Monthly Archives: April 2012

Who Will Care for the Caregivers?

By Kamal Menghrajani

Some paid caregivers are barely making ends meet. (Getty Images: Justin Sullivan)

Some paid caregivers are barely making ends meet. (Getty Images: Justin Sullivan)

Some people who care for vulnerable older adults are in dire economic straits, according to a new study [PDF] from the UCLA Center for Health Policy Research.

Hundreds of thousands of people provide care – from cooking and cleaning to bathing and dressing – for adults with disabilities or long-term illnesses who receive benefits from Medi-Cal. As it turns out, those who get paid for this work may not be pulling in enough money to make ends meet.

Geoffrey Hoffman, a researcher at the Center and lead author of the report said, “These paid Medi-Cal caregivers have incomes that are quite low compared to other Californians, about half as much monthly household income.”

“This aging population [of caregivers] is going to lead to great burdens on the health care system.”

He continued, “A third of them do not have health insurance. A number of them live in poverty or near-poverty, and, among those, a third of them have what is called ‘food insecurity’ – not enough food to put on the table every month.”

At issue is the amount that Medi-Cal is paying these caregivers. Even if you add income from other jobs, they earn a little over $11 per hour on average — close to minimum wage, and about two-thirds of the median income in California — making it difficult for them to live on their earnings. Many believe that the value of the care they provide is much greater than what they earn, but monetary constraints have led California lawmakers to decrease financial support for these services.

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Progress on the Fresh Food Front in Nation’s Salad Bowl

Farmers' Market in Fresno. (David Prasad: Flickr)

Fresh vegetables for sale at farmers' market in Fresno. (David Prasad: Flickr)

Fresno is located in the heart of what farmers like to call the nation’s salad bowl — prime farmland where a multitude of fruits and vegetables are grown. So at first blush, Fresno might seem like an unusual place for the California Pan-Ethnic Health Network to hold a half-day meeting about “Ensuring Access to Healthy Foods.”

But it’s no secret to anyone working in health in California that “food insecurity”is a big problem in the Central Valley. A group of about thirty participants listened yesterday as Edie Jessup of the Central California Regional Obesity Prevention Program (CCROPP) flashed through a powerpoint including the sobering number that 40 percent of the Valley’s residents are hungry. “It’s a paradox,” she said. “We raise the food for the nation.”

The point of the meeting was not just to bemoan the problem but to outline strategies for solutions, especially at the local level. After going through the numbers about childhood and adult obesity, high unemployment rates in rural areas and health disparities for communities of color, Jessup said that she sees a big shift from just a few years ago. Continue reading

“Texting” is Latest Weapon in War on Central Valley Pollution

By: Sasha Khokha

Weedpatch residents voice concerns to environmental officials. (Photo: Tracey Brieger)

Weedpatch residents address concerns to environmental officials about pollution problems in Kern County. (Tracey Brieger: Californians for Pesticide Reform)

What would you do if you saw a pipe spewing black water into your street? Would you know who to call? What if you could take a picture of it and text it in to someone who promised to look into the problem, no questions asked? A new website could make it easier for residents of some of Kern County’s poorest farmworker towns to do just that.

You don’t usually see tour buses bouncing along the county’s rural roads, pock-marked with potholes, winding past almond orchards and miles of dusty vegetable fields. But recently, some two dozen state, local, and federal officials climbed aboard a giant bus to visit farmworker communities facing a host of environmental problems.

Tom Frantz, a local air quality activist and almond farmer helping to lead the tour, bellowed into the bus intercom. “On our right is the community recycling center. San Joaquin valley is the trash dump for Los Angeles,” he said.  The bus stopped at a composting facility that handles green waste and food scraps from L.A.

“This is where two workers from Arvin tragically died when they were asked to go down into drainage pipe that was filled with hydrogen sulfide,” Frantz explains. Continue reading

Quick Read: Report calls for doubling nation’s public health spending

The United States spends more on healthcare than any other industrialized country … but gets less. The U.S. lags behind its peers in life expectancy and childhood mortality because the government “chronically” underfunds public health systems, the Institute of Medicine says in a new report out today.

The U. S.

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TEDMED (Virtually) Comes to California

Cookie Monster, now a fruit advocate, will be discussing the importance of eating in moderation at TEDMED. (Photo: PBS)

Cookie Monster, now a fruit advocate, will be discussing the importance of eating in moderation at TEDMED. (Photo: PBS)

What if R2D2 were your doctor? Do proteins have their own social network? And, while we’re at it, can we reshape human perceptions without saying a word?

Those are just a few of the questions that are being addressed this week at the annual TEDMED conference, an off-shoot of the popular TED talks.

The talks, starting today and running through Friday, April 13, explore the future of health and medicine. TEDMED participants range from singer Jill Sobule (best known for her 1995 single “Supermodel“) and our beloved Cookie Monster (yeah, you read that correctly), to the Director of the National Institute of Health Francis Collins and Food and Drug Administration Commissioner Margaret Hamburg.

