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.
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"content": "\u003cp>Maryjane Davis, a 17-year-old with long brown hair, pulls out a thick, white binder from her backpack in the bedroom she shares with her two younger sisters. The binder is filled with information -- about different kinds of contraceptives, how to prevent sexually transmitted infections, and emotionally healthy relationships versus abusive ones.\u003c/p>\n\u003cp>Maryjane carries it almost daily to her high school in Fresno. It’s a handy tool she turns to when other students approach her during lunch breaks with questions about sexual health or how to select the right contraceptive.\u003c/p>\n\u003cp>“I just keep it on my person. That way in case someone needs something, I can just pull it out,\" she says. “It makes me feel like a superhero. And it's kind of like a superpower to know about sex ed and healthy relationships.”\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/266812920\" 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>Maryjane trained to become a peer health ambassador at \u003ca href=\"http://www.fresnobarriosunidos.org/\" target=\"_blank\">Fresno Barrios Unidos\u003c/a>, a local education and advocacy group.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Three years ago, Maryjane wasn’t as informed. She thought kissing equaled sex. She had all kinds of questions, but asking her parents or searching online wasn’t yielding answers. Many of her friends were in the same boat, she says. Some were getting pregnant and dropping out of school.\u003c/p>\n\u003cp>It worried her that some teen moms she knew “weren't sure how they got pregnant or when they even started to get pregnant,” she says. When Maryjane sought to learn more about sex, she says her middle school teacher handed her an “abstinence card” to sign. It stated that the person signing it would avoid sex until marriage.\u003c/p>\n\u003cp>“I didn’t even know what the word abstinence meant,” she says. “It was just one card and that was going to be my sex ed class.\"\u003c/p>\n\u003cfigure id=\"attachment_189989\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"wp-image-189989 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/05/RS19634_WithSiblingsBedroom-qut.jpg\" alt=\"Maryjane Davis in her bedroom with sister Ricci, 12, friend Mary Jane Rodriguez, 11, and sister Lily, 8. Maryjane trained to become a peer health ambassador with a local non-profit to help friends at school learn about how to prevent STDs and unplanned pregnancies.\" width=\"1920\" height=\"1261\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19634_WithSiblingsBedroom-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19634_WithSiblingsBedroom-qut-400x263.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19634_WithSiblingsBedroom-qut-800x525.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19634_WithSiblingsBedroom-qut-768x504.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19634_WithSiblingsBedroom-qut-1440x946.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19634_WithSiblingsBedroom-qut-1180x775.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19634_WithSiblingsBedroom-qut-960x631.jpg 960w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Maryjane Davis in her bedroom with sister Ricci, 12, friend Mary Jane Rodriguez, 11, and sister Lily, 8. Maryjane often carries the binder she's holding to help educate kids at school on sexual health. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>New State Law Requires Comprehensive Sex Ed\u003c/strong>\u003c/p>\n\u003cp>Until last year, public schools in California were not required to teach sex education, although information on HIV/AIDS prevention has been mandatory. At Fresno Unified, the fourth largest school district in the state, students learned about HIV/AIDS prevention and some sex ed. But youth health advocates say the quality and accuracy of that education varied greatly from school to school, leaving many kids without the necessary tools to make informed decisions about their health.\u003c/p>\n\u003cp>Fresno County has the state’s second highest rates of the sexually transmitted infections chlamydia and gonorrhea, according to the California Department of Public Health. The county also has one of the highest rates of teen pregnancy.\u003c/p>\n\u003cp>Barrios Unidos has been filling the gap in education. For years, it has offered teen pregnancy prevention and other sex ed through after school programs. Maryjane signed up for one course and felt empowered by the new information.\u003c/p>\n\u003cp>Maryjane and other students lobbied Fresno Unified to improve its sex ed, and last October, the school board approved a comprehensive program.\u003c/p>\n\u003cp>The Fresno Unified school board’s vote came just two months before a California law requiring all districts to provide comprehensive sexual education and HIV prevention went into effect. The \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160AB329\" target=\"_blank\">California Healthy Youth Act\u003c/a> mandates that curriculum on “human development and sexuality, including education on pregnancy, contraception and sexually transmitted infections” be provided to students at least once in junior high or middle school and once in high school. Parents can refuse the classes on behalf of their children.\u003c/p>\n\u003cp>\u003cstrong>'Full Imprementation' in Fresno Schools\u003c/strong>\u003c/p>\n\u003cp>Science and biology classes at Fresno Unified now teach 7th and 9th graders the Positive Prevention Plus curriculum, the highest-rated sexual health education program approved by the California Department of Education, says Rosario Sanchez, associate superintendent of curriculum and instruction at Fresno Unified.\u003c/p>\n\u003cp>“We are in full implementation,” says Sanchez. “Giving (our students) access to this information is critical, so we can reduce the county stats that are stark.”\u003c/p>\n\u003cp>Fresno Unified, with 73,000 students, now also contracts with Barrios Unidos to provide half of the sex ed courses to high school students.\u003c/p>\n\u003cp>“The education they are getting is very comprehensive and medically accurate,\" says Socorro Santillan, executive director at Barrios Unidos. Students \"will be able to make good decisions for themselves not based on scare tactics, but knowledge.”\u003c/p>\n\u003cp>Fourteen other area school districts are working with the Fresno County Office of Education to provide the classes, says Kayla Wilson, a consultant with FCOE.\u003c/p>\n\u003cp>Over the last two months, Wilson and five nurses have been teaching a similar curriculum to 7th and 9th graders in the Fresno County school districts of Fowler, Mendota and Firebaugh-Las Deltas.\u003c/p>\n\u003cp>Wilson said a lot of her outreach work focuses on speaking with parents and school boards about the curriculum, and addressing parents' and administrators' fears about what the students will be learning. She said no students have opted out so far.\u003c/p>\n\u003cfigure id=\"attachment_189987\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"size-full wp-image-189987\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/05/RS19632_HoldingBinder-qut.jpg\" alt=\"Maryjane Davis, 17, holds the binder with sexual health information that she uses to answer the questions of peers at school in Fresno. She says some teen moms didn't know how they got pregnant.\" width=\"1920\" height=\"1952\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19632_HoldingBinder-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19632_HoldingBinder-qut-400x407.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19632_HoldingBinder-qut-800x813.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19632_HoldingBinder-qut-768x781.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19632_HoldingBinder-qut-1440x1464.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19632_HoldingBinder-qut-1180x1200.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19632_HoldingBinder-qut-960x976.jpg 960w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19632_HoldingBinder-qut-32x32.jpg 32w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19632_HoldingBinder-qut-50x50.jpg 50w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19632_HoldingBinder-qut-64x64.jpg 64w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Maryjane Davis, 17, holds the binder with sexual health information that she uses to answer the questions of peers at school in Fresno. She says some teen moms didn't know how they got pregnant. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>At Maryjane Davis’ home, sex ed has changed the family dynamics. Maryjane's mother, Sara Angulo, was so inspired by her daughter's greater confidence and desire to help other teens after taking the sex ed course at Barrios Unidos that she took her 8- and 12-year-old daughters to age-appropriate sex ed classes at Barrios as well.\u003c/p>\n\u003cp>“I think it's very important that everyone learns,” says Angulo, 38. “There are questions that they won't ask me. But they'll ask someone else, and so it's awesome.”\u003c/p>\n\u003cp>Angulo, who has nine children, says when she was growing up, there was no talk about sex in her family.\u003c/p>\n\u003cp>“It was never, never talked about. I had my first (baby) at a very young age,\" she says. \"It was almost expected to be a teenage mother in my family,” says Angulo.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“These girls know enough to (say), ‘I can wait.’”\u003c/p>\n\n",
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"excerpt": "17-year-old Maryjane Davis makes it her mission to teach Fresno teens about sexual health, to prevent STDs and unplanned pregnancies. . ",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Maryjane Davis, a 17-year-old with long brown hair, pulls out a thick, white binder from her backpack in the bedroom she shares with her two younger sisters. The binder is filled with information -- about different kinds of contraceptives, how to prevent sexually transmitted infections, and emotionally healthy relationships versus abusive ones.\u003c/p>\n\u003cp>Maryjane carries it almost daily to her high school in Fresno. It’s a handy tool she turns to when other students approach her during lunch breaks with questions about sexual health or how to select the right contraceptive.\u003c/p>\n\u003cp>“I just keep it on my person. That way in case someone needs something, I can just pull it out,\" she says. “It makes me feel like a superhero. And it's kind of like a superpower to know about sex ed and healthy relationships.”\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/266812920&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/266812920'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Maryjane trained to become a peer health ambassador at \u003ca href=\"http://www.fresnobarriosunidos.org/\" target=\"_blank\">Fresno Barrios Unidos\u003c/a>, a local education and advocacy group.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Three years ago, Maryjane wasn’t as informed. She thought kissing equaled sex. She had all kinds of questions, but asking her parents or searching online wasn’t yielding answers. Many of her friends were in the same boat, she says. Some were getting pregnant and dropping out of school.\u003c/p>\n\u003cp>It worried her that some teen moms she knew “weren't sure how they got pregnant or when they even started to get pregnant,” she says. When Maryjane sought to learn more about sex, she says her middle school teacher handed her an “abstinence card” to sign. It stated that the person signing it would avoid sex until marriage.\u003c/p>\n\u003cp>“I didn’t even know what the word abstinence meant,” she says. “It was just one card and that was going to be my sex ed class.\"\u003c/p>\n\u003cfigure id=\"attachment_189989\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"wp-image-189989 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/05/RS19634_WithSiblingsBedroom-qut.jpg\" alt=\"Maryjane Davis in her bedroom with sister Ricci, 12, friend Mary Jane Rodriguez, 11, and sister Lily, 8. Maryjane trained to become a peer health ambassador with a local non-profit to help friends at school learn about how to prevent STDs and unplanned pregnancies.\" width=\"1920\" height=\"1261\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19634_WithSiblingsBedroom-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19634_WithSiblingsBedroom-qut-400x263.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19634_WithSiblingsBedroom-qut-800x525.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19634_WithSiblingsBedroom-qut-768x504.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19634_WithSiblingsBedroom-qut-1440x946.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19634_WithSiblingsBedroom-qut-1180x775.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19634_WithSiblingsBedroom-qut-960x631.jpg 960w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Maryjane Davis in her bedroom with sister Ricci, 12, friend Mary Jane Rodriguez, 11, and sister Lily, 8. Maryjane often carries the binder she's holding to help educate kids at school on sexual health. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>New State Law Requires Comprehensive Sex Ed\u003c/strong>\u003c/p>\n\u003cp>Until last year, public schools in California were not required to teach sex education, although information on HIV/AIDS prevention has been mandatory. At Fresno Unified, the fourth largest school district in the state, students learned about HIV/AIDS prevention and some sex ed. But youth health advocates say the quality and accuracy of that education varied greatly from school to school, leaving many kids without the necessary tools to make informed decisions about their health.\u003c/p>\n\u003cp>Fresno County has the state’s second highest rates of the sexually transmitted infections chlamydia and gonorrhea, according to the California Department of Public Health. The county also has one of the highest rates of teen pregnancy.\u003c/p>\n\u003cp>Barrios Unidos has been filling the gap in education. For years, it has offered teen pregnancy prevention and other sex ed through after school programs. Maryjane signed up for one course and felt empowered by the new information.\u003c/p>\n\u003cp>Maryjane and other students lobbied Fresno Unified to improve its sex ed, and last October, the school board approved a comprehensive program.\u003c/p>\n\u003cp>The Fresno Unified school board’s vote came just two months before a California law requiring all districts to provide comprehensive sexual education and HIV prevention went into effect. The \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160AB329\" target=\"_blank\">California Healthy Youth Act\u003c/a> mandates that curriculum on “human development and sexuality, including education on pregnancy, contraception and sexually transmitted infections” be provided to students at least once in junior high or middle school and once in high school. Parents can refuse the classes on behalf of their children.\u003c/p>\n\u003cp>\u003cstrong>'Full Imprementation' in Fresno Schools\u003c/strong>\u003c/p>\n\u003cp>Science and biology classes at Fresno Unified now teach 7th and 9th graders the Positive Prevention Plus curriculum, the highest-rated sexual health education program approved by the California Department of Education, says Rosario Sanchez, associate superintendent of curriculum and instruction at Fresno Unified.\u003c/p>\n\u003cp>“We are in full implementation,” says Sanchez. “Giving (our students) access to this information is critical, so we can reduce the county stats that are stark.”\u003c/p>\n\u003cp>Fresno Unified, with 73,000 students, now also contracts with Barrios Unidos to provide half of the sex ed courses to high school students.\u003c/p>\n\u003cp>“The education they are getting is very comprehensive and medically accurate,\" says Socorro Santillan, executive director at Barrios Unidos. Students \"will be able to make good decisions for themselves not based on scare tactics, but knowledge.”\u003c/p>\n\u003cp>Fourteen other area school districts are working with the Fresno County Office of Education to provide the classes, says Kayla Wilson, a consultant with FCOE.\u003c/p>\n\u003cp>Over the last two months, Wilson and five nurses have been teaching a similar curriculum to 7th and 9th graders in the Fresno County school districts of Fowler, Mendota and Firebaugh-Las Deltas.\u003c/p>\n\u003cp>Wilson said a lot of her outreach work focuses on speaking with parents and school boards about the curriculum, and addressing parents' and administrators' fears about what the students will be learning. She said no students have opted out so far.\u003c/p>\n\u003cfigure id=\"attachment_189987\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"size-full wp-image-189987\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/05/RS19632_HoldingBinder-qut.jpg\" alt=\"Maryjane Davis, 17, holds the binder with sexual health information that she uses to answer the questions of peers at school in Fresno. She says some teen moms didn't know how they got pregnant.\" width=\"1920\" height=\"1952\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19632_HoldingBinder-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19632_HoldingBinder-qut-400x407.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19632_HoldingBinder-qut-800x813.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19632_HoldingBinder-qut-768x781.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19632_HoldingBinder-qut-1440x1464.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19632_HoldingBinder-qut-1180x1200.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19632_HoldingBinder-qut-960x976.jpg 960w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19632_HoldingBinder-qut-32x32.jpg 32w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19632_HoldingBinder-qut-50x50.jpg 50w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19632_HoldingBinder-qut-64x64.jpg 64w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Maryjane Davis, 17, holds the binder with sexual health information that she uses to answer the questions of peers at school in Fresno. She says some teen moms didn't know how they got pregnant. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>At Maryjane Davis’ home, sex ed has changed the family dynamics. Maryjane's mother, Sara Angulo, was so inspired by her daughter's greater confidence and desire to help other teens after taking the sex ed course at Barrios Unidos that she took her 8- and 12-year-old daughters to age-appropriate sex ed classes at Barrios as well.\u003c/p>\n\u003cp>“I think it's very important that everyone learns,” says Angulo, 38. “There are questions that they won't ask me. But they'll ask someone else, and so it's awesome.”\u003c/p>\n\u003cp>Angulo, who has nine children, says when she was growing up, there was no talk about sex in her family.\u003c/p>\n\u003cp>“It was never, never talked about. I had my first (baby) at a very young age,\" she says. \"It was almost expected to be a teenage mother in my family,” says Angulo.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“These girls know enough to (say), ‘I can wait.’”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"slug": "how-fresno-man-started-biking-and-reversed-type-2-diabetes",
"title": "How Fresno Man Started Biking and Reversed Type 2 Diabetes",
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"content": "\u003cp>FRESNO — Jaime Rangel holds a bike tire and begins checking with his hands for thorns and other sharp objects that might be puncturing the tire’s rubber tread. His fingers, stained with black patches of oil, move quickly and seamlessly. He’s done this type of work dozens of times before.\u003c/p>\n\u003cp>All around him, a steady stream of kids line up to get their bikes’ flat tires and faulty brakes fixed at this free event at a park in southeast Fresno.\u003c/p>\n\u003cp>[soundcloud url=”https://api.soundcloud.com/tracks/261604685″ 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>The free bike repairs are a preamble to the Cumbia Ride, a group bike ride with Latin American dance music started last year by Fresno’s \u003ca href=\"http://www.cultivalasalud.org/news-and-media/\" target=\"_blank\" rel=\"noopener\">Cultiva la Salud\u003c/a> to promote biking and a healthier lifestyle among Latino families.\u003c/p>\n\u003cp>Rangel, 26, says he’s here fixing bikes because he relates to many of the young riders at the event — kids who can’t afford to have their bikes repaired.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“When I was a kid, no one showed me how to fix a bike,” he says. “My mom never took me to a bike shop because we grew up low income, so everything I had to learn from scratch.”\u003c/p>\n\u003cfigure id=\"attachment_177121\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-177121 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/04/RS19203_IMG_9791-qut.jpg\" alt=\"Eloise Betancourt, 37, chats with Jaime Rangel as her son Lorenzo, 11, works on his bike with mechanic Chris Eacock. Betancourt lost her kids' bikes and most of the family's belongings after she couldn't afford to pay for storage, but Lorenzo saved money from running errands and bought three beat up bikes at a garage sale for him and his sisters.\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/27/2016/04/RS19203_IMG_9791-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/27/2016/04/RS19203_IMG_9791-qut-400x267.jpg 400w, https://cdn.kqed.org/wp-content/uploads/sites/27/2016/04/RS19203_IMG_9791-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/27/2016/04/RS19203_IMG_9791-qut-768x512.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/27/2016/04/RS19203_IMG_9791-qut-1440x960.jpg 1440w, https://cdn.kqed.org/wp-content/uploads/sites/27/2016/04/RS19203_IMG_9791-qut-1180x787.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/27/2016/04/RS19203_IMG_9791-qut-960x640.jpg 960w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Eloise Betancourt, 37, brought her son, Lorenzo, 11 (R) to repair his bike. Biking is a main mode of transportation for the Betancourt family, but they lost their bikes and most of their belongings after they couldn’t afford to pay for storage. Lorenzo worked mowing lawns and saved $25 to buy bikes in need of repairs at a garage sale for himself and his sisters. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Rangel makes a point of showing those skills to the kids and parents lingering by their bikes. He wants young people and adults, especially in working-class neighborhoods like southeast Fresno, to be able to bike more to fend off chronic illnesses such as diabetes.\u003c/p>\n\u003cp>Rangel speaks from personal experience.\u003c/p>\n\u003cp>\u003cstrong>Facing Type 2 Diabetes as a Teen\u003c/strong>\u003c/p>\n\u003cp>Rangel was just 14 and living with his family in Los Angeles when he was diagnosed with Type 2 diabetes. Obesity and a sedentary lifestyle are risk factors for the illness. While he was tall — 6-foot-1 — he weighed 260 pounds.\u003c/p>\n\u003cp>It’s been a dozen years since he was diagnosed, but he clearly recalls how frightened he was. The disease had already transformed the lives of his mother, two sets of grandparents and other relatives. He knew what he was facing.\u003c/p>\n\u003cp>“I was really scared,” says Rangel. “I was seeing there were only certain foods they would eat, taking their insulin shots. And I was like, ‘Nah, that can’t happen. I’m too young!'”\u003c/p>\n\u003cp>Until about two decades ago, Type 2 diabetes in children and teens was practically unheard of. But the number of adolescents living with the disease has\u003ca href=\"http://www.diabetes.org/diabetes-basics/statistics/\" target=\"_blank\" rel=\"noopener\"> gone up in recent years,\u003c/a> in large part because of the \u003ca href=\"http://care.diabetesjournals.org/content/34/Supplement_2/S161.full#ref-8\" target=\"_blank\" rel=\"noopener\">obesity epidemic\u003c/a>.\u003c/p>\n\u003cp>As with adults, rates of Type 2 diabetes are higher among Hispanic, African-American and Asian-Pacific Islander youth than non-Hispanic whites, \u003ca href=\"http://templatelab.com/national-diabetes-report-2014/\" target=\"_blank\" rel=\"noopener\">according to data from the Centers for Disease Control and Prevention\u003c/a>. Uncontrolled diabetes can lead to blindness, heart disease, amputations, kidney failure and other serious complications.\u003c/p>\n\u003cp>Rangel’s doctor had said he needed to lose weight and give up foods he loved. But he didn’t know how to start. He loved the idea of biking, but his family couldn’t afford to buy him one.\u003c/p>\n\u003cp>Instead, a close friend stepped in with a gift of a BMX bike. He didn’t know how to ride and at first it was scary. He fell a lot the first couple of times he tried.\u003c/p>\n\u003cp>“I was a big dude riding a really small bike, so I didn’t know how to balance my weight,” Rangel says. “But I just kept going. I didn’t want to stop, and I just kept doing it so I could get better.”\u003c/p>\n\u003cp>With each trip he took, he ventured longer distances. Rangel says he enjoyed the independence he felt while crossing large swaths of the traffic-jammed city. Under the power of his own legs pushing down on his bike’s pedals, he would travel from his home in the Lincoln Heights neighborhood to the beach at Santa Monica — 20 miles away.\u003c/p>\n\u003cp>Within a year, Rangel had reversed his Type 2 diabetes. His blood sugar levels returned to a normal range. It’s surprising to many, but children and young adults can beat the disease through exercise, say medical experts.