The report focused on California’s experiences during the first full year after implementation of the Affordable Care Act’s coverage expansion. Focusing on those who have gained coverage either through Covered California or an expanded Medi-Cal program, the report examined the state’s health care system after roughly 4.4 million people have enrolled in coverage in the two programs. Using results from a comprehensive survey, the report found that those with insurance were more likely to use it, but the newly insured had more trouble than the previously insured navigating how to use their coverage. Additionally, almost half (47%) of those newly enrolled in Covered California reported having difficulty affording their monthly premiums, compared to 27% of those who were previously ensured prior to 2014. The report also found that community clinics and health centers are increasingly relied upon by the uninsured and newly insured.
The comprehensive report analyzes the status of women and girls in a number of arenas, including education, employment, poverty, business leadership, political representation, and mental and physical health.
The report finds that California is becoming increasingly diverse, with communities of color now representing 61% of the state’s female population, up from 56% in 2005. Latinas are the fastest growing racial and ethnic group. And that trend is likely to continue, with nearly a third of Latinas (32%) under the age of 18, compared to just 16% of Whites.
The main takeaway from the report is that women, especially women of color, are still not on equal footing as men, particularly in terms of socioeconomic status:
In order to fully address the root causes of the health inequities we see in our state, it is important to remember that what influences our health goes far beyond what happens in a doctor’s office. Many social and environmental factors contribute to our health and wellbeing. Among these, community planning and transportation design have some of the biggest impacts.
Today in Oakland, Prevention Institute hosted From Streetscapes to Thriving Communities, an event focused on how we can design our communities to better promote health. In particular, the event focused on creating safe streets:
Streets are in many ways at the heart of our communities, and street design can shape health out-comes in powerful ways – preventing traffic injuries and violence, promoting community cohesion and mental health, supporting physical activity, and more. But street design isn’t enough. Residents need safe places to play, great destinations, and a thriving local economy.
Two prominent experts, Dinesh Mohan and Dick Jackson, engaged in a terrific discussion on creating healthier streets. Here are some highlights from Twitter:
As you can see from the chart, there are some dramatic variations in high blood pressure rates across the Asian ethnic subgroups. Japanese adults, for example, have the highest rate at 35.4%, which is higher than other populations, including Chinese (18.2%) and South Asian (8.2%) adults.
“Our results suggest that susceptible populations like the Filipino and Japanese subgroups may warrant early and aggressive intervention in blood pressure reduction to help decrease cardiovascular risk,” said Dr. Powell Jose, Research Physician at the Palo Alto Medical Foundation Research Institute. “Physicians should attempt to better understand cultural differences and barriers that may influence diet and health behaviors in Asian-American subgroups. Nutrition and lifestyle counseling must be offered to these higher risk populations to help control hypertension in addition to medical therapy, when indicated.”
The U.S. Department of Health and Human Services Office of National Coordinator for Health Information Technology has proposed a regulation to require electronic health record systems to document and use disaggregated data on race, ethnicity, language, sexual orientation, gender identity, and social and behavioral factors that influence health. This data will make it easier to identify disparities and achieve health equity.
The regulation would require up to 900 race and ethnicity categories and up to 600 language categories, the first time that any federal department has required comprehensive disaggregation. This also would be the first time that sexual orientation and gender identity data would be routinely collected.
Public comments supporting this proposed regulation are needed. Please submit yours today! While comments submitted by organizations are important, it also is very important for individual members of the public to submit personalized comments.
First, our Inland Empire convening, cohosted by the California Partnership and the Community Clinic Association of San Bernardino County, will now be June 5th in Riverside at the United Domestic Workers Community Room, 3600 Lime Street, Suite 421. The agenda will be the same and we are excited to discuss Health for All efforts to extend coverage to California’s immigrant population, behavioral health integration, and including equity when considering ways to improve quality of care. We’d also like to hear from residents in the Inland Empire about the unique health needs your communities face. Register today and we can work together to improve health in Riverside and San Bernardino Counties.
The American Lung Association State of the Air 2015 report, released last week, showed that while progress has been made, California continues to have some of the worst air pollution in the country. In fact, 28 million Californians live in counties where ozone or particle pollution levels can make the air unhealthy to breathe. (Click on the map to enlarge.)
Covering air pollution data from 2011-2013, State of the Air 2015 shows that California cities still dominate lists for the most polluted areas in the nation for ozone (smog) as well as short-term and annual particle pollution (soot). Several cities had both higher year round averages and unhealthy days on average of particle pollution driven largely by drought weather conditions.
Specifically, of the top ten cities in the nation with the worst air pollution, California metropolitan areas rank as follows:
Prevention Institute and the Movember Foundation introduce the Making Connections Initiative and are inviting Letters of Interest from sites to support planning and implementation of upstream, community-driven, mental health, and wellbeing strategies for men and boys. As lead coordinator of the initiative, Prevention Institute encourages applicants who can design multi-sector, collaborative approaches for high-need communities such as boys and men of color and their families, and/or military and veteran communities/families.
On Thursday, May 14th, Governor Jerry Brown released his revised budget proposal for the 2015-16 fiscal year. Despite a rosy economic picture with $6.7 billion in additional revenues, the revised budget does not restore any of the devastating cuts made during the recession to health and human services programs on which millions of Californians rely. The majority of the additional revenues ($5.5 billion) will go to K-12 education, but the remaining $1.2 billion will be split between the Rainy Day Fund and paying down debts.
Just as our state endures an historic drought, millions of Californians also face extreme needs and can’t afford to wait for that rainy day! Locking these funds away won’t help Medi-Cal recipients who are struggling to find a doctor because of low reimbursement rates or can’t access dental care due to limited dental benefits; or those on CalWORKS whose benefits were cut so severely that they remain in deep poverty. The budget proposal also fails to include funding for Health for All legislation to extend coverage to the over one million undocumented immigrants left out of the Affordable Care Act. Senator Holly Mitchell put it best when she said, “The budget is not simply a math problem…The Legislature has options to use a significant portion of the funds to meet human needs.”
Continuing an effort to explore Affordable Care Act (ACA) implementation in the states, the Kaiser Family Foundation and the Blue Shield of California Foundation are examining ACA implementation in California at abriefing and panel discussion in Sacramento on May 28th. A state official, experts, and advocates will discuss issues and challenges related to the implementation of the law and the practical impact of providing coverage to roughly 4.5 million Californians who have coverage via the state marketplace or the Medi-Cal expansion.
The event will feature the release of the report Coverage Expansions and the Remaining Uninsured: A Look at California During Year One of ACA Implementation, based on the latest round of The Henry J. Kaiser Family Foundation’s Survey of Low-Income Americans and the ACA. The report, funded by the Blue Shield of California Foundation, provides a California snapshot of who gained coverage or remained uninsured in 2014. It also provides information on how the newly insured view their coverage and any problems they have encountered in using their coverage; how the remaining uninsured and newly insured fare with respect to access to medical care and financial burden; and why people in California continue to lack coverage.