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Blog Posts from July 2015

Blog Posts from July 2015

Obesity rates among California’s adult population are staggering, as seen in a recent study, Obesity in California, from the UCLA Center for Health Policy Research. This afternoon, the Center hosted a seminar to discuss some of the findings in the report and make the connection between social and environmental factors like safety and access to healthy foods and the rise in obesity rates.

The seminar, Environmental Factors Driving Rising Obesity in California, featured a presentation from two of the study’s authors, Research Scientist Joelle Wolstein and Senior Research Scientist Susan Babey. Here are some highlights from the presentation:

Obesity rates have risen dramatically since the late 1960s.

The California Assembly Health Committee took another important step to increasing access to health coverage to all children in the state regardless of immigration status by passing Senator Ricardo Lara’s SB 4. The bill passed along party lines, with Democratic members in support and Republicans in opposition. The committee also passed one of CPEHN’s co-sponsored bills, SB 137 (Hernandez), which would enhance consumer protections by improving health plan’s provider directories. This important bill received bipartisan support.

The hearing began with Senator Lara explaining the benefits of his bill, which would expand access to full-scope Medi-Cal to all children regardless of immigration status and allow California to apply for a waiver through section 1332 of the Affordable Care Act allowing undocumented adults to purchase coverage through Covered California. He talked about the tremendous community support he’s received while working on Health for All legislation over the last two years.

Editor's note: This terrific event is great for anyone looking for new technologies and strategies for furthering a social justice mission. In particular, there is an emphasis on how to use technology to promote equity in California's communities of color.

On July 30 and 31, fellow capacity builders, mentors, and community organizers from across the state are joining together at the first California Nonprofit Technology Leadership Summit held near Bakersfield at the National Chavez Center.

The CA Tech Summit will be an immersive experience to strengthen the network of leaders in rural and urban areas who are passionate about social justice and technology.

Over the past five years, participants from more than thirty unique California cities convened for the California Nonprofit Technology Festivals in Fresno, Sacramento, Coachella, Los Angeles, and Richmond. From community health, environmental justice, to youth leadership organizations, a diverse range of nonprofits collaborated to learn new skills and share knowledge.

From this ongoing work, a core group of returning participants and organizations expressed interest in diving deeper into ways to grow and support leaders, create mentoring resources, and share capacity building models. The CA Tech Summit is designed to address this need.

What is on the agenda?

We hope that people leave the Valley with expanded support networks and sustainable practices for navigating the intersection of technology and social change. The interactive agenda will be created with participant input before and during the Summit. Topics may include:

This post originally appeared on the John Snow, Inc., blog, The Pump.

At JSI, we’ve been closely observing the shifting health care landscape and identifying promising practices and frameworks for achieving the Triple Aim (reduced per capita cost, improved experience of care, and improved population health) and whole-person care. One of the most interesting dialogues underway is how to better understand and respond to social determinants of health (SDOH). The evidence keeps growing indicating that factors outside the clinic walls such as educational opportunity and community environments play a more significant role in determining health outcomes than factors such as access to care and genetics. This has led many to contend that zip code says more about health prospects than genetic code.

From a health system perspective, there is recognition that many of the highest cost patients would be better served, and cost less, if social and clinical needs were addressed in concert. From a clinician’s perspective, there is a hunger for new approaches and tools to address circumstances outside the clinic walls that are causing and exacerbating chronic illnesses. A Robert Wood Johnson Foundation-funded survey found that the vast majority of physicians not only see social needs as just as important to address as medical conditions but wish they could write prescriptions to address those needs.

While adults often reminisce about their care-free childhood summers, this time of year means a loss of critical resources for many kids across our state. Eighty percent of California students who rely on the health and academic benefits of free or reduced-price lunches during the school year miss out on similar meals during the summer. That results in a summer nutrition gap that cuts across our state, affecting nearly two million of our most vulnerable children.

Research and common sense tell us that kids need year-round access to nutritious meals. They need those meals to learn, grow, and achieve at their fullest potential. The good news: California’s summer nutrition gap is sizeable, but not inevitable.

Summer Electronic Benefit Transfer (EBT) for Children is a well-tested solution that provides low-income families with nutrition assistance benefits to purchase food when school is out and students lose access to affordable school meals. Summer EBT has been found to:

  • Reduce food insecurity among children and their families,
  • Reduce consumption of sugars from sugar-sweetened beverages, and
  • Increase consumption of fruits, vegetables, and whole grains.

Summer EBT works, but it’s not yet at work everywhere, and California’s children lack access. Representative Susan Davis (CA-53) and Senator Patty Murray (WA) have introduced the Stop Child Summer Hunger Act of 2015 to make Summer EBT a reality for kids across the country.