\u003c/p>\n\u003cfigure id=\"attachment_177119\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-177119 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/04/RS19210_IMG_9853-qut.jpg\" alt=\"Jaime Rangel, 26, helps Gustavo Ruiz, 12, fix the flat tire on his bike at the Mosqueda Community Center park. Rangel says he makes a point of showing kids and adults who may not have funds to repair their bikes at a shop, how to fix their bikes on their own. \" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/27/2016/04/RS19210_IMG_9853-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/27/2016/04/RS19210_IMG_9853-qut-400x267.jpg 400w, https://cdn.kqed.org/wp-content/uploads/sites/27/2016/04/RS19210_IMG_9853-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/27/2016/04/RS19210_IMG_9853-qut-768x512.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/27/2016/04/RS19210_IMG_9853-qut-1440x960.jpg 1440w, https://cdn.kqed.org/wp-content/uploads/sites/27/2016/04/RS19210_IMG_9853-qut-1180x787.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/27/2016/04/RS19210_IMG_9853-qut-960x640.jpg 960w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Jaime Rangel helps Gustavo Ruiz, 12, align a tire on his bike at the Mosqueda Community Center park in southeast Fresno. As manager for Bici Projects, Rangel teaches kids and adults ‘in the barrio’ how to repair bikes, part of a larger effort to promote biking among local Latino families. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The experience marked Rangel deeply. He had managed to rid himself of the illness without taking medication while having fun, too.\u003c/p>\n\u003cp>“Biking changed my life. I lost a lot of weight,” says Rangel, who now weighs about 220 pounds.\u003c/p>\n\u003cp>Rangel’s family noticed the change in the way he looked and the dramatic improvement in his health. At Rangel’s insistence, his mom, cousins and uncles began biking — a dramatic change for his family, he says.\u003c/p>\n\u003cp>“We all got rid of our diabetes, pretty much,” says Rangel, who recently moved to Fresno. “Now when I’m in L.A., about 20 of us go bike riding together. So it changed not just me, but my whole family at the same time.”\u003c/p>\n\u003cp>Rangel wants to promote biking and a more active lifestyle to create positive change in his new home in Fresno. The most recent \u003ca href=\"http://www.cdph.ca.gov/programs/ohir/Documents/OHIRProfiles2016.pdf\" target=\"_blank\" rel=\"noopener\">state data\u003c/a> show the county had the fourth-highest death rate from diabetes. Central Valley counties Kern and Kings also top the list.\u003c/p>\n\u003cp>Using his personal experience and love for biking as a mantra, Rangel coordinates youth engagement for the San Joaquin Valley Latino Environmental Advancement & Policy Project and manages the group’s Bici Projects (short for “bicicleta” — bicycle in Spanish).\u003c/p>\n\u003cp>\u003cstrong>How Can Type 2 Diabetes Disappear?\u003c/strong>\u003c/p>\n\u003cp>Type 2 diabetes is an illness affecting a person’s ability to use insulin, and not everyone can beat the disease through exercise and weight loss. But there’s “tremendous hope” for young people and others diagnosed with the disease early on, says Dr. Saleh Adi, medical director of the Madison Clinic for Pediatric Diabetes at UCSF.\u003c/p>\n\u003cp>Insulin is a hormone that allows the body to use sugars from carbohydrates. Patients with Type 1 diabetes, an irreversible autoimmune disorder, must take insulin medication for life because their bodies are no longer able to produce it.\u003c/p>\n\u003cp>In contrast, people with Type 2 diabetes are still able to make insulin for the most part, but their bodies don’t respond to it properly, and they develop what’s called insulin resistance. Exercise can change that because active muscle “is the biggest site of insulin action,” says Adi.\u003c/p>\n\u003cp>“Exercising increases your sensitivity to insulin, and that’s true in everybody,” says Adi, whose pediatric clinic tries to get patients to engage in physical activity for six months before prescribing them medication.\u003c/p>\n\u003cp>“We’ve seen quite a few cases where the disease disappears,” he says. “If you catch it early enough and do what it takes, which is exercising and losing the weight.”\u003c/p>\n\u003cp>Adi readily acknowledges squeezing more exercise into daily routines is not easy, but he says even 10 more minutes of walking can begin to make a difference.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“Don’t give up. You can really get rid of Type 2 diabetes if you change your lifestyle,” says Adi. “I’m talking about moderate exercise, that will really help.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>FRESNO — Jaime Rangel holds a bike tire and begins checking with his hands for thorns and other sharp objects that might be puncturing the tire’s rubber tread. His fingers, stained with black patches of oil, move quickly and seamlessly. He’s done this type of work dozens of times before.\u003c/p>\n\u003cp>All around him, a steady stream of kids line up to get their bikes’ flat tires and faulty brakes fixed at this free event at a park in southeast Fresno.\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/261604685″&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/261604685″'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The free bike repairs are a preamble to the Cumbia Ride, a group bike ride with Latin American dance music started last year by Fresno’s \u003ca href=\"http://www.cultivalasalud.org/news-and-media/\" target=\"_blank\" rel=\"noopener\">Cultiva la Salud\u003c/a> to promote biking and a healthier lifestyle among Latino families.\u003c/p>\n\u003cp>Rangel, 26, says he’s here fixing bikes because he relates to many of the young riders at the event — kids who can’t afford to have their bikes repaired.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“When I was a kid, no one showed me how to fix a bike,” he says. “My mom never took me to a bike shop because we grew up low income, so everything I had to learn from scratch.”\u003c/p>\n\u003cfigure id=\"attachment_177121\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-177121 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/04/RS19203_IMG_9791-qut.jpg\" alt=\"Eloise Betancourt, 37, chats with Jaime Rangel as her son Lorenzo, 11, works on his bike with mechanic Chris Eacock. Betancourt lost her kids' bikes and most of the family's belongings after she couldn't afford to pay for storage, but Lorenzo saved money from running errands and bought three beat up bikes at a garage sale for him and his sisters.\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/27/2016/04/RS19203_IMG_9791-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/27/2016/04/RS19203_IMG_9791-qut-400x267.jpg 400w, https://cdn.kqed.org/wp-content/uploads/sites/27/2016/04/RS19203_IMG_9791-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/27/2016/04/RS19203_IMG_9791-qut-768x512.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/27/2016/04/RS19203_IMG_9791-qut-1440x960.jpg 1440w, https://cdn.kqed.org/wp-content/uploads/sites/27/2016/04/RS19203_IMG_9791-qut-1180x787.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/27/2016/04/RS19203_IMG_9791-qut-960x640.jpg 960w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Eloise Betancourt, 37, brought her son, Lorenzo, 11 (R) to repair his bike. Biking is a main mode of transportation for the Betancourt family, but they lost their bikes and most of their belongings after they couldn’t afford to pay for storage. Lorenzo worked mowing lawns and saved $25 to buy bikes in need of repairs at a garage sale for himself and his sisters. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Rangel makes a point of showing those skills to the kids and parents lingering by their bikes. He wants young people and adults, especially in working-class neighborhoods like southeast Fresno, to be able to bike more to fend off chronic illnesses such as diabetes.\u003c/p>\n\u003cp>Rangel speaks from personal experience.\u003c/p>\n\u003cp>\u003cstrong>Facing Type 2 Diabetes as a Teen\u003c/strong>\u003c/p>\n\u003cp>Rangel was just 14 and living with his family in Los Angeles when he was diagnosed with Type 2 diabetes. Obesity and a sedentary lifestyle are risk factors for the illness. While he was tall — 6-foot-1 — he weighed 260 pounds.\u003c/p>\n\u003cp>It’s been a dozen years since he was diagnosed, but he clearly recalls how frightened he was. The disease had already transformed the lives of his mother, two sets of grandparents and other relatives. He knew what he was facing.\u003c/p>\n\u003cp>“I was really scared,” says Rangel. “I was seeing there were only certain foods they would eat, taking their insulin shots. And I was like, ‘Nah, that can’t happen. I’m too young!'”\u003c/p>\n\u003cp>Until about two decades ago, Type 2 diabetes in children and teens was practically unheard of. But the number of adolescents living with the disease has\u003ca href=\"http://www.diabetes.org/diabetes-basics/statistics/\" target=\"_blank\" rel=\"noopener\"> gone up in recent years,\u003c/a> in large part because of the \u003ca href=\"http://care.diabetesjournals.org/content/34/Supplement_2/S161.full#ref-8\" target=\"_blank\" rel=\"noopener\">obesity epidemic\u003c/a>.\u003c/p>\n\u003cp>As with adults, rates of Type 2 diabetes are higher among Hispanic, African-American and Asian-Pacific Islander youth than non-Hispanic whites, \u003ca href=\"http://templatelab.com/national-diabetes-report-2014/\" target=\"_blank\" rel=\"noopener\">according to data from the Centers for Disease Control and Prevention\u003c/a>. Uncontrolled diabetes can lead to blindness, heart disease, amputations, kidney failure and other serious complications.\u003c/p>\n\u003cp>Rangel’s doctor had said he needed to lose weight and give up foods he loved. But he didn’t know how to start. He loved the idea of biking, but his family couldn’t afford to buy him one.\u003c/p>\n\u003cp>Instead, a close friend stepped in with a gift of a BMX bike. He didn’t know how to ride and at first it was scary. He fell a lot the first couple of times he tried.\u003c/p>\n\u003cp>“I was a big dude riding a really small bike, so I didn’t know how to balance my weight,” Rangel says. “But I just kept going. I didn’t want to stop, and I just kept doing it so I could get better.”\u003c/p>\n\u003cp>With each trip he took, he ventured longer distances. Rangel says he enjoyed the independence he felt while crossing large swaths of the traffic-jammed city. Under the power of his own legs pushing down on his bike’s pedals, he would travel from his home in the Lincoln Heights neighborhood to the beach at Santa Monica — 20 miles away.\u003c/p>\n\u003cp>Within a year, Rangel had reversed his Type 2 diabetes. His blood sugar levels returned to a normal range. It’s surprising to many, but children and young adults can beat the disease through exercise, say medical experts.\u003c/p>\n\u003cfigure id=\"attachment_177119\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-177119 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/04/RS19210_IMG_9853-qut.jpg\" alt=\"Jaime Rangel, 26, helps Gustavo Ruiz, 12, fix the flat tire on his bike at the Mosqueda Community Center park. Rangel says he makes a point of showing kids and adults who may not have funds to repair their bikes at a shop, how to fix their bikes on their own. \" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/27/2016/04/RS19210_IMG_9853-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/27/2016/04/RS19210_IMG_9853-qut-400x267.jpg 400w, https://cdn.kqed.org/wp-content/uploads/sites/27/2016/04/RS19210_IMG_9853-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/27/2016/04/RS19210_IMG_9853-qut-768x512.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/27/2016/04/RS19210_IMG_9853-qut-1440x960.jpg 1440w, https://cdn.kqed.org/wp-content/uploads/sites/27/2016/04/RS19210_IMG_9853-qut-1180x787.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/27/2016/04/RS19210_IMG_9853-qut-960x640.jpg 960w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Jaime Rangel helps Gustavo Ruiz, 12, align a tire on his bike at the Mosqueda Community Center park in southeast Fresno. As manager for Bici Projects, Rangel teaches kids and adults ‘in the barrio’ how to repair bikes, part of a larger effort to promote biking among local Latino families. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The experience marked Rangel deeply. He had managed to rid himself of the illness without taking medication while having fun, too.\u003c/p>\n\u003cp>“Biking changed my life. I lost a lot of weight,” says Rangel, who now weighs about 220 pounds.\u003c/p>\n\u003cp>Rangel’s family noticed the change in the way he looked and the dramatic improvement in his health. At Rangel’s insistence, his mom, cousins and uncles began biking — a dramatic change for his family, he says.\u003c/p>\n\u003cp>“We all got rid of our diabetes, pretty much,” says Rangel, who recently moved to Fresno. “Now when I’m in L.A., about 20 of us go bike riding together. So it changed not just me, but my whole family at the same time.”\u003c/p>\n\u003cp>Rangel wants to promote biking and a more active lifestyle to create positive change in his new home in Fresno. The most recent \u003ca href=\"http://www.cdph.ca.gov/programs/ohir/Documents/OHIRProfiles2016.pdf\" target=\"_blank\" rel=\"noopener\">state data\u003c/a> show the county had the fourth-highest death rate from diabetes. Central Valley counties Kern and Kings also top the list.\u003c/p>\n\u003cp>Using his personal experience and love for biking as a mantra, Rangel coordinates youth engagement for the San Joaquin Valley Latino Environmental Advancement & Policy Project and manages the group’s Bici Projects (short for “bicicleta” — bicycle in Spanish).\u003c/p>\n\u003cp>\u003cstrong>How Can Type 2 Diabetes Disappear?\u003c/strong>\u003c/p>\n\u003cp>Type 2 diabetes is an illness affecting a person’s ability to use insulin, and not everyone can beat the disease through exercise and weight loss. But there’s “tremendous hope” for young people and others diagnosed with the disease early on, says Dr. Saleh Adi, medical director of the Madison Clinic for Pediatric Diabetes at UCSF.\u003c/p>\n\u003cp>Insulin is a hormone that allows the body to use sugars from carbohydrates. Patients with Type 1 diabetes, an irreversible autoimmune disorder, must take insulin medication for life because their bodies are no longer able to produce it.\u003c/p>\n\u003cp>In contrast, people with Type 2 diabetes are still able to make insulin for the most part, but their bodies don’t respond to it properly, and they develop what’s called insulin resistance. Exercise can change that because active muscle “is the biggest site of insulin action,” says Adi.\u003c/p>\n\u003cp>“Exercising increases your sensitivity to insulin, and that’s true in everybody,” says Adi, whose pediatric clinic tries to get patients to engage in physical activity for six months before prescribing them medication.\u003c/p>\n\u003cp>“We’ve seen quite a few cases where the disease disappears,” he says. “If you catch it early enough and do what it takes, which is exercising and losing the weight.”\u003c/p>\n\u003cp>Adi readily acknowledges squeezing more exercise into daily routines is not easy, but he says even 10 more minutes of walking can begin to make a difference.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“Don’t give up. You can really get rid of Type 2 diabetes if you change your lifestyle,” says Adi. “I’m talking about moderate exercise, that will really help.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "How Theater Helps This HIV-Positive Grandmother Transform Lives",
"title": "How Theater Helps This HIV-Positive Grandmother Transform Lives",
"headTitle": "Vital Signs | State of Health | KQED News",
"content": "\u003cp>For decades, Cassandra Steptoe felt like she couldn’t talk about her HIV diagnosis with anyone.\u003c/p>\n\u003cp>\"I couldn't forgive myself for getting HIV,\" says Steptoe, who spent much of her early adult life in and out of jail for shoplifting and burglaries linked to her IV drug use. \"But someone told me a long time ago, if you are looking for a reason to feel shame, you can always find it. I learned to look for something else: forgiveness.\"\u003c/p>\n\u003cp>For Steptoe, now 59 and a grandmother, it wasn't until her 40s -- after decades of struggling with addiction -- that she finally completed a rehab program and committed to ongoing HIV treatment.\u003c/p>\n\u003cp>Today she talks openly about that experience onstage, as part of a theater project aimed at inspiring others. The quote about learning to forgive herself is part of an autobiographical monologue Steptoe wrote and performs in a San Francisco theater production of \u003ca href=\"https://www.facebook.com/MedeaProject/\" target=\"_blank\">The Medea Project: Theater for Incarcerated Women/HIV Circle\u003c/a>.\u003c/p>\n\u003cp>It was Steptoe's physician, \u003ca href=\"http://whp.ucsf.edu/about/team-members/edward-machtinger-m-d\">Dr. Edward Machtinger\u003c/a>, who first told her about the project. Established by playwright and director \u003ca href=\"http://www.culturalodyssey.org/v2/aboutus/rhodessa_bio.html\" target=\"_blank\">Rhodessa Jones\u003c/a> in 2008 as an extension of an improvisational production that draws on and explores the \u003ca href=\"http://www.npr.org/templates/story/story.php?storyId=15146105\" target=\"_blank\">experiences of jailed women\u003c/a>, the \"HIV Circle\" focuses on the experiences of women living with the AIDS virus.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The therapeutic aspect of the performance workshop is called \u003ca href=\"http://rtc.umn.edu/docs/pep_facguide.pdf\" target=\"_blank\">peer empowerment\u003c/a>, explains Machtinger, an internist and director of the Women's HIV Program at the University of California, San Francisco. The strength and healing Steptoe and others have gained from processing and sharing their stories this way is profound, he says — and can serve as a model for helping other patients deal with psychological trauma.\u003c/p>\n\u003cfigure id=\"attachment_164615\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"size-full wp-image-164615\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/03/RS18863_IMG_9455-qut.jpg\" alt=\"Cassandra Steptoe at the apartment she shares with her 8-year-old granddaughter in San Francisco. She credits The Medea Project with helping her improve her overall well-being.\" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18863_IMG_9455-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18863_IMG_9455-qut-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18863_IMG_9455-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18863_IMG_9455-qut-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18863_IMG_9455-qut-1440x960.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18863_IMG_9455-qut-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18863_IMG_9455-qut-960x640.jpg 960w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Cassandra Steptoe at the apartment she shares with her 8-year-old granddaughter in San Francisco. She credits The Medea Project with helping her improve her overall well-being. \u003ccite>(Farida Jhabvala Romero / KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Medications 'Not Enough'\u003c/strong>\u003c/p>\n\u003cp>With the theater group, Steptoe began writing about her experiences and sharing them with a small group of women, some of whom had gone through similar struggles of addiction and histories of incarceration. The process of uncovering her past and making sense of her experiences in a cathartic, supportive environment helped Steptoe end her feelings of isolation.\u003c/p>\n\u003cp>\"Having these women that really love you and support you ... it feels good to have some real friends, 'cause I never had that before,\" Steptoe says. \"We're all sharing something together 'cause we all get something out of everybody's story.\"\u003c/p>\n\u003cp>The potential of peer empowerment is not just anecdotal. Machtinger has \u003ca href=\"http://www.sciencedirect.com/science/article/pii/S1055329014000971\" target=\"_blank\">studied\u003c/a> the Medea Project's life-saving impact on his patients.\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/256844757\" 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>Machtinger says the patients in the Medea Project followed by his research team went through an extraordinary transformation. Many who had barely disclosed their HIV status to anyone when they began, became activists and leaders in their communities, helping to destigmatize HIV while pursuing personal goals and leading productive lives.\u003c/p>\n\u003cp>\"For them to develop what they described as \"sisterhood\" was the most important and most profound type of healing that I ever witnessed,\" Machtinger says.\u003c/p>\n\u003cp>He began seeking alternative methods to help his patients after increasingly noticing that a large proportion were successfully receiving antiretroviral treatment, but still dying from reasons that had \"nothing to do with HIV,\" such as murder, suicide or drug overdose.\u003c/p>\n\u003cp>\"They could have their HIV under control, (but) their lives were not getting better,\" Machtinger says. \"That was because their core issue -- a life of trauma and the impacts of depression, isolation and shame -- wasn’t being effectively addressed. And to us, that's not acceptable.\"\u003c/p>\n\u003cp>Machtinger's experience is reverberating beyond the Medea Project. He says witnessing and studying the impact of peer empowerment has helped inform a broader role. He is part of an advisory group helping to develop new guidelines for trauma-informed primary care for the federal Substance Abuse and Mental Health Services Administration.\u003c/p>\n\u003cp>The new guidelines will likely include a substantial focus on interventions with peer empowerment as one ingredient to help people with severe trauma heal, says Machtinger.\u003c/p>\n\u003cp>\"The core elements of the Medea Project are really lessons for other interventions to help people overcome trauma and other stigmatizing situations and conditions,\" says Machtinger, adding that childhood and adult trauma have been linked to a variety of illnesses, such as hepatitis C, heart disease and diabetes.\u003c/p>\n\u003cp>He expects the new guidelines for primary care clinics and other health providers to be finalized and published later this year.\u003c/p>\n\u003cp>\u003cstrong>Trauma at the Root of HIV Diagnosis\u003c/strong>\u003c/p>\n\u003cp>Steptoe now realizes she was infected with HIV through unprotected sex and sharing needles. She used to be addicted to heroin and cocaine. During a decades-long period of her life, she was in and out of the criminal justice system. She worked as a prostitute and survived abusive relationships -- getting beat up so badly one time that she spent three months recovering at a hospital, she said.\u003c/p>\n\u003cp>Steptoe says experiencing sexual abuse repeatedly as a child and teen led her on the path that eventually resulted in HIV infection.\u003c/p>\n\u003cp>\"Sexual abuse came from family,\" she says. \"And I guess I was kind of covering all that up by choosing the drugs. It kind of took me out there into the street, looking for love in the wrong places because I didn't have it at home. I started shooting drugs and that led into prostitution and to prison.\"\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/stateofhealth/2012/03/20/trauma-fuels-hiv-epidemic-among-women/http://ww2.kqed.org/stateofhealth/2012/03/20/trauma-fuels-hiv-epidemic-among-women/\">Recent studies\u003c/a> show that HIV-positive women suffer disproportionately from high rates of trauma and post-traumatic stress disorder. The high rates of trauma also lead to increased risk of further spreading HIV, according to researchers.\u003c/p>\n\u003cp>\u003cstrong>Transforming Her Life\u003c/strong>\u003c/p>\n\u003cp>Now Steptoe is busy and full of energy. She takes antiretroviral medication religiously every morning, eats a healthy diet and works out by taking Zumba fitness classes at her gym.\u003c/p>\n\u003cp>Steptoe, a mother of three and grandmother of nine has also taken full custody of her 8-year-old granddaughter, who frequently accompanies her to rehearsals.\u003c/p>\n\u003cp>\"She teaches me how to love, and she gives me patience,\" says Steptoe, who also cares for other kids in her Mission apartment building.\u003c/p>\n\u003cp>Rhodessa Jones, the Medea Project's dynamic and energetic director, says Steptoe has flourished since she joined the organization, becoming a leader and inspiration to other women.\u003c/p>\n\u003cp>\"She’s so powerful, positive and forceful. She gets it,\" says Jones, who founded Medea more than 23 years ago. \"Theater has really been expressive therapy for her. It gives her a space to speak her truth.\"\u003c/p>\n\u003cfigure id=\"attachment_164614\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"size-full wp-image-164614\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/03/RS18862_IMG_9445-qut.jpg\" alt='Performers at The Medea Project rehearse in San Francisco. Founder and director Rhodessa Jones, uses Greek, Roman and African mythology to introduce \"the universality of all of our stories.\"' width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18862_IMG_9445-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18862_IMG_9445-qut-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18862_IMG_9445-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18862_IMG_9445-qut-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18862_IMG_9445-qut-1440x960.