Monthly Archives: December 2011

Building Houses Near Transit Is Good; But What About Air Pollution?

(Ordinary Grace: Flickr)

(Ordinary Grace: Flickr)

California has embarked on a landmark effort to reduce greenhouse gasses.  As part of that work, local jurisdictions are busy spotlighting zones for housing infill and transit-oriented development. Infill sounds good, right? Let’s avoid further suburban sprawl and direct people to mass transit, reducing greenhouse gasses.

Not so fast.

Here’s the problem: the state Air Resources Board has evaluated air pollution risk and identified swaths of urban areas that create public health hazards because of diesel truck traffic or other pollution.

Call it the irony of unintended consequences. The housing development areas overlap with the communities with high air pollution in too many places in the Bay Area. It looks like we’re on a road to reduce greenhouse gases while increasing public health risks.

That’s where a study today from the Pacific Institute is critically important. It has lots of colorful maps and detailed information that provide tools to cities and counties to consider when planning new housing.

Here’s a starting point in San Francisco County. The blue priority development area is almost completely encircled by an area the Air Resources Board says has health risk from toxic air pollution.

San Francisco map shows "Priority Development Area" located almost completely inside an area of concur to the state Air Resources Board. (Map: Pacific Institute)

San Francisco map shows “Priority Development Area” located almost completely inside an area of concur to the state Air Resources Board. (Map: Pacific Institute)

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How Lawsuits Can Stymie Some Trigger Cuts

By Sarah Varney

(League of Women Voters: Flickr)

(League of Women Voters: Flickr)

Trigger cuts have been the weapon of choice in many recent budgetary negotiations, most famously as the Congressional ‘Super Committee’ failed to come to agreement last month.

But in California, where Governor Jerry Brown yesterday announced nearly a billion dollars in additional reductions to state spending, that budget gun is jammed, as advocates for the elderly and mentally and physically disabled have managed to thwart the automatic reductions by asserting that the state’s severe cuts — some $15 billion to health and human services since 2008 — are beginning to violate federal law.

That defense has largely been the result of an aggressive legal strategy by disability rights groups, something witnessed recently when the state aborted a plan to eliminate funding for adult day health care centers in the face of a lawsuit by Disability Rights California. The centers offer health care services, shared meals and exercise among other activities and, most experts agree, help keep seniors and disabled people out of nursing homes.

The state cuts are running headlong into the Americans with     Disabilities Act.
But that’s not the only place where state lawyers are busy. Officials in Sacramento are also preparing to defend the recent decision by state lawmakers to reduce what it pays doctors who care for Medicaid recipients before the U.S. Supreme Court. Legal advocates also successfully sued in federal court to stop $100 million in automatic cuts to the state’s home care program for the disabled and frail seniors known as In-Home Supportive Services. A hearing has yet to be set.

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Should Older Adults be Screened for Cancer?

(Jason DeRusha: Flickr)

(Jason DeRusha: Flickr)

Right about now, you might be thinking you’ve heard enough of cancer screening. From mammography to prostate cancer, cancer screening tests have been much debated this fall. Should a 40 year old woman get a mammogram or not? Should men abandon the PSA test? Yet another study released this week looks at a surprisingly unexplored group–older Americans.

Researchers wanted to look at this group because of an “ambiguity of recommendations” for them. While it seems like there’s some ambiguity for the rest of us, the ambiguity here is particularly surprising since age is perhaps the most significant risk factor for many cancers.

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“Landmark” in Gene Therapy Treatment

People with hemophilia lack a substance that helps blood clot.  (Shannon Muskopf: Flickr)

People with hemophilia lack a substance that helps blood clot. (Shannon Muskopf: Flickr)

In a preliminary study, six patients in England were successfully treated by gene therapy for the blood-clotting disease hemophilia B. Researchers injected each patient with the correct form of the gene that makes the needed substance that helps blood to clot, called a clotting factor.

“I think it’s a significant advancement in gene therapy and a treatment for hemophilia,” said Mark Kay, Professor at Stanford’s School of Medicine and a co-author of the study. “It’s been over a year for some of the patients and they are continuing to make the [clotting] factor. We have to start at low doses and work our way up. We have patients that are at 10 percent level for half a year.”

The current medication has a lifetime cost per adult patient of up to $20 million.

That 10 percent is remarkable. In hemophilia, people with a severe form of the disease have less than one percent of the clotting factor. Those with 10 percent are often able to live a normal life.

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Top Health Concerns for San Jose’s Vietnamese Community

More than 130,000 Vietnamese have relocated to Santa Clara County since the end of the Vietnam War.

Over 130,000 Vietnamese people relocated to Santa Clara County since the end of the Vietnam War. (Photo: Monica M. DaveyAFP/Getty Images)

The first wave of Vietnamese refugees came to the San Jose area in the 1980s, after the fall of Saigon. Now San Jose has the largest Vietnamese population of any city in the country. Santa Clara County is also second largest of any county in the U.S., after Orange County.

Today, Santa Clara released its first-ever Vietnamese health assessment to get a better understanding of this growing population’s health needs.

Health Officer Martin Fenstersheib says Santa Clara County didn’t have a good understanding of what the health needs of its Vietnamese community were prior to this report.

“We had a great interest in doing this because we tend to lump all of our statistics together, especially in the Asian, Pacific Island community. So things are reported that way also.”

Vietnamese adults have the highest mortality rates for liver cancer, more than four times higher than other county residents.

