Subject: Studies in the News 02-43 (July 29, 2002)


CALIFORNIA RESEARCH BUREAU
CALIFORNIA STATE LIBRARY
Studies in the News:
Health Care Supplement


Contents This Week

Introductory Material HEALTH
   Senior's health security at risk
   Adult vision problems
   Treatment for adult HIV infection
   Eligible children losing health coverage
   State trends in health risk factors
   Home health care service
   Measuring children's food security
   Rising cost of health care
   Latino children and health
   LA County health services deficit
   Managed health care audit
   State medical boards' ranking
   Medicare+Choice utilized by minorities
   Comparing Medicare+Choice across states
   Treating children of depressed parents
   Mental health services for foster care children
   Protecting mental health patients
   Teenage anxiety
   Mental health insurance
   Health care data on racial/ethnic disparities
   Doctors' views on disparities
   Racial and ethnic disparities in health care
   Racial disparities in quality of care
   Health care interpreters for limited-English speakers
   Minority nurses workforce
   Nursing staff levels and quality of care
   Nursing shortage and technology
   Nursing homes resident assessment data
   HMO physicians' incentives and patient trust
   Pharmaceutical innovation patterns
   Formularies to control rising drug costs
   Rising cost of prescription drugs
   Prescription medications warnings
   Community-based public health approach
   Charting the quality of health care
   Nicotine's effect on SIDS
   Tobacco industry and Hollywood
   Exporting knowledge of tobacco control
   Smoking's lasting effects
   End-of-life care
   Efforts to expand health coverage
PREVIOUSLY IN STUDIES IN THE NEWS
   Studies in the News, May 20, 2002
   Studies in the News, May 9, 2002
   Studies in the News, June 6, 2002
   Studies in the News, June 28, 2002
   Studies in the News, June 28, 2002
Introduction to Studies in the News

Studies in the News is a very current compilation of items significant to the Legislature and Governor's Office. It is created weekly by the State Library's Research Bureau to supplement the public policy debate in California’s Capitol. To help share the latest information with state policymakers, these reading lists are now being made accessible through the State Library’s website. This week's list of current articles in various public policy areas is presented below.

Service to State Employees:

  • When available, the URL for the full text of each item is provided.

  • Items in the State Library collection can be checked out to state officials and staff.

  • Access to all materials listed will be provided by the State Information Reference Center, either by e-mail to cslsirc@library.ca.gov or by calling 654-0261.

The following studies are currently on hand:

HEALTH

AGING

Beyond 50.02: A Report to the Nation on Trends in Health Security. By the American Association of Retired Persons (The Association, Washington, DC) May 2002. 29 p.

Full Text at: www.aarp.org/beyond50/graphics/pdfs/beyond50_02one.pdf

["A report from the AARP finds that there is good news and bad news about the health security of Americans over 50. The report finds that Americans age 50+ are healthier and living longer overall, but their long-term health security remains at risk." HandsNet (June 14, 2002)]

[Request #S5521]

Return to the Table of Contents

Vision Problems in the U.S.: Prevalence of Adult Vision Impairment and Age-Related Eye Disease in America. By Prevent Blindness America and the National Eye Institute. (National Institutes of Health, Washington, DC) 2002. 42 p.

Full Text at: www.nei.nih.gov/eyedata/pdf/VPUS.pdf

["Age-related Blindness Expected to Double: More than 1 million Americans age 40 and older suffer from blindness today, a number that will double in the next few decades as the boomer generation ages, says a government report.... The experts predict that, by 2020, 1.8 million Americans will be blind and another 3.4 million will suffer from impaired vision that could threaten their way of life. USA Today (March 21, 2002) 8D.]

[Request #S5562]

Return to the Table of Contents

AIDS

"Antiretroviral Treatment for Adult HIV Infection In 2002." By Patrick G. Yeni and others. IN: JAMA: Journal of the American Medical Association, vol.288, no. 2 (July 10, 2002) 14 p.

