Monthly Archives: August 2012

August 20, 2012 | 1:42 PM | By

Field Poll: Strong Statewide Support for Health Care Law

Supporters demonstrate in favor of the Affordable Care Act on June 28, 2012 when the U.S. Supreme Court issued its ruling on the health care overhaul. (SEIU International: Flickr)

Supporters demonstrate in favor of the Affordable Care Act on June 28, 2012 when the U.S. Supreme Court issued its ruling on the health care overhaul. (SEIU International: Flickr)

While Americans as a whole remain sharply divided over the Affordable Care Act, a majority of California voters — 54 percent — support the federal health care overhaul, a new Field Poll shows. Just over a third of Californians — 37 percent — oppose the law.

This strong support is not terribly surprising in a heavily Democratic state. In addition, more than one in five Californians is uninsured. Support for the health care overhaul is two-to-one among those without insurance or people who say they or a family member has gone without coverage in the last two years.

The Field Poll also dug into the nitty-gritty of the requirements of the Affordable Care Act, specifically the Health Benefit Exchange, an online marketplace where people will be able to shop for health insurance. California was the first state to pass legislation to commence setting up an exchange. Starting next fall, people will begin enrolling for coverage that will begin January 1, 2014. Continue reading →

FILED UNDER: Reform, Affordable Care Act, Health Insurance Exchange, Uninsured
August 17, 2012 | 11:56 AM | By

Hospital Policies Dramatically Improve Breastfeeding Rates

By Alice Daniel, California Healthline

(fikirbaz: Flickr)

(fikirbaz: Flickr)

Patti McCowan was fairly new to her job as director of perinatal and pediatric services at Tulare Regional Medical Center when statistics came out showing the hospital had the worst rate in the county for exclusive breastfeeding.

That was four years ago and only 15 percent of new mothers were exclusively breastfeeding — meaning they weren’t giving their infants any supplemental formula — while in the hospital. But 80 percent of women coming in to give birth said their goal was to breastfeed exclusively, McGowan says.

“We were not doing something right,” said McCowan. “We were letting 65 percent [of babies] have a bottle. We realized something had to be done.”

Jump ahead to 2012, and Tulare Regional Medical Center has one of the highest rates for exclusive breastfeeding in the Central Valley– nearly 62 percent, according to the California Department of Public Health — and the highest in Tulare County.

The county’s other two hospitals had much lower exclusive breastfeeding rates; one was 27.9%, the other was 38.5%. Continue reading →

FILED UNDER: Place Matters, Policy, Breastfeeding
August 16, 2012 | 11:23 AM | By

In Medicine, Don’t Believe Everything You Know

(Pmccormi: Flickr)

(Pmccormi: Flickr)

By Eve Harris

How do you know your doctor is right? Ideally you and your doctor have a relationship based on trust. That is, you believe she knows the best options to recommend to you. You may think your doctor is right, but — how does your doctor know she’s right? We’d like to think physicians are relying on the latest evidence of medical practice. But not all physicians do that.

I recently joined in a robust, four-day discussion designed to address this issue at the 14th Rocky Mountain Workshop on How to Practice Evidence-Based Health Care. Doctors, policy makers and yes, journalists gathered to explore what many patients might have thought they were already getting: evidence-based health care, also called evidence based medicine.

In evidence based medicine, a hierarchy of evidence guides decisions about patient care. But at the same time, evidence based medicine recognizes that evidence alone is not sufficient. That’s because treatment options come with risks, and different patients will react differently to different risks. It’s not a simple matter of “Drug X” or “Treatment Y” has a five percent higher likelihood of success. If “Treatment Y” involves a risk or side effect a patient finds unacceptable, then this patient’s preference is part of the decision process.

Decision makers must always acknowledge these trade offs.

