Subject: Studies in the News 07-42 (July 26, 2007)


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


Contents This Week

Introductory Material HEALTH
   SCHIP has been a success
   Fixing SCHIP
   Need for dental care in Contra Costa County.
   Long-term chemical danger for fetuses
   Plan for leafy greens safety
   Berkeley residents live longer
   Reduced risk of heart attack deaths
   Wide use of angioplasty questioned
   Heart disease linked to war stress
   Government underpayment increases private costs
   Uninsured charged more by hospitals
   Hospital must expand care to working poor
   Demand for long-term care expected to rise
   Hospital volume tied to care for premature babies
   Obese workers file more injury claims
   Kids gain more weight in summer
   Some viruses can boost immunities
   More smoking deterrents urged
   Higher disease rates among minority women
PREVIOUSLY IN STUDIES IN THE NEWS
   Studies in the News, April - June 2007
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.

  • California State Employees may contact the State Information & Reference Center (916-654-0206; cslsirc@library.ca.gov) with the SITN issue number and the item number [S#].

  • All other interested individuals should contact their local library - the items may be available there, or may be borrowed by your local library on your behalf.

The following studies are currently on hand:

HEALTH

CHILDREN

The Children’s Health Insurance Program in Action: A State’s Perspective on CHIP. Statement of Genevieve Kenney, The Urban Institute. Submitted before the Committee on Finance, U.S, Senate. (The Institute, Washington, DC) April 4, 2007. 11 p.

Full Text at: www.urban.org/UploadedPDF/901067_Kenney_SCHIP.pdf

[“The research evidence strongly indicates that SCHIP has been a success, leading to improvements in insurance coverage and access to care among low-income children, without crowding out employer coverage on a large scale. The research also clearly indicates that reductions in program funding or eligibility, either to children or their parents, would have adverse effects on the health and well-being of children.”]

[Request #S74201]

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Fixing SCHIP and Expanding Children's Health Care Coverage. By Nina Owcharenko, Heritage Foundation. Backgrounder No. 2029. (The Foundation, Washington, DC) May 2, 2007. 11 p.

Full Text at: www.heritage.org/Research/HealthCare/upload/bg_2029.pdf

[“The large number of uninsured children is universally acknowledged as a serious problem, but policymakers have inappropriately fixated on expanding the State Children’s Health Insurance Program (SCHIP) as the sole solution. Rather than expanding the role of SCHIP, Congress should consider efforts to cover children in the broader context of health reform by refocusing SCHIP to help children in low-income working families, as originally intended, and promoting policy prescriptions that reach beyond SCHIP and improve the health care system for all Americans, including children.”]

[Request #S74205]

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DENTAL CARE

Healthy Teeth for Life: The Oral Health of Children in Contra Costa County. By Padmini Parthasarathy, Family, Maternal and Child Health Programs, Contra Costa Health Services. (FMCH, Martinez, California) April 2007. 32 p.

Full Text at: www.cchealth.org/services/dental/pdf/healthy_teeth_for_life_2007.pdf

[“Untreated dental disease remains a serious problem for low-income children in Contra Costa County, with 12 percent in need of urgent treatment for rotting teeth, infections and other painful conditions. Yet obtaining treatment can be difficult, particularly for those living in the eastern and western edges of the county. Only a handful of local pediatric dentists will accept Denti-Cal patients. The report makes a number of recommendations, including increasing the operating time for dental surgery at Contra Costa Regional Medical Center, training general dentists to treat young children, expanding water fluoridation in East County, and expanding education and prevention programs.” Contra Costa Times (June 12, 2007) 1.]

[Request #S74202]

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ENVIRONMENTAL TOXINS

The Faroes Statement: Human Health Effects of Developmental Exposure to Environmental Toxicants. By the International Scientific Committee of the International Conference on Fetal Programming and Developmental Toxicity. (The Committee, Copenhagen, Denmark) May 24, 2007. 4 p.

