Subject: Studies in the News 04-47 (July 13, 2004)


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


Contents This Week

Introductory Material HEALTH
   Accessing specialty care for the uninsured
   Public insurance programs
   Biomedical research and development industry
   Prostate cancer test misses some tumors
   Few women receive mammograms
   Toxic chemicals in computer dust
   Workforce needs in California's homecare system
   Use of alternative medicines
   Labor force status and insurance coverage
   Insurance coverage for middle class
   Benefits cost crisis
   Radio stations promoting health
   Uncompensated care for aliens
   Medical malpractice trials and verdicts
   Advantages to preferred provider organizations
   Medicare transformation in chronic care
   Nutrition education programs
   Public health emergency preparedness
   Assisted living and consumer protection
   Environmental tobacco smoke
   Adult smoking reduction
   Characteristics of the uninsured
   Cost of medical coverage for the uninsured
PREVIOUSLY IN STUDIES IN THE NEWS
   Studies in the News, June 2004
   Studies in the News, June 2004
Introduction to Studies in the News

Studies in the News: Children and Family Supplement is a service provided to the First 5 California by the California State Library. The service features weekly lists of current articles focusing on Children and Family policy. Prior lists can be viewed from the California State Library's Web site at www.library.ca.gov/CRB/SITN/.

How to Obtain Materials Listed in SITN:

  • When available on the Internet, 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

ACCESS TO CARE

Examining Access to Specialty Care for California's Uninsured. By Mathematica Policy Research, Inc. Prepared for the California Healthcare Foundation. Issue Brief. (The Foundation, Oakland, California) May 2004. 7 p.

Full Text at: www.chcf.org/documents/insurance/AccessToSpecialtyCareForCalifUninsuredIB.pdf

["This issue brief attempts to answer the questions: How, and with what ease, are California's uninsured able to obtain specialty care, and how does their experience vary around the state? The research team found widespread problems ... with many communities experiencing worse access compared to just a few years ago.... [It] also lists short-term action steps for local health leaders ... and longer-term implications for state and national policymakers."]

[Request #S3408]

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Access to Physicians in California's Public Insurance Programs. By Mathematica Policy Research, Inc. Prepared for the California Healthcare Foundation. (The Foundation, Oakland, California) May 26, 2004. 17 p.

Full Text at: www.chcf.org/documents/policy/AccessToPhysiciansInCAPublicProgramsIB.pdf

["This issue brief provides insight into the issues associated with physician access for people covered by California's Medi-Cal and Healthy Families programs. The authors summarize five studies and the results of an extensive review of literature.... The findings underscore areas for improvements in California's public insurance programs and suggest dimensions of access that should continue to be monitored."]

[Request #S3409]

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BIOTECHNOLOGY

Biomedicine: The Next Wave for California's Economy. By David L. Gollaher, California Healthcare Institute, and Tracy Lefteroff, PriceWaterhouseCoopers LLP. (The Institute, La Jolla, California) 2002. 33 p.

["This report reflects a quarter century of public and private investment in biomedical research and development, and robust collaboration between academic institutions and commercial companies.... As they invent new treatments and cures for disease, California biomedical firms are creating high-quality, knowledge-intensive jobs."]

[Request #S3410]

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CANCER

"Prevalence of Prostate Cancer among Men with a Prostate-Specific Antigen Level 4.0 ng per Milliliter." By Ian M. Thompson and others. IN: New England Journal of Medicine, vol. 350, no. 22 (May 27, 2004) pp. 2239-2246.

Full Text at: content.nejm.org/cgi/content/short/350/22/2239

["Significant numbers of older men whose results on a popular screening test for prostate cancer are normal may nonetheless have cancer, a new study has found. The result raises questions about what a normal test score should be and whether these men are better off let alone or treated when, through biopsies, cancer cells are discovered. New York Times (May 27, 2004) A1.]

[Request #S3411]

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"Mammographic Screening: Patterns of Use and Estimated Impact on Breast Carcinoma Survival." By Karen Blanchard and others. IN: Cancer (June 21, 2004) online.

["Despite more than a decade of urging by doctors that women over 40 should receive mammograms yearly, few actually do so, according to a large cancer study. Only 6 percent of women who received a mammogram in 1992 received mammograms yearly for the next 10 years, according to a study of 72,417 women of all ages at Massachusetts General Hospital, the largest look at mammography to date." The Boston Globe (June 21, 2004) A2.]

