Why Stand-alone Family Planning Clinics Struggle to Survive in Age of Obamacare
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Mission Neighbors Vow to Save Beloved UCSF Clinic
Gov. Brown Signs Major Tobacco Bills, Raises Legal Age to 21
For Hispanic And Black Teens, Birth Rates Plummet
Suicide Rates Climb In U.S., Especially Among Adolescent Girls
Girls Given Drugs That Cause Birth Defects Don't Get Contraception Counseling
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Students linger in the reception area and halls, en route to see therapists and the school's nurse, Mary-Michael Watts.\u003c/p>\n\u003cp>In her small office, Watts sees young patients with a range of concerns, from stomach aches to mental health needs. A big part of her job is counseling students on how to prevent unplanned pregnancies and sexually transmitted diseases, a major health concern in San Francisco. The county is among the highest for chlamydia and gonorrhea rates \u003ca href=\"http://www.cdph.ca.gov/data/statistics/pages/stddata.aspx\" target=\"_blank\">in the state\u003c/a>, according to the California Department of Public Health.\u003c/p>\n\u003cp>For free checkups, testing, treatment and contraceptives, Watts has referred hundreds of students -- many of whom are low income -- to the New Generation Health Center, about a mile from Mission High. The clinic has provided free reproductive health services to teens and young adults for 20 years, and Watts considers New Generation a key resource.\u003c/p>\n\u003cp>\"Everything they do is reproductive health related,\" Watts says. \"They have a heightened radar and sensitivity to any kind of abuse that might be taking place and to the general well-being of the student that might be missed in a primary health clinic.\"\u003c/p>\n\u003cfigure id=\"attachment_198168\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"wp-image-198168 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/06/RS19853_IMG_0008-qut.jpg\" alt=\"Mission High nurse Mary-Michael Watts listens to a patient at the school's wellness center. Watts considers New Generation a key resource for students.\" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/06/RS19853_IMG_0008-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/27/2016/06/RS19853_IMG_0008-qut-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/06/RS19853_IMG_0008-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/06/RS19853_IMG_0008-qut-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2016/06/RS19853_IMG_0008-qut-1440x960.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2016/06/RS19853_IMG_0008-qut-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2016/06/RS19853_IMG_0008-qut-960x640.jpg 960w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Mission High nurse Mary-Michael Watts listens to a patient at the school's wellness center. Watts considers New Generation a key resource for low income teens in the Mission area.\u003c/figcaption>\u003c/figure>\n\u003cp>So Watts and her young patients were shocked to learn that New Generation was supposed to close down in July due to financial troubles. The UC San Francisco family planning clinic has lost patients for years and became financially unsustainable, university officials say.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The news did not sit well with dozens of supporters who protested UCSF's closure plans and \u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/05/06/mission-save-beloved-uc-san-francisco-clinic/\">vowed to save the clinic\u003c/a>. After a growing outcry, UCSF Chancellor Sam Hawgood \u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/05/11/uc-san-francisco-drops-plans-to-close-mission-clinic/\">agreed last month\u003c/a> to cover New Generation's budget deficit of about $400,000 -- for one year. But Hawgood stressed the clinic remains on shaky financial footing and must still find long-term solutions.\u003c/p>\n\u003cp>New Generation's troubles stem in part from the very specialization in reproductive health that has made it such a valuable resource for young patients in the Mission District, say experts. They contend that the Affordable Care Act has changed the business model for clinics like this, forcing most to transform by adding primary care services or merging with other health centers in order to remain competitive.\u003c/p>\n\u003cp>\u003cstrong>Obamacare Shifts Business Model for Family Planning Clinics\u003c/strong>\u003c/p>\n\u003cp>New Generation saw about 2,200 patients last year, 27 percent less than in 2011, says Dr. Rebecca Jackson, who supervises the clinic. Jackson took the initial decision to close New Generation after the clinic lost foundation grants -- a key source of revenue -- and dipped into the red.