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Voices for Health Equity

Voices for Health Equity

Welcome to Tuesday Tidbits! If you would like your resource/event to be highlighted, please let me know at ddexter@cpehn.org. Thanks!

We spend a lot of time talking about the importance of certain types of health coverage and care (i.e. Medi-Cal, subsidies in Covered California, and our safety net programs). These programs need our support because our most vulnerable populations rely on them for their continued health. But sometimes it’s good to look at what remains the source of health coverage for the majority of Americans: employer-sponsored insurance (ESI).

Earlier this year, The Robert Wood Johnson Foundation and the University of Minnesota’s State Health Access Data Assistance Center (SHADAC) released an interesting analysis of state-by-state trends in ESI over the past decade. Their findings showed that across the country ESI enrollment has decreased in the last 10 years, seemingly in line with a common criticism of the Affordable Care Act (ACA): that it will reduce the availability of and enrollment in ESI. However, the researchers caution that the ACA should be monitored and evaluated within the context of the larger trends in ESI over the years preceding its implementation:

This post originally appeared on the Health Access Blog.

Tomorrow, the Supreme Court will hear oral arguments on King v. Burwell, a case that contests the subsidies available in the 36 states that have federally facilitated marketplaces or FFMs. The case is based on a hyper-literal, politically motivated mis-reading of Section 1311 of the Affordable Care Act (ACA), which says that subsidies are available to people “enrolled through an Exchange established by the State under 1311." At stake is nothing less than affordable coverage for 8 million Americans (See Kaiser Family Foundation’s helpful overview of King v. Burwell here).

No matter how it gets decided in June, King v. Burwell will have no impact in California – end of story. But it is fair to say that an adverse decision will create two health care Americas – one that provides peace of mind for its residents (California) and another that will put families right back where they started: at risk of ‎not receiving the health care they need.

States like California that are implementing the ACA in good faith are already demonstrating that the ‎law effectively increases health coverage, aids the long-term effort to lower costs, and creates helpful competition – something that could be achieved elsewhere if only a state had the will to implement the statute effectively.

CPEHN’s legislative briefing, Cultivating Health Equity, is this Thursday in Sacramento! We are very excited to bring together our founding ethnic partner organizations – the Asian & Pacific Islander American Health Forum, the California Black Health Network, the California Rural Indian Health Board, and the Latino Coalition for a Healthy California – to highlight the top policy priorities for improving the health and well-being of communities of color in California this year. We are also looking forward to engaging conversations and presentations from top advocates and leaders in the fight for health equity. Here are a few highlights and speakers joining us at the Capitol this Thursday:

Multicultural Health Policy Agenda
Our founding ethnic partners join us to highlight the top health policy priorities for communities of color.

Speakers include:
Xavier Morales, Executive Director, Latino Coalition for a Health California 
B. Darcel Lee, President/CEO, California Black Health Network
Amanda Wilbur, Health Policy Analyst, California Rural Indian Health Board
Iyanrick John, Senior Policy Analyst, Asian Pacific Islander American Health Forum
Sarah de Guia, Executive Director, California Pan-Ethnic Health Network

Welcome to Friday Facts! Each week we'll be taking a look at a specific chart from the Data & Resources section of our website. This week we're focusing on the languages spoken in San Diego County, and the percentage of people who speak those languages who are Limited English Proficient.

Language access in our health care system has long been a point of emphasis for our work at CPEHN. For example, in 2003, CPEHN sponsored SB 853 (Escutia), the Health Care Language Assistance Act. The first of its kind in the country, this law now holds health plans accountable for the provision of linguistically-appropriate services.

The reason that laws like SB 853 and other language access measures are necessary is because of California’s uniquely diverse population. As you can see in our Friday Facts table, over 40 different languages are spoken in San Diego County alone.

San Diego County has a large (92,836) Tagalog-speaking population, and roughly 2 out of every 5 of these individuals are Limited English Proficient (LEP), meaning they speak English less than very well. Almost two-thirds of the county’s large Vietnamese-speaking population is LEP, as is half of all those who speak Chinese. The county is also home to over 320,000 Spanish-speakers who are LEP.

Such large numbers of LEP individuals in San Diego County shows the importance of providing linguistically accessible services. Navigating the health care system is challenging enough when you receive services in your primary language, imagine how difficult it would be with a language barrier.

The Latino Coalition for a Healthy California has worked tirelessly for the past year to reduce sugar-sweetened beverage consumption both in Berkeley and across the state, and we’re gearing up for a new battle this year. We're talking about an urgent social justice issue: one out of every two Latino children will get type 2 diabetes in their lifetimes unless things change. These statistics are simply unacceptable, which is why we’re working to engage our community across the state to become informed advocates on this issue.

After successful forums last year in Fresno, Stockton, Berkeley, Santa Ana, and Baldwin Park, where we presented to over 100 people, we are heading back to Southern California to spread the word about the type 2 diabetes epidemic in the Latino community. 

We’ll cover why diabetes has become so common among Latinos, what California advocacy and community groups are doing to prevent it, and how you and your neighbors can join the effort. This forum is ideal for community members concerned about diabetes and healthy food access, promotoras/community health workers, teachers, parents, and local leaders. All are welcome. 