Full Text at: www.pptox.dk/Consensus/tabid/72/Default.aspx

[“Many of the world's leading environmental scientists warned that exposure to common chemicals makes babies more likely to develop an array of health problems later in life, including diabetes, attention deficit disorders, prostate cancer, fertility problems, thyroid disorders and even obesity.... In a process called 'fetal programming,' the children then are susceptible to diseases later in life — and perhaps could even pass on those altered traits to their children and grandchildren. The scientists urged leaders not to wait for more scientific certainty and recommended that governments revise regulations and procedures to take into account subtle effects on fetal and infant development.” Los Angeles Times (May 25, 2007) 1.]

[Request #S74203]

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FOOD SAFETY

California Leafy Green Products Handler Marketing Agreement. January 24, 2007. AND: Leafy Greens Marketing Agreement Audit Start Date: Press Release. July 6, 2007. By the California Department of Food and Agriculture, Marketing Branch. (The Department, Sacramento, California)

[“California officials gave the go-ahead for the farm industry's plan to establish voluntary safety standards for leafy vegetables, which supporters hope will restore public confidence and prevent the kind of bacterial contamination that sickened hundreds last year.... Under the plan, the agriculture department will appoint a panel of industry representatives that will have authority to enact safety rules. The state will provide inspectors to help ensure compliance, but the industry board will administer the program and make enforcement decisions. As a first step, the program focuses on 'handlers' -- companies that package or distribute vegetables.” San Jose Mercury News (February 8, 2007) 1.]

Marketing Agreement. 14 p.
marketing agreement

Press Release. 1 p.
press release

[Request #S74204]

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HEALTH STATISTICS

City of Berkeley Health Status Report, 2007. By the City of Berkeley Public Health Division. (The Division, Berkeley, California) May 22, 2007. 206 p.

Full Text at: www.ci.berkeley.ca.us/publichealth/reports/cobhsr2007_entirereport.pdf

[“Berkeley residents have longer, healthier lives than almost anyone else in the Bay Area. The average life expectancy for Berkeley residents is 83, five years longer than the national average and four years longer than their fellow Alameda County residents. One reason for Berkeley's high life expectancy is its demographics. Affluent, educated people in general tend to live longer because they have better access to health care, healthful food, less stressful lives and more time for recreation.” San Francisco Chronicle (May 23, 2007) 1.]

[Request #S74206]

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HEART DISEASE

“Decline in Rates of Death and Heart Failure in Acute Coronary Syndromes, 1999-2006.” By Keith A. A. Fox, and others. IN: Journal of the American Medical Association, vol. 297, no. 17 (May 2, 2007) pp. 1892-1900.

[“Greater use of angioplasty and new drug treatments over the past several years has contributed to a nearly 50% decrease in the number of hospitalized heart attack patients who die or develop severe heart failure. The study noted that the improvements likely were a ‘direct consequence’ of guidelines put in place by heart organizations in the U.S. and Europe. Those guidelines recommend the use of angioplasty and the administration of certain drugs, including aspirin, statins, anti-clotting drugs, blood thinners such as clopidogrel and heparin, and blood pressure drugs such as ACE inhibitors.“ California Healthline (May 2, 2007) 1.]

[Request #S74207]

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“Optimal Medical Therapy with or without PCI for Stable Coronary Disease.” By Boden W. E., and others. IN: New England Journal of Medicine, vol. 356, no. 15 (March 26, 2007) pp. 1503 - 1516.

[“For patients with clogged arteries who have not had a heart attack, the widely used surgical treatment of balloon angioplasty with the insertion of a stent is no better than conventional drug treatment. About 1 million stenting procedures are performed each year, costing about $40,000 per surgery. About 65% are performed on patients such as those in the study. In the rush to perform angioplasty, the effectiveness of drug treatment ‘was lost in the shuffle.'" Los Angeles Times (March 27, 2007) 1.]

[Request #S74208]

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“Prospective Study of Posttraumatic Stress Disorder Symptoms and Coronary Heart Disease in the Normative Aging Study.” By Laura D. Kubzansky, and others. IN: Archives of General Psychiatry, vol. 64, no. 1 (January 2007) pp. 109-116.