\u003c/p>\n\u003cp>\"Over the years, we tried everything we could think of actually to keep it open and just came up against a wall,\" says Jackson, an obstetrics and gynecology professor at UCSF.\u003c/p>\n\u003cp>Jackson attributes New Generation's loss of patients in part to the Affordable Care Act.\u003c/p>\n\u003cp>Since the Affordable Care Act was fully implemented in January, 2014, nearly five million low-income Californians have \u003ca href=\"http://www.dhcs.ca.gov/dataandstats/statistics/Documents/Fast_Facts_December_2015_ADA.pdf\">gained Medi-Cal insurance\u003c/a>. Those newly insured can now get medical services from head to toe at primary care clinics that also offer reproductive health. That's why Jackson doesn't see New Generation getting a lot more patients back any time soon.\u003c/p>\n\u003cp>Even when patients with Medi-Cal choose New Generation for their reproductive health care, those payments are not enough to keep the clinic afloat, says Jackson, as Medi-Cal's reimbursement rates are among the lowest in the nation.\u003c/p>\n\u003cp>New Generation's main source of patient revenue had been a more generous program than Medi-Cal, the state's Family Planning, Access, Care, and Treatment program, or Family PACT. But that program has seen significant drops in enrollment as more people gained comprehensive insurance.\u003c/p>\n\u003cp>The clinic saw these changes coming, says Jackson, but wasn't able to adapt successfully.\u003c/p>\n\u003cp>\"We tried a lot of different kinds of things to keep it open, like partnering with a primary care clinic, for example, or potentially getting another clinic to take us over, and it was difficult and couldn't get anyone to do those things,\" says Jackson.\u003c/p>\n\u003cp>UCSF is now forming working groups with community members to figure out how to salvage these services for low-income teens in San Francisco, either through keeping New Generation open or through other providers.\u003c/p>\n\u003cfigure id=\"attachment_180822\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"wp-image-180822 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/05/RS19400_IMG_9941-qut.jpg\" alt=\"Dr. Rebecca Jackson, New Generation's main supervisor, and Dr. Valerie French (right), medical director, listen to speakers at a community forum in April about the potential closure of New Generation. After the meeting, Jackson said she was hopeful New Generation could find more funds to stay open "given the huge outpouring of concerned people." \" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19400_IMG_9941-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19400_IMG_9941-qut-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19400_IMG_9941-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19400_IMG_9941-qut-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19400_IMG_9941-qut-1440x960.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19400_IMG_9941-qut-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19400_IMG_9941-qut-960x640.jpg 960w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Dr. Rebecca Jackson, (left), New Generation's main supervisor, and Dr. Valerie French, medical director, listen to speakers at a community forum in April about the potential closure of New Generation. After the meeting, Jackson said she was hopeful the clinic could find more funds to stay open \"given the huge outpouring of concerned people.\" \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Family Planning Centers Transform\u003c/strong>\u003c/p>\n\u003cp>Other reproductive health centers, such as Planned Parenthood, have added more kinds of services or merged with other clinics in order to stay competitive in the age of Obamacare, says Amy Moy from the California Family Health Council. The agency is responsible for distributing federal funds for family planning to more than 60 health organizations. That money trickles down to 340 health centers statewide.\u003c/p>\n\u003cp>While mergers can cut down costs, adding comprehensive health services allows clinics to potentially become \u003ca href=\"https://www.cms.gov/Outreach-and-Education/Medicare%E2%80%A6\" target=\"_blank\">federally qualified health centers\u003c/a>, with enhanced reimbursement from Medicare and Medi-Cal and other benefits.\u003c/p>\n\u003cp>Clinics like New Generation face a tough road to stay in business unless they change, Moy says.\u003c/p>\n\u003cp>\"The numbers of family planning health centers that are stand-alone or women's health centers that provide primarily family planning services really are dwindling,\" Moy says. \"And we anticipate that trend to continue.\"\u003c/p>\n\u003cp>Still, she says these types of clinics remain important -- especially for adolescents who value confidentiality.\u003c/p>\n\u003cp>\"A big fear is if there is a loss of those safe spaces that teens won't ... access these services that they need to stay safe and help prevent unintended pregnancy,\" Moy says.