The forums are all from 6:00 pm to 7:30 pm and will be held in English and Spanish. Dinner will be provided and admission is free.

On January 9, 2015, the U.S. Department of Agriculture (USDA) released a proposed rule with new science-based nutrition standards for meals provided through the Child and Adult Care Food Program (CACFP). The CACFP provides reimbursements for meals and snacks served to children in child care facilities, after-school programs, and emergency shelters. Each day, an average of 475,000 children in California are benefitting from the nutrition resources provided through CACFP. 

California has more than 3 million children between the ages of 0 and 5, of which more than one in four (26.6%) live in poverty. Early childhood is a critical time of development. Nutrition habits and preferences are developed within the first five years of life. Young children are especially vulnerable to the impacts of food insecurity, with poor nutrition affecting a young child's ability to learn and grow. CACFP is an essential component of our child care system. Not only does the program ensure young children in child care receive adequate and healthful foods, but it also supports the overall quality of child care. 

Yesterday we talked about the upcoming California Transportation Choices Summit 2015, hosted by TransForm in Sacramento on April 27th. Don’t forget to register for that, because it’s going to be great.

We talked about the importance of complete streets, which promote safety of all users, including pedestrians, bicyclists, motorists, and public transit riders. This week, researchers from the University of Michigan and Brigham Young University released some interesting findings that could provide a simple way to improve pedestrian safety.

The study, published in the latest Journal of Consumer Research, finds that if a road sign depicts figures in a more active state, then motorists react significantly faster. Here’s a good overview from the study’s author:

“A sign that evokes more perceived movement increases the observer’s perception of risk, which in turn brings about earlier attention and earlier stopping,” said study co-author Ryan Elder a professor in BYU’s Marriott School of Management. “If you want to grab attention, you need signs that are more dynamic. … If the figures look like they’re walking, then your brain doesn’t worry about them shooting out into the road. But if they’re running, then you can imagine them being in front of your car in a hurry.”

The study found that a driver of a car going 60 miles per hour could react 50 milliseconds faster to more dynamic warning signs. This would result in stopping 4.4 feet shorter.

Welcome to Tuesday Tidbits! If you would like your resource/event to be highlighted, please let me know at ddexter@cpehn.org. Thanks!

One of the primary social and environmental determinants of health that we focus on at CPEHN is access to healthy transportation options. From our health to our environment to the earth’s climate, how we get around has a tremendous impact on our daily lives. At CPEHN, we often work with our partners to promote the concept of complete streets, which are safe for all users, including pedestrians, bicyclists, motorists, and transit riders.

Each year, our partners at TransForm put on an excellent event in Sacramento, the California Transportation Choices Summit. The 2015 event, ”A Year of Action,” will be held on April 27th in Sacramento. The next day is an advocacy day, which will allow attendees the opportunity to meet with policymakers and their staff and represent their communities’ transportation needs. Here’s a summary from their website of what to expect at this year’s event:

“The Summit and Advocacy Day brings together advocates and leaders from across the state from every issue area: public health, bicycle and pedestrian, social justice, affordable housing, disability rights, labor, transit and more.  At the daylong Summit, legislative leaders and expert panels present on a range of topics, plus attendees break into groups based on geography and issue areas to discuss strategy.”

There’s nothing like a good funding opportunity to add some intrigue to a Monday morning. In this case, $690,000 is available from California’s Student/Resident Experiences and Rotations in Community Health (CalSEARCH) that will help strengthen the state’s health care workforce.

This opportunity has two different components. CalSEARCH will provide grant opportunities through the Workforce Education and Training Program (WET) to organizations for mental health rotations for students and residents within the public mental health system, and through The California Endowment to organizations supporting Community Health Workers/Promotores in one of the 14 Building Healthy Communities or designated counties of the Central Valley.

The Request for Applications was posted on the CalSEARCH site late last week and is available for review. The final applications are due on March 20, 2015. If you have questions, CalSEARCH is hosting a pair of technical assistance webinars, the first tomorrow (February 24th) and another on March 9th. You can register to attend these webinars here.

Welcome to Friday Facts! Each week we'll be taking a look at a specific chart from the Data & Resources section of our website. This week we're focusing on the percentage of children, by race and ethnicity, living in poverty in Sacramento County.

One key determinant of health is family economics. In our 2012 report, The Landscape of Opportunity: Cultivating Health Equity in California, we discussed how living in poverty can impact a person’s health. For example, we found that, according to the California Health Interview Survey, the rates of self-reported poor or fair overall health are much higher for those who are living below the Federal Poverty Level (FPL), which is currently $11,770 a year for an individual and $24,250 for a family of four.

For today’s Friday Facts, we’re taking a look at a particularly vulnerable population in a location best known as the seat of power for the state. As you can see from the table on our website, there are high rates of poverty among children in Sacramento County. In particular, children in communities of color experience high rates of poverty. For example, African American children (42.2%) are nearly three times as likely to live in poverty as their White counterparts (14.8%). Latino children (34.8%) and Asian children (22.2%) are also more likely to live in poverty than White children.

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