Subject: Studies in the News 02-77 (December 19, 2002)


CALIFORNIA RESEARCH BUREAU
CALIFORNIA STATE LIBRARY
Studies in the News


Contents This Week

Introductory Material HEALTH
   State strategies for health coverage
   Filters blocking access to health information
   Addressing asthma in schools
   Brain cancer and cellular phones
   Healthy Start is proven program
   Oral health legislation
   Medicaid buy-in programs for disabled workers
   State aid for substance abuse treatment
   Prevention of fatal drug overdoses
   Mercury and health
   Managing health care costs
   Health care cost survey
   Curing a crisis in malpractice
   Doctors' relutance to deal with HMOs
   Fewer doctors caring for the indigent
   Marijuana for medical purposes
   Medicaid enrollment trends
   Hospital nurse staffing
   Quality of nursing homes
   Pregnancies late in reproductive age
   Seniors and prescription drugs
   Employer drug benefit plans
   Public health law and ethics
   State of vaccinations
PREVIOUSLY IN STUDIES IN THE NEWS
   Studies in the News, November 22, 2002
   Studies in the News, December 12, 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

ACCESS TO CARE

Assessing State Strategies for Health Coverage Expansion: Summary of Case Studies of Oregon, Rhode Island, New Jersey, and Georgia. By Sharon Silow-Carroll, Economic and Social Research Institute, and others. (The Commonwealth Fund, New York, New York) November 2002. 106 p.

Full Text at: www.cmwf.org/programs/insurance/silow-carroll_statestrategieslong_565.pdf

["States are carrying out their own innovative programs to increase the number of residents with health insurance coverage..... While states have recently faced the challenge of sustaining gains in health insurance coverage due to budget shortfalls, they have also overcome barriers and made significant progress in expanding health insurance, and can provide lessons for other states."]

[Request #S6950]

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Does Pornography-Blocking Software Block Access to Health Information on the Internet? By Caroline R. Richardson, University of Michigan Medical School, and others. IN: JAMA: Journal of the American Medical Association, vol. 288, no. 22 (December 11, 2002) pp. 2887-2894.

["Teenagers who look to the Internet for health information as part of their 'wired generation' birthright are blocked from many useful sites by antipornography filters that federal law requires in school and library computers, this new study has found. 'A little bit of filtering is O.K., but more isn't necessarily better,' said Vicky Rideout, Vice President of the Henry J. Kaiser Family Foundation, which produced the report." New York Times (December 11, 2002)]

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ASTHMA

Strategies for Addressing Asthma Within a Coordinated School Health Program. By Centers for Disease Control and Prevention. (The Centers, Atlanta, Georgia) 2002. 12 p.

Full Text at: www.cdc.gov/nccdphp/dash/00_pdf/asthma.pdf

["Asthma-friendly schools are those that make an effort to create safe and supportive learning environments for students with asthma and have policies that allow students to manage their asthma. This CDC manual offers guidance on reaching these objectives."] Connect for Kids (December 2, 2002)]

[Request #S6952]

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CANCER

"Cellular and Cordless Telephones and the Risk for Brain Tumours." By L. Hardell and others. IN: European Journal of Cancer Prevention, vol. 11, no. 4 (August 2002) pp. 377-386.

["Microwave exposure from the use of cellular telephones has been discussed in recent years as a potential risk factor for brain tumours. We included in a case-control study 1617 patients aged 20-80 years of both sexes with brain tumour diagnosed.... In total, use of analogue cellular telephones gave an increased risk with an odds ratio of 1.3 (91% confidence interval(CI) 1.02-1.6).... No clear association was found for digital or cordless telephones."]

[Request #S6953]

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CHILDREN

Proven and Promising Programs: Healthy Start. By the Promising Practices Network. (The Network, Santa Monica, California) November 2002. 8 p.

Full Text at: www.promisingpractices.net/program.asp?programid=118#contactinformation

["A new addition to the Promising Practice Network details a program description to learn how this program helps to reduce infant mortality and increase birth weights of babies born to at-risk mothers. The Healthy Start program combines strong case management with efforts to increase public awareness in high-risk communities to achieve significant improvements in maternal and infant health." HandsNet (November 18, 2002)]

[Request #S6954]

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DENTAL CARE

State of the States: Overview of 2002 Oral Health State Legislation. By the Center for Policy Alternatives. (The Center, Washington, DC) 2002. 12 p.