[Request #S3412]

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ENVIRONMENTAL TOXINS

Brominated Flame Retardants in Dust on Computers: The Case for Safer Chemicals and Better Computer Design. By Alexandra McPherson and others. (Computer TakeBack Campaign) June 2004. 43 p.

Full Text at: www.computertakeback.com/docUploads/bfr%5Freport%2Epdf?CFID=4852596&CFTOKEN=83036781

["Dust on personal computers and other electronic gadgets can be contaminated with toxic substances that could lead to neurological and reproductive health problems, according to a report.... The toxic substances consist of manufacturing chemicals, called brominated flame retardants, which are used to help make PCs and other devices fire-resistant, the study said." San Francisco Chronicle (June 4, 2004) C1.]

[Request #S3413]

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HEALTH CARE

"Workforce Needs in California's Homecare System." By Eileen Boris and others, California Policy Research Center. CPRC Briefing Paper. (The Center, Berkeley, California) May 24, 2004. 7 p.

Full Text at: www.ucop.edu/cprc/boris.pdf

["In-Home Supportive Services (IHSS) enables more than 300,000 low-income elderly and younger disabled recipients to stay in their homes rather than live in more expensive institutional settings.... IHSS is key to California's compliance with the Olmstead decision, which requires that states provide services that allow people with disabilities to live in community settings rather than institutions. Proposed budget cuts in wages, benefits, and services will slow the growth and increase turnover of the workforce, make it more difficult to match consumers with competent providers, and severely undermine the effectiveness and integrity of IHSS."]

[Request #S3414]

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Complementary and Alternative Medicine Use Among Adults: United States, 2002. By Patricia M. Barnes and others, Centers for Disease Control and Prevention. Vital and Health Statistics. No. 343. (The Centers, Atlanta, Georgia.) May 27, 2004. 20p.

Full Text at: www.cdc.gov/nchs/data/ad/ad343.pdf

["Drawing from a long list of 'alternative' medical therapies as diverse as the Atkins diet, acupuncture, homeopathy and prayer, federal health researchers reported that nearly two out of three Americans were using unconventional approaches to mend their bodies or maintain their health." San Francisco Chronicle (May 28, 2004) A1.]

[Request #S3415]

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HEALTH INSURANCE

Labor Force Status and Insurance Coverage, 1999 and 2002: Health Policy Online. By Jack Hadley, Urban Institute. Health Policy Online. No. 7. (The Institute, Washington, DC) May 2004. 9 p.

Full Text at: www.urban.org/UploadedPDF/1000643_healthpolicyonline_no7.pdf

["The study examined changes in coverage among the employed, the unemployed, and those not in the labor force. During this period, the number of people who were unemployed or out of the labor force increased. The number of uninsured adults increased by 1.9 million between 1999 and 2002. The largest increase occurred among the unemployed, whose uninsurance rate went from 33.7 percent in 1999 to 34.6 percent in 2002." Assessing the New Federalism (May 20, 2004) 1.]

[Request #S3416]

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Changes in Insured Coverage and Access to Care for Middle-Class Americans, 1999-2002. By Linda J. Blumberg and John Holahan, Urban Institute. Health Policy Online. No. 8. (The Institute, Washington, DC) May 2004. 10 p.

Full Text at: www.urban.org/UploadedPDF/1000644_healthpolicyonline_no8.pdf

["The authors found that the low-income population was the hardest hit by the economic decline. Low-income adults were particularly adversely affected because the decline in employer-sponsored insurance was only slightly offset by the increase in Medicaid and state program coverage.... Among lower-middle-income adults the number reporting unmet need for care increased significantly, primarily because of unmet need for prescription drugs."]

[Request #S3417]

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The Benefits Cost Crisis: Causes, Consequences and Solutions: Executive Summary. By Deloitte and Touche and the UCLA Anderson Forecast. March 25, 2004. 11 p.

["Health care and business leaders met with economists and researchers ... to share their opinions regarding solutions to the rippling impacts of rising health care costs on American business.... For the third straight year, premiums increased in the double digits last year.... The total bill for health care in 2002 came to $1.55 trillion -- approximately 14% of GDP."]

[Request #S3418]

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IMMIGRATION & IMMIGRANTS

"Radio is Good for Immigrant's Health: Native Language Radio Stations Take the Lead in Promoting the Health of Immigrant Children." By Julieta Santana, Action Alliance for Children. IN: Children's Advocate (May-June 2004) 2 p.