\u003c/p>\n\u003cp>\u003cstrong>Teen Patients Prefer Confidential Services\u003c/strong>\u003c/p>\n\u003cp>Mission High student Damaris Bonner says she prefers New Generation to other clinics in the area, and its potential closure is frustrating.\u003c/p>\n\u003cp>\"That’s the one clinic I felt comfortable at,\" says Bonner, 17. \"It makes no sense to close it down.\"\u003c/p>\n\u003cfigure id=\"attachment_198166\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"size-full wp-image-198166\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/06/RS19851_Damaris-Bonner-edit-2-qut.jpg\" alt=\"Mission High student Damaris Bonner, 17, at the school's wellness center. Bonner has been a patient at New Generation for nearly two years and says she prefers the clinic to others in the area.\" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/06/RS19851_Damaris-Bonner-edit-2-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/27/2016/06/RS19851_Damaris-Bonner-edit-2-qut-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/06/RS19851_Damaris-Bonner-edit-2-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/06/RS19851_Damaris-Bonner-edit-2-qut-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2016/06/RS19851_Damaris-Bonner-edit-2-qut-1440x960.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2016/06/RS19851_Damaris-Bonner-edit-2-qut-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2016/06/RS19851_Damaris-Bonner-edit-2-qut-960x640.jpg 960w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Mission High student Damaris Bonner, 17, at the school's wellness center. Bonner has been a patient at New Generation for nearly two years and says she prefers the clinic to others in the area.\u003c/figcaption>\u003c/figure>\n\u003cp>Like other patients, Bonner likes New Generation's confidential services. Because it's a space dedicated to youth, she doesn't fear running into parents or aunties there. Another plus is that the small clinic offers same-day appointments that are hard to come by elsewhere.\u003c/p>\n\u003cp>Other clinics offer reproductive health in the area, which UCSF officials say ameliorates any impact of a potential closure to patients. Still, Bonner feels local teens would face extra barriers to access reproductive health if New Generation closes. She resents that a clinic she and other young people trust could be \"taken away.\"\u003c/p>\n\u003cp>\"It's like, why? Let us youth take care of ourselves,\" says Bonner, who has been a patient at New Generation for nearly two years. \"It's crucial that we have these tools for us because when we don't that's when you start seeing unplanned pregnancies and STDs.\"\u003c/p>\n\u003cp>Mission High's nurse Watts is following closely developments about New Generation. She fears losing the clinic could translate to unplanned pregnancies and STDs among students .\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\"It kind of terrifies me to think that I might not be able to pick up the phone and call them,\" says Watts. \"New Generation is an integral part of my job.\"\u003c/p>\n\n","blocks":[],"excerpt":"Since the Affordable Care Act was fully implemented, the newly insured can now get medical services at primary care clinics that also offer reproductive health.\r\n","status":"publish","parent":0,"modified":1466095874,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":34,"wordCount":1366},"headData":{"title":"Why Stand-alone Family Planning Clinics Struggle to Survive in Age of Obamacare | KQED","description":"Since the Affordable Care Act was fully implemented, the newly insured can now get medical services at primary care clinics that also offer reproductive health.\r\n","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Why Stand-alone Family Planning Clinics Struggle to Survive in Age of Obamacare","datePublished":"2016-06-15T15:30:27.000Z","dateModified":"2016-06-16T16:51:14.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"198146 http://ww2.kqed.org/stateofhealth/?p=198146","disqusUrl":"https://ww2.kqed.org/stateofhealth/2016/06/15/why-stand-alone-family-planning-clinics-struggle-to-survive-in-age-of-obamacare/","disqusTitle":"Why Stand-alone Family Planning Clinics Struggle to Survive in Age of Obamacare","path":"/stateofhealth/198146/why-stand-alone-family-planning-clinics-struggle-to-survive-in-age-of-obamacare","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>The wellness center at San Francisco's Mission High School is a busy place during lunch time. Students linger in the reception area and halls, en route to see therapists and the school's nurse, Mary-Michael Watts.