[“A study of 1,946 male veterans of World War II and Korea suggests that vets with symptoms of post-traumatic stress disorder are at greater risk of heart attacks as they age. In PTSD, the body's normal hormonal response to stress becomes trigger-happy, scientists believe. Long after traumatic events, people remain edgy, fearful and prone to nightmares and flashbacks. The continual release of adrenaline prompted by these symptoms may wear down the cardiovascular system.” Chicago Tribune (January 2, 2007) 3.]

[Request #S74209]

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HOSPITALS

Cost Shifting in California Hospitals: What Is the Effect on Private Payers? By Daniel P. Kessler, Stanford University. (California Foundation for Commerce and Education, Sacramento, California) June 6, 2007. 28 p.

Full Text at: tinyurl.com/27jbap

["The study finds that government underpayments to hospitals in the Medicare and Medi-Cal programs are a substantial factor in driving up private health care costs, but that the impact on private payers of uncompensated care for the uninsured was minimal."]

[Request #S74210]

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“From ‘Soak The Rich’ To ‘Soak The Poor’: Recent Trends In Hospital Pricing.” By Gerard F. Anderson. IN: Health Affairs, vol. 26, no. 3 (May/June 2007) pp. 780-789.

[“California hospitals charged uninsured patients more than three times what private insurers or government programs would pay for the same services, a higher differential than all but two states in the country. The two-year study examined hospital charges between 1984 and 2004. It found the gap between the rates hospitals charge to uninsured patients and other payers widened greatly over time. Also widening was the ratio between what hospitals charge and what the federal government has determined to be the actual cost of care.” San Francisco Chronicle (May 8, 2007) 1.]

[Request #S74211]

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INSURANCE

Renee Alford, et al. v. Count of San Diego, et al. California Court of Appeals, Fourth Appellate District. D048578. May 23, 2007. 27 p.

Full Text at: www.courtinfo.ca.gov/opinions/documents/D048758.PDF

[“County officials cannot deny medical care to thousands of poor adults with serious illnesses because their incomes exceed a $1,078 monthly cap. In rejecting the policy as illegal, the court wrote that ‘courts have long concluded . . . that a county's obligation to provide subsistence medical care to the poor includes not only those with no ability to pay, but also those with a limited ability to pay, sometimes referred to as the 'working poor.''” San Diego Union-Tribune (May 24, 2007) 1.]

[Request #S74212]

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LONG TERM CARE

Meeting the Long-Term Care Needs of the Baby Boomers: How Changing Families Will Affect Paid Helpers and Institutions. By Richard W. Johnson, and others, The Urban Institute. Retirement Project Discussion Paper 07-04. (The Institute, Washington, DC) May 2007. 61 p.

Full Text at: www.urban.org/UploadedPDF/311451_Meeting_Care.pdf

[“The demand for long-term care services will surge in coming decades when the baby boomers reach their 80s. Declining family sizes, increasing childlessness, and rising divorce rates will limit the number of family caregivers. Rising female employment rates may further reduce the availability of family care, increasing the future need for paid home care. This study projects to 2040 the number of people ages 65 and older with disabilities and their use of long-term care services.”]

[Request #S74213]

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NEONATAL CARE

Level and Volume of Neonatal Intensive Care and Mortality in Very-Low-Birth-Weight Infants. By Ciaran S. Phibbs, and others. IN: New England Journal of Medicine, vol. 356, no. 21 (May 24, 2007) pp. 2165-2175.

[“Infants born very prematurely are up to twice as likely to survive if treated at a high-volume neonatal intensive care unit in a large hospital. Infants receiving care in high-level NICUs with more than 100 premature patients treated annually had the lowest mortality rate at 18%. Mid-level NICU units, which lack ventilators and neonatal surgeons, that treated fewer than 10 infants per year had a premature infant mortality rate of about 32%. Researchers recommended that NICUs in the same regions be consolidated to form larger units with greater volume, which they estimate could prevent 21% of deaths among premature infants.” California Healthline (May 24, 2007) 1.]

[Request #S74214]

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OBESITY

“Obesity and Workers' Compensation: Results From the Duke Health and Safety Surveillance System.” By Truls Ostbye, and others. IN: Archives of Internal Medicine, vol. 167, no. 8 (April 23, 2007) pp. 766-773.