Full Text at: www.4children.org/pdf/504radio.pdf

["Radio Bilingüe recently received an award from the National Partnership for Immunization for getting a record number of children vaccinated. In the Bay Area, Northeast Medical Services credits their success in enrolling a record number of children in Healthy Families to local Chinese radio stations, Sing Tao 96.1 and KEST 1450 AM. In Orange County, Tu Nha Den Truong (From Home to School), a weekly Vietnamese radio show on parenting and child development is one of the most listened to programs on VNCR 106.3 FM radio station."]

[Request #S3419]

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Undocumented Aliens: Questions Persist about Their Impact on Hospital's Uncompensated Care Costs. By the U.S. General Accounting Office. GAO-04-472. (The Office, Washington, DC) May 28, 2004. 39 p.; Appendices.

Full Text at: www.gao.gov/cgi-bin/gertrpr?GAO-04-472 .

["GAO outlined the several sources of federal funding available to help hospitals cover the costs of care for undocumented aliens, including Medicaid coverage for emergency medical services, supplemental Medicaid payments to hospitals treating a disproportionate share of low-income patients, and $100 million in funds made available to 12 states, including California, for FY 1998-2001 for emergency services to undocumented aliens."]

[Request #S3420]

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MALPRACTICE

Medical Malpractice Trials and Verdicts in Large Counties, 2001. By Thomas H. Cohen, Bureau of Justice Statistics. Civil Justice Data Brief. NCJ 203098. (The Bureau, Washington, DC) 2004. 2 p.

Full Text at: www.ojp.usdoj.gov/bjs/pub/pdf/mmtvlc01.pdf

["Of the 1,156 medical malpractice trials litigated in the Nation's 75 most populous counties during 2001, most were disposed of by jury trial (96%). In an estimated 9 out of 10 medical malpractice trials, the alleged harm involved either a permanent injury (57%) or a death claim (33%). About half of the sampled medical malpractice trials were brought against surgeons, while a third were against nonsurgeons."]

[Request #S3421]

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MEDICARE

Preferred Provider Organizations and Medicare: Is There an Advantage? By Robert E. Hurley and others, Center for Studying Health System Change. Issue Brief. (The Center, Washington, DC) 2004. 4 p.

Full Text at: www.hschange.org/CONTENT/671/671.pdf

["A key component of the new Medicare reform law is an overhaul of Medicare managed care, including a strong emphasis on recruiting private plans —- especially preferred provider organizations (PPO).... This study, based on findings from ... site visits to 12 nationally representative communities, explores the reasons for the strong growth in commercial PPO enrollment and examines whether PPOs ... can add value to Medicare."]

[Request #S3422]

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Chronic Care Improvement: How Medicare Transformation Can Save Lives, Save Money, and Stimulate an Emerging Technology Industry. By the Information Technology Association of America. (The Association, Arlington, Virginia) May 2004. 11 p.

Full Text at: www.itaa.org/isec/docs/choniccare.pdf

["Improvements in the care of Medicare patients with severe chronic conditions could prevent 1.7 million hospitalizations and produce more than $30 billion in savings each year, according to the Information Technology Association of America." Health Care Policy Report (May 17, 2004) 686.]

[Request #S3423]

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OBESITY

Nutrition Education: USDA Provides Services Through Multiple Programs, but Stronger Linkages among Efforts Are Needed. By U.S. General Accounting Office. (The Office, Washington, DC) April 2004. 56 p.

Full Text at: www.gao.gov/new.items/d04528.pdf

["The Centers for Disease Control and Prevention recently reported that poor nutrition and lack of physical activity are catching up to tobacco use as the leading cause of death in the United States.... To help improve nutrition, the U.S. Department of Agriculture provides nutrition education through five of its programs.... GAO identified several key actions ... that increased the likelihood that programs providing nutrition education will achieve their goals."]

[Request #S3424]

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PUBLIC HEALTH

"How Prepared Are Americans For Public Health Emergencies? Twelve Communities Weigh In: U.S. Communities Have Made Much Progress Since 9/11, But Gaps in Preparedness Still Remain." By Megan McHugh, Mathematica Policy Research, and others. IN: Health Affairs, vol. 23, no. 3 (May/June 2004) pp. 201-209.