\u003c/p>\n\u003cp>In her small office, Watts sees young patients with a range of concerns, from stomach aches to mental health needs. A big part of her job is counseling students on how to prevent unplanned pregnancies and sexually transmitted diseases, a major health concern in San Francisco. The county is among the highest for chlamydia and gonorrhea rates \u003ca href=\"http://www.cdph.ca.gov/data/statistics/pages/stddata.aspx\" target=\"_blank\">in the state\u003c/a>, according to the California Department of Public Health.\u003c/p>\n\u003cp>For free checkups, testing, treatment and contraceptives, Watts has referred hundreds of students -- many of whom are low income -- to the New Generation Health Center, about a mile from Mission High. The clinic has provided free reproductive health services to teens and young adults for 20 years, and Watts considers New Generation a key resource.\u003c/p>\n\u003cp>\"Everything they do is reproductive health related,\" Watts says. \"They have a heightened radar and sensitivity to any kind of abuse that might be taking place and to the general well-being of the student that might be missed in a primary health clinic.\"\u003c/p>\n\u003cfigure id=\"attachment_198168\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"wp-image-198168 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/06/RS19853_IMG_0008-qut.jpg\" alt=\"Mission High nurse Mary-Michael Watts listens to a patient at the school's wellness center. Watts considers New Generation a key resource for students.\" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/06/RS19853_IMG_0008-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/27/2016/06/RS19853_IMG_0008-qut-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/06/RS19853_IMG_0008-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/06/RS19853_IMG_0008-qut-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2016/06/RS19853_IMG_0008-qut-1440x960.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2016/06/RS19853_IMG_0008-qut-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2016/06/RS19853_IMG_0008-qut-960x640.jpg 960w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Mission High nurse Mary-Michael Watts listens to a patient at the school's wellness center. Watts considers New Generation a key resource for low income teens in the Mission area.\u003c/figcaption>\u003c/figure>\n\u003cp>So Watts and her young patients were shocked to learn that New Generation was supposed to close down in July due to financial troubles. The UC San Francisco family planning clinic has lost patients for years and became financially unsustainable, university officials say.\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 news did not sit well with dozens of supporters who protested UCSF's closure plans and \u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/05/06/mission-save-beloved-uc-san-francisco-clinic/\">vowed to save the clinic\u003c/a>. After a growing outcry, UCSF Chancellor Sam Hawgood \u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/05/11/uc-san-francisco-drops-plans-to-close-mission-clinic/\">agreed last month\u003c/a> to cover New Generation's budget deficit of about $400,000 -- for one year. But Hawgood stressed the clinic remains on shaky financial footing and must still find long-term solutions.\u003c/p>\n\u003cp>New Generation's troubles stem in part from the very specialization in reproductive health that has made it such a valuable resource for young patients in the Mission District, say experts. They contend that the Affordable Care Act has changed the business model for clinics like this, forcing most to transform by adding primary care services or merging with other health centers in order to remain competitive.\u003c/p>\n\u003cp>\u003cstrong>Obamacare Shifts Business Model for Family Planning Clinics\u003c/strong>\u003c/p>\n\u003cp>New Generation saw about 2,200 patients last year, 27 percent less than in 2011, says Dr. Rebecca Jackson, who supervises the clinic. Jackson took the initial decision to close New Generation after the clinic lost foundation grants -- a key source of revenue -- and dipped into the red.\u003c/p>\n\u003cp>\"Over the years, we tried everything we could think of actually to keep it open and just came up against a wall,\" says Jackson, an obstetrics and gynecology professor at UCSF.\u003c/p>\n\u003cp>Jackson attributes New Generation's loss of patients in part to the Affordable Care Act.\u003c/p>\n\u003cp>Since the Affordable Care Act was fully implemented in January, 2014, nearly five million low-income Californians have \u003ca href=\"http://www.dhcs.ca.gov/dataandstats/statistics/Documents/Fast_Facts_December_2015_ADA.pdf\">gained Medi-Cal insurance\u003c/a>. Those newly insured can now get medical services from head to toe at primary care clinics that also offer reproductive health. That's why Jackson doesn't see New Generation getting a lot more patients back any time soon.