Subject: Studies in the News 06-32 (July 19, 2006)


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


Contents This Week

Introductory Material HEALTH
   Adolescents' attitudes influenced by media
   AIDS resources and care
   Treatments for autism
   Diagnosing autism in children
   Resilience in children
   SCHIP redistributions
   Medicaid and community services for disabled
   Predictive genetic testing of minors
   Consumer-driven health plans and rising costs
   Affordable health insurance for lower middle-class
   Employer-sponsored health insurance
   Reducing lead poisoning in children
   Kaiser arbitration oversight
   Federal Medicaid spending continues to slow
   Unhealthy insurance
   Aging Californians uninformed about Medicare
   Medicare's hospital insurance program
   Enrollees' perceptions of Medicare part D
   States sue federal government on Medicare
   States receive clawback bills
   Screening for maternal depression
   Child psychiatrist shortage looms
   Life changing implants for paraplegic
   Nursing home transition
   Prenatal soy reduces obesity
   Food fitness and obesity
   Shortage of doctors
   Prescription drug price trends
   Public health disease reporting systems
   Fifty states pandemic plans
   Tylenol dosages prompt concerns
   Medicaid changes requirements
PREVIOUSLY IN STUDIES IN THE NEWS
   Studies in the News, May - July 2006
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

ADOLESCENCE

Social and Cultural Influences on Adolescents' Body Image: [Special Issue] . IN: Journal of Youth and Adolescence, vol. 35, no. 2. (April 2006) pp. 141-301.

["This issue explores body image concerns, the effects of media exposure, individual and sociocultural influences, friends and psychosocial aspects of body images and concerns in boys and girls. It also looks at whether body images play a role in risky sexual behavior and attitudes." NOTE: Social and Cultural... is available for 3-day loan.]

[Request #S63201]

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AIDS

Ryan White Reauthorization Issues. By Federal Funds Information for States. FFIS Issue Brief. (FFIS, Washington, DC) April 12, 2006. 8 p.

Full Text at: www.ncsl.org/ffis/subs/ib/2006/IB06-19.pdf

["The Ryan White Comprehensive AIDS Resources Emergency (CARE) Act of 1990 expired at the end of the federal fiscal year (FY) 2005. Efforts to reauthorize it in the 2005 session of Congress were not successful, and the authorization was extended through FY 2006 by the appropriation. This issue brief presents issues expected to be addressed this year in the reauthorization process."]

[Request #S63202]

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AUTISM

Pivotal Response Treatments for Autism: Communication, Social, and Academic Development. By Robert L. Koegel and others. (Paul H. Brookes Publishing, Baltimore, Maryland) 2006. 296 p.

["It is hypothesized that autism itself may be a much milder disorder than previously suspected and that many of the seemingly severe aspects of the disorder may be side effects resulting from abnormal development. If corrected early, especially significant gains may be possible. Pivotal Response Treatments are aimed at the core areas of the disorder to put the children back onto a more normalized course of development." NOTE: Pivotal Response ... is available for loan.]

[Request #S63203]

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"Mental Health in the United States: Parental Report of Diagnosed Autism in Children Aged 4-17 Years -- United States, 2003-2004." By L.A. Schieve and others. IN: MWWR, vol. 55, no. 17. (May 5, 2006) pp. 481-486.

Full Text at: www.cdc.gov/mmwr/preview/mmwrhtml/mm5517a3.htm?s_cid=mm5517a3_e

["As of 2003--2004, autism had been diagnosed in at least 300,000 U.S. children aged 4--17 years. In addition, parental reports of autism were associated with reported social, emotional, and behavioral symptoms and specialized needs."]

[Request #S63204]

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CHILDREN

Handbook of Resilience in Children. Edited by Sam Goldstein and Robert B. Brooks. (Kluwer Academic/Plenum Publishers, New York, New York) 2005. 416 p.

["Even the most significant technological and medical advances of the 21st century have been tempered by the increasing risk posed to children in the form of such stressors as poverty, victimization, and family dysfunction. To overcome such challenging societal pressures, children must become skilled in navigating through these turbulent times. With the proper support from parents, extended families, and communities, children are much more likely to experience positive development rather than dysfunction in their adult lives." NOTE: Handbook of Resilience... is available for loan.]

[Request #S63206]

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SCHIP Redistributions Published. By Federal Funds Information for States. FFIS Issue Brief. (FFIS, Washington, DC) April 25, 2006. 4 p.

