Author Archives: Rachel Dornhelm

Rachel Dornhelm got her start in radio at WHYY. After anthropology graduate school, Rachel lived in Uzbekistan working with youth near the drying Aral Sea. Rachel returned to radio full-time in 2001. Her work has appeared on WNYC, WBUR, Marketplace, NPR news magazines and KQED.

How An Increase in Minimum Wage Can Improve Health

(Getty Images)

(Getty Images)

A bill by state Sen. Mark Leno aimed at raising the minimum wage passed the California Senate and is moving on to the Assembly.

But what does this have to do with health?

A “powerful intervention” for public health.    

Generally, advocates of raising the minimum wage try to sway public opinion by using economic arguments. But there’s an increasing move to tie health outcomes and health costs directly to the minimum wage, just as health advocates have long tied socioeconomic status generally to health status.

A new study finds that raising the state minimum wage could prevent hundreds of premature deaths in California each year and save millions in health costs.

Human Impact Partners, or HIP, conducted a “rapid health analysis” of Leno’s proposed SB935, which would raise the current $8-an-hour minimum wage to $13 an hour by 2017. Continue reading

State’s Walk and Bike Infrastructure Poised for Healthy Update

(Getty images)

(Getty images)

Far more Californians are choosing biking or walking to get around these days. Over the last 10 years, the number of trips Californians made on foot and by bike doubled, according to the latest California Household Travel Survey.

Every $1 million invested in bikeways, returns between $1.2 million and $3.8 million in health care savings.
Now the state has launched the Active Transportation Program (ATP). Caltrans funds, combined with other regional and federal grants will create a $360 million pot of money that will be awarded to program applicants this August.

The money will be targeted at projects like bike lanes and safer intersections for pedestrians, but also non-infrastructure programs like bike-to-work events and community engagement.

Jeanie Ward-Waller is the California advocacy organizer for the Safe Routes to School National Partnership. She said this is the most money by far that has been offered to improve walk/bike routes. Continue reading

Expert: Millions More Uninsured Will Get Coverage in Next Three Years

Covered California application in Chinese.

Covered California application in Chinese.

Now that the final numbers from Covered California’s first open enrollment period are in, experts are already looking ahead to the next steps.

Nearly 1.4 million Californians have signed up for health care coverage through the exchange. Another 1.9 million are now covered by the expanded Medi-Cal program. That’s almost 3.5 million state residents.

And yet 5.8 million Californians remain uninsured.

Gerald Kominski, professor of Health Policy and Management and director of the UCLA Center for Health Policy Research, said these numbers are on target with early projections. Continue reading

New Report Finds Dramatic Racial Disparities for California Kids

(Getty Images)

(Getty Images)

Many children of color in the state face different health and education opportunities from the earliest years.

That’s according to a new study from the Annie E. Casey Foundation.

The report looked at factors like birthweight, access to preschool and, later, reading and math proficiency. The researchers then created an index that weighted these and other social markers to measure a child’s opportunity to thrive later on.

The findings were stark. On a scale of 0 to 1000 (with 1000 being the highest), Asian and Pacific Islander children in California scored 768, Whites 748, American Indians 529, Latinos 405, and African American children 395.

“A multicultural state needs multicultural solutions,” Nadereh Pourat, UCLA Center for Health Policy Research

The report gives this analogy for thinking about the results. Think about a power grid that brings power to an area. A “prosperity grid” offers critical links to help kids succeed – in this case whether someone in their household has a high school diploma, their parents income, and achievement levels at their school.

“The inability of children of color to connect to this network through their neighborhoods clearly has significant consequences for their healthy development and well-being,” the authors wrote. Continue reading

California Measles Cases Jump Dramatically; 49 So Far in 2014

Vial of Measles Mumps and Rubella (MMR) vaccine. (Geoff Caddick/AFP/Getty Images)

Vial of Measles Mumps and Rubella (MMR) vaccine. (Geoff Caddick/AFP/Getty Images)

The state is reporting 49 confirmed cases of measles so far in 2014.

Last year at this time there were just four.

This is the first year since 2000, when officials declared measles eliminated in the U.S., that the number of cases in California climbed above 40. And it’s just April.

The California Department of Public Health says the highest number of cases – 21 – have been reported in Orange County. Other affected counties in Southern California include Los Angeles County with 10, Riverside with 5 and San Diego County with 4.

In Northern California the cases were spread out between Alameda, Contra Costa, Santa Clara and San Mateo. Continue reading

Oakland Schools Help Parents Sign Up for Covered California

Gabino Pablo gets help with Covered Calfiornia enrollment as the deadline approaches. (Rachel Dornhelm/KQED)

Antonia Briones (left), an Alameda County Social Services Agency eligibility technician, helps Gabino Pablo (right) with Covered California enrollment as the deadline approaches. (Rachel Dornhelm/KQED)

The robocall went out this week to every parent of an Oakland public school student:

“Hello! This is the Oakland Unified School District calling to remind you that March 31st is the deadline for enrolling in health insurance … The OUSD Central Family Resource Center is here to help.”