\u003c/p>\n\u003cp>Even when patients with Medi-Cal choose New Generation for their reproductive health care, those payments are not enough to keep the clinic afloat, says Jackson, as Medi-Cal's reimbursement rates are among the lowest in the nation.\u003c/p>\n\u003cp>New Generation's main source of patient revenue had been a more generous program than Medi-Cal, the state's Family Planning, Access, Care, and Treatment program, or Family PACT. But that program has seen significant drops in enrollment as more people gained comprehensive insurance.\u003c/p>\n\u003cp>The clinic saw these changes coming, says Jackson, but wasn't able to adapt successfully.\u003c/p>\n\u003cp>\"We tried a lot of different kinds of things to keep it open, like partnering with a primary care clinic, for example, or potentially getting another clinic to take us over, and it was difficult and couldn't get anyone to do those things,\" says Jackson.\u003c/p>\n\u003cp>UCSF is now forming working groups with community members to figure out how to salvage these services for low-income teens in San Francisco, either through keeping New Generation open or through other providers.\u003c/p>\n\u003cfigure id=\"attachment_180822\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"wp-image-180822 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/05/RS19400_IMG_9941-qut.jpg\" alt=\"Dr. Rebecca Jackson, New Generation's main supervisor, and Dr. Valerie French (right), medical director, listen to speakers at a community forum in April about the potential closure of New Generation. After the meeting, Jackson said she was hopeful New Generation could find more funds to stay open "given the huge outpouring of concerned people." \" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19400_IMG_9941-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19400_IMG_9941-qut-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19400_IMG_9941-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19400_IMG_9941-qut-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19400_IMG_9941-qut-1440x960.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19400_IMG_9941-qut-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19400_IMG_9941-qut-960x640.jpg 960w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Dr. Rebecca Jackson, (left), New Generation's main supervisor, and Dr. Valerie French, medical director, listen to speakers at a community forum in April about the potential closure of New Generation. After the meeting, Jackson said she was hopeful the clinic could find more funds to stay open \"given the huge outpouring of concerned people.\" \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Family Planning Centers Transform\u003c/strong>\u003c/p>\n\u003cp>Other reproductive health centers, such as Planned Parenthood, have added more kinds of services or merged with other clinics in order to stay competitive in the age of Obamacare, says Amy Moy from the California Family Health Council. The agency is responsible for distributing federal funds for family planning to more than 60 health organizations. That money trickles down to 340 health centers statewide.\u003c/p>\n\u003cp>While mergers can cut down costs, adding comprehensive health services allows clinics to potentially become \u003ca href=\"https://www.cms.gov/Outreach-and-Education/Medicare%E2%80%A6\" target=\"_blank\">federally qualified health centers\u003c/a>, with enhanced reimbursement from Medicare and Medi-Cal and other benefits.\u003c/p>\n\u003cp>Clinics like New Generation face a tough road to stay in business unless they change, Moy says.\u003c/p>\n\u003cp>\"The numbers of family planning health centers that are stand-alone or women's health centers that provide primarily family planning services really are dwindling,\" Moy says. \"And we anticipate that trend to continue.\"\u003c/p>\n\u003cp>Still, she says these types of clinics remain important -- especially for adolescents who value confidentiality.\u003c/p>\n\u003cp>\"A big fear is if there is a loss of those safe spaces that teens won't ... access these services that they need to stay safe and help prevent unintended pregnancy,\" Moy says.\u003c/p>\n\u003cp>\u003cstrong>Teen Patients Prefer Confidential Services\u003c/strong>\u003c/p>\n\u003cp>Mission High student Damaris Bonner says she prefers New Generation to other clinics in the area, and its potential closure is frustrating.\u003c/p>\n\u003cp>\"That’s the one clinic I felt comfortable at,\" says Bonner, 17. \"It makes no sense to close it down.\"\u003c/p>\n\u003cfigure id=\"attachment_198166\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"size-full wp-image-198166\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/06/RS19851_Damaris-Bonner-edit-2-qut.jpg\" alt=\"Mission High student Damaris Bonner, 17, at the school's wellness center. Bonner has been a patient at New Generation for nearly two years and says she prefers the clinic to others in the area.\" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/06/RS19851_Damaris-Bonner-edit-2-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/27/2016/06/RS19851_Damaris-Bonner-edit-2-qut-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/06/RS19851_Damaris-Bonner-edit-2-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/06/RS19851_Damaris-Bonner-edit-2-qut-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2016/06/RS19851_Damaris-Bonner-edit-2-qut-1440x960.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2016/06/RS19851_Damaris-Bonner-edit-2-qut-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2016/06/RS19851_Damaris-Bonner-edit-2-qut-960x640.jpg 960w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Mission High student Damaris Bonner, 17, at the school's wellness center. Bonner has been a patient at New Generation for nearly two years and says she prefers the clinic to others in the area.\u003c/figcaption>\u003c/figure>\n\u003cp>Like other patients, Bonner likes New Generation's confidential services. Because it's a space dedicated to youth, she doesn't fear running into parents or aunties there. Another plus is that the small clinic offers same-day appointments that are hard to come by elsewhere.\u003c/p>\n\u003cp>Other clinics offer reproductive health in the area, which UCSF officials say ameliorates any impact of a potential closure to patients. Still, Bonner feels local teens would face extra barriers to access reproductive health if New Generation closes. She resents that a clinic she and other young people trust could be \"taken away.\"\u003c/p>\n\u003cp>\"It's like, why? Let us youth take care of ourselves,\" says Bonner, who has been a patient at New Generation for nearly two years. \"It's crucial that we have these tools for us because when we don't that's when you start seeing unplanned pregnancies and STDs.\"\u003c/p>\n\u003cp>Mission High's nurse Watts is following closely developments about New Generation. She fears losing the clinic could translate to unplanned pregnancies and STDs among students .\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>\"It kind of terrifies me to think that I might not be able to pick up the phone and call them,\" says Watts. \"New Generation is an integral part of my job.\"\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/198146/why-stand-alone-family-planning-clinics-struggle-to-survive-in-age-of-obamacare","authors":["8659"],"categories":["stateofhealth_11"],"tags":["stateofhealth_2615","stateofhealth_2519","stateofhealth_2753"],"featImg":"stateofhealth_180898","label":"stateofhealth"},"stateofhealth_189984":{"type":"posts","id":"stateofhealth_189984","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"189984","score":null,"sort":[1464613208000]},"guestAuthors":[],"slug":"fresno-teen-fights-for-health-with-sex-ed","title":"Fresno Teen Reliable Sex Ed Resource for Fellow Students","publishDate":1464613208,"format":"standard","headTitle":"Vital Signs | State of Health | KQED News","labelTerm":{"term":2363,"site":"stateofhealth"},"content":"\u003cp>Maryjane Davis, a 17-year-old with long brown hair, pulls out a thick, white binder from her backpack in the bedroom she shares with her two younger sisters. The binder is filled with information -- about different kinds of contraceptives, how to prevent sexually transmitted infections, and emotionally healthy relationships versus abusive ones.\u003c/p>\n\u003cp>Maryjane carries it almost daily to her high school in Fresno. It’s a handy tool she turns to when other students approach her during lunch breaks with questions about sexual health or how to select the right contraceptive.\u003c/p>\n\u003cp>“I just keep it on my person. That way in case someone needs something, I can just pull it out,\" she says. “It makes me feel like a superhero. And it's kind of like a superpower to know about sex ed and healthy relationships.”\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/266812920\" 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>Maryjane trained to become a peer health ambassador at \u003ca href=\"http://www.fresnobarriosunidos.org/\" target=\"_blank\">Fresno Barrios Unidos\u003c/a>, a local education and advocacy group.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Three years ago, Maryjane wasn’t as informed. She thought kissing equaled sex. She had all kinds of questions, but asking her parents or searching online wasn’t yielding answers. Many of her friends were in the same boat, she says. Some were getting pregnant and dropping out of school.