Full Text at: jama.ama-assn.org/issues/v288n2/rpdf/jst20002.pdf

["New information warrants updated recommendations for the 4 central issues in antiretroviral therapy: when to start, what drugs to start with, when to change, and what to change to.... Because of increased awareness of the activity and toxicity of current drugs, the threshold for initiation of therapy has shifted to a later time in the course of HIV disease.... Availability of new drugs has broadened options for therapy initiation."]

[Request #S5563]

Return to the Table of Contents

CHILDREN

Why Eligible Children Lose or Leave SCHIP: Findings from a Comprehensive Study of Retention and Disenrollment. By Cynthia Pernice and others, National Academy for State Health Policy. (The Academy, Portland, Maine) February 2002. 24 p.; Appendices.

["Children are eligible for health insurance programs, yet they lose coverage. This generally happens because families do something that makes the child lose coverage. This study examines 'lapsed families' and suggests ways to help keep families in the program."]

[Request #S4556]

Return to the Table of Contents

HEALTH STATISTICS

"State Trends in Health Risk Factors and Receipt of Clinical Preventive Services among U.S. Adults during the 1990s." By David E. Nelson and others. IN: JAMA: Journal of the American Medical Association, vol. 287, no. 20 (May 22/29, 2002) pp. 2659-2667.

["Americans' Health Habits A Mixed Bag: Less smoking, binge drinking in California, and seat-belt use is up.... Obesity, on the other hand, rose sharply in California from 10.8 percent in 1999 to 18.6 percent in 2000. Physical inactivity also went up from 18.8 percent in 1991 to 21.4 percent in 2000." San Francisco Chronicle (May 22, 2002) A3.]

[Request #S5524]

Return to the Table of Contents

HOME VISITING

Collaborating to Improve In-Home Supportive Services: Stakeholder Perspectives on Implementing California's Public Authorities. By Janet Heinritz-Canterbury. Paraprofessional Healthcare Institute. (The Institute, Bronx, New York) 2002. 52 p.

Full Text at: www.paraprofessional.org/publications/CA%20PA%20Report.pdf

["This paper analyzes the four-stakeholder coalition that successfully passed legislation and implemented the county public authority structure to improve the quality of jobs and services offered by California's In-Home Supportive Services. Today, home care workers in several counties in California have unionized and have substantially increased their wages and benefits. This has helped to stabilize the workforce, thereby, improving care for consumers as well." Policy Action News (June 26, 2002) 1.]

[Request #S5525]

Return to the Table of Contents

HUNGER

Measuring Children's Food Security in U.S. Households, 1995-99. By Mark Nord and Gary Bickel. ERS Food Assistance and Nutrition Research Report No. FANRR25. (Economic Research Service, U.S. Department of Agriculture, Washington, DC) April 2002. 38 p.

Full Text at: www.ers.usda.gov/publications/fanrr25/

["The prevalence of hunger among children in U.S. households is estimated by applying the newly developed children’s food security scale to data from the nationally representative Current Population Survey Food Security Supplements for the years 1995-99. Prevalence estimates are presented for all U.S. households and for subgroups defined by household structure, race and ethnicity, income, and rural/urban residence."]

[Request #S5526]

Return to the Table of Contents

INSURANCE

"The Unraveling of Health Insurance." IN: Consumer Reports, vol. 67, no. 7 (July 2002) pp. 48-54.

Full Text at: www.consumerreports.org/main/detailv2.jsp?CONTENT%3C%3Ecnt_id=157033&FOLDER%3C%3Efolder_id=18151&bmUID=1024440953266

["The gap between costs for the sick and the well is widening as employers feel the pressure of steeply rising health-insurance premiums. Spending for health care shot up nearly 7 percent in 2000, and insurance premiums for employers rose an average of 11 percent in 2001 -- with no end to the increases in sight.... Today, employers are feeling maxed out. 'If employer costs are up 15 percent, they are passing along 50 to 80 percent of the increase to employees,' says Gregg Lehman, president of the National Business Coalition on Health."]

[Request #S5527]

Return to the Table of Contents

LATINOS

“The Health of Latino Children Urgent Priorities, Unanswered Questions, and A Research Agenda.” By Glenn Flores and others. IN: JAMA: Journal of American Medical Association, vol. 288, no. 1 (July 3, 2002) pp. 82-90.