Full Text at: www.stateaction.org/issues/healthcare/dental/2002.pdf

["This policy brief tracks the newest wave of state legislation on oral health. It is anticipated that with this information, analysts can understand the directions that state policymakers are taking, and identify 'best practices' that should be highlighted across the states."]

[Request #S6955]

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DISABILITIES

Medicaid Buy-In Programs for Workers with Disabilities. By Donna Folkemer, National Conference of State Legislatures. Legisbrief. Vol. 10, No. 46. (NCSL, Denver, Colorado) November/December 2002. 2 p.

["Congress gave states, in 1997 and 1999, opportunities to extend Medicaid coverage to working people with disabilities, with the Medicaid buy-in program. Disabled workers who have sufficient income share in the cost of the program, that is -- 'buy in' to Medicaid -- through monthly premium payments or services co-payments. Twenty-four states are operating these programs."]

[Request #S6956]

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DRUG USE

Substance Abuse: State Actions to Aid Recovery. By National Governors Association Center for Best Practices. (The Center, Washington, DC) October 2002. 11 p.

Full Text at: www.nga.org/cda/files/1002SUBSTANCEABUSE.pdf

[“The hidden costs of substance abuse and chemical dependency place an enormous burden on state budgets, economic productivity, and the well being of individuals and families. Of the $81.3 billion that states spent on substance abuse in 1998, approximately $78.3 billion (95.3 percent) went toward eradicating the crime, death, disease, and other social problems associated with the use of alcohol, tobacco, and illicit drugs. Only $3.4 billion (3.7 percent) was spent on the direct treatment and prevention of substance abuse and chemical dependency. Collectively, however, the costs account for 13 percent of total state spending.”]

[Request #S6957]

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“Predictors And Prevention Of Nonfatal Overdose Among Street-Recruited Injection Heroin Users In The San Francisco Bay Area, 1998-1999.” By K. H. Seal and others. IN: American Journal of Public Health, vol. 91 no. 11 (November 2001) pp. 1842-1846.

Full Text at: itsa.ucsf.edu/~uhs/od.ajph.pdf

[“In the newest twist in harm reduction among users of dangerous drugs, a controversial study conducted here suggests that heroin addicts can be trained to treat fellow junkies against potentially fatal overdoses…. Supplied with syringes containing the anti-overdose drug naloxone and trained in cardio-pulmonary resusitation, the users were able to take timely lifesaving measures with a drug now available only to physicians and paramedics. The moment a companion had an overdose reaction, the trained addict injected the drug into the victim’s leg or shoulder.” Los Angeles Times (December 2, 2002) 1.]

[Request #S6958]

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ENVIRONMENTAL TOXINS

"Mercury, Fish Oils, and the Risk of Myocardial Infarction." By Eliseo Guallar and others. "Mercury and the Risk of Coronary Heart Disease in Men." By Kazuko Yoshizawa and others. IN: New England Journal of Medicine, vol. 347, no. 22 (November 28, 2002) pp. 1747-1754; 1755-1760.

["Two studies ... on the long-term effects of mercury exposure on the hearts of middle-age and elderly men had opposite findings. One found no clear link between mercury levels and the risk of heart disease; and the other found that men who had suffered a heart attack had higher mercury levels. Experts agreed that more research is needed and that people should not stop eating fish." The Press Enterprise (November 28, 2002) A4.]

[Request #S6959]

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HEALTH CARE INDUSTRY

Managing Health-Care Costs: Lessons from the Private Sector. By National Governors Association Center for Best Practices. (The Center, Washington, DC) October 2002. 9 p.

Full Text at: www.nga.org/cda/files/1002HEALTHCARE.pdf

[“Escalating health-care costs are placing tremendous pressure on corporate profits and the solvency of state budgets.... Both the public and private sectors are aggressively seeking proven methods to control medical expenditures.”]

[Request #S6962]

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HEALTH CARE POLICY

Health Care Cost Survey: 2003. By Towers Perrin (Towers Perrin, New York, New York) October 2, 2002. 1 p.

Full Text at: www.towers.com/towers_news/news/pressrelease_2002/pr100202.htm

["For the fourth consecutive year, large employers will experience a double-digit increase in their health care costs, according to the preliminary results of the 2003 Towers Perrin Survey.... The survey found that the cost of large employers' health benefit plans will increase 15% on average in 2002 and that HMO increases outpaced increases in other types of health plans."]