Earlier this month, the California Department of Health Care Services released a review of the rates paid out to dentists offering services through the Denti-Cal program. The report found that enrollment in the program has risen dramatically in the past five years, but low provider reimbursement rates have left the newly enrolled with limited options for oral health care.

Between 2009 and 2014, the number of children enrolled in Denti-Cal increased by 40%. (Note: Adult full-scope Denti-Cal services were cut in 2009.) Most of this increase occurred between 2011 and 2013 when the Healthy Families program transitioned into Medi-Cal. However, as enrollment skyrocketed, the number of Denti-Cal providers dropped by 14%.

The reason for the decreasing provider pool is clear: California’s reimbursement rates are some of the lowest in the country.  California’s average reimbursement rates come in at less than one-third (28.3%) of the region’s commercial insurance rates. Compared to other states, California’s average rates are less than two-thirds of Texas’s (65.5%) and three-quarters of New York’s (75.4%).

A recent KPBS story discussed what California needs to do to increase provider participation:

Jenny Kattlove, programs director of The Children's Partnership, a nonprofit advocacy group, said dentists who treat kids with Denti-Cal coverage take a financial hit.

For 30 years, California has led the crusade against Big Tobacco. The state blazed trails in tobacco control with bold media campaigns, smoke-free air laws, and tobacco taxes to fund public health. In 1994, when California passed its smoke-free workplace law, it became the first state to change its Labor Code to reflect the growing recognition that smoking in the workplace exposes people to toxic secondhand smoke. To protect workers, California amended its Labor Code to prohibit smoking in enclosed places of employment.

But the law didn’t cover all workplaces. The smoke-free workplace law left gaping holes in the Labor Code, and permitted smoking in hotels, cabs of trucks, warehouses, small businesses, long-term health care facilities, and outdoor places of employment. These holes have left many workers – hotel maids, truck drivers, nannies, orderlies, and construction workers – unprotected. The exemptions still exist today, even though more than 25 states and the District of Columbia have since adopted more comprehensive smoke-free laws.

Unfortunately, the law’s shortcomings disproportionately affect populations too often hurt by flawed and unfair policies. Many people from low-income communities and communities of color work in industries that are not protected under the law. Because the places where they work are not smoke-free, these groups are regularly exposed to secondhand smoke and residual toxins on surfaces (also known as thirdhand smoke) in hotel rooms, trucks, and even their employers’ homes.

Earlier this week, the UCLA Center for Culture, Trauma, and Mental Health Disparities released two studies showing that low-income African Americans and Latinos are disproportionately impacted by mental health issues and chronic conditions. The studies examine five environmental factors that can be used to predict adult depression, anxiety, and post-traumatic stress disorder:

  • Experiences of discrimination due to racial, ethnic, gender, or sexual orientation
  • A history of sexual abuse
  • A history of violence in the family or from an intimate partner
  • A history of violence in  an individuals’ community
  • A chronic fear of being killed or seriously injured

The researchers found that repeated exposure to these factors can have a more severe impact as they accrue over a lifetime.

“The costs to society of these life experiences are substantial,” said Hector Myers, a former UCLA psychology professor and first author of the Psychological Trauma study. (Myers is now a professor at Vanderbilt University.) “We know there is a poorer overall quality of life, a loss of productivity, greater social dependency, disability, health and mental health care costs, and early mortality as a result of repeated experiences of stress and trauma.”

They also expressed confidence that the findings of the study could be used to better address the health needs of communities that experience societal trauma at higher rates. Further, they noted that with the Affordable Care Act (ACA), there is increased access to mental health treatment and care.

A new issue of our Health Equity Forum newsletter was released today and it starts off July with a lot of great articles and resources highlighting efforts to improve health and equity in California.

CPEHN’s Executive Director, Sarah de Guia, opens the newsletter with an article about the emotional last few weeks for social justice advocates. She celebrates last week’s Supreme Court decisions regarding the Affordable Care Act and same-sex marriage. However, she also takes time to remember the lives lost in the tragic hate crime in Charleston.

Our Ethnic Partner Spotlight features an article from Xavier Morales, Executive Director of the Latino Coalition for a Healthy California. He focuses on the importance of addressing the diabetes health crisis in communities of color and what policy steps can be taken.

The American Lung Association in California has an interesting piece on their terrific new report, State of the Air 2015. The report looks at how California’s cities rank nationally in terms of air quality and what trends have become evident over the last decade. And the RYSE Center in Richmond has a compelling story on the challenges facing those returning from the juvenile justice system.

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