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The decline is slight -- from 81.2 to 81.1 years -- but worrisome.\u003c/p>\n\u003cp>While the report did not include causes of death, \u003ca href=\"http://www.npr.org/sections/health-shots/2016/04/20/474884894/life-expectancy-drops-for-white-women-increases-for-black-men\" target=\"_blank\">NPR reports\u003c/a> that the author of the analysis, Elizabeth Arias, looked deeper and examined causes of death for white people over the last 15 years.\u003c/p>\n\u003cp>\"For the age group 25 to 54, suicide went up,\" she told reporter Alison Kodjak. \"'Unintentional poisonings,' which is mainly alcohol and drug poisoning, and chronic liver disease -- those went up by quite a bit.\"\u003c/p>\n\u003cp>The report was drawn from all deaths recorded in the U.S. in 2014. Life expectancy for whites overall dropped to 78.8 years in 2014 from 78.9 in 2013.\u003c/p>\n\u003cp>The\u003ca href=\"http://www.nytimes.com/2016/04/20/health/life-expectancy-decline-mortality.html?_r=0\" target=\"_blank\"> New York Times\u003c/a> details that life expectancy for whites had been going up for decades but \u003ca href=\"http://www.nytimes.com/2015/10/28/health/death-rates-declining-for-decades-have-flattened-study-finds.html\" target=\"_blank\">stagnated more recently\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>It inched up in 2010 and 2011, and was flat in 2012 and 2013.\u003c/p>\n\u003cp>Recent research has documented surprising increases in death rates among less educated whites. Last year, a paper by Anne Case and Angus Deaton \u003ca href=\"http://www.pnas.org/content/112/49/15078\" target=\"_blank\">documented rising death rates among middle-age white Americans\u003c/a>, particularly those with no more than a high school education.\u003ca href=\"http://www.nytimes.com/2016/01/17/science/drug-overdoses-propel-rise-in-mortality-rates-of-young-whites.html\" target=\"_blank\"> Other research\u003c/a> has found rising rates among younger whites.\u003c/p>\n\u003cp>The pattern had puzzled demographers, but the recent analyses have pointed to suffering and anxiety among working-class whites.\u003c/p>\u003c/blockquote>\n\u003cp>(For a powerful look at one tragedy, read \u003ca href=\"http://www.washingtonpost.com/sf/national/2016/04/08/we-dont-know-why-it-came-to-this/\" target=\"_blank\">this Washington Post story\u003c/a> of the death of one 54-year-old woman in Tecumseh, Oklahoma.)\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>These structural conditions also affect men, but their overall life expectancy was unchanged.\u003c/p>\n\u003cp>While the news for whites is gloomy, other groups saw increases. Black men, in particular, had a relatively large gain in life expectancy of about six months, from 71.8 to 72.2 years (for blacks overall the rise was 75.1 to 75.2 years). Hispanic men and women both gained, from 81.6 to 81.8 years between 2013 and 2014.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"The gap between the white and black populations is quickly closing, and it's mainly because the black population is experiencing a great drop in mortality,\" \u003ca href=\"https://www.washingtonpost.com/news/to-your-health/wp/2016/04/20/cdc-life-expectancy-for-non-hispanic-white-women-dips-for-first-time-in-decades/\" target=\"_blank\">Arias told the Washington Post\u003c/a>.\u003c/p>\n\n","blocks":[],"excerpt":"Suicide, drug abuse and alcohol have begun to shorten the lives of white women. Hispanic men and women gained overall.","status":"publish","parent":0,"modified":1461197182,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":14,"wordCount":396},"headData":{"title":"Life Expectancy Down for White Women, Up for Black Men | KQED","description":"Suicide, drug abuse and alcohol have begun to shorten the lives of white women. Hispanic men and women gained overall.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Life Expectancy Down for White Women, Up for Black Men","datePublished":"2016-04-20T17:13:13.000Z","dateModified":"2016-04-21T00:06:22.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"175011 http://ww2.kqed.org/stateofhealth/?p=175011","disqusUrl":"https://ww2.kqed.org/stateofhealth/2016/04/20/life-expectancy-down-for-white-women-up-for-black-men/","disqusTitle":"Life Expectancy Down for White Women, Up for Black Men","path":"/stateofhealth/175011/life-expectancy-down-for-white-women-up-for-black-men","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>For the first time since the U.S. government began keeping records, the life expectancy for white women has declined, according to a \u003ca href=\"http://www.cdc.gov/nchs/products/databriefs/db244.htm\" target=\"_blank\">report\u003c/a> from the Centers for Disease Control and Prevention's National Center for Health Statistics. The decline is slight -- from 81.2 to 81.1 years -- but worrisome.\u003c/p>\n\u003cp>While the report did not include causes of death, \u003ca href=\"http://www.npr.org/sections/health-shots/2016/04/20/474884894/life-expectancy-drops-for-white-women-increases-for-black-men\" target=\"_blank\">NPR reports\u003c/a> that the author of the analysis, Elizabeth Arias, looked deeper and examined causes of death for white people over the last 15 years.\u003c/p>\n\u003cp>\"For the age group 25 to 54, suicide went up,\" she told reporter Alison Kodjak. \"'Unintentional poisonings,' which is mainly alcohol and drug poisoning, and chronic liver disease -- those went up by quite a bit.\"\u003c/p>\n\u003cp>The report was drawn from all deaths recorded in the U.S. in 2014. Life expectancy for whites overall dropped to 78.8 years in 2014 from 78.9 in 2013.\u003c/p>\n\u003cp>The\u003ca href=\"http://www.nytimes.com/2016/04/20/health/life-expectancy-decline-mortality.html?_r=0\" target=\"_blank\"> New York Times\u003c/a> details that life expectancy for whites had been going up for decades but \u003ca href=\"http://www.nytimes.com/2015/10/28/health/death-rates-declining-for-decades-have-flattened-study-finds.html\" target=\"_blank\">stagnated more recently\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>It inched up in 2010 and 2011, and was flat in 2012 and 2013.\u003c/p>\n\u003cp>Recent research has documented surprising increases in death rates among less educated whites. Last year, a paper by Anne Case and Angus Deaton \u003ca href=\"http://www.pnas.org/content/112/49/15078\" target=\"_blank\">documented rising death rates among middle-age white Americans\u003c/a>, particularly those with no more than a high school education.\u003ca href=\"http://www.nytimes.com/2016/01/17/science/drug-overdoses-propel-rise-in-mortality-rates-of-young-whites.html\" target=\"_blank\"> Other research\u003c/a> has found rising rates among younger whites.\u003c/p>\n\u003cp>The pattern had puzzled demographers, but the recent analyses have pointed to suffering and anxiety among working-class whites.\u003c/p>\u003c/blockquote>\n\u003cp>(For a powerful look at one tragedy, read \u003ca href=\"http://www.washingtonpost.com/sf/national/2016/04/08/we-dont-know-why-it-came-to-this/\" target=\"_blank\">this Washington Post story\u003c/a> of the death of one 54-year-old woman in Tecumseh, Oklahoma.)\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>These structural conditions also affect men, but their overall life expectancy was unchanged.\u003c/p>\n\u003cp>While the news for whites is gloomy, other groups saw increases. Black men, in particular, had a relatively large gain in life expectancy of about six months, from 71.8 to 72.2 years (for blacks overall the rise was 75.1 to 75.2 years). Hispanic men and women both gained, from 81.6 to 81.8 years between 2013 and 2014.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"The gap between the white and black populations is quickly closing, and it's mainly because the black population is experiencing a great drop in mortality,\" \u003ca href=\"https://www.washingtonpost.com/news/to-your-health/wp/2016/04/20/cdc-life-expectancy-for-non-hispanic-white-women-dips-for-first-time-in-decades/\" target=\"_blank\">Arias told the Washington Post\u003c/a>.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/175011/life-expectancy-down-for-white-women-up-for-black-men","authors":["240"],"categories":["stateofhealth_11"],"tags":["stateofhealth_249","stateofhealth_2519","stateofhealth_397"],"featImg":"stateofhealth_175018","label":"stateofhealth"},"stateofhealth_152183":{"type":"posts","id":"stateofhealth_152183","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"152183","score":null,"sort":[1456259097000]},"guestAuthors":[],"slug":"half-of-gay-black-men-will-get-hiv-cdc-analysis-shows","title":"Half of Gay Black Men Will Get HIV, CDC Analysis Shows","publishDate":1456259097,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>NEW YORK (AP) — About half of gay and bisexual black men will be diagnosed with the AIDS virus in their lifetime, according to the \u003ca href=\"http://www.cdc.gov/nchhstp/newsroom/docs/factsheets/lifetime-risk-hiv-dx-us.pdf\" target=\"_blank\">first-ever comprehensive national estimates\u003c/a> from the Centers for Disease Control and Prevention.\u003c/p>\n\u003cp>Overall, for the average American, the odds of an HIV infection is 1 in 99 and has been declining.\u003c/p>\n\u003cp>But the risk varies widely for different groups. For example, the projection is 1 in 2 for gay black men but fewer than 1 in 2,500 for heterosexual white men.\u003c/p>\n\u003cp>\"The differences are stark,\" said Dr. Jonathan Mermin of the CDC's National Center for HIV/AIDS. The CDC released the estimates at a Boston medical conference on Tuesday.\u003c/p>\n\u003cp>HIV, or human immunodeficiency virus, is spread mainly through sex and sharing needles for injecting drugs. In the U.S., infections have long been most common in men who have sex with men. Since AIDS was first identified more than 30 years ago, medicines have changed it from a death sentence to a chronic threat.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The report provides an unusually vivid picture of what's been happening with HIV infections. The estimates were calculated from HIV diagnosis and death figures from 2009 through 2013.\u003c/p>\n\u003cp>New HIV infections have been falling in the United States, to about 40,000 annually. A disproportionately large share — about 10,000 cases — has been in gay and bisexual black men. That number has been holding steady while infections in other groups have fallen.\u003c/p>\n\u003cp>The lifetime risk of HIV has also has been declining. Several years ago, the CDC put that estimate at less than 1 in 78 for all Americans. It fell about 20 percent, to 1 in 99, and dropped for both men and women. That suggests prevention efforts are paying off, Mermin said.\u003c/p>\n\u003cp>The earlier estimate was based on 33 states; the \u003ca href=\"http://www.cdc.gov/nchhstp/newsroom/docs/factsheets/lifetime-risk-hiv-dx-us.pdf\" target=\"_blank\">new report\u003c/a> covers all 50 states and the District of Columbia. That allowed the agency — for the first time — to calculate lifetime risk for specific groups, like gay black men, and for states.\u003c/p>\n\u003cp>Again, the overall risk that the average American will be diagnosed with HIV during his or her lifetime is 1 in 99.\u003c/p>\n\u003cp>Findings include:\u003c/p>\n\u003cul>\n\u003cli>Based on geography, the chances of being diagnosed with HIV is highest in Washington, D.C., and Southern states like Georgia, Florida, Louisiana and Maryland.\u003c/li>\n\u003cli>The risk is lowest in North Dakota. One in 670 residents of that state will be diagnosed with HIV, compared to about 1 in 50 in Maryland and Georgia.\u003c/li>\n\u003cli>In California, the overall risk is 1 in 102\u003c/li>\n\u003cli>Gay and bisexual men have the highest risk, but there are racial differences within that group. For gay white men it's about 1 in 11 — a significantly smaller proportion than the estimate for blacks and Hispanics.\u003c/li>\n\u003cli>Among heterosexuals, blacks are far more likely to be infected than other racial groups. For example, 1 in 49 black women compared to 1 in 1,083 white women.\u003c/li>\n\u003c/ul>\n\u003cp>“You see this community that is at far higher risk for HIV infection, but there almost seems to be a concerted effort not to talk about it,” Greg Millett, vice president and director of Public Policy at AmfAR, the Foundation for AIDS Research, told \u003ca href=\"http://www.bloomberg.com/news/articles/2016-02-23/gay-black-men-are-still-bearing-the-brunt-of-the-hiv-crisis\" target=\"_blank\">Bloomberg News\u003c/a>. He was not involved in the research, but did work at CDC until 2014.\u003c/p>\n\u003cp>In a \u003ca href=\"http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)60899-X/abstract\" target=\"_blank\">2012 analysis,\u003c/a> Millett found the disparity was not linked to gay black men engaging in riskier sex. As Bloomberg reports:\u003c/p>\n\u003cblockquote>\u003cp>Rather, he cites such structural barriers as access to health insurance that have made it harder for blacks to get HIV testing and treatment that can control the virus and reduce the risk of infecting a partner.\u003c/p>\u003c/blockquote>\n\u003cp>Marguerita Lightfoot, director of the UC San Francisco Center for AIDS Prevention called the numbers \"shocking.\"\u003c/p>\n\u003cp>[contextly_sidebar id=\"UwZFLWI6km758gDhJI39O7UhloU3at8y\"]She agreed that HIV testing is a first step toward reducing the risk of infected men spreading the virus to others. With treatments available today, the virus can be reduced to undetectable levels in the bloodstream, making it virtually impossible to infect others.\u003c/p>\n\u003cp>For those who are negative, a key strategy that has become available just in the last two years is \"PrEP\" -- pre-exposure prophylaxis -- a pill that can dramatically reduce the risk of acquiring the virus. \"The big thing we can be doing is making sure young, black men in particular get access to PrEP,\" Lightfoot said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The report is a \"wake up call,\" Lightfoot said. \"We know clearly who we need to be targeting. We just need to get to work.\"\u003c/p>\n\n","blocks":[],"excerpt":"It's the first comprehensive analysis that looks at all 50 states and rates by race and ethnicity.","status":"publish","parent":0,"modified":1456270200,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":20,"wordCount":765},"headData":{"title":"Half of Gay Black Men Will Get HIV, CDC Analysis Shows | KQED","description":"It's the first comprehensive analysis that looks at all 50 states and rates by race and ethnicity.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Half of Gay Black Men Will Get HIV, CDC Analysis Shows","datePublished":"2016-02-23T20:24:57.000Z","dateModified":"2016-02-23T23:30:00.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"152183 http://ww2.kqed.org/stateofhealth/?p=152183","disqusUrl":"https://ww2.kqed.org/stateofhealth/2016/02/23/half-of-gay-black-men-will-get-hiv-cdc-analysis-shows/","disqusTitle":"Half of Gay Black Men Will Get HIV, CDC Analysis Shows","nprByline":"Mike Stobbe","path":"/stateofhealth/152183/half-of-gay-black-men-will-get-hiv-cdc-analysis-shows","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>NEW YORK (AP) — About half of gay and bisexual black men will be diagnosed with the AIDS virus in their lifetime, according to the \u003ca href=\"http://www.cdc.gov/nchhstp/newsroom/docs/factsheets/lifetime-risk-hiv-dx-us.pdf\" target=\"_blank\">first-ever comprehensive national estimates\u003c/a> from the Centers for Disease Control and Prevention.\u003c/p>\n\u003cp>Overall, for the average American, the odds of an HIV infection is 1 in 99 and has been declining.\u003c/p>\n\u003cp>But the risk varies widely for different groups. For example, the projection is 1 in 2 for gay black men but fewer than 1 in 2,500 for heterosexual white men.