[“Obese employees lost many more workdays and filed twice as many workers' compensation claims, and those cases cost nearly seven times as much as those filed by their slimmer counterparts. The average workers' compensation medical claims cost per 100 employees was $51,019 for obese workers and $7,503 for non-obese workers. Most obese workers lost 13 times as many days of work as their colleagues who weighed less. Obese workers lost an average of 183.63 days of work per 100 employees compared with 14.19. The most common injuries experienced by obese workers affected the lower extremities, wrists or hands, and backs. Most injuries were caused by falls and lifting.” San Francisco Chronicle (April 24, 2007) 1.]

[Request #S74215]

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“The Effect of School on Overweight in Childhood: Gain in Body Mass Index During the School Year and During Summer Vacation.” By Paul T. von Hippel, and others. IN: American Journal of Public Health, vol. 97, no. 4 (April 2007) pp. 696-702.

[“The nation's schools often are blamed for the growing numbers of overweight youth, but a national study found that young children actually got fatter during their summer breaks than while in school. The BMIs of children in the study increased on average more than twice as much during summer breaks, with Hispanic and African-American students seeing even larger increases. This gap in the growth rate of Hispanic and African-American students' BMIs did not exist during the school year. Researchers concluded that school diet and exercise policies contribute less to childhood obesity than what children do outside of school.” Press Release, Indiana University (February 28, 2007) 1.]

[Request #S74216]

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RESEARCH

“Herpesvirus Latency Confers Symbiotic Protection From Bacterial Infection.” By Erik S. Barton, and others. IN: Nature, vol. 447, no. 7142 (May 17, 2007) pp. 326-329.

[“Viruses, like those that cause genital herpes and mononucleosis, appear to bolster immunities to the plague and a certain kind of food poisoning -- at least in lab mice. These viruses may be important in crafting our immune system, encouraging humans to look at viruses not as a biological nuisance, but as a crucial partner in evolutionary biology. What the study shows is that viruses, like the bacteria in someone's gut, aren't always harmful.” San Francisco Chronicle (May 17, 2007) 1.]

[Request #S74217]

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SMOKING

Ending the Tobacco Problem: Blueprint for the Nation. By the Committee on Reducing Tobacco Use, Institute of Medicine. (The Institute, Washington, DC) May 2007. 8 p.

Full Text at: www.iom.edu/Object.File/Master/43/183/Tobacco%20report%20brief%20general.pdf

[“The percentage of Americans who light up has been cut in half, tobacco companies have paid billions of dollars in legal settlements and smoking has come to be widely reviled as a nasty habit. But that is not enough, a report said that called for several new measures to further drive down tobacco use. The report calls for state and local governments to ban smoking in malls, restaurants and virtually all other public indoor settings, and for the Food and Drug Administration to regulate the marketing, packaging and sale of tobacco products.” Washington Post (May 25, 2007) A3.]

[Request #S74218]

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WOMEN

Health Indicators for Women in Los Angeles County: Highlighting Disparities by Ethnicity and Insurance Status. By the Los Angeles County Department of Public Health, Office of Women’s Health. (The Department, Los Angeles, California) May 2007. 20 p.

Full Text at: www.lapublichealth.org/owh/docs/final%20data%20report%20pdf.pdf

[“Minority women living in Los Angeles County suffer disproportionate rates of chronic disease. Women in general have higher rates of diabetes, high blood pressure, high cholesterol, arthritis, asthma and depression than men. The two leading causes of death among women overall were heart disease and stroke. Particularly startling, rates of obesity among all women have climbed to 20%. African American women had the highest mortality rate of any group, with more than half at risk for developing heart disease.” Los Angeles Times (May 24, 2007) 1.]

[Request #S74219]

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

HEALTH CARE POLICY

"Health." IN: Studies in the News, (May 2007 - June 2007).

[Includes:  "Health risk of ethanol," "The state of diabetes complications," "Weighing the costs of a pandemic," "Nursing home review critical," "TV food advertising to children," "Medicine errors kill thousands," "Hidden tax on health insurance," "Panel develops nutrition standard for schools," "California women’s health," "Palliative care in California," "SCHIP moves children from private to government insurance," "Transforming Medi-Cal," and "Health care issues for aging female population."]

[Request #S74220]

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