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18862_IMG_9445-qut-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18862_IMG_9445-qut-960x640.jpg 960w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Performers at The Medea Project rehearse in San Francisco. Founder and director Rhodessa Jones, uses Greek, Roman and African mythology to introduce \"the universality of all of our stories.\" \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The Medea Project uses Greek, Roman and African mythology to introduce \"the universality of all of our stories,\" says Jones, who asked Steptoe to imagine going back in time to age 14 and write the lessons she would give herself. The result was Steptoe's piece \"Younger Self.\"\u003c/p>\n\u003cp>Steptoe wrote the piece, performed in January in San Francisco, about the moment in 1987 when she first found out she was HIV-positive. She was serving time in jail and received a health checkup.\u003c/p>\n\u003cp>\"My world crashed. I didn't have no education of what I had, I didn't have no support,\" says Steptoe, adding that she considered her condition \"a death sentence\" at the time. \"I had to relive that again by writing this because I needed to heal.\"\u003c/p>\n\u003cp>\u003cstrong>'HIV is a Health Condition, Not a Crime'\u003c/strong>\u003c/p>\n\u003cp>After receiving the diagnosis, she remembers crying at night with a pillow over her head so others wouldn't hear.\u003c/p>\n\u003cp>Steptoe then kept her HIV status a secret for many years.\u003c/p>\n\u003cp>But, years later, the key for her to find and use her voice was becoming a part of The Medea Project, she says. The main motivation for telling her story? She wants to give hope to others, and help them feel they are not alone.\u003c/p>\n\u003cp>\"Now I can tell the world that HIV is just a health condition, not a crime,\" says Steptoe, who doesn't hesitate to share her story as a lead actress for Medea in front of audiences of hundreds of people.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\"I don't have shame around it no more,” Steptoe says. “I let my grandkids know that even if you go the wrong way, you can still turn your life around.\"\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>For decades, Cassandra Steptoe felt like she couldn’t talk about her HIV diagnosis with anyone.\u003c/p>\n\u003cp>\"I couldn't forgive myself for getting HIV,\" says Steptoe, who spent much of her early adult life in and out of jail for shoplifting and burglaries linked to her IV drug use. \"But someone told me a long time ago, if you are looking for a reason to feel shame, you can always find it. I learned to look for something else: forgiveness.\"\u003c/p>\n\u003cp>For Steptoe, now 59 and a grandmother, it wasn't until her 40s -- after decades of struggling with addiction -- that she finally completed a rehab program and committed to ongoing HIV treatment.\u003c/p>\n\u003cp>Today she talks openly about that experience onstage, as part of a theater project aimed at inspiring others. The quote about learning to forgive herself is part of an autobiographical monologue Steptoe wrote and performs in a San Francisco theater production of \u003ca href=\"https://www.facebook.com/MedeaProject/\" target=\"_blank\">The Medea Project: Theater for Incarcerated Women/HIV Circle\u003c/a>.\u003c/p>\n\u003cp>It was Steptoe's physician, \u003ca href=\"http://whp.ucsf.edu/about/team-members/edward-machtinger-m-d\">Dr. Edward Machtinger\u003c/a>, who first told her about the project. Established by playwright and director \u003ca href=\"http://www.culturalodyssey.org/v2/aboutus/rhodessa_bio.html\" target=\"_blank\">Rhodessa Jones\u003c/a> in 2008 as an extension of an improvisational production that draws on and explores the \u003ca href=\"http://www.npr.org/templates/story/story.php?storyId=15146105\" target=\"_blank\">experiences of jailed women\u003c/a>, the \"HIV Circle\" focuses on the experiences of women living with the AIDS virus.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The therapeutic aspect of the performance workshop is called \u003ca href=\"http://rtc.umn.edu/docs/pep_facguide.pdf\" target=\"_blank\">peer empowerment\u003c/a>, explains Machtinger, an internist and director of the Women's HIV Program at the University of California, San Francisco. The strength and healing Steptoe and others have gained from processing and sharing their stories this way is profound, he says — and can serve as a model for helping other patients deal with psychological trauma.\u003c/p>\n\u003cfigure id=\"attachment_164615\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"size-full wp-image-164615\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/03/RS18863_IMG_9455-qut.jpg\" alt=\"Cassandra Steptoe at the apartment she shares with her 8-year-old granddaughter in San Francisco. She credits The Medea Project with helping her improve her overall well-being.\" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18863_IMG_9455-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18863_IMG_9455-qut-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18863_IMG_9455-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18863_IMG_9455-qut-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18863_IMG_9455-qut-1440x960.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18863_IMG_9455-qut-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18863_IMG_9455-qut-960x640.jpg 960w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Cassandra Steptoe at the apartment she shares with her 8-year-old granddaughter in San Francisco. She credits The Medea Project with helping her improve her overall well-being. \u003ccite>(Farida Jhabvala Romero / KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Medications 'Not Enough'\u003c/strong>\u003c/p>\n\u003cp>With the theater group, Steptoe began writing about her experiences and sharing them with a small group of women, some of whom had gone through similar struggles of addiction and histories of incarceration. The process of uncovering her past and making sense of her experiences in a cathartic, supportive environment helped Steptoe end her feelings of isolation.\u003c/p>\n\u003cp>\"Having these women that really love you and support you ... it feels good to have some real friends, 'cause I never had that before,\" Steptoe says. \"We're all sharing something together 'cause we all get something out of everybody's story.\"\u003c/p>\n\u003cp>The potential of peer empowerment is not just anecdotal. Machtinger has \u003ca href=\"http://www.sciencedirect.com/science/article/pii/S1055329014000971\" target=\"_blank\">studied\u003c/a> the Medea Project's life-saving impact on his patients.\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/256844757&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/256844757'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Machtinger says the patients in the Medea Project followed by his research team went through an extraordinary transformation. Many who had barely disclosed their HIV status to anyone when they began, became activists and leaders in their communities, helping to destigmatize HIV while pursuing personal goals and leading productive lives.\u003c/p>\n\u003cp>\"For them to develop what they described as \"sisterhood\" was the most important and most profound type of healing that I ever witnessed,\" Machtinger says.\u003c/p>\n\u003cp>He began seeking alternative methods to help his patients after increasingly noticing that a large proportion were successfully receiving antiretroviral treatment, but still dying from reasons that had \"nothing to do with HIV,\" such as murder, suicide or drug overdose.\u003c/p>\n\u003cp>\"They could have their HIV under control, (but) their lives were not getting better,\" Machtinger says. \"That was because their core issue -- a life of trauma and the impacts of depression, isolation and shame -- wasn’t being effectively addressed. And to us, that's not acceptable.\"\u003c/p>\n\u003cp>Machtinger's experience is reverberating beyond the Medea Project. He says witnessing and studying the impact of peer empowerment has helped inform a broader role. He is part of an advisory group helping to develop new guidelines for trauma-informed primary care for the federal Substance Abuse and Mental Health Services Administration.\u003c/p>\n\u003cp>The new guidelines will likely include a substantial focus on interventions with peer empowerment as one ingredient to help people with severe trauma heal, says Machtinger.\u003c/p>\n\u003cp>\"The core elements of the Medea Project are really lessons for other interventions to help people overcome trauma and other stigmatizing situations and conditions,\" says Machtinger, adding that childhood and adult trauma have been linked to a variety of illnesses, such as hepatitis C, heart disease and diabetes.\u003c/p>\n\u003cp>He expects the new guidelines for primary care clinics and other health providers to be finalized and published later this year.\u003c/p>\n\u003cp>\u003cstrong>Trauma at the Root of HIV Diagnosis\u003c/strong>\u003c/p>\n\u003cp>Steptoe now realizes she was infected with HIV through unprotected sex and sharing needles. She used to be addicted to heroin and cocaine. During a decades-long period of her life, she was in and out of the criminal justice system. She worked as a prostitute and survived abusive relationships -- getting beat up so badly one time that she spent three months recovering at a hospital, she said.\u003c/p>\n\u003cp>Steptoe says experiencing sexual abuse repeatedly as a child and teen led her on the path that eventually resulted in HIV infection.\u003c/p>\n\u003cp>\"Sexual abuse came from family,\" she says. \"And I guess I was kind of covering all that up by choosing the drugs. It kind of took me out there into the street, looking for love in the wrong places because I didn't have it at home. I started shooting drugs and that led into prostitution and to prison.\"\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/stateofhealth/2012/03/20/trauma-fuels-hiv-epidemic-among-women/http://ww2.kqed.org/stateofhealth/2012/03/20/trauma-fuels-hiv-epidemic-among-women/\">Recent studies\u003c/a> show that HIV-positive women suffer disproportionately from high rates of trauma and post-traumatic stress disorder. The high rates of trauma also lead to increased risk of further spreading HIV, according to researchers.\u003c/p>\n\u003cp>\u003cstrong>Transforming Her Life\u003c/strong>\u003c/p>\n\u003cp>Now Steptoe is busy and full of energy. She takes antiretroviral medication religiously every morning, eats a healthy diet and works out by taking Zumba fitness classes at her gym.\u003c/p>\n\u003cp>Steptoe, a mother of three and grandmother of nine has also taken full custody of her 8-year-old granddaughter, who frequently accompanies her to rehearsals.\u003c/p>\n\u003cp>\"She teaches me how to love, and she gives me patience,\" says Steptoe, who also cares for other kids in her Mission apartment building.\u003c/p>\n\u003cp>Rhodessa Jones, the Medea Project's dynamic and energetic director, says Steptoe has flourished since she joined the organization, becoming a leader and inspiration to other women.\u003c/p>\n\u003cp>\"She’s so powerful, positive and forceful. She gets it,\" says Jones, who founded Medea more than 23 years ago. \"Theater has really been expressive therapy for her. It gives her a space to speak her truth.\"\u003c/p>\n\u003cfigure id=\"attachment_164614\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"size-full wp-image-164614\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/03/RS18862_IMG_9445-qut.jpg\" alt='Performers at The Medea Project rehearse in San Francisco. Founder and director Rhodessa Jones, uses Greek, Roman and African mythology to introduce \"the universality of all of our stories.\"' width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18862_IMG_9445-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18862_IMG_9445-qut-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18862_IMG_9445-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18862_IMG_9445-qut-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18862_IMG_9445-qut-1440x960.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18862_IMG_9445-qut-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2016/03/RS18862_IMG_9445-qut-960x640.jpg 960w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Performers at The Medea Project rehearse in San Francisco. Founder and director Rhodessa Jones, uses Greek, Roman and African mythology to introduce \"the universality of all of our stories.\" \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The Medea Project uses Greek, Roman and African mythology to introduce \"the universality of all of our stories,\" says Jones, who asked Steptoe to imagine going back in time to age 14 and write the lessons she would give herself. The result was Steptoe's piece \"Younger Self.\"\u003c/p>\n\u003cp>Steptoe wrote the piece, performed in January in San Francisco, about the moment in 1987 when she first found out she was HIV-positive. She was serving time in jail and received a health checkup.\u003c/p>\n\u003cp>\"My world crashed. I didn't have no education of what I had, I didn't have no support,\" says Steptoe, adding that she considered her condition \"a death sentence\" at the time. \"I had to relive that again by writing this because I needed to heal.\"\u003c/p>\n\u003cp>\u003cstrong>'HIV is a Health Condition, Not a Crime'\u003c/strong>\u003c/p>\n\u003cp>After receiving the diagnosis, she remembers crying at night with a pillow over her head so others wouldn't hear.\u003c/p>\n\u003cp>Steptoe then kept her HIV status a secret for many years.\u003c/p>\n\u003cp>But, years later, the key for her to find and use her voice was becoming a part of The Medea Project, she says. The main motivation for telling her story? She wants to give hope to others, and help them feel they are not alone.\u003c/p>\n\u003cp>\"Now I can tell the world that HIV is just a health condition, not a crime,\" says Steptoe, who doesn't hesitate to share her story as a lead actress for Medea in front of audiences of hundreds of people.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Mobile Clinics Serve California's Growing Homeless Youth Population",
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"content": "\u003cp>Dr. Seth Ammerman listens intently to his new patient. Ernesto, who does not want his last name disclosed, is homeless. Ernesto is earning a high school degree and working part time, but at night, he and his brother share a tent that they set up on San Jose streets. The daily stress of being homeless is wearing Ernesto out and making him light up too many cigarettes.\u003c/p>\n\u003caside class=\"pullquote alignright\">'These kids, because of all these access barriers — lack of insurance, lack of transportation — they’re not going to get this kind of care unless we go to them.'\u003ccite>Dr. Seth Ammerman, medical director, Stanford Teen Health Van \u003c/cite>\u003c/aside>\n\u003cp>“I just want to cut down on my smoking,” says Ernesto, 21, with a tentative, soft voice. “I’ve been on the streets all the time, you know? I just want to make sure I’m OK.”\u003c/p>\n\u003cp>That's why Ernesto walked into this mobile clinic parked just a few steps away from his classroom at the San Jose Conservation Corps & Charter School. He's sitting in a fully equipped exam room inside a shiny blue tour bus with Wi-Fi and the ability to get HIV test results in 20 minutes.\u003c/p>\n\u003cp>During the consultation with Ernesto, Ammerman nods sympathetically. In his 20 years working in this teen health van, Ammerman has treated thousands of uninsured and homeless adolescents ages 24 and under.\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/247566086\" 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>Twice a week, Ammerman and two nurses park the clinic at continuation high schools and other places frequented by at-risk adolescents in Santa Clara, San Mateo and San Francisco counties. The van is a community project of the Lucile Packard Children's Hospital Stanford and Children's Health Fund, with support from Samsung.\u003c/p>\n\u003cfigure id=\"attachment_146678\" class=\"wp-caption alignright\" style=\"max-width: 1920px\">\u003cimg class=\"wp-image-146678 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/02/RS18410_IMG_9380.JPG-qut.jpg\" alt=\"\" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18410_IMG_9380.JPG-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18410_IMG_9380.JPG-qut-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18410_IMG_9380.JPG-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18410_IMG_9380.JPG-qut-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18410_IMG_9380.JPG-qut-1440x960.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18410_IMG_9380.JPG-qut-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18410_IMG_9380.JPG-qut-960x640.jpg 960w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">The teen health van parks at continuation high schools and other places frequented by adolescents in Santa Clara, San Mateo and San Francisco counties. Inside, patients are seen in two exam rooms and a nursing station. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The team provides free medical, nutrition and mental health services, including reproductive health care and treatment for chronic illnesses, substance abuse and depression. All medications are free and provided at the time of consultation. A social worker is available for counseling and connects adolescents to additional resources; a registered dietitian works with patients who are malnourished, a frequent health issue for this population.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Some of the 400 patients who visit the teen health van each year have never seen a doctor, says Ammerman.\u003c/p>\n\u003cp>“Going to the patients makes all the difference, and it's not just a matter of convenience,” says Ammerman, a clinical professor of adolescent medicine at Stanford University. “It really is that these kids, because of all these access barriers -- lack of insurance, lack of transportation -- they're not going to get this kind of care unless we go to them.”\u003c/p>\n\u003cp>For many patients here, the teen health van can become a trustworthy and reliable place in an otherwise unstable world.\u003c/p>\n\u003cp>Grace Kim first set foot in the van 10 years ago when she was 17. She admits she was skeptical.\u003c/p>\n\u003cp>\"Because it was a van, and I wasn't really sure what they could really provide for me,\" says Kim, 27. \"Off the bat I don't trust people very easily and that probably comes from the territory that I grew up in.\"\u003c/p>\n\u003cp>Kim, a second-generation Korean-American, says she grew up with abusive relatives in a house \"full of conflict.\" By the time she was 14, she had already attempted suicide. With the help of a high school counselor, Kim moved out of her parents' home into a transitional living program, which required her to get medical checkups at the van initially. For the next four years, Kim was a regular patient.\u003c/p>\n\u003cfigure id=\"attachment_147012\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"wp-image-147012 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/02/RS18425_IMG_9465.JPG-qut.jpg\" alt=\"Grace Kim, 27, credits the teen health van with helping her overcome depression, malnutrition and other health issues when she 17. Kim was photographed near Santa Clara University, where she is a masters student.\" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18425_IMG_9465.JPG-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18425_IMG_9465.JPG-qut-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18425_IMG_9465.JPG-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18425_IMG_9465.JPG-qut-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18425_IMG_9465.JPG-qut-1440x960.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18425_IMG_9465.JPG-qut-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18425_IMG_9465.JPG-qut-960x640.jpg 960w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Grace Kim credits the teen health van with helping her overcome depression and other health issues when she was 17. Kim was photographed near Santa Clara University, where she is a master's student in counseling psychology.\u003c/figcaption>\u003c/figure>\n\u003cp>Ammerman and other staff at the van treated Kim's malnutrition, substance abuse and other health issues. They connected her with free visits to see a psychiatrist at Stanford Medical Center who treated her depression, and she thrived.\u003c/p>\n\u003cp>\"If I didn't get that help, I would probably be in a very bad place,\" says Kim, now a master's student in counseling psychology at Santa Clara University. \"The whole mental health aspect of it was probably the most beneficial, probably the most powerful.\"\u003c/p>\n\u003cp>Today, Kim facilitates a support group for suicide survivors at Santa Clara Valley Medical Center and says her passion for her work comes from those dark days in her past. She still keeps in touch with Ammerman, calling him once in a while with health-related questions.\u003c/p>\n\u003cp>\"I trust him absolutely with everything because he's seen me at my worst, and he still to this day has the most faith in me,\" says Kim, adding that Ammerman motivated her to take care of herself and do better. \"To have someone care for you and tell you that you can get better and do anything that you put you heart into. ... I mean, there are no words for that.\"\u003c/p>\n\u003cp>Kim recognizes she was lucky to have access to housing, medical and mental health resources, but that may not be true for others.\u003c/p>\n\u003cp>\u003cstrong>Health Van Patients Often Face Precarious Housing\u003c/strong>\u003c/p>\n\u003cp>Over 40 percent of Stanford's teen health van patients are homeless, says Ammerman. These are adolescents up to age 25 living on the streets, in cars and, most commonly, overcrowded apartments. While doubling up with relatives or friends may sound like housing, it's not stable because people can be asked to leave at any time.\u003c/p>\n\u003cp>Ammerman says he's seen a significant increase in this population of teens and young adults -- those living in overcrowded conditions -- since 2008. Working families unable to make rent are more likely to end up in these challenging conditions.\u003c/p>\n\u003cp>\"We are seeing, unfortunately, more homeless kids. And that's really due to the housing crisis that we are all aware of here in the Bay Area,\" says Ammerman.\u003c/p>\n\u003cp>\u003cstrong>Homeless Youth Population Growing in California\u003c/strong>\u003c/p>\n\u003cp>Most Bay Area counties and the state as a whole are seeing a greater number of homeless kids in recent years, according to figures collected by the California Department of Education and crunched by \u003ca href=\"http://www.kidsdata.org/topic/230/homeless-students/table#fmt=355&loc=2,265,59,4,127,171,341,338,339,217&tf=79,73,67,64&sortType=asc\" target=\"_blank\">Kidsdata.org\u003c/a>. The education department designates students as \"homeless\" if their primary residence at any point in the school year was a:\u003c/p>\n\u003cul>\n\u003cli>Shelter\u003c/li>\n\u003cli>Hotel or motel\u003c/li>\n\u003cli>Shared housing with others due to loss of housing or economic hardship\u003c/li>\n\u003cli>No shelter at all.\u003c/li>\n\u003c/ul>\n\u003cp>Statewide, the rate of homeless public school students in grades K-12 jumped by one-third in just three years -- from 3.6 percent in 2011 to 4.8 percent in 2014. \u003ca href=\"http://www.kidsdata.org/topic/793/homeless-students-residence/table#fmt=1211&loc=2&tf=79,73,67,64&ch=1132,1133,1134,1135&sortColumnId=0&sortType=asc\" target=\"_blank\">More than 86 percent\u003c/a> of the nearly 300,000 homeless public school students statewide are living doubled up with friends or relatives.\u003c/p>\n\u003cp>\"So it's a very unstable housing situation, and that is always problematic for your health,\" says Ammerman.\u003c/p>\n\u003cp>Children and youth facing homelessness or housing insecurity are more likely than their peers to face \u003ca href=\"http://pediatrics.aappublications.org/content/131/6/1206\" target=\"_blank\">chronic illness\u003c/a> and mental health problems, as well as\u003ca href=\"http://www.homelesschildrenamerica.org/\"> traumas\u003c/a> and safety risks, studies show.\u003c/p>\n\u003cp>\u003cstrong>Resources for Homeless Youth are Not Keeping Up\u003c/strong>\u003c/p>\n\u003cp>Shahera Hyatt directs the California Homeless Youth Project at the \u003ca href=\"https://www.library.ca.gov/crb/\" target=\"_blank\">California Research Bureau\u003c/a> in Sacramento. She supports Ammerman's experience as to why the state is seeing a lot more child, youth and family homelessness.\u003c/p>\n\u003cp>\"We know that housing affordability is in crisis proportions,\" says Hyatt. \"In many communities across the state there's rapid gentrification happening and a very low housing stock.\"\u003c/p>\n\u003cp>Homeless youth -- particularly those constantly on the streets or without any access to shelters -- risk sexual abuse, police harassment and substance addiction. Yet the state is woefully lacking in services and resources for this population, says Hyatt.\u003c/p>\n\u003cp>Sacramento has a single six-bed transitional housing center for young adults -- and a nine-month waiting list of about 100 people, says Hyatt. She added that two-thirds of the state's counties lack shelters and other basic services for homeless youth.