\u003c/p>\n\u003cp>\"The differences are stark,\" said Dr. Jonathan Mermin of the CDC's National Center for HIV/AIDS. The CDC released the estimates at a Boston medical conference on Tuesday.\u003c/p>\n\u003cp>HIV, or human immunodeficiency virus, is spread mainly through sex and sharing needles for injecting drugs. In the U.S., infections have long been most common in men who have sex with men. Since AIDS was first identified more than 30 years ago, medicines have changed it from a death sentence to a chronic threat.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The report provides an unusually vivid picture of what's been happening with HIV infections. The estimates were calculated from HIV diagnosis and death figures from 2009 through 2013.\u003c/p>\n\u003cp>New HIV infections have been falling in the United States, to about 40,000 annually. A disproportionately large share — about 10,000 cases — has been in gay and bisexual black men. That number has been holding steady while infections in other groups have fallen.\u003c/p>\n\u003cp>The lifetime risk of HIV has also has been declining. Several years ago, the CDC put that estimate at less than 1 in 78 for all Americans. It fell about 20 percent, to 1 in 99, and dropped for both men and women. That suggests prevention efforts are paying off, Mermin said.\u003c/p>\n\u003cp>The earlier estimate was based on 33 states; the \u003ca href=\"http://www.cdc.gov/nchhstp/newsroom/docs/factsheets/lifetime-risk-hiv-dx-us.pdf\" target=\"_blank\">new report\u003c/a> covers all 50 states and the District of Columbia. That allowed the agency — for the first time — to calculate lifetime risk for specific groups, like gay black men, and for states.\u003c/p>\n\u003cp>Again, the overall risk that the average American will be diagnosed with HIV during his or her lifetime is 1 in 99.\u003c/p>\n\u003cp>Findings include:\u003c/p>\n\u003cul>\n\u003cli>Based on geography, the chances of being diagnosed with HIV is highest in Washington, D.C., and Southern states like Georgia, Florida, Louisiana and Maryland.\u003c/li>\n\u003cli>The risk is lowest in North Dakota. One in 670 residents of that state will be diagnosed with HIV, compared to about 1 in 50 in Maryland and Georgia.\u003c/li>\n\u003cli>In California, the overall risk is 1 in 102\u003c/li>\n\u003cli>Gay and bisexual men have the highest risk, but there are racial differences within that group. For gay white men it's about 1 in 11 — a significantly smaller proportion than the estimate for blacks and Hispanics.\u003c/li>\n\u003cli>Among heterosexuals, blacks are far more likely to be infected than other racial groups. For example, 1 in 49 black women compared to 1 in 1,083 white women.\u003c/li>\n\u003c/ul>\n\u003cp>“You see this community that is at far higher risk for HIV infection, but there almost seems to be a concerted effort not to talk about it,” Greg Millett, vice president and director of Public Policy at AmfAR, the Foundation for AIDS Research, told \u003ca href=\"http://www.bloomberg.com/news/articles/2016-02-23/gay-black-men-are-still-bearing-the-brunt-of-the-hiv-crisis\" target=\"_blank\">Bloomberg News\u003c/a>. He was not involved in the research, but did work at CDC until 2014.\u003c/p>\n\u003cp>In a \u003ca href=\"http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)60899-X/abstract\" target=\"_blank\">2012 analysis,\u003c/a> Millett found the disparity was not linked to gay black men engaging in riskier sex. As Bloomberg reports:\u003c/p>\n\u003cblockquote>\u003cp>Rather, he cites such structural barriers as access to health insurance that have made it harder for blacks to get HIV testing and treatment that can control the virus and reduce the risk of infecting a partner.\u003c/p>\u003c/blockquote>\n\u003cp>Marguerita Lightfoot, director of the UC San Francisco Center for AIDS Prevention called the numbers \"shocking.\"\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>She agreed that HIV testing is a first step toward reducing the risk of infected men spreading the virus to others. With treatments available today, the virus can be reduced to undetectable levels in the bloodstream, making it virtually impossible to infect others.\u003c/p>\n\u003cp>For those who are negative, a key strategy that has become available just in the last two years is \"PrEP\" -- pre-exposure prophylaxis -- a pill that can dramatically reduce the risk of acquiring the virus. \"The big thing we can be doing is making sure young, black men in particular get access to PrEP,\" Lightfoot said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The report is a \"wake up call,\" Lightfoot said. \"We know clearly who we need to be targeting. We just need to get to work.\"\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/152183/half-of-gay-black-men-will-get-hiv-cdc-analysis-shows","authors":["byline_stateofhealth_152183"],"categories":["stateofhealth_11"],"tags":["stateofhealth_249","stateofhealth_313","stateofhealth_2519","stateofhealth_320"],"featImg":"stateofhealth_152208","label":"stateofhealth"},"stateofhealth_90763":{"type":"posts","id":"stateofhealth_90763","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"90763","score":null,"sort":[1444412754000]},"guestAuthors":[],"slug":"no-one-explained-before-surgery-video","title":"'No One Explained' Before Surgery (Video)","publishDate":1444412754,"format":"video","headTitle":"Vital Signs | State of Health | KQED News","labelTerm":{"term":2363,"site":"stateofhealth"},"content":"\u003cp>Fully one-third of California farmworkers speak a language indigenous to Mexico. They likely do not understand Spanish. And when they need to see a doctor, there's usually no one to translate for them.\u003c/p>\n\u003cp>In an emergency, it can be downright frightening. Angelina Diaz-Ramirez, 50, suffered a heart attack while working in a green bean field near Salinas. She is from southern Mexico and speaks Triqui.\u003c/p>\n\u003cp>Diaz-Ramirez was taken by ambulance, and she says no one explained anything to her before she underwent a surgery. \"I was scared, but I didn't have a choice,\" she says.\u003c/p>\n\u003cp>As part of our ongoing series Vital Signs, photojournalist Jeremy Raff produced the video about Diaz-Ramirez. Read his \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/09/28/need-a-medical-interpreter-try-looking-in-californias-strawberry-fields/\" target=\"_blank\">full story \u003c/a>on the dire need for medical interpreters for indigenous Mexicans who have immigrated to California.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n","blocks":[],"excerpt":"\"When I woke up, I just felt pain where they did the surgery. I cried because I didn't understand.\"","status":"publish","parent":0,"modified":1444493359,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":6,"wordCount":139},"headData":{"title":"'No One Explained' Before Surgery (Video) | KQED","description":""When I woke up, I just felt pain where they did the surgery. I cried because I didn't understand."","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"'No One Explained' Before Surgery (Video)","datePublished":"2015-10-09T17:45:54.000Z","dateModified":"2015-10-10T16:09:19.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"90763 http://ww2.kqed.org/stateofhealth/?p=90763","disqusUrl":"https://ww2.kqed.org/stateofhealth/2015/10/09/no-one-explained-before-surgery-video/","disqusTitle":"'No One Explained' Before Surgery (Video)","videoEmbed":"https://vimeo.com/140479930","path":"/stateofhealth/90763/no-one-explained-before-surgery-video","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Fully one-third of California farmworkers speak a language indigenous to Mexico. They likely do not understand Spanish. And when they need to see a doctor, there's usually no one to translate for them.\u003c/p>\n\u003cp>In an emergency, it can be downright frightening. Angelina Diaz-Ramirez, 50, suffered a heart attack while working in a green bean field near Salinas. She is from southern Mexico and speaks Triqui.\u003c/p>\n\u003cp>Diaz-Ramirez was taken by ambulance, and she says no one explained anything to her before she underwent a surgery. \"I was scared, but I didn't have a choice,\" she says.\u003c/p>\n\u003cp>As part of our ongoing series Vital Signs, photojournalist Jeremy Raff produced the video about Diaz-Ramirez. Read his \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/09/28/need-a-medical-interpreter-try-looking-in-californias-strawberry-fields/\" target=\"_blank\">full story \u003c/a>on the dire need for medical interpreters for indigenous Mexicans who have immigrated to California.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/90763/no-one-explained-before-surgery-video","authors":["8344"],"series":["stateofhealth_2363"],"categories":["stateofhealth_11"],"tags":["stateofhealth_249","stateofhealth_407","stateofhealth_2519"],"featImg":"stateofhealth_91176","label":"stateofhealth_2363"},"stateofhealth_86029":{"type":"posts","id":"stateofhealth_86029","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"86029","score":null,"sort":[1443627013000]},"guestAuthors":[],"slug":"african-americans-face-higher-colon-cancer-risk-less-likely-to-be-screened","title":"African-Americans Face Higher Colon Cancer Risk, Less Likely to be Screened","publishDate":1443627013,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>Every year, 140,000 Americans are diagnosed with colon cancer, and more than 50,000 die from it. It's the third leading cause of cancer-related deaths. But among those tens of thousands who are suffering, African-Americans are especially vulnerable.\u003c/p>\n\u003cp>“African-Americans are more likely to get colon cancer, they’re more likely to have an advanced stage of disease when they’re diagnosed with colon cancer,\" says Dr. Fola May, a gastroenterologist at UCLA. \"They’re more likely to die from colon cancer.”\u003c/p>\n\u003caside class=\"pullquote alignright\">\n“It’s a message that we need to get out, especially to the African-American community, that by going and having a colonoscopy, you lessen the chances of being diagnosed with this.\"\u003cbr>\n\u003ccite>Erin Stennis, widow of colon cancer patient\u003c/cite>\u003cbr>\n\u003c/aside>\n\u003cp>May is co-author of a \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/25737445\" target=\"_blank\">recent study\u003c/a> that looked at the records of Californians between 40 and 80 years old who have a parent, sibling, or child that’s had colon cancer. That population is at higher risk of developing colon cancer themselves. But of that group, only three out of five had been screened for colon cancer themselves.\u003c/p>\n\u003cp>Dr. Brennan Spiegel, senior author of the study and director of health services at Cedars Sinai in Los Angeles, said this finding revealed \"a big problem.\" The findings grew more sobering from there.\u003c/p>\n\u003cp>\"(W)hen we drilled down into that group and looked at racial and ethnic disparities, we found that African-Americans were 71 percent less likely to get screened than white Californians,\" he said. \"So, this is an even bigger indictment.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Colon cancer screening is especially beneficial, because benign lesions can be found and removed, preventing cancer from having a chance to develop.\u003c/p>\n\u003cp>You might think that close relatives of colon cancer patients would want to be screened. But take the case of the family of Cordell Harper, a 67-year-old African-American man. Fourteen years ago he was diagnosed with colon cancer. He underwent surgery and chemotherapy.\u003c/p>\n\u003cp>Harper has three brothers. They all refuse to get colonoscopies.\u003c/p>\n\u003cp>“So, if having a brother get colon cancer doesn’t make you want to get a colonoscopy, what will?” he asks, with a laugh. \"Having issues, you know, and it may be too late then.”\u003c/p>\n\u003cp>Harper’s brothers are all over 50. That’s the age many\u003ca href=\"http://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/colorectal-cancer-screening\" target=\"_blank\"> national organizations\u003c/a> recommend people begin colon cancer screening. But those with a family history \u003ca href=\"http://www.cancer.org/cancer/colonandrectumcancer/moreinformation/colonandrectumcancerearlydetection/colorectal-cancer-early-detection-acs-recommendations\" target=\"_blank\">should start sooner\u003c/a>. Part of the reason Harper’s brothers won’t get screened has to do with the stigma of having a colonoscopy, which involves threading a flexible tube, called a colonoscope, through the rectum and into the colon. Dr. Fola May says that’s a common concern.\u003c/p>\n\u003cp>“Men in our \u003ca href=\"http://www.researchgate.net/publication/276209726_Addressing_Low_Colorectal_Cancer_Screening_in_African_Americans_Using_Focus_Groups_to_Inform_the_Development_of_Effective_Interventions\" target=\"_blank\">focus group study \u003c/a>and men in other studies have said, ‘I do not want any sort of procedure where I have to have any sort of instrument that’s placed into my behind,' \" May said. \"That was a persistent theme throughout our ... studies.”\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/226272254\" params=\"color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" iframe=\"true\" /]\u003c/p>\n\u003cp>That was the case with Michael Stennis, who died of colon cancer in 2003. I met his wife, Erin Stennis, at a “Relay for Life” cancer event in Los Angeles this summer. After he found blood in his stool, a gastroenterologist told him to get a colonoscopy.\u003c/p>\n\u003cp>“When he found out what a colonoscopy was, he said no one was going to do that to him,\" Erin Stennis told me. \"So he literally sucked up the pain for about six years, and it got to the point where I found him one day hunched over in a closet in our home.”\u003c/p>\n\u003cp>Her husband was soon diagnosed with stage four colon cancer. He lived just two more years. During that time, the couple talked to everyone they could, going to churches and other groups, to try to raise awareness of colon cancer among African Americans.\u003c/p>\n\u003cp>“I think it’s a message that we need to get out, especially to the African-American community,\" Erin Stennis said, \"that by going and having a colonoscopy, you lessen the chances of being diagnosed with this. It’s getting over the stigma attached to colonoscopy and what the procedure entails.\"\u003c/p>\n\u003cp>But the low screening rates are due to more than stigma. In another \u003ca href=\"http://www.gastrojournal.org/article/S0016-5085(15)32000-X/abstract\" target=\"_blank\">study\u003c/a>, Spiegel and his colleagues, found that part of the responsibility may rest with doctors.\u003c/p>\n\u003cp>“We found that African-Americans were more likely to say that their doctor never recommended a colonoscopy or any kind of colon cancer screening than any other racial and ethnic groups,” Dr. Spiegel said.\u003c/p>\n\u003cp>Dr. Spiegel says that’s a big failure at the provider level. A nudge from the doctor could make a big difference.\u003c/p>\n\u003cp>“We found that when doctors do recommend screening, it increases the chances of getting screened by nearly twofold,” Dr. Spiegel said.\u003c/p>\n\u003cp>Dr. Spiegel’s team is planning a follow-up study to see if the Affordable Care Act, which fully covers preventive tests like colonoscopies, will make any dent in the racial disparity of colon cancer outcomes.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Avishay Artsy reported this story as a 2015 California Health Journalism Fellow at the USC Annenberg School of Journalism.