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ouRXperience: An “F” in Air Quality; Hmong Shaman Training; Healthy Food Access; Child Abuse Awareness

Wood-burning stoves are a major source of air pollution in Butte County. (Photo: Marley Zalay)

Editor’s Note: KQED produces ouRXperience, a blog from community correspondents, to enrich coverage of health issues across California.

Recently, ouRXperience featured posts from four California communities:

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Talking About Choices May Encourage Colon Cancer Screening

By: Kamal Menghrajani

Doctor greating patient

Patient-doctor discussions about choices in colon cancer screening may encourage more people to follow through. (Vic Lawrence: Flickr)

Although about 50,000 people in the U.S. died from colorectal cancer (CRC) last year, as many as half of those deaths could have been prevented by routine screening. That’s 25,000 lives that could have been saved using tools that are already widely available.

The problem is getting people to undergo screening can be a bit of a challenge. The “ick” factor of colonoscopies, concerns about paying for them, and other barriers get in the way of adequate screenings. Alternatives do exist, such as the fecal occult blood test (FOBT) – a non-invasive test people can do at home and send into the lab. As reported here in the past, new tools are also being developed that use more advanced science to check for markers of cancer, though these are still gaining traction.

But now doctors are looking at the psychology of how they talk to patients to figure out what might get the most people to get on board with screening.

In a study published today in the Archives of Internal Medicine, researchers from three medical schools, including UCSF, focused on just colonoscopies and FOBT. The study was done in San Francisco through the Community Health Network, and randomized doctors into three study groups: one to recommend only FOBT, one to recommend only colonoscopy, and one to offer patients a choice between the two.

Researchers presumed that recommending just one or the other would send a clear signal and be more effective than giving patients a choice.

They were wrong.

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Insurance Commissioner Calls Aetna Rate Hike “Unreasonable”

By: Kamal Menghrajani

AetnaRate_Images Money_Apr62012

Aetna has raised rates on its PPO by 30 percent in the past two years. (Images Money: Flickr)

If you were a California business making nearly 28 percent profit, would you change your business strategy if someone asked you nicely?

Probably not.

In a nutshell, that’s what’s going on between California’s Department of Insurance and the health care insurer Aetna.

The Department of Insurance has many jobs, one of which is to make sure that rates stay reasonable by regulating what insurance companies can charge consumers … with one exception.

According to Insurance Commissioner Dave Jones, “I have that authority for auto insurance, for homeowners’ insurance, for property insurance, for casualty insurance — basically for almost all other insurance lines, except health insurance and HMO products.”

“This is the first time that a health insurer has disregarded our request that it lower its rate increase.”

Jones doesn’t like it. “It’s quite a loophole, and it’s a loophole through which health insurers and HMOs have been driving ever-increasing rate hikes –- 10-20-30-40 — sometimes as much as 80 percent annual rate increases.”

This time around, Aetna increased their PPO rates by 1.8 percent for the quarter that began April 1st. This seems like a modest hike, but it brings up the total rate hike in the last year to 8 percent, and it means that small businesses are paying 30.3 percent more for health insurance than they were two years ago. Continue reading

Quick Read: Down the Insurance Rabbit Hole

A scholar of social policy learns first-hand exactly how the social system works when her sister-in-law in California suffers a devastating automobile accident. The woman was uninsured because her husband’s employer did not offer health insurance. The family could not afford it on their own.

ON the second day of oral arguments over the Affordable Care Act, Solicitor General Donald B. Verrilli Jr., trying to explain what sets health care apart, told the Supreme Court, “This is a market in which you may be healthy one day and you may be a very unhealthy participant in that market the next day.”

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California Advocates For Healthy Food in U.S. Farm Bill

California food advocates are hoping to shift national farm policy to support healthier foods for all. (Liji Jinaraj:Flickr)

The U.S. Farm Bill is up for reauthorization in Congress this year and California food and health advocates are eager to use the opportunity to shift national policy towards healthier eating, which would also benefit California farmers.

A panel of food experts that included Michael Pollan, author of bestseller Omnivore’s Dilemma, and Karen Ross, Secretary of the California Department of Food and Agriculture packed an auditorium at U.C. Berkeley Thursday evening.

Budget cuts in Washington D.C. emerged as a big theme. Every panelist recognized the need to play defense in order to keep money in the bill for important programs such as Supplemental Nutrition Assistance Program or SNAP, formerly known as food stamps. Currently, 77 percent of the money in the Farm Bill goes to support food and nutrition programs like SNAP. “One in five of our citizens find themselves food insecure in a month or a year,” said Karen Ross referring to California specifically. “And it’s ironic that we have that need in a state that’s the number one producer of so many of those crops,” she continued. Continue reading