Subject: Studies in the News 04-72 (November 3, 2004)


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


Contents This Week

Introductory Material HEALTH
   Barriers to health insurance for uninsured
   Community health centers
   Breast cancer and the environment
   Chronic exposure to arsenic
   Consumer medical plans criticized.
   Minorities in the health care workforce
   Health care costs and insurance premium trends
   Traffic exposure and cardiovascular disease
   Influenza-associated hospitalizations in the United States
   Increases on job based health insurance premiums
   Employer provided health insurance
   Preventing Medicaid fraud
   Extended work hours and patient safety
   Training in behavioral and developmental pediatrics
   Access to needed medical care
   Substance abuse and teens
PREVIOUSLY IN STUDIES IN THE NEWS
   Studies in the News, September 2004
   Studies in the News, August 2004
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

ACCESS TO CARE

Assessing County Capacity to Meet the Needs of California's Uninsured: 2004 Survey Findings. By Annette Gardner, Institute for Health Policy Studies, University of California, San Francisco. Prepared for the California Healthcare Foundation. (The Foundation, Oakland, California) September 2004. 43 p.

Full Text at: www.chcf.org/documents/insurance/AssessingCountyCapacity2004SurveyFindings.pdf

["The purpose (of the survey) was to inventory county price increases, access to health care for the uninsured, and assess constraints on insurance coverage programs."]

[Request #S4324]

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The Fundamentals of Community Health Centers. By Jessamy Taylor, National Health Policy Forum, George Washington University. (The Forum, Washington, DC) August 31, 2004. 32 p.

Full Text at: www.nhpf.org/pdfs_bp/BP%5FCHC%5F08%2D31%2D04%2Epdf

["This background paper examines the dominant model of federal grant funding for primary care in the health care safety net: the community health center. It describes the history of the health center program and highlights key policy issues influencing health centers, such as Medicaid payment policies and medically underserved area designations. The paper also examines the recent presidential initiative to expand community health centers, including a review of the process used to identify new grantees, an assessment of remaining gaps in capacity, an exploration of continuing challenges, and a discussion of unresolved policy questions."]

[Request #S4325]

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CANCER

State of the Evidence: What is the Connection Between the Environment and Breast Cancer? Edited By Nancy Evans, Breast Cancer Fund. (The Fund, San Francisco, California) 2004. 78 p.

Full Text at: www.breastcancerfund.org/atf/cf/{DE68F7B2-5F6A-4B57-9794-AFE5D27A3CFF}/sov_low.pdf

["Exposure to radiation, environmental toxins and common chemicals found in household items, such as plastic food containers, pesticides and paints, contribute 'more than previously understood' to a person's breast cancer risk." California Healthline (October 7, 2004) 1.]

[Request #S4326]

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"Toenail Arsenic Content and Cutaneous Melanoma in Iowa." By Laura E. Beane Freeman and others. IN: American Journal of Epidemiology, vol. 160, no. 7 (October 1, 2004) pp. 679-687.

["Chronic exposure to arsenic, which can be measured in toenail clippings, seems to be associated with an elevated risk of melanoma skin cancer.... Patients with the highest toenail arsenic concentrations were more than twice as likely to have melanoma as those with the lowest concentrations." Reuters (October 11, 2004) 1.]

[Request #S4327]

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HEALTH CARE

Will Consumer-directed Health Care Improve System Performance? By Karen Davis, Commonwealth Fund. Issue Brief. (The Fund, New York, New York) 2004. 4 p.

Full Text at: www.cmwf.org/usr_doc/davis_cdhc-hsr_ib_773.pdf

["An independent health and social research organization is warning that consumer-directed health care plans may not be the needed panacea to cut health care costs. The report said that such plans -- promoted as a means to encourage consumers to take better care of themselves and thus reduce medical costs - could instead worsen them." Kansas City Star (August 20, 2004) 1.]