\u003c/p>\n\u003cp>\"There’s a lot of mythology about why young people become homeless ... that they are unruly or want to live outside. But that's not true,\" says Hyatt. \"A lot of these people are really disenfranchised by the lack of services out there and become homeless.\"\u003c/p>\n\u003cp>Since 1988, California has spent $1.1 million annually on programs that serve homeless youth: the Homeless Youth and Exploitation Program and the California Youth Crisis Line, according to the California Coalition for Youth.\u003c/p>\n\u003cp>A bill introduced last month by Assemblywoman Young Kim, \u003ca href=\"https://ad65.asmrc.org/press-release/14533\" target=\"_blank\">AB1699\u003c/a>, would provide $25 million in funding for homeless youth emergency service projects. The bill's first hearing should be in the next two months, according to Bryan Shroyer in Kim's office.\u003c/p>\n\u003cp>\u003cstrong>Popularity of Mobile Clinics Increases\u003c/strong>\u003c/p>\n\u003cp>Meanwhile, mobile health clinics like Ammerman's in San Jose continue to fill a gap in access to care for uninsured youth. That model of delivering care directly to underserved populations has been gaining popularity nationwide.\u003c/p>\n\u003cp>In the last two decades, the number of mobile clinics has grown to about 2,000 throughout the country, according to the Mobile Health Clinics Association.\u003c/p>\n\u003cp>\"What we are seeing is greater acceptance that mobile care can be really high-quality care,\" says Dr. Delaney Gracy, chief medical officer with the Children's Health Fund. \"More people are realizing that mobile health is an important part of safety net care.\"\u003c/p>\n\u003cfigure id=\"attachment_146679\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"wp-image-146679 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/02/RS18411_IMG_4503.JPG-qut.jpg\" alt=\"Ammerman fill a prescription for a patient. The teen health van provides medications for free.\" width=\"1920\" height=\"1440\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18411_IMG_4503.JPG-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18411_IMG_4503.JPG-qut-400x300.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18411_IMG_4503.JPG-qut-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18411_IMG_4503.JPG-qut-768x576.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18411_IMG_4503.JPG-qut-1440x1080.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18411_IMG_4503.JPG-qut-1180x885.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18411_IMG_4503.JPG-qut-960x720.jpg 960w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Ammerman fills a prescription for a patient. The teen health van provides medications for free. \u003ccite>(Farida Jhabvala Romero / KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>At the teen health van's exam room, Ammerman is ending his consultation with Ernesto by handing him packages of nicotine gum, the medication Ernesto chose from several options to help him quit smoking. Before Ernesto leaves, Ammerman has one last question for first-time patients like him.\u003c/p>\n\u003cp>\"We literally ask each kid, 'What are you good at, what are your strengths?' And they're shocked at this question because no one's ever asked that before,\" says Ammerman.\u003c/p>\n\u003cp>When Ernesto's turn comes to answer, he thinks for a while before responding.\u003c/p>\n\u003cp>\"Um ... I like to work and stay busy,\" says Ernesto. \"And I motivate my brothers a lot, as much as I can.\"\u003c/p>\n\u003cp>\"Cool! That's a really cool thing,\" responds Ammerman.\u003c/p>\n\u003cp>As his patients successfully take steps to care for their health, says Ammerman, they also gain the confidence to tackle other goals, like getting steady housing.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\"These kids have strengths, and by focusing on their strengths it can really make a difference. Because strength builds strength. And success builds success,\" says Ammerman.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Dr. Seth Ammerman listens intently to his new patient. Ernesto, who does not want his last name disclosed, is homeless. Ernesto is earning a high school degree and working part time, but at night, he and his brother share a tent that they set up on San Jose streets. The daily stress of being homeless is wearing Ernesto out and making him light up too many cigarettes.\u003c/p>\n\u003caside class=\"pullquote alignright\">'These kids, because of all these access barriers — lack of insurance, lack of transportation — they’re not going to get this kind of care unless we go to them.'\u003ccite>Dr. Seth Ammerman, medical director, Stanford Teen Health Van \u003c/cite>\u003c/aside>\n\u003cp>“I just want to cut down on my smoking,” says Ernesto, 21, with a tentative, soft voice. “I’ve been on the streets all the time, you know? I just want to make sure I’m OK.”\u003c/p>\n\u003cp>That's why Ernesto walked into this mobile clinic parked just a few steps away from his classroom at the San Jose Conservation Corps & Charter School. He's sitting in a fully equipped exam room inside a shiny blue tour bus with Wi-Fi and the ability to get HIV test results in 20 minutes.\u003c/p>\n\u003cp>During the consultation with Ernesto, Ammerman nods sympathetically. In his 20 years working in this teen health van, Ammerman has treated thousands of uninsured and homeless adolescents ages 24 and under.\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/247566086&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/247566086'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Twice a week, Ammerman and two nurses park the clinic at continuation high schools and other places frequented by at-risk adolescents in Santa Clara, San Mateo and San Francisco counties. The van is a community project of the Lucile Packard Children's Hospital Stanford and Children's Health Fund, with support from Samsung.\u003c/p>\n\u003cfigure id=\"attachment_146678\" class=\"wp-caption alignright\" style=\"max-width: 1920px\">\u003cimg class=\"wp-image-146678 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/02/RS18410_IMG_9380.JPG-qut.jpg\" alt=\"\" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18410_IMG_9380.JPG-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18410_IMG_9380.JPG-qut-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18410_IMG_9380.JPG-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18410_IMG_9380.JPG-qut-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18410_IMG_9380.JPG-qut-1440x960.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18410_IMG_9380.JPG-qut-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18410_IMG_9380.JPG-qut-960x640.jpg 960w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">The teen health van parks at continuation high schools and other places frequented by adolescents in Santa Clara, San Mateo and San Francisco counties. Inside, patients are seen in two exam rooms and a nursing station. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The team provides free medical, nutrition and mental health services, including reproductive health care and treatment for chronic illnesses, substance abuse and depression. All medications are free and provided at the time of consultation. A social worker is available for counseling and connects adolescents to additional resources; a registered dietitian works with patients who are malnourished, a frequent health issue for this population.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Some of the 400 patients who visit the teen health van each year have never seen a doctor, says Ammerman.\u003c/p>\n\u003cp>“Going to the patients makes all the difference, and it's not just a matter of convenience,” says Ammerman, a clinical professor of adolescent medicine at Stanford University. “It really is that these kids, because of all these access barriers -- lack of insurance, lack of transportation -- they're not going to get this kind of care unless we go to them.”\u003c/p>\n\u003cp>For many patients here, the teen health van can become a trustworthy and reliable place in an otherwise unstable world.\u003c/p>\n\u003cp>Grace Kim first set foot in the van 10 years ago when she was 17. She admits she was skeptical.\u003c/p>\n\u003cp>\"Because it was a van, and I wasn't really sure what they could really provide for me,\" says Kim, 27. \"Off the bat I don't trust people very easily and that probably comes from the territory that I grew up in.\"\u003c/p>\n\u003cp>Kim, a second-generation Korean-American, says she grew up with abusive relatives in a house \"full of conflict.\" By the time she was 14, she had already attempted suicide. With the help of a high school counselor, Kim moved out of her parents' home into a transitional living program, which required her to get medical checkups at the van initially. For the next four years, Kim was a regular patient.\u003c/p>\n\u003cfigure id=\"attachment_147012\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"wp-image-147012 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/02/RS18425_IMG_9465.JPG-qut.jpg\" alt=\"Grace Kim, 27, credits the teen health van with helping her overcome depression, malnutrition and other health issues when she 17. Kim was photographed near Santa Clara University, where she is a masters student.\" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18425_IMG_9465.JPG-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18425_IMG_9465.JPG-qut-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18425_IMG_9465.JPG-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18425_IMG_9465.JPG-qut-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18425_IMG_9465.JPG-qut-1440x960.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18425_IMG_9465.JPG-qut-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18425_IMG_9465.JPG-qut-960x640.jpg 960w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Grace Kim credits the teen health van with helping her overcome depression and other health issues when she was 17. Kim was photographed near Santa Clara University, where she is a master's student in counseling psychology.\u003c/figcaption>\u003c/figure>\n\u003cp>Ammerman and other staff at the van treated Kim's malnutrition, substance abuse and other health issues. They connected her with free visits to see a psychiatrist at Stanford Medical Center who treated her depression, and she thrived.\u003c/p>\n\u003cp>\"If I didn't get that help, I would probably be in a very bad place,\" says Kim, now a master's student in counseling psychology at Santa Clara University. \"The whole mental health aspect of it was probably the most beneficial, probably the most powerful.\"\u003c/p>\n\u003cp>Today, Kim facilitates a support group for suicide survivors at Santa Clara Valley Medical Center and says her passion for her work comes from those dark days in her past. She still keeps in touch with Ammerman, calling him once in a while with health-related questions.\u003c/p>\n\u003cp>\"I trust him absolutely with everything because he's seen me at my worst, and he still to this day has the most faith in me,\" says Kim, adding that Ammerman motivated her to take care of herself and do better. \"To have someone care for you and tell you that you can get better and do anything that you put you heart into. ... I mean, there are no words for that.\"\u003c/p>\n\u003cp>Kim recognizes she was lucky to have access to housing, medical and mental health resources, but that may not be true for others.\u003c/p>\n\u003cp>\u003cstrong>Health Van Patients Often Face Precarious Housing\u003c/strong>\u003c/p>\n\u003cp>Over 40 percent of Stanford's teen health van patients are homeless, says Ammerman. These are adolescents up to age 25 living on the streets, in cars and, most commonly, overcrowded apartments. While doubling up with relatives or friends may sound like housing, it's not stable because people can be asked to leave at any time.\u003c/p>\n\u003cp>Ammerman says he's seen a significant increase in this population of teens and young adults -- those living in overcrowded conditions -- since 2008. Working families unable to make rent are more likely to end up in these challenging conditions.\u003c/p>\n\u003cp>\"We are seeing, unfortunately, more homeless kids. And that's really due to the housing crisis that we are all aware of here in the Bay Area,\" says Ammerman.\u003c/p>\n\u003cp>\u003cstrong>Homeless Youth Population Growing in California\u003c/strong>\u003c/p>\n\u003cp>Most Bay Area counties and the state as a whole are seeing a greater number of homeless kids in recent years, according to figures collected by the California Department of Education and crunched by \u003ca href=\"http://www.kidsdata.org/topic/230/homeless-students/table#fmt=355&loc=2,265,59,4,127,171,341,338,339,217&tf=79,73,67,64&sortType=asc\" target=\"_blank\">Kidsdata.org\u003c/a>. The education department designates students as \"homeless\" if their primary residence at any point in the school year was a:\u003c/p>\n\u003cul>\n\u003cli>Shelter\u003c/li>\n\u003cli>Hotel or motel\u003c/li>\n\u003cli>Shared housing with others due to loss of housing or economic hardship\u003c/li>\n\u003cli>No shelter at all.\u003c/li>\n\u003c/ul>\n\u003cp>Statewide, the rate of homeless public school students in grades K-12 jumped by one-third in just three years -- from 3.6 percent in 2011 to 4.8 percent in 2014. \u003ca href=\"http://www.kidsdata.org/topic/793/homeless-students-residence/table#fmt=1211&loc=2&tf=79,73,67,64&ch=1132,1133,1134,1135&sortColumnId=0&sortType=asc\" target=\"_blank\">More than 86 percent\u003c/a> of the nearly 300,000 homeless public school students statewide are living doubled up with friends or relatives.\u003c/p>\n\u003cp>\"So it's a very unstable housing situation, and that is always problematic for your health,\" says Ammerman.\u003c/p>\n\u003cp>Children and youth facing homelessness or housing insecurity are more likely than their peers to face \u003ca href=\"http://pediatrics.aappublications.org/content/131/6/1206\" target=\"_blank\">chronic illness\u003c/a> and mental health problems, as well as\u003ca href=\"http://www.homelesschildrenamerica.org/\"> traumas\u003c/a> and safety risks, studies show.\u003c/p>\n\u003cp>\u003cstrong>Resources for Homeless Youth are Not Keeping Up\u003c/strong>\u003c/p>\n\u003cp>Shahera Hyatt directs the California Homeless Youth Project at the \u003ca href=\"https://www.library.ca.gov/crb/\" target=\"_blank\">California Research Bureau\u003c/a> in Sacramento. She supports Ammerman's experience as to why the state is seeing a lot more child, youth and family homelessness.\u003c/p>\n\u003cp>\"We know that housing affordability is in crisis proportions,\" says Hyatt. \"In many communities across the state there's rapid gentrification happening and a very low housing stock.\"\u003c/p>\n\u003cp>Homeless youth -- particularly those constantly on the streets or without any access to shelters -- risk sexual abuse, police harassment and substance addiction. Yet the state is woefully lacking in services and resources for this population, says Hyatt.\u003c/p>\n\u003cp>Sacramento has a single six-bed transitional housing center for young adults -- and a nine-month waiting list of about 100 people, says Hyatt. She added that two-thirds of the state's counties lack shelters and other basic services for homeless youth.\u003c/p>\n\u003cp>\"There’s a lot of mythology about why young people become homeless ... that they are unruly or want to live outside. But that's not true,\" says Hyatt. \"A lot of these people are really disenfranchised by the lack of services out there and become homeless.\"\u003c/p>\n\u003cp>Since 1988, California has spent $1.1 million annually on programs that serve homeless youth: the Homeless Youth and Exploitation Program and the California Youth Crisis Line, according to the California Coalition for Youth.\u003c/p>\n\u003cp>A bill introduced last month by Assemblywoman Young Kim, \u003ca href=\"https://ad65.asmrc.org/press-release/14533\" target=\"_blank\">AB1699\u003c/a>, would provide $25 million in funding for homeless youth emergency service projects. The bill's first hearing should be in the next two months, according to Bryan Shroyer in Kim's office.\u003c/p>\n\u003cp>\u003cstrong>Popularity of Mobile Clinics Increases\u003c/strong>\u003c/p>\n\u003cp>Meanwhile, mobile health clinics like Ammerman's in San Jose continue to fill a gap in access to care for uninsured youth. That model of delivering care directly to underserved populations has been gaining popularity nationwide.\u003c/p>\n\u003cp>In the last two decades, the number of mobile clinics has grown to about 2,000 throughout the country, according to the Mobile Health Clinics Association.\u003c/p>\n\u003cp>\"What we are seeing is greater acceptance that mobile care can be really high-quality care,\" says Dr. Delaney Gracy, chief medical officer with the Children's Health Fund. \"More people are realizing that mobile health is an important part of safety net care.\"\u003c/p>\n\u003cfigure id=\"attachment_146679\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"wp-image-146679 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/02/RS18411_IMG_4503.JPG-qut.jpg\" alt=\"Ammerman fill a prescription for a patient. The teen health van provides medications for free.\" width=\"1920\" height=\"1440\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18411_IMG_4503.JPG-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18411_IMG_4503.JPG-qut-400x300.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18411_IMG_4503.JPG-qut-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18411_IMG_4503.JPG-qut-768x576.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18411_IMG_4503.JPG-qut-1440x1080.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18411_IMG_4503.JPG-qut-1180x885.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2016/02/RS18411_IMG_4503.JPG-qut-960x720.jpg 960w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Ammerman fills a prescription for a patient. The teen health van provides medications for free. \u003ccite>(Farida Jhabvala Romero / KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>At the teen health van's exam room, Ammerman is ending his consultation with Ernesto by handing him packages of nicotine gum, the medication Ernesto chose from several options to help him quit smoking. Before Ernesto leaves, Ammerman has one last question for first-time patients like him.\u003c/p>\n\u003cp>\"We literally ask each kid, 'What are you good at, what are your strengths?' And they're shocked at this question because no one's ever asked that before,\" says Ammerman.\u003c/p>\n\u003cp>When Ernesto's turn comes to answer, he thinks for a while before responding.\u003c/p>\n\u003cp>\"Um ... I like to work and stay busy,\" says Ernesto. \"And I motivate my brothers a lot, as much as I can.\"\u003c/p>\n\u003cp>\"Cool! That's a really cool thing,\" responds Ammerman.\u003c/p>\n\u003cp>As his patients successfully take steps to care for their health, says Ammerman, they also gain the confidence to tackle other goals, like getting steady housing.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"These kids have strengths, and by focusing on their strengths it can really make a difference. Because strength builds strength. And success builds success,\" says Ammerman.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Teens in San Francisco's Bayview Find Haven in Garden",
"title": "Teens in San Francisco's Bayview Find Haven in Garden",
"headTitle": "Vital Signs | State of Health | KQED News",
"content": "\u003cp>On a sunny day in San Francisco's southeast corner, a group of teenagers are getting ready to plant strawberries and build raised garden beds in a small plot of land blocks away from the former Hunters Point Naval Shipyard.\u003c/p>\n\u003cp>Over the last few years, these teens have transformed the weedy yard at the Oakdale Community Center into a small orchard and farm with roaming chickens and beehives.\u003c/p>\n\u003cp>They've nurtured what once was rocky soil and have grown collard greens, chives and peppers. They've cooked and tasted fresh vegetables or distributed them free to their neighbors. Some have used power tools to build a large chicken coop for the 14 or so resident chickens that lay a dozen eggs per day in the summer.\u003c/p>\n\u003cfigure id=\"attachment_138586\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"wp-image-138586 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/01/RS18016_IMG_9245.JPG-qut.jpg\" alt=\"Dominique Brooks, 12, cuts open a bag of soil for a garden bed as Mutee [[LAST NAME]], 10, and residents of the Hunters Point West public housing development look on.\" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/01/RS18016_IMG_9245.JPG-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/27/2016/01/RS18016_IMG_9245.JPG-qut-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/01/RS18016_IMG_9245.JPG-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/01/RS18016_IMG_9245.JPG-qut-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2016/01/RS18016_IMG_9245.JPG-qut-1440x960.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2016/01/RS18016_IMG_9245.JPG-qut-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2016/01/RS18016_IMG_9245.JPG-qut-960x640.jpg 960w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Dominique Brooks, 12, (R) and Mutee Algaaffar, 10, cut open a bag of soil while working at the City of Dreams gardening after-school program. 'Junior gardeners' such as Brooks and Algaaffar have built more than 30 garden beds throughout the Hunters Point West public housing development, across the street from the Oakdale Community Center. \u003ccite>(Farida Jhabvala Romero / KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The gardeners -- some as young as 10 -- are all part of an after-school program run by the nonprofit City of Dreams in the Bayview-Hunters Point neighborhood. The organization employs 32 kids from the area as junior gardeners, paying them $35 for completing eight gardening sessions. It's a modest stipend for anyone, but earning the cash gives an air of formality to kids like Zavion Gilbert, 15, who shows up regularly to work.\u003c/p>\n\u003cp>“It’s kind of like a job but it’s teaching us a lot of stuff, too,” says Zavion, who aspires to become a chef. “I keep doing it because it got me more interested in life and healthy things. I want to work with vegetables and stuff.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>On the day I visited, a handful of volunteers -- U.S. Army veterans -- were teaching Zavion and Dominique Brooks, 12, to drill wooden planks and assemble garden beds. The adult volunteers supervised Brooks and other teens as they cut a plastic sheet and inserted it into the bottom of a garden bed to prevent weeds from growing inside.\u003c/p>\n\u003cfigure id=\"attachment_138589\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"wp-image-138589 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/01/RS18021_IMG_9273.JPG-qut.jpg\" alt=\"Peppers growing in the Oakdale Community Center garden. The garden also has chives, sunflowers, radishes, pomegranates, as well as lemon and orange trees.\" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/01/RS18021_IMG_9273.JPG-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/27/2016/01/RS18021_IMG_9273.JPG-qut-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/01/RS18021_IMG_9273.JPG-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/01/RS18021_IMG_9273.JPG-qut-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2016/01/RS18021_IMG_9273.JPG-qut-1440x960.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2016/01/RS18021_IMG_9273.JPG-qut-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2016/01/RS18021_IMG_9273.JPG-qut-960x640.jpg 960w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Different varieties of peppers grow at the Oakdale Community Center garden. Local teenagers also tend to chives, collar greens, sunflowers and fruit trees. \u003ccite>(Farida Jhabvala Romero / KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Dominique has participated in the garden since its inception over four years ago, and points proudly to the lemon, pomegranate and orange trees that she planted along the edges. A few of the trees are now about as tall as she is.\u003c/p>\n\u003cp>\"The garden is joyful,\" says Dominique, a middle schooler with long braided hair. \"It helps me do more stuff, and it helps me learn. If I go to college and want to know more stuff about plants, I'll already know something because I started gardening at a young age.\"\u003c/p>\n\u003cfigure id=\"attachment_138614\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"wp-image-138614 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/01/RS18017_IMG_9248.JPG-qut.jpg\" alt=\"Dominique Brooks and Mutee Algaaffar put the finishing touches on a new garden bed for residents of the Hunters Point West housing development. The garden sits right across the street.\" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/01/RS18017_IMG_9248.JPG-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/27/2016/01/RS18017_IMG_9248.JPG-qut-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/01/RS18017_IMG_9248.JPG-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/01/RS18017_IMG_9248.JPG-qut-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2016/01/RS18017_IMG_9248.JPG-qut-1440x960.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2016/01/RS18017_IMG_9248.JPG-qut-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2016/01/RS18017_IMG_9248.JPG-qut-960x640.jpg 960w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Dominique Brooks and Mutee Algaaffar put the finishing touches on a new garden bed for people who live across the street at the Hunters Point West housing development. \u003ccite>(Farida Jhabvala Romero / KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>She says she likes being in the garden, in part because she considers it safer than hanging out in the streets nearby. She says she has witnessed shootings firsthand.