a very high red blood cell count, said \u003ca href=\"http://www.chop.edu/doctors/lorch-scott-a#.VWR3YtJVhBc\">Dr. Scott Lorch\u003c/a>, an associate professor of pediatrics at the University of Pennsylvania Perelman School of Medicine.\u003c/p>\n\u003cp>\"Polycythemia can have medical consequences for the infant, including blood clots, respiratory distress and even strokes in the worst case scenario,\" Lorch said. Some studies have found \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/17307809\" target=\"_blank\">higher levels of red blood cells\u003c/a> in babies with delayed cord clamping, but there were no complications.\u003c/p>\n\u003cp>Lorch also pointed out that this study involved a mostly homogenous population in a country outside the U.S.\u003c/p>\n\u003cp>\"We should see whether similar effects are seen in higher-risk populations, such as the low socioeconomic population, racial and ethnic minorities and those at higher risk for neurodevelopmental delay,\" Lorch said.\u003c/p>\n\u003cp>So far, studies on delayed cord clamping have excluded infants born in distress, such as those with breathing difficulties or other problems. But Rabe said these infants may actually benefit most from the practice.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>These babies often need more blood volume to help with blood pressure, breathing and circulation problems, Rabe said. \"Also, the placental blood is rich with stem cells, which could help to repair any brain damage the baby might have suffered during a difficult birth,\" she added. \"Milking of the cord would be the easiest way to get the extra blood into the baby quickly in an emergency situation.\"\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2015 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Delayed+Umbilical+Cord+Clamping+May+Benefit+Children+Years+Later&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n",
"disqusIdentifier": "30359 http://ww2.kqed.org/stateofhealth/?p=30359",
"disqusUrl": "https://ww2.kqed.org/stateofhealth/2015/05/26/delayed-umbilical-cord-clamping-may-benefit-children-years-later/",
"stats": {
"hasVideo": false,
"hasChartOrMap": false,
"hasAudio": false,
"hasPolis": false,
"wordCount": 839,
"hasGoogleForm": false,
"hasGallery": false,
"hasHearkenModule": false,
"iframeSrcs": [],
"paragraphCount": 22
},
"modified": 1432662381,
"excerpt": "Extra minutes attached to the umbilical cord at birth may slightly boost social and motor skills at age 4. ",
"headData": {
"twImgId": "",
"twTitle": "",
"ogTitle": "",
"ogImgId": "",
"twDescription": "",
"description": "Extra minutes attached to the umbilical cord at birth may slightly boost social and motor skills at age 4. ",
"title": "Delayed Umbilical Cord Clamping May Benefit Children Years Later | KQED",
"ogDescription": "",
"schema": {
"@context": "https://schema.org",
"@type": "Article",
"headline": "Delayed Umbilical Cord Clamping May Benefit Children Years Later",
"datePublished": "2015-05-26T10:32:48-07:00",
"dateModified": "2015-05-26T10:46:21-07:00",
"image": "https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"
}
},
"guestAuthors": [],
"slug": "delayed-umbilical-cord-clamping-may-benefit-children-years-later",
"status": "publish",
"nprApiLink": "http://api.npr.org/query?id=409697568&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004",
"nprByline": "Tara Haelle, NPR",
"nprStoryDate": "Tue, 26 May 2015 12:06:25 -0400",
"nprLastModifiedDate": "Tue, 26 May 2015 12:06:25 -0400",
"nprHtmlLink": "http://www.npr.org/sections/health-shots/2015/05/26/409697568/delayed-umbilical-cord-clamping-may-benefit-children-years-later?ft=nprml&f=409697568",
"nprStoryId": "409697568",
"nprRetrievedStory": "1",
"nprPubDate": "Tue, 26 May 2015 12:06:00 -0400",
"path": "/stateofhealth/30359/delayed-umbilical-cord-clamping-may-benefit-children-years-later",
"audioTrackLength": null,
"parsedContent": [
{
"type": "contentString",
"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>A couple extra minutes attached to the umbilical cord at birth may translate into a small boost in neurodevelopment several years later, a study suggests.\u003c/p>\n\u003cp>Children whose cords were cut more than three minutes after birth had slightly higher social skills and fine motor skills than those whose cords were cut within 10 seconds. The results showed no differences in IQ.\u003c/p>\n\u003cp>\"There is growing evidence from a number of studies that all infants, those born at term and those born early, benefit from receiving extra blood from the placenta at birth,\" said \u003ca href=\"http://www.sussex.ac.uk/profiles/197709\" target=\"_blank\">Dr. Heike Rabe\u003c/a>, a neonatologist at Brighton & Sussex Medical School in England. Rabe's editorial accompanied the \u003ca href=\"http://dx.doi.org/10.1001/jamapediatrics.2015.0358\" target=\"_blank\">study\u003c/a> published Tuesday in the journal \u003cem>JAMA Pediatrics\u003c/em>.\u003c/p>\n\u003cp>Delaying the clamping of the cord allows more blood to transfer from the placenta to the infant, sometimes increasing the infant's blood volume by up to a third. The iron in the blood increases infants' iron storage, and iron is essential for healthy brain development.\u003c/p>\n\u003cp>\"The extra blood at birth helps the baby to cope better with the transition from life in the womb, where everything is provided for them by the placenta and the mother, to the outside world,\" Rabe said. \"Their lungs get more blood so that the exchange of oxygen into the blood can take place smoothly.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
"attributes": {
"named": {},
"numeric": []
}
},
{
"type": "component",
"content": "",
"name": "ad",
"attributes": {
"named": {
"label": "fullwidth"
},
"numeric": [
"fullwidth"
]
}
},
{
"type": "contentString",
"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Past studies have shown \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/25831651\" target=\"_blank\">higher levels of iron\u003c/a> and \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/23843134\" target=\"_blank\">other positive effects\u003c/a> later in infancy among babies whose cords were clamped after several minutes, but few studies have looked at results past infancy.\u003c/p>\n\u003cp>In this study, researchers randomly assigned half of 263 healthy Swedish full-term newborns to have their cords clamped more than three minutes after birth. The other half were clamped less than 10 seconds after birth.\u003c/p>\n\u003cp>Four years later, the children underwent a series of assessments for IQ, motor skills, social skills, problem-solving, communication skills and behavior. Those with delayed cord clamping showed modestly higher scores in social skills and fine motor skills. When separated by sex, only the boys showed statistically significant improvement.\u003c/p>\n\u003cp>\"We don't know exactly why, but speculate that girls receive extra protection through higher estrogen levels whilst being in the womb,\" Rabe said. \"The results in term infants are consistent with those of follow-up in preterm infants.\"\u003c/p>\n\u003cp>Delayed cord clamping has garnered more attention in the past few years for its potential benefits to the newborn. Until recently, clinicians believed early clamping reduced the risk of hemorrhaging in the mother, but \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/25404605\" target=\"_blank\">research hasn't borne\u003c/a> that out.\u003c/p>\n\u003cp>Much of the research has focused on \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/25984654\" target=\"_blank\">preterm infants,\u003c/a> who appear to \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/24901269\" target=\"_blank\">benefit most\u003c/a> from delayed cord clamping, Rabe said. Preemies who had delayed cord clamping tend to have better blood pressure in the days immediately after birth, need fewer drugs to support blood pressure, need fewer blood transfusions, have less bleeding into the brain and have a lower risk of \u003ca href=\"http://www.nlm.nih.gov/medlineplus/ency/article/001148.htm\" target=\"_blank\">necrotizing enterocolitis\u003c/a>, a life-threatening bowel injury, she said.\u003c/p>\n\u003cp>This study is among the few looking at healthy, full-term infants in a country high in resources, as opposed to developing countries where iron deficiency may be more likely.\u003c/p>\n\u003cp>The American Congress of Obstetricians and Gynecologists has \u003ca href=\"http://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Timing-of-Umbilical-Cord-Clamping-After-Birth\" target=\"_blank\">not yet endorsed the practice\u003c/a>, citing \u003ca href=\"http://www.acog.org/About-ACOG/News-Room/News-Releases/2012/Time-to-Clamp-the-Cord\">insufficient\u003c/a> evidence for full-term infants. The World Health Organization \u003ca href=\"http://www.who.int/elena/titles/full_recommendations/cord_clamping/en/\" target=\"_blank\">recommends delayed cord clamping\u003c/a> of not less than one minute.\u003c/p>\n\u003cp>It is unclear if the practice could harm infants' health. Some studies have found a \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/23843134\" target=\"_blank\">higher risk of jaundice\u003c/a>, a build-up of bilirubin in the blood from the breakdown of red blood cells. Jaundice is treated with blue light therapy and \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/25831651\" target=\"_blank\">rarely has serious complications\u003c/a>.\u003c/p>\n\u003cp>Another potential risk is a condition called polycythemia, a very high red blood cell count, said \u003ca href=\"http://www.chop.edu/doctors/lorch-scott-a#.VWR3YtJVhBc\">Dr. Scott Lorch\u003c/a>, an associate professor of pediatrics at the University of Pennsylvania Perelman School of Medicine.\u003c/p>\n\u003cp>\"Polycythemia can have medical consequences for the infant, including blood clots, respiratory distress and even strokes in the worst case scenario,\" Lorch said. Some studies have found \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/17307809\" target=\"_blank\">higher levels of red blood cells\u003c/a> in babies with delayed cord clamping, but there were no complications.\u003c/p>\n\u003cp>Lorch also pointed out that this study involved a mostly homogenous population in a country outside the U.S.\u003c/p>\n\u003cp>\"We should see whether similar effects are seen in higher-risk populations, such as the low socioeconomic population, racial and ethnic minorities and those at higher risk for neurodevelopmental delay,\" Lorch said.\u003c/p>\n\u003cp>So far, studies on delayed cord clamping have excluded infants born in distress, such as those with breathing difficulties or other problems. But Rabe said these infants may actually benefit most from the practice.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>These babies often need more blood volume to help with blood pressure, breathing and circulation problems, Rabe said. \"Also, the placental blood is rich with stem cells, which could help to repair any brain damage the baby might have suffered during a difficult birth,\" she added. \"Milking of the cord would be the easiest way to get the extra blood into the baby quickly in an emergency situation.\"\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2015 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Delayed+Umbilical+Cord+Clamping+May+Benefit+Children+Years+Later&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n\u003c/div>\u003c/p>",
"attributes": {
"named": {},
"numeric": []
}
}
],
"link": "/stateofhealth/30359/delayed-umbilical-cord-clamping-may-benefit-children-years-later",
"authors": [
"byline_stateofhealth_30359"
],
"categories": [
"stateofhealth_12",
"stateofhealth_13"
],
"tags": [
"stateofhealth_96",
"stateofhealth_461"
],
"featImg": "stateofhealth_30360",
"label": "stateofhealth"
},
"stateofhealth_29198": {
"type": "posts",
"id": "stateofhealth_29198",
"meta": {
"index": "posts_1716263798",
"site": "stateofhealth",
"id": "29198",
"score": null,
"sort": [
1432481401000
]
},
"parent": 0,
"labelTerm": {
"site": "stateofhealth"
},
"blocks": [],
"publishDate": 1432481401,
"format": "standard",
"disqusTitle": "Despite Efforts, ER Visits Spike in California Kids with Asthma",
"title": "Despite Efforts, ER Visits Spike in California Kids with Asthma",
"headTitle": "State of Health | KQED News",