The day after that call went out the Central Family Resource Center, housed in a small portable building. was swamped. Over a 100 calls came in and 30 families dropped by.

“We’re just getting flooded with calls and people dropping in asking for appointments so we’re all hands on deck trying to respond to the demand,” said Eliza Schiffrin, the center’s program coordinator. Continue reading

Higher Autism Numbers Announced as Feds Introduce Early Screening Program

(Getty Images)

(Getty Images)

Every two years, the federal government announces the rate of autism. This is what NPR’s shots blog had to say about today’s numbers, which show 1 in 68 children in the U.S. have an autism spectrum disorder.

That’s a remarkable jump from just two years ago, when the figure was 1 in 88 and an even bigger jump from 2007, when it was just 1 in 150.

But officials at the Centers for Disease Control and Prevention officials say the agency’s skyrocketing estimates don’t necessarily mean that kids are more likely to have autism now than they were 10 years ago.

“It may be that we’re getting better at identifying autism,” says Coleen Boyle, director of the CDC’s National Center on Birth Defects and Developmental disabilities.

For one thing, the prevalence seems to vary in different communities and among children of different races. The CDC found white children are far more likely to be identified with autism, even though scientists don’t believe the rates are truly different between whites, Hispanics or blacks.

“What we need to focus on is getting more people identified so they can get the supports they need,” Shannon Rosa, Bay Area parent advocate.

That means that the discrepancy lies in the diagnosis and services available in different communities. The shots blog points out the work of George Washington University anthropologist Roy Richard Grinker.

Along with other researchers, he studied autism prevalence in South Korea. They found that 1 in 38 children there met the criteria for autism spectrum disorder. Grinker thinks that the US number is likely closer to the one they saw in South Korea. Which means that in two years the CDC estimate will likely tick higher still.

Continue reading

Covered California Gives Until April 15 to Finish Applications in Progress

Peter Lee, executive director of Covered California. (Max Whitaker/Getty Images)

Peter Lee, executive director of Covered California. (Max Whitaker/Getty Images)

The deadline for Covered California applications is fast approaching: midnight on March 31.

The state is still strongly encouraging people to finish by that time. However, on Wednesday, Covered California announced that if you have an application in the works by March 31, you will have until April 15 to complete it.

Peter Lee, executive director of Covered California, said health exchange enrollment has been surging ahead of the deadline. Continue reading

Advocates Want State to Delay Health Transition for Elderly and Disabled

(Getty Images)

(Getty Images)

Next month, a federal pilot program aimed at improving care for the most vulnerable is set to start rolling out in some California counties.

Cal MediConnect is supposed to help seniors and disabled people in seven California counties get better coordinated health services — from in-home caregivers to physicians. Those who are affected will automatically be rolled into the program. They have the opportunity, though, to make choices about where and how they will get their care.

But some advocates say information about making those choices has been unclear and is coming too late.

With four counties set to roll out the program in April and May, they are calling on the state to put the program on hold.

“We sent (the state) a letter with five other organizations saying there should be a delay,” said Amber Cutler, a staff attorney with the National Senior Citizens Law Center. “They are always putting out fires (with this) and have no time to prepare to prevent problems. That is particularly troublesome when thinking about adding Los Angeles and Alameda in July. We’re talking about hundreds of thousands of people who will be affected.” Continue reading

How Important Is Cost Transparency To Lowering Health Costs?

AetnaRate_Images Money_Apr62012

(flickr: Images Money)

The largest public employees retirement system in the country – CalPERS – has plenty to gain from a drop in health care costs. After all, they cover 1.6 million employees, retirees and their families in California.

Now they’re saying, they found a way to decrease the amount they’ve spent on knee and hip replacements by 19 percent in a year, which could have implications for other employer health plans.

Lisa Aliferis blogged about the CalPERS experiment in controlling costs right here on State of Health about a year ago. Aliferis wrote that they decided to tackle costs around these two surgeries, which cost them $55 million dollars a year in 2008.

Now, you might not think there would be much difference in the price for getting a knee or hip replacement across the state. But think again. CalPERS asked Anthem Blue Cross — which manages its PPO plans — to examine the range of prices for these operations in California.

Anthem came back with the startling information that CalPERS was paying $15,000 on the low end to $110,000 on the high end, a more than seven-fold difference from lowest to highest.

“So we started asking ourselves,” Kathy Donneson, Chief of the CalPERS Heatlhy Plan Administration Division told me, “what are we getting from the $110,000 surgery that we couldn’t get from the $15,000 surgery?”

That’s when CalPERS turned to what’s called a “value based purchasing” approach for elective hip and knee replacements, starting with its non-Medicare population. CalPERS set a threshold price of $30,000 for the hospitalization and device charges for these operations. That $30,000 is slightly higher than the average price CalPERS had been paying for a hip or knee replacement. Anthem identified 46 hospitals across the state which would do these operations at the threshold price.

Continue reading