\u003c/p>\n\u003cp>“One day somebody got shot in front of the garden right there,\" recalls Dominique, pointing to the street. \"We didn't know what to do. We didn't know it was coming.\"\u003c/p>\n\u003cp>The Bayview-Hunters Point area struggles with gang violence and poverty. The proportion of residents living at or below 200 percent poverty is \u003ca href=\"https://www.sfdph.org/dph/files/HCSMP/HCSMP_DataHandout_ENG_03222012.pdf\" target=\"_blank\">50 percent higher \u003c/a>than for San Francisco as a whole.\u003c/p>\n\u003cp>\"When you hang out in the neighborhood, you see the pressure that the families are under to just make it,\" says Cody Reynolds, 52, lead gardener in the project. \"These kids come to us frustrated, upset. They are kids dealing with this violence that, as an adult, I have a hard time dealing with.\"\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/243109730\" 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>Reynolds is an artist who has lived in Bayview-Hunters Point for 20 years. He says most of those years he kept to himself and wasn't deeply engaged with the community. He dreaded the summers, when he says teens would break windows at his warehouse studio.\u003c/p>\n\u003cp>\"I realized they didn't have any activities. They weren't being engaged to do better,\" says Reynolds.\u003c/p>\n\u003cp>So he tried a small experiment. An avid gardener for a long time, he would keep his \"hands grounded\" by tending to plants in pots and tires. One day, a group of teens stopped by to try to sell him a bike. Instead, Reynolds offered them a job: to plant avocado and other trees in the neighborhood. He paid them a small amount out of his own pocket. It was a success.\u003c/p>\n\u003cfigure id=\"attachment_138588\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"wp-image-138588 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/01/RS18025_IMG_9292.JPG-qut.jpg\" alt=\"Murals by participants of the gardening after school program cover the walls of the old daycare center where the garden is now set. \" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/01/RS18025_IMG_9292.JPG-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/27/2016/01/RS18025_IMG_9292.JPG-qut-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/01/RS18025_IMG_9292.JPG-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/01/RS18025_IMG_9292.JPG-qut-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2016/01/RS18025_IMG_9292.JPG-qut-1440x960.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2016/01/RS18025_IMG_9292.JPG-qut-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2016/01/RS18025_IMG_9292.JPG-qut-960x640.jpg 960w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Murals by participants of the gardening after-school program decorate the walls of the Oakdale Community Center. \u003ccite>(Farida Jhabvala Romero / KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The experience brewed a dream for him: to turn open spaces in Bayview-Hunters Point into orchards with fresh foods for residents, involving youth. This garden with the teens, at the Oakdale Community Center, is a first big step.\u003c/p>\n\u003cp>\"We are turning a food desert into a food forest. In the Bayview we have lots of sunshine and the right weather to grow everything from apples and pears to watermelon, squash and cucumbers,\" says Reynolds, while helping Mutee Algaaffar, 10, plant a large patch of strawberries.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"For the kids, this is their nature and you see how they resonate here,\" he says. \"Everyone is a little calmer. It's just a natural place to be.\"\u003c/p>\n\n",
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"excerpt": "Community center engages local teens in growing food and sharing it with neighbors.",
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"headline": "Teens in San Francisco's Bayview Find Haven in Garden",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>On a sunny day in San Francisco's southeast corner, a group of teenagers are getting ready to plant strawberries and build raised garden beds in a small plot of land blocks away from the former Hunters Point Naval Shipyard.\u003c/p>\n\u003cp>Over the last few years, these teens have transformed the weedy yard at the Oakdale Community Center into a small orchard and farm with roaming chickens and beehives.\u003c/p>\n\u003cp>They've nurtured what once was rocky soil and have grown collard greens, chives and peppers. They've cooked and tasted fresh vegetables or distributed them free to their neighbors. Some have used power tools to build a large chicken coop for the 14 or so resident chickens that lay a dozen eggs per day in the summer.\u003c/p>\n\u003cfigure id=\"attachment_138586\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"wp-image-138586 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/01/RS18016_IMG_9245.JPG-qut.jpg\" alt=\"Dominique Brooks, 12, cuts open a bag of soil for a garden bed as Mutee [[LAST NAME]], 10, and residents of the Hunters Point West public housing development look on.\" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/01/RS18016_IMG_9245.JPG-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/27/2016/01/RS18016_IMG_9245.JPG-qut-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/01/RS18016_IMG_9245.JPG-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/01/RS18016_IMG_9245.JPG-qut-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2016/01/RS18016_IMG_9245.JPG-qut-1440x960.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2016/01/RS18016_IMG_9245.JPG-qut-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2016/01/RS18016_IMG_9245.JPG-qut-960x640.jpg 960w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Dominique Brooks, 12, (R) and Mutee Algaaffar, 10, cut open a bag of soil while working at the City of Dreams gardening after-school program. 'Junior gardeners' such as Brooks and Algaaffar have built more than 30 garden beds throughout the Hunters Point West public housing development, across the street from the Oakdale Community Center. \u003ccite>(Farida Jhabvala Romero / KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The gardeners -- some as young as 10 -- are all part of an after-school program run by the nonprofit City of Dreams in the Bayview-Hunters Point neighborhood. The organization employs 32 kids from the area as junior gardeners, paying them $35 for completing eight gardening sessions. It's a modest stipend for anyone, but earning the cash gives an air of formality to kids like Zavion Gilbert, 15, who shows up regularly to work.\u003c/p>\n\u003cp>“It’s kind of like a job but it’s teaching us a lot of stuff, too,” says Zavion, who aspires to become a chef. “I keep doing it because it got me more interested in life and healthy things. I want to work with vegetables and stuff.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>On the day I visited, a handful of volunteers -- U.S. Army veterans -- were teaching Zavion and Dominique Brooks, 12, to drill wooden planks and assemble garden beds. The adult volunteers supervised Brooks and other teens as they cut a plastic sheet and inserted it into the bottom of a garden bed to prevent weeds from growing inside.\u003c/p>\n\u003cfigure id=\"attachment_138589\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"wp-image-138589 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/01/RS18021_IMG_9273.JPG-qut.jpg\" alt=\"Peppers growing in the Oakdale Community Center garden. The garden also has chives, sunflowers, radishes, pomegranates, as well as lemon and orange trees.\" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/01/RS18021_IMG_9273.JPG-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/27/2016/01/RS18021_IMG_9273.JPG-qut-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/01/RS18021_IMG_9273.JPG-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/01/RS18021_IMG_9273.JPG-qut-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2016/01/RS18021_IMG_9273.JPG-qut-1440x960.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2016/01/RS18021_IMG_9273.JPG-qut-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2016/01/RS18021_IMG_9273.JPG-qut-960x640.jpg 960w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Different varieties of peppers grow at the Oakdale Community Center garden. Local teenagers also tend to chives, collar greens, sunflowers and fruit trees. \u003ccite>(Farida Jhabvala Romero / KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Dominique has participated in the garden since its inception over four years ago, and points proudly to the lemon, pomegranate and orange trees that she planted along the edges. A few of the trees are now about as tall as she is.\u003c/p>\n\u003cp>\"The garden is joyful,\" says Dominique, a middle schooler with long braided hair. \"It helps me do more stuff, and it helps me learn. If I go to college and want to know more stuff about plants, I'll already know something because I started gardening at a young age.\"\u003c/p>\n\u003cfigure id=\"attachment_138614\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"wp-image-138614 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/01/RS18017_IMG_9248.JPG-qut.jpg\" alt=\"Dominique Brooks and Mutee Algaaffar put the finishing touches on a new garden bed for residents of the Hunters Point West housing development. The garden sits right across the street.\" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/01/RS18017_IMG_9248.JPG-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/27/2016/01/RS18017_IMG_9248.JPG-qut-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/01/RS18017_IMG_9248.JPG-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/01/RS18017_IMG_9248.JPG-qut-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2016/01/RS18017_IMG_9248.JPG-qut-1440x960.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2016/01/RS18017_IMG_9248.JPG-qut-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2016/01/RS18017_IMG_9248.JPG-qut-960x640.jpg 960w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Dominique Brooks and Mutee Algaaffar put the finishing touches on a new garden bed for people who live across the street at the Hunters Point West housing development. \u003ccite>(Farida Jhabvala Romero / KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>She says she likes being in the garden, in part because she considers it safer than hanging out in the streets nearby. She says she has witnessed shootings firsthand.\u003c/p>\n\u003cp>“One day somebody got shot in front of the garden right there,\" recalls Dominique, pointing to the street. \"We didn't know what to do. We didn't know it was coming.\"\u003c/p>\n\u003cp>The Bayview-Hunters Point area struggles with gang violence and poverty. The proportion of residents living at or below 200 percent poverty is \u003ca href=\"https://www.sfdph.org/dph/files/HCSMP/HCSMP_DataHandout_ENG_03222012.pdf\" target=\"_blank\">50 percent higher \u003c/a>than for San Francisco as a whole.\u003c/p>\n\u003cp>\"When you hang out in the neighborhood, you see the pressure that the families are under to just make it,\" says Cody Reynolds, 52, lead gardener in the project. \"These kids come to us frustrated, upset. They are kids dealing with this violence that, as an adult, I have a hard time dealing with.\"\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/243109730&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/243109730'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Reynolds is an artist who has lived in Bayview-Hunters Point for 20 years. He says most of those years he kept to himself and wasn't deeply engaged with the community. He dreaded the summers, when he says teens would break windows at his warehouse studio.\u003c/p>\n\u003cp>\"I realized they didn't have any activities. They weren't being engaged to do better,\" says Reynolds.\u003c/p>\n\u003cp>So he tried a small experiment. An avid gardener for a long time, he would keep his \"hands grounded\" by tending to plants in pots and tires. One day, a group of teens stopped by to try to sell him a bike. Instead, Reynolds offered them a job: to plant avocado and other trees in the neighborhood. He paid them a small amount out of his own pocket. It was a success.\u003c/p>\n\u003cfigure id=\"attachment_138588\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"wp-image-138588 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/01/RS18025_IMG_9292.JPG-qut.jpg\" alt=\"Murals by participants of the gardening after school program cover the walls of the old daycare center where the garden is now set. \" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/01/RS18025_IMG_9292.JPG-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/27/2016/01/RS18025_IMG_9292.JPG-qut-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/01/RS18025_IMG_9292.JPG-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/01/RS18025_IMG_9292.JPG-qut-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2016/01/RS18025_IMG_9292.JPG-qut-1440x960.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2016/01/RS18025_IMG_9292.JPG-qut-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2016/01/RS18025_IMG_9292.JPG-qut-960x640.jpg 960w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Murals by participants of the gardening after-school program decorate the walls of the Oakdale Community Center. \u003ccite>(Farida Jhabvala Romero / KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The experience brewed a dream for him: to turn open spaces in Bayview-Hunters Point into orchards with fresh foods for residents, involving youth. This garden with the teens, at the Oakdale Community Center, is a first big step.\u003c/p>\n\u003cp>\"We are turning a food desert into a food forest. In the Bayview we have lots of sunshine and the right weather to grow everything from apples and pears to watermelon, squash and cucumbers,\" says Reynolds, while helping Mutee Algaaffar, 10, plant a large patch of strawberries.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"For the kids, this is their nature and you see how they resonate here,\" he says. \"Everyone is a little calmer. It's just a natural place to be.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Hayward 'Promotoras' Make House Calls, Connect Neighbors to Health Care",
"title": "Hayward 'Promotoras' Make House Calls, Connect Neighbors to Health Care",
"headTitle": "Vital Signs | State of Health | KQED News",
"content": "\u003cp>Carolina Arroyo-Solveson and Guadalupe Perez are community health workers, but the bulk of their work is done outside a clinic or hospital setting. Instead, they share health information right in people's homes.\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/237124405\" 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>The two women are \u003cem>\u003ca href=\"http://www.cdc.gov/minorityhealth/promotores.html\" target=\"_blank\">promotoras de \u003c/a>\u003cspan style=\"color: #24890d\">salud\u003c/span>, \u003c/em>Spanish-speaking lay health educators. Promotoras have a long history in California, and Arroyo-Solveson and Perez are working today in Hayward as part of \u003ca href=\"http://www.haywardpromise.org/\" target=\"_blank\">Hayward Promise Neighborhood\u003c/a>, a federally-funded initiative that is honing in on the Jackson Triangle neighborhood, a lower-income, ethnically diverse area of the city.\u003c/p>\n\u003cp>The women go door to door, connecting residents to community clinics and other health services.\u003c/p>\n\u003caside class=\"pullquote alignright\">'They know that we are part of the community. We have our kids in the same schools. We go to the same stores.'\u003cbr>\n\u003ccite>Guadalupe Perez, a promotora in Hayward\u003c/cite>\u003c/aside>\n\u003cp>Arroyo-Solveson says there is nothing like face-to-face interaction to reach parents and others who may feel isolated or distrustful of government programs for which they would qualify.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"Often when you have cultural barriers, language barriers, economic barriers, it’s very hard to feel empowered,\" Arroyo-Solveson says. \"We are trying to bridge these services for them so they can get empowered and engaged with the community.\"\u003c/p>\n\u003cp>Arroyo-Solveson is originally from Chile and says her own immigrant experience helps her relate to the families she works with.\u003c/p>\n\u003cp>Today, Arroyo-Solveson and Perez will meet with Liliana Salas, a stay-at-home mother with two children. Salas has invited the promotoras to her home, which is a welcome change from days past.\u003c/p>\n\u003cp>“When we started this work, nobody would tell us, 'Can you please come to our home?' They would slam the door or take a long time to answer,\" Arroyo-Solveson says with a chuckle. \"Now people hear about us and invite us to their home, which is wonderful.\"\u003c/p>\n\u003cp>Perez says that part of the success of promotoras in reaching residents is their familiarity with the neighborhood.\u003c/p>\n\u003cp>\"They know that we are part of the community. We have our kids in the same schools. We go to the same stores,\" says Perez.\u003c/p>\n\u003cp>After everyone is settled in Salas' living room, Arroyo-Solveson and Perez try to assess the family's needs. Do they have health insurance? They do. Has Salas heard of CalFresh, the state's food stamps program? She hasn’t, but wants to know more.\u003c/p>\n\u003cfigure id=\"attachment_117943\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/12/RS17562_Promotoras_with_Liliana.JPG-qut.jpg\">\u003cimg class=\"wp-image-117943 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/12/RS17562_Promotoras_with_Liliana.JPG-qut.jpg\" alt=\"\" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/12/RS17562_Promotoras_with_Liliana.JPG-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/27/2015/12/RS17562_Promotoras_with_Liliana.JPG-qut-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/12/RS17562_Promotoras_with_Liliana.JPG-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2015/12/RS17562_Promotoras_with_Liliana.JPG-qut-1440x960.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2015/12/RS17562_Promotoras_with_Liliana.JPG-qut-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2015/12/RS17562_Promotoras_with_Liliana.JPG-qut-960x640.jpg 960w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Liliana Salas (R), a stay-at-home mom, listens to Perez explain CalFresh, the state's Supplemental Nutrition Assistance Program, formerly known as food stamps. Perez and Arroyo-Solveson visited Salas at her home as part of the Hayward Promise Neighborhood initiative. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Salas listens attentively and asks questions as the promotoras explain how to apply for CalFresh. They also describe neighborhood events nearby -- the local library is offering kids help with their homework, and a community center is soon holding a drum circle.\u003c/p>\n\u003cp>“It’s a great event that helps to relieve stress,” explains Perez in Spanish. “And you can bring your kids to participate.\"\u003c/p>\n\u003cp>As the women close their visit, Salas promises to review the information, including a subsidized training course to become a medical assistant.\u003c/p>\n\u003cp>“I’ll try to find the programs that are the most relevant to me and my family,” says Salas, holding a stack of papers and phone numbers for local resources.\u003c/p>\n\u003cfigure id=\"attachment_117947\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/12/RS17559_IMG_9794.JPG-qut.jpg\">\u003cimg class=\"wp-image-117947 size-thumbnail\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/12/RS17559_IMG_9794.JPG-qut-400x267.jpg\" alt=\"\" width=\"400\" height=\"267\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/12/RS17559_IMG_9794.JPG-qut-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/12/RS17559_IMG_9794.JPG-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2015/12/RS17559_IMG_9794.JPG-qut-1440x960.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2015/12/RS17559_IMG_9794.JPG-qut-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2015/12/RS17559_IMG_9794.JPG-qut-960x640.jpg 960w\" sizes=\"(max-width: 400px) 100vw, 400px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Carolina Arroyo-Solveson (L) and Guadalupe Perez prepare to visit immigrant families in Hayward's Jackson Triangle neighborhood. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Perez says it's interactions like these that give her role meaning. And she is committed. She volunteers as a promotora; her work is generally unpaid. During her four years as a promotora for the \u003ca href=\"http://www.tvhc.org/\" target=\"_blank\">Tiburcio Vasquez Health Center\u003c/a>, Perez says she has witnessed positive changes in people’s mindsets -– and consequently, their lives.\u003c/p>\n\u003cp>One example she cites is clients who are initially resigned to getting chronic diseases like diabetes if their relatives also suffer from it.\u003c/p>\n\u003cp>“We'll tell them, ‘No. Don’t think like this! You can break the pattern.’ How? By exercising, changing your diet and being more relaxed,” says Perez, adding that many of the parents she meets with work more than one job and face high levels of stress.\u003c/p>\n\u003cp>Nationwide, Latinos are \u003ca href=\"http://minorityhealth.hhs.gov/omh/browse.aspx?lvl=4&lvlid=63\" target=\"_blank\">40 percent\u003c/a> more likely to die from diabetes than non-Hispanic whites, according to federal statistics.\u003c/p>\n\u003cp>Perez, a mother of three who cleans homes for a living, says that her own family has benefited from the knowledge she’s gained as a promotora. Her kids are more aware of nutritional labels as they browse aisles at the supermarket –- and appreciate the dangers of too much sugar and salt in their diets. Her husband reduced his daily soda intake from three or more cans daily to just one.\u003c/p>\n\u003cfigure id=\"attachment_117944\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/12/RS17560_IMG_9809.JPG-qut.jpg\">\u003cimg class=\"wp-image-117944 size-thumbnail\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/12/RS17560_IMG_9809.JPG-qut-400x267.jpg\" alt=\"\" width=\"400\" height=\"267\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/12/RS17560_IMG_9809.JPG-qut-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/12/RS17560_IMG_9809.JPG-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2015/12/RS17560_IMG_9809.JPG-qut-1440x960.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2015/12/RS17560_IMG_9809.JPG-qut-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2015/12/RS17560_IMG_9809.JPG-qut-960x640.jpg 960w\" sizes=\"(max-width: 400px) 100vw, 400px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Perez shares information about a support group for parents to a resident she visited at her home. Most of the immigrant families Perez works with in Hayward's Jackson Triangle are low income. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Perez says being a promotora has also boosted her confidence and sense of purpose.\u003c/p>\n\u003cp>\"The training of promotora completely changed my life,\" says Perez, who is originally from Mexico.\u003c/p>\n\u003cp>She’s lost weight by adding vegetables to her diet and exercising more. It’s an approach she preaches to her clients: make the time for small beneficial changes that you can keep.\u003c/p>\n\u003cp>“I don’t have the time to go to the gym and also I don’t have money to go to the gym, so I do my exercise at home,” she said. “I have some zumba videos, so I'll play them and dance at home with my kids.\"\u003c/p>\n\u003cp>Another benefit she says, is how much more connected she feels with her community. Before, she would try to ignore problems -- like drug users at the park or gang-related violence. Now, she's taking an active role in improving her neighborhood.\u003c/p>\n\u003cp>\"Health is about everything -- good schools, access to good foods, and feeling safe in your neighborhood,\" says Perez, who earlier this year received a volunteer award from the city of Hayward.\u003c/p>\n\u003cp>Arroyo-Solveson says promotoras are an agent of change with tangible impacts.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\"When I see that children get vaccinated because we have provided [parents with] resources on where to do that, they get health insurance because the promotoras came with all the information. It’s just a wonderful thing to see the transformation,\" says Arroyo-Solvenson. \"We are transforming a community with information, with care, because we care for them.\"\u003c/p>\n\n",