[Request #S4328]

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HEALTH CARE INDUSTRY

Missing Persons: Minorities in the Health Professions. By The Sullivan Commission. (The Commission, Durham, North Carolina) 2004. 208 p.

Full Text at: admissions.duhs.duke.edu/sullivancommission/documents/Sullivan_Final_Report_000.pdf

["There is an imbalance in the makeup of the nation's physicians, dentists, and nurses. This imbalance contributes to the gap in health status and the impaired access to health care experienced by a significant portion of our population.... While some outstanding physicians, dentists, and nurses are minorities, access to a health profession career remains largely separate and unequal. This report ... examines the root cause of this challenge and provides detailed recommendations on how to increase the representation of minorities in the nation's medical, dental, and nursing workforce."]

[Request #S4329]

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Wall Street Comes to Washington. By Center for Studying Health System Change. Issue Brief, no. 87. (The Center, Washington, DC) August 2004. 4 p.

Full Text at: www.hschange.org/CONTENT/702/702.pdf

["While health care cost trends likely will continue slowing through the end of 2004, the longer-term outlook for a sustained slowdown in underlying costs and private health insurance premiums largely depends on the strength of the economy."]

[Request #S4330]

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HEART DISEASE

"Exposure to Traffic and the Onset of Myocardial Infarction." By Annette Peters and others. IN: New England Journal of Medicine, vol. 351, no. 17 (October 21, 2004) pp. 1721-1730.

["In a study that gave new meaning to the concept of a 'killer commute,' researchers concluded that people caught up in traffic are three times more likely to suffer a fatal heart attack within the hour than those who aren't tied up on the road.... Traffic jams were more likely to take a toll on women and on people 60 and older." Rueters (October 22, 2004) 1.]

[Request #S4331]

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INFECTIOUS DISEASE

"Influenza-associated Hospitalizations in the United States" By David K. Shay and others. IN: Journal of the American Medical Association, vol. 292, no. 11 (2004) pp. 1333-1340.

["The number of people hospitalized in the United States because of the flu has climbed substantially over the past two decades to an average of more than 200,000 a year, in large part because of the aging of the population, a government study found." Contra Costa Times (August 15, 2004) 1.]

[Request #S4332]

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INSURANCE

Employer Health Benefits 2004 Annual Survey. By Henry J. Kaiser Family Foundation. (The Foundation, Washington, DC) September 2004. 164 p.

Full Text at: www.kff.org/insurance/7148/loader.cfm?url=/commonspot/security/getfile.cfm&PageID=46288

["Premiums for job-based health insurance jumped 11.2 percent on average this year across the nation ... the latest evidence of a painful rise in medical costs that is placing an increasingly heavy burden on employers and consumers. The 2004 increase was less than last year's 13.9 percent leap, but it was the fourth consecutive annual double-digit rate hike.... Although premium increases moderated, employer payments for health insurance still rose five times faster than the rate of inflation and workers' earnings. The cumulative effect of several years of rising costs has been severe, and a growing number of businesses have dropped health coverage for their workers completely, the study noted." San Francisco Chronicle (September 10, 2004) 1.]

[Request #S4333]

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Workers Receiving Employer-provided Health Insurance. By Heather Boushey and Joseph Wright. Center for Economic and Policy Research. (The Center, Washington, DC) August 13, 2004. Various pagings.

Full Text at: www.cepr.net/health_insurance/hi_3.html

["The health insurance system in the United States is individualized, and private coverage is generally tied to employment. Most adults receive health insurance in their own name and have traditionally received health insurance from their employer. Among those with health insurance, the share of individuals who have insurance in their own name – that is, people who receive health insurance from their own employer, independently purchase their own plan, or receive government health insurance coverage under their own name, rather than a spouse’s, rose over the decade from 1992 to 2002."]

[Request #S4334]

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MEDICAID

Medicaid Program Integrity: State and Federal Efforts to Prevent and Detect Improper Payments. By U.S. Government Accountability Office. GAO-04-707. (The Office, Washington, DC) July 16, 2004. 34 p.

