Is California’s prison health system really fixed?
Filed under: Health journalism, Hot Health Headline
After years of failing to prevent preventable inmate deaths, the California Department of Corrections health system was placed under a federal receivership in 2005. Soon after, state officials claimed that the system had reached an “acceptable standard,” and that they were ready to take control back from the feds.
Over the course of a year, Southern California Public Radio’s Julie Small has been digging deep into the system to determine if it’s really as acceptable as the Schwarzenegger administration claims. You can see the whole series here. There are five main installments, four of which come with sidebars. Everything comes in text and audio with a little video and photo mixed in.
- Part 1: California’s budget woes thwart improvements to prison medicine
- Part 2: Chino prison sees some improvements in medical care
- Part 3: California inmates still suffer from lapses in prison medical care
- Part 4: Vacaville’s California Medical Facility – The ‘gold standard’ for prison medical care in California
- Part 5: Fewer improvements planned for prison medical care
Chino Prison’s medical system from 89.3 KPCC on Vimeo.
ReportingOnHealth.org has a conversation with Small about the subject.
Related
Hear Small talk about her reporting process and the difficulties of covering prison health with our friends at Reporting on Health, and check out this related Q and A.
Endowment funds local health reporter
Filed under: Health journalism, Hot Health Headline
Let’s get the headline out of the way first: The Merced Sun-Star is hiring a health care reporter!
Now, the interesting part. The Sun-Star’s new 18-month spot is funded by The California Endowment, which you may remember as a key backer of California Watch. 
It’s part of the endowment’s 10-year plan to improve local health.
Merced County was chosen as one of the 14 places in the state to work with the endowment in a 10-year plan to help transform communities and neighborhoods into places where everybody can be healthy, safe and ready to learn, according to Building Healthy Communities.
Thanks to that larger mission, the Merced health care reporter will cover some interesting sub-beats in addition to the Sun-Star’s traditional health coverage.
The endowment started with 10 goals to accomplish over the next decade. After polling folks in those communities, it set three priorities over the next three years: create healthier youngsters to grow, learn, play and lead, which organizers call “Healthy Youth Development;” prevent and reduce violence; and link economic development to community health.
They’re areas that are certainly not foreign to health care journalists, and a reminder that reporting on the health of the community means thinking beyond hospitals and outbreaks.
AHCJ members will probably already remember that this isn’t the first time Merced has taken the lead in health care journalism innovation, and that the new reporter is really the next step in an ongoing process.
Update
The California Endowment’s Mary Lou Fulton posted some background on the project, a sort of “how-to” primer she wrote for foundations looking to support local news. In addition to explaining why the foundation chose to fund local projects, Fulton also spends a considerable amount of time addressing concerns about editorial independence and conflicts of interest.
AHCJ member wins LA Emmy for PCOS coverage
AHCJ member Gerri Shaftel Constant of KTTV-Los Angeles earned her 10th Los Angeles Area Emmy Award for a three-part series on polycystic ovary syndrome, a female hormone disorder. The series profiled two women who suffer from PCOS, as well as a local physician who is a national pioneer in its management. PCOS is linked to obesity, acne, diabetes and facial hair growth, as well as numerous other associated symptoms. The series was titled “Hormone Nightmare,” and won in the “Medical News Story - Multi Report” category.
Send us your latest news
Got a new job? Earned a promotion? Won an award or fellowship? Just published a book? AHCJ members are encouraged to share your news by sending it to info@healthjournalism.org. Member news items are posted on Covering Health and in HealthBeat, AHCJ’s newsletter.
Whooping cough: Not just a problem for kids
Maryn McKenna, AHCJ board member and self-proclaimed “most vaccinated person on the planet,” writes about her own bout with whooping cough. She’d had her shots back in the day, but apparently whooping cough immunity conferred by childhood vaccines fades, and anyone over the age of 12 probably needs a booster. 
This is relevant because, while whooping cough is not generally fatal to adults, it’s easily transmitted to more vulnerable folks. And in California and across the country, it’s on the march and vaccine supplies are limited.
