Author Archives: state of health

Male in Life, Female in Death: The Story of Christopher Lee’s Death Certificate

Christopher Lee lived his life as a man, but after he died by suicide, the death certificate listed his gender as female.

Christopher Lee lived his life as a man, but after he died by suicide, the death certificate listed his gender as female.

By Matt Levin

Death certificates are typically pretty boring documents. A box for name, a box for date, a box for place and time, for cause of death. A bureaucratic afterthought to help family and friends settle the affairs of a deceased loved one.

“I looked at it, and it said ‘female’ on it. And I asked her, ‘Why does it say female? He was male.’”
A death certificate was not on the forefront of Chino Scott-Chung’s mind as he waited for the ashes of his best friend, Christopher Lee. Lee, 48, had committed suicide in December 2012, and Scott-Chung was still reeling from the death of the friend who had served as best man in his wedding.

After receiving the ashes, Scott-Chung prepared to leave when the employee from the Oakland cremation services company handed him Lee’s death certificate.

Scott-Chung immediately noticed something was wrong. Something that Christopher would never have consented to if he were still alive. Continue reading

Obamacare Means New Challenges for California’s Safety Net Providers

Natividad Medical Center is a public hospital in Salinas. It's part of the system of safety net institutions that serve Californians with nowhere else to go. Even as health reform is implemented, millions of Californians will remain uninsured. (Lisa Morehouse/KQED)

Natividad Medical Center is a public hospital in Salinas. It’s part of the system of safety net institutions that serve Californians with nowhere else to go. Even as health reform is implemented, millions of Californians will remain uninsured. (Lisa Morehouse/KQED)

By Lisa Morehouse

California leads the nation in the number of people getting insurance through the Affordable Care Act. But now that the final deadline has come and gone on Tuesday, millions are still left uninsured. These people will still turn to community clinics and public hospitals for care — they are the safety net institutions that serve Californians with nowhere else to go. But as the ACA is implemented, those institutions are facing changes.

One such place is Centro Medico. It’s tucked away in a corner of a shopping center in Cathedral City, a predominantly Latino bedroom community sandwiched between the resort towns of Palm Springs and Rancho Mirage. Here is where many hospitality workers who serve the neighboring resorts live.

Centro Medico’s manager, Daisy Morfin, sees a lot of pent-up need for medical care. Since enrollment in the Affordable Care Act started last fall, she says the clinic is getting up to 10 new patients a day.

Many are people who have qualified for health insurance for the first time in years — or ever. Continue reading

Prisons Are Main Source of California’s Psychiatric Housing

(Photo/Gregory D. Cook)

(Photo/Gregory D. Cook)

By Hannah Guzik, HealthyCal

California’s jails and prisons hold far more people with severe psychiatric illnesses than state hospitals, according to a recent report from the Treatment Advocacy Center and the National Sheriffs’ Association.

“For a state with 38 million people — 1 in every 8 Americans lives in California — there are almost no public psychiatric beds available for individuals with serious mental illness,” the report says.

Four state hospitals — Metropolitan, Patton, Napa, and Atascadero — have just over 4,500 beds, but 88 percent of them are reserved for mentally ill individuals who have been charged with crimes, according to the report. Another state hospital at Coalinga is used almost exclusively for sexually violent predators. Continue reading

Could What You Believe About Your Food Affect Your Metabolism?

(via NPR)

In a study, people were given either a “healthy” milkshake or an “indulgent” one. But both milkshakes were the same. (via NPR)

By Alix Spiegel, NPR

Ever spend a lot of time looking at a food label, weighing — is this food good for me? Bad for me?

Here’s the thing you probably haven’t stopped to consider: how the label itself is affecting you.

Sounds crazy, but if participants believed the milkshake was “indulgent,” they thought they’d eaten more, and their digestion was affected. 
“Labels are not just labels; they evoke a set of beliefs,” says Alia Crum, a clinical psychologist who does research at the Columbia Business School in New York.

A couple of years ago, Crum found herself considering what seems like a pretty strange question. She wanted to know whether the information conveyed by a nutritional label could physically change what happens to you — “whether these labels get under the skin literally,” she says, “and actually affect the body’s physiological processing of the nutrients that are consumed.”

As a student, Crum had spent years studying the placebo effect — how a sugar pill can physically alter a body if the person taking the pill believes it will. She figured food labels might work the same way. So she came up with an experiment. Continue reading

Despite Obamacare, Big Gap in Substance Abuse Treatment

Jessica Schabel, 19, is under treatment at the Impact Drug and Alcohol Treatment Center in Pasadena for heroin and methamphetamine addiction. Her insurance benefits only allowed for 30 days, but the facility paid for her to stay an additional 30 days to continue treatment. (Heidi de Marco/KHN)

Jessica Schabel, 19, is under treatment at the Impact Drug and Alcohol Treatment Center in Pasadena for heroin and methamphetamine addiction. Her insurance benefits only allowed for 30 days, but the facility paid for her to stay an additional 30 days to continue treatment. (Heidi de Marco/KHN)

By Anna Gorman, Kaiser Health News

The nation’s health law has promised sweeping changes to help millions of people with drug or alcohol addiction get treatment. Many unable to afford services in the past now can receive them without first landing in jail or an emergency room, health officials say.