["The Latino Consortium of the American Academy of Pediatrics Center for Child Health Research identified the most important urgent priorities and unanswered questions in Latino child health.... Latino children are at high risk for school dropout, environmental hazards, obesity, diabetes mellitus, asthma, lack of health insurance, nonfinancial barriers to health care access, and impaired quality of care.... This article suggests areas in which more research is needed and ways to improve research and care of Latino children."]

[Request #S5528]

Return to the Table of Contents

LOS ANGELES

Los Angeles County Department of Health Services: Current Proposals Will Not Resolve Its Budget Crisis, and Without Significant Additional Revenue It May Be Forced to Limit Services. By the Bureau of State Audits, California State Auditor. 2001-119. (The Bureau, Sacramento, California) May 2002. 146 p.

Full Text at: www.bsa.ca.gov/bsa/pdfs/2001119.pdf

["Los Angeles County's health department will be $170 million deeper in the red than it previously estimated, a state audit has found.... Most of the deficit is caused by the end of a billion-dollar federal bailout that has helped the department stay solvent.... The county's health director is to provide recommendations on how to deal with the financial problems." Associated Press (May 31, 2002) 1.]

[Request #S5529]

Return to the Table of Contents

MANAGED HEALTH CARE

Department of Managed Health Care: Assessments for Specialized and Full-Service HMOs Do Not Reflect Its Workload and Have Disparate Financial Impacts. By the Bureau of State Audits, California State Auditor. 2001-126. (The Bureau, Sacramento, California) May 2002. 68 p.

Full Text at: www.bsa.ca.gov/bsa/pdfs/2001126.pdf

["Big HMOs Not Paying Way, Audit Finds: A dispropotionate amount of the department's budget is being paid for by specialized HMOs, while the bulk of the regulatory work is devoted to full service plans.... The report includes proposals such as changing the system so payments are aligned with regulatory activity. Such a change would require altering state law." San Francisco Chronicle (May 31, 2002) B3.]

[Request #S5530]

Return to the Table of Contents

MEDICAL STANDARDS

Ranking of State Medical Boards’ Serious Disciplinary Actions in 2001. By the Health Research Group, Public Citizen. HRG Publication #1616. (Public Citizen, Washington, DC) April 2002. Various pagings.

Full Text at: www.citizen.org/publications/release.cfm?ID=7166

["Medical Boards: 'Major Gap' Found in Disciplinary Actions: The study found that last year, state medical boards nationwide issued 2,708 serious disciplinary actions -- such as license revocations, surrenders, suspensions and probations -- against doctors, or a rate of 3.36 actions per 1,000 physicians.... The rate 'varied widely' between the highest- and lowest- ranked state medical boards." American Health Line (April 11, 2002) 1.]

[Request #S5531]

Return to the Table of Contents

MEDICARE

Medicare + Choice: Who Enrolls? By Kenneth E. Thorpe and others. Emory University (The University, Atlanta, Georgia) April 25, 2002. 30 p.

Full Text at: http://bcbshealthissues.com/relatives/19466.pdf

["A new study finds that low-income and minority Medicare beneficiaries rely 'disproportionately' on Medicare+Choice to provide supplemental health coverage. If M+C coverage were not available, 52% of current beneficiaries would purchase 'relatively more expensive' Medigap coverage, 30% would not be able to afford Medigap policies and would likely not purchase supplemental coverage, and 18% would seek Medicaid coverage, the study says. The end of M+C would particularly affect African-Americans, adding that three out of five black beneficiaries would likely go without supplemental coverage." HandsNet (May 3, 2002) 1.]

[Request #S5532]

Return to the Table of Contents

California Medicare+Choice Members Pay More to Get More. By Peggy Lipper and Craig Paxton, Cattaneo & Stroud, Inc. Prepared for California HealthCare Foundation (The Foundation, Oakland, California) June 2002. 4 p.