"content": "\u003cp>Children in California increasingly are flocking to emergency rooms for treatment of asthma, despite millions of dollars spent on programs to control the disease.\u003c/p>\n\u003cp>Statewide, the rates of ER visits for asthma symptoms rose by about 18 percent for California children ages 5 to 17 and by 6 percent for children under 5 between 2005 and 2012, according to a Kaiser Health News analysis of the \u003ca href=\"http://www.ehib.org/page.jsp?page_key=124\" target=\"_blank\">latest available rates by county\u003c/a>.\u003c/p>\n\u003cp>In some parts of the state, especially the Central Valley, the increases were far higher. The rate of emergency room visits for children 5 and older more than doubled in rural Madera County and nearly doubled In Merced. In Sacramento County, they rose by 48 percent and in Los Angeles, the largest county in the nation, by 17 percent.\u003c/p>\n\u003cp>All told, more than 72,000 California children under 18 visited the ER for asthma in 2012.\u003c/p>\n\u003cp>\"There's clearly more work to be done if this many kids are going to the emergency department,\" said Anne Kelsey Lamb, director of the Regional Asthma Management and Prevention program of the Oakland-based Public Health Institute. \"We know a lot about what works. We absolutely should be able to reduce the rates we're seeing.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>At the national level, asthma-related emergency room visit rates have declined in recent years, according to federal health data through 2010, the latest available.\u003c/p>\n\u003cp>Although ER visits declined in some counties, including Alameda, San Mateo and Marin, the overall rise in California has frustrated public health experts who have spent millions of dollars and countless hours to improve and expand asthma prevention programs around the state. The state and federal governments alone spend $1.54 million annually on such projects in California, including grants to schools to improve indoor air quality and training community health workers.\u003c/p>\n\u003cp>The good news is fewer kids are actually being admitted into hospitals. Overnight-or-longer stays are \u003ca href=\"http://www.kidsdata.org/topic/239/asthma-hospitalizations/trend#fmt=2298&loc=2&tf=1,73&ch=790&pdist=7\" target=\"_blank\">declining statewide\u003c/a> and nationally. That's due largely to better medicines and more aggressive treatment in the ER, asthma specialists say.\u003c/p>\n\u003cp>The reasons for the increase in ER visits are complex, experts say. They include parents not properly administering medications, poverty and inadequate insurance coverage, persistently high levels of indoor and outdoor pollution in some regions and the limited reach of programs that seek to manage symptoms or prevent them.\u003c/p>\n\u003cfigure id=\"attachment_29220\" class=\"wp-caption alignright\" style=\"max-width: 770px\">\u003cimg class=\"wp-image-29220 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/05/county-asthma-rates_0-to-4_final_052215_770.jpg\" alt=\"Source: Kaiser Health News\" width=\"770\" height=\"737\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/05/county-asthma-rates_0-to-4_final_052215_770.jpg 770w, https://ww2.kqed.org/app/uploads/sites/27/2015/05/county-asthma-rates_0-to-4_final_052215_770-400x383.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/05/county-asthma-rates_0-to-4_final_052215_770-32x32.jpg 32w\" sizes=\"(max-width: 770px) 100vw, 770px\">\u003cfigcaption class=\"wp-caption-text\">Source: Kaiser Health News\u003c/figcaption>\u003c/figure>\n\u003cp>The rising rates don’t seem to reflect an actual increase in the respiratory disease – about 15 percent of California children have been diagnosed with asthma, a number that has remained \u003ca href=\"http://www.kidsdata.org/topic/238/asthma/trend#fmt=97&loc=2&tf=4,77\" target=\"_blank\">fairly steady\u003c/a> since 2001.\u003c/p>\n\u003cfigure id=\"attachment_29221\" class=\"wp-caption alignright\" style=\"max-width: 770px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/05/county-asthma-rates_5-to-17_final_052215_770.jpg\" target=\"_blank\">\u003cimg class=\"wp-image-29221 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/05/county-asthma-rates_5-to-17_final_052215_770.jpg\" alt=\"county-asthma-rates_5-to-17_final_052215_770\" width=\"770\" height=\"737\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/05/county-asthma-rates_5-to-17_final_052215_770.jpg 770w, https://ww2.kqed.org/app/uploads/sites/27/2015/05/county-asthma-rates_5-to-17_final_052215_770-400x383.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/05/county-asthma-rates_5-to-17_final_052215_770-32x32.jpg 32w\" sizes=\"(max-width: 770px) 100vw, 770px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Source: Kaiser Health News\u003c/figcaption>\u003c/figure>\n\u003cp>The rates of ER visits vary widely by county, from a high of 300 visits per 10,000 children under age 5 (Madera County) to a low of 32 (Sutter County) in 2012. Younger children visit the ER at higher rates because they are more likely to have undiagnosed asthma and because their lung function is more difficult to measure, complicating the task of finding the right combination of medicines, Kelsey Lamb said.\u003c/p>\n\u003cp>Some families seek treatment in the ER for symptoms that easily could be dealt with in a clinic because they can’t get a timely doctor's appointment or don't have a regular doctor – especially those without health insurance. Sometimes, a bad cold and flu season can aggravate asthma that is usually well-controlled.\u003c/p>\n\u003cp>Affected children often live in homes with dust, mold or pets, which trigger asthma symptoms. They may need two inhalers – one for school and one for home – but insurance sometimes only pays for one.\u003c/p>\n\u003cp>In the Central Valley, persistent poverty and outdoor air pollution levels combine to produce the highest rates of ER visits for childhood asthma in the state.\u003c/p>\n\u003cp>While particulate matter and ozone air pollution levels \u003ca href=\"http://www.kidsdata.org/topic/525/environment-airquality-ozone/trend#fmt=1086&loc=2,357,364,362,356,354&tf=4,64%20(\" target=\"_blank\">are declining somewhat\u003c/a> in the region, they still can be high enough to trigger asthma attacks, said John Capitman, a California State University-nono public health professor and executive director of the Central Valley Health Policy Institute. In \u003ca href=\"http://www.latimes.com/local/lanow/la-me-clean-air-lungs-children-20150304-story.html#page=1\" target=\"_blank\">Los Angeles\u003c/a>, the same holds true, although particulates are slightly \u003ca href=\"http://www.kidsdata.org/topic/524/environment-airquality/trend#fmt=1087&loc=357,364,362&tf=4,64\" target=\"_blank\">lower than in parts of in the Central Valley\u003c/a>\u003cu>. \u003c/u>\u003c/p>\n\u003cp>Across California, local and regional asthma programs aim to educate families and doctors to help keep kids out of the hospital. In counties including Orange and Los Angeles, medically equipped vans called “Breathmobiles” provide comprehensive care in community settings and ensure children don’t end up repeatedly in the ER.\u003c/p>\n\u003cp>It worked for Daniel Lee, 5, of Buena Park, who was still experiencing severe asthma symptoms after five trips to the ER last year. It turned out the doctors at the hospital had mixed his medications incorrectly -- a common mistake when kids are treated in emergency rooms rather than by asthma-trained pediatricians, said Dr. Olga Guijon, associate medical director of the Breathmobile for Children’s Hospital of Orange County.\u003c/p>\n\u003cfigure id=\"attachment_29214\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/05/er-asthma-10-e1432333735519.jpg\" target=\"_blank\">\u003cimg class=\"wp-image-29214 size-thumbnail\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/05/er-asthma-10-400x267.jpg\" alt=\"The Childrens Hospital of Orange County Breathmobile is a mobile asthma clinic dedicated to serving low-income communities in the area. \" width=\"400\" height=\"267\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The Childrens Hospital of Orange County Breathmobile is a mobile asthma clinic dedicated to serving low-income communities in the area. \u003ccite>(Photo by Heidi de Marco/KHN)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“All he wants to do is play soccer,” said his mother Young Lee, during a recent visit to the Breathmobile in Anaheim. “But every time he’s running around on the field, he says: ‘I feel weird’. So he has to stop.”\u003c/p>\n\u003cp>\u003cspan style=\"line-height: 1.5\">Daniel has improved drastically after being treated at the Breathmobile and having his medication adjusted, his mother said.\u003c/span>\u003cbr>\nThough often effective, these programs are expensive and can't serve enough children to make a real difference statewide, Capitman said. And health outreach workers have found it difficult to get reimbursed by insurers, including Medi-Cal, for proven strategies including home visits to minimize risks, Capitman said.\u003c/p>\n\u003cp>Dr. Amy Harrison, a pediatric pulmonologist at Children's Hospital Orange County, suggested that the recession had driven some families to her hospital's ER, because they had lost their insurance or had high-deductible insurance that led them to forego prescriptions and regular doctor visits.\u003c/p>\n\u003cp>Because the data don’t extend beyond 2012, it remains unclear how expanded coverage offered since last year under the Affordable Care Act and California's Medicaid program will \u003ca href=\"http://www.vox.com/2015/5/4/8547375/obamacare-emergency-room\" target=\"_blank\">affect emergency room visits\u003c/a>. But experts like Capitman hope to see more funding for programs that manage or prevent asthma symptoms through the Affordable Care Act's \u003ca href=\"http://www.hhs.gov/open/prevention/index.html\" target=\"_blank\">Prevention and Public Health Fund\u003c/a>.\u003c/p>\n\u003cp>Asthma care for kids has improved markedly in recent years, in part because of the wider use of steroid inhalers. Influential asthma management \u003ca href=\"http://www.nhlbi.nih.gov/health-pro/guidelines/current/asthma-guidelines\" target=\"_blank\">guidelines\u003c/a> released in 2007 also have helped.\u003c/p>\n\u003cp>But some families simply don't know how to manage their child's condition at home, or know when to seek medical care before an ER visit becomes necessary, \u003cspan class=\"Apple-style-span\">said Dr. Rami Keisari, medical director of the Pediatric Asthma Disease Management Program at the county-run Santa Clara Valley Medical Center in San Jose\u003cb>.\u003c/b>\u003c/span>\u003c/p>\n\u003cp>\"One of the biggest challenges we have is getting parents to use the medications every day,\" Keisari said. \"We have a really hard time convincing parents that this is a chronic condition.\"\u003c/p>\n\u003cp>Some of the few large counties with declining ER visits have invested heavily in targeting kids who are at risk. Alameda County children who have been treated in ERs are referred to the county's free Asthma Start program, which offers free home visits during which health workers identify asthma triggers, offer education and provide equipment such as spacers and nebulizers – even vacuum cleaners, said program director Brenda Yamashita of the Alameda County Department of Public Health.\u003c/p>\n\u003cp>Parents learn to freeze stuffed animals to kill asthma-triggering dust mites, track their children's symptoms on a calendar, and clean surfaces without bleach, which can aggravate symptoms. Alameda Alliance for Health, the county's public, nonprofit health insurance plan, reimburses Yamashita's program for home visits.\u003c/p>\n\u003cp>For parents in substandard rental housing, staffers call on the county's Healthy Homes department to press landlords to get rid of vermin, fix leaks and address other code violations.\u003c/p>\n\u003cp>In Santa Clara County, Keisari's staff keeps tabs on kids for as long as three years. Every month, a public health nurse calls parents and asks about their children's symptoms and medications.\u003c/p>\n\u003cp>The county's overall child ER visit rates are low compared to other counties. Even so, the number of children the program serves is limited compared to the need. And while the county's asthma ER visit rates declined by 21 percent for children under 5, they rose 12 percent for children aged 5 to 17.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\"We're doing better with all these programs, but is it adequate? No. Every time a kid winds up in the ER with bad exacerbation of asthma, it's a failure,\" said Stanford University child health policy researcher Dr. Paul Wise.\u003c/p>\n\n",
"disqusIdentifier": "29198 http://ww2.kqed.org/stateofhealth/?p=29198",
"disqusUrl": "https://ww2.kqed.org/stateofhealth/2015/05/24/despite-efforts-er-visits-spike-in-california-kids-with-asthma/",
"stats": {
"hasVideo": false,
"hasChartOrMap": false,
"hasAudio": false,
"hasPolis": false,
"wordCount": 1472,
"hasGoogleForm": false,
"hasGallery": false,
"hasHearkenModule": false,
"iframeSrcs": [],
"paragraphCount": 32
},
"modified": 1432922646,
"excerpt": "Statewide, asthma visits to the ER went up 18 percent, and more than doubled in parts of the Central Valley.",
"headData": {
"twImgId": "",
"twTitle": "",
"ogTitle": "",
"ogImgId": "",
"twDescription": "",
"description": "Statewide, asthma visits to the ER went up 18 percent, and more than doubled in parts of the Central Valley.",
"title": "Despite Efforts, ER Visits Spike in California Kids with Asthma | KQED",
"ogDescription": "",
"schema": {
"@context": "https://schema.org",
"@type": "Article",
"headline": "Despite Efforts, ER Visits Spike in California Kids with Asthma",
"datePublished": "2015-05-24T08:30:01-07:00",