\u003c/p>\n\u003cp>It worried her that some teen moms she knew “weren't sure how they got pregnant or when they even started to get pregnant,” she says. When Maryjane sought to learn more about sex, she says her middle school teacher handed her an “abstinence card” to sign. It stated that the person signing it would avoid sex until marriage.\u003c/p>\n\u003cp>“I didn’t even know what the word abstinence meant,” she says. “It was just one card and that was going to be my sex ed class.\"\u003c/p>\n\u003cfigure id=\"attachment_189989\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"wp-image-189989 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/05/RS19634_WithSiblingsBedroom-qut.jpg\" alt=\"Maryjane Davis in her bedroom with sister Ricci, 12, friend Mary Jane Rodriguez, 11, and sister Lily, 8. Maryjane trained to become a peer health ambassador with a local non-profit to help friends at school learn about how to prevent STDs and unplanned pregnancies.\" width=\"1920\" height=\"1261\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19634_WithSiblingsBedroom-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19634_WithSiblingsBedroom-qut-400x263.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19634_WithSiblingsBedroom-qut-800x525.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19634_WithSiblingsBedroom-qut-768x504.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19634_WithSiblingsBedroom-qut-1440x946.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19634_WithSiblingsBedroom-qut-1180x775.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19634_WithSiblingsBedroom-qut-960x631.jpg 960w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Maryjane Davis in her bedroom with sister Ricci, 12, friend Mary Jane Rodriguez, 11, and sister Lily, 8. Maryjane often carries the binder she's holding to help educate kids at school on sexual health. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>New State Law Requires Comprehensive Sex Ed\u003c/strong>\u003c/p>\n\u003cp>Until last year, public schools in California were not required to teach sex education, although information on HIV/AIDS prevention has been mandatory. At Fresno Unified, the fourth largest school district in the state, students learned about HIV/AIDS prevention and some sex ed. But youth health advocates say the quality and accuracy of that education varied greatly from school to school, leaving many kids without the necessary tools to make informed decisions about their health.\u003c/p>\n\u003cp>Fresno County has the state’s second highest rates of the sexually transmitted infections chlamydia and gonorrhea, according to the California Department of Public Health. The county also has one of the highest rates of teen pregnancy.\u003c/p>\n\u003cp>Barrios Unidos has been filling the gap in education. For years, it has offered teen pregnancy prevention and other sex ed through after school programs. Maryjane signed up for one course and felt empowered by the new information.\u003c/p>\n\u003cp>Maryjane and other students lobbied Fresno Unified to improve its sex ed, and last October, the school board approved a comprehensive program.\u003c/p>\n\u003cp>The Fresno Unified school board’s vote came just two months before a California law requiring all districts to provide comprehensive sexual education and HIV prevention went into effect. The \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160AB329\" target=\"_blank\">California Healthy Youth Act\u003c/a> mandates that curriculum on “human development and sexuality, including education on pregnancy, contraception and sexually transmitted infections” be provided to students at least once in junior high or middle school and once in high school. Parents can refuse the classes on behalf of their children.\u003c/p>\n\u003cp>\u003cstrong>'Full Imprementation' in Fresno Schools\u003c/strong>\u003c/p>\n\u003cp>Science and biology classes at Fresno Unified now teach 7th and 9th graders the Positive Prevention Plus curriculum, the highest-rated sexual health education program approved by the California Department of Education, says Rosario Sanchez, associate superintendent of curriculum and instruction at Fresno Unified.\u003c/p>\n\u003cp>“We are in full implementation,” says Sanchez. “Giving (our students) access to this information is critical, so we can reduce the county stats that are stark.”\u003c/p>\n\u003cp>Fresno Unified, with 73,000 students, now also contracts with Barrios Unidos to provide half of the sex ed courses to high school students.\u003c/p>\n\u003cp>“The education they are getting is very comprehensive and medically accurate,\" says Socorro Santillan, executive director at Barrios Unidos. Students \"will be able to make good decisions for themselves not based on scare tactics, but knowledge.”\u003c/p>\n\u003cp>Fourteen other area school districts are working with the Fresno County Office of Education to provide the classes, says Kayla Wilson, a consultant with FCOE.