Full Text at: www.chcf.org/documents/other/MedicareTrends3.pdf

["This issue compares California Medicare+Choice plans to those in the rest of the country and highlights the range of benefits, prevalence of out-of-pocket expenses, and levels of copayments."]

[Request #S5533]

Return to the Table of Contents

MENTAL HEALTH

Children of Depressed Parents: Mechanisms of Risk and Implications for Treatment. By Sherryl H. Goodman and Ian H. Gotlib. (American Psychological Association, Washington, DC) 2002. 352 p.

[Includes: "Maternal Depression, Infant Psychobiological Development, and Risk for Depression;" "Parental Depression and Child Attachment: Hostile and Helpless Profiles of Parent and Child Behavior Among Families at Risk;" and others. NOTE: Children of Depressed ... is available for 3-day loan.]

[Request #S4577]

Return to the Table of Contents

"Providing Mental Health Services to Young Children in Foster Care: A Family-by-Family, Moment-by-Moment Approach to Change." By Elaine Groppenbacher and others. IN: Zero to Three, vol. 22, no. 5 (April/May 2002) pp. 33-37.

["This article discusses the experiences of a mental health center ... when Araizon's system of financing behavioral health services allowed for services to be offered to children under 4 whose foster or adoptive parent, or case manager, detected problems."]

[Request #S5534]

Return to the Table of Contents

Seclusion and Restraints: A Failure, Not a Treatment: Protecting Mental Health Patients from Abuses. By Laurel Mildred, California Senate Office of Research. (The Office, Sacramento, California) March 2002. 18 p.

Full Text at: www.sen.ca.gov/sor/HEALTH/Restraints.html

["State to Study Use of Restraints for Mental Illness; Patient Deaths Propel Senate Panel Hearings: Report shows that 14 Californians have died in the past three years after they were restrained.... [It] also notes that a maze of bureaucracy makes it impossible to determine how often mental health staffs use restraint to control unruly wards." San Francisco Chronicle (March 21, 2002) A20.]

[Request #S5535]

Return to the Table of Contents

"Anxiety, Affect, and Activity in Teenagers: Monitoring Daily Life With Electronic Diaries." By Barbara Henker, University of California, Los Angeles, and others. IN: Journal of the American Academy of Child and Adolescent Psychiatry, vol. 41, no. 6 (June 2002) pp. 660-670.

["This study finds that the rates of anxiety among teenagers appear unexpectedly high, and their anxiety makes them more prone to overeat and smoke. The study, one of the first to involve teenagers' use of hand-held computer diaries, found that high rates of anxiety led to more frequent episodes of anger, sadness and fatigue and altered teenage behavior significantly. The findings, part of a long-term study, may also provide insight into teenage perceptions and moods that may have changed after the terrorist attacks of Sept. 11, 2001." HandsNet (July 12, 2002) 1.]

[Request #S5536]

Return to the Table of Contents

Mental Health Insurance: Should Mental Health Benefits Equal Medical Benefits? IN: CQ Researcher, vol. 12, no. 12 (March 29, 2002) pp. 265-288.

["More than 30 million Americans suffer from schizophrenia, severe depression and other mental disorders.... Historically, employers' insurance has paid much lower treatment benefits for mental problems than for medical illness. Congress is condsidering broadening the federal law requiring equal treatment -- or 'parity' -- in health insurance. Conservative lawmakers and business lobbies claim the cost of parity is too high."]

[Request #S5537]

Return to the Table of Contents

MINORITIES

Developing a Health Plan Report Card on Quality of Care for Minority Populations. David R. Nerenz and others. Commonwealth Fund. (The Fund, New York, New York) July 2002. 48 p.

Full Text at: www.cmwf.org/programs/minority/nerenz_reportcard_547.pdf

["This report finds that, despite legal and practical concerns, health plans can and should collect data on disparities in quality of care for racial and ethnic minority groups. The study stresses the importance of racial and ethnic data collection as the key to improving quality and eliminating disparities in care. The authors also recommend that standards be developed to indicate what magnitude of disparity should be cause for concern. Analysis of the health plan data revealed that disparities in care often existed between racial and ethnic groups."]