Full Text at: www.ncsl.org/ffis/subs/ib/2006/IB06-23.pdf

["Centers for Medicare and Medicaid Services published redistributions of federal fiscal year (FY) 2003 unexpended funds from the State Children's Health Insurance Programs (SCHIP) and allotments from the additional $238 million provided in the Deficit Reduction Act of 2006. Both allocations are directed toward states whose FY 2006 SCHIP expenditures were expected to exceed available resources, though the composition of potential recipient states may change."]

[Request #S63208]

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DISABILITIES

Medicaid and Community Services for Developmental Disabilities. By Richard Hemp and others, National Conference of State Legislatures. NCSL Legisbrief. (NCSL, Denver, Colorado) April/May 2006. 2 p.

["Increased Medicaid spending for mental retardation and other development disabilites is balanced by decreased institutional spending for care facilities.... Waivers have helped contain Medicaid long-term care costs.... Waivers finance a wide range of community services."]

[Request #S63210]

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GENETICS

Predictive Genetic Testing of Minors. By Alissa Johnson, National Conference of State Legislatures. NCSL Legisbrief. (NCSL, Denver, Colorado) April/May 2006. 2 p.

["Predictive genetic testing to determine whether a person has an increased susceptibility to future disease raises some universal concerns. These concerns, coupled with a minor's inability to control decisions about testing, may provide compelling reasons for policymakers to consider whether appropriate policies exist. Many state legislatures have enacted laws to protect individuals from potential harm such as insurance discrimination based on genetic information."]

[Request #S63212]

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HEALTH INSURANCE

Consumer-Driven Health Plans: Small but Growing Enrollment Fueled by Rising Cost of Health Care Coverage. By U.S Government Accountability Office. GAO-06-514. (The Office, Washington, DC) April 28, 2006. 38 p.

Full Text at: www.gao.gov/cgi-bin/getrpt?GAO-06-514

["Insurance carriers, employers and individuals are showing increasing interest in customer-directed health plans (CDHSP).... GAO was asked to review the prevalence of CDHPs, how the associated accounts are funded and used, and the facters that may contribute to the growth or limit the appeal of these plans."]

[Request #S63213]

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Gaps in Health Insurance: An All-American Problem: Findings from the Commonwealth Fund Biennial Health Insurance Survey. By Sara R. Collins and others, The Commonwealth Fund. (The Fund, New York, New, York) April 2006. 38 p.

Full Text at: www.cmwf.org/usr_doc/Collins_gapshltins_920.pdf

["Forty-one percent of adults with incomes between $20,000-$40,000 a year did not have health insurance for at least part of 2005, up from 28 percent without coverage in 2001. Employers are dropping health coverage or are offering insurance plans that are too expensive for many workers to afford."]

[Request #S63214]

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"Employer-Sponsored Health Insurance in the United State: Origins and Implications." By David Blumenthal. IN: New England Journal of Medicine, vol. 355, no. 1. (July 6, 2006) pp. 82-88.

["The author outlines how employer-sponsored health insurance became the cornerstone of the nation’s health care system. He discusses the implications of employer-based insurance for access to health care and its affordability and quality."]

[Request #S63215]

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LEAD POISONING

Improving Childhood Blood Lead Level Screening, Reporting, and Surveillance in Allegheny County, Pennsylvania. By Donna Keyser and others, RAND. (RAND, Santa Monica, California) 2006. 61 p.

Full Text at: www.rand.org/pubs/monographs/MG423/index.html

["This report is intended primarily for state and local policymakers, public health officials, health care and health plan providers, local government agencies, and parents interested in improving childhood blood lead level screening, reporting, and surveillance."]

[Request #S63219]

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MANAGED HEALTH CARE

Seventh Annual Report of the Office of the Independent Administrator of the Kaiser Foundation Health Plan Mandatory Arbitration System for Disputes with Health Plan Members January 1, 2005-December 1, 2005. By the Office of the Independent Administrator. (The Administrator, Los Angeles, California) 2006. 67 p.

Full Text at: www.oia-kaiserarb.com/oia/Forms%20&%20Reports/7th%20Annual%20Report.pdf

["In 2005, the Office of Independent Administrator administered 829 cases. The OIA categorizes cases by the subject of their claim: medical malpractice, premises liability, other tort, lien, or benefits and coverage cases. Medical malpractice cases were the most common, making up 92% (764 cases) in the OIA system."]