\u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"They are more likely to be diagnosed with advanced disease and are more likely to die of colon cancer.","status":"publish","parent":0,"modified":1443636107,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":24,"wordCount":922},"headData":{"title":"African-Americans Face Higher Colon Cancer Risk, Less Likely to be Screened | KQED","description":"They are more likely to be diagnosed with advanced disease and are more likely to die of colon cancer.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"African-Americans Face Higher Colon Cancer Risk, Less Likely to be Screened","datePublished":"2015-09-30T15:30:13.000Z","dateModified":"2015-09-30T18:01:47.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"86029 http://ww2.kqed.org/stateofhealth/?p=86029","disqusUrl":"https://ww2.kqed.org/stateofhealth/2015/09/30/african-americans-face-higher-colon-cancer-risk-less-likely-to-be-screened/","disqusTitle":"African-Americans Face Higher Colon Cancer Risk, Less Likely to be Screened","nprByline":"Avishay Artsy","path":"/stateofhealth/86029/african-americans-face-higher-colon-cancer-risk-less-likely-to-be-screened","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Every year, 140,000 Americans are diagnosed with colon cancer, and more than 50,000 die from it. It's the third leading cause of cancer-related deaths. But among those tens of thousands who are suffering, African-Americans are especially vulnerable.\u003c/p>\n\u003cp>“African-Americans are more likely to get colon cancer, they’re more likely to have an advanced stage of disease when they’re diagnosed with colon cancer,\" says Dr. Fola May, a gastroenterologist at UCLA. \"They’re more likely to die from colon cancer.”\u003c/p>\n\u003caside class=\"pullquote alignright\">\n“It’s a message that we need to get out, especially to the African-American community, that by going and having a colonoscopy, you lessen the chances of being diagnosed with this.\"\u003cbr>\n\u003ccite>Erin Stennis, widow of colon cancer patient\u003c/cite>\u003cbr>\n\u003c/aside>\n\u003cp>May is co-author of a \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/25737445\" target=\"_blank\">recent study\u003c/a> that looked at the records of Californians between 40 and 80 years old who have a parent, sibling, or child that’s had colon cancer. That population is at higher risk of developing colon cancer themselves. But of that group, only three out of five had been screened for colon cancer themselves.\u003c/p>\n\u003cp>Dr. Brennan Spiegel, senior author of the study and director of health services at Cedars Sinai in Los Angeles, said this finding revealed \"a big problem.\" The findings grew more sobering from there.\u003c/p>\n\u003cp>\"(W)hen we drilled down into that group and looked at racial and ethnic disparities, we found that African-Americans were 71 percent less likely to get screened than white Californians,\" he said. \"So, this is an even bigger indictment.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Colon cancer screening is especially beneficial, because benign lesions can be found and removed, preventing cancer from having a chance to develop.\u003c/p>\n\u003cp>You might think that close relatives of colon cancer patients would want to be screened. But take the case of the family of Cordell Harper, a 67-year-old African-American man. Fourteen years ago he was diagnosed with colon cancer. He underwent surgery and chemotherapy.\u003c/p>\n\u003cp>Harper has three brothers. They all refuse to get colonoscopies.\u003c/p>\n\u003cp>“So, if having a brother get colon cancer doesn’t make you want to get a colonoscopy, what will?” he asks, with a laugh. \"Having issues, you know, and it may be too late then.”\u003c/p>\n\u003cp>Harper’s brothers are all over 50. That’s the age many\u003ca href=\"http://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/colorectal-cancer-screening\" target=\"_blank\"> national organizations\u003c/a> recommend people begin colon cancer screening. But those with a family history \u003ca href=\"http://www.cancer.org/cancer/colonandrectumcancer/moreinformation/colonandrectumcancerearlydetection/colorectal-cancer-early-detection-acs-recommendations\" target=\"_blank\">should start sooner\u003c/a>. Part of the reason Harper’s brothers won’t get screened has to do with the stigma of having a colonoscopy, which involves threading a flexible tube, called a colonoscope, through the rectum and into the colon. Dr. Fola May says that’s a common concern.\u003c/p>\n\u003cp>“Men in our \u003ca href=\"http://www.researchgate.net/publication/276209726_Addressing_Low_Colorectal_Cancer_Screening_in_African_Americans_Using_Focus_Groups_to_Inform_the_Development_of_Effective_Interventions\" target=\"_blank\">focus group study \u003c/a>and men in other studies have said, ‘I do not want any sort of procedure where I have to have any sort of instrument that’s placed into my behind,' \" May said. \"That was a persistent theme throughout our ... studies.”\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cdiv class='utils-parseShortcode-shortcodes-__shortcodes__shortcodeWrapper'>\n \u003ciframe width='100%' height='166'\n scrolling='no' frameborder='no'\n src='https://w.soundcloud.com/player/?url=https://api.soundcloud.com/tracks/226272254&visual=true&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false'\n title='https://api.soundcloud.com/tracks/226272254'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>That was the case with Michael Stennis, who died of colon cancer in 2003. I met his wife, Erin Stennis, at a “Relay for Life” cancer event in Los Angeles this summer. After he found blood in his stool, a gastroenterologist told him to get a colonoscopy.\u003c/p>\n\u003cp>“When he found out what a colonoscopy was, he said no one was going to do that to him,\" Erin Stennis told me. \"So he literally sucked up the pain for about six years, and it got to the point where I found him one day hunched over in a closet in our home.”\u003c/p>\n\u003cp>Her husband was soon diagnosed with stage four colon cancer. He lived just two more years. During that time, the couple talked to everyone they could, going to churches and other groups, to try to raise awareness of colon cancer among African Americans.\u003c/p>\n\u003cp>“I think it’s a message that we need to get out, especially to the African-American community,\" Erin Stennis said, \"that by going and having a colonoscopy, you lessen the chances of being diagnosed with this. It’s getting over the stigma attached to colonoscopy and what the procedure entails.\"\u003c/p>\n\u003cp>But the low screening rates are due to more than stigma. In another \u003ca href=\"http://www.gastrojournal.org/article/S0016-5085(15)32000-X/abstract\" target=\"_blank\">study\u003c/a>, Spiegel and his colleagues, found that part of the responsibility may rest with doctors.\u003c/p>\n\u003cp>“We found that African-Americans were more likely to say that their doctor never recommended a colonoscopy or any kind of colon cancer screening than any other racial and ethnic groups,” Dr. Spiegel said.\u003c/p>\n\u003cp>Dr. Spiegel says that’s a big failure at the provider level. A nudge from the doctor could make a big difference.\u003c/p>\n\u003cp>“We found that when doctors do recommend screening, it increases the chances of getting screened by nearly twofold,” Dr. Spiegel said.\u003c/p>\n\u003cp>Dr. Spiegel’s team is planning a follow-up study to see if the Affordable Care Act, which fully covers preventive tests like colonoscopies, will make any dent in the racial disparity of colon cancer outcomes.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Avishay Artsy reported this story as a 2015 California Health Journalism Fellow at the USC Annenberg School of Journalism.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/86029/african-americans-face-higher-colon-cancer-risk-less-likely-to-be-screened","authors":["byline_stateofhealth_86029"],"categories":["stateofhealth_11","stateofhealth_13"],"tags":["stateofhealth_193","stateofhealth_249","stateofhealth_2519"],"featImg":"stateofhealth_86077","label":"stateofhealth"},"stateofhealth_83818":{"type":"posts","id":"stateofhealth_83818","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"83818","score":null,"sort":[1443451543000]},"guestAuthors":[],"slug":"need-a-medical-interpreter-try-looking-in-californias-strawberry-fields","title":"Mexican Indigenous Immigrants' Dire Need for Medical Interpreters","publishDate":1443451543,"format":"image","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>Imagine you are rushed to the hospital as pain radiates through your chest. Doctors whirl around you, but you don’t know what's happening because everyone is speaking a foreign language.\u003c/p>\n\u003cp>That’s what happened to farmworker Angelina Diaz-Ramirez, 50, after she had a heart attack in a Monterey County green bean field in 2012.\u003c/p>\n\u003cp>The foreman of her work crew took her to the main road and put her in an ambulance, alone. Diaz-Ramirez is an immigrant from Mexico, and while there were Spanish-speaking staff, she was still isolated by a language barrier.\u003c/p>\n\u003cp>That's because Diaz-Ramirez, like a third of California farmworkers, speaks a language indigenous to southern Mexico. She doesn’t understand Spanish. Her language, Triqui, is as different from Spanish as Navajo is from English.\u003c/p>\n\u003cp>https://vimeo.com/140479930\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>At the hospital, without a Triqui interpreter, “no one explained anything to me,” said Diaz-Ramirez.\u003c/p>\n\u003cp>“I was scared, but I didn’t have a choice,\" she said.\u003c/p>\n\u003cp>As anesthesia blotted out the operating room, Diaz-Ramirez had no idea a surgeon was about to cut open her chest to implant a pacemaker.\u003c/p>\n\u003cp>\u003cstrong>Medical Interpreters Are Key\u003c/strong>\u003c/p>\n\u003cp>Diaz-Ramirez’s case highlights the importance of trained medical interpreters, researchers say.\u003c/p>\n\u003caside class=\"pullquote alignright\">'No one explained anything to me. I was scared but I didn't have a choice.'\u003ccite>Angelina Diaz-Ramirez, Triqui farmworker who had heart surgery without an interpreter\u003c/cite>\u003c/aside>\n\u003cp>Interpreters are “absolutely necessary,” said Alicia Fernandez, a medical interpretation expert at UC San Francisco, because quality health care and basic informed consent are nearly impossible without one.\u003c/p>\n\u003cp>Interpreters “enormously increase patient understanding and satisfaction,” said Fernandez. She adds that interpreters also “increase physician satisfaction with the care they deliver.”\u003c/p>\n\u003cp>Medicine, she said, is not an antiseptic, scientific process. Doctors can’t just scan, medicate and operate. Clear communication is essential for accurate diagnosis and effective treatment.\u003c/p>\n\u003cp>[contextly_sidebar id=\"2KQd30QKKYZZL3bwvUkl6icTu31wfvST\"]\u003c/p>\n\u003cp>That’s why using improvised sign language, or asking a child to interpret -- just \"getting by\" -- is simply not good enough, said Fernandez.\u003c/p>\n\u003cp>“Getting by leads to mistakes,” she said. “And mistakes can be tragic, for both the patient and the physician.”\u003c/p>\n\u003cp>\u003cstrong>Indigenous Farmworkers Without Interpreters\u003c/strong>\u003c/p>\n\u003cp>Erica Gastelum, a pediatrician in Fresno, regrets that she rarely has access to an interpreter for her Mixteco-speaking patients. She says without one, “You're not able to provide equal care to all comers.”\u003c/p>\n\u003cfigure id=\"attachment_83923\" class=\"wp-caption alignleft\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/09/Lagnuage-map.png\">\u003cimg class=\"wp-image-83923 size-thumbnail\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/09/Lagnuage-map-400x225.png\" alt=\"This map shows where Mexican indigenous languages originate. Triqui and Mixteco belong to the oto-mangue family, in southwest of the country (Jeremy Raff/KQED). \" width=\"400\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">This map shows where Mexican indigenous languages originate. Triqui and Mixteco belong to the oto-mangue family, in the southwest of the country. (Jeremy Raff/KQED).\u003c/figcaption>\u003c/figure>\n\u003cp>She remembers a 1-year-old boy with fatal congenital heart disease. Doctors had exhausted every option, and the family was gathered in the intensive care unit.\u003c/p>\n\u003cp>“This is it, this is the moment where we’re going to disconnect the tubes,” said Gastelum. “It seemed like they understood. But in such a crucial moment like that, it would have been so much better to have a culturally sensitive, in-person interpreter.”\u003c/p>\n\u003cp>Most hospitals, including Gastelum’s, have telephone services that should let doctors call up an interpreter for any language. In practice, though, the system doesn’t always work for more unusual languages.\u003c/p>\n\u003cp>“When you try to use the phone interpreter line to get the indigenous speaker, you’ll be on hold for like two hours,” said Jasmine Walker, also a pediatrician in Fresno. “Then when you get them, they don't actually speak the language that you need.”\u003c/p>\n\u003cp>Seth Holmes is a physician who lived and worked alongside Triqui migrant farmworkers for 10 years and wrote about his experiences in the book \"\u003ca href=\"http://www.ucpress.edu/book.php?isbn=9780520275140\" target=\"_blank\">Fresh Fruit, Broken Bodies\u003c/a>.\" As the migrants followed crops up and down the West Coast, they often asked Holmes to accompany them to health clinics.\u003c/p>\n\u003cp>In dozens of clinics throughout California, Washington and Oregon, he said, “I have never seen any Triqui person get a medical interpreter.”\u003c/p>\n\u003cp>Hospitals may underestimate how many indigenous patients they have -- and how many interpreters they need -- because many providers assume all Mexicans speak Spanish. Some indigenous people may be afraid to call attention to themselves by asking for an interpreter because they are undocumented.\u003c/p>\n\u003cp>“They don't know that they’re entitled to someone who speaks their language,” said Leoncio Vasquez, who has been training interpreters for 15 years.\u003c/p>\n\u003cp>Any health care facility receiving public money has a legal obligation under both state and federal law to provide an interpreter to every patient who needs one. But only a few health care providers have made\u003ca href=\"http://www.indigenousfarmworkers.org/\" target=\"_blank\"> California’s 120,000 indigenous farmworkers\u003c/a> an explicit priority.\u003c/p>\n\u003cp>\u003cstrong>Interpreting a Big Opportunity for Some Farmworkers\u003c/strong>\u003c/p>\n\u003cp>Brigida Gonzalez, wearing a big \"Qualified Interpreter\" badge, hustles around Natividad Medical Center in Salinas. It's a big building and she’s needed all over.\u003c/p>\n\u003cp>Today she’s a professional employee at a big hospital. A year ago, she was picking strawberries nearby.\u003c/p>\n\u003cfigure id=\"attachment_83917\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/09/Brigida-Patient3-e1443272915487.png\">\u003cimg class=\"wp-image-83917 size-thumbnail\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/09/Brigida-Patient3-400x225.png\" alt=\"Interpreter Brigida Gonzalez\" width=\"400\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Before interpreter training, Brigida Gonzalez (R) worked in the strawberry fields nearby. \u003ccite>(Jeremy Raff/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In the fields one day, another picker noticed Gonzalez spoke English -- a rarity in agriculture -- and suggested she look into Natividad’s training program.\u003c/p>\n\u003cp>Staff at Natividad were thrilled to hear from Gonzalez, “because it was so hard to find someone who spoke English, Spanish and an indigenous language like Mixteco and Triqui,” she said.\u003c/p>\n\u003cp>Gonzalez completed Natividad's six-month training program for indigenous interpreters, the first of its kind, and now works there part time.