[Request #S5538]

Return to the Table of Contents

National Survey of Physicians: Doctors on Disparities in Medical Care: Highlights and Chartpack. By the Kaiser Family Foundation. (The Foundation, Menlo Park, California) March 2002. 22 p.

Full Text at: www.kff.org/content/2002/20020321a/Physician%20Survey_%20Part%20I_%20Disparities.pdf

["The majority of doctors tend to say the health care system 'rarely' or 'never' treats people unfairly based on various characteristics -- though significant minorities of physicians disagree.... [Those] doctors are more likely to say that the health care system 'very often' or 'somewhat often' treats people unfairly based on their race or ethnicity."]

[Request #S5539]

Return to the Table of Contents

Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. Edited by Brian D. Smedley and others, Institute of Medicine. (National Academy Press, Washington, DC) [March] 2002. 562 p.

Full Text at: www.nap.edu/books/030908265X/html/

["Racial Disparities: IOM Report Finds Broad Inequalities: Minorities in America generally receive poorer health care than whites, even when income, insurance and medical conditions are similar.... The report identified several reasons for the disparities, including language barriers, inadequate coverage, provider bias and a lack of minority doctors." American Health Line (March 21, 2002) 1.]

[Request #S5540]

Return to the Table of Contents

"Racial Disparities in the Quality of Care for Enrollees in Medicare Managed Care." By Eric C. Schneider and others. IN: JAMA: Journal of the American Medical Association, vol. 287, no. 10. (March 12, 2002) pp. 1288-1294.

["Study Says Blacks Get Poorer Medical Care: Researchers looked at federal quality-control records for patients in Medicare managed-care plans. In examining 305,000 cases, they found that blacks were less likely to receive adequate care in all four areas measured: Eye exams for diabetics, preventive drugs after a heart attack, breast cancer screening, and follow-up care after leaving a mental hospital." Boston Globe (March 13, 2002) A1.]

[Request #S5541]

Return to the Table of Contents

What a Difference An Interpreter Can Make: Health Care Experiences of Uninsured with Limited English Proficiency. By Dennis Andrulis and others. Prepared for the Access Project, Brandeis University. (The University, Boston, Massachusetts) April 2002. 16 p.

Full Text at: http://www.accessproject.org/downloads/c_LEPEngembarg.pdf

["This report, based on a survey of 4,161 uninsured respondents ... compares the perceptions and experiences of adults who needed and easily got an interpreter with those who needed and did not get an interpreter (or had difficulty getting one), and with other uninsured who did not need an interpreter. Overall, the uninsured who got an interpreter had similar or more positive experiences at the hospital where they received care than the uninsured without language barriers."]

[Request #S5542]

Return to the Table of Contents

NURSES

Minority Nurses in the New Century: Characteristics and Workforce Utilization Pattern -- A Survey. By the American Nurses Association. (The Association, Washington, DC) February 2002. 96 p.

["Some Nursing Leaders Say Discrimination Can Hamper Minority Recruitment: The survey was based on responses from 5,284 nurses who are African-American, white, Hispanic, Asian-American/Pacific Islander and American Indian/Alaskan Native. African American nurses were more likely than other respondents to say they were denied promotions for jobs for which they were qualified." AMNews (March 11, 2002) 1.]

[Request #S4700]

Return to the Table of Contents

"Nurse Staffing Levels and the Quality of Care in Hospitals." By Jack Needleman, Harvard School of Public Health, and others. IN: New England Journal of Medicine, vol. 346, no. 22 (May 30, 2002) pp. 1715-1722.

["Study Shows Having More RNs Saves Lives: The researchers compared the 25 percent of general medical and surgical patients who received the most nursing care with the 25 percent who got the least.... In some of the most striking findings, medical patients with the greatest proportion of RN care, relative to LPNs and aides, were 9 percent less likely to suffer shock or cardiac arrest or to get a urinary tract infection." Chicago Tribune (May 30, 2002) 10.]

[Request #S5543]

Return to the Table of Contents

The Nursing Shortage: Can Technology Help? By Joanna Case and others, First Consulting Group. Prepared for the California HealthCare Foundation. (The Foundation, Oakland, California) June 2002. 36 p.