Continue reading →

FILED UNDER: Policy, You're the Boss, Evidence Based Medicine, Shared Decision Making
August 15, 2012 | 9:07 AM | By

Suburban Junkies

This morning, KQED’s The California Report aired its investigation of young painkiller drug abusers who have turned to heroin. The problem seems to be hitting affluent California suburbs hardest. Today’s story is part of a multi-media collaboration between KQED and California Watch which includes this gripping video — stories of addiction and lives lost.

More from California Watch.

FILED UNDER: Policy, Drug Addiction
August 13, 2012 | 9:18 AM | By

Paul Ryan’s Plan for Medicare

By Marilyn Werber Serafini, Kaiser Health News

Republican Presidential Candidate Mitt Romney Announces Rep. Paul Ryan As His Vice Presidential Pick

Mitt Romney introduces Paul Ryan as his choice for running mate in Norfolk, Va., last Saturday. (Photo by Win McNamee/Getty Images)

Wisconsin Republican Paul Ryan, GOP presidential hopeful Mitt Romney’s choice for vice president, has provoked consternation from Democrats and anxiety among some congressional Republicans with his proposals to reshape Medicare.

The Republican-controlled House, along party lines, twice approved his proposals to overhaul the popular social insurance program for the elderly and disabled by giving beneficiaries a set amount of money every year to buy coverage from competing health plans. That is a fundamental shift from today’s program, where the federal government pays for as many services as beneficiaries use.

The proposals were never enacted because of opposition from the Democratic-controlled Senate and President Barack Obama.

This year, Democratic congressional candidates nationwide are making the protection of traditional Medicare a centerpiece of their campaigns, just as Republicans attacked them two years ago for curbing future Medicare spending as part of the 2010 health care law. Now, Democrats are hammering their GOP opponents for voting for Ryan’s proposals, which were included in the last two House budget resolutions.

Here is a guide to some of the issues and questions raised by Ryan’s plan.

Q. What is Ryan’s latest Medicare plan? Continue reading →

FILED UNDER: Policy, Reform, Medicare, Paul Ryan
August 9, 2012 | 2:17 PM | By

Richmond Refinery Fire: 8 Health Questions Answered

Monday night's Chevron Refinery fire as seen from the Berkeley Hills. (Daniel Parks: Flickr)

Monday night's Chevron Refinery fire as seen from the Berkeley Hills. (Daniel Parks: Flickr)

Contra Costa Health Services has posted a succinct “Frequently Asked Questions Related to the Chevron Fire on August 6, 2012.” [PDF] It’s good information — cleaning fruits, vegetables, avoiding groundwater, health impact, etc.

I republish it here, in its entirety:

1. What are the health impacts from the refinery fire?

Smoke can cause throat and eye irritation, though it generally is not serious
if the exposure is limited. These symptoms should resolve on their own after a few days for most people. Exposure to smoke can be more serious for people with pre-existing lung disease, such as asthma, and they may experience wheezing or have trouble breathing. As of August 8, more than 1,700 people have gone to the emergency room with nose, throat or eye irritation or respiratory issues, although none have been hospitalized.

2. What chemicals were released into the air and how dangerous are they? Continue reading →

FILED UNDER: Place Matters, environmental health, Richmond Refinery Fire
August 9, 2012 | 11:46 AM | By

California Heats Up and That Means Health Risks

Map from the National Weather Service shows the areas of 'excessive heat' alerts in California.

Map from the National Weather Service shows the areas of 'excessive heat' alerts in California.

The rest of the nation has sweltered this summer, but California has escaped extreme heat — until now. The National Weather Service may not have high-end graphics, but its map tells the story. The San Joaquin Valley, starting south of Modesto, is colored a brownish-red and that means excessive heat warning. Temperatures are expected to exceed 100 degrees every day until Tuesday. The bright pink areas indicate a heat “watch” (click here if you don’t know the difference). This kind of heat is not just a weather story, it’s a significant health and environment story too.