Full Text at: www.gao.gov/new.items/d04707.pdf

["While the report said it could not put a dollar figure on the extent of Medicaid fraud, it detailed several schemes uncovered by state and federal prosecutors. In California, for example, 15 laboratories billed more than $20 million for tests that were never ordered by physicians.... In addition, there are indications that Medicaid fraud involving drug pricing practices is increasing." Associated Press (August 19, 2004) 1.]

[Request #S4335]

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NURSES

"The Working Hours of Hospital Staff Nurses and Patient Safety." By Anne Rogers and others. IN: Health Affairs, vol. 24, no. 4 (July/August 2004) pp. 201-112.

["The use of extended work shifts and overtime has escalated as hospitals cope with a shortage of registered nurses. Little is known, however, about the prevalence of those extended work periods and their effects on patient safety.... The risk of making an error were significantly increased when work shifts were longer than twelve hours, when nurses worked overtime, or when they worked more than forty hours per week."]

[Request #S4337]

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RESEARCH

A Need for Faculty Development in Developmental and Behavioral Pediatrics. By Edward L. Schor and Caren Elfenbein, The Commonwealth Fund. (The Fund, New York, New York) October 2004. 8 p.

Full Text at: www.cmwf.org/usr_doc/785_Schor_faculty_devel_IB.pdf

["For pediatricians, managing issues of child development and behavior is essential for providing comprehensive preventive care and treating many acute and chronic health conditions. The expertise necessary to provide comprehensive resident training in this subject may be lacking."]

[Request #S4338]

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UNINSURED POPULATION

Trends in Americans' Access to Needed Medical Care, 2001-2003. By Bradley C. Strunk and Peter J. Cuningham. Center for Studying Health System Change. Tracking Report; No. 10. (The Center, Washington, DC) August 2004. 4 p.

Full Text at: www.hschange.org/CONTENT/701/701.pdf

["Despite a weak economy and rapidly rising health care costs, the proportion of Americans that reported an unmet medical need between 2001 and 2003 declined by 0.5 percentage points, the equivalent of about 1 million fewer people going without needed care. At the same time, the proportion of Americans delaying needed care declined by 1.1 percentage points, or about 2 million people."]

[Request #S4339]

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YOUTH

National Survey of American Attitudes on Substance Abuse IX: Teen Dating Practices and Sexual Activity. By The National Center on Addiction and Substance Abuse. (The Center, New York, New York) August 2004. 70 p.

Full Text at: www.casacolumbia.org/pdshopprov/files/august_2004_casa_teen_survey.pdf

["Teenagers who reported that at least half of their friends were sexually active were 31 times likelier to get drunk, 5 1/2 times likelier to smoke and 22 1/2 times likelier to have tried marijuana.... Thirty-one percent of the teenagers surveyed said they had a boyfriend or girlfriend, which increased their average risk." New York Times (August 20, 2004) 1.]

[Request #S4340]

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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, 04-62 - 04-64 (September 2004)

Full Text at: www.library.ca.gov/SITN/2004/0464.htm

[Includes: "Native American health care system;" "Childhood predictors of Native American alcoholism;" "Child abuse predeterminate for later alcoholism;" "Type 2 diabetes mellitus in children;" "Native Americans and health care;" "Quality of care for American Indians and Alaskan natives;" "Racial and ethnic disparities in health care;" "Medicare increases impact on Medicaid programs;" "Access to recovery grants;" and others.]

[Request #S4341]

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"Health" IN: Studies in the News, 04-68 (October 2004).

Full Text at: www.library.ca.gov/SITN/2003/0468.htm

[Includes: "Analysis of poll on health care access;" "Health care reimbursements for aliens;" "Hospital emergency room crisis;" "Rising health care costs;" "States allotment federal medical assistance percentage;" "Anti-smoking ads upheld;" "Higher hospital bills for the uninsured;"

[Request #S4342]

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