Full Text at: www.chcf.org/topics/download.cfm?pg=ihealth&fn=NursingShortageTechnology%2Epdf&pid=87451&itemid=19800

["With the growing adoption and advancement of technology, an increasing need for nurses, and a generation raised with computers reaching employment age, there is no better time for hospitals to explore the wide range of technology that can provide significant benefits for clinicians.... There is hard work still to be done in the automation of clinical processes, but the benefits, glimpsed here, may be tremendous."]

[Request #S5544]

Return to the Table of Contents

NURSING HOMES

Nursing Homes: Federal Efforts to Monitor Resident Assessment Data should Complement State Activities. By the U.S. General Accounting Office. GAO-02-279. (The Office, Washington, DC) February 2002. 48 p.

Full Text at: http://gao.gov/cgi-bin/getrpt?GAO-02-279

["We are making recommendations to the Center for Medicaid and Medicare Services that include determining the adequacy of each state's efforts to ensure minimum data set (MDS) accuracy and providing additional guidance and technical assistance to individual states as needed, routinely monitoring state review activities and progress as part of CMS' own ongoing federal oversight of nursing home quality."]

[Request #S5545]

Return to the Table of Contents

PHYSICIANS

"How Disclosing HMO Physician Incentives Affects Trust; Not All Cost-Minimizing Physician Incentives Are Ethically Troubling to Patients." By Mark A. Hall and others. IN: Health Affairs, vol. 21, no. 2 (March/April 2002) 9 p.

["This study advances understanding of physician incentives and patient trust using a stratified controlled intervention that assesses the impact on trust of disclosing to members of two different HMO plans how the HMO pays its primary care physicians."]

[Request #S5546]

Return to the Table of Contents

PRESCRIPTION DRUGS

Changing Patterns of Pharmaceutical Innovation. By the National Institute for Health Care Management Research and Educational Foundation. (The Foundation, Washington, DC) May 2002. 24 p.

Full Text at: http://www.nihcm.org/innovations.pdf

["Many New Drugs Not Innovative; Some Called Similar to Existing Treatments: Nearly half of all new prescription drugs introduced between 1989 and 2000 may not be much better than existing medications, according to a report. Only 35 percent of drugs approved by the Food and Drug Administration were based on new chemicals acting in new ways to treat a disease.... Most new approvals were modifications of drugs whose active ingredients had already been approved." San Jose Mercury News (May 29, 2002) 1.]

[Request #S5547]

Return to the Table of Contents

"Drug Lists: Putting Formularies to Work to Control Rising Medicaid Rx Drug Costs." IN: State Health Notes, vol. 23, no. 367 (March 11, 2002) pp. 1-2.

["As one answer to rising Medicaid prescription drug costs, a growing number of states are experimenting with 'preferred lists,' with preapproval for excluded products. The industry objects but so far, the courts haven't."

[Request #S5548]

Return to the Table of Contents

Bitter Pill: The Rising Prices of Prescription Drugs for Older Americans. By Families USA. (Familes USA, Washington, DC) June 2002. 24 p.

Full Text at: www.familiesusa.org/BitterPillreport.pdf

["The prices of the 50 most prescribed drugs for older Americans rose, on average, at almost triple the overall rate of inflation last year." San Francisco Chronicle (June 25, 2002) A4.]

[Request #S5549]

Return to the Table of Contents

"Timing of New Black Box Warnings and Withdrawals for Prescription Medications." By Karen E. Lasser and others. IN: JAMA: Journal of the American Medical Association, vol. 287, no. 17 (May 1, 2002) pp. 2215-2220.

["Recently approved drugs may be more likely to have unrecognized adverse drug reactions (ADRs) than established drugs, but no recent studies have examined how frequently postmarketing surveillance identifies important ADRs.... The estimated probability of acquiring a new black box warning or being withdrawn from the market over 25 years was 20%.... Serious ADRs commonly emerge after Food and Drug Administration approval. The safety of new agents cannot be known with certainty until a drug has been on the market for many years."]