\u003c/p>\n\u003cp>\u003cstrong>Not Just Hospitals\u003c/strong>\u003c/p>\n\u003cp>The need for trilingual interpreters like Gonzalez is growing, and it's not just hospitals.\u003c/p>\n\u003cp>Four hours down the coast in Oxnard, all three school districts have hired Mixteco interpreters, and the police have one on contract.\u003c/p>\n\u003cp>Altogether, there are about 20 Mixteco speakers making a good living with their language skills in Ventura County.\u003c/p>\n\u003cp>These opportunities are one reason why Argelia Zarate, the Oxnard school district’s first full-time Mixteco interpreter, encourages students to practice their Mixteco so they don’t lose it.\u003c/p>\n\u003cfigure id=\"attachment_83919\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/09/Argelia-1-of-1-e1443466270661.jpg\">\u003cimg class=\"size-full wp-image-83919\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/09/Argelia-1-of-1-e1443466270661.jpg\" alt=\"Argelia Zarate, a Mixteco interpreter at the Oxnard School District, encourages students to practice their native languages.\" width=\"1920\" height=\"1280\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Argelia Zarate, a Mixteco interpreter at the Oxnard School District, encourages students to practice their native languages. \u003ccite>(Jeremy Raff/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“I didn't go to college, yet I have this job,” said Zarate, “because the community is growing so big that they don't need bilinguals-- they need trilinguals.”\u003c/p>\n\u003cp>The U.S. Bureau of Labor Statistics expects employment of interpreters and translators to grow by\u003ca href=\"http://www.bls.gov/ooh/media-and-communication/interpreters-and-translators.htm\" target=\"_blank\"> 46 percent between 2012 and 2022.\u003c/a> Driving that demand is the \u003ca href=\"http://www.census.gov/content/dam/Census/library/publications/2013/acs/acs-22.pdf\" target=\"_blank\">158 percent increase since 1980 \u003c/a>in the number of people who speak a language other than English at home.\u003c/p>\n\u003cp>Nationally, the median hourly wage for interpreters is $25, compared with $9.09 for farm work.\u003c/p>\n\u003cp>Zarate says the better pay, stable hours and a chance to serve her community all make interpreting a big step up from field work.\u003c/p>\n\u003cp>“Here everybody is nice to you: they talk to you, appreciate what you do,” Zarate said at the elementary school where she works. “In the fields, they treat you like you’re nothing, a slave working for a little bit of money.”\u003c/p>\n\u003cp>The Mixteco/Indigena Community Organizing Project has trained dozens of interpreters in Ventura County and has pressured public agencies to make use of them.\u003c/p>\n\u003cfigure id=\"attachment_83920\" class=\"wp-caption alignright\" style=\"max-width: 5010px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/09/Argelia-2-of-2.jpg\">\u003cimg class=\"size-full wp-image-83920\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/09/Argelia-2-of-2.jpg\" alt=\"Maria, 6, arrived in Oxnard, CA, from the Mexican state of Oaxaca recently and speaks only Mixteco (Jeremy Raff/KQED).\" width=\"5010\" height=\"3340\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/09/Argelia-2-of-2.jpg 5010w, https://ww2.kqed.org/app/uploads/sites/27/2015/09/Argelia-2-of-2-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/09/Argelia-2-of-2-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2015/09/Argelia-2-of-2-1440x960.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2015/09/Argelia-2-of-2-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2015/09/Argelia-2-of-2-960x640.jpg 960w\" sizes=\"(max-width: 5010px) 100vw, 5010px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Maria, 6, arrived in Oxnard, CA, from the Mexican state of Oaxaca recently and speaks only Mixteco. (Jeremy Raff/KQED).\u003c/figcaption>\u003c/figure>\n\u003cp>Today, “Ventura County has invested in having better language access than most parts of California, and honestly most parts of Oaxaca,” said Margaret Sawyer, the group’s development director, referring to the Mexican state that many Mixteco migrants are from.\u003c/p>\n\u003cp>\u003cstrong>Barriers Remain\u003c/strong>\u003c/p>\n\u003cp>Not everyone trilingual can make the switch from farm work, though, because there are only a few full-time jobs.\u003c/p>\n\u003cp>Instead, most hospitals rely on freelance part-time interpreters, who have a hard time making a living.\u003c/p>\n\u003cp>“They will have you for two or three hours, then you’re done for the whole day,” said Israel Vasquez, a trilingual interpreter. “You can’t really live off that.” He eventually quit because he couldn’t get enough hours.\u003c/p>\n\u003cp>“Making a living specifically in health care interpreting right now is not really going to happen,” said Don Schinske, executive director of the California Healthcare Interpreting Association.\u003c/p>\n\u003cp>Part of the problem, Schinske said, is that even though federal law requires hospitals to provide interpreters, there is not a direct federal funding stream to pay for those services.\u003c/p>\n\u003cp>“You get a lot of this sentiment from hospitals: ‘Look, we’re trying to get people services in their language, but it is a nicety, not a necessity,’ ” said Schinske.\u003c/p>\n\u003cp>The indigenous interpretation programs at Natividad Medical Center are funded by private donations from agricultural businesses in the area, who have contributed $1.7 million since 2010.\u003c/p>\n\u003cp>Meanwhile, \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201520160AB635\" target=\"_blank\">a bill \u003c/a>that would make it easier for hospitals to get federal money for medical interpreters has stalled in the California Legislature.\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/225965640\" params=\"color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" iframe=\"true\" /]\u003c/p>\n\u003cp>\u003cstrong>Wasted Resource\u003c/strong>\u003c/p>\n\u003cp>Farmworker Angelina Diaz-Ramirez returned home after her surgery with a new pacemaker ticking in her chest -- and a stack of printed instructions that she couldn’t read.\u003c/p>\n\u003cp>“I didn’t know what to do,\" she said, through an interpreter. \"I had strong pain. Should I call them back?”\u003c/p>\n\u003cp>Diaz-Ramirez didn’t know who her cardiologist was, how to get an appointment or which medications to take. It's just the kind of confusion that a trained medical interpreter can prevent.\u003c/p>\n\u003cp>\"I just felt very sad,\" she said.\u003c/p>\n\u003cp>Every week, indigenous people with these same questions visit Leoncio Vasquez, the interpreter trainer in Fresno.\u003c/p>\n\u003cp>He looks through their paperwork, pieces together a backstory, and helps them figure out what to do next -- something that should have happened at the hospital or clinic, with one of the dozens of interpreters Vasquez has already trained.\u003c/p>\n\u003cp>But those interpreters “can’t find jobs related to interpreting,” said Vasquez. What do they do instead? “Some go back to the fields to do farm work.”\u003c/p>\n\u003cp>To Vasquez, it's a waste. He says that until more hospitals recognize these immigrants’ valuable language skills, trained interpreters will stay in the fields, picking strawberries.\u003c/p>\n\u003cp>\u003cem>This piece was produced with support from the Institute for Justice and Journalism.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003ci>California has the seventh-largest economy in the world, and immigrants have a long history in building that prosperity. Today one out of every three working people in California is an immigrant — a share that has grown in recent decades. Our state is shaped by these workers and entrepreneurs — 6 million people who’ve found a job in the Golden State. In our series “\u003ca href=\"http://ww2.kqed.org/news/series/california-immigrants-at-work\">Immigrant Shift\u003c/a>,” KQED and The California Report explore the impact they have, the challenges they face and the policies that affect them.\u003c/i>\u003c/p>\n\n","blocks":[],"excerpt":"One in three California farmworkers speaks an indigenous language and barely understands Spanish. ","status":"publish","parent":0,"modified":1443477793,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":67,"wordCount":1896},"headData":{"title":"Mexican Indigenous Immigrants' Dire Need for Medical Interpreters | KQED","description":"One in three California farmworkers speaks an indigenous language and barely understands Spanish. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Mexican Indigenous Immigrants' Dire Need for Medical Interpreters","datePublished":"2015-09-28T14:45:43.000Z","dateModified":"2015-09-28T22:03:13.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"83818 http://ww2.kqed.org/stateofhealth/?p=83818","disqusUrl":"https://ww2.kqed.org/stateofhealth/2015/09/28/need-a-medical-interpreter-try-looking-in-californias-strawberry-fields/","disqusTitle":"Mexican Indigenous Immigrants' Dire Need for Medical Interpreters","path":"/stateofhealth/83818/need-a-medical-interpreter-try-looking-in-californias-strawberry-fields","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Imagine you are rushed to the hospital as pain radiates through your chest. Doctors whirl around you, but you don’t know what's happening because everyone is speaking a foreign language.\u003c/p>\n\u003cp>That’s what happened to farmworker Angelina Diaz-Ramirez, 50, after she had a heart attack in a Monterey County green bean field in 2012.\u003c/p>\n\u003cp>The foreman of her work crew took her to the main road and put her in an ambulance, alone. Diaz-Ramirez is an immigrant from Mexico, and while there were Spanish-speaking staff, she was still isolated by a language barrier.\u003c/p>\n\u003cp>That's because Diaz-Ramirez, like a third of California farmworkers, speaks a language indigenous to southern Mexico. She doesn’t understand Spanish. Her language, Triqui, is as different from Spanish as Navajo is from English.\u003c/p>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"vimeoLink","attributes":{"named":{"vimeoId":"140479930"},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>At the hospital, without a Triqui interpreter, “no one explained anything to me,” said Diaz-Ramirez.\u003c/p>\n\u003cp>“I was scared, but I didn’t have a choice,\" she said.\u003c/p>\n\u003cp>As anesthesia blotted out the operating room, Diaz-Ramirez had no idea a surgeon was about to cut open her chest to implant a pacemaker.\u003c/p>\n\u003cp>\u003cstrong>Medical Interpreters Are Key\u003c/strong>\u003c/p>\n\u003cp>Diaz-Ramirez’s case highlights the importance of trained medical interpreters, researchers say.\u003c/p>\n\u003caside class=\"pullquote alignright\">'No one explained anything to me. I was scared but I didn't have a choice.'\u003ccite>Angelina Diaz-Ramirez, Triqui farmworker who had heart surgery without an interpreter\u003c/cite>\u003c/aside>\n\u003cp>Interpreters are “absolutely necessary,” said Alicia Fernandez, a medical interpretation expert at UC San Francisco, because quality health care and basic informed consent are nearly impossible without one.\u003c/p>\n\u003cp>Interpreters “enormously increase patient understanding and satisfaction,” said Fernandez. She adds that interpreters also “increase physician satisfaction with the care they deliver.”\u003c/p>\n\u003cp>Medicine, she said, is not an antiseptic, scientific process. Doctors can’t just scan, medicate and operate. Clear communication is essential for accurate diagnosis and effective treatment.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>That’s why using improvised sign language, or asking a child to interpret -- just \"getting by\" -- is simply not good enough, said Fernandez.\u003c/p>\n\u003cp>“Getting by leads to mistakes,” she said. “And mistakes can be tragic, for both the patient and the physician.”\u003c/p>\n\u003cp>\u003cstrong>Indigenous Farmworkers Without Interpreters\u003c/strong>\u003c/p>\n\u003cp>Erica Gastelum, a pediatrician in Fresno, regrets that she rarely has access to an interpreter for her Mixteco-speaking patients. She says without one, “You're not able to provide equal care to all comers.”\u003c/p>\n\u003cfigure id=\"attachment_83923\" class=\"wp-caption alignleft\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/09/Lagnuage-map.png\">\u003cimg class=\"wp-image-83923 size-thumbnail\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/09/Lagnuage-map-400x225.png\" alt=\"This map shows where Mexican indigenous languages originate. Triqui and Mixteco belong to the oto-mangue family, in southwest of the country (Jeremy Raff/KQED). \" width=\"400\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">This map shows where Mexican indigenous languages originate. Triqui and Mixteco belong to the oto-mangue family, in the southwest of the country. (Jeremy Raff/KQED).\u003c/figcaption>\u003c/figure>\n\u003cp>She remembers a 1-year-old boy with fatal congenital heart disease. Doctors had exhausted every option, and the family was gathered in the intensive care unit.\u003c/p>\n\u003cp>“This is it, this is the moment where we’re going to disconnect the tubes,” said Gastelum. “It seemed like they understood. But in such a crucial moment like that, it would have been so much better to have a culturally sensitive, in-person interpreter.”\u003c/p>\n\u003cp>Most hospitals, including Gastelum’s, have telephone services that should let doctors call up an interpreter for any language. In practice, though, the system doesn’t always work for more unusual languages.\u003c/p>\n\u003cp>“When you try to use the phone interpreter line to get the indigenous speaker, you’ll be on hold for like two hours,” said Jasmine Walker, also a pediatrician in Fresno. “Then when you get them, they don't actually speak the language that you need.”\u003c/p>\n\u003cp>Seth Holmes is a physician who lived and worked alongside Triqui migrant farmworkers for 10 years and wrote about his experiences in the book \"\u003ca href=\"http://www.ucpress.edu/book.php?isbn=9780520275140\" target=\"_blank\">Fresh Fruit, Broken Bodies\u003c/a>.\" As the migrants followed crops up and down the West Coast, they often asked Holmes to accompany them to health clinics.\u003c/p>\n\u003cp>In dozens of clinics throughout California, Washington and Oregon, he said, “I have never seen any Triqui person get a medical interpreter.”\u003c/p>\n\u003cp>Hospitals may underestimate how many indigenous patients they have -- and how many interpreters they need -- because many providers assume all Mexicans speak Spanish. Some indigenous people may be afraid to call attention to themselves by asking for an interpreter because they are undocumented.\u003c/p>\n\u003cp>“They don't know that they’re entitled to someone who speaks their language,” said Leoncio Vasquez, who has been training interpreters for 15 years.\u003c/p>\n\u003cp>Any health care facility receiving public money has a legal obligation under both state and federal law to provide an interpreter to every patient who needs one. But only a few health care providers have made\u003ca href=\"http://www.indigenousfarmworkers.org/\" target=\"_blank\"> California’s 120,000 indigenous farmworkers\u003c/a> an explicit priority.\u003c/p>\n\u003cp>\u003cstrong>Interpreting a Big Opportunity for Some Farmworkers\u003c/strong>\u003c/p>\n\u003cp>Brigida Gonzalez, wearing a big \"Qualified Interpreter\" badge, hustles around Natividad Medical Center in Salinas. It's a big building and she’s needed all over.\u003c/p>\n\u003cp>Today she’s a professional employee at a big hospital. A year ago, she was picking strawberries nearby.