[Request #S6963]

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MALPRACTICE

Curing a Crisis in Medical Malpractice. By Cheye Calvo and Erica Knievel, National Conference of State Legislatures. Legisbrief. Vol. 10, No. 38. (NCSL, Denver, Colorado) October 2002. 2 p.

["Four types of action -- prevention, tort reform, alternatives to litigation and insurance options -- characterize potential state initiatives to improve the equity, efficiency and consistency of medical malpractice systems.... Many states authorize joint underwriting associations to serve as malpractice insurers of last resort."]

[Request #S6964]

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MANAGED HEALTH CARE

California Physicians 2002: Practice and Perceptions. By Kevin Grumbach and others, The Center for the Health Professions, University of California, San Francisco. (The Center, San Francisco, California) December 2002. 69 p.

Full Text at: www.futurehealth.ucsf.edu/pdf_files/Phass2.pdf

["If you're covered by an HMO, finding a doctor can be next to impossible. Only 58 percent of the state's doctors are accepting new HMO patients, say researchers at the University of California-San Francisco who surveyed more that 1,000 physicians. And more than a third of the state's specialty physicians have no HMO patients at all." San Jose Mercury News(December 4, 2002)1.]

[Request #S6965]

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Mounting Pressures: Physicians Serving Medicaid Patients and the Uninsured, 1997-2001. By Peter J. Cunningham, Center for Studying Health System Change. (The Center, Washington, DC) December 2002. 4 p.

Full Text at: www.hschange.com/CONTENT/505/

["A growing number of America's doctors have stopped providing Medicare to the poor, according to a new study that blames increasing financial pressure on medical practices. The report found that the percentage of physicians who provide charity care for little or no charge dropped to 71.5 percent last year from 76.3 percent in 1997. During the same period, the percentage of doctors who treat patients with Medicaid, or Medi-Cal in California, declined to 85.4 percent from 87.1 percent." San Diego Union Tribune (December 5, 2002) C1.]

[Request #S6966]

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MARIJUANA

Marijuana: Early Experiences with Four States' Laws That Allow Use for Medical Purposes. By U.S. General Accounting Office. (The Office, Washington, DC) November 2002. 63 p.

Full Text at: www.gao.gov/cgi-bin/getrpt?GAO-03-189

["We selected Oregon, Alaska, Hawaii and Calfornia because they had marijuana laws in effect for at least six months and data was available on patient and physician participation. For these states, we are reporting on (1) their approach to implementing their medical marijuana laws;(2)the number, age, gender and medical conditions of patients;(3)how many doctors are known to have recommended marijuana; and (4)perceptions of federal and state law enforcement officials."]

[Request #S6967]

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MEDICAID

Managing Medicaid Take-Up: Medicaid Enrollment Trends: 1995 - 2000. By Courtney E. Burke and Craig W. Abbey, Federalism Research Group, The Nelson A. Rockefeller Institute of Government. (The Institute, Albany, New York) August 2002. 20 p.

Full Text at: www.rockinst.org/publications/federalism/brief_73002.pdf

["This report examines trends in Medicaid enrollment among low-income adults and children between 1995, the last year before the passage of welfare reform, and 2000 the last year for which complete enrollment data are available. It also examines Medicaid 'take-up,' or states' success in enrolling those who are elibible for Medicaid."]

[Request #S6968]

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NURSES

"Hospital Nurse Staffing and Patient Mortality, Nurse Burnout, and Job Dissatisfaction." By Linda H. Aiken. IN: JAMA: Journal of American Medical Association, vol. 288, no.16 (October 23, 2002) pp. 1987-1993.

["[A] study ... documents the link between nurse staffing and increased risk of patients dying after surgery, as well as with increased nurse burnout and job dissatisfaction.... Investigators for the latest study found that when nurse caseloads exceeded four patients, the risk of a patient's dying increased by about 7%. If one nurse is caring for eight patients, that patients are 31% more likely to die." Contra Costa Times (October 24, 2002) A13.]

[Request #S6969]

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NURSING HOMES

California Nursing Home Search: Web Site Overview and Research Findings. By the California HealthCare Foundation. (The Foundation, Oakland, California) October 2002. 21 p.