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"excerpt": "Spanish-speaking lay health workers go door to door in the Jackson Triangle neighborhood, a low-income area of Hayward.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Carolina Arroyo-Solveson and Guadalupe Perez are community health workers, but the bulk of their work is done outside a clinic or hospital setting. Instead, they share health information right in people's homes.\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/237124405&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/237124405'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The two women are \u003cem>\u003ca href=\"http://www.cdc.gov/minorityhealth/promotores.html\" target=\"_blank\">promotoras de \u003c/a>\u003cspan style=\"color: #24890d\">salud\u003c/span>, \u003c/em>Spanish-speaking lay health educators. Promotoras have a long history in California, and Arroyo-Solveson and Perez are working today in Hayward as part of \u003ca href=\"http://www.haywardpromise.org/\" target=\"_blank\">Hayward Promise Neighborhood\u003c/a>, a federally-funded initiative that is honing in on the Jackson Triangle neighborhood, a lower-income, ethnically diverse area of the city.\u003c/p>\n\u003cp>The women go door to door, connecting residents to community clinics and other health services.\u003c/p>\n\u003caside class=\"pullquote alignright\">'They know that we are part of the community. We have our kids in the same schools. We go to the same stores.'\u003cbr>\n\u003ccite>Guadalupe Perez, a promotora in Hayward\u003c/cite>\u003c/aside>\n\u003cp>Arroyo-Solveson says there is nothing like face-to-face interaction to reach parents and others who may feel isolated or distrustful of government programs for which they would qualify.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"Often when you have cultural barriers, language barriers, economic barriers, it’s very hard to feel empowered,\" Arroyo-Solveson says. \"We are trying to bridge these services for them so they can get empowered and engaged with the community.\"\u003c/p>\n\u003cp>Arroyo-Solveson is originally from Chile and says her own immigrant experience helps her relate to the families she works with.\u003c/p>\n\u003cp>Today, Arroyo-Solveson and Perez will meet with Liliana Salas, a stay-at-home mother with two children. Salas has invited the promotoras to her home, which is a welcome change from days past.\u003c/p>\n\u003cp>“When we started this work, nobody would tell us, 'Can you please come to our home?' They would slam the door or take a long time to answer,\" Arroyo-Solveson says with a chuckle. \"Now people hear about us and invite us to their home, which is wonderful.\"\u003c/p>\n\u003cp>Perez says that part of the success of promotoras in reaching residents is their familiarity with the neighborhood.\u003c/p>\n\u003cp>\"They know that we are part of the community. We have our kids in the same schools. We go to the same stores,\" says Perez.\u003c/p>\n\u003cp>After everyone is settled in Salas' living room, Arroyo-Solveson and Perez try to assess the family's needs. Do they have health insurance? They do. Has Salas heard of CalFresh, the state's food stamps program? She hasn’t, but wants to know more.\u003c/p>\n\u003cfigure id=\"attachment_117943\" class=\"wp-caption alignnone\" style=\"max-width: 1920px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/12/RS17562_Promotoras_with_Liliana.JPG-qut.jpg\">\u003cimg class=\"wp-image-117943 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/12/RS17562_Promotoras_with_Liliana.JPG-qut.jpg\" alt=\"\" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/12/RS17562_Promotoras_with_Liliana.JPG-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/27/2015/12/RS17562_Promotoras_with_Liliana.JPG-qut-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/12/RS17562_Promotoras_with_Liliana.JPG-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2015/12/RS17562_Promotoras_with_Liliana.JPG-qut-1440x960.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2015/12/RS17562_Promotoras_with_Liliana.JPG-qut-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2015/12/RS17562_Promotoras_with_Liliana.JPG-qut-960x640.jpg 960w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Liliana Salas (R), a stay-at-home mom, listens to Perez explain CalFresh, the state's Supplemental Nutrition Assistance Program, formerly known as food stamps. Perez and Arroyo-Solveson visited Salas at her home as part of the Hayward Promise Neighborhood initiative. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Salas listens attentively and asks questions as the promotoras explain how to apply for CalFresh. They also describe neighborhood events nearby -- the local library is offering kids help with their homework, and a community center is soon holding a drum circle.\u003c/p>\n\u003cp>“It’s a great event that helps to relieve stress,” explains Perez in Spanish. “And you can bring your kids to participate.\"\u003c/p>\n\u003cp>As the women close their visit, Salas promises to review the information, including a subsidized training course to become a medical assistant.\u003c/p>\n\u003cp>“I’ll try to find the programs that are the most relevant to me and my family,” says Salas, holding a stack of papers and phone numbers for local resources.\u003c/p>\n\u003cfigure id=\"attachment_117947\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/12/RS17559_IMG_9794.JPG-qut.jpg\">\u003cimg class=\"wp-image-117947 size-thumbnail\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/12/RS17559_IMG_9794.JPG-qut-400x267.jpg\" alt=\"\" width=\"400\" height=\"267\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/12/RS17559_IMG_9794.JPG-qut-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/12/RS17559_IMG_9794.JPG-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2015/12/RS17559_IMG_9794.JPG-qut-1440x960.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2015/12/RS17559_IMG_9794.JPG-qut-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2015/12/RS17559_IMG_9794.JPG-qut-960x640.jpg 960w\" sizes=\"(max-width: 400px) 100vw, 400px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Carolina Arroyo-Solveson (L) and Guadalupe Perez prepare to visit immigrant families in Hayward's Jackson Triangle neighborhood. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Perez says it's interactions like these that give her role meaning. And she is committed. She volunteers as a promotora; her work is generally unpaid. During her four years as a promotora for the \u003ca href=\"http://www.tvhc.org/\" target=\"_blank\">Tiburcio Vasquez Health Center\u003c/a>, Perez says she has witnessed positive changes in people’s mindsets -– and consequently, their lives.\u003c/p>\n\u003cp>One example she cites is clients who are initially resigned to getting chronic diseases like diabetes if their relatives also suffer from it.\u003c/p>\n\u003cp>“We'll tell them, ‘No. Don’t think like this! You can break the pattern.’ How? By exercising, changing your diet and being more relaxed,” says Perez, adding that many of the parents she meets with work more than one job and face high levels of stress.\u003c/p>\n\u003cp>Nationwide, Latinos are \u003ca href=\"http://minorityhealth.hhs.gov/omh/browse.aspx?lvl=4&lvlid=63\" target=\"_blank\">40 percent\u003c/a> more likely to die from diabetes than non-Hispanic whites, according to federal statistics.\u003c/p>\n\u003cp>Perez, a mother of three who cleans homes for a living, says that her own family has benefited from the knowledge she’s gained as a promotora. Her kids are more aware of nutritional labels as they browse aisles at the supermarket –- and appreciate the dangers of too much sugar and salt in their diets. Her husband reduced his daily soda intake from three or more cans daily to just one.\u003c/p>\n\u003cfigure id=\"attachment_117944\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/12/RS17560_IMG_9809.JPG-qut.jpg\">\u003cimg class=\"wp-image-117944 size-thumbnail\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/12/RS17560_IMG_9809.JPG-qut-400x267.jpg\" alt=\"\" width=\"400\" height=\"267\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/12/RS17560_IMG_9809.JPG-qut-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/12/RS17560_IMG_9809.JPG-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2015/12/RS17560_IMG_9809.JPG-qut-1440x960.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2015/12/RS17560_IMG_9809.JPG-qut-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2015/12/RS17560_IMG_9809.JPG-qut-960x640.jpg 960w\" sizes=\"(max-width: 400px) 100vw, 400px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Perez shares information about a support group for parents to a resident she visited at her home. Most of the immigrant families Perez works with in Hayward's Jackson Triangle are low income. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Perez says being a promotora has also boosted her confidence and sense of purpose.\u003c/p>\n\u003cp>\"The training of promotora completely changed my life,\" says Perez, who is originally from Mexico.\u003c/p>\n\u003cp>She’s lost weight by adding vegetables to her diet and exercising more. It’s an approach she preaches to her clients: make the time for small beneficial changes that you can keep.\u003c/p>\n\u003cp>“I don’t have the time to go to the gym and also I don’t have money to go to the gym, so I do my exercise at home,” she said. “I have some zumba videos, so I'll play them and dance at home with my kids.\"\u003c/p>\n\u003cp>Another benefit she says, is how much more connected she feels with her community. Before, she would try to ignore problems -- like drug users at the park or gang-related violence. Now, she's taking an active role in improving her neighborhood.\u003c/p>\n\u003cp>\"Health is about everything -- good schools, access to good foods, and feeling safe in your neighborhood,\" says Perez, who earlier this year received a volunteer award from the city of Hayward.\u003c/p>\n\u003cp>Arroyo-Solveson says promotoras are an agent of change with tangible impacts.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"When I see that children get vaccinated because we have provided [parents with] resources on where to do that, they get health insurance because the promotoras came with all the information. It’s just a wonderful thing to see the transformation,\" says Arroyo-Solvenson. \"We are transforming a community with information, with care, because we care for them.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Lake County Native Americans Learn Power of Exercise to Fight Diabetes",
"title": "Lake County Native Americans Learn Power of Exercise to Fight Diabetes",
"headTitle": "Vital Signs | State of Health | KQED News",
"content": "\u003cp>Johnny Gonzales kneels next to his client, Jorje Mendez, who is struggling through the last set of pushups at the gym.\u003c/p>\n\u003cp>“Give me eight of them!” says Gonzales, 59. “Be strict. This is where all the gains are made right here. If you can do this, you can do anything!”\u003c/p>\n\u003cp>It's a pretty typical gym in an atypical setting. Gonzales works with patients of the Lake County Tribal Health Clinic, and the gym is within the clinic itself.\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/231367075\" 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>Patients diagnosed with prediabetes who enroll in a program to lose weight are eligible for work with Gonzales -- free of charge.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The clinic, which targets members of the six local Pomo tribes in the county, also offers classes on healthy eating and other lifestyle changes that can reduce the risk of diabetes.\u003c/p>\n\u003cfigure id=\"attachment_102193\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/11/RS17291_IMG_9342.JPG-qut.jpg\">\u003cimg class=\"wp-image-102193 size-thumbnail\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/11/RS17291_IMG_9342.JPG-qut-400x267.jpg\" alt=\"Trainer Johny Gonzales coaches Jorje Mendez through a set of exercises at Lake County Tribal Health Consortium. Increasing physical activity is a key goal of the clinic's diabetes prevention program.\" width=\"400\" height=\"267\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/11/RS17291_IMG_9342.JPG-qut-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/11/RS17291_IMG_9342.JPG-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2015/11/RS17291_IMG_9342.JPG-qut-1440x960.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2015/11/RS17291_IMG_9342.JPG-qut-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2015/11/RS17291_IMG_9342.JPG-qut-960x640.jpg 960w\" sizes=\"(max-width: 400px) 100vw, 400px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Trainer Johnny Gonzales coaches Jorje Mendez through a set of exercises at Lake County Tribal Health Consortium. Increasing physical activity is a key goal of the clinic's diabetes prevention program. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Mendez, 33, an accountant and father of five, was a cross-country champion at Clear Lake High during his younger days, but settled into a more sedentary lifestyle that involved “eating a lot -- and [drinking] a lot of alcohol.” His weight ballooned to 300 pounds.\u003c/p>\n\u003cp>He decided to join the clinic's program after he was diagnosed as prediabetic. Grueling sessions with Gonzales three times a week have helped him lose over 45 pounds, he says.\u003c/p>\n\u003cp>“I feel better now,” says Mendez. “Other places you got to pay a fortune; I don’t have that. So I’m blessed to come here.”\u003c/p>\n\u003cp>Access to this gym and Gonzales' training sessions are a game changer for patients like Mendez, who wouldn't be able to afford it otherwise. In Lake County, a quarter of the population lives below the federal poverty level, and the median household income of $36,548 is much lower than the statewide average.\u003c/p>\n\u003cp>The clinic’s local efforts target a rapidly growing disease among Native Americans, who are twice as likely to be diagnosed with diabetes compared with non-Hispanic whites, according to the U.S. Department of Health and Human Services’ \u003ca href=\"http://www.ihs.gov/MedicalPrograms/Diabetes/HomeDocs/Resources/FactSheets/2012/Fact_sheet_AIAN_508c.pdf\" target=\"_blank\">Indian Health Service\u003c/a>. Particularly alarming is the impact of the disease among Native young people ages 10 to 19. That population is nine times more likely to be diagnosed with Type 2 diabetes than non-Hispanic white children.\u003c/p>\n\u003cp>Gonzales, who has worked with the Lake County Tribal Health Consortium since 2002, says that reality requires immediate attention.\u003c/p>\n\u003cp>“We are seeing it. We have kids that are 12 years old that weigh 240, 250. So they are candidates for diabetes,” says Gonzales. “When you see a 12-year-old kid that is prediabetic, that is pretty sad. A lot of it is lack of education to that kid, or their parents just don’t know.”\u003c/p>\n\u003cp>Gonzales, a former Marine, says Native American communities in Lake County face challenges that make them susceptible to diabetes. He has witnessed how lack of physical activity and healthy foods can take a toll in people's bodies.\u003c/p>\n\u003cp>“A lot of aching and pains weren’t due to injuries. It’s because they were inactive,” says Gonzales of clients living at Big Valley Rancheria, one of the local Pomo reservations. “Their challenge is trying to eat healthy. On this reservation and some of the other reservations, it’s not the healthiest food.”\u003c/p>\n\u003cfigure id=\"attachment_102194\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/11/RS17292_IMG_9344.JPG-qut-1.jpg\">\u003cimg class=\"wp-image-102194 size-thumbnail\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/11/RS17292_IMG_9344.JPG-qut-1-400x267.jpg\" alt='Johny Gonzales shows off a food guide for patients in the Lake County Tribal Health clinic diabetes prevention program. He recommends clients to stay away from processed foods and to \"get off the couch.\" ' width=\"400\" height=\"267\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/11/RS17292_IMG_9344.JPG-qut-1-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/11/RS17292_IMG_9344.JPG-qut-1-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2015/11/RS17292_IMG_9344.JPG-qut-1-1440x960.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2015/11/RS17292_IMG_9344.JPG-qut-1-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2015/11/RS17292_IMG_9344.JPG-qut-1-960x640.jpg 960w\" sizes=\"(max-width: 400px) 100vw, 400px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Johnny Gonzales shows off a food guide for patients in the Lake County Tribal Health clinic diabetes prevention program. He recommends that clients stay away from processed foods and 'get off the couch.' \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Even with those challenges, Gonzales remains evangelical about the healing powers of physical activity. It’s a deep-seated belief stemming from his personal experience after he hurt his back while working as a welder. Doctors told him he couldn’t do construction work anymore and recommended surgery. At the time, Gonzales balked at the procedure and chose instead to swim and exercise to strengthen his back.\u003c/p>\n\u003cp>“I noticed that when I was active I didn’t hurt nearly as bad, but when I wasn’t active I hurt all the time,” says Gonzales. “I didn’t want to depend on meds all the time, so I had to be active. That’s when I started pursuing becoming a trainer.”\u003c/p>\n\u003cp>Gonzales tells his clients that physical activity and perseverance are great medicines to combat diabetes and other ills. That helps him stay optimistic while on his job, which includes leading exercise workshops at nearby reservations. Participants often crowd the training, he says, though at other times nobody shows up. That doesn't dampen his passion for the job.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“Things tend to move a little slow in native country. Sometimes we just have to take baby steps,” he says. “And as a provider, you can’t give up or they give up themselves.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Johnny Gonzales kneels next to his client, Jorje Mendez, who is struggling through the last set of pushups at the gym.\u003c/p>\n\u003cp>“Give me eight of them!” says Gonzales, 59. “Be strict. This is where all the gains are made right here. If you can do this, you can do anything!”\u003c/p>\n\u003cp>It's a pretty typical gym in an atypical setting. Gonzales works with patients of the Lake County Tribal Health Clinic, and the gym is within the clinic itself.\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/231367075&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/231367075'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Patients diagnosed with prediabetes who enroll in a program to lose weight are eligible for work with Gonzales -- free of charge.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The clinic, which targets members of the six local Pomo tribes in the county, also offers classes on healthy eating and other lifestyle changes that can reduce the risk of diabetes.\u003c/p>\n\u003cfigure id=\"attachment_102193\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/11/RS17291_IMG_9342.JPG-qut.jpg\">\u003cimg class=\"wp-image-102193 size-thumbnail\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/11/RS17291_IMG_9342.JPG-qut-400x267.jpg\" alt=\"Trainer Johny Gonzales coaches Jorje Mendez through a set of exercises at Lake County Tribal Health Consortium. Increasing physical activity is a key goal of the clinic's diabetes prevention program.\" width=\"400\" height=\"267\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/11/RS17291_IMG_9342.JPG-qut-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/11/RS17291_IMG_9342.JPG-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2015/11/RS17291_IMG_9342.JPG-qut-1440x960.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2015/11/RS17291_IMG_9342.JPG-qut-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2015/11/RS17291_IMG_9342.JPG-qut-960x640.jpg 960w\" sizes=\"(max-width: 400px) 100vw, 400px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Trainer Johnny Gonzales coaches Jorje Mendez through a set of exercises at Lake County Tribal Health Consortium. Increasing physical activity is a key goal of the clinic's diabetes prevention program. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Mendez, 33, an accountant and father of five, was a cross-country champion at Clear Lake High during his younger days, but settled into a more sedentary lifestyle that involved “eating a lot -- and [drinking] a lot of alcohol.” His weight ballooned to 300 pounds.\u003c/p>\n\u003cp>He decided to join the clinic's program after he was diagnosed as prediabetic. Grueling sessions with Gonzales three times a week have helped him lose over 45 pounds, he says.\u003c/p>\n\u003cp>“I feel better now,” says Mendez. “Other places you got to pay a fortune; I don’t have that. So I’m blessed to come here.”\u003c/p>\n\u003cp>Access to this gym and Gonzales' training sessions are a game changer for patients like Mendez, who wouldn't be able to afford it otherwise. In Lake County, a quarter of the population lives below the federal poverty level, and the median household income of $36,548 is much lower than the statewide average.\u003c/p>\n\u003cp>The clinic’s local efforts target a rapidly growing disease among Native Americans, who are twice as likely to be diagnosed with diabetes compared with non-Hispanic whites, according to the U.S. Department of Health and Human Services’ \u003ca href=\"http://www.ihs.gov/MedicalPrograms/Diabetes/HomeDocs/Resources/FactSheets/2012/Fact_sheet_AIAN_508c.pdf\" target=\"_blank\">Indian Health Service\u003c/a>. Particularly alarming is the impact of the disease among Native young people ages 10 to 19. That population is nine times more likely to be diagnosed with Type 2 diabetes than non-Hispanic white children.\u003c/p>\n\u003cp>Gonzales, who has worked with the Lake County Tribal Health Consortium since 2002, says that reality requires immediate attention.\u003c/p>\n\u003cp>“We are seeing it. We have kids that are 12 years old that weigh 240, 250. So they are candidates for diabetes,” says Gonzales. “When you see a 12-year-old kid that is prediabetic, that is pretty sad. A lot of it is lack of education to that kid, or their parents just don’t know.”\u003c/p>\n\u003cp>Gonzales, a former Marine, says Native American communities in Lake County face challenges that make them susceptible to diabetes. He has witnessed how lack of physical activity and healthy foods can take a toll in people's bodies.\u003c/p>\n\u003cp>“A lot of aching and pains weren’t due to injuries. It’s because they were inactive,” says Gonzales of clients living at Big Valley Rancheria, one of the local Pomo reservations. “Their challenge is trying to eat healthy. On this reservation and some of the other reservations, it’s not the healthiest food.”\u003c/p>\n\u003cfigure id=\"attachment_102194\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/11/RS17292_IMG_9344.JPG-qut-1.jpg\">\u003cimg class=\"wp-image-102194 size-thumbnail\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/11/RS17292_IMG_9344.JPG-qut-1-400x267.jpg\" alt='Johny Gonzales shows off a food guide for patients in the Lake County Tribal Health clinic diabetes prevention program. He recommends clients to stay away from processed foods and to \"get off the couch.\" ' width=\"400\" height=\"267\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/11/RS17292_IMG_9344.JPG-qut-1-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/11/RS17292_IMG_9344.JPG-qut-1-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2015/11/RS17292_IMG_9344.JPG-qut-1-1440x960.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2015/11/RS17292_IMG_9344.JPG-qut-1-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2015/11/RS17292_IMG_9344.JPG-qut-1-960x640.jpg 960w\" sizes=\"(max-width: 400px) 100vw, 400px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Johnny Gonzales shows off a food guide for patients in the Lake County Tribal Health clinic diabetes prevention program. He recommends that clients stay away from processed foods and 'get off the couch.' \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Even with those challenges, Gonzales remains evangelical about the healing powers of physical activity. It’s a deep-seated belief stemming from his personal experience after he hurt his back while working as a welder. Doctors told him he couldn’t do construction work anymore and recommended surgery. At the time, Gonzales balked at the procedure and chose instead to swim and exercise to strengthen his back.\u003c/p>\n\u003cp>“I noticed that when I was active I didn’t hurt nearly as bad, but when I wasn’t active I hurt all the time,” says Gonzales. “I didn’t want to depend on meds all the time, so I had to be active. That’s when I started pursuing becoming a trainer.”\u003c/p>\n\u003cp>Gonzales tells his clients that physical activity and perseverance are great medicines to combat diabetes and other ills. That helps him stay optimistic while on his job, which includes leading exercise workshops at nearby reservations. Participants often crowd the training, he says, though at other times nobody shows up. That doesn't dampen his passion for the job.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“Things tend to move a little slow in native country. Sometimes we just have to take baby steps,” he says. “And as a provider, you can’t give up or they give up themselves.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "In Fresno, Car Washes Common Way to Pay for Funerals",