\u003c/p>\n\u003cfigure id=\"attachment_83917\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/09/Brigida-Patient3-e1443272915487.png\">\u003cimg class=\"wp-image-83917 size-thumbnail\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/09/Brigida-Patient3-400x225.png\" alt=\"Interpreter Brigida Gonzalez\" width=\"400\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Before interpreter training, Brigida Gonzalez (R) worked in the strawberry fields nearby. \u003ccite>(Jeremy Raff/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In the fields one day, another picker noticed Gonzalez spoke English -- a rarity in agriculture -- and suggested she look into Natividad’s training program.\u003c/p>\n\u003cp>Staff at Natividad were thrilled to hear from Gonzalez, “because it was so hard to find someone who spoke English, Spanish and an indigenous language like Mixteco and Triqui,” she said.\u003c/p>\n\u003cp>Gonzalez completed Natividad's six-month training program for indigenous interpreters, the first of its kind, and now works there part time.\u003c/p>\n\u003cp>\u003cstrong>Not Just Hospitals\u003c/strong>\u003c/p>\n\u003cp>The need for trilingual interpreters like Gonzalez is growing, and it's not just hospitals.\u003c/p>\n\u003cp>Four hours down the coast in Oxnard, all three school districts have hired Mixteco interpreters, and the police have one on contract.\u003c/p>\n\u003cp>Altogether, there are about 20 Mixteco speakers making a good living with their language skills in Ventura County.\u003c/p>\n\u003cp>These opportunities are one reason why Argelia Zarate, the Oxnard school district’s first full-time Mixteco interpreter, encourages students to practice their Mixteco so they don’t lose it.\u003c/p>\n\u003cfigure id=\"attachment_83919\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/09/Argelia-1-of-1-e1443466270661.jpg\">\u003cimg class=\"size-full wp-image-83919\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/09/Argelia-1-of-1-e1443466270661.jpg\" alt=\"Argelia Zarate, a Mixteco interpreter at the Oxnard School District, encourages students to practice their native languages.\" width=\"1920\" height=\"1280\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Argelia Zarate, a Mixteco interpreter at the Oxnard School District, encourages students to practice their native languages. \u003ccite>(Jeremy Raff/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“I didn't go to college, yet I have this job,” said Zarate, “because the community is growing so big that they don't need bilinguals-- they need trilinguals.”\u003c/p>\n\u003cp>The U.S. Bureau of Labor Statistics expects employment of interpreters and translators to grow by\u003ca href=\"http://www.bls.gov/ooh/media-and-communication/interpreters-and-translators.htm\" target=\"_blank\"> 46 percent between 2012 and 2022.\u003c/a> Driving that demand is the \u003ca href=\"http://www.census.gov/content/dam/Census/library/publications/2013/acs/acs-22.pdf\" target=\"_blank\">158 percent increase since 1980 \u003c/a>in the number of people who speak a language other than English at home.\u003c/p>\n\u003cp>Nationally, the median hourly wage for interpreters is $25, compared with $9.09 for farm work.\u003c/p>\n\u003cp>Zarate says the better pay, stable hours and a chance to serve her community all make interpreting a big step up from field work.\u003c/p>\n\u003cp>“Here everybody is nice to you: they talk to you, appreciate what you do,” Zarate said at the elementary school where she works. “In the fields, they treat you like you’re nothing, a slave working for a little bit of money.”\u003c/p>\n\u003cp>The Mixteco/Indigena Community Organizing Project has trained dozens of interpreters in Ventura County and has pressured public agencies to make use of them.\u003c/p>\n\u003cfigure id=\"attachment_83920\" class=\"wp-caption alignright\" style=\"max-width: 5010px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/09/Argelia-2-of-2.jpg\">\u003cimg class=\"size-full wp-image-83920\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/09/Argelia-2-of-2.jpg\" alt=\"Maria, 6, arrived in Oxnard, CA, from the Mexican state of Oaxaca recently and speaks only Mixteco (Jeremy Raff/KQED).\" width=\"5010\" height=\"3340\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/09/Argelia-2-of-2.jpg 5010w, https://ww2.kqed.org/app/uploads/sites/27/2015/09/Argelia-2-of-2-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/09/Argelia-2-of-2-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2015/09/Argelia-2-of-2-1440x960.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2015/09/Argelia-2-of-2-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2015/09/Argelia-2-of-2-960x640.jpg 960w\" sizes=\"(max-width: 5010px) 100vw, 5010px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Maria, 6, arrived in Oxnard, CA, from the Mexican state of Oaxaca recently and speaks only Mixteco. (Jeremy Raff/KQED).\u003c/figcaption>\u003c/figure>\n\u003cp>Today, “Ventura County has invested in having better language access than most parts of California, and honestly most parts of Oaxaca,” said Margaret Sawyer, the group’s development director, referring to the Mexican state that many Mixteco migrants are from.\u003c/p>\n\u003cp>\u003cstrong>Barriers Remain\u003c/strong>\u003c/p>\n\u003cp>Not everyone trilingual can make the switch from farm work, though, because there are only a few full-time jobs.\u003c/p>\n\u003cp>Instead, most hospitals rely on freelance part-time interpreters, who have a hard time making a living.\u003c/p>\n\u003cp>“They will have you for two or three hours, then you’re done for the whole day,” said Israel Vasquez, a trilingual interpreter. “You can’t really live off that.” He eventually quit because he couldn’t get enough hours.\u003c/p>\n\u003cp>“Making a living specifically in health care interpreting right now is not really going to happen,” said Don Schinske, executive director of the California Healthcare Interpreting Association.\u003c/p>\n\u003cp>Part of the problem, Schinske said, is that even though federal law requires hospitals to provide interpreters, there is not a direct federal funding stream to pay for those services.\u003c/p>\n\u003cp>“You get a lot of this sentiment from hospitals: ‘Look, we’re trying to get people services in their language, but it is a nicety, not a necessity,’ ” said Schinske.\u003c/p>\n\u003cp>The indigenous interpretation programs at Natividad Medical Center are funded by private donations from agricultural businesses in the area, who have contributed $1.7 million since 2010.\u003c/p>\n\u003cp>Meanwhile, \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201520160AB635\" target=\"_blank\">a bill \u003c/a>that would make it easier for hospitals to get federal money for medical interpreters has stalled in the California Legislature.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cdiv class='utils-parseShortcode-shortcodes-__shortcodes__shortcodeWrapper'>\n \u003ciframe width='100%' height='166'\n scrolling='no' frameborder='no'\n src='https://w.soundcloud.com/player/?url=https://api.soundcloud.com/tracks/225965640&visual=true&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false'\n title='https://api.soundcloud.com/tracks/225965640'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Wasted Resource\u003c/strong>\u003c/p>\n\u003cp>Farmworker Angelina Diaz-Ramirez returned home after her surgery with a new pacemaker ticking in her chest -- and a stack of printed instructions that she couldn’t read.\u003c/p>\n\u003cp>“I didn’t know what to do,\" she said, through an interpreter. \"I had strong pain. Should I call them back?”\u003c/p>\n\u003cp>Diaz-Ramirez didn’t know who her cardiologist was, how to get an appointment or which medications to take. It's just the kind of confusion that a trained medical interpreter can prevent.\u003c/p>\n\u003cp>\"I just felt very sad,\" she said.\u003c/p>\n\u003cp>Every week, indigenous people with these same questions visit Leoncio Vasquez, the interpreter trainer in Fresno.\u003c/p>\n\u003cp>He looks through their paperwork, pieces together a backstory, and helps them figure out what to do next -- something that should have happened at the hospital or clinic, with one of the dozens of interpreters Vasquez has already trained.\u003c/p>\n\u003cp>But those interpreters “can’t find jobs related to interpreting,” said Vasquez. What do they do instead? “Some go back to the fields to do farm work.”\u003c/p>\n\u003cp>To Vasquez, it's a waste. He says that until more hospitals recognize these immigrants’ valuable language skills, trained interpreters will stay in the fields, picking strawberries.\u003c/p>\n\u003cp>\u003cem>This piece was produced with support from the Institute for Justice and Journalism.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003ci>California has the seventh-largest economy in the world, and immigrants have a long history in building that prosperity. Today one out of every three working people in California is an immigrant — a share that has grown in recent decades. Our state is shaped by these workers and entrepreneurs — 6 million people who’ve found a job in the Golden State. In our series “\u003ca href=\"http://ww2.kqed.org/news/series/california-immigrants-at-work\">Immigrant Shift\u003c/a>,” KQED and The California Report explore the impact they have, the challenges they face and the policies that affect them.\u003c/i>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/83818/need-a-medical-interpreter-try-looking-in-californias-strawberry-fields","authors":["230"],"categories":["stateofhealth_11"],"tags":["stateofhealth_280","stateofhealth_249","stateofhealth_407","stateofhealth_325","stateofhealth_53","stateofhealth_2519","stateofhealth_251"],"featImg":"stateofhealth_83922","label":"stateofhealth"},"stateofhealth_59811":{"type":"posts","id":"stateofhealth_59811","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"59811","score":null,"sort":[1439243955000]},"guestAuthors":[],"slug":"for-latinos-medi-cal-offers-insurance-but-few-doctors","title":"For Latinos, Medi-Cal Offers Insurance, But Few Doctors","publishDate":1439243955,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>SACRAMENTO, Calif. (AP) -- Miriam Uribe enrolled in Medi-Cal, California's low-income health insurance program, last November. But 10 months later, she still hasn't found a primary care doctor who can see her.\u003c/p>\n\u003cp>\"Once you have (insurance), you actually still don't have it because it's still a struggle to find someone,\" the 20-year-old college student from Bellflower said.\u003c/p>\n\u003cp>Uribe isn't alone. Even though Latinos make up nearly half of California's 12.5 million Medi-Cal enrollees, \u003ca href=\"http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/M/PDF%20MediCalAccessComparedUCLA.pdf\" target=\"_blank\">a report \u003c/a>by the independent California HealthCare Foundation found that 36 percent of the Spanish-speaking Medi-Cal population has been told that a physician won't take them, compared to 7 percent of the overall Medi-Cal population. Even those who speak both English and Spanish reported similar difficulty accessing doctors.\u003c/p>\n\u003cp>\"The numbers are very, very shocking,\" said Sarah de Guia, executive director of the California Pan-Ethnic Health Network, a multicultural health advocacy group.\u003c/p>\n\u003cp>De Guia said the study doesn't explain why Latinos — whether they speak English or Spanish — are being turned away at higher rates, but public policy officials say the biggest obstacle is finding doctors who are willing to take the lower payments offered by Medi-Cal. Language barriers also play a role.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The study, which compared people on Medi-Cal to those with employer-sponsored health insurance, found Latinos and Asian-Americans reported the highest rate of needing language assistance to understand their doctor. Specifically, 28 percent of Asian-Americans said their doctor does not listen carefully, compared to 15 percent of all Medi-Cal enrollees.\u003c/p>\n\u003cp>Shana Alex Charles, a research scientist at the UCLA Center for Health Policy Research who helped conduct the study, said there may not be enough providers who speak Spanish — or there could be an overall shortage of providers in communities of color.\u003c/p>\n\u003cp>Miriam Lagos, 53, a recent Medi-Cal enrollee who lives in Sherman Oaks, said she was told she has to wait a year just to see a specialist for hearing trouble in her right ear.\u003c/p>\n\u003cp>\"We are not well-regarded by the doctors. They don't want to see us,\" Lagos said in an interview in Spanish.\u003c/p>\n\u003cp>Medi-Cal, which is California's version of Medicaid, has grown rapidly in recent years as the state embraced an optional expansion under the Affordable Care Act. That surge has already led to widespread complaints about delays in patients being able to see doctors, specialists and dentists.\u003c/p>\n\u003cp>[contextly_sidebar id=\"KAFIl6XdCpNjavq1j56T3GJSiyALel8g\"]Doctors and hospitals say the state pays much less for medical services than private insurance or Medicare, which means fewer primary care doctors and specialists are willing to treat Medi-Cal patients. Lawmakers have convened a special legislative session to discuss increasing provider payments but there is no agreement yet on how to pay for them.\u003c/p>\n\u003cp>California's regulators says the state is committed to giving Medi-Cal recipients full and equal access to health care. The Department of Health Care Services says it works with health plans to monitor and reduce disparities in health care, and Medi-Cal provides materials and offers hotline assistance in 13 spoken and 12 written languages.\u003c/p>\n\u003cp>The California Medical Association, which represents the state's doctors, encourages its members to be sensitive to language and cultural differences as millions more residents gain access to health care, said spokeswoman Molly Weedn. The group is part of a coalition pushing for higher Medi-Cal provider payments and supports a bill by Assembly Speaker Toni Atkins, D-San Diego, seeking federal funding for medical interpreters in Medi-Cal.\u003c/p>\n\u003cp>The industry could also do more to train a more diverse medical and clinical workforce, said Xavier Morales, executive director of the Latino Coalition for A Healthy California. A 2014 review by the California HealthCare Foundation found Latinos are \u003ca href=\"http://www.chcf.org/publications/2014/03/california-physicians\" target=\"_blank\">underrepresented in the physician workforce\u003c/a>: 38 percent of the state's population is Latino but only 4 percent of physicians were Latino.\u003c/p>\n\u003cp>\"When you look at graduates from medical schools, they don't really match the population,\" Morales said.\u003c/p>\n\u003cp>Andrea Castillo, 21, a Medi-Cal recipient from McFarland, said it would be nice to see more Latino doctors. Growing up the oldest daughter of farm laborers, Castillo recalls driving long distances to translate for relatives at the doctor's office.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"You don't often see a provider who looks like you, who understands you,\" Castillo said.\u003c/p>\n\n","blocks":[],"excerpt":"36 percent of the Spanish-speaking Medi-Cal population has been told that a physician won't take them, compared to 7 percent of the overall Medi-Cal population. ","status":"publish","parent":0,"modified":1439251450,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":19,"wordCount":737},"headData":{"title":"For Latinos, Medi-Cal Offers Insurance, But Few Doctors | KQED","description":"36 percent of the Spanish-speaking Medi-Cal population has been told that a physician won't take them, compared to 7 percent of the overall Medi-Cal population. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"For Latinos, Medi-Cal Offers Insurance, But Few Doctors","datePublished":"2015-08-10T21:59:15.000Z","dateModified":"2015-08-11T00:04:10.