[Request #S63220]

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MEDICAID

Federal Medicaid Spending Continues to Slow. By Federal Funds Information for States. FFIS Issue Brief. (FFIS, Washington, DC) July 10, 2006. 3 p.

Full Text at: www.ncsl.org/ffis/subs/ib/2006/IB06-29.pdf

["Projected growth in Medicaid spending ... has not materialized. Preliminary data show federal Medicaid spending for the first three quarters of FY 2006 at a level below that for FY 2005."]

[Request #S63221]

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MEDICARE

"Unintended Consequences of Caps on Medicare Drug Benefits." By John Hsu and others. IN: New England Journal of Medicine, vol. 354, no. 22. (June 1, 2006) pp. 2349-2359

["Millions of Medi-care recipients across the nation have been signing up for a new benefit offering limited coverage of presciption drugs. Optimists hoped that shifting the risk would empower patients to make more rational choices about care. The study, however suggests that once Americans are confronted with the true expenses of health care they make wrong decisions that end up costing the system just as much money."]

[Request #S63218]

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When You're 64: What Consumers Don't Know About Medicare. By the California HealthCare Foundation. (The Foundation, Oakland, California) February 2006. 7 p.

Full Text at: www.chcf.org/documents/insurance/WhenYoure64MedicareIssueBrief.pdf

["This issue brief reports that despite an abundance of information and counseling resources, many 64-year-old Californians are uninformed about Medicare, lacking basic understanding of both how it works and where to find help. These seniors are either leaving decisions to chance or making choices at enrollment that could increase their costs and limit their future options."]

[Request #S63222]

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Medicare Finances: Findings of the 2006 Trustees Report. By Paul N. Van Water and Joni Lavery. National Academy of Social Insurance. (The Academy, Washington, DC) May 2006. 8 p.

Full Text at: www.nasi.org/usr_doc/medicare_brief_013.pdf

["Unlike Social Security taxes, which are not imposed on earnings above a set level, Medicare taxes are collected on workers’ entire earnings. This payroll tax revenue will provide 86 percent of the income of the Hospital Insurance program in 2006.... The Hospital Insurance Trust Fund is projected to run surpluses for the next few years but is not adequately financed beyond then."]

[Request #S63223]

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Enrollees' Perceptions of Medicare Part D: Three Months and Counting. By Teresa A. Keenan, American Association of Retired Persons. (The Association, Washington, DC) April 2006. 12 p.

Full Text at: assets.aarp.org/rgcenter/health/medicare_enrollees.pdf

["Although the new Medicare prescription drug benefit is just four months old, enrollees suggest that they are already reaping financial benefits from enrolling. The majority believe the premiums, benefits and costs of the program to be about the same or better than the coverage they previously had, and many are recognizing at least some cost savings from enrolling."]

[Request #S63224]

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MEDICARE & MEDICAID

Attorney General Abbott Files United States Supreme Court Complaint Over Medicare Drug Program Payments: Press Release. By the Office of Texas Attorney General Greg Abbott. (The Office, Austin, Texas) March 3, 2006. AND Attorney General Lockyer Announces Planned Legal Challenge of Flawed Federal Prescription Drug Plan Will Be Put on Hold But State Will Join Multi-State Action If Federal Claim of Benefit to State Proves False: Press Release. By the Office of California Attorney General Bill Lockyer. (The Office, Sacramento, California) February 23, 2006.

["Texas, Kentucky, Maine, Missouri, and New Jersey, with the support of 10 other states, have sought original jurisdiction with the U.S. Supreme Court to challenge the 'clawback' federal mandate enacted as part of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, charging that the law constitutes an unconstitutional tax imposed on the states in their sovereign capacities.... The 15 states want the Court to reverse the mandate, which requires states to pay a portion of the costs associated with providing federal Medicare drug coverage to dual eligibles, or persons eligible for both Medicare and Medicaid." State Tax Notes (June 12, 2006) p. 871 ]

Texas Press Release. 1 p.
http://www.oag.state.tx.us/oagnews/release.php?id=1483

California Press Release. 1 p.
http://ag.ca.gov/newsalerts/release.php?id=1262

[Request #S63225]

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States Receive Clawback Bills. By Federal Funds Information for States. FFIS Issue Brief. (FFIS, Washington, DC) April 19, 2006. 3 p.

