Monthly Archives: November 2012

New Mapping Finds More Breast Cancer ‘Areas of Concern’

Map of breast cancer "areas of concern" in the Bay Area. (Image: California Breast Cancer Mapping Project)

Map of breast cancer "areas of concern" in the Bay Area. (Image: California Breast Cancer Mapping Project)

A new study finds Marin County isn’t the only part of the Bay Area where breast cancer rates are higher than the state average.

Researchers with the California Breast Cancer Mapping Project say they’ve also found a higher rate of breast cancer — defined as 10 to 20 percent above statewide average — in parts of Alameda, Sonoma, Napa, Solano and Contra Costa Counties.

Researchers looked at breast cancer rates by census tract, a more targeted approach than other numbers which are collected county-wide.

“This is an opportunity for us to think about communities affected by breast cancer in new ways,” said Dr. Eric Roberts, of Oakland’s Public Health Institute and principal investigator for the study [PDF]. “And one of them is that — although no one argues that there isn’t an excess of breast cancer in Marin County — when you look at it this way, it appears more that Marin County is part of an extended area.” Continue reading

‘Monster’ Energy Drinks Under Investigation by FDA and SF City Attorney

By Mina Kim

Nineteen-year-old Malaysia Sanders stands in front of Friendly Liquor in San Francisco. She doesn't drink energy drinks anymore, but she did when she was 14 because she thought they were "cool." (Catherine Borgeson/KQED)

In the last few months, Southern California-based Monster Beverage has faced increasing questions about its energy drinks. The Food and Drug Administration is investigating whether the drinks are linked to five deaths, and there’s interest at the state and local level, too. Monster has until Friday to respond to a query from the San Francisco City Attorney.

The legal case of fourteen year-old Anais Fournier prompted the FDA to disclose that it’s investigating five deaths that could be linked to Monster Beverage. After the Maryland teen drank two large cans of Monster Energy within a 24 hour period, she went into cardiac arrest and died a few days later.

That was last year, and this October, Fournier’s mother filed a wrongful death lawsuit against Monster Beverage of Corona. With those two 24-ounce cans of Monster Energy, Fournier had consumed more than five times the daily amount of caffeine that the American Academy of Pediatrics recommends is safe for teens. Continue reading

Engage With Grace This Thanksgiving Weekend

Editor’s note: State of Health is participating in the Engage with Grace blogrally. Engage with Grace aims to get people talking about their wishes for end of life and advanced care. The Health Care Blog has put up the HTML code, if you want to host this on your own blog.

By Alexandra Drane

One of our favorite things we ever heard Steve Jobs say is: “If you live each day as if it was your last, someday you’ll most certainly be right.” We love it for three reasons: 1) It reminds all of us that living with intention is one of the most important things we can do. 2) It reminds all of us that one day will be our last. 3) It’s a great example of how Steve Jobs just made most things (even things about death – even things he was quoting) sound better.

Most of us do pretty well with the living with intention part – but the dying thing? Not so much. And maybe that doesn’t bother us so much as individuals because heck, we’re not going to die anyway!! That’s one of those things that happens to other people.

Then one day it does happen — to someone else. But it’s someone that we love. And everything about our perspective on end of life changes.

Know what you want at the end of your life; know the preferences of your loved ones. Print out this one slide.

If you haven’t personally had the experience of seeing or helping a loved one navigate the incredible complexities of terminal illness, then just ask someone who has. Chances are nearly three out of four of those stories will be bad ones — involving actions and decisions that were at odds with that person’s values. And the worst part about it? Most of this mess is unintentional — no one is deliberately trying to make anyone else suffer. It’s just that few of us are taking the time to figure out our own preferences for what we’d like when our time is near, making sure those preferences are known, and appointing someone to advocate on our behalf. Continue reading

Quick Read: With Routine Mammograms, Some Breast Cancers May Be Overtreated

Dartmouth’s Gilbert Welch, a well-known analyst of the usefulness of mammography, found that since the early 1980’s — when screening mammography was widely introduced — there has been a doubling in the rate of early stage breast cancer. The problem, he says, is we’re not seeing what should be a corresponding decrease in late stage cancer.


The endless debate over routine mammograms is getting another kick from an analysis that sharply questions whether the test really does what it’s supposed to. Dr. H. Gilbert Welch, coauthor of the analysis of mammography’s impact, which was just published in the New England Journal of Medicine, tell Shots that the aim was to “get down to a very basic question.”

Read more at: www.npr.org

Quick Read: Answers to Every Possible Thanksgiving Health Question

This is a highly entertaining read for both food safety and mental health advice. Plus, Hamblin includes a nod to Cole Porter’s “Anything Goes.”


How bad is it that I stuff our turkey a few days in advance? Bad — disgusting actually, don’t do that. Is quinoa stuffing healthier than regular stuffing? Yes. If regular white bread stuffing is what’s on the table, though, don’t let the words quinoa stuffing leave your mouth.