"dateModified": "2015-05-29T11:04:06-07:00",
"image": "https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"
}
},
"guestAuthors": [],
"slug": "despite-efforts-er-visits-spike-in-california-kids-with-asthma",
"status": "publish",
"nprByline": "\u003cstrong>Barbara Feder Ostrov\u003cbr />Kaiser Health News\u003c/strong>",
"path": "/stateofhealth/29198/despite-efforts-er-visits-spike-in-california-kids-with-asthma",
"audioTrackLength": null,
"parsedContent": [
{
"type": "contentString",
"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Children in California increasingly are flocking to emergency rooms for treatment of asthma, despite millions of dollars spent on programs to control the disease.\u003c/p>\n\u003cp>Statewide, the rates of ER visits for asthma symptoms rose by about 18 percent for California children ages 5 to 17 and by 6 percent for children under 5 between 2005 and 2012, according to a Kaiser Health News analysis of the \u003ca href=\"http://www.ehib.org/page.jsp?page_key=124\" target=\"_blank\">latest available rates by county\u003c/a>.\u003c/p>\n\u003cp>In some parts of the state, especially the Central Valley, the increases were far higher. The rate of emergency room visits for children 5 and older more than doubled in rural Madera County and nearly doubled In Merced. In Sacramento County, they rose by 48 percent and in Los Angeles, the largest county in the nation, by 17 percent.\u003c/p>\n\u003cp>All told, more than 72,000 California children under 18 visited the ER for asthma in 2012.\u003c/p>\n\u003cp>\"There's clearly more work to be done if this many kids are going to the emergency department,\" said Anne Kelsey Lamb, director of the Regional Asthma Management and Prevention program of the Oakland-based Public Health Institute. \"We know a lot about what works. We absolutely should be able to reduce the rates we're seeing.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
"attributes": {
"named": {},
"numeric": []
}
},
{
"type": "component",
"content": "",
"name": "ad",
"attributes": {
"named": {
"label": "fullwidth"
},
"numeric": [
"fullwidth"
]
}
},
{
"type": "contentString",
"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>At the national level, asthma-related emergency room visit rates have declined in recent years, according to federal health data through 2010, the latest available.\u003c/p>\n\u003cp>Although ER visits declined in some counties, including Alameda, San Mateo and Marin, the overall rise in California has frustrated public health experts who have spent millions of dollars and countless hours to improve and expand asthma prevention programs around the state. The state and federal governments alone spend $1.54 million annually on such projects in California, including grants to schools to improve indoor air quality and training community health workers.\u003c/p>\n\u003cp>The good news is fewer kids are actually being admitted into hospitals. Overnight-or-longer stays are \u003ca href=\"http://www.kidsdata.org/topic/239/asthma-hospitalizations/trend#fmt=2298&loc=2&tf=1,73&ch=790&pdist=7\" target=\"_blank\">declining statewide\u003c/a> and nationally. That's due largely to better medicines and more aggressive treatment in the ER, asthma specialists say.\u003c/p>\n\u003cp>The reasons for the increase in ER visits are complex, experts say. They include parents not properly administering medications, poverty and inadequate insurance coverage, persistently high levels of indoor and outdoor pollution in some regions and the limited reach of programs that seek to manage symptoms or prevent them.\u003c/p>\n\u003cfigure id=\"attachment_29220\" class=\"wp-caption alignright\" style=\"max-width: 770px\">\u003cimg class=\"wp-image-29220 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/05/county-asthma-rates_0-to-4_final_052215_770.jpg\" alt=\"Source: Kaiser Health News\" width=\"770\" height=\"737\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/05/county-asthma-rates_0-to-4_final_052215_770.jpg 770w, https://ww2.kqed.org/app/uploads/sites/27/2015/05/county-asthma-rates_0-to-4_final_052215_770-400x383.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/05/county-asthma-rates_0-to-4_final_052215_770-32x32.jpg 32w\" sizes=\"(max-width: 770px) 100vw, 770px\">\u003cfigcaption class=\"wp-caption-text\">Source: Kaiser Health News\u003c/figcaption>\u003c/figure>\n\u003cp>The rising rates don’t seem to reflect an actual increase in the respiratory disease – about 15 percent of California children have been diagnosed with asthma, a number that has remained \u003ca href=\"http://www.kidsdata.org/topic/238/asthma/trend#fmt=97&loc=2&tf=4,77\" target=\"_blank\">fairly steady\u003c/a> since 2001.\u003c/p>\n\u003cfigure id=\"attachment_29221\" class=\"wp-caption alignright\" style=\"max-width: 770px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/05/county-asthma-rates_5-to-17_final_052215_770.jpg\" target=\"_blank\">\u003cimg class=\"wp-image-29221 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/05/county-asthma-rates_5-to-17_final_052215_770.jpg\" alt=\"county-asthma-rates_5-to-17_final_052215_770\" width=\"770\" height=\"737\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/05/county-asthma-rates_5-to-17_final_052215_770.jpg 770w, https://ww2.kqed.org/app/uploads/sites/27/2015/05/county-asthma-rates_5-to-17_final_052215_770-400x383.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/05/county-asthma-rates_5-to-17_final_052215_770-32x32.jpg 32w\" sizes=\"(max-width: 770px) 100vw, 770px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Source: Kaiser Health News\u003c/figcaption>\u003c/figure>\n\u003cp>The rates of ER visits vary widely by county, from a high of 300 visits per 10,000 children under age 5 (Madera County) to a low of 32 (Sutter County) in 2012. Younger children visit the ER at higher rates because they are more likely to have undiagnosed asthma and because their lung function is more difficult to measure, complicating the task of finding the right combination of medicines, Kelsey Lamb said.\u003c/p>\n\u003cp>Some families seek treatment in the ER for symptoms that easily could be dealt with in a clinic because they can’t get a timely doctor's appointment or don't have a regular doctor – especially those without health insurance. Sometimes, a bad cold and flu season can aggravate asthma that is usually well-controlled.\u003c/p>\n\u003cp>Affected children often live in homes with dust, mold or pets, which trigger asthma symptoms. They may need two inhalers – one for school and one for home – but insurance sometimes only pays for one.\u003c/p>\n\u003cp>In the Central Valley, persistent poverty and outdoor air pollution levels combine to produce the highest rates of ER visits for childhood asthma in the state.\u003c/p>\n\u003cp>While particulate matter and ozone air pollution levels \u003ca href=\"http://www.kidsdata.org/topic/525/environment-airquality-ozone/trend#fmt=1086&loc=2,357,364,362,356,354&tf=4,64%20(\" target=\"_blank\">are declining somewhat\u003c/a> in the region, they still can be high enough to trigger asthma attacks, said John Capitman, a California State University-nono public health professor and executive director of the Central Valley Health Policy Institute. In \u003ca href=\"http://www.latimes.com/local/lanow/la-me-clean-air-lungs-children-20150304-story.html#page=1\" target=\"_blank\">Los Angeles\u003c/a>, the same holds true, although particulates are slightly \u003ca href=\"http://www.kidsdata.org/topic/524/environment-airquality/trend#fmt=1087&loc=357,364,362&tf=4,64\" target=\"_blank\">lower than in parts of in the Central Valley\u003c/a>\u003cu>. \u003c/u>\u003c/p>\n\u003cp>Across California, local and regional asthma programs aim to educate families and doctors to help keep kids out of the hospital. In counties including Orange and Los Angeles, medically equipped vans called “Breathmobiles” provide comprehensive care in community settings and ensure children don’t end up repeatedly in the ER.\u003c/p>\n\u003cp>It worked for Daniel Lee, 5, of Buena Park, who was still experiencing severe asthma symptoms after five trips to the ER last year. It turned out the doctors at the hospital had mixed his medications incorrectly -- a common mistake when kids are treated in emergency rooms rather than by asthma-trained pediatricians, said Dr. Olga Guijon, associate medical director of the Breathmobile for Children’s Hospital of Orange County.\u003c/p>\n\u003cfigure id=\"attachment_29214\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/05/er-asthma-10-e1432333735519.jpg\" target=\"_blank\">\u003cimg class=\"wp-image-29214 size-thumbnail\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/05/er-asthma-10-400x267.jpg\" alt=\"The Childrens Hospital of Orange County Breathmobile is a mobile asthma clinic dedicated to serving low-income communities in the area. \" width=\"400\" height=\"267\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The Childrens Hospital of Orange County Breathmobile is a mobile asthma clinic dedicated to serving low-income communities in the area. \u003ccite>(Photo by Heidi de Marco/KHN)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“All he wants to do is play soccer,” said his mother Young Lee, during a recent visit to the Breathmobile in Anaheim. “But every time he’s running around on the field, he says: ‘I feel weird’. So he has to stop.”\u003c/p>\n\u003cp>\u003cspan style=\"line-height: 1.5\">Daniel has improved drastically after being treated at the Breathmobile and having his medication adjusted, his mother said.\u003c/span>\u003cbr>\nThough often effective, these programs are expensive and can't serve enough children to make a real difference statewide, Capitman said. And health outreach workers have found it difficult to get reimbursed by insurers, including Medi-Cal, for proven strategies including home visits to minimize risks, Capitman said.\u003c/p>\n\u003cp>Dr. Amy Harrison, a pediatric pulmonologist at Children's Hospital Orange County, suggested that the recession had driven some families to her hospital's ER, because they had lost their insurance or had high-deductible insurance that led them to forego prescriptions and regular doctor visits.\u003c/p>\n\u003cp>Because the data don’t extend beyond 2012, it remains unclear how expanded coverage offered since last year under the Affordable Care Act and California's Medicaid program will \u003ca href=\"http://www.vox.com/2015/5/4/8547375/obamacare-emergency-room\" target=\"_blank\">affect emergency room visits\u003c/a>. But experts like Capitman hope to see more funding for programs that manage or prevent asthma symptoms through the Affordable Care Act's \u003ca href=\"http://www.hhs.gov/open/prevention/index.html\" target=\"_blank\">Prevention and Public Health Fund\u003c/a>.\u003c/p>\n\u003cp>Asthma care for kids has improved markedly in recent years, in part because of the wider use of steroid inhalers. Influential asthma management \u003ca href=\"http://www.nhlbi.nih.gov/health-pro/guidelines/current/asthma-guidelines\" target=\"_blank\">guidelines\u003c/a> released in 2007 also have helped.\u003c/p>\n\u003cp>But some families simply don't know how to manage their child's condition at home, or know when to seek medical care before an ER visit becomes necessary, \u003cspan class=\"Apple-style-span\">said Dr. Rami Keisari, medical director of the Pediatric Asthma Disease Management Program at the county-run Santa Clara Valley Medical Center in San Jose\u003cb>.\u003c/b>\u003c/span>\u003c/p>\n\u003cp>\"One of the biggest challenges we have is getting parents to use the medications every day,\" Keisari said. \"We have a really hard time convincing parents that this is a chronic condition.\"\u003c/p>\n\u003cp>Some of the few large counties with declining ER visits have invested heavily in targeting kids who are at risk. Alameda County children who have been treated in ERs are referred to the county's free Asthma Start program, which offers free home visits during which health workers identify asthma triggers, offer education and provide equipment such as spacers and nebulizers – even vacuum cleaners, said program director Brenda Yamashita of the Alameda County Department of Public Health.\u003c/p>\n\u003cp>Parents learn to freeze stuffed animals to kill asthma-triggering dust mites, track their children's symptoms on a calendar, and clean surfaces without bleach, which can aggravate symptoms. Alameda Alliance for Health, the county's public, nonprofit health insurance plan, reimburses Yamashita's program for home visits.\u003c/p>\n\u003cp>For parents in substandard rental housing, staffers call on the county's Healthy Homes department to press landlords to get rid of vermin, fix leaks and address other code violations.\u003c/p>\n\u003cp>In Santa Clara County, Keisari's staff keeps tabs on kids for as long as three years. Every month, a public health nurse calls parents and asks about their children's symptoms and medications.\u003c/p>\n\u003cp>The county's overall child ER visit rates are low compared to other counties. Even so, the number of children the program serves is limited compared to the need. And while the county's asthma ER visit rates declined by 21 percent for children under 5, they rose 12 percent for children aged 5 to 17.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