The worst news in this upsetting trend is this: We’re doing it to ourselves. As far as anyone can tell, the rise in pertussis is not due to any change in the organism, or to any mysterious error among the manufacturers who make pertussis vaccines. It’s due to vaccine refusal, to parents turning away from vaccines because they think the vaccines are more harmful than the diseases they prevent — or, more selfishly, because they think the wall of immunity created by other vaccinated children will protect their unimmunized ones.
That wall of immunity, McKenna says, hasn’t been helping the unvaccinated kids, who are 23 times more likely to pick up the disease than their immunized peers.
The Texas Tribune’s Ben Freed learns, through conversations with public health experts, that the “entirely preventable” disease can be stopped with vaccination rates between 80 percent and 85 percent. Unfortunately, adult rates are nowhere close to those numbers, though the state is taking steps to increase adult vaccinations.
California officials are urging people to get vaccinated as that state has now seen a six-fold increase in whooping cough this year.
California’s doctors: Aging, white and specialized
Filed under: Health data, Hot Health Headline, Studies
In California Watch’s blog, Joanna Lin breaks down the California HealthCare Foundation’s latest report on the state’s physician supply. Nationwide, a quarter of physicians are over sixty. In California, which leads the nation in doctors nearing retirement, that number is 29 percent. In addition to aging, the state is also faced with particular ethnic disparities among caregivers.
… Latinos represent 37 percent of the state’s population, but 5 percent of its doctors. The disparity is even greater in the Central Coast, Inland Empire and San Joaquin Valley regions, and most severe in Los Angeles County, where 47 percent of the population and only 5 percent of doctors are Latino. Statewide, 18 percent of doctors speak Spanish.
While California led the nation in retention of graduating state medical students, a “substantial proportion” of California doctors come from other states and countries, Lin writes. That number may shrink as the UC system plans to add two more medical schools in the next five years, budget willing. For more specifics, take a look at the report itself. It’s loaded with easy-to-understand summary statistics and beautiful charts and graphs.
Cannabis carpetbaggers crisscross California
The Redding Record Searchlight’s Ryan Sabalow paints a classic tale of the principled old guard taking a stand against exploitative, profit-hungry carpetbaggers, one that just happens to take place in the wild west of northern California’s medical marijuana clinics. Since last year’s federal directive effectively allowed the state’s clinics to operate with impunity, a number of traveling physicians have come up from the south to open clinics in this northern outdoor recreation hub which more than 100,000 residents call home.
At $150 for each brief exam (no tricky medical procedures involved), the granting of medical marijuana recommendations is low-overhead work that holds the promise of substantial profit. A physician would need to see just 30 patients a day to gross more than $1 million a year, Sabalow writes. One local Redding doctor (the only one who specializes in pot, really) has found that the newcomers seem to care more about money than medicine.
[Dr. Terrence Malee] gave the example of a cage fighter who came in to his office trying to intimidate him into getting a recommendation that allowed him to have 7 ounces of marijuana in a week, when most patients are only recommended 2.
“I said, ‘Look, bud, the last time you went to the doctor and asked him for 1,000 Vicodin, did he give it to you? No. Well, I’m not going to give you 7 ounces either,” Malee said, laughing.
In a companion piece, Sabalow looks beyond California’s borders, thanks in part to the responses of other AHCJ members via our electronic discussion list. In particular, he looks at Montana, where traveling “cannabis caravans” have swelled the ranks of medicinal marijuana users in every corner of the state and Colorado, where five doctors accounted for over half of the state’s medical marijuana recommendations.
The Record Searchlight’s editorial board followed up with an piece that questions the wisdom of making medicinal marijuana so easy to obtain.
But it’s hard not to see a stretching of the state’s groundbreaking 1996 Compassionate Use Act beyond all recognition when patients arrive not thanks to a referral from their family doctor, but after hearing a 30-second ad on the local rock station.
For more on Colorado’s effort to reign in physicians who recommend medical marijuana, see Eric Whitney’s piece for Colorado Public Radio.