High heat is hazardous to people, pets and livestock. San Joaquin County Public Health Services warns people to drink plenty of water, stay cool in an air-conditioned room and wear loose-fitting clothing. And, please, do not leave children, seniors or pets in a parked car for any period of time, even with windows cracked. The interior of the car can heat up very fast — to deadly levels — within minutes.

Those at highest risk for heat stress are children under age 4, adults with disabilities, anyone with a chronic illness and the elderly. Continue reading →

FILED UNDER: Place Matters, Air Quality, environmental health, Heat
August 9, 2012 | 8:36 AM | By

Soda Industry Spending Big to Defeat Richmond Beverage Tax

Rosa Lara talks with Alejandra Nava at La Raza market. Lara is a paid organizer for the community coalition against beverage taxes.

Rosa Lara talks with Alejandra Nava at La Raza market in Richmond. Lara is a paid organizer for the community coalition against beverage taxes.

Earlier this week, KQED’s Mina Kim looked at the ongoing soda tax campaign in Richmond. In November, voters there will decide whether to impose a penny-an-ounce fee on sweetened drinks. Today, William Harless at California Watch drilled down into newly-released campaign finance disclosures and learned that — not surprisingly — tax opponents are outspending tax supporters.

What might be more surprising is that the margin is 10 to 1. Harless reports that the American Beverage Association, based in Washington and representing Coca Cola, PepsiCo et. al. has spent $150,000 since June. (Note that the City Council voted to put the tax on the ballot on May 15.)

Harless earlier reported that the beverage association is funding the Community Coalition Against Beverage Taxes. To date, that organization has spent an additional $200,000, again according to campaign finance records.

While dramatically outspent, more organizations are also joining the campaign to support the tax. Continue reading →

FILED UNDER: Place Matters, Policy, Obesity, Richmond Soda Tax
August 8, 2012 | 1:06 PM | By

Could Marin County’s High Breast Cancer Rate Have a Genetic Link?

View of Marin County from Mt. Tamalpais. (Flickr: Steve Mohundro)

View of Marin County from Mt. Tamalpais. (Flickr: Steve Mohundro)

Let’s start out with the disclaimers — first, this small study — just 338 samples — has to be proven in a larger study. Second, even if true, we are years away from seeing new treatments.

Still this new research from UCSF is intriguing to say the least. Researchers at UC San Francisco looked at cell samples from women shown through previous testing to be at higher risk of breast cancer. They found that those women were almost twice as likely to have a genetic variation involving a vitamin D receptor. The research was published online earlier this week and will be in the November print edition of the Journal of the American College of Surgeons.

Marin County has one of the highest rates of breast cancer in the world. A 2003 study found that the land in Marin was not a factor — a woman’s risk of developing cancer did not go up if she lived longer in Marin County. In conducting that study, researchers had used cell samples taken from the mouths of women — half the women had breast cancer, half did not. Those samples were kept frozen after the study was complete. Continue reading →

FILED UNDER: Place Matters, Breast Cancer, Genetic Risk
August 8, 2012 | 6:05 AM | By

Clinic for the Homeless to Open in Oakland

Wendy Georges (second from the left) leads a planning session for the new TRUST Clinic (Photo: David Modersbach)

By Alvin Tran

Alameda County has new plans in store for its homeless population – it intends to open an integrated medical clinic in downtown Oakland.

The TRUST Clinic is one of the county’s newest projects and involves the collaboration of several agencies including Alameda County’s Health Care for the Homeless Program, Social Services Agency and Behavioral Health Services.

But unlike other clinics in Alameda County, TRUST will be one of just two which will offer integrated health services, including primary care, behavioral health, case management with housing assistance, and medical-legal partnerships.

“This clinic is a very innovative idea. It’s not something that’s being done in very many places,” said Dr. Michael Boroff, a clinical psychologist who will be working at the clinic. “It embraces the integrated health care … with medical and mental health and all of these different aspects of services combining and working together as a team.”

Continue reading →

FILED UNDER: Place Matters, Homeless, Mental Health