"attributes": {
"named": {},
"numeric": []
}
},
{
"type": "component",
"content": "",
"name": "ad",
"attributes": {
"named": {
"label": "floatright"
},
"numeric": [
"floatright"
]
}
},
{
"type": "contentString",
"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"We're doing better with all these programs, but is it adequate? No. Every time a kid winds up in the ER with bad exacerbation of asthma, it's a failure,\" said Stanford University child health policy researcher Dr. Paul Wise.\u003c/p>\n\n\u003c/div>\u003c/p>",
"attributes": {
"named": {},
"numeric": []
}
}
],
"link": "/stateofhealth/29198/despite-efforts-er-visits-spike-in-california-kids-with-asthma",
"authors": [
"byline_stateofhealth_29198"
],
"categories": [
"stateofhealth_11",
"stateofhealth_13"
],
"tags": [
"stateofhealth_23",
"stateofhealth_96"
],
"featImg": "stateofhealth_29232",
"label": "stateofhealth"
}
},
"podcastsReducer": {
"isFetching": false,
"fetchFailed": false,
"hasFetched": false,
"podcasts": {}
},
"radioProgramsReducer": {
"isFetching": false,
"fetchFailed": false,
"hasFetched": false,
"radioPrograms": {}
},
"radioSearchSegmentsReducer": {},
"programsReducer": {
"all-things-considered": {
"id": "all-things-considered",
"title": "All Things Considered",
"info": "Every weekday, \u003cem>All Things Considered\u003c/em> hosts Robert Siegel, Audie Cornish, Ari Shapiro, and Kelly McEvers present the program's trademark mix of news, interviews, commentaries, reviews, and offbeat features. Michel Martin hosts on the weekends.",
"airtime": "MON-FRI 1pm-2pm, 4:30pm-6:30pm\u003cbr />SAT-SUN 5pm-6pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/All-Things-Considered-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.npr.org/programs/all-things-considered/",
"meta": {
"site": "news",
"source": "npr"
},
"link": "/radio/program/all-things-considered"
},
"american-suburb-podcast": {
"id": "american-suburb-podcast",
"title": "American Suburb: The Podcast",
"tagline": "The flip side of gentrification, told through one town",
"info": "Gentrification is changing cities across America, forcing people from neighborhoods they have long called home. Call them the displaced. Now those priced out of the Bay Area are looking for a better life in an unlikely place. American Suburb follows this migration to one California town along the Delta, 45 miles from San Francisco. But is this once sleepy suburb ready for them?",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/American-Suburb-Podcast-Tile-703x703-1.jpg",
"officialWebsiteLink": "/news/series/american-suburb-podcast",
"meta": {
"site": "news",
"source": "kqed",
"order": 19
},
"link": "/news/series/american-suburb-podcast/",
"subscribe": {
"npr": "https://rpb3r.app.goo.gl/RBrW",
"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?mt=2&id=1287748328",
"tuneIn": "https://tunein.com/radio/American-Suburb-p1086805/",
"rss": "https://ww2.kqed.org/news/series/american-suburb-podcast/feed/podcast",
"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkMzMDExODgxNjA5"
}
},
"baycurious": {
"id": "baycurious",
"title": "Bay Curious",
"tagline": "Exploring the Bay Area, one question at a time",
"info": "KQED’s new podcast, Bay Curious, gets to the bottom of the mysteries — both profound and peculiar — that give the Bay Area its unique identity. And we’ll do it with your help! You ask the questions. You decide what Bay Curious investigates. And you join us on the journey to find the answers.",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Bay-Curious-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED Bay Curious",
"officialWebsiteLink": "/news/series/baycurious",
"meta": {
"site": "news",
"source": "kqed",
"order": 3
},
"link": "/podcasts/baycurious",
"subscribe": {
"apple": "https://podcasts.apple.com/us/podcast/bay-curious/id1172473406",
"npr": "https://www.npr.org/podcasts/500557090/bay-curious",
"rss": "https://ww2.kqed.org/news/category/bay-curious-podcast/feed/podcast",
"amazon": "https://music.amazon.com/podcasts/9a90d476-aa04-455d-9a4c-0871ed6216d4/bay-curious",
"stitcher": "https://www.stitcher.com/podcast/kqed/bay-curious",
"spotify": "https://open.spotify.com/show/6O76IdmhixfijmhTZLIJ8k"
}
},
"bbc-world-service": {
"id": "bbc-world-service",
"title": "BBC World Service",
"info": "The day's top stories from BBC News compiled twice daily in the week, once at weekends.",
"airtime": "MON-FRI 9pm-10pm, TUE-FRI 1am-2am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/BBC-World-Service-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.bbc.co.uk/sounds/play/live:bbc_world_service",
"meta": {
"site": "news",
"source": "BBC World Service"
},
"link": "/radio/program/bbc-world-service",
"subscribe": {
"apple": "https://itunes.apple.com/us/podcast/global-news-podcast/id135067274?mt=2",
"tuneIn": "https://tunein.com/radio/BBC-World-Service-p455581/",
"rss": "https://podcasts.files.bbci.co.uk/p02nq0gn.rss"
}
},
"californiareport": {
"id": "californiareport",
"title": "The California Report",
"tagline": "California, day by day",
"info": "KQED’s statewide radio news program providing daily coverage of issues, trends and public policy decisions.",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-California-Report-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED The California Report",
"officialWebsiteLink": "/californiareport",
"meta": {
"site": "news",
"source": "kqed",
"order": 8
},
"link": "/californiareport",
"subscribe": {
"apple": "https://podcasts.apple.com/us/podcast/kqeds-the-california-report/id79681292",
"amazon": "https://music.amazon.com/podcasts/26099305-72af-4542-9dde-ac1807fe36d5/kqed-s-the-california-report",
"npr": "https://www.npr.org/podcasts/432285393/the-california-report",
"stitcher": "https://www.stitcher.com/podcast/kqedfm-kqeds-the-california-report-podcast-8838",
"rss": "https://ww2.kqed.org/news/tag/tcram/feed/podcast"
}
},
"californiareportmagazine": {
"id": "californiareportmagazine",
"title": "The California Report Magazine",
"tagline": "Your state, your stories",
"info": "Every week, The California Report Magazine takes you on a road trip for the ears: to visit the places and meet the people who make California unique. The in-depth storytelling podcast from the California Report.",
"airtime": "FRI 4:30pm-5pm, 6:30pm-7pm, 11pm-11:30pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-California-Report-Magazine-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED The California Report Magazine",
"officialWebsiteLink": "/californiareportmagazine",
"meta": {
"site": "news",
"source": "kqed",
"order": 10
},
"link": "/californiareportmagazine",
"subscribe": {
"apple": "https://podcasts.apple.com/us/podcast/the-california-report-magazine/id1314750545",
"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM3NjkwNjk1OTAz",
"npr": "https://www.npr.org/podcasts/564733126/the-california-report-magazine",
"stitcher": "https://www.stitcher.com/podcast/kqed/the-california-report-magazine",
"rss": "https://ww2.kqed.org/news/tag/tcrmag/feed/podcast"
}
},
"city-arts": {
"id": "city-arts",
"title": "City Arts & Lectures",
"info": "A one-hour radio program to hear celebrated writers, artists and thinkers address contemporary ideas and values, often discussing the creative process. Please note: tapes or transcripts are not available",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/05/cityartsandlecture-300x300.jpg",
"officialWebsiteLink": "https://www.cityarts.net/",
"airtime": "SUN 1pm-2pm, TUE 10pm, WED 1am",
"meta": {
"site": "news",
"source": "City Arts & Lectures"
},
"link": "https://www.cityarts.net",
"subscribe": {
"tuneIn": "https://tunein.com/radio/City-Arts-and-Lectures-p692/",
"rss": "https://www.cityarts.net/feed/"
}
},
"closealltabs": {
"id": "closealltabs",
"title": "Close All Tabs",
"tagline": "Your irreverent guide to the trends redefining our world",
"info": "Close All Tabs breaks down how digital culture shapes our world through thoughtful insights and irreverent humor.",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2025/02/CAT_2_Tile-scaled.jpg",
"imageAlt": "KQED Close All Tabs",
"officialWebsiteLink": "/podcasts/closealltabs",
"meta": {
"site": "news",
"source": "kqed",
"order": 1
},
"link": "/podcasts/closealltabs",
"subscribe": {
"apple": "https://podcasts.apple.com/us/podcast/close-all-tabs/id214663465",
"rss": "https://feeds.megaphone.fm/KQINC6993880386",
"amazon": "https://music.amazon.com/podcasts/92d9d4ac-67a3-4eed-b10a-fb45d45b1ef2/close-all-tabs",
"spotify": "https://open.spotify.com/show/6LAJFHnGK1pYXYzv6SIol6?si=deb0cae19813417c"
}
},
"code-switch-life-kit": {
"id": "code-switch-life-kit",
"title": "Code Switch / Life Kit",
"info": "\u003cem>Code Switch\u003c/em>, which listeners will hear in the first part of the hour, has fearless and much-needed conversations about race. Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />",
"airtime": "SUN 9pm-10pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Code-Switch-Life-Kit-Podcast-Tile-360x360-1.jpg",
"meta": {
"site": "radio",
"source": "npr"
},
"link": "/radio/program/code-switch-life-kit",
"subscribe": {
"apple": "https://podcasts.apple.com/podcast/1112190608?mt=2&at=11l79Y&ct=nprdirectory",
"google": "https://podcasts.google.com/feed/aHR0cHM6Ly93d3cubnByLm9yZy9yc3MvcG9kY2FzdC5waHA_aWQ9NTEwMzEy",
"spotify": "https://open.spotify.com/show/3bExJ9JQpkwNhoHvaIIuyV",
"rss": "https://feeds.npr.org/510312/podcast.xml"
}
},
"commonwealth-club": {
"id": "commonwealth-club",
"title": "Commonwealth Club of California Podcast",
"info": "The Commonwealth Club of California is the nation's oldest and largest public affairs forum. As a non-partisan forum, The Club brings to the public airwaves diverse viewpoints on important topics. The Club's weekly radio broadcast - the oldest in the U.S., dating back to 1924 - is carried across the nation on public radio stations and is now podcasting. Our website archive features audio of our recent programs, as well as selected speeches from our long and distinguished history. This podcast feed is usually updated twice a week and is always un-edited.",
"airtime": "THU 10pm, FRI 1am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Commonwealth-Club-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.commonwealthclub.org/podcasts",
"meta": {
"site": "news",
"source": "Commonwealth Club of California"
},
"link": "/radio/program/commonwealth-club",
"subscribe": {
"apple": "https://itunes.apple.com/us/podcast/commonwealth-club-of-california-podcast/id976334034?mt=2",
"google": "https://podcasts.google.com/feed/aHR0cDovL3d3dy5jb21tb253ZWFsdGhjbHViLm9yZy9hdWRpby9wb2RjYXN0L3dlZWtseS54bWw",
"tuneIn": "https://tunein.com/radio/Commonwealth-Club-of-California-p1060/"
}
},
"forum": {
"id": "forum",
"title": "Forum",
"tagline": "The conversation starts here",
"info": "KQED’s live call-in program discussing local, state, national and international issues, as well as in-depth interviews.",
"airtime": "MON-FRI 9am-11am, 10pm-11pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Forum-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED Forum with Mina Kim and Alexis Madrigal",
"officialWebsiteLink": "/forum",
"meta": {
"site": "news",
"source": "kqed",
"order": 9
},
"link": "/forum",
"subscribe": {
"apple": "https://podcasts.apple.com/us/podcast/kqeds-forum/id73329719",
"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM5NTU3MzgxNjMz",
"npr": "https://www.npr.org/podcasts/432307980/forum",
"stitcher": "https://www.stitcher.com/podcast/kqedfm-kqeds-forum-podcast",
"rss": "https://feeds.megaphone.fm/KQINC9557381633"
}
},
"freakonomics-radio": {
"id": "freakonomics-radio",
"title": "Freakonomics Radio",
"info": "Freakonomics Radio is a one-hour award-winning podcast and public-radio project hosted by Stephen Dubner, with co-author Steve Levitt as a regular guest. It is produced in partnership with WNYC.",
"imageSrc": "https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/05/freakonomicsRadio.png",
"officialWebsiteLink": "http://freakonomics.com/",
"airtime": "SUN 1am-2am, SAT 3pm-4pm",
"meta": {
"site": "radio",
"source": "WNYC"
},
"link": "/radio/program/freakonomics-radio",
"subscribe": {
"npr": "https://rpb3r.app.goo.gl/4s8b",
"apple": "https://itunes.apple.com/us/podcast/freakonomics-radio/id354668519",
"tuneIn": "https://tunein.com/podcasts/WNYC-Podcasts/Freakonomics-Radio-p272293/",
"rss": "https://feeds.feedburner.com/freakonomicsradio"
}
},
"fresh-air": {
"id": "fresh-air",
"title": "Fresh Air",
"info": "Hosted by Terry Gross, \u003cem>Fresh Air from WHYY\u003c/em> is the Peabody Award-winning weekday magazine of contemporary arts and issues. One of public radio's most popular programs, Fresh Air features intimate conversations with today's biggest luminaries.",
"airtime": "MON-FRI 7pm-8pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Fresh-Air-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.npr.org/programs/fresh-air/",