Full Text at: www.ncsl.org/ffis/subs/ib/2006/IB06-21.pdf

["The Centers for Medicare and Medicaid Services sent letters to states providing them with bills for their January, February and March 2006 'phased down monthly contribution' for the Medicare Part D prescription drug benefit, commonly known as the 'clawback.' The bills are based on the reduced per capita drug cost announced in February 2006."]

[Request #S63226]

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MENTAL HEALTH

Financing Strategies for Medicaid Reimbursement of Maternal Depression Screening by Pediatric Providers. By Karen Van Landeghem. (National Academy for State Health Policy, Portland, Maine) April 2006. 4 p.

Full Text at: www.nashp.org/Files/Maternal_depression_screening_brief.pdf

["The healthy development of young children can be affected significantly by maternal depression. Infants and young children of depressed mothers can experience a range of problems including lower activity levels, fussiness, and problems with social interactions. Maternal depression is one of the most common yet unrecognized, undiagnosed, and untreated complications of pregnancy."]

[Request #S63227]

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Child Psychiatrist Shortage Looms. By Michelle Herman, National Conference of State Legislatures. NCSL Legisbrief. (NCSL, Denver, Colorado) March 2006. 2 p.

["Almost one in five children in the United States has a diagnosable mental disorder, but only about 20 percent to 25 percent of these children receive treatment. One reason for this treatment gap is a shortage of child and adolescent psychiatrists."]

[Request #S63228]

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NEUROSCIENCE

"Neuroprosthetics: In Search of the Sixth Sense." By Alison Abbott. IN: Nature, vol. 442, no. 7099. (July 13, 2006) p. 125.

["Brain implants lets paralyzed man control a computer, a television set and a robot using his thoughts. The implant sensor eavesdropped on the electrical signals emitted by neurons in his motor cortex as they controlled the imaginary arm movement.'"] Sacramento Bee (July 13 2006) A19.]

[Request #S63229]

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NURSING HOMES

Nursing Home Transition. By Carla Curran, National Conference of State Legislatures. NCSL Legisbrief. (NCSL, Denver, Colorado) April/May 2006. 2 p.

["Laws in several states address the transition from nursing homes to the community, and some legislatures have directed state administrative agencies to apply for federal waivers. Federal grants help support programs to move nursing home residents back to their own homes."]

[Request #S63230]

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OBESITY

"Maternal Genistein Alters Coat Color and Protects Avy Mouse Offspring from Obesity by Modifying the Fetal Epigenome." By Randy L. Jirtle and others. IN: Environmental Health Perspectives, vol. 114, no. 4. (April 2006) pp. 567-572.

Full Text at: www.ehponline.org/members/2006/8700/8700.pdf

["A single nutrient found in soy products elicits changes in gene behavior that permanently reduce an embryo's risk of becoming obese later in life. The findings of this animal study -- yet to be confirmed in humans could explain why Asians have lower rates of obesity and cancer, the researchers said. In other words, it may not only be the hamburgers and fries we are eating, but also what our parents consumed or encountered in the environment that predisposes us to various conditions." myDNA News (March 30, 2006) 1.]

[Request #S63207]

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Fitness, Food and Finding Solutions: Approaches to Nutrition, Physical Activity and Obesity Treatment. By National Conference of State Legislatures. (NCSL, Denver, Colorado) January 2006. 25 p.

["Although most agree that the increasing prevalence of obesity in the United States is a serious health problem, opinions vary as to the appropriate response.... Efforts are needed to promote a healthier diet and regular physical activity in our homes, schools, workplaces and communities."]

[Request #S63231]

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PHYSICIANS

Physicians for Underserved Area Act: H.R. 4997: Testimony. By Edward Salsberg, Association of American Medical Colleges. Presented to Subcommittee on Immigration, Border Security, and Claims, U.S. House Committee on Judiciary. (The Association, Washington, DC) 2006. 22 p.

Full Text at: www.aamc.org/advocacy/library/workforce/testimony/2006/051806.pdf

[" A looming doctor shortage threatens to create a national health care crisis by further limiting access to physicians, jeopardizing quality and accelerating cost increases. Twelve states -- including California Texas and Florida - report some physician shortages now or expect them within a few years. The shortages are putting pressure on medical schools to boost enrollment and on lawmakers to lift a cap on funding for immigration of foreign physicians." Sacramento Bee (June 4, 2006) 1.]

[Request #S63232]

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PRESCRIPTION DRUGS

Trends in Manufacturer Prices of Brand Name Prescription Drugs Used by Older Americans: 2005 Year-End Update. By David Gross and others, American Association of Retired Persons. (The Association, Washington, DC) April 2006.