Full Text at: www.calnhs.org/documents/research/CalNHS_overview_project_findings.pdf

["Most California Nursing Homes Don't Meet Health, Safety Standards: The study analyzed publicly available federal and state inspection records and other data to examine the quality of the state's nursing homes. Its findings are included in a new web site that people looking for nursing home care can use to review the records of different facilities." San Jose Mercury (October 16, 2002) A1.]

[Request #S6970]

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PREGNANCY

"Pregnancy in the Sixth Decade of Life: Obstetric Outcomes in Women of Advanced Reproductive Age." By Richard J. Paulson and others. IN: JAMA: Journal of American Medical Association, vol. 288 no. 18 (November 13, 2002) pp. 2320-2323.

["Women in their sixth decade of life can get pregnant with relative ease using eggs from younger women and can expect to have reasonably normal pregnancies and healthy outcomes, according to a new study.... The new findings confirm previous evidence that it is older women's eggs, not their wombs that go into decline at menopause, leading to age-related fertility problems." Sacramento Bee (November 13, 2002) A8.]

[Request #S6972]

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PRESCRIPTION DRUGS

Californa Seniors and Prescription Drugs. By Tricia Neuman and others. The Henry J. Kaiser Family Foundation and Tufts-New England Medical Center. (The Foundation, Menlo Park, California) November 2002. 39 p.

Full Text at: www.kff.org/content/2002/6058/6058v2.pdf

["The absence of a Medicare drug benefit affects seniors nationwide -- including the 3.4 million seniors who live in Californa. In the past, seniors have relied upon a variety of insurance sources to supplement Medicare and help with their drug cost. However, access to drug coverage is on the decline mainly due to the erosion of both employer sponsored retiree health plans and Medicare+Choice offerings."]

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"Employer Drug Benefit Plans and Spending on Prescription Drugs." By Geoffrey F. Joyce and others. IN: JAMA: Journal of the American Medical Association, vol. 288, no. 14 (October 9, 2002)pp 1733-1739.

["Spending on outpatient prescription drugs has increased at double-digit rates for the past decade and is now the third largest component of health care expenses behind hospital care and physician services.... With spending rising so rapidly for working-aged adults, many employers and health insurance providers have changed their benefits packages to encourage less and lower-cost pharmaceutical drugs."]

[Request #S6974]

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PUBLIC HEALTH

Public Health Law and Ethics. Edited by Lawrence O Gostin. (University of California Press, Berkeley, California) 2002. 523 p.

["In this book, [Lawrence Gostin] offers a critical analysis and synthesis of law and science that promises to improve the effectiveness of public policy in enhancing the health of populations. The articles collected in the Reader and Gostin's commentary on them demonstrate the significance of law and the analysis of it for effective health policy." NOTE: Public Health Law ... is available for 3-day loan.]

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VACCINES

The Jordan Report 20th Anniversary: Accelerated Development of Vaccines 2002. By the National Institute of Health, U.S. Department of Health and Human Services, and National Insitute of Allergy and Infectious Diseases. (The Institute, Bethesda, Maryland) November 2002. 267 p.

Full Text at: www.niaid.nih.gov/dmid/vaccines/jordan20/jordan20_2002.pdf

["This edition describes the state of the science, reviews the last two decades, and highlights important achievements in the field of vaccinology, including new vaccines for hepatitis B and Haemophilus influenzae type b, and an improved vaccine against whooping cough.... The report is intended to inform policymakers, researchers, and the public about recent accomplishments and future trends in vaccine research." National Center for Education in Maternal and Child Health and Georgetown University's MCH Alert (November 22,2002) online.]

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

HEALTH CARE

"Health." IN: Studies in the News, 02-71 (November 22, 2002).

Full Text at: www.library.ca.gov/SITN/2002/0271.htm

[Includes: "Ecstasy drug use;" "Increase health insurance costs;" "Sacramento area hospital costs;" "Federal grants for immunization;" "Disparities in childhood immunization rates;" "Health care for psychiatric disorder;" "Nursing home databases;" "Vaccination and autism;" and others.]

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"Health." IN: Studies in the News, 02-74 (December 12, 2002).

Full Text at: www.library.ca.gov/SITN/2002/0274.htm

[Includes: "Lack of transportation to health care;" "Air pollution and medical costs;" "Hormones and Alzheimer's;" "Growth hormones and healthy people;" "Free rein for states' tobacco funds;" and others.]

[Request #S6978]

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