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"59811 http://ww2.kqed.org/stateofhealth/?p=59811","disqusUrl":"https://ww2.kqed.org/stateofhealth/2015/08/10/for-latinos-medi-cal-offers-insurance-but-few-doctors/","disqusTitle":"For Latinos, Medi-Cal Offers Insurance, But Few Doctors","nprByline":"Judy Lin","path":"/stateofhealth/59811/for-latinos-medi-cal-offers-insurance-but-few-doctors","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>SACRAMENTO, Calif. (AP) -- Miriam Uribe enrolled in Medi-Cal, California's low-income health insurance program, last November. But 10 months later, she still hasn't found a primary care doctor who can see her.\u003c/p>\n\u003cp>\"Once you have (insurance), you actually still don't have it because it's still a struggle to find someone,\" the 20-year-old college student from Bellflower said.\u003c/p>\n\u003cp>Uribe isn't alone. Even though Latinos make up nearly half of California's 12.5 million Medi-Cal enrollees, \u003ca href=\"http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/M/PDF%20MediCalAccessComparedUCLA.pdf\" target=\"_blank\">a report \u003c/a>by the independent California HealthCare Foundation found that 36 percent of the Spanish-speaking Medi-Cal population has been told that a physician won't take them, compared to 7 percent of the overall Medi-Cal population. Even those who speak both English and Spanish reported similar difficulty accessing doctors.\u003c/p>\n\u003cp>\"The numbers are very, very shocking,\" said Sarah de Guia, executive director of the California Pan-Ethnic Health Network, a multicultural health advocacy group.\u003c/p>\n\u003cp>De Guia said the study doesn't explain why Latinos — whether they speak English or Spanish — are being turned away at higher rates, but public policy officials say the biggest obstacle is finding doctors who are willing to take the lower payments offered by Medi-Cal. Language barriers also play a role.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The study, which compared people on Medi-Cal to those with employer-sponsored health insurance, found Latinos and Asian-Americans reported the highest rate of needing language assistance to understand their doctor. Specifically, 28 percent of Asian-Americans said their doctor does not listen carefully, compared to 15 percent of all Medi-Cal enrollees.\u003c/p>\n\u003cp>Shana Alex Charles, a research scientist at the UCLA Center for Health Policy Research who helped conduct the study, said there may not be enough providers who speak Spanish — or there could be an overall shortage of providers in communities of color.\u003c/p>\n\u003cp>Miriam Lagos, 53, a recent Medi-Cal enrollee who lives in Sherman Oaks, said she was told she has to wait a year just to see a specialist for hearing trouble in her right ear.\u003c/p>\n\u003cp>\"We are not well-regarded by the doctors. They don't want to see us,\" Lagos said in an interview in Spanish.\u003c/p>\n\u003cp>Medi-Cal, which is California's version of Medicaid, has grown rapidly in recent years as the state embraced an optional expansion under the Affordable Care Act. That surge has already led to widespread complaints about delays in patients being able to see doctors, specialists and dentists.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>Doctors and hospitals say the state pays much less for medical services than private insurance or Medicare, which means fewer primary care doctors and specialists are willing to treat Medi-Cal patients. Lawmakers have convened a special legislative session to discuss increasing provider payments but there is no agreement yet on how to pay for them.\u003c/p>\n\u003cp>California's regulators says the state is committed to giving Medi-Cal recipients full and equal access to health care. The Department of Health Care Services says it works with health plans to monitor and reduce disparities in health care, and Medi-Cal provides materials and offers hotline assistance in 13 spoken and 12 written languages.\u003c/p>\n\u003cp>The California Medical Association, which represents the state's doctors, encourages its members to be sensitive to language and cultural differences as millions more residents gain access to health care, said spokeswoman Molly Weedn. The group is part of a coalition pushing for higher Medi-Cal provider payments and supports a bill by Assembly Speaker Toni Atkins, D-San Diego, seeking federal funding for medical interpreters in Medi-Cal.\u003c/p>\n\u003cp>The industry could also do more to train a more diverse medical and clinical workforce, said Xavier Morales, executive director of the Latino Coalition for A Healthy California. A 2014 review by the California HealthCare Foundation found Latinos are \u003ca href=\"http://www.chcf.org/publications/2014/03/california-physicians\" target=\"_blank\">underrepresented in the physician workforce\u003c/a>: 38 percent of the state's population is Latino but only 4 percent of physicians were Latino.\u003c/p>\n\u003cp>\"When you look at graduates from medical schools, they don't really match the population,\" Morales said.\u003c/p>\n\u003cp>Andrea Castillo, 21, a Medi-Cal recipient from McFarland, said it would be nice to see more Latino doctors. Growing up the oldest daughter of farm laborers, Castillo recalls driving long distances to translate for relatives at the doctor's office.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"You don't often see a provider who looks like you, who understands you,\" Castillo said.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/59811/for-latinos-medi-cal-offers-insurance-but-few-doctors","authors":["byline_stateofhealth_59811"],"categories":["stateofhealth_11","stateofhealth_2442"],"tags":["stateofhealth_249","stateofhealth_325","stateofhealth_99"],"featImg":"stateofhealth_59839","label":"stateofhealth"},"stateofhealth_48036":{"type":"posts","id":"stateofhealth_48036","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"48036","score":null,"sort":[1437030062000]},"guestAuthors":[],"slug":"heres-another-reason-women-should-not-use-vaginal-douches","title":"Here's Another Reason Women Should Not Use Vaginal Douches","publishDate":1437030062,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>Doctors advise against douching -- the cleaning of the inside of the vagina -- because it can lead to bacterial infection, pelvic inflammatory disease and problems during pregnancy. While the practice is on the decline,\u003ca href=\"http://www.cdc.gov/nchs/nsfg/key_statistics/d.htm#douching\" target=\"_blank\"> nearly one in five women\u003c/a> ages 15-44 still does it.\u003c/p>\n\u003cp>Now \u003ca href=\"http://www.ehjournal.net/content/14/1/57\" target=\"_blank\">a study\u003c/a> published this week identifies another harm: higher exposure to phthalates, a class of chemicals that are suspected to be \u003ca href=\"http://toxtown.nlm.nih.gov/text_version/chemicals.php?id=65\" target=\"_blank\">hormone disruptors.\u003c/a> And African-American women appear to be at increased risk because of their more frequent use of these products.\u003c/p>\n\u003cp>It appears to be the first time scientists have looked at personal care products and phthalate exposure, and study authors were surprised by the magnitude of the relationship between exposure and levels of chemicals.\u003c/p>\n\u003cp>\"We were surprised it was as important as it was,\" said co-author Tracey Woodruff, an OB/GYN professor at UCSF.\u003c/p>\n\u003cp>In the study, Woodruff and her colleagues looked at 759 women, ages 20-49, who had participated in a \u003ca href=\"http://www.cdc.gov/nchs/nhanes/about_nhanes.htm\" target=\"_blank\">national health survey \u003c/a>from the Centers for Disease Control and Prevention, and had said they used a range of feminine hygiene products. The women also provided urine samples. Researchers tested those samples for metabolites of phthalates.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Women who reported douching in the last month had 52 percent higher concentrations of the metabolite diethyl phthalate (DEP) in their urine, compared with women who had never used the product. Women who used the products two or more times a month had 152 percent higher concentration of DEP than non-users.\u003c/p>\n\u003cp>In a statement, senior author Ami Zota, an assistant professor at the George Washington University School of Public Health, said, \"These findings raise questions about the health and safety of vaginal douches and other fragranced products used in and around the vaginal area.\"\u003c/p>\n\u003cp>In the study, 37 percent of African-American women reported douching in the last month, compared with 14 percent of white women and 10 percent of Mexican-American women.\u003c/p>\n\u003cp>Woodruff framed the higher use of of the product by African-American women as a social justice issue, saying that advertising is targeted to them and that \"certain groups of women feel they might need to conform to certain beauty standards and practices within the population.\"\u003c/p>\n\u003cp>\"This is not uncommon for many types of beauty products,\" she added.\u003c/p>\n\u003cp>According to the National Institutes of Health, (NIH) phthalates are a \u003ca href=\"http://toxtown.nlm.nih.gov/text_version/chemicals.php?id=24\" target=\"_blank\">group of chemicals\u003c/a> \"used to soften and increase the flexibility of plastic and vinyl.\" But they are also used as fragrance in beauty products.\u003c/p>\n\u003cp>Woodruff noted that \"phthalate\" generally does not appear on product labels. Instead, it merely says \"fragrance.\"\u003c/p>\n\u003cp>\"If women are using douche products, and they're scented, there's potentially a high likelihood\" that they contain phthalates.\u003c/p>\n\u003cp>The researchers reviewed many feminine care products, including tampons, sanitary napkins, feminine spray, feminine powder and feminine wipes/towelettes, but did not find an association with phthalate exposure with these other products.\u003c/p>\n\u003cp>Woodruff said the study did not look at health effects. Indeed, the health effects are \"not yet fully known,\" \u003ca href=\"http://toxtown.nlm.nih.gov/text_version/chemicals.php?id=24\" target=\"_blank\">says the NIH\u003c/a>, although they are under investigation.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Pregnant women are being recruited for \u003ca href=\"http://prhe.ucsf.edu/prhe/maternalfetalexposure.html\" target=\"_blank\">new studies\u003c/a> at UCSF, Woodruff said. One of the areas of investigation is to \"measure phthalate exposure and look for adverse health effects.\"\u003c/p>\n\n","blocks":[],"excerpt":"A study finds women who use douches are exposed to higher levels of phthalates, a hormone disruptor.","status":"publish","parent":0,"modified":1437016653,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":18,"wordCount":542},"headData":{"title":"Here's Another Reason Women Should Not Use Vaginal Douches | KQED","description":"A study finds women who use douches are exposed to higher levels of phthalates, a hormone disruptor.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Here's Another Reason Women Should Not Use Vaginal Douches","datePublished":"2015-07-16T07:01:02.000Z","dateModified":"2015-07-16T03:17:33.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"48036 http://ww2.kqed.org/stateofhealth/?p=48036","disqusUrl":"https://ww2.kqed.org/stateofhealth/2015/07/16/heres-another-reason-women-should-not-use-vaginal-douches/","disqusTitle":"Here's Another Reason Women Should Not Use Vaginal Douches","path":"/stateofhealth/48036/heres-another-reason-women-should-not-use-vaginal-douches","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Doctors advise against douching -- the cleaning of the inside of the vagina -- because it can lead to bacterial infection, pelvic inflammatory disease and problems during pregnancy. While the practice is on the decline,\u003ca href=\"http://www.cdc.gov/nchs/nsfg/key_statistics/d.htm#douching\" target=\"_blank\"> nearly one in five women\u003c/a> ages 15-44 still does it.\u003c/p>\n\u003cp>Now \u003ca href=\"http://www.ehjournal.net/content/14/1/57\" target=\"_blank\">a study\u003c/a> published this week identifies another harm: higher exposure to phthalates, a class of chemicals that are suspected to be \u003ca href=\"http://toxtown.nlm.nih.gov/text_version/chemicals.php?id=65\" target=\"_blank\">hormone disruptors.\u003c/a> And African-American women appear to be at increased risk because of their more frequent use of these products.\u003c/p>\n\u003cp>It appears to be the first time scientists have looked at personal care products and phthalate exposure, and study authors were surprised by the magnitude of the relationship between exposure and levels of chemicals.\u003c/p>\n\u003cp>\"We were surprised it was as important as it was,\" said co-author Tracey Woodruff, an OB/GYN professor at UCSF.\u003c/p>\n\u003cp>In the study, Woodruff and her colleagues looked at 759 women, ages 20-49, who had participated in a \u003ca href=\"http://www.cdc.gov/nchs/nhanes/about_nhanes.htm\" target=\"_blank\">national health survey \u003c/a>from the Centers for Disease Control and Prevention, and had said they used a range of feminine hygiene products. The women also provided urine samples. Researchers tested those samples for metabolites of phthalates.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Women who reported douching in the last month had 52 percent higher concentrations of the metabolite diethyl phthalate (DEP) in their urine, compared with women who had never used the product. Women who used the products two or more times a month had 152 percent higher concentration of DEP than non-users.\u003c/p>\n\u003cp>In a statement, senior author Ami Zota, an assistant professor at the George Washington University School of Public Health, said, \"These findings raise questions about the health and safety of vaginal douches and other fragranced products used in and around the vaginal area.\"\u003c/p>\n\u003cp>In the study, 37 percent of African-American women reported douching in the last month, compared with 14 percent of white women and 10 percent of Mexican-American women.\u003c/p>\n\u003cp>Woodruff framed the higher use of of the product by African-American women as a social justice issue, saying that advertising is targeted to them and that \"certain groups of women feel they might need to conform to certain beauty standards and practices within the population.\"\u003c/p>\n\u003cp>\"This is not uncommon for many types of beauty products,\" she added.\u003c/p>\n\u003cp>According to the National Institutes of Health, (NIH) phthalates are a \u003ca href=\"http://toxtown.nlm.nih.gov/text_version/chemicals.php?id=24\" target=\"_blank\">group of chemicals\u003c/a> \"used to soften and increase the flexibility of plastic and vinyl.\" But they are also used as fragrance in beauty products.\u003c/p>\n\u003cp>Woodruff noted that \"phthalate\" generally does not appear on product labels. Instead, it merely says \"fragrance.\"\u003c/p>\n\u003cp>\"If women are using douche products, and they're scented, there's potentially a high likelihood\" that they contain phthalates.\u003c/p>\n\u003cp>The researchers reviewed many feminine care products, including tampons, sanitary napkins, feminine spray, feminine powder and feminine wipes/towelettes, but did not find an association with phthalate exposure with these other products.\u003c/p>\n\u003cp>Woodruff said the study did not look at health effects. Indeed, the health effects are \"not yet fully known,\" \u003ca href=\"http://toxtown.nlm.nih.gov/text_version/chemicals.php?id=24\" target=\"_blank\">says the NIH\u003c/a>, although they are under investigation.