Full Text at: content.healthaffairs.org/cgi/reprint/23/3/201

["Since the terrorist attacks of 11 September 2001, emergency preparedness has become a top priority in metropolitan areas, and some of these areas have received considerable federal funding to help support improvements. Although much progress has been made, preparedness still varies across communities.... Experience with other public health emergencies, strong leadership, successful collaboration, and adequate funding contributed to high states of readiness. Important challenges include a shortage of funding, delay in the receipt of federal funding, and staffing shortages."]

[Request #S3425]

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RESIDENTIAL CARE

Assisted Living: Examples of State Efforts to Improve Consumer Protection. By the U.S. General Accounting Office. GAO-04-684. (The Office, Washington, DC) April 5, 2004. 44 p.

Full Text at: www.gao.gov/new.items/d04684.pdf

["Consumers faced with choosing an assisted living facility often do not have key information they need in order to identify the one most likely to meet their individual needs. Initiatives in Florida and Texas have made critical data for selection among facilities readily available to prospective assisted living residents."]

[Request #S3426]

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SMOKING

Environmental Tobacco Smoke. By Helene Kent and Amy Winterfeld, National Conference of State Legislatures. Legisbrief. Vol. 12, No. 29. (NCSL, Denver, Colorado) June/July 2004. 2 p.

["Environmental tobacco smoke is a combination of smoke from burning tobacco products and exhaled smoke. States vary in their responses to controlling ETS. Forty-four states and the District of Columbia restrict smoking in government workplaces.... [Includes list of state] laws restricting smoking in public places."]

[Request #S3427]

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Adult Smoking. By the Tobacco Control Section, California Department of Health Services. (The Department, Sacramento, California) May 26, 2004. 2 p.

Full Text at: www.dhs.ca.gov/ps/cdic/ccb/tcs/documents/adultsmoking.pdf

["Smoking among adults in California dropped to a record low of 16.2 percent in 2003, but smoking rates remained significantly higher among low-income people with less education." Sacramento Bee (May 27, 2004) A3.]

[Request #S3428]

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UNINSURED POPULATION

Characteristics of the Uninsured: A View from the States. By the States Health Access Data Assistance Center, University of Minnesota. Prepared for the Robert Wood Johnson Foundation. (The Foundation, Princeton, New Jersey) May 2004. 57 p.

Full Text at: covertheuninsuredweek.org/media/research/brffs.pdf

["A comprehensive analysis of government data shows that a significant number of working Americans in every state do not have health care coverage, with at least 20 million working Americans not having coverage." CNN.com (May 5, 2004) 1.]

[Request #S3429]

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The Cost of Care for the Uninsured: What Do We Spend, Who Pays and What Would Full Coverage Add to Medical Spending. By Jack Hadley and John Holahan. The Henry J. Kaiser Family Foundation. (The Foundation, Menlo Park, California) May 10, 2004 15 p.

Full Text at: www.kff.org/uninsured/loader.cfm?url=/commonspot/security/getfile.cfm&PageID=35965

["Today, there are nearly 44 million Americans without health insurance coverage. A substantial body of research shows that there are serious health and financial consequences associated with being uninsured. Moreover, research shows that leaving a large share of the population without health insurance affects not only those who are uninsured, but also the health and economic well-being of the nation. Yet, despite these findings, the number of uninsured Americans continues to grow. Although the national debate over ensuring health coverage for more Americans periodically gains momentum, it then stalls -- perhaps in part because not enough is known about both the benefits and the costs of expanding coverage to more, if not all, of the uninsured."]

[Request #S3430]

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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

"Health." IN: Studies in the News, 04-40 (June 2004)

Full Text at: www.library.ca.gov/SITN/2004/0440.htm

[Includes: "Partial birth abortion ban unconstitutional;" "Changing options for insurance coverage;" "Lead content in Mexican candy;" "Doubling copays for drugs increases risk;" "State report cards on women's health;" and others.]

[Request #S3431]

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"Health." IN: Studies in the News, 04-45 (June 2004)

Full Text at: www.library.ca.gov/SITN/2004/0445.htm

[Includes: "Racial disparities in nursing home care;" "Attorney General sues over tuna labeling;" "No damages allowed against HMOs;" "Nursing homes in crisis;" "Schools can help obesity problem;" "Internet pharmacies' risk;" "Physical activity and community design;" "Smoking among high school students;" and others.]

[Request #S3432]

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