"meta": {
"site": "radio",
"source": "npr"
},
"link": "/radio/program/fresh-air",
"subscribe": {
"npr": "https://rpb3r.app.goo.gl/4s8b",
"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=214089682&at=11l79Y&ct=nprdirectory",
"tuneIn": "https://tunein.com/radio/Fresh-Air-p17/",
"rss": "https://feeds.npr.org/381444908/podcast.xml"
}
},
"here-and-now": {
"id": "here-and-now",
"title": "Here & Now",
"info": "A live production of NPR and WBUR Boston, in collaboration with stations across the country, Here & Now reflects the fluid world of news as it's happening in the middle of the day, with timely, in-depth news, interviews and conversation. Hosted by Robin Young, Jeremy Hobson and Tonya Mosley.",
"airtime": "MON-THU 11am-12pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Here-And-Now-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "http://www.wbur.org/hereandnow",
"meta": {
"site": "news",
"source": "npr"
},
"link": "/radio/program/here-and-now",
"subsdcribe": {
"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?mt=2&id=426698661",
"tuneIn": "https://tunein.com/radio/Here--Now-p211/",
"rss": "https://feeds.npr.org/510051/podcast.xml"
}
},
"hidden-brain": {
"id": "hidden-brain",
"title": "Hidden Brain",
"info": "Shankar Vedantam uses science and storytelling to reveal the unconscious patterns that drive human behavior, shape our choices and direct our relationships.",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/05/hiddenbrain.jpg",
"officialWebsiteLink": "https://www.npr.org/series/423302056/hidden-brain",
"airtime": "SUN 7pm-8pm",
"meta": {
"site": "news",
"source": "NPR"
},
"link": "/radio/program/hidden-brain",
"subscribe": {
"apple": "https://itunes.apple.com/us/podcast/hidden-brain/id1028908750?mt=2",
"tuneIn": "https://tunein.com/podcasts/Science-Podcasts/Hidden-Brain-p787503/",
"rss": "https://feeds.npr.org/510308/podcast.xml"
}
},
"how-i-built-this": {
"id": "how-i-built-this",
"title": "How I Built This with Guy Raz",
"info": "Guy Raz dives into the stories behind some of the world's best known companies. How I Built This weaves a narrative journey about innovators, entrepreneurs and idealists—and the movements they built.",
"imageSrc": "https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/05/howIBuiltThis.png",
"officialWebsiteLink": "https://www.npr.org/podcasts/510313/how-i-built-this",
"airtime": "SUN 7:30pm-8pm",
"meta": {
"site": "news",
"source": "npr"
},
"link": "/radio/program/how-i-built-this",
"subscribe": {
"npr": "https://rpb3r.app.goo.gl/3zxy",
"apple": "https://itunes.apple.com/us/podcast/how-i-built-this-with-guy-raz/id1150510297?mt=2",
"tuneIn": "https://tunein.com/podcasts/Arts--Culture-Podcasts/How-I-Built-This-p910896/",
"rss": "https://feeds.npr.org/510313/podcast.xml"
}
},
"hyphenacion": {
"id": "hyphenacion",
"title": "Hyphenación",
"tagline": "Where conversation and cultura meet",
"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2025/03/Hyphenacion_FinalAssets_PodcastTile.png",
"imageAlt": "KQED Hyphenación",
"officialWebsiteLink": "/podcasts/hyphenacion",
"meta": {
"site": "news",
"source": "kqed",
"order": 15
},
"link": "/podcasts/hyphenacion",
"subscribe": {
"apple": "https://podcasts.apple.com/us/podcast/hyphenaci%C3%B3n/id1191591838",
"spotify": "https://open.spotify.com/show/2p3Fifq96nw9BPcmFdIq0o?si=39209f7b25774f38",
"youtube": "https://www.youtube.com/c/kqedarts",
"amazon": "https://music.amazon.com/podcasts/6c3dd23c-93fb-4aab-97ba-1725fa6315f1/hyphenaci%C3%B3n",
"rss": "https://feeds.megaphone.fm/KQINC2275451163"
}
},
"jerrybrown": {
"id": "jerrybrown",
"title": "The Political Mind of Jerry Brown",
"tagline": "Lessons from a lifetime in politics",
"info": "The Political Mind of Jerry Brown brings listeners the wisdom of the former Governor, Mayor, and presidential candidate. Scott Shafer interviewed Brown for more than 40 hours, covering the former governor's life and half-century in the political game – and Brown has some lessons he'd like to share. ",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-Political-Mind-of-Jerry-Brown-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED The Political Mind of Jerry Brown",
"officialWebsiteLink": "/podcasts/jerrybrown",
"meta": {
"site": "news",
"source": "kqed",
"order": 18
},
"link": "/podcasts/jerrybrown",
"subscribe": {
"npr": "https://www.npr.org/podcasts/790253322/the-political-mind-of-jerry-brown",
"apple": "https://itunes.apple.com/us/podcast/id1492194549",
"rss": "https://ww2.kqed.org/news/series/jerrybrown/feed/podcast/",
"tuneIn": "http://tun.in/pjGcK",
"stitcher": "https://www.stitcher.com/podcast/kqed/the-political-mind-of-jerry-brown",
"spotify": "https://open.spotify.com/show/54C1dmuyFyKMFttY6X2j6r?si=K8SgRCoISNK6ZbjpXrX5-w",
"amazon": "https://music.amazon.com/podcasts/44420f75-3b0e-4301-ab3b-16da6b09e543/the-political-mind-of-jerry-brown"
}
},
"latino-usa": {
"id": "latino-usa",
"title": "Latino USA",
"airtime": "MON 1am-2am, SUN 6pm-7pm",
"info": "Latino USA, the radio journal of news and culture, is the only national, English-language radio program produced from a Latino perspective.",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/latinoUsa.jpg",
"officialWebsiteLink": "http://latinousa.org/",
"meta": {
"site": "news",
"source": "npr"
},
"link": "/radio/program/latino-usa",
"subscribe": {
"npr": "https://rpb3r.app.goo.gl/xtTd",
"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=79681317&at=11l79Y&ct=nprdirectory",
"tuneIn": "https://tunein.com/radio/Latino-USA-p621/",
"rss": "https://feeds.npr.org/510016/podcast.xml"
}
},
"marketplace": {
"id": "marketplace",
"title": "Marketplace",
"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
"airtime": "MON-FRI 4pm-4:30pm, MON-WED 6:30pm-7pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Marketplace-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.marketplace.org/",
"meta": {
"site": "news",
"source": "American Public Media"
},
"link": "/radio/program/marketplace",
"subscribe": {
"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=201853034&at=11l79Y&ct=nprdirectory",
"tuneIn": "https://tunein.com/radio/APM-Marketplace-p88/",
"rss": "https://feeds.publicradio.org/public_feeds/marketplace-pm/rss/rss"
}
},
"masters-of-scale": {
"id": "masters-of-scale",
"title": "Masters of Scale",
"info": "Masters of Scale is an original podcast in which LinkedIn co-founder and Greylock Partner Reid Hoffman sets out to describe and prove theories that explain how great entrepreneurs take their companies from zero to a gazillion in ingenious fashion.",
"airtime": "Every other Wednesday June 12 through October 16 at 8pm (repeats Thursdays at 2am)",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Masters-of-Scale-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://mastersofscale.com/",
"meta": {
"site": "radio",
"source": "WaitWhat"
},
"link": "/radio/program/masters-of-scale",
"subscribe": {
"apple": "http://mastersofscale.app.link/",
"rss": "https://rss.art19.com/masters-of-scale"
}
},
"mindshift": {
"id": "mindshift",
"title": "MindShift",
"tagline": "A podcast about the future of learning and how we raise our kids",
"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Mindshift-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED MindShift: How We Will Learn",
"officialWebsiteLink": "/mindshift/",
"meta": {
"site": "news",
"source": "kqed",
"order": 12
},
"link": "/podcasts/mindshift",
"subscribe": {
"apple": "https://podcasts.apple.com/us/podcast/mindshift-podcast/id1078765985",
"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5",
"npr": "https://www.npr.org/podcasts/464615685/mind-shift-podcast",
"stitcher": "https://www.stitcher.com/podcast/kqed/stories-teachers-share",
"spotify": "https://open.spotify.com/show/0MxSpNYZKNprFLCl7eEtyx"
}
},
"morning-edition": {
"id": "morning-edition",
"title": "Morning Edition",
"info": "\u003cem>Morning Edition\u003c/em> takes listeners around the country and the world with multi-faceted stories and commentaries every weekday. Hosts Steve Inskeep, David Greene and Rachel Martin bring you the latest breaking news and features to prepare you for the day.",
"airtime": "MON-FRI 3am-9am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Morning-Edition-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.npr.org/programs/morning-edition/",
"meta": {
"site": "news",
"source": "npr"
},
"link": "/radio/program/morning-edition"
},
"onourwatch": {
"id": "onourwatch",
"title": "On Our Watch",
"tagline": "Deeply-reported investigative journalism",
"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/On-Our-Watch-Podcast-Tile-703x703-1.jpg",
"imageAlt": "On Our Watch from NPR and KQED",
"officialWebsiteLink": "/podcasts/onourwatch",
"meta": {
"site": "news",
"source": "kqed",
"order": 11
},
"link": "/podcasts/onourwatch",
"subscribe": {
"apple": "https://podcasts.apple.com/podcast/id1567098962",
"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5ucHIub3JnLzUxMDM2MC9wb2RjYXN0LnhtbD9zYz1nb29nbGVwb2RjYXN0cw",
"npr": "https://rpb3r.app.goo.gl/onourwatch",
"spotify": "https://open.spotify.com/show/0OLWoyizopu6tY1XiuX70x",
"tuneIn": "https://tunein.com/radio/On-Our-Watch-p1436229/",
"stitcher": "https://www.stitcher.com/show/on-our-watch",
"rss": "https://feeds.npr.org/510360/podcast.xml"
}
},
"on-the-media": {
"id": "on-the-media",
"title": "On The Media",
"info": "Our weekly podcast explores how the media 'sausage' is made, casts an incisive eye on fluctuations in the marketplace of ideas, and examines threats to the freedom of information and expression in America and abroad. For one hour a week, the show tries to lift the veil from the process of \"making media,\" especially news media, because it's through that lens that we see the world and the world sees us",
"airtime": "SUN 2pm-3pm, MON 12am-1am",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/onTheMedia.png",
"officialWebsiteLink": "https://www.wnycstudios.org/shows/otm",
"meta": {
"site": "news",
"source": "wnyc"
},
"link": "/radio/program/on-the-media",
"subscribe": {
"apple": "https://itunes.apple.com/us/podcast/on-the-media/id73330715?mt=2",
"tuneIn": "https://tunein.com/radio/On-the-Media-p69/",
"rss": "http://feeds.wnyc.org/onthemedia"
}
},
"pbs-newshour": {
"id": "pbs-newshour",
"title": "PBS NewsHour",
"info": "Analysis, background reports and updates from the PBS NewsHour putting today's news in context.",
"airtime": "MON-FRI 3pm-4pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/PBS-News-Hour-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.pbs.org/newshour/",
"meta": {
"site": "news",
"source": "pbs"
},
"link": "/radio/program/pbs-newshour",
"subscribe": {
"apple": "https://itunes.apple.com/us/podcast/pbs-newshour-full-show/id394432287?mt=2",
"tuneIn": "https://tunein.com/radio/PBS-NewsHour---Full-Show-p425698/",
"rss": "https://www.pbs.org/newshour/feeds/rss/podcasts/show"
}
},
"perspectives": {
"id": "perspectives",
"title": "Perspectives",
"tagline": "KQED's series of daily listener commentaries since 1991",
"info": "KQED's series of daily listener commentaries since 1991.",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2025/01/Perspectives_Tile_Final.jpg",
"imageAlt": "KQED Perspectives",
"officialWebsiteLink": "/perspectives/",
"meta": {
"site": "radio",
"source": "kqed",
"order": 14
},
"link": "/perspectives",
"subscribe": {
"apple": "https://podcasts.apple.com/us/podcast/id73801135",
"npr": "https://www.npr.org/podcasts/432309616/perspectives",
"rss": "https://ww2.kqed.org/perspectives/category/perspectives/feed/",
"google": "https://podcasts.google.com/feed/aHR0cHM6Ly93dzIua3FlZC5vcmcvcGVyc3BlY3RpdmVzL2NhdGVnb3J5L3BlcnNwZWN0aXZlcy9mZWVkLw"
}
},
"planet-money": {
"id": "planet-money",
"title": "Planet Money",
"info": "The economy explained. Imagine you could call up a friend and say, Meet me at the bar and tell me what's going on with the economy. Now imagine that's actually a fun evening.",
"airtime": "SUN 3pm-4pm",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/planetmoney.jpg",
"officialWebsiteLink": "https://www.npr.org/sections/money/",
"meta": {
"site": "news",
"source": "npr"
},
"link": "/radio/program/planet-money",
"subscribe": {
"npr": "https://rpb3r.app.goo.gl/M4f5",
"apple": "https://itunes.apple.com/us/podcast/planet-money/id290783428?mt=2",
"tuneIn": "https://tunein.com/podcasts/Business--Economics-Podcasts/Planet-Money-p164680/",
"rss": "https://feeds.npr.org/510289/podcast.xml"
}
},
"politicalbreakdown": {
"id": "politicalbreakdown",
"title": "Political Breakdown",
"tagline": "Politics from a personal perspective",
"info": "Political Breakdown is a new series that explores the political intersection of California and the nation. Each week hosts Scott Shafer and Marisa Lagos are joined with a new special guest to unpack politics -- with personality — and offer an insider’s glimpse at how politics happens.",
"airtime": "THU 6:30pm-7pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Political-Breakdown-2024-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED Political Breakdown",
"officialWebsiteLink": "/podcasts/politicalbreakdown",