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Pregnant women are being recruited for \u003ca href=\"http://prhe.ucsf.edu/prhe/maternalfetalexposure.html\" target=\"_blank\">new studies\u003c/a> at UCSF, Woodruff said. One of the areas of investigation is to \"measure phthalate exposure and look for adverse health effects.\"\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/48036/heres-another-reason-women-should-not-use-vaginal-douches","authors":["240"],"categories":["stateofhealth_11"],"tags":["stateofhealth_249","stateofhealth_397"],"featImg":"stateofhealth_48117","label":"stateofhealth"},"stateofhealth_23009":{"type":"posts","id":"stateofhealth_23009","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"23009","score":null,"sort":[1418800984000]},"guestAuthors":[],"slug":"study-west-eliminates-race-gap-on-key-health-measures-disparities","title":"Study: Western States Eliminate Race Gap on Key Health Measures","publishDate":1418800984,"format":"aside","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cfigure id=\"attachment_23040\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/12/iStock_000001039817_Large-e1418800457273.jpg\">\u003cimg class=\"size-large wp-image-23040\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/12/iStock_000001039817_Large-640x425.jpg\" alt=\"Researchers looked at how effectively patients had their blood pressure, blood sugar and cholesterol controlled. (Getty Images)\" width=\"640\" height=\"425\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Researchers looked at how effectively patients had their blood pressure, blood sugar and cholesterol controlled. (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>A major new study looking at health disparities across the U.S. finds that significant gaps in managing heart disease and diabetes persist -- except in Western states, where the gap has been eliminated.\u003c/p>\n\u003caside class=\"pullquote alignleft\">'It's possible to eliminate deeply ingrained racial disparities.' \u003c/aside>\n\u003cp>Researchers at the University of Michigan and Harvard University \u003ca title=\"http://www.nejm.org/doi/full/10.1056/NEJMsa1407273\" href=\"http://www.nejm.org/doi/full/10.1056/NEJMsa1407273\" target=\"_blank\">looked at 100,000 Medicare patients\u003c/a> who were enrolled in HMOs, called \"Medicare Advantage\" plans, from 2006 to 2011. While management of blood pressure, cholesterol and blood sugar improved overall, blacks \"substantially\" trailed whites everywhere except\u003ca title=\"https://www.census.gov/geo/maps-data/maps/pdfs/reference/us_regdiv.pdf\" href=\"https://www.census.gov/geo/maps-data/maps/pdfs/reference/us_regdiv.pdf\" target=\"_blank\"> the Western U.S\u003c/a>., an area from the Rocky Mountains to the Pacific, as well as Alaska and Hawaii.\u003c/p>\n\u003cp>\"We were certainly hoping we would see indications of progress in eliminating disparities in the country as a whole,\" said lead author Dr. John Ayanian, who heads the Institute for Healthcare Policy and Innovation at the University of Michigan. He said that while it was \"disappointing\" that disparities persisted, \"it's also heartening to see that ... in the West, the disparities had been eliminated, and that was both surprising and encouraging.\"\u003c!--more-->\u003c/p>\n\u003cp>The \u003ca title=\"/www.nejm.org/doi/full/10.1056/NEJMsa1407273\" href=\"/www.nejm.org/doi/full/10.1056/NEJMsa1407273\" target=\"_blank\">study was published\u003c/a> in the New England Journal of Medicine and was funded by a grant from the National Institute on Aging.\u003c/p>\n\u003cp>\u003ciframe width=\"100%\" height=\"166\" scrolling=\"no\" frameborder=\"no\" src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/182310570&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\">\u003c/iframe>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Disparities in health care have long been noted in the American system. The researchers wrote that, in 2008, \"life expectancy was 5.4 years shorter for black men and 3.7 years shorter for black women than for white men and white women.\" Heart disease and diabetes -- diseases that can be better managed by controlling blood pressure, cholesterol and blood sugar, the risk factors measured in the study -- accounted for 38 percent of the gap in mortality between black and white men, and 54 percent of the gap among women, the researchers said. That's why closing the racial gap on these measures is so critical.\u003c/p>\n\u003cp>\"It's one of the first large studies to show that it's possible to eliminate deeply ingrained racial disparities in important risk factors,\" Ayanian said. He said that outcomes for Hispanics, Asians and Pacific Islanders were \"also encouraging.\" Hispanics were 1 to 3 percent less likely than whites to have blood pressure, cholesterol or blood sugar under control. Asians and Pacific Islanders were more likely than whites to have good control of blood pressure and cholesterol. Blood sugar control was about the same.\u003c/p>\n\u003cp>\u003cstrong>Kaiser Health Plans Noted\u003c/strong>\u003c/p>\n\u003cp>Specifically, the researchers pointed to Kaiser health plans as being successful in eliminating disparities.\u003c/p>\n\u003cp>\"Our findings in the West of nearly identical control of three major risk factors among black Medicare enrollees and white Medicare enrollees in Kaiser health plans and control of [blood sugar] in other health plans show the potential to achieve equity in these key health outcomes,\" the researchers wrote. Kaiser includes \"nearly half\" of Medicare HMO enrollees in the western region of the U.S., Ayanian said.\u003c/p>\n\u003cp>Kaiser representatives said they did not have any advance knowledge of the publication of the study. Dr. Joseph Young who leads Northern California Kaiser's clinical hypertension program said that Kaiser adopted a \"population management approach to managing chronic conditions\" in 2006. He said that Kaiser has created registries for people with various kinds of conditions, so that patients who might be missing preventive care or better management of disease can be easily identified.\u003c/p>\n\u003cp>In the area of blood pressure control specifically, Kaiser changed its drug formulary to allow a \"combined pill\" -- a single pill that includes two drugs, to make medication adherence easier for patients.\u003c/p>\n\u003cp>These population-based strategies across the board resulted in big improvements in overall outcome for Kaiser patients. Young said that during the 2000s, \"very serious heart attacks ... fell by 62 percent, and our stroke mortality fell by 42 percent.\" Kaiser does have some remaining racial disparities in its non-Medicare population, and Young said they are \"actively focusing\" on closing those remaining gaps.\u003c/p>\n\u003cp>Dr. Anthony Iton leads the Healthy Communities initiative at the California Endowment. He's also past director of the Alameda County Public Health Department. In both roles, he has championed fighting disparities in health care. He called the study \"very hopeful\" and believes that Kaiser's approaches are replicable elsewhere. \"We want clinicians to do what Kaiser is doing and take seriously to provide high quality race-blind clinical care. Kaiser is showing it can be done.\"\u003c/p>\n\u003cp>\"Any other system that says it's not doable has to explain how they can justify not providing the same high-quality care to everyone that comes in the door,\" Iton said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Still, Iton observed that California probably has \"less of a socioeconomic spread between whites and blacks than you do in the Southeastern United States. Those are quite disparate populations. ... It's a heavier lift in the Southeast than in the West, but despite that it's clearly doable.\"\u003c/p>\n\n","blocks":[],"excerpt":"National study points to the success of Kaiser health plans in ending disparities among older members.","status":"publish","parent":0,"modified":1419028594,"stats":{"hasAudio":true,"hasVideo":false,"hasChartOrMap":true,"iframeSrcs":["https://w.soundcloud.com/player/"],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":18,"wordCount":820},"headData":{"title":"Study: Western States Eliminate Race Gap on Key Health Measures | KQED","description":"National study points to the success of Kaiser health plans in ending disparities among older members.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Study: Western States Eliminate Race Gap on Key Health Measures","datePublished":"2014-12-17T07:23:04.000Z","dateModified":"2014-12-19T22:36:34.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"23009 http://blogs.kqed.org/stateofhealth/?p=23009","disqusUrl":"https://ww2.kqed.org/stateofhealth/2014/12/16/study-west-eliminates-race-gap-on-key-health-measures-disparities/","disqusTitle":"Study: Western States Eliminate Race Gap on Key Health Measures","path":"/stateofhealth/23009/study-west-eliminates-race-gap-on-key-health-measures-disparities","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_23040\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/12/iStock_000001039817_Large-e1418800457273.jpg\">\u003cimg class=\"size-large wp-image-23040\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/12/iStock_000001039817_Large-640x425.jpg\" alt=\"Researchers looked at how effectively patients had their blood pressure, blood sugar and cholesterol controlled. (Getty Images)\" width=\"640\" height=\"425\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Researchers looked at how effectively patients had their blood pressure, blood sugar and cholesterol controlled. (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>A major new study looking at health disparities across the U.S. finds that significant gaps in managing heart disease and diabetes persist -- except in Western states, where the gap has been eliminated.\u003c/p>\n\u003caside class=\"pullquote alignleft\">'It's possible to eliminate deeply ingrained racial disparities.' \u003c/aside>\n\u003cp>Researchers at the University of Michigan and Harvard University \u003ca title=\"http://www.nejm.org/doi/full/10.1056/NEJMsa1407273\" href=\"http://www.nejm.org/doi/full/10.1056/NEJMsa1407273\" target=\"_blank\">looked at 100,000 Medicare patients\u003c/a> who were enrolled in HMOs, called \"Medicare Advantage\" plans, from 2006 to 2011. While management of blood pressure, cholesterol and blood sugar improved overall, blacks \"substantially\" trailed whites everywhere except\u003ca title=\"https://www.census.gov/geo/maps-data/maps/pdfs/reference/us_regdiv.pdf\" href=\"https://www.census.gov/geo/maps-data/maps/pdfs/reference/us_regdiv.pdf\" target=\"_blank\"> the Western U.S\u003c/a>., an area from the Rocky Mountains to the Pacific, as well as Alaska and Hawaii.\u003c/p>\n\u003cp>\"We were certainly hoping we would see indications of progress in eliminating disparities in the country as a whole,\" said lead author Dr. John Ayanian, who heads the Institute for Healthcare Policy and Innovation at the University of Michigan. He said that while it was \"disappointing\" that disparities persisted, \"it's also heartening to see that ... in the West, the disparities had been eliminated, and that was both surprising and encouraging.\"\u003c!--more-->\u003c/p>\n\u003cp>The \u003ca title=\"/www.nejm.org/doi/full/10.1056/NEJMsa1407273\" href=\"/www.nejm.org/doi/full/10.1056/NEJMsa1407273\" target=\"_blank\">study was published\u003c/a> in the New England Journal of Medicine and was funded by a grant from the National Institute on Aging.\u003c/p>\n\u003cp>\u003ciframe width=\"100%\" height=\"166\" scrolling=\"no\" frameborder=\"no\" src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/182310570&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\">\u003c/iframe>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Disparities in health care have long been noted in the American system. The researchers wrote that, in 2008, \"life expectancy was 5.4 years shorter for black men and 3.7 years shorter for black women than for white men and white women.\" Heart disease and diabetes -- diseases that can be better managed by controlling blood pressure, cholesterol and blood sugar, the risk factors measured in the study -- accounted for 38 percent of the gap in mortality between black and white men, and 54 percent of the gap among women, the researchers said. That's why closing the racial gap on these measures is so critical.\u003c/p>\n\u003cp>\"It's one of the first large studies to show that it's possible to eliminate deeply ingrained racial disparities in important risk factors,\" Ayanian said. He said that outcomes for Hispanics, Asians and Pacific Islanders were \"also encouraging.\" Hispanics were 1 to 3 percent less likely than whites to have blood pressure, cholesterol or blood sugar under control. Asians and Pacific Islanders were more likely than whites to have good control of blood pressure and cholesterol. Blood sugar control was about the same.\u003c/p>\n\u003cp>\u003cstrong>Kaiser Health Plans Noted\u003c/strong>\u003c/p>\n\u003cp>Specifically, the researchers pointed to Kaiser health plans as being successful in eliminating disparities.\u003c/p>\n\u003cp>\"Our findings in the West of nearly identical control of three major risk factors among black Medicare enrollees and white Medicare enrollees in Kaiser health plans and control of [blood sugar] in other health plans show the potential to achieve equity in these key health outcomes,\" the researchers wrote. Kaiser includes \"nearly half\" of Medicare HMO enrollees in the western region of the U.S., Ayanian said.\u003c/p>\n\u003cp>Kaiser representatives said they did not have any advance knowledge of the publication of the study. Dr. Joseph Young who leads Northern California Kaiser's clinical hypertension program said that Kaiser adopted a \"population management approach to managing chronic conditions\" in 2006. He said that Kaiser has created registries for people with various kinds of conditions, so that patients who might be missing preventive care or better management of disease can be easily identified.\u003c/p>\n\u003cp>In the area of blood pressure control specifically, Kaiser changed its drug formulary to allow a \"combined pill\" -- a single pill that includes two drugs, to make medication adherence easier for patients.\u003c/p>\n\u003cp>These population-based strategies across the board resulted in big improvements in overall outcome for Kaiser patients. Young said that during the 2000s, \"very serious heart attacks ... fell by 62 percent, and our stroke mortality fell by 42 percent.\" Kaiser does have some remaining racial disparities in its non-Medicare population, and Young said they are \"actively focusing\" on closing those remaining gaps.\u003c/p>\n\u003cp>Dr. Anthony Iton leads the Healthy Communities initiative at the California Endowment. He's also past director of the Alameda County Public Health Department. In both roles, he has championed fighting disparities in health care. He called the study \"very hopeful\" and believes that Kaiser's approaches are replicable elsewhere. \"We want clinicians to do what Kaiser is doing and take seriously to provide high quality race-blind clinical care. Kaiser is showing it can be done.\"\u003c/p>\n\u003cp>\"Any other system that says it's not doable has to explain how they can justify not providing the same high-quality care to everyone that comes in the door,\" Iton said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Still, Iton observed that California probably has \"less of a socioeconomic spread between whites and blacks than you do in the Southeastern United States. Those are quite disparate populations. ... It's a heavier lift in the Southeast than in the West, but despite that it's clearly doable.