["A variety of surveys have suggested that better discounts overall are available outside of Medicare, at outlets such as Costco, Drugstore.com, and particularly in government programs operated by the Department of Veterans Affairs and Medicaid. Ten leading Medicare drug plans were charging prices for 10 top brand-name drugs that averaged 2% more than at Costco in Los Feliz, 4% more than at Drugstore.com, 61% more than in Canada and 78% more than the other federal programs." Los Angeles Times (April 18, 2006) A1.]

Trends in Brand Name Prescription Drugs. 8 p.
http://assets.aarp.org/rgcenter/health/dd134_drugprices.pdf

Trends in Generic Prescription Drugs. 4 p.
http://assets.aarp.org/rgcenter/health/dd135_drugprices.pdf

Price Surveys for 2004-2005. Various pagings.
http://www.aarp.org/research/health/drugs/aresearch-import-869-2004-06--IB69.html#brand

[Request #S63233]

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PUBLIC HEALTH

Test to Evaluate Public Health Disease Reporting Systems in Local Public Health Agencies. By David J. Dausey and others, RAND. (RAND, Santa Monica, California) 2006. 87 p.

Full Text at: www.rand.org/pubs/technical_reports/2005/RAND_TR-260.pdf

["This manual is designed to aid in the development of tests to evaluate the ability of public health disease reporting systems to receive and respond to case reports 24 hours a day, 7 days a week. Its primary objective is to provide benchmarks to evaluate testing performance."]

[Request #S63234]

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State Pandemic Plans. By the U.S. Department of Health & Human Services. (The Department, Washington, DC) 2006. Various pagings.

Full Text at: www.pandemicflu.gov/plan/stateplans.html

["Los Angeles County and the rest of California have nowhere near the capacity to treat the hundreds of thousands of people who might need medical care should a pandemic flu strike. Officials are only beginning to work out how they would find the extra hospital beds, health workers and equipment needed in such a crisis."]

[Request #S63235]

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RESEARCH

"Aminotransferase Elevations in Healthy Adults Receiving 4 Grams of Acetaminophen Daily: A Randomized Controlled Trial." By Paul B. Watkins and others. IN: Journal of the American Medical Association, vol. 296, no. 1. (July 5, 2006). pp. 87-93.

Full Text at: jama.ama-assn.org/cgi/reprint/296/1/87

["Although overdoses of Tylenol can harm the liver this study is the first to spot hints of trouble in healthy people taking the pain reliever as directed. Dr. Paul Watkins, the lead author, said he plans other studies to see if patients' livers become accustomed to acetaminophen overtime. He noted that large numbers of elderly arthritis patients take high doses of Tylenol for long periods without liver injury." Sacramento Bee (July 5, 2006) A1.]

[Request #S63236]

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UNINSURED POPULATION

"Medicaid Changes Hit State Aliens." By Victoria Colliver. IN: San Francisco Chronicle (June 9, 2006) Various pagings.

["New federal rules that require Medicaid recipients to prove their citizenship could push huge numbers of beneficiaries off state programs for the poor and disabled and into the ranks of the uninsured, health advocates warn. The rules could have especially severe consequences in California, where 6.8 million people are enrolled in Medi-Cal. Nursing home patients, the homeless, the mentally ill and people born at home could be among those most affected."]

[Request #S63237]

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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 - July 2006).

Full Text at: www.library.ca.gov/SITN/2006/0605.htm

[Includes: "Economics of employer mandated health care;" "Flaws in health savings accounts;" "Holding health plans accountable;" "Obese children and car seats;" "Effects of mercury fillings in children;" "Cost of Massachusetts-style coverage;" "Strategies for mitigating a pandemic influenza;" "Pandemic influenza implementation plan;" "Certified Nurse Assistants training;" "Status of physical education;" "Future hospital demand;" "Access to care for mental illnesses;" "Gaps in health insurance;" "Mental health insurance coverage;" "Pharmaceutical marketers put patients at risk;" "Problems with nanomaterials in sunscreens;" "Chemical exposure and reproductive health;" "Risk of receiving poor quality health care;" "Expanding health insurance coverage for children;" "Sudden unexplained infant death initiative;" "Road traffic and childhood asthma;" "Effectiveness of teen drug programs;" "Health care forecasts;" "Employer-based health insurance; and others."]

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