[Request #S5550]

Return to the Table of Contents

PUBLIC HEALTH

Participatory Evaluation: What Is It? Why Do It? What Are the Challenges? By Ann Zukoski and Mia Luluquisen. Prepared for the Partnership for the Public's Health. Community-Based Public Health Policy Practice Issue #5. (The Partnership, Oakland, California) April 2002. 6 p.

Full Text at: www.partnershipph.org/col4/policy/apr02.pdf

["Participatory evaluation is a partnership approach to evaluation in which stakeholders actively engage in developing the evaluation and all phases of its implementation.... This policy brief discusses the key concepts of participatory evaluation and some tips for applying it. We also present some real-life examples from two evaluators who work with grantees of the Partnership for the Public's Health Initiative."]

[Request #S5551]

Return to the Table of Contents

RESEARCH

Quality of Health Care in the United States: A Chartbook. By Sheila Leatherman, University of North Carolina School of Public Health, and Douglas McCarthy, Argus Insights. (The Commonwealth Fund, New York, New York) April 2002. 164 p.

Full Text at: www.cmwf.org/programs/quality/leatherman_chbk_520.pdf

["This is a first-of-its kind portrait of the state of health care quality in the United States. Based on over 150 published studies and reports of quality of care, the chartbook contains a series of 54 charts and accompanying analysis that documents serious gaps on many crucial health quality dimensions. It aims to provide an authoritative, comprehensive, and useful resource for policymakers, providers, and the public about quality of care. It also includes a unique section on successful examples of collaborative projects that have led to improvement."]

[Request #S5552]

Return to the Table of Contents

SMOKING

"Lung Tissue Concentrations of Nicotine in Sudden Infant Death Syndrome (SIDS)." By K.I. McMartin and others. IN: Journal of Pediatrics, vol. 140, no. 2, (February 2002) pp. 205-209. CH NTC 02-23 Arrived 4/17/02

["Within both reportedly smoking and nonsmoking families, children who die of SIDS have higher concentrations [of nicotine] in their lungs than control children who die of other causes," state the authors. They hypothesize that measurements of nicotine and/or its metabolite -- cotinine -- in lung tissue samples from pediatric patients may contribute to the understanding of the role of environmental tobacco smoke (ETS) in SIDS. This article reports on a comparison of lung tissue analysis of nicotine and cotinine in SIDS and non-SIDS cases and on stratification according to the smoking status of the household." National Center for Education in Maternal and Child Health (MCH Alert, March 22, 2002)1.]

[Request #S4719]

Return to the Table of Contents

"How the Tobacco Industry Built Its Relationship with Hollywood." By Curtis Mekemson, American Lung Association and Stanton A. Glantz, University of California, San Francisco. IN: Tobacco Control, vol. 11, supplement 1 (2002) pp. i81-i91.

Full Text at: tc.bmjjournals.com/cgi/reprint/11/suplol_1/i81.pdf

["The study examined the ties between Hollywood and cigarette makers by reviewing more than 1,500 previously secret internal tobacco-industry documents, made public through the 1998 tobacco settlement. The study found that tobacco companies aggressively pursued product placement in films in the 1980s and 'undertook an extensive campaign to hook Hollywood on tobacco by providing free cigarettes to actors." Join Together Online (March 13, 2002) 1.]

[Request #S5553]

Return to the Table of Contents

"CDC Sends Expertise Abroad to Help With Tobacco Control." By: By Mary Ellen Butler. IN: U. S. Medicine (July 16, 2002) 1.

Full Text at: www.usmedicine.com/dailyNews.cfm?dailyID=37

["The Center for Disease Control and Prevention (CDC) will be exporting some of its knowledge about tobacco control programs to Vietnam and other parts of Southeast Asia over the next two years."]

[Request #S5554]

Return to the Table of Contents

Does Early Smoking Signal Later Problems? By Rand Health. RB-4547. (RAND, Santa Monica, California) 2002. 4 p.