Calif. finds 3,500 nurses were disciplined elsewhere
Filed under: Health data, Health journalism, Hospitals, Hot Health Headline, Nursing
California’s nursing board has confirmed what fans of Charles Ornstein and Tracy Weber’s disciplined caregivers series for ProPublica and the Los Angeles Times already suspected, that about 3,500 California nurses had clean records there despite being disciplined in other states. You can find Ornstein and Weber’s report on these developments at ProPublica or the LA Times.
After last year’s report by ProPublica and The Times, California ran its list of 376,000 active and inactive nurses against a database maintained by the National Council of State Boards of Nursing, to which nearly all states voluntarily report their disciplinary actions. Among the matches were nurses who had been disciplined by multiple states, sometimes for the same incident.
California officials said they couldn’t disclose the names of any nurses who turned up in the search until a formal disciplinary charge is filed. While those cases are pending, the nurses remain free to practice in California.
Of the 3,500 nurses whose records matched, “as many as 2,000 … will face discipline in California, officials estimate,” Ornstein and Weber write. “That’s more registered nurses than the state has sanctioned in the last four years combined.”
Vaccine waivers contribute to outbreak
Filed under: Health data, Health journalism, Public health
In the wake of California’s public health director’s declaration that whooping cough has reached epidemic status, California Watch’s Christina Jewett looks at public health data and where the number of cases are highest.
She finds the most cases in Marin County, one of the state’s most affluent, and in Fresno County, which has “a vulnerable population gripped with child poverty and other ills.”
One contributing factor, according the Marin’s public health officer, is that more than 7 percent of kindergartners start school without vaccinations. Parents there are signing waivers to opt out of immunizations based on their beliefs that vaccinations are dangerous.
Jewett includes links for more information about such fears and about whooping cough. Her piece also includes the county-by-county data on whooping cough in California.
Calif. dental care crisis could get worse
Filed under: Health data, Health journalism, Hot Health Headline
Laurie Udesky, writing for The New York Times, has found that that pediatric dental care in the state has reached rock bottom, especially for children from low-income families. Unfortunately, in California, it’s starting to look like there may be a floor even lower than rock bottom. Udesky writes: “If Gov. Arnold Schwarzenegger’s recent proposed cuts remain — amounting to a $16.5 million reduction to Healthy Families and a $523 million reduction to Medi-Cal —more cases of untreated dental-related illnesses are likely.”
California children’s dental health was ranked third from the bottom in the National Survey of Children’s Health, above only Arizona and Texas. In the Bay Area, children and teenagers up to the age of 17 made nearly 1,980 visits to emergency rooms for preventable dental conditions in 2007. The cost of these visits averaged $172, but if a problem required hospitalization it cost an average of $5,000.
Today, experts interviewed said the dental care crisis had reached an even more alarming level. “We can only go up from here,” said Dr. Jared I. Fine, the dental health administrator at Alameda County Public Health Department. “We have an epidemic of dental disease in children that’s absurdly pervasive.”
For more on children’s dental health, check out The Cost of Delay (PDF), a report the Pew Center on the States released earlier this year. It seeks to answer the questions “What can states do to ensure better dental care?” and “How many states are doing those things right now?” and includes a strong body of statistics and analysis within its 74 pages.
The National Survey of Children’s Health, last fully updated in 2007, is still a comprehensive source for national data on pediatric dental health. There are data fields for overall dental health, as well as for specific oral health issues in children. For an overview of the data, I just pulled the overall health numbers and mapped a subset of them.
Warehouses are ‘magnets for pollution’
Mira Loma, a town east of Los Angeles that’s become home to distribution centers and warehouses for some of the nation’s largest corporations, often finds itself playing host to more than 800 tractor trailers an hour.
Photo by cupcakes2 via Flickr
And, even in air-quality deprived Southern California, that makes for some serious pollution.
Caitlan Carroll, of American Public Media’s Marketplace, assessed their impact. Locals complain of soot, stench and respiratory problems and planners openly wish the village of Mira Loma weren’t so close to the warehouse district.
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Spend a week at the CDC studying public health, meeting sources. Apply for the AHCJ-CDC Health Journalism Fellowships today!
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- Briefing: Reporting on health reform between now and 2014
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