"meta": {
"site": "radio",
"source": "kqed",
"order": 5
},
"link": "/podcasts/politicalbreakdown",
"subscribe": {
"apple": "https://podcasts.apple.com/us/podcast/political-breakdown/id1327641087",
"amazon": "https://music.amazon.com/podcasts/e0c2d153-ad36-4c8d-901d-f1da6a724824/political-breakdown",
"npr": "https://www.npr.org/podcasts/572155894/political-breakdown",
"stitcher": "https://www.stitcher.com/podcast/kqed/political-breakdown",
"spotify": "https://open.spotify.com/show/07RVyIjIdk2WDuVehvBMoN",
"rss": "https://ww2.kqed.org/news/tag/political-breakdown/feed/podcast"
}
},
"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/",
"meta": {
"site": "news",
"source": "Possible"
},
"link": "/radio/program/possible",
"subscribe": {
"apple": "https://podcasts.apple.com/us/podcast/possible/id1677184070",
"spotify": "https://open.spotify.com/show/730YpdUSNlMyPQwNnyjp4k"
}
},
"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",
"officialWebsiteLink": "https://www.pri.org/programs/the-world",
"meta": {
"site": "news",
"source": "PRI"
},
"link": "/radio/program/pri-the-world",
"subscribe": {
"apple": "https://itunes.apple.com/us/podcast/pris-the-world-latest-edition/id278196007?mt=2",
"tuneIn": "https://tunein.com/podcasts/News--Politics-Podcasts/PRIs-The-World-p24/",
"rss": "http://feeds.feedburner.com/pri/theworld"
}
},
"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.",
"airtime": "SUN 12am-1am, SAT 2pm-3pm",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/radiolab1400.png",
"officialWebsiteLink": "https://www.wnycstudios.org/shows/radiolab/",
"meta": {
"site": "science",
"source": "WNYC"
},
"link": "/radio/program/radiolab",
"subscribe": {
"apple": "https://itunes.apple.com/us/podcast/radiolab/id152249110?mt=2",
"tuneIn": "https://tunein.com/radio/RadioLab-p68032/",
"rss": "https://feeds.wnyc.org/radiolab"
}
},
"reveal": {
"id": "reveal",
"title": "Reveal",
"info": "Created by The Center for Investigative Reporting and PRX, Reveal is public radios first one-hour weekly radio show and podcast dedicated to investigative reporting. Credible, fact based and without a partisan agenda, Reveal combines the power and artistry of driveway moment storytelling with data-rich reporting on critically important issues. The result is stories that inform and inspire, arming our listeners with information to right injustices, hold the powerful accountable and improve lives.Reveal is hosted by Al Letson and showcases the award-winning work of CIR and newsrooms large and small across the nation. In a radio and podcast market crowded with choices, Reveal focuses on important and often surprising stories that illuminate the world for our listeners.",
"airtime": "SAT 4pm-5pm",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/reveal300px.png",
"officialWebsiteLink": "https://www.revealnews.org/episodes/",
"meta": {
"site": "news",
"source": "npr"
},
"link": "/radio/program/reveal",
"subscribe": {
"apple": "https://itunes.apple.com/us/podcast/reveal/id886009669",
"tuneIn": "https://tunein.com/radio/Reveal-p679597/",
"rss": "http://feeds.revealradio.org/revealpodcast"
}
},
"rightnowish": {
"id": "rightnowish",
"title": "Rightnowish",
"tagline": "Art is where you find it",
"info": "Rightnowish digs into life in the Bay Area right now… ish. Journalist Pendarvis Harshaw takes us to galleries painted on the sides of liquor stores in West Oakland. We'll dance in warehouses in the Bayview, make smoothies with kids in South Berkeley, and listen to classical music in a 1984 Cutlass Supreme in Richmond. Every week, Pen talks to movers and shakers about how the Bay Area shapes what they create, and how they shape the place we call home.",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Rightnowish-Podcast-Tile-500x500-1.jpg",
"imageAlt": "KQED Rightnowish with Pendarvis Harshaw",
"officialWebsiteLink": "/podcasts/rightnowish",
"meta": {
"site": "arts",
"source": "kqed",
"order": 16
},
"link": "/podcasts/rightnowish",
"subscribe": {
"npr": "https://www.npr.org/podcasts/721590300/rightnowish",
"rss": "https://ww2.kqed.org/arts/programs/rightnowish/feed/podcast",
"apple": "https://podcasts.apple.com/us/podcast/rightnowish/id1482187648",
"stitcher": "https://www.stitcher.com/podcast/kqed/rightnowish",
"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkMxMjU5MTY3NDc4",
"spotify": "https://open.spotify.com/show/7kEJuafTzTVan7B78ttz1I"
}
},
"science-friday": {
"id": "science-friday",
"title": "Science Friday",
"info": "Science Friday is a weekly science talk show, broadcast live over public radio stations nationwide. Each week, the show focuses on science topics that are in the news and tries to bring an educated, balanced discussion to bear on the scientific issues at hand. Panels of expert guests join host Ira Flatow, a veteran science journalist, to discuss science and to take questions from listeners during the call-in portion of the program.",
"airtime": "FRI 11am-1pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Science-Friday-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.wnycstudios.org/shows/science-friday",
"meta": {
"site": "news",
"source": "npr"
},
"link": "/radio/program/science-friday",
"subscribe": {
"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=73329284&at=11l79Y&ct=nprdirectory",
"tuneIn": "https://tunein.com/radio/Science-Friday-p394/",
"rss": "http://feeds.wnyc.org/science-friday"
}
},
"snap-judgment": {
"id": "snap-judgment",
"title": "Snap Judgment",
"tagline": "Real stories with killer beats",
"info": "The Snap Judgment radio show and podcast mixes real stories with killer beats to produce cinematic, dramatic radio. Snap's musical brand of storytelling dares listeners to see the world through the eyes of another. This is storytelling... with a BEAT!! Snap first aired on public radio stations nationwide in July 2010. Today, Snap Judgment airs on over 450 public radio stations and is brought to the airwaves by KQED & PRX.",
"airtime": "SAT 1pm-2pm, 9pm-10pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/05/Snap-Judgment-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED Snap Judgment",
"officialWebsiteLink": "https://snapjudgment.org",
"meta": {
"site": "arts",
"source": "kqed",
"order": 4
},
"link": "https://snapjudgment.org",
"subscribe": {
"apple": "https://podcasts.apple.com/us/podcast/snap-judgment/id283657561",
"npr": "https://www.npr.org/podcasts/449018144/snap-judgment",
"stitcher": "https://www.pandora.com/podcast/snap-judgment/PC:241?source=stitcher-sunset",
"spotify": "https://open.spotify.com/show/3Cct7ZWmxHNAtLgBTqjC5v",
"rss": "https://snap.feed.snapjudgment.org/"
}
},
"soldout": {
"id": "soldout",
"title": "SOLD OUT: Rethinking Housing in America",
"tagline": "A new future for housing",
"info": "Sold Out: Rethinking Housing in America",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Sold-Out-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED Sold Out: Rethinking Housing in America",
"officialWebsiteLink": "/podcasts/soldout",
"meta": {
"site": "news",
"source": "kqed",
"order": 13
},
"link": "/podcasts/soldout",
"subscribe": {
"npr": "https://www.npr.org/podcasts/911586047/s-o-l-d-o-u-t-a-new-future-for-housing",
"apple": "https://podcasts.apple.com/us/podcast/introducing-sold-out-rethinking-housing-in-america/id1531354937",
"rss": "https://feeds.megaphone.fm/soldout",
"spotify": "https://open.spotify.com/show/38dTBSk2ISFoPiyYNoKn1X",
"stitcher": "https://www.stitcher.com/podcast/kqed/sold-out-rethinking-housing-in-america",
"tunein": "https://tunein.com/radio/SOLD-OUT-Rethinking-Housing-in-America-p1365871/"
}
},
"spooked": {
"id": "spooked",
"title": "Spooked",
"tagline": "True-life supernatural stories",
"info": "",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/10/Spooked-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED Spooked",
"officialWebsiteLink": "https://spookedpodcast.org/",
"meta": {
"site": "news",
"source": "kqed",
"order": 7
},
"link": "https://spookedpodcast.org/",
"subscribe": {
"apple": "https://podcasts.apple.com/us/podcast/spooked/id1279361017",
"npr": "https://www.npr.org/podcasts/549547848/snap-judgment-presents-spooked",
"spotify": "https://open.spotify.com/show/76571Rfl3m7PLJQZKQIGCT",
"rss": "https://feeds.simplecast.com/TBotaapn"
}
},
"tech-nation": {
"id": "tech-nation",
"title": "Tech Nation Radio Podcast",
"info": "Tech Nation is a weekly public radio program, hosted by Dr. Moira Gunn. Founded in 1993, it has grown from a simple interview show to a multi-faceted production, featuring conversations with noted technology and science leaders, and a weekly science and technology-related commentary.",
"airtime": "FRI 10pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Tech-Nation-Radio-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "http://technation.podomatic.com/",
"meta": {
"site": "science",
"source": "Tech Nation Media"
},
"link": "/radio/program/tech-nation",
"subscribe": {
"rss": "https://technation.podomatic.com/rss2.xml"
}
},
"ted-radio-hour": {
"id": "ted-radio-hour",
"title": "TED Radio Hour",
"info": "The TED Radio Hour is a journey through fascinating ideas, astonishing inventions, fresh approaches to old problems, and new ways to think and create.",
"airtime": "SUN 3pm-4pm, SAT 10pm-11pm",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/tedRadioHour.jpg",
"officialWebsiteLink": "https://www.npr.org/programs/ted-radio-hour/?showDate=2018-06-22",
"meta": {
"site": "news",
"source": "npr"
},
"link": "/radio/program/ted-radio-hour",
"subscribe": {
"npr": "https://rpb3r.app.goo.gl/8vsS",
"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=523121474&at=11l79Y&ct=nprdirectory",
"tuneIn": "https://tunein.com/radio/TED-Radio-Hour-p418021/",
"rss": "https://feeds.npr.org/510298/podcast.xml"
}
},
"thebay": {
"id": "thebay",
"title": "The Bay",
"tagline": "Local news to keep you rooted",
"info": "Host Devin Katayama walks you through the biggest story of the day with reporters and newsmakers.",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-Bay-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED The Bay",
"officialWebsiteLink": "/podcasts/thebay",
"meta": {
"site": "radio",
"source": "kqed",
"order": 2
},
"link": "/podcasts/thebay",
"subscribe": {
"apple": "https://podcasts.apple.com/us/podcast/the-bay/id1350043452",
"amazon": "https://music.amazon.com/podcasts/d800ea4c-7a2c-42f2-b861-edaf78a5db0b/the-bay",
"npr": "https://www.npr.org/podcasts/586725995/the-bay",
"stitcher": "https://www.stitcher.com/podcast/kqed/the-bay",
"spotify": "https://open.spotify.com/show/4BIKBKIujizLHlIlBNaAqQ",
"rss": "https://feeds.megaphone.fm/KQINC8259786327"
}
},
"thelatest": {
"id": "thelatest",
"title": "The Latest",
"tagline": "Trusted local news in real time",
"info": "",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2025/05/The-Latest-2025-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED The Latest",
"officialWebsiteLink": "/thelatest",
"meta": {
"site": "news",
"source": "kqed",
"order": 6
},
"link": "/thelatest",
"subscribe": {
"apple": "https://podcasts.apple.com/us/podcast/the-latest-from-kqed/id1197721799",
"npr": "https://www.npr.org/podcasts/1257949365/the-latest-from-k-q-e-d",
"spotify": "https://open.spotify.com/show/5KIIXMgM9GTi5AepwOYvIZ?si=bd3053fec7244dba",
"rss": "https://feeds.megaphone.fm/KQINC9137121918"
}
},
"theleap": {
"id": "theleap",
"title": "The Leap",
"tagline": "What if you closed your eyes, and jumped?",
"info": "Stories about people making dramatic, risky changes, told by award-winning public radio reporter Judy Campbell.",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-Leap-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED The Leap",
"officialWebsiteLink": "/podcasts/theleap",
"meta": {
"site": "news",
"source": "kqed",
"order": 17
},
"link": "/podcasts/theleap",
"subscribe": {
"apple": "https://podcasts.apple.com/us/podcast/the-leap/id1046668171",
"npr": "https://www.npr.org/podcasts/447248267/the-leap",
"stitcher": "https://www.stitcher.com/podcast/kqed/the-leap",
"spotify": "https://open.spotify.com/show/3sSlVHHzU0ytLwuGs1SD1U",
"rss": "https://ww2.kqed.org/news/programs/the-leap/feed/podcast"
}
},
"the-moth-radio-hour": {
"id": "the-moth-radio-hour",
"title": "The Moth Radio Hour",
"info": "Since its launch in 1997, The Moth has presented thousands of true stories, told live and without notes, to standing-room-only crowds worldwide. Moth storytellers stand alone, under a spotlight, with only a microphone and a roomful of strangers. The storyteller and the audience embark on a high-wire act of shared experience which is both terrifying and exhilarating. Since 2008, The Moth podcast has featured many of our favorite stories told live on Moth stages around the country. For information on all of our programs and live events, visit themoth.org.",
"airtime": "SAT 8pm-9pm and SUN 11am-12pm",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/theMoth.jpg",
"officialWebsiteLink": "https://themoth.org/",
"meta": {
"site": "arts",
"source": "prx"
},
"link": "/radio/program/the-moth-radio-hour",
"subscribe": {
"apple": "https://itunes.apple.com/us/podcast/the-moth-podcast/id275699983?mt=2",