Full Text at: www.rand.org/publications/RB/RB4547/

["Researchers examined the trajectory of smoking from the middle school years to the end of high school and assessed the association between early smoking and other concurrent high-risk behaviors as well as later behaviors. Even occasional smoking during the middle school years may contribute to later problems, including dropping out of high school.... Smokers were 21 times more likely to engage in marijuana use or drinking on a weekly basis; eight times more likely to engage in binge drinking, and 36 times more likely to use hard drugs."]

[Request #S5556]

Return to the Table of Contents

TERMINALLY ILL PATIENTS

"End-of-Life Care: Movement Promotes Care to Ease Pain for the Terminally Ill." IN: State Health Notes, vol. 23, no. 371 (May 6, 2002) pp. 1-2.

["Most terminally ill patients die in hospitals or nursing homes, often in pain. The 'end-of-life movement' is promoting palliative care as a more humane alternative. Interest is growing, the number of programs across the country is increasing rapidly."]

[Request #S5557]

Return to the Table of Contents

UNINSURED

County Efforts to Expand Health Coverage among the Uninsured in Six California Counties. By Peter Long, UCLA School of Public Health. Prepared for the Medi-Cal Policy Institute. (The Institute, Oakland, California) February 2002. 24 p.

Full Text at: www.medi-cal.org/documents/CountyEffortsToCoverUninsured.pdf

["To address gaps in public coverage at the state level, six California counties have expanded health insurance coverage or created access programs targeting two groups of uninsured individuals. This background paper summarizes major coverage expansions in these six counties (Alameda, Contra Costa, San Francisco, San Joaquin, Santa Clara and Solano.... Summary tables, which describe the major features of each progam and their outreach, enrollment, access, and retention activities, are included."]

[Request #S5558]

Return to the Table of Contents


PREVIOUSLY IN STUDIES IN THE NEWS
[This section links to items in Studies in the News since the last Health Care Supplement.]

HEALTH CARE

"Health." IN: Studies in the News, 02-30 (May 20, 2002).

Full Text at: www.library.ca.gov/SITN/2002/0230.htm

[Includes: "State Children's Health Insurance Program;" "Emergency room visits;" "Trend of tiered hospital plans;" "CalPERS health care choices;" "Medical malpractice insurance crisis;" and others.]

[Request #S5559]

Return to the Table of Contents

"Health." IN: Studies in the News, 02-28 (May 9, 2002).

Full Text at: www.library.ca.gov/SITN/2002/0228.htm

[Includes: "Economics of alcohol abuse policies;" "Long-term care and Olmstead decision;" "Accessible information technology;" "Strategies to curb childhood obesity;" "Substance abuse treatment and diversion programs; and others.] "Untreated sexually transmitted diseases."]

[Request #S5560]

Return to the Table of Contents

"Health." IN: Studies in the News, 02-33 (June 6, 2002).

Full Text at: www.library.ca.gov/SITN/2002/0233.htm

[Includes: "Federal AIDS treatment grants;" "Access to treatments by HIV-infected patients;" "HHS funds for developmental disabilities;" "The consequences of a lack of health insurance;" "Poor medical care for uninsured;" "Marijuana subject to federal laws;" "Congressional action on human cloning;" "Regulation of non-reproductive cloning;" and others.]

[Request #S5564]

Return to the Table of Contents

"Health." IN: Studies in the News, 02-37 (June 28, 2002).

Full Text at: www.library.ca.gov/SITN/2002/0237.htm

[Includes: "Genetic screening of populations;" "Health care policy in California;" "State health policy;" "Employer sponsored health insurance trends;" "Regulatory impact on hospitals;" "Medicare home health care costs;" "SCHIP coverage of fetuses;" and others.]

[Request #S5565]

Return to the Table of Contents

"Health." IN: Studies in the News, 02-41 (July 22, 2002).

Full Text at: www.library.ca.gov/SITN/2002/0241.htm

[Includes: "National survey of health care;" "Osteoarthritis of the knee;" "Health coverage for families;" "Health insurance survey;" "Health policy for low-income people;" "Child obesity triggering illnesses;" "State programs to reduce diversion;" "Covering uninsured parents;" and others.

[Request #S5566]

Return to the Table of Contents