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"content": "\u003cp>As expensive as medical care can be, it also costs a lot to die. Evangelina Quintanilla learned this a year ago when she lost her father, and again when her mother passed away in September.\u003c/p>\n\u003cp>Quintanilla, a single mother of eight in Fresno, couldn’t afford a funeral for either of her parents. She maxed out all her credit cards to pay for her father’s services. Because she was still paying off those bills when her mother died a year later, she had to get creative -- so she held a car wash.\u003c/p>\n\u003cp>Washing cars for funeral donations is not uncommon in Fresno, where over a quarter of residents fall below the federal poverty level. Drive along the city’s busiest boulevards on any weekend and you’re bound to see groups of kids holding up brightly colored posters showing the names and faces of family members who died.\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/229734373\" 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>After her mother's death, Quintanilla’s first idea was to beg. “We were just going to go from place to place by asking 50 cents, 25 cents, 10 cents,” she said. “Anything was good.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>But her sister had noticed people washing cars a few weeks earlier at a Central Fresno gas station. She urged Quintanilla to call and see if they could do the same. The owner said sure, but asked for a small fee and urged them to be frugal with water.\u003c/p>\n\u003cfigure id=\"attachment_98428\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/10/RS16910_IMG_2590-qut.jpg\">\u003cimg class=\"wp-image-98428 size-thumbnail\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/10/RS16910_IMG_2590-qut-400x300.jpg\" alt=\"In English and Spanish, a funeral home representative explains that donations are accepted to pay for Quintanilla’s mother's funeral.\" width=\"400\" height=\"300\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS16910_IMG_2590-qut-400x300.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS16910_IMG_2590-qut-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS16910_IMG_2590-qut-1440x1080.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS16910_IMG_2590-qut-1180x885.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS16910_IMG_2590-qut-960x720.jpg 960w\" sizes=\"(max-width: 400px) 100vw, 400px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">In English and Spanish, a funeral home representative explains that donations are accepted to pay for Quintanilla’s mother's funeral. (Click to enlarge.) \u003ccite>(Kerry Klein/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>So Quintanilla and 20 or so family members set up folding chairs and lined up buckets of soapy water early on a Saturday morning in September. It was hot that day, over 90 degrees in the afternoon, and a light dusting of ash was blowing into the valley from the Rough Fire. It was a good day to find dirty cars -- and a miserable day to be out in the elements.\u003c/p>\n\u003cp>Quintanilla sat in a minivan while her children, cousins, aunts and uncles washed the pickup trucks and station wagons that rolled in. The 41-year-old is disabled; she has survived two strokes and suffers from high blood pressure and diabetes. Doctors have advised her not to work and warned her against exerting herself. “I’m like, ‘OK, tell me what I need to do. I need to be here for my kids. Tell me.’ ”\u003c/p>\n\u003cp>Many of these same health problems led to the death of Quintanilla’s mother. Just like her daughter, she suffered a string of chronic health issues, including diabetes. When she came down with a bad infection, her body ultimately couldn’t fend it off. She was in the hospital for a month before she died of sepsis. Quintanilla wonders if her mother’s fate could become her own. She says her brother jokes, “You’re probably next.”\u003c/p>\n\u003cp>When she can, she thinks back to a happy memory of her mother. “I never asked her age 'cause my mom used to tell people she was younger,” she says, in a fit of laughter. “My mom was in her 60s but she said she was 50.”\u003c/p>\n\u003cp>By about 4 p.m., Quintanilla says, they had washed around 75 cars and raised close to $600. But they still had a long way to go: Cremation services would cost at least $2,500. “We wanted to view her, but it costs more money,” she says. “Everything does.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>They still probably made more money than they would have from begging. “The biggest donation we got was $150,” she says, choking up. “I think everybody’s been generous.\"\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>As expensive as medical care can be, it also costs a lot to die. Evangelina Quintanilla learned this a year ago when she lost her father, and again when her mother passed away in September.\u003c/p>\n\u003cp>Quintanilla, a single mother of eight in Fresno, couldn’t afford a funeral for either of her parents. She maxed out all her credit cards to pay for her father’s services. Because she was still paying off those bills when her mother died a year later, she had to get creative -- so she held a car wash.\u003c/p>\n\u003cp>Washing cars for funeral donations is not uncommon in Fresno, where over a quarter of residents fall below the federal poverty level. Drive along the city’s busiest boulevards on any weekend and you’re bound to see groups of kids holding up brightly colored posters showing the names and faces of family members who died.\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/229734373&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/229734373'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>After her mother's death, Quintanilla’s first idea was to beg. “We were just going to go from place to place by asking 50 cents, 25 cents, 10 cents,” she said. “Anything was good.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But her sister had noticed people washing cars a few weeks earlier at a Central Fresno gas station. She urged Quintanilla to call and see if they could do the same. The owner said sure, but asked for a small fee and urged them to be frugal with water.\u003c/p>\n\u003cfigure id=\"attachment_98428\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/10/RS16910_IMG_2590-qut.jpg\">\u003cimg class=\"wp-image-98428 size-thumbnail\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/10/RS16910_IMG_2590-qut-400x300.jpg\" alt=\"In English and Spanish, a funeral home representative explains that donations are accepted to pay for Quintanilla’s mother's funeral.\" width=\"400\" height=\"300\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS16910_IMG_2590-qut-400x300.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS16910_IMG_2590-qut-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS16910_IMG_2590-qut-1440x1080.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS16910_IMG_2590-qut-1180x885.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/RS16910_IMG_2590-qut-960x720.jpg 960w\" sizes=\"(max-width: 400px) 100vw, 400px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">In English and Spanish, a funeral home representative explains that donations are accepted to pay for Quintanilla’s mother's funeral. (Click to enlarge.) \u003ccite>(Kerry Klein/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>So Quintanilla and 20 or so family members set up folding chairs and lined up buckets of soapy water early on a Saturday morning in September. It was hot that day, over 90 degrees in the afternoon, and a light dusting of ash was blowing into the valley from the Rough Fire. It was a good day to find dirty cars -- and a miserable day to be out in the elements.\u003c/p>\n\u003cp>Quintanilla sat in a minivan while her children, cousins, aunts and uncles washed the pickup trucks and station wagons that rolled in. The 41-year-old is disabled; she has survived two strokes and suffers from high blood pressure and diabetes. Doctors have advised her not to work and warned her against exerting herself. “I’m like, ‘OK, tell me what I need to do. I need to be here for my kids. Tell me.’ ”\u003c/p>\n\u003cp>Many of these same health problems led to the death of Quintanilla’s mother. Just like her daughter, she suffered a string of chronic health issues, including diabetes. When she came down with a bad infection, her body ultimately couldn’t fend it off. She was in the hospital for a month before she died of sepsis. Quintanilla wonders if her mother’s fate could become her own. She says her brother jokes, “You’re probably next.”\u003c/p>\n\u003cp>When she can, she thinks back to a happy memory of her mother. “I never asked her age 'cause my mom used to tell people she was younger,” she says, in a fit of laughter. “My mom was in her 60s but she said she was 50.”\u003c/p>\n\u003cp>By about 4 p.m., Quintanilla says, they had washed around 75 cars and raised close to $600. But they still had a long way to go: Cremation services would cost at least $2,500. “We wanted to view her, but it costs more money,” she says. “Everything does.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>They still probably made more money than they would have from begging. “The biggest donation we got was $150,” she says, choking up. “I think everybody’s been generous.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Tj Keeya Talamoni-Marcks walks off the field with sweat dripping from his forehead, as more than 20 other Clear Lake High School students finish their grueling football practice in temperatures that reached over 90 degrees.\u003c/p>\n\u003cp>Clear Lake's Cardinals are getting ready to play against Colusa High in a few days, and Talamoni-Marcks, a tackle and guard, holds his helmet with one hand and makes a beeline for the water fountain while limping. He recently recovered from a toe injury, and complains about pain in his foot. Still, he shrugs it off, saying pain and visible bruises on his arms are “part of the game.”\u003c/p>\n\u003cp>Sports are a source of pride for Talamoni-Marks and his family, of Pomo Indian and Samoan descent. The 15-year-old wants to follow in his parents’ footsteps -- his mom was a basketball star and his dad \"running back of the year\" at Clear Lake High, the only high school in Lakeport, about 120 miles north of San Francisco.\u003c/p>\n\u003cp>\"Sports keep me away from drugs and alcohol. They keep me healthy,\" he says. \"I want to get other Natives healthier too, and I think sports could be the way.\"\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/228392878\" 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>His teammate and childhood friend, Rodrigo Lupercio, agrees heartily.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>For both teenagers, sports have become an inspiration to tackle a bigger challenge than any football match: substance abuse among Pomo Indian communities in Lake County.\u003c/p>\n\u003cp>Nationwide, Native Americans are more likely to die of alcohol-related causes such as \u003ca href=\"http://www.cdc.gov/nchs/data/dvs/LCWK1_2013.pdf\" target=\"_blank\">chronic liver disease\u003c/a> and fatal motor \u003ca href=\"http://www.cdc.gov/motorvehiclesafety/native/factsheet.html\" target=\"_blank\">crashes involving alcohol\u003c/a> than any other ethnic group in the U.S., according to the Centers for Disease Control. Native Americans also have very high rates of \u003ca href=\"http://www.cdc.gov/tobacco/campaign/tips/resources/data/cigarette-smoking-in-united-states.html\" target=\"_blank\">cigarette smoking\u003c/a> compared to whites, blacks, Hispanics or Asians.\u003c/p>\n\u003cp>Lupercio, from the Big Valley Band of Pomo Indians, has witnessed the toll of alcohol and tobacco use on his grandfather. The two are very close. They used to play baseball and \"always have a good time\" together, he says. But now, Lupercio, just 14, fears the worst.\u003c/p>\n\u003cp>\"He shakes a lot and has a hard time walking. Because he drank so much throughout all of his life, it became part of his system. He needs it,\" said Lupercio. \"It makes me sad because I know I won't be seeing him in a couple of years.\"\u003c/p>\n\u003cfigure id=\"attachment_90209\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/10/IMG_9368-e1444259274261.jpg\">\u003cimg class=\"size-full wp-image-90209\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/10/IMG_9368-e1444259274261.jpg\" alt=\"Rodrigo Lupercio plays football, basketball and baseball at Clear Lake High. He says more physical activity through sports at Indian reservations could decrease substance abuse.\" width=\"1920\" height=\"1280\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Rodrigo Lupercio plays football, basketball and baseball at Clear Lake High. He says more physical activity through sports at Indian reservations could decrease substance abuse. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Talamoni-Marcks tries to convince his mother to quit smoking after seeing another smoker, his former karate teacher, have to breathe through a hole in his throat. The lesson?\u003c/p>\n\u003cp>\"I don't think I would ever,\" he says of smoking. \"I hate it. (My mother) is addicted to it, and I hate to see her like that.\"\u003c/p>\n\u003cp>Last summer, the two teenagers took their views on addiction a step further. As part of their applications to a native youth health summit in Washington, D.C., they wrote essays on ways to improve the health of their communities.\u003c/p>\n\u003cp>The National Indian Health Board, a non-profit representing tribal governments organizing the summit, selected them along with 28 others to meet with staff members for the U.S. Senate Committee on Indian Affairs and discuss their ideas.\u003c/p>\n\u003cp>Lupercio spoke of seeking greater participation in sports at the Big Valley Rancheria, the reservation where he's spent most of his life.\u003c/p>\n\u003cp>\"Down in the reservation, I’d say all Indians should have their own sports teams. I think that would get them active, and they wouldn’t want to do drugs. They’d just want to just do sports,\" he said.\u003c/p>\n\u003cp>Talamoni-Marcks wants to keep sporting events with Native participants alcohol and smoke-free.\u003c/p>\n\u003cp>\"Give them water rather than beer, don't let them smoke there. And just have a fun game, while keeping healthy,\" said Talamoni-Marcks.\u003c/p>\n\u003cp>The teenagers also want a rehab and wellness center for youth and adults within their tribal communities, and greater educational opportunities that will lead to better jobs. The unemployment rate for Native Americans was almost double the national rate in 2013, according to \u003ca href=\"http://www.bls.gov/cps/cpsrace2013.pdf\" target=\"_blank\">figures\u003c/a> from the Bureau of Labor Statistics.\u003c/p>\n\u003cp>Talamoni-Marcks and Lupercio hope their meeting in Washington with the Senate staffers will eventually bring much needed resources to change the health outcomes in their communities. They believe that advocacy can make a difference. But if that takes too long, they dream of another path that does not involve the federal budget.\u003c/p>\n\u003cp>\"I want to play professional sports to help my family, to help my community, to come back and donate money while doing stuff I love to do,\" said Talamoni-Marcks.\u003c/p>\n\u003cp>For Lupercio, who wants to become a professional football player, the most important thing now is emotional support for his grandfather.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"I just want to say, 'I love you grandpa, and you’ll always be in my heart,' \" he said.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Tj Keeya Talamoni-Marcks walks off the field with sweat dripping from his forehead, as more than 20 other Clear Lake High School students finish their grueling football practice in temperatures that reached over 90 degrees.\u003c/p>\n\u003cp>Clear Lake's Cardinals are getting ready to play against Colusa High in a few days, and Talamoni-Marcks, a tackle and guard, holds his helmet with one hand and makes a beeline for the water fountain while limping. He recently recovered from a toe injury, and complains about pain in his foot. Still, he shrugs it off, saying pain and visible bruises on his arms are “part of the game.”\u003c/p>\n\u003cp>Sports are a source of pride for Talamoni-Marks and his family, of Pomo Indian and Samoan descent. The 15-year-old wants to follow in his parents’ footsteps -- his mom was a basketball star and his dad \"running back of the year\" at Clear Lake High, the only high school in Lakeport, about 120 miles north of San Francisco.\u003c/p>\n\u003cp>\"Sports keep me away from drugs and alcohol. They keep me healthy,\" he says. \"I want to get other Natives healthier too, and I think sports could be the way.\"\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/228392878&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/228392878'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>His teammate and childhood friend, Rodrigo Lupercio, agrees heartily.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>For both teenagers, sports have become an inspiration to tackle a bigger challenge than any football match: substance abuse among Pomo Indian communities in Lake County.\u003c/p>\n\u003cp>Nationwide, Native Americans are more likely to die of alcohol-related causes such as \u003ca href=\"http://www.cdc.gov/nchs/data/dvs/LCWK1_2013.pdf\" target=\"_blank\">chronic liver disease\u003c/a> and fatal motor \u003ca href=\"http://www.cdc.gov/motorvehiclesafety/native/factsheet.html\" target=\"_blank\">crashes involving alcohol\u003c/a> than any other ethnic group in the U.S., according to the Centers for Disease Control. Native Americans also have very high rates of \u003ca href=\"http://www.cdc.gov/tobacco/campaign/tips/resources/data/cigarette-smoking-in-united-states.html\" target=\"_blank\">cigarette smoking\u003c/a> compared to whites, blacks, Hispanics or Asians.\u003c/p>\n\u003cp>Lupercio, from the Big Valley Band of Pomo Indians, has witnessed the toll of alcohol and tobacco use on his grandfather. The two are very close. They used to play baseball and \"always have a good time\" together, he says. But now, Lupercio, just 14, fears the worst.\u003c/p>\n\u003cp>\"He shakes a lot and has a hard time walking. Because he drank so much throughout all of his life, it became part of his system. He needs it,\" said Lupercio. \"It makes me sad because I know I won't be seeing him in a couple of years.\"\u003c/p>\n\u003cfigure id=\"attachment_90209\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/10/IMG_9368-e1444259274261.jpg\">\u003cimg class=\"size-full wp-image-90209\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/10/IMG_9368-e1444259274261.jpg\" alt=\"Rodrigo Lupercio plays football, basketball and baseball at Clear Lake High. He says more physical activity through sports at Indian reservations could decrease substance abuse.\" width=\"1920\" height=\"1280\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Rodrigo Lupercio plays football, basketball and baseball at Clear Lake High. He says more physical activity through sports at Indian reservations could decrease substance abuse. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Talamoni-Marcks tries to convince his mother to quit smoking after seeing another smoker, his former karate teacher, have to breathe through a hole in his throat. The lesson?\u003c/p>\n\u003cp>\"I don't think I would ever,\" he says of smoking. \"I hate it. (My mother) is addicted to it, and I hate to see her like that.\"\u003c/p>\n\u003cp>Last summer, the two teenagers took their views on addiction a step further. As part of their applications to a native youth health summit in Washington, D.C., they wrote essays on ways to improve the health of their communities.\u003c/p>\n\u003cp>The National Indian Health Board, a non-profit representing tribal governments organizing the summit, selected them along with 28 others to meet with staff members for the U.S. Senate Committee on Indian Affairs and discuss their ideas.\u003c/p>\n\u003cp>Lupercio spoke of seeking greater participation in sports at the Big Valley Rancheria, the reservation where he's spent most of his life.\u003c/p>\n\u003cp>\"Down in the reservation, I’d say all Indians should have their own sports teams. I think that would get them active, and they wouldn’t want to do drugs. They’d just want to just do sports,\" he said.\u003c/p>\n\u003cp>Talamoni-Marcks wants to keep sporting events with Native participants alcohol and smoke-free.\u003c/p>\n\u003cp>\"Give them water rather than beer, don't let them smoke there. And just have a fun game, while keeping healthy,\" said Talamoni-Marcks.\u003c/p>\n\u003cp>The teenagers also want a rehab and wellness center for youth and adults within their tribal communities, and greater educational opportunities that will lead to better jobs. The unemployment rate for Native Americans was almost double the national rate in 2013, according to \u003ca href=\"http://www.bls.gov/cps/cpsrace2013.pdf\" target=\"_blank\">figures\u003c/a> from the Bureau of Labor Statistics.\u003c/p>\n\u003cp>Talamoni-Marcks and Lupercio hope their meeting in Washington with the Senate staffers will eventually bring much needed resources to change the health outcomes in their communities. They believe that advocacy can make a difference. But if that takes too long, they dream of another path that does not involve the federal budget.\u003c/p>\n\u003cp>\"I want to play professional sports to help my family, to help my community, to come back and donate money while doing stuff I love to do,\" said Talamoni-Marcks.\u003c/p>\n\u003cp>For Lupercio, who wants to become a professional football player, the most important thing now is emotional support for his grandfather.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"I just want to say, 'I love you grandpa, and you’ll always be in my heart,' \" he said.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Valley Fire Triggers Memories of Vietnam Trauma for Evacuated Veteran",
"title": "Valley Fire Triggers Memories of Vietnam Trauma for Evacuated Veteran",
"headTitle": "Vital Signs | State of Health | KQED News",
"content": "\u003cp>\u003cem>Editor's note: For Lake County veterans who fought in Vietnam, the sights and sounds of the Valley Fire two weeks ago immediately stirred images of burning napalm and exploding grenades. As part of our \u003ca href=\"http://ww2.kqed.org/stateofhealth/series/vital-signs/\" target=\"_blank\">Vital Signs\u003c/a> series, reporter April Dembosky interviewed Vietnam veteran Jack Reece. He shares his story, starting with his view of the fire -- just before he fled his home in Hidden Valley. The interview has been edited for length and clarity.\u003c/em>\u003c/p>\n\u003cp>I was up there on that hillside watching that fire come off of Cobb [in Lake County] and then down and into the valley.\u003c/p>\n\u003cp>It was like a unit moving forward with tanks and everything, and those canisters, those propane canisters going off, they make a \"whooooo... boom!\"\u003c/p>\n\u003cp>I tried to stay there as long as I could, and then I had to drive out through a firestorm. All those houses were on fire and I had to drive through it, about 150 yards. It tripped me, the flashes.\u003c/p>\n\u003cp>It all flashed back.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>I mean, watching people get hit with napalm. Taking a hill and having little children dropping grenades down these things. You run up to them and kill them all -- and find out they’re children. It's horrible. You don’t want to know. I was a squad leader and a hit man.\u003c/p>\n\u003cp>My whole f***ing leg got blown apart. All the way up to here. And then I got a concussion. I was in a coma for three days.\u003c/p>\n\u003cp>Ninety-six of us went over in our unit, and only 14 of us came back.\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/225536921\" 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>As soon as you go through an experience like that again, you start hearing people screaming and yelling. I don’t need that in my life and so, I self medicated. Night before last -- I like gin and tonic, and I can just, run 'em through. It was okay, for just that night, because I couldn’t get any meds -- because my meds were up the house.\u003c/p>\n\u003cp>Monday morning, I knew I had to, I knew it. I got my ass over there and got to see the psychiatrist, and she took care of me.\u003c/p>\n\u003cp>Because with vets, we’re never going to get over it, honey. Never. But, we can learn to manage it. When we realize we’re at those points where we go and we need help and we ask for it. Most guys don’t know that. They freak out on it.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Anyway. I’m so fortunate. I think the guys upstairs, whoever’s watching over, they have to do double time with me.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>Editor's note: For Lake County veterans who fought in Vietnam, the sights and sounds of the Valley Fire two weeks ago immediately stirred images of burning napalm and exploding grenades. As part of our \u003ca href=\"http://ww2.kqed.org/stateofhealth/series/vital-signs/\" target=\"_blank\">Vital Signs\u003c/a> series, reporter April Dembosky interviewed Vietnam veteran Jack Reece. He shares his story, starting with his view of the fire -- just before he fled his home in Hidden Valley. The interview has been edited for length and clarity.\u003c/em>\u003c/p>\n\u003cp>I was up there on that hillside watching that fire come off of Cobb [in Lake County] and then down and into the valley.\u003c/p>\n\u003cp>It was like a unit moving forward with tanks and everything, and those canisters, those propane canisters going off, they make a \"whooooo... boom!\"\u003c/p>\n\u003cp>I tried to stay there as long as I could, and then I had to drive out through a firestorm. All those houses were on fire and I had to drive through it, about 150 yards. It tripped me, the flashes.\u003c/p>\n\u003cp>It all flashed back.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>I mean, watching people get hit with napalm. Taking a hill and having little children dropping grenades down these things. You run up to them and kill them all -- and find out they’re children. It's horrible. You don’t want to know. I was a squad leader and a hit man.\u003c/p>\n\u003cp>My whole f***ing leg got blown apart. All the way up to here. And then I got a concussion. I was in a coma for three days.\u003c/p>\n\u003cp>Ninety-six of us went over in our unit, and only 14 of us came back.\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/225536921&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/225536921'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>As soon as you go through an experience like that again, you start hearing people screaming and yelling. I don’t need that in my life and so, I self medicated. Night before last -- I like gin and tonic, and I can just, run 'em through. It was okay, for just that night, because I couldn’t get any meds -- because my meds were up the house.\u003c/p>\n\u003cp>Monday morning, I knew I had to, I knew it. I got my ass over there and got to see the psychiatrist, and she took care of me.\u003c/p>\n\u003cp>Because with vets, we’re never going to get over it, honey. Never. But, we can learn to manage it. When we realize we’re at those points where we go and we need help and we ask for it. Most guys don’t know that. They freak out on it.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Anyway. I’m so fortunate. I think the guys upstairs, whoever’s watching over, they have to do double time with me.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Help Wanted: Last Pediatrician on Mendocino Coast Retires",