Three top health concerns are highlighted in the report: access to health care and health insurance, stigma related to getting mental health services, and cancer — particularly liver cancer related to Hepatitis B. Fenstersheib says the report recommends creating a task force to focus on reducing these health disparities.

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One Woman’s Apology to President Obama

President Obama signs health care reform law. (Photo: White House)

President Obama signs health care reform law. (Photo: White House)

Earlier this week, the Los Angeles Times published an opinion piece from Spike Dolomite Ward, a San Fernando Valley woman who ended up uninsured.

Her story sparked heated debate on the Times’ discussion board — 1,190 comments so far. It’s worth reading her entire essay, but I excerpt it here and include some of the more pointed reader comments at the end.

I want to apologize to President Obama. But first, some background.

I found out three weeks ago I have cancer. I’m 49 years old, have been married for almost 20 years and have two kids. My husband has his own small computer business, and I run a small nonprofit in the San Fernando Valley. I am also an artist. Money is tight, and we don’t spend it frivolously. …

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ouRXperience: Mendota Clinic Expansion; Students Help the Needy; New Correspondent

Health clinic expansion coming in Mendota. (Photo: Sam Rubio)

Health clinic expansion coming in Mendota. (Photo: Sam Rubio)

Editor’s Note: KQED produces ouRXperience, a blog from community correspondents, to enrich coverage of health issues across California. The mission of ouRXperience is to give voice to those Californians whose concerns might otherwise be overlooked.

This week ouRXperience featured posts from three California communities:

  • In San Bernardino, Bobbi Albano profiled Loma Linda University students who throw a Christmas Fiesta every year for needy children.
  • From Mendota, Sam Rubio wrote about the major expansion at the local health clinic.
  • And in Merced, ouRXperience welcomes new correspondent Changvang Her, whose stories will focus on Merced in general and the Hmong community in particular.

How Much Do Elderly Patients Want to Know and Should Doctors Tell Them?

(Ryan Wilcox: Flickr)

(Ryan Wilcox: Flickr)

Not so long ago, it was common for doctors to keep sick patients, even terminally ill patients, in the dark about their prognosis. Today, many patients are actively involved in managing their illnesses, in partnership with their doctors. Indeed, one of the tabs on this blog is “You’re the Boss.”

But a “Perspective” in today’s New England Journal of Medicine says doctors have shied away from explicit conversations about prognosis with a group of patients they should engage–the very elderly. The writers recommend doctors discuss “overall prognosis” with elderly patients who have a life expectancy of less than 10 years or who are 85.

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And The Environmental Causes of Breast Cancer Are…?

Suspicious mass on mammogram. (KristieWells: Flickr)

Suspicious mass on mammogram. (KristieWells: Flickr)

Seventy percent of women who develop breast cancer have no known risk factors. For years, advocates and activists have trumpeted the need for more research into possible environmental causes of the disease. Today, the prestigious Institute of Medicine (IOM) released a much anticipated 360 page study, Breast Cancer and the Environment. But it unfortunately was unable to give women or their doctors any new environmental clues.

As the New York Times reports, most of what the IOM did recommend is already known and might not have much effect anyway.

The most consistent data suggest that women can reduce their risk by avoiding unnecessary medical radiation, forgoing hormone treatments for menopause that combine estrogen and progestin, limiting alcohol intake and minimizing weight gain, the report found. (Controlling weight appears helpful only in preventing postmenopausal breast cancers, not those in younger women.) Overuse of CT scans, which deliver a relatively high dose of radiation, was a particular concern, but the report stated that women should not be deterred from having routine mammograms, which use a much smaller dose. …

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Could Richmond Be First California City to Tax Soda?

Price going up? (Karen Blumberg: Flickr)

Price going up? (Karen Blumberg: Flickr)

Last night the Richmond City Council voted to let the people decide. The Council instructed staff to prepare a ballot measure for next November to tax sugar-sweetened beverages, what most people call a “soda tax.”

Richmond voters may have the chance to make their city the first in California, and one of the first in the country, to slap a special tax not just on sodas, but also sports drinks, energy drinks, fruit-flavored drinks and the like. 100 percent fruit juice and diet drinks would not be affected.

The goals are twofold. If the drinks cost more, people will drink fewer of them. Plus, taxes generate revenue, which the City Council says it would devote to new sports fields and other health programs. The motivation for the tax is childhood obesity. Wendel Brunner, Public Health Director of the Contra Costa Health Department walked people through the makings of what has become an epidemic.

  • 32 percent of school children in Richmond are obese
  • 24 percent of adults in Richmond are obese
  • 11 percent of all deaths in Richmond are linked to obesity–obesity is shortening people’s lives by years
And, if childhood obesity goes unchecked in Richmond, Contra Costa Health researchers found, the percentage of obese adults will almost double from the current 24 percent to 42 percent. 
“The thing about sugar-sweetened beverages is that the calories are insidious.”
So, what’s the connection to sugar-sweetened beverages? It comes from Brunner’s most jaw-dropping number: the average Richmond teenager who drinks sugary beverages every day consumes a whopping 150,000 calories a year–just from these sweetened drinks. That adds up to 20-30 pounds of additional weight over the year. As Brunner reported, it’s those sweet drinks that are driving the obesity epidemic. “The thing about sugar-sweetened beverages is that the calories are insidious,” he says, “so you consume a Big Gulp, you don’t realize that you’ve drunk about 350 calories.” Continue reading