\"\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/23009/study-west-eliminates-race-gap-on-key-health-measures-disparities","authors":["240"],"categories":["stateofhealth_11","stateofhealth_13"],"tags":["stateofhealth_249","stateofhealth_803"],"featImg":"stateofhealth_23040","label":"stateofhealth"},"stateofhealth_14795":{"type":"posts","id":"stateofhealth_14795","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"14795","score":null,"sort":[1378458059000]},"guestAuthors":[],"slug":"bill-to-increase-abortion-providers-on-governors-desk","title":"Bill to Increase Abortion Providers on Governor's Desk","publishDate":1378458059,"format":"aside","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cfigure id=\"attachment_14796\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/09/RS1369_IMG_1902-scr-e1378443813373.jpg\">\u003cimg class=\"size-large wp-image-14796\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/09/RS1369_IMG_1902-scr-640x480.jpg\" alt=\"(Craig Miller/KQED)\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Craig Miller/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Elaine Korry\u003c/strong>\u003c/p>\n\u003cp>Once again, California has shown it is willing to buck national trends. While other states have been \u003ca href=\"http://www.bloomberg.com/news/2013-09-03/abortion-clinics-close-at-record-pace-after-states-tighten-rules.html\" target=\"_blank\">regulating abortion clinics out of existence\u003c/a>, lawmakers in the Golden State have passed a measure that actually expands access to abortion services.\u003c/p>\n\u003cp>\u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140AB154\" target=\"_blank\">The bill\u003c/a>, AB154 by Assemblymember Toni Atkins (D-San Diego), would permit certified midwives and specially trained clinicians, such as nurse practitioners and physician assistants, to perform what is called an aspiration abortion during the first trimester of pregnancy. The change in law is designed to broaden access to abortion in areas where few, if any, doctors perform the procedure.\u003c/p>\n\u003cp>In nearly half of California's 58 counties, there are no abortion providers except for hospitals, which provide urgent care in case of emergencies. But especially in rural areas, women who want a first trimester abortion often must travel long distances to obtain one at an unfamiliar clinic. According to Atkins, that geographic disparity is unjustified.\u003c!--more-->\u003c/p>\n\u003cp>“Women need access to this procedure,” said Atkins, who formerly was the administrator of a health clinic. “And they should be able to get it in their own home communities, from providers they already know and trust.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Abortion may be a complicated political or social issue, but, according to Atkins, medically\u003cstrong> \u003c/strong>it's straightforward; a simple procedure that can be performed safely in an outpatient setting by nurse practitioners, midwives or physician assistants. Under AB154, these clinicians would be in contact with a supervising physician, although the doctor need not be present for the procedure.\u003c/p>\n\u003cp>In California, trained clinicians are already permitted to prescribe medications that can prevent or abort a pregnancy. But abortion opponents argued that empowering non-physicians to terminate pregnancies surgically would deprive\u003cstrong> \u003c/strong>women in rural counties of equal medical care.\u003c/p>\n\u003cp>“Rather than focus on increasing the number of doctors serving [rural] areas, we're lowering the standard of care,” said Assemblywoman Marie Waldron (R-Escondido). “It’s just to get people out there to perform the procedures, and it is going to put people at risk,” she said.\u003c/p>\n\u003cp>However, a study earlier this year reached a different conclusion. Researchers at UCSF’s Advancing New Standards in Reproductive Health program obtained waivers from the state to allow midwives, nurse practitioners and physician assistants to perform early abortions.\u003c/p>\n\u003cp>\u003ca href=\"http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2012.301159?prevSearch=%28abortion%29+and+%5BContrib%3A+weitz%5D&searchHistoryKey=\" target=\"_blank\">The study\u003c/a>, published earlier this year in the \u003cem>American Journal of Public Health\u003c/em>, found the rate of complications was “clinically equivalent,” whether the procedure was performed by a doctor or by a trained clinician.\u003c/p>\n\u003cp>Tracy Weitz, UCSF professor of obstetrics and gynecology, was the lead author of the study. “For about five years we collected data on forty clinicians who performed over 5,000 procedures,” said Weitz. “And what we found is that their safety outcomes were the same as their physician colleagues, so that they are safe providers of early abortion care,” she said.\u003c/p>\n\u003cp>Overall, said Weitz, the rate of complications was quite low -- about 2 percent -- which she says makes abortion a much safer alternative than a full-term pregnancy.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Lawmakers approved AB154 by a wide margin last month. If it is signed by Gov. Brown, California will join four other states (Montana, New Hampshire, Oregon and Vermont) that already permit clinicians other than physicians to perform early abortions. The governor has until October 13 to sign or veto the legislation.\u003c/p>\n\n","blocks":[],"excerpt":"Once again, California has shown it is willing to buck national trends. While other states have been regulating abortion clinics out of existence, lawmakers in the Golden State have passed a measure that actually expands access to abortion services. ","status":"publish","parent":0,"modified":1378526220,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":15,"wordCount":574},"headData":{"title":"Bill to Increase Abortion Providers on Governor's Desk | KQED","description":"Once again, California has shown it is willing to buck national trends. While other states have been regulating abortion clinics out of existence, lawmakers in the Golden State have passed a measure that actually expands access to abortion services. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Bill to Increase Abortion Providers on Governor's Desk","datePublished":"2013-09-06T09:00:59.000Z","dateModified":"2013-09-07T03:57:00.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"14795 http://blogs.kqed.org/stateofhealth/?p=14795","disqusUrl":"https://ww2.kqed.org/stateofhealth/2013/09/06/bill-to-increase-abortion-providers-on-governors-desk/","disqusTitle":"Bill to Increase Abortion Providers on Governor's Desk","path":"/stateofhealth/14795/bill-to-increase-abortion-providers-on-governors-desk","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_14796\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/09/RS1369_IMG_1902-scr-e1378443813373.jpg\">\u003cimg class=\"size-large wp-image-14796\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/09/RS1369_IMG_1902-scr-640x480.jpg\" alt=\"(Craig Miller/KQED)\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Craig Miller/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Elaine Korry\u003c/strong>\u003c/p>\n\u003cp>Once again, California has shown it is willing to buck national trends. While other states have been \u003ca href=\"http://www.bloomberg.com/news/2013-09-03/abortion-clinics-close-at-record-pace-after-states-tighten-rules.html\" target=\"_blank\">regulating abortion clinics out of existence\u003c/a>, lawmakers in the Golden State have passed a measure that actually expands access to abortion services.\u003c/p>\n\u003cp>\u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140AB154\" target=\"_blank\">The bill\u003c/a>, AB154 by Assemblymember Toni Atkins (D-San Diego), would permit certified midwives and specially trained clinicians, such as nurse practitioners and physician assistants, to perform what is called an aspiration abortion during the first trimester of pregnancy. The change in law is designed to broaden access to abortion in areas where few, if any, doctors perform the procedure.\u003c/p>\n\u003cp>In nearly half of California's 58 counties, there are no abortion providers except for hospitals, which provide urgent care in case of emergencies. But especially in rural areas, women who want a first trimester abortion often must travel long distances to obtain one at an unfamiliar clinic. According to Atkins, that geographic disparity is unjustified.\u003c!--more-->\u003c/p>\n\u003cp>“Women need access to this procedure,” said Atkins, who formerly was the administrator of a health clinic. “And they should be able to get it in their own home communities, from providers they already know and trust.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Abortion may be a complicated political or social issue, but, according to Atkins, medically\u003cstrong> \u003c/strong>it's straightforward; a simple procedure that can be performed safely in an outpatient setting by nurse practitioners, midwives or physician assistants. Under AB154, these clinicians would be in contact with a supervising physician, although the doctor need not be present for the procedure.\u003c/p>\n\u003cp>In California, trained clinicians are already permitted to prescribe medications that can prevent or abort a pregnancy. But abortion opponents argued that empowering non-physicians to terminate pregnancies surgically would deprive\u003cstrong> \u003c/strong>women in rural counties of equal medical care.\u003c/p>\n\u003cp>“Rather than focus on increasing the number of doctors serving [rural] areas, we're lowering the standard of care,” said Assemblywoman Marie Waldron (R-Escondido). “It’s just to get people out there to perform the procedures, and it is going to put people at risk,” she said.\u003c/p>\n\u003cp>However, a study earlier this year reached a different conclusion. Researchers at UCSF’s Advancing New Standards in Reproductive Health program obtained waivers from the state to allow midwives, nurse practitioners and physician assistants to perform early abortions.\u003c/p>\n\u003cp>\u003ca href=\"http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2012.301159?prevSearch=%28abortion%29+and+%5BContrib%3A+weitz%5D&searchHistoryKey=\" target=\"_blank\">The study\u003c/a>, published earlier this year in the \u003cem>American Journal of Public Health\u003c/em>, found the rate of complications was “clinically equivalent,” whether the procedure was performed by a doctor or by a trained clinician.\u003c/p>\n\u003cp>Tracy Weitz, UCSF professor of obstetrics and gynecology, was the lead author of the study. “For about five years we collected data on forty clinicians who performed over 5,000 procedures,” said Weitz. “And what we found is that their safety outcomes were the same as their physician colleagues, so that they are safe providers of early abortion care,” she said.\u003c/p>\n\u003cp>Overall, said Weitz, the rate of complications was quite low -- about 2 percent -- which she says makes abortion a much safer alternative than a full-term pregnancy.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Lawmakers approved AB154 by a wide margin last month. If it is signed by Gov. Brown, California will join four other states (Montana, New Hampshire, Oregon and Vermont) that already permit clinicians other than physicians to perform early abortions. The governor has until October 13 to sign or veto the legislation.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/14795/bill-to-increase-abortion-providers-on-governors-desk","authors":["8344"],"categories":["stateofhealth_11"],"tags":["stateofhealth_249"],"featImg":"stateofhealth_14796","label":"stateofhealth"}},"programsReducer":{"possible":{"id":"possible","title":"Possible","info":"Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.","airtime":"SUN 2pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Possible-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.possible.fm/","meta":{"site":"news","source":"Possible"},"link":"/radio/program/possible","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/possible/id1677184070","spotify":"https://open.spotify.com/show/730YpdUSNlMyPQwNnyjp4k"}},"1a":{"id":"1a","title":"1A","info":"1A is home to the national conversation. 1A brings on great guests and frames the best debate in ways that make you think, share and engage.","airtime":"MON-THU 11pm-12am","imageSrc":"https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/1a.jpg","officialWebsiteLink":"https://the1a.org/","meta":{"site":"news","source":"npr"},"link":"/radio/program/1a","subscribe":{"npr":"https://rpb3r.app.goo.gl/RBrW","apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=1188724250&at=11l79Y&ct=nprdirectory","tuneIn":"https://tunein.com/radio/1A-p947376/","rss":"https://feeds.npr.org/510316/podcast.xml"}},"all-things-considered":{"id":"all-things-considered","title":"All Things Considered","info":"Every weekday, \u003cem>All Things Considered\u003c/em> hosts Robert Siegel, Audie Cornish, Ari Shapiro, and Kelly McEvers present the program's trademark mix of news, interviews, commentaries, reviews, and offbeat features. Michel Martin hosts on the weekends.","airtime":"MON-FRI 1pm-2pm, 4:30pm-6:30pm\u003cbr />SAT-SUN 5pm-6pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/All-Things-Considered-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.npr.org/programs/all-things-considered/","meta":{"site":"news","source":"npr"},"link":"/radio/program/all-things-considered"},"american-suburb-podcast":{"id":"american-suburb-podcast","title":"American Suburb: The Podcast","tagline":"The flip side of gentrification, told through one town","info":"Gentrification is changing cities across America, forcing people from neighborhoods they have long called home. Call them the displaced. Now those priced out of the Bay Area are looking for a better life in an unlikely place. American Suburb follows this migration to one California town along the Delta, 45 miles from San Francisco. But is this once sleepy suburb ready for them?","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/American-Suburb-Podcast-Tile-703x703-1.jpg","officialWebsiteLink":"/news/series/american-suburb-podcast","meta":{"site":"news","source":"kqed","order":"13"},"link":"/news/series/american-suburb-podcast/","subscribe":{"npr":"https://rpb3r.app.goo.gl/RBrW","apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?mt=2&id=1287748328","tuneIn":"https://tunein.com/radio/American-Suburb-p1086805/","rss":"https://ww2.kqed.org/news/series/american-suburb-podcast/feed/podcast","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkMzMDExODgxNjA5"}},"baycurious":{"id":"baycurious","title":"Bay Curious","tagline":"Exploring the Bay Area, one question at a time","info":"KQED’s new podcast, Bay Curious, gets to the bottom of the mysteries — both profound and peculiar — that give the Bay Area its unique identity. And we’ll do it with your help! You ask the questions. You decide what Bay Curious investigates. 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You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Mindshift-Podcast-Tile-703x703-1.jpg","imageAlt":"KQED MindShift: How We Will Learn","officialWebsiteLink":"/mindshift/","meta":{"site":"news","source":"kqed","order":"2"},"link":"/podcasts/mindshift","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/mindshift-podcast/id1078765985","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5","npr":"https://www.npr.org/podcasts/464615685/mind-shift-podcast","stitcher":"https://www.stitcher.com/podcast/kqed/stories-teachers-share","spotify":"https://open.spotify.com/show/0MxSpNYZKNprFLCl7eEtyx"}},"morning-edition":{"id":"morning-edition","title":"Morning Edition","info":"\u003cem>Morning Edition\u003c/em> takes listeners around the country and the world with multi-faceted stories and commentaries every weekday. 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On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. 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