"title": "Help Wanted: Last Pediatrician on Mendocino Coast Retires",
"headTitle": "Vital Signs | State of Health | KQED News",
"content": "\u003cp>Dr. Bill Mahon was a young pediatrician in the early 1970s when he fell in love with the rugged coast and majestic redwoods of Mendocino County. Like other people who have moved to Mendocino from around the country, settling here for him was a personal choice that prioritized lifestyle over money.\u003c/p>\n\u003cp>The prospect of practicing medicine in a small community also called to him. In 1977 he left his well-paying job at Kaiser Sacramento to join a practice with two other pediatricians in Fort Bragg.\u003c/p>\n\u003cp>Still, the move was a risk.\u003c/p>\n\u003caside class=\"pullquote alignright\">“For me it’s rather sad. For all these years there have been resident pediatricians. Now for the first time in 40 years, there is none.”\u003ccite>Dr. Bill Mahon\u003c/cite>\u003c/aside>\n\u003cp>“There were no guarantees coming to the coast. This was a practice that started from scratch, and I just trusted the fact that it would increase and everything would be fine\u003cstrong>,”\u003c/strong> Mahon, now 68, says. “My first month of work here I made $200. That was it.\"\u003c/p>\n\u003cp>Over time, the private practice grew to include any patient regardless of ability to pay, says Mahon. Some patients were not insured. Many had Medi-Cal, the state's health insurance program for lower income residents, which – until Mahon’s office gained rural health clinic status in the 90s – provided reimbursements that were “pretty meager.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“Early on we actually did trades at the practice,” says Mahon, with a chuckle. “We would trade a visit for a salmon or pottery or some other commodity, which, in the end, felt good from both sides.”\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/220845410\" 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>For more than 35 years, Mahon examined patients day in, day out at his small clinic, next to Mendocino Coast District Hospital, the only hospital for miles. He handled everything from regular check ups to broken bones to very sick kids who might need a spinal taps or IV treatment. He got to know families closely. Going anywhere in town almost certainly involved bumping into a former patient.\u003c/p>\n\u003cp>\"It really is the personal aspects of practice here,\" says Mahon. \"The connection with the parents, the connection with the kids and then how that connection spilled over into the larger community.\"\u003c/p>\n\u003cp>Sometimes, he was roused out of bed in the middle of the night to attend to a newborn after a complicated delivery or speak with a distressed parent with an urgent question. Then those kids grew up – and many had kids of their own and brought them to see Mahon.\u003c/p>\n\u003cp>“I frequently tell people that I had a dream practice,” he says. “I took care of at least two generations of children. I wouldn’t trade a minute of it.”\u003c/p>\n\u003cp>Now Mahon is mostly retired. He only works at the hospital on call a few days a month. Families in most of the Mendocino Coast region no longer have access to a pediatrician who lives there permanently. The doctors that Mahon joined in the 70s have long since retired, and other pediatricians have come and gone.\u003c/p>\n\u003cfigure id=\"attachment_68048\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/08/RS16489_vscocam-photo-1.jpeg\">\u003cimg class=\"wp-image-68048 size-thumbnail\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/08/RS16489_vscocam-photo-1-400x320.jpeg\" alt=\"RS16489_vscocam-photo-1\" width=\"400\" height=\"320\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/08/RS16489_vscocam-photo-1-400x320.jpeg 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/08/RS16489_vscocam-photo-1-800x640.jpeg 800w, https://ww2.kqed.org/app/uploads/sites/27/2015/08/RS16489_vscocam-photo-1-1440x1152.jpeg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2015/08/RS16489_vscocam-photo-1-1180x944.jpeg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2015/08/RS16489_vscocam-photo-1-960x768.jpeg 960w\" sizes=\"(max-width: 400px) 100vw, 400px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The Mendocino Coast District Hospital in Fort Bragg has pediatricians on call for emergencies only. Dr. Mahon still works there a few days a month, but no longer sees patients on a day-to-day basis. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Until recently, a nurse practitioner and physician assistant at the clinic handled most cases. But, with no pediatrician in the office, if a patient showed up very sick or with a complicated case, the clinic’s staff sent them to the hospital's emergency department, which has on call access to a pediatrician.\u003c/p>\n\u003cp>“This community deserves better,” says Mahon. “For me it’s rather sad. For all these years there have been resident pediatricians and now for the first time in 40 years, there is none.”\u003c/p>\n\u003cp>Mendocino Coast Clinics, which absorbed Dr. Mahon’s practice a few years ago, contracted an outside agency to bring in a temporary pediatrician for three months. He started last week.\u003c/p>\n\u003cp>“This is a stop gap measure,” says Paula Cohen, executive director at Mendocino Coast Clinics. “We would love to find someone who wants to move to this community and make it their home.”\u003c/p>\n\u003cp>Their search to find someone permanent has a few leads. Cohen says she interviewed an out-of-state doctor last weekend, and her staff is reviewing resumes. However, it’s hard for tiny Fort Bragg –- population 7,300 -- to compete with metropolitan areas when recruiting physicians.\u003c/p>\n\u003cp>Cohen says physicians might prefer the amenities – cultural activities, department stores, even supermarkets -- of bigger cities. A physician who is married might need to look in areas that offer career opportunities for their spouses – who if they work in financial services or tech, say, might not want to move to Fort Bragg.\u003c/p>\n\u003cp>The practice of medicine has also changed since Mahon came to the coast. Today, new physicians might not want to practice by themselves and independently treat the wide range of diseases and behavioral disorders in babies and children that Mahon did.\u003c/p>\n\u003cp>Most new physicians are educated in metropolitan areas, with a large suite of specialists available, says Janet Coffman, associate professor at the Institute for Health Policy Studies at UC San Francisco.\u003c/p>\n\u003cp>“If you are in a rural area and the only pediatrician,\" says Coffman, \"people are expecting you to do a wider scope of practice. New physicians might not be prepared for that kind of medicine.\"\u003c/p>\n\u003cp>Another big challenge is that most new doctors are looking for higher salaries that help them repay their debt from medical school. Graduates of public medical schools owed a median debt of $170,000, while private medical school graduates owed a median debt of $200,000, according to 2014 \u003ca href=\"https://www.aamc.org/download/152968/data/debtfactcard.pdf\" target=\"_blank\">figures\u003c/a> from the Association of American Medical Colleges (AAMC). Rural areas serving a majority of Medi-Cal patients, such as Fort Bragg, might not offer competitive salaries.\u003c/p>\n\u003cp>Coffman said that the state could help rural communities recruit new physicians by expanding programs that help doctors repay their debt if they practice in a medically underserved area. One such program, the \u003ca href=\"http://www.oshpd.ca.gov/hpef/stlrp.html\" target=\"_blank\">Steven M. Thompson Physician Corps Loan Repayment\u003c/a> offers up to $105,000 in financial assistance. Medical schools could also expand programs that train physicians for the daily challenges of practicing in a rural setting.\u003c/p>\n\u003cp>The issue is pressing in Mendocino County and other nearby Northern California counties, where more than half of all doctors practicing are 56 or older and nearing retirement age, according to a 2009 report by the \u003ca href=\"http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/F/PDF%20FewerAndMoreSpecializedMDSupplyInCA.pdf\" target=\"_blank\">California HealthCare Foundation\u003c/a>. Statewide, the physician workforce is one of the oldest in the nation, with only New Mexico having a greater proportion of active physicians over 60, based on AAMC \u003ca href=\"https://www.aamc.org/download/362168/data/2013statephysicianworkforcedatabook.pdf\" target=\"_blank\">data\u003c/a>.\u003c/p>\n\u003cp>Meanwhile, families in Fort Bragg are dealing with the lack of a regular pediatrician they trust.\u003c/p>\n\u003cp>Cassandra and Milo Young now drive their three children 60 winding miles inland to a pediatric practice in Ukiah. The road is so twisty that the kids sometimes get sick on the way. The trips usually take an entire day and represent additional costs in gas and time off work.\u003c/p>\n\u003cp>“It’s definitely a downfall to the area,\" says Cassandra Young. She moved to the coast after working as a creative director at a large advertising firm in New York City.\u003c/p>\n\u003cp>\"We made certain concessions to give this lifestyle to our children. We gave up the big career and department stores. But giving up good quality pediatric care doesn’t feel like something we should have to give up,\" Young says.\u003c/p>\n\u003cp>She says she likes the pediatric practice in Ukiah well enough, but misses Dr. Mahon.\u003c/p>\n\u003cp>\u003cstrong>“\u003c/strong>He’s just wonderful, the kind of doctor we all wish our kids could have,” Young says. “It would be amazing to get another Dr. Mahon to move out here, and be our country doctor.”\u003c/p>\n\u003cp> \u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This story is part of our series \u003ca href=\"http://ww2.kqed.org/stateofhealth/series/vital-signs/\" target=\"_blank\">Vital Signs\u003c/a>. Send story ideas to fjhabvala@kqed.org.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Dr. Bill Mahon was a young pediatrician in the early 1970s when he fell in love with the rugged coast and majestic redwoods of Mendocino County. Like other people who have moved to Mendocino from around the country, settling here for him was a personal choice that prioritized lifestyle over money.\u003c/p>\n\u003cp>The prospect of practicing medicine in a small community also called to him. In 1977 he left his well-paying job at Kaiser Sacramento to join a practice with two other pediatricians in Fort Bragg.\u003c/p>\n\u003cp>Still, the move was a risk.\u003c/p>\n\u003caside class=\"pullquote alignright\">“For me it’s rather sad. For all these years there have been resident pediatricians. Now for the first time in 40 years, there is none.”\u003ccite>Dr. Bill Mahon\u003c/cite>\u003c/aside>\n\u003cp>“There were no guarantees coming to the coast. This was a practice that started from scratch, and I just trusted the fact that it would increase and everything would be fine\u003cstrong>,”\u003c/strong> Mahon, now 68, says. “My first month of work here I made $200. That was it.\"\u003c/p>\n\u003cp>Over time, the private practice grew to include any patient regardless of ability to pay, says Mahon. Some patients were not insured. Many had Medi-Cal, the state's health insurance program for lower income residents, which – until Mahon’s office gained rural health clinic status in the 90s – provided reimbursements that were “pretty meager.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“Early on we actually did trades at the practice,” says Mahon, with a chuckle. “We would trade a visit for a salmon or pottery or some other commodity, which, in the end, felt good from both sides.”\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/220845410&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/220845410'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>For more than 35 years, Mahon examined patients day in, day out at his small clinic, next to Mendocino Coast District Hospital, the only hospital for miles. He handled everything from regular check ups to broken bones to very sick kids who might need a spinal taps or IV treatment. He got to know families closely. Going anywhere in town almost certainly involved bumping into a former patient.\u003c/p>\n\u003cp>\"It really is the personal aspects of practice here,\" says Mahon. \"The connection with the parents, the connection with the kids and then how that connection spilled over into the larger community.\"\u003c/p>\n\u003cp>Sometimes, he was roused out of bed in the middle of the night to attend to a newborn after a complicated delivery or speak with a distressed parent with an urgent question. Then those kids grew up – and many had kids of their own and brought them to see Mahon.\u003c/p>\n\u003cp>“I frequently tell people that I had a dream practice,” he says. “I took care of at least two generations of children. I wouldn’t trade a minute of it.”\u003c/p>\n\u003cp>Now Mahon is mostly retired. He only works at the hospital on call a few days a month. Families in most of the Mendocino Coast region no longer have access to a pediatrician who lives there permanently. The doctors that Mahon joined in the 70s have long since retired, and other pediatricians have come and gone.\u003c/p>\n\u003cfigure id=\"attachment_68048\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/08/RS16489_vscocam-photo-1.jpeg\">\u003cimg class=\"wp-image-68048 size-thumbnail\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/08/RS16489_vscocam-photo-1-400x320.jpeg\" alt=\"RS16489_vscocam-photo-1\" width=\"400\" height=\"320\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/08/RS16489_vscocam-photo-1-400x320.jpeg 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/08/RS16489_vscocam-photo-1-800x640.jpeg 800w, https://ww2.kqed.org/app/uploads/sites/27/2015/08/RS16489_vscocam-photo-1-1440x1152.jpeg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2015/08/RS16489_vscocam-photo-1-1180x944.jpeg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2015/08/RS16489_vscocam-photo-1-960x768.jpeg 960w\" sizes=\"(max-width: 400px) 100vw, 400px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The Mendocino Coast District Hospital in Fort Bragg has pediatricians on call for emergencies only. Dr. Mahon still works there a few days a month, but no longer sees patients on a day-to-day basis. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Until recently, a nurse practitioner and physician assistant at the clinic handled most cases. But, with no pediatrician in the office, if a patient showed up very sick or with a complicated case, the clinic’s staff sent them to the hospital's emergency department, which has on call access to a pediatrician.\u003c/p>\n\u003cp>“This community deserves better,” says Mahon. “For me it’s rather sad. For all these years there have been resident pediatricians and now for the first time in 40 years, there is none.”\u003c/p>\n\u003cp>Mendocino Coast Clinics, which absorbed Dr. Mahon’s practice a few years ago, contracted an outside agency to bring in a temporary pediatrician for three months. He started last week.\u003c/p>\n\u003cp>“This is a stop gap measure,” says Paula Cohen, executive director at Mendocino Coast Clinics. “We would love to find someone who wants to move to this community and make it their home.”\u003c/p>\n\u003cp>Their search to find someone permanent has a few leads. Cohen says she interviewed an out-of-state doctor last weekend, and her staff is reviewing resumes. However, it’s hard for tiny Fort Bragg –- population 7,300 -- to compete with metropolitan areas when recruiting physicians.\u003c/p>\n\u003cp>Cohen says physicians might prefer the amenities – cultural activities, department stores, even supermarkets -- of bigger cities. A physician who is married might need to look in areas that offer career opportunities for their spouses – who if they work in financial services or tech, say, might not want to move to Fort Bragg.\u003c/p>\n\u003cp>The practice of medicine has also changed since Mahon came to the coast. Today, new physicians might not want to practice by themselves and independently treat the wide range of diseases and behavioral disorders in babies and children that Mahon did.\u003c/p>\n\u003cp>Most new physicians are educated in metropolitan areas, with a large suite of specialists available, says Janet Coffman, associate professor at the Institute for Health Policy Studies at UC San Francisco.\u003c/p>\n\u003cp>“If you are in a rural area and the only pediatrician,\" says Coffman, \"people are expecting you to do a wider scope of practice. New physicians might not be prepared for that kind of medicine.\"\u003c/p>\n\u003cp>Another big challenge is that most new doctors are looking for higher salaries that help them repay their debt from medical school. Graduates of public medical schools owed a median debt of $170,000, while private medical school graduates owed a median debt of $200,000, according to 2014 \u003ca href=\"https://www.aamc.org/download/152968/data/debtfactcard.pdf\" target=\"_blank\">figures\u003c/a> from the Association of American Medical Colleges (AAMC). Rural areas serving a majority of Medi-Cal patients, such as Fort Bragg, might not offer competitive salaries.\u003c/p>\n\u003cp>Coffman said that the state could help rural communities recruit new physicians by expanding programs that help doctors repay their debt if they practice in a medically underserved area. One such program, the \u003ca href=\"http://www.oshpd.ca.gov/hpef/stlrp.html\" target=\"_blank\">Steven M. Thompson Physician Corps Loan Repayment\u003c/a> offers up to $105,000 in financial assistance. Medical schools could also expand programs that train physicians for the daily challenges of practicing in a rural setting.\u003c/p>\n\u003cp>The issue is pressing in Mendocino County and other nearby Northern California counties, where more than half of all doctors practicing are 56 or older and nearing retirement age, according to a 2009 report by the \u003ca href=\"http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/F/PDF%20FewerAndMoreSpecializedMDSupplyInCA.pdf\" target=\"_blank\">California HealthCare Foundation\u003c/a>. Statewide, the physician workforce is one of the oldest in the nation, with only New Mexico having a greater proportion of active physicians over 60, based on AAMC \u003ca href=\"https://www.aamc.org/download/362168/data/2013statephysicianworkforcedatabook.pdf\" target=\"_blank\">data\u003c/a>.\u003c/p>\n\u003cp>Meanwhile, families in Fort Bragg are dealing with the lack of a regular pediatrician they trust.\u003c/p>\n\u003cp>Cassandra and Milo Young now drive their three children 60 winding miles inland to a pediatric practice in Ukiah. The road is so twisty that the kids sometimes get sick on the way. The trips usually take an entire day and represent additional costs in gas and time off work.\u003c/p>\n\u003cp>“It’s definitely a downfall to the area,\" says Cassandra Young. She moved to the coast after working as a creative director at a large advertising firm in New York City.\u003c/p>\n\u003cp>\"We made certain concessions to give this lifestyle to our children. We gave up the big career and department stores. But giving up good quality pediatric care doesn’t feel like something we should have to give up,\" Young says.\u003c/p>\n\u003cp>She says she likes the pediatric practice in Ukiah well enough, but misses Dr. Mahon.\u003c/p>\n\u003cp>\u003cstrong>“\u003c/strong>He’s just wonderful, the kind of doctor we all wish our kids could have,” Young says. “It would be amazing to get another Dr. Mahon to move out here, and be our country doctor.”\u003c/p>\n\u003cp> \u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"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. ",
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"info": "The Political Mind of Jerry Brown brings listeners the wisdom of the former Governor, Mayor, and presidential candidate. Scott Shafer interviewed Brown for more than 40 hours, covering the former governor's life and half-century in the political game – and Brown has some lessons he'd like to share. ",
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"marketplace": {
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"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
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"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
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"order": 12
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"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
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"info": "Our weekly podcast explores how the media 'sausage' is made, casts an incisive eye on fluctuations in the marketplace of ideas, and examines threats to the freedom of information and expression in America and abroad. For one hour a week, the show tries to lift the veil from the process of \"making media,\" especially news media, because it's through that lens that we see the world and the world sees us",
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"planet-money": {
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"info": "The economy explained. Imagine you could call up a friend and say, Meet me at the bar and tell me what's going on with the economy. Now imagine that's actually a fun evening.",
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"politicalbreakdown": {
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"title": "Political Breakdown",
"tagline": "Politics from a personal perspective",
"info": "Political Breakdown is a new series that explores the political intersection of California and the nation. Each week hosts Scott Shafer and Marisa Lagos are joined with a new special guest to unpack politics -- with personality — and offer an insider’s glimpse at how politics happens.",
"airtime": "THU 6:30pm-7pm",
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"possible": {
"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",
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"pri-the-world": {
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"title": "PRI's The World: Latest Edition",
"info": "Each weekday, host Marco Werman and his team of producers bring you the world's most interesting stories in an hour of radio that reminds us just how small our planet really is.",
"airtime": "MON-FRI 2pm-3pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-World-Podcast-Tile-360x360-1.jpg",
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},
"radiolab": {
"id": "radiolab",
"title": "Radiolab",
"info": "A two-time Peabody Award-winner, Radiolab is an investigation told through sounds and stories, and centered around one big idea. In the Radiolab world, information sounds like music and science and culture collide. Hosted by Jad Abumrad and Robert Krulwich, the show is designed for listeners who demand skepticism, but appreciate wonder. WNYC Studios is the producer of other leading podcasts including Freakonomics Radio, Death, Sex & Money, On the Media and many more.",
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},
"reveal": {
"id": "reveal",
"title": "Reveal",
"info": "Created by The Center for Investigative Reporting and PRX, Reveal is public radios first one-hour weekly radio show and podcast dedicated to investigative reporting. Credible, fact based and without a partisan agenda, Reveal combines the power and artistry of driveway moment storytelling with data-rich reporting on critically important issues. The result is stories that inform and inspire, arming our listeners with information to right injustices, hold the powerful accountable and improve lives.Reveal is hosted by Al Letson and showcases the award-winning work of CIR and newsrooms large and small across the nation. In a radio and podcast market crowded with choices, Reveal focuses on important and often surprising stories that illuminate the world for our listeners.",
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"officialWebsiteLink": "https://www.revealnews.org/episodes/",
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},
"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.",
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"source": "kqed",
"order": 16
},
"link": "/podcasts/rightnowish",
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},
"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.",
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},
"snap-judgment": {
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