Read more at: www.theatlantic.com

Five New Obamacare Regulations Just Out

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

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

The Department of Health and Human Services issued a whole slew of long-awaited regulations Tuesday about the Affordable Care Act. They are important to consumers because they have to do with both cost and (loosely) what must be covered. States have some latitude in the coverage area, more on that in a moment.

Friendly reminder that most of what the feds released are for the new state based exchanges. Individuals and small businesses will be able to buy insurance through the state’s exchange, Covered California. If you get insurance through your employer, you will continue to do so.

  1. Guaranteed issue and renewal: you no longer can be denied getting insurance due to a pre-existing condition. Insurance companies can no longer jack up rates or drop you completely when it’s time to renew. They may only raise rates annually (on your birthday!) and only by a set amount.
  2. Fair premiums: premiums can only differ based on age, family size, tobacco use and where you live. Adults will be within a 3:1 ratio. In other words, a premium for a 63-year-old can be a maximum of three times the rate of a 21-year-old. Everyone over age 63 is in the same rate band. Women can no longer be charged more than men. Continue reading

Missive From Massachusetts: Addressing Health Care Costs

Editor’s note: The Massachusetts health care overhaul has been a model for the federal plan. The state has reached near-universal access, but that’s only one piece (albeit a big one) of health care reform. Another big piece is cost, which the state is now addressing.

By Martha Bebinger, Kaiser Health News

Boston, as seen from Boston harbor. (Nietnagel/Flickr)

The skyline of Boston, Massachusetts. (Nietnagel/Flickr)

Massachusetts is the first state to say that health care costs must stop increasing faster than that of most other goods and services. Prof. Stuart Altman, a Brandeis economist who advised President Richard Nixon on health policy and President Bill Clinton on Medicare, has responsibility for helping the state achieve that goal.

Gov. Deval Patrick recently named Altman to chair the Health Policy Commission, the new board overseeing the sweeping cost-control law. The board, whose other members were announced last week, will monitor progress toward keeping health care spending in line with state economic growth overall. While he’s “hopeful” the state can meet this goal, Altman notes that many attempts have failed over the years. Here is an edited transcript of my interview with Altman about the challenge facing Massachusetts:

How do you see this new role?

“[Historically,] I’ve seen both the private sector fall apart and the government sector fall apart. Now, I think what’s being done is smarter.”
Massachusetts has put together the best kind of balanced program that I could think of in the country, where it is relying at one level on the many changes that are going on in the private sector. But it also has put together an overarching public assessment of what’s going on to make sure that it works, and it actually brings cost down without hurting quality.

If the changes that are currently in place don’t do that, this commission is responsible for giving an early warning sign. So we don’t have direct regulatory power to force the system to change, but we do have a monitoring role to make sure that it is working. If it’s not, [we would] first direct the delivery system and the payers to change, and if that doesn’t work, we could also recommend back to the legislature that the state needs more authority. Continue reading

Quick Read: Raul Ruiz Win Tells Story of Election 2012 — and Importance of SDOH to Voters

Incoming Congressman Raul Ruiz has a compelling life story and believes he could do more to address SDOH — the social determinants of health the casual reader knows as jobs, the economy, and schools — from Congress than as an emergency room doctor. He defeated incumbent Mary Bono Mack in his district east of Los Angeles (includes Palm Springs, Palm Desert and out to the Nevada border).


If the growing sway of Latinos in American politics was the story of election 2012, Raul Ruiz’s triumph in California’s 36th Congressional District was a dramatic subplot. The son of migrant farmworkers who scraped his way through UCLA and then Harvard Medical School, Ruiz dislodged Rep.

Read more at: www.politico.com

Quick Read: What Are Richmond Residents Breathing?

As part of a 2010 agreement, Chevron agreed to install additional air monitors in Richmond, but the plan stalled. Last summer’s refinery fire put the plan back in motion.


On August 6th, a fire broke out at the Chevron oil refinery in Richmond, hobbling refinery operations, contributing to a statewide spike in gas prices, and sending 15 thousand people to nearby hospitals, complaining of headaches, dizziness and other ailments.

Read more at: science.kqed.org

Health Clinics Continue Growing — and Preparing — for January 2014

By Lauren Whaley, CHCF Center for Health Reporting

(LaurenWhaley/CHCF Center for Health Reporting)

Dr. Paul Gregerson says November 7, the day after the election, was a “very good day in my life.”

“The Obama election is very good news, let me tell you,” he says. “I couldn’t be happier.”

Gregerson’s joy — and relief — stems from his role as chief medical officer at the John Wesley Community Health Institute in Los Angeles. Gregerson sees patients daily at the Institute’s clinic in downtown LA’s Skid Row neighborhood.

He sees Obamacare (and California’s full-steam ahead movement on it) as a way to increase quality health care to his patients. About 20 percent of them are currently enrolled in Medi-Cal. Come January 2014, when the president’s Affordable Care Act goes into full effect, about 80 percent will qualify, he says.

Under the new law, the clinic will get reimbursed for more of the patients it already sees — and for many of the new patients it expects to see. About a million more Angelenos are expected to get health insurance. Studies show that people visit the doctor more often when they’re insured. Community health centers have been planning for an explosion of new patients for several years. Continue reading