"tuneIn": "https://tunein.com/radio/The-Moth-p273888/",
"rss": "http://feeds.themoth.org/themothpodcast"
}
},
"the-new-yorker-radio-hour": {
"id": "the-new-yorker-radio-hour",
"title": "The New Yorker Radio Hour",
"info": "The New Yorker Radio Hour is a weekly program presented by the magazine's editor, David Remnick, and produced by WNYC Studios and The New Yorker. Each episode features a diverse mix of interviews, profiles, storytelling, and an occasional burst of humor inspired by the magazine, and shaped by its writers, artists, and editors. This isn't a radio version of a magazine, but something all its own, reflecting the rich possibilities of audio storytelling and conversation. Theme music for the show was composed and performed by Merrill Garbus of tUnE-YArDs.",
"airtime": "SAT 10am-11am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-New-Yorker-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.wnycstudios.org/shows/tnyradiohour",
"meta": {
"site": "arts",
"source": "WNYC"
},
"link": "/radio/program/the-new-yorker-radio-hour",
"subscribe": {
"apple": "https://itunes.apple.com/us/podcast/id1050430296",
"tuneIn": "https://tunein.com/podcasts/WNYC-Podcasts/New-Yorker-Radio-Hour-p803804/",
"rss": "https://feeds.feedburner.com/newyorkerradiohour"
}
},
"the-sam-sanders-show": {
"id": "the-sam-sanders-show",
"title": "The Sam Sanders Show",
"info": "One of public radio's most dynamic voices, Sam Sanders helped launch The NPR Politics Podcast and hosted NPR's hit show It's Been A Minute. Now, the award-winning host returns with something brand new, The Sam Sanders Show. Every week, Sam Sanders and friends dig into the culture that shapes our lives: what's driving the biggest trends, how artists really think, and even the memes you can't stop scrolling past. Sam is beloved for his way of unpacking the world and bringing you up close to fresh currents and engaging conversations. The Sam Sanders Show is smart, funny and always a good time.",
"airtime": "FRI 12-1pm AND SAT 11am-12pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2025/11/The-Sam-Sanders-Show-Podcast-Tile-400x400-1.jpg",
"officialWebsiteLink": "https://www.kcrw.com/shows/the-sam-sanders-show/latest",
"meta": {
"site": "arts",
"source": "KCRW"
},
"link": "https://www.kcrw.com/shows/the-sam-sanders-show/latest",
"subscribe": {
"rss": "https://feed.cdnstream1.com/zjb/feed/download/ac/28/59/ac28594c-e1d0-4231-8728-61865cdc80e8.xml"
}
},
"the-splendid-table": {
"id": "the-splendid-table",
"title": "The Splendid Table",
"info": "\u003cem>The Splendid Table\u003c/em> hosts our nation's conversations about cooking, sustainability and food culture.",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-Splendid-Table-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.splendidtable.org/",
"airtime": "SUN 10-11 pm",
"meta": {
"site": "radio",
"source": "npr"
},
"link": "/radio/program/the-splendid-table"
},
"this-american-life": {
"id": "this-american-life",
"title": "This American Life",
"info": "This American Life is a weekly public radio show, heard by 2.2 million people on more than 500 stations. Another 2.5 million people download the weekly podcast. It is hosted by Ira Glass, produced in collaboration with Chicago Public Media, delivered to stations by PRX The Public Radio Exchange, and has won all of the major broadcasting awards.",
"airtime": "SAT 12pm-1pm, 7pm-8pm",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/thisAmericanLife.png",
"officialWebsiteLink": "https://www.thisamericanlife.org/",
"meta": {
"site": "news",
"source": "wbez"
},
"link": "/radio/program/this-american-life",
"subscribe": {
"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=201671138&at=11l79Y&ct=nprdirectory",
"rss": "https://www.thisamericanlife.org/podcast/rss.xml"
}
},
"tinydeskradio": {
"id": "tinydeskradio",
"title": "Tiny Desk Radio",
"info": "We're bringing the best of Tiny Desk to the airwaves, only on public radio.",
"airtime": "SUN 8pm and SAT 9pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2025/04/300x300-For-Member-Station-Logo-Tiny-Desk-Radio-@2x.png",
"officialWebsiteLink": "https://www.npr.org/series/g-s1-52030/tiny-desk-radio",
"meta": {
"site": "news",
"source": "npr"
},
"link": "/radio/program/tinydeskradio",
"subscribe": {
"rss": "https://feeds.npr.org/g-s1-52030/rss.xml"
}
},
"wait-wait-dont-tell-me": {
"id": "wait-wait-dont-tell-me",
"title": "Wait Wait... Don't Tell Me!",
"info": "Peter Sagal and Bill Kurtis host the weekly NPR News quiz show alongside some of the best and brightest news and entertainment personalities.",
"airtime": "SUN 10am-11am, SAT 11am-12pm, SAT 6pm-7pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Wait-Wait-Podcast-Tile-300x300-1.jpg",
"officialWebsiteLink": "https://www.npr.org/programs/wait-wait-dont-tell-me/",
"meta": {
"site": "news",
"source": "npr"
},
"link": "/radio/program/wait-wait-dont-tell-me",
"subscribe": {
"npr": "https://rpb3r.app.goo.gl/Xogv",
"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=121493804&at=11l79Y&ct=nprdirectory",
"tuneIn": "https://tunein.com/radio/Wait-Wait-Dont-Tell-Me-p46/",
"rss": "https://feeds.npr.org/344098539/podcast.xml"
}
},
"weekend-edition-saturday": {
"id": "weekend-edition-saturday",
"title": "Weekend Edition Saturday",
"info": "Weekend Edition Saturday wraps up the week's news and offers a mix of analysis and features on a wide range of topics, including arts, sports, entertainment, and human interest stories. The two-hour program is hosted by NPR's Peabody Award-winning Scott Simon.",
"airtime": "SAT 5am-10am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Weekend-Edition-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.npr.org/programs/weekend-edition-saturday/",
"meta": {
"site": "news",
"source": "npr"
},
"link": "/radio/program/weekend-edition-saturday"
},
"weekend-edition-sunday": {
"id": "weekend-edition-sunday",
"title": "Weekend Edition Sunday",
"info": "Weekend Edition Sunday features interviews with newsmakers, artists, scientists, politicians, musicians, writers, theologians and historians. The program has covered news events from Nelson Mandela's 1990 release from a South African prison to the capture of Saddam Hussein.",
"airtime": "SUN 5am-10am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Weekend-Edition-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.npr.org/programs/weekend-edition-sunday/",
"meta": {
"site": "news",
"source": "npr"
},
"link": "/radio/program/weekend-edition-sunday"
}
},
"racesReducer": {},
"racesGenElectionReducer": {},
"racesGenElection2026Reducer": {},
"racesGenElection2026PresidentialReducer": {},
"radioSchedulesReducer": {},
"listsReducer": {
"posts/stateofhealth?category=tests-treatments": {
"isFetching": false,
"latestQuery": {
"from": 180,
"size": 12
},
"vitalsOnly": false,
"totalRequested": 12,
"isLoading": false,
"isLoadingMore": true,
"total": {
"value": 411,
"relation": "eq"
},
"items": [
"stateofhealth_39028",
"stateofhealth_35574",
"stateofhealth_35558",
"stateofhealth_34965",
"stateofhealth_33185",
"stateofhealth_31444",
"stateofhealth_31026",
"stateofhealth_30459",
"stateofhealth_30382",
"stateofhealth_30425",
"stateofhealth_30359",
"stateofhealth_29198"
],
"complete": true
}
},
"recallGuideReducer": {
"intros": {},
"policy": {},
"candidates": {}
},
"savedArticleReducer": {
"articles": [],
"status": {}
},
"newslettersReducer": {
"isFetching": false,
"fetchFailed": false,
"hasFetched": false,
"newsletters": {},
"isSubscribing": false,
"isUnsubscribing": false,
"subscribedNewsletters": {}
},
"termsReducer": {
"about": {
"name": "About",
"type": "terms",
"id": "about",
"slug": "about",
"link": "/about",
"taxonomy": "site"
},
"arts": {
"name": "Arts & Culture",
"grouping": [
"arts",
"pop",
"trulyca"
],
"description": "KQED Arts provides daily in-depth coverage of the Bay Area's music, art, film, performing arts, literature and arts news, as well as cultural commentary and criticism.",
"type": "terms",
"id": "arts",
"slug": "arts",
"link": "/arts",
"taxonomy": "site"
},
"artschool": {
"name": "Art School",
"parent": "arts",
"type": "terms",
"id": "artschool",
"slug": "artschool",
"link": "/artschool",
"taxonomy": "site"
},
"bayareabites": {
"name": "KQED food",
"grouping": [
"food",
"bayareabites",
"checkplease"
],
"parent": "food",
"type": "terms",
"id": "bayareabites",
"slug": "bayareabites",
"link": "/food",
"taxonomy": "site"
},
"bayareahiphop": {
"name": "Bay Area Hiphop",
"type": "terms",
"id": "bayareahiphop",
"slug": "bayareahiphop",
"link": "/bayareahiphop",
"taxonomy": "site"
},
"campaign21": {
"name": "Campaign 21",
"type": "terms",
"id": "campaign21",
"slug": "campaign21",
"link": "/campaign21",
"taxonomy": "site"
},
"careers": {
"name": "Careers",
"type": "terms",
"id": "careers",
"slug": "careers",
"link": "/careers",
"taxonomy": "site"
},
"checkplease": {
"name": "KQED food",
"grouping": [
"food",
"bayareabites",
"checkplease"
],
"parent": "food",
"type": "terms",
"id": "checkplease",
"slug": "checkplease",
"link": "/food",
"taxonomy": "site"
},
"education": {
"name": "Education",
"grouping": [
"education"
],
"type": "terms",
"id": "education",
"slug": "education",
"link": "/education",
"taxonomy": "site"
},
"elections": {
"name": "Elections",
"type": "terms",
"id": "elections",
"slug": "elections",
"link": "/elections",
"taxonomy": "site"
},
"events": {
"name": "Events",
"type": "terms",
"id": "events",
"slug": "events",
"link": "/events",
"taxonomy": "site"
},
"event": {
"name": "Event",
"alias": "events",
"type": "terms",
"id": "event",
"slug": "event",
"link": "/event",
"taxonomy": "site"
},
"filmschoolshorts": {
"name": "Film School Shorts",
"type": "terms",
"id": "filmschoolshorts",
"slug": "filmschoolshorts",
"link": "/filmschoolshorts",
"taxonomy": "site"
},
"food": {
"name": "KQED food",
"grouping": [
"food",
"bayareabites",
"checkplease"
],
"type": "terms",
"id": "food",
"slug": "food",
"link": "/food",
"taxonomy": "site"
},
"forum": {
"name": "Forum",
"relatedContentQuery": "posts/forum?",
"parent": "news",
"type": "terms",
"id": "forum",
"slug": "forum",
"link": "/forum",
"taxonomy": "site"
},
"futureofyou": {
"name": "Future of You",
"grouping": [
"science",
"futureofyou"
],
"parent": "science",
"type": "terms",
"id": "futureofyou",
"slug": "futureofyou",
"link": "/futureofyou",
"taxonomy": "site"
},
"jpepinheart": {
"name": "KQED food",
"relatedContentQuery": "posts/food,bayareabites,checkplease",
"parent": "food",
"type": "terms",
"id": "jpepinheart",
"slug": "jpepinheart",
"link": "/food",
"taxonomy": "site"
},
"liveblog": {
"name": "Live Blog",
"type": "terms",
"id": "liveblog",
"slug": "liveblog",
"link": "/liveblog",
"taxonomy": "site"
},
"livetv": {
"name": "Live TV",
"parent": "tv",
"type": "terms",
"id": "livetv",
"slug": "livetv",
"link": "/livetv",
"taxonomy": "site"
},
"lowdown": {
"name": "The Lowdown",
"relatedContentQuery": "posts/lowdown?",
"parent": "news",
"type": "terms",
"id": "lowdown",
"slug": "lowdown",
"link": "/lowdown",
"taxonomy": "site"
},
"mindshift": {
"name": "Mindshift",
"parent": "news",
"description": "MindShift explores the future of education by highlighting the innovative – and sometimes counterintuitive – ways educators and parents are helping all children succeed.",
"type": "terms",
"id": "mindshift",
"slug": "mindshift",
"link": "/mindshift",
"taxonomy": "site"
},
"news": {
"name": "News",
"grouping": [
"news",
"forum"
],
"type": "terms",
"id": "news",
"slug": "news",
"link": "/news",
"taxonomy": "site"
},
"newsletters": {
"name": "newsletters",
"type": "terms",
"id": "newsletters",
"slug": "newsletters",
"link": "/newsletters",
"taxonomy": "site"
},
"perspectives": {
"name": "Perspectives",
"parent": "radio",
"type": "terms",
"id": "perspectives",
"slug": "perspectives",
"link": "/perspectives",
"taxonomy": "site"
},
"podcasts": {
"name": "Podcasts",
"type": "terms",
"id": "podcasts",
"slug": "podcasts",
"link": "/podcasts",
"taxonomy": "site"
},
"pop": {
"name": "Pop",
"parent": "arts",
"type": "terms",
"id": "pop",
"slug": "pop",
"link": "/pop",
"taxonomy": "site"
},
"pressroom": {
"name": "Pressroom",
"type": "terms",
"id": "pressroom",
"slug": "pressroom",
"link": "/pressroom",
"taxonomy": "site"
},
"quest": {
"name": "Quest",
"parent": "science",
"type": "terms",
"id": "quest",
"slug": "quest",
"link": "/quest",
"taxonomy": "site"
},
"radio": {
"name": "Radio",
"grouping": [
"forum",
"perspectives"
],
"description": "Listen to KQED Public Radio – home of Forum and The California Report – on 88.5 FM in San Francisco, 89.3 FM in Sacramento, 88.3 FM in Santa Rosa and 88.1 FM in Martinez.",
"type": "terms",
"id": "radio",
"slug": "radio",
"link": "/radio",
"taxonomy": "site"
},
"root": {
"name": "KQED",
"image": "https://ww2.kqed.org/app/uploads/2020/02/KQED-OG-Image@1x.png",
"imageWidth": 1200,
"imageHeight": 630,
"headData": {
"title": "KQED | News, Radio, Podcasts, TV | Public Media for Northern California",
"description": "KQED provides public radio, television, and independent reporting on issues that matter to the Bay Area. We’re the NPR and PBS member station for Northern California."