An old law bars many residential drug treatment centers from billing Medicaid.
“There is no illness that will be more favorably affected [by the Affordable Care Act] than substance abuse,” said A. Thomas McLellan, former U.S. deputy drug czar who now heads Treatment Research Institute in Philadelphia. “This is the beginning of substance abuse disorders being part of mainstream health care.”

The law requires that substance abuse treatment be offered to people newly insured through the insurance exchanges or Medicaid, the government health plan for the poor and disabled.

But serious impediments remain to widespread access, including a shortage of substance abuse providers and available beds nationwide, say treatment experts and government officials. Continue reading

Analysis: Nearly 500,000 Uninsured Now Covered on California Exchange

Certified specialist helps a consumer apply to Covered California at a free enrollment fair at Pasadena City College. (David McNew/Getty Images)

Certified specialist helps a consumer apply to Covered California at a free enrollment fair at Pasadena City College. (David McNew/Getty Images)

By David Gorn, California Healthline

No one knows yet exactly how many of the 1.2 million people enrolled so far in Covered California were previously uninsured — but one person has a pretty good guess.

“Over the next few years at the exchange, we expect to see much higher numbers of the previously uninsured.” 

Ken Jacobs, chair of the Labor Center at UC-Berkeley, projects about 39 percent of enrollees were previously uninsured, or roughly 468,000 people. (With Thursday’s announcement of an additional 70,000 people enrolled on Covered California during the grace period, it’s reasonable that the number of previously-insured-now-covered will rise.)

That means it’s likely that 61 percent of Covered California enrollees already had health insurance.

“One reason is you have to look at who was expected to enroll in the exchange, and there were two large groups,” Jacobs said. “One of those groups is the people in the individual market.” Continue reading

Prescription: Take New Medicare Data With A Dose of Caution

The data details payments to individual doctors, but experts warn against drawing sweeping conclusions from the numbers.(Getty Images)

The data details payments to individual doctors, but experts warn against drawing sweeping conclusions from the numbers.   (Getty Images)

By Mark Memmott, NPR

The headlines about one of Wednesday’s big stories — the release of data from 2012 about Medicare payment to doctors around the nation — are certainly serious sounding:

— “Sliver of Medicare Doctors Get Big Share of Payouts.” (The New York Times)

— “Small Slice of Doctors Account for Big Chunk of Medicare Costs.” (The Wall Street Journal)

— “Release of Medicare doctor payments shows some huge payouts.” (Los Angeles Times)

Here’s how The Associated Press sums up the news: Continue reading

School Nurses on Front Lines to Raise Vaccine Rates

(Jane Meredith Adams/EdSource)

Robyn Ettl, Grass Valley Unified school nurse, gives a vision test to second grader Chase Littlejohn at the Grass Valley Charter School. (Jane Meredith Adams/EdSource)

By Jane Meredith Adams, EdSource

In her 33 years as a school nurse, Robyn Ettl has listened, sometimes quietly, sometimes not, to parents in rural Nevada County explain why their children don’t need vaccinations against contagious and potentially fatal diseases, including polio, diphtheria, measles and pertussis.

Parents must now meet with health provider before opting-out of vaccines for their children.

Now, with nearly a half a million children in California registering for kindergarten in the fall, school nurses like Ettl are more invested than ever in a delicate task: trying to change the minds of parents intent on opting out of school-entrance immunizations.

Under a state law that took effect Jan. 1, parents may no longer simply file a letter to opt-out of vaccines. Instead, they are required to consult with a health practitioner –- doctor, naturopath or credentialed school nurse –- before they’re allowed to obtain what’s known as a “personal-belief exemption” from their child’s required immunizations. Continue reading

50-Year Review: Mammography Benefits Oversold, Harms Minimized

(Getty Images)

(Getty Images)

By Nancy Shute, NPR

Two months ago, a widely publicized Canadian study found that mammograms did not reduce breast cancer deaths, but that study was fiercely criticized by the nation’s radiologists as “incredibly flawed and misleading.”

A few weeks earlier, an analysis found that screening all women annually starting at age 40, as the American Cancer Society recommends, costs $6.5 billion more a year more than following the U.S. Preventive Service’s Task Force recommendation that women be screened every other year starting at age 50.

Now, the latest entries — two studies that try to put all the previous research on mammography’s harms and benefits in perspective.

First, researchers at Harvard took a broad look at all the research on mammograms since 1960 — more than 50 years of study. They also looked at evidence on the harms of false positives and overdiagnoses, in which a woman is treated for a cancer that would never have proved deadly. And they reviewed whether current efforts to try to personalize a woman’s cancer risk helped a woman figure out whether it was worth her while to get a mammogram. Continue reading

Covered California Extends Deadline — With Caveats

Screenshot from CoveredCA.com, the website of Covered California.

Screenshot from CoveredCA.com, the website of Covered California.

By Lisa Aliferis and April Dembosky

Because of what it termed a “dramatic spike” in traffic, Covered California announced late Monday that it would extend the March 31 deadline to enroll in a health insurance plan. But the extension has certain limitations.

  • Anyone who has not been able to get on the website for technical reason can apply in person or through the Covered California call center by April 15
  • Anyone who starts an application by midnight Monday (March 31) has until April 15 to finish, either online or in person (this was previously announced)
  • Anyone who is filing a paper application must mail it today; it must be postmarked March 31 — but Covered California strongly encourages people to apply in person as opposed to mailing your application

For consumers who complete an application and select a plan by 11:59pm April 15, insurance will take effect May 1. Continue reading