},
"type": "terms",
"id": "root",
"slug": "root",
"link": "/root",
"taxonomy": "site"
},
"science": {
"name": "Science",
"grouping": [
"science",
"futureofyou"
],
"description": "KQED Science brings you award-winning science and environment coverage from the Bay Area and beyond.",
"type": "terms",
"id": "science",
"slug": "science",
"link": "/science",
"taxonomy": "site"
},
"stateofhealth": {
"name": "State of Health",
"parent": "science",
"type": "terms",
"id": "stateofhealth",
"slug": "stateofhealth",
"link": "/stateofhealth",
"taxonomy": "site"
},
"support": {
"name": "Support",
"type": "terms",
"id": "support",
"slug": "support",
"link": "/support",
"taxonomy": "site"
},
"thedolist": {
"name": "The Do List",
"parent": "arts",
"type": "terms",
"id": "thedolist",
"slug": "thedolist",
"link": "/thedolist",
"taxonomy": "site"
},
"trulyca": {
"name": "Truly CA",
"grouping": [
"arts",
"pop",
"trulyca"
],
"parent": "arts",
"type": "terms",
"id": "trulyca",
"slug": "trulyca",
"link": "/trulyca",
"taxonomy": "site"
},
"tv": {
"name": "TV",
"type": "terms",
"id": "tv",
"slug": "tv",
"link": "/tv",
"taxonomy": "site"
},
"voterguide": {
"name": "Voter Guide",
"parent": "elections",
"alias": "elections",
"type": "terms",
"id": "voterguide",
"slug": "voterguide",
"link": "/voterguide",
"taxonomy": "site"
},
"guiaelectoral": {
"name": "Guia Electoral",
"parent": "elections",
"alias": "elections",
"type": "terms",
"id": "guiaelectoral",
"slug": "guiaelectoral",
"link": "/guiaelectoral",
"taxonomy": "site"
},
"stateofhealth_category_tests-treatments": {
"isLoading": true
},
"stateofhealth_13": {
"type": "terms",
"id": "stateofhealth_13",
"meta": {
"index": "terms_1716263798",
"site": "stateofhealth",
"id": "13",
"found": true
},
"relationships": {},
"featImg": null,
"name": "Tests & Treatments",
"description": "Information and new research about advances in discovering and treating diseases and conditions.",
"taxonomy": "category",
"headData": {
"twImgId": null,
"twTitle": null,
"ogTitle": null,
"ogImgId": null,
"twDescription": null,
"description": "Information and new research about advances in discovering and treating diseases and conditions.",
"title": "Tests & Treatments Archives | KQED Arts",
"ogDescription": null
},
"ttid": 13,
"slug": "tests-treatments",
"isLoading": false,
"link": "/stateofhealth/category/tests-treatments"
},
"stateofhealth_155": {
"type": "terms",
"id": "stateofhealth_155",
"meta": {
"index": "terms_1716263798",
"site": "stateofhealth",
"id": "155",
"found": true
},
"relationships": {},
"featImg": null,
"name": "Autism",
"description": null,
"taxonomy": "tag",
"headData": {
"twImgId": null,
"twTitle": null,
"ogTitle": null,
"ogImgId": null,
"twDescription": null,
"description": null,
"title": "Autism Archives | KQED Arts",
"ogDescription": null
},
"ttid": 155,
"slug": "autism",
"isLoading": false,
"link": "/stateofhealth/tag/autism"
},
"stateofhealth_2407": {
"type": "terms",
"id": "stateofhealth_2407",
"meta": {
"index": "terms_1716263798",
"site": "stateofhealth",
"id": "2407",
"found": true
},
"relationships": {},
"featImg": null,
"name": "Digital Health",
"description": null,
"taxonomy": "category",
"headData": {
"twImgId": null,
"twTitle": null,
"ogTitle": null,
"ogImgId": null,
"twDescription": null,
"description": null,
"title": "Digital Health Archives | KQED Arts",
"ogDescription": null
},
"ttid": 2418,
"slug": "digital-health",
"isLoading": false,
"link": "/stateofhealth/category/digital-health"
},
"stateofhealth_461": {
"type": "terms",
"id": "stateofhealth_461",
"meta": {
"index": "terms_1716263798",
"site": "stateofhealth",
"id": "461",
"found": true
},
"relationships": {},
"featImg": null,
"name": "Science",
"description": null,
"taxonomy": "tag",
"headData": {
"twImgId": null,
"twTitle": null,
"ogTitle": null,
"ogImgId": null,
"twDescription": null,
"description": null,
"title": "Science Archives | KQED Arts",
"ogDescription": null
},
"ttid": 462,
"slug": "science",
"isLoading": false,
"link": "/stateofhealth/tag/science"
},
"stateofhealth_11": {
"type": "terms",
"id": "stateofhealth_11",
"meta": {
"index": "terms_1716263798",
"site": "stateofhealth",
"id": "11",
"found": true
},
"relationships": {},
"featImg": null,
"name": "Community Health",
"description": "\r\n\r\nFrom rural California to urban neighborhoods, where you live affects your health",
"taxonomy": "category",
"headData": {
"twImgId": null,
"twTitle": null,
"ogTitle": null,
"ogImgId": null,
"twDescription": null,
"description": "From rural California to urban neighborhoods, where you live affects your health",
"title": "Community Health Archives | KQED Arts",
"ogDescription": null
},
"ttid": 11,
"slug": "place-matters",
"isLoading": false,
"link": "/stateofhealth/category/place-matters"
},
"stateofhealth_40": {
"type": "terms",
"id": "stateofhealth_40",
"meta": {
"index": "terms_1716263798",
"site": "stateofhealth",
"id": "40",
"found": true
},
"relationships": {},
"featImg": null,
"name": "End of Life Care",
"description": null,
"taxonomy": "tag",
"headData": {
"twImgId": null,
"twTitle": null,
"ogTitle": null,
"ogImgId": null,
"twDescription": null,
"description": null,
"title": "End of Life Care Archives | KQED Arts",
"ogDescription": null
},
"ttid": 40,
"slug": "end-of-life-care",
"isLoading": false,
"link": "/stateofhealth/tag/end-of-life-care"
},
"stateofhealth_12": {
"type": "terms",
"id": "stateofhealth_12",
"meta": {
"index": "terms_1716263798",
"site": "stateofhealth",
"id": "12",
"found": true
},
"relationships": {},
"featImg": null,
"name": "Living Healthy",
"description": "Health is about much more than medicine. We show you what's new to help you attain and maintain a healthy life",
"taxonomy": "category",
"headData": {
"twImgId": null,
"twTitle": null,
"ogTitle": null,
"ogImgId": null,
"twDescription": null,
"description": "Health is about much more than medicine. We show you what's new to help you attain and maintain a healthy life",
"title": "Living Healthy Archives | KQED Arts",
"ogDescription": null
},
"ttid": 12,
"slug": "living-healthy",
"isLoading": false,
"link": "/stateofhealth/category/living-healthy"
},
"stateofhealth_46": {
"type": "terms",
"id": "stateofhealth_46",
"meta": {
"index": "terms_1716263798",
"site": "stateofhealth",
"id": "46",
"found": true
},
"relationships": {},
"featImg": null,
"name": "Breast Cancer",
"description": null,
"taxonomy": "tag",
"headData": {
"twImgId": null,
"twTitle": null,
"ogTitle": null,
"ogImgId": null,
"twDescription": null,
"description": null,
"title": "Breast Cancer Archives | KQED Arts",
"ogDescription": null
},
"ttid": 46,
"slug": "breast-cancer",
"isLoading": false,
"link": "/stateofhealth/tag/breast-cancer"
},
"stateofhealth_235": {
"type": "terms",
"id": "stateofhealth_235",
"meta": {
"index": "terms_1716263798",
"site": "stateofhealth",
"id": "235",
"found": true
},
"relationships": {},
"featImg": null,
"name": "Overtreatment",
"description": null,
"taxonomy": "tag",
"headData": {
"twImgId": null,
"twTitle": null,
"ogTitle": null,
"ogImgId": null,
"twDescription": null,
"description": null,
"title": "Overtreatment Archives | KQED Arts",
"ogDescription": null
},
"ttid": 235,
"slug": "overtreatment",
"isLoading": false,
"link": "/stateofhealth/tag/overtreatment"
},
"stateofhealth_31": {
"type": "terms",
"id": "stateofhealth_31",
"meta": {
"index": "terms_1716263798",
"site": "stateofhealth",
"id": "31",
"found": true
},
"relationships": {},
"featImg": null,
"name": "Vaccines",
"description": null,
"taxonomy": "tag",
"headData": {
"twImgId": null,
"twTitle": null,
"ogTitle": null,
"ogImgId": null,
"twDescription": null,
"description": null,
"title": "Vaccines Archives | KQED Arts",
"ogDescription": null
},
"ttid": 31,
"slug": "vaccines",
"isLoading": false,
"link": "/stateofhealth/tag/vaccines"
},
"stateofhealth_14": {
"type": "terms",
"id": "stateofhealth_14",
"meta": {
"index": "terms_1716263798",
"site": "stateofhealth",
"id": "14",
"found": true
},
"relationships": {},
"featImg": null,
"name": "Policy",
"description": "Actions by people in power – lawmakers, regulators and the like – can make a difference to your health, for better or for worse. We keep you informed",
"taxonomy": "category",
"headData": {
"twImgId": null,
"twTitle": null,
"ogTitle": null,
"ogImgId": null,
"twDescription": null,
"description": "Actions by people in power – lawmakers, regulators and the like – can make a difference to your health, for better or for worse. We keep you informed",
"title": "Policy Archives | KQED Arts",
"ogDescription": null
},
"ttid": 14,
"slug": "policy",
"isLoading": false,
"link": "/stateofhealth/category/policy"
},
"stateofhealth_96": {
"type": "terms",
"id": "stateofhealth_96",
"meta": {
"index": "terms_1716263798",
"site": "stateofhealth",
"id": "96",
"found": true
},
"relationships": {},
"featImg": null,
"name": "Children's Health",
"description": null,
"taxonomy": "tag",
"headData": {
"twImgId": null,
"twTitle": null,
"ogTitle": null,
"ogImgId": null,
"twDescription": null,
"description": null,
"title": "Children's Health Archives | KQED Arts",
"ogDescription": null
},
"ttid": 96,
"slug": "childrens-health",
"isLoading": false,
"link": "/stateofhealth/tag/childrens-health"
},
"stateofhealth_2492": {
"type": "terms",
"id": "stateofhealth_2492",
"meta": {
"index": "terms_1716263798",
"site": "stateofhealth",
"id": "2492",
"found": true
},
"relationships": {},
"featImg": null,
"name": "Price Check",
"description": null,
"taxonomy": "series",
"headData": {
"twImgId": null,
"twTitle": null,
"ogTitle": null,
"ogImgId": null,
"twDescription": null,
"description": null,
"title": "Price Check Archives | KQED Arts",
"ogDescription": null
},
"ttid": 802,
"slug": "price-check",
"isLoading": false,
"link": "/stateofhealth/series/price-check"
},
"stateofhealth_482": {
"type": "terms",
"id": "stateofhealth_482",
"meta": {
"index": "terms_1716263798",
"site": "stateofhealth",
"id": "482",
"found": true
},
"relationships": {},
"featImg": null,
"name": "Health Care Costs",
"description": null,
"taxonomy": "tag",
"headData": {
"twImgId": null,
"twTitle": null,
"ogTitle": null,
"ogImgId": null,
"twDescription": null,
"description": null,
"title": "Health Care Costs Archives | KQED Arts",
"ogDescription": null
},
"ttid": 483,
"slug": "health-care-costs",
"isLoading": false,
"link": "/stateofhealth/tag/health-care-costs"
},
"stateofhealth_841": {
"type": "terms",
"id": "stateofhealth_841",
"meta": {
"index": "terms_1716263798",
"site": "stateofhealth",
"id": "841",
"found": true
},
"relationships": {},
"featImg": null,
"name": "PriceCheck",
"description": null,
"taxonomy": "tag",
"headData": {
"twImgId": null,
"twTitle": null,
"ogTitle": null,
"ogImgId": null,
"twDescription": null,
"description": null,
"title": "PriceCheck Archives | KQED Arts",
"ogDescription": null
},
"ttid": 844,
"slug": "pricecheck",
"isLoading": false,
"link": "/stateofhealth/tag/pricecheck"
},
"stateofhealth_2363": {
"type": "terms",
"id": "stateofhealth_2363",
"meta": {
"index": "terms_1716263798",
"site": "stateofhealth",
"id": "2363",
"found": true
},
"relationships": {},
"featImg": null,
"name": "Vital Signs",
"description": "What does health look like for you, your family, and your neighborhood? Share your story about what your community needs to be healthy.\r\n\r\nIf you would like to learn more, please contact KQED's \u003ca href=\"mailto:fjhabvala@kqed.org\" target=\"_blank\">Farida Jhabvala Romero.\u003c/a>",
"taxonomy": "series",
"headData": {
"twImgId": null,
"twTitle": null,
"ogTitle": null,
"ogImgId": null,
"twDescription": null,
"description": "What does health look like for you, your family, and your neighborhood? Share your story about what your community needs to be healthy. If you would like to learn more, please contact KQED's Farida Jhabvala Romero.",
"title": "Vital Signs Archives | KQED Arts",
"ogDescription": null
},
"ttid": 722,
"slug": "vital-signs",
"isLoading": false,
"link": "/stateofhealth/series/vital-signs"
},
"stateofhealth_783": {
"type": "terms",
"id": "stateofhealth_783",
"meta": {
"index": "terms_1716263798",
"site": "stateofhealth",
"id": "783",
"found": true
},
"relationships": {},
"featImg": null,
"name": "Trans Health",
"description": null,
"taxonomy": "tag",
"headData": {
"twImgId": null,
"twTitle": null,
"ogTitle": null,
"ogImgId": null,
"twDescription": null,
"description": null,
"title": "Trans Health Archives | KQED Arts",
"ogDescription": null
},
"ttid": 785,
"slug": "trans-health",
"isLoading": false,
"link": "/stateofhealth/tag/trans-health"
},
"stateofhealth_160": {
"type": "terms",
"id": "stateofhealth_160",
"meta": {
"index": "terms_1716263798",
"site": "stateofhealth",
"id": "160",
"found": true
},
"relationships": {},
"featImg": null,
"name": "Abortion",
"description": null,
"taxonomy": "tag",
"headData": {
"twImgId": null,
"twTitle": null,
"ogTitle": null,
"ogImgId": null,
"twDescription": null,
"description": null,
"title": "Abortion Archives | KQED Arts",
"ogDescription": null
},
"ttid": 160,
"slug": "abortion",
"isLoading": false,
"link": "/stateofhealth/tag/abortion"
},
"stateofhealth_23": {
"type": "terms",
"id": "stateofhealth_23",
"meta": {
"index": "terms_1716263798",
"site": "stateofhealth",
"id": "23",
"found": true
},
"relationships": {},
"featImg": null,
"name": "asthma",
"description": null,
"taxonomy": "tag",
"headData": {
"twImgId": null,
"twTitle": null,
"ogTitle": null,
"ogImgId": null,
"twDescription": null,
"description": null,
"title": "asthma Archives | KQED Arts",
"ogDescription": null
},
"ttid": 23,
"slug": "asthma",
"isLoading": false,
"link": "/stateofhealth/tag/asthma"
}
},
"userPermissionsReducer": {
"wpLoggedIn": false
},
"eventsReducer": {},
"fssReducer": {},
"tvDailyScheduleReducer": {},
"tvWeeklyScheduleReducer": {},
"tvPrimetimeScheduleReducer": {},
"tvMonthlyScheduleReducer": {},
"userAccountReducer": {
"user": {
"email": null,
"emailStatus": "EMAIL_UNVALIDATED",
"loggedStatus": "LOGGED_OUT",
"loggingChecked": false,
"articles": [],
"firstName": null,
"lastName": null,
"phoneNumber": null,
"fetchingMembership": false,
"membershipError": false,
"memberships": [
{
"id": null,
"startDate": null,
"firstName": null,
"lastName": null,
"familyNumber": null,
"memberNumber": null,
"memberSince": null,
"expirationDate": null,
"pfsEligible": false,
"isSustaining": false,
"membershipLevel": "Prospect",
"membershipStatus": "Non Member",
"lastGiftDate": null,
"renewalDate": null,
"lastDonationAmount": null
}
]
},
"authModal": {
"isOpen": false,
"view": "LANDING_VIEW"
},
"error": null
},
"youthMediaReducer": {},
"checkPleaseReducer": {
"filterData": {
"region": {
"key": "Restaurant Region",
"filters": [
"Any Region"
]
},
"cuisine": {
"key": "Restaurant Cuisine",
"filters": [
"Any Cuisine"
]
}
},
"restaurantDataById": {},
"restaurantIdsSorted": [],
"error": null
},
"userAgentReducer": {
"userAgent": "Mozilla/5.0 AppleWebKit/537.36 (KHTML, like Gecko; compatible; ClaudeBot/1.0; +claudebot@anthropic.com)",
"isBot": true
},
"requestOutcomesReducer": {
"notFound": []
},
"navPromosReducer": {
"isFetching": false,
"fetchFailed": false,
"hasFetched": true,
"promos": {
"news": {
"name": "2026 Voter Guide",
"link": "/voterguide",
"imageURL": "https://cdn.kqed.org/wp-content/uploads/2026/10/Nav-News-Nov2026ElectionCoverage@2x-7bd4aad4.png",
"description": "Get informed in minutes with our Voter Guide for California’s November 3 election."
},
"podcasts-radio": {},
"video-tv": {},
"events": {},
"support": {}
}
}
}