\u003c/p>\n\u003cp>Over the last two months, Wilson and five nurses have been teaching a similar curriculum to 7th and 9th graders in the Fresno County school districts of Fowler, Mendota and Firebaugh-Las Deltas.\u003c/p>\n\u003cp>Wilson said a lot of her outreach work focuses on speaking with parents and school boards about the curriculum, and addressing parents' and administrators' fears about what the students will be learning. She said no students have opted out so far.\u003c/p>\n\u003cfigure id=\"attachment_189987\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"size-full wp-image-189987\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/05/RS19632_HoldingBinder-qut.jpg\" alt=\"Maryjane Davis, 17, holds the binder with sexual health information that she uses to answer the questions of peers at school in Fresno. She says some teen moms didn't know how they got pregnant.\" width=\"1920\" height=\"1952\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19632_HoldingBinder-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19632_HoldingBinder-qut-400x407.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19632_HoldingBinder-qut-800x813.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19632_HoldingBinder-qut-768x781.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19632_HoldingBinder-qut-1440x1464.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19632_HoldingBinder-qut-1180x1200.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19632_HoldingBinder-qut-960x976.jpg 960w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19632_HoldingBinder-qut-32x32.jpg 32w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19632_HoldingBinder-qut-50x50.jpg 50w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19632_HoldingBinder-qut-64x64.jpg 64w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Maryjane Davis, 17, holds the binder with sexual health information that she uses to answer the questions of peers at school in Fresno. She says some teen moms didn't know how they got pregnant. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>At Maryjane Davis’ home, sex ed has changed the family dynamics. Maryjane's mother, Sara Angulo, was so inspired by her daughter's greater confidence and desire to help other teens after taking the sex ed course at Barrios Unidos that she took her 8- and 12-year-old daughters to age-appropriate sex ed classes at Barrios as well.\u003c/p>\n\u003cp>“I think it's very important that everyone learns,” says Angulo, 38. “There are questions that they won't ask me. But they'll ask someone else, and so it's awesome.”\u003c/p>\n\u003cp>Angulo, who has nine children, says when she was growing up, there was no talk about sex in her family.\u003c/p>\n\u003cp>“It was never, never talked about. I had my first (baby) at a very young age,\" she says. \"It was almost expected to be a teenage mother in my family,” says Angulo.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“These girls know enough to (say), ‘I can wait.’”\u003c/p>\n\n","blocks":[],"excerpt":"17-year-old Maryjane Davis makes it her mission to teach Fresno teens about sexual health, to prevent STDs and unplanned pregnancies. . ","status":"publish","parent":0,"modified":1464722679,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":29,"wordCount":1099},"headData":{"title":"Fresno Teen Reliable Sex Ed Resource for Fellow Students | KQED","description":"17-year-old Maryjane Davis makes it her mission to teach Fresno teens about sexual health, to prevent STDs and unplanned pregnancies. . ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Fresno Teen Reliable Sex Ed Resource for Fellow Students","datePublished":"2016-05-30T13:00:08.000Z","dateModified":"2016-05-31T19:24:39.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"189984 http://ww2.kqed.org/stateofhealth/?p=189984","disqusUrl":"https://ww2.kqed.org/stateofhealth/2016/05/30/fresno-teen-fights-for-health-with-sex-ed/","disqusTitle":"Fresno Teen Reliable Sex Ed Resource for Fellow Students","path":"/stateofhealth/189984/fresno-teen-fights-for-health-with-sex-ed","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Maryjane Davis, a 17-year-old with long brown hair, pulls out a thick, white binder from her backpack in the bedroom she shares with her two younger sisters. The binder is filled with information -- about different kinds of contraceptives, how to prevent sexually transmitted infections, and emotionally healthy relationships versus abusive ones.\u003c/p>\n\u003cp>Maryjane carries it almost daily to her high school in Fresno. It’s a handy tool she turns to when other students approach her during lunch breaks with questions about sexual health or how to select the right contraceptive.\u003c/p>\n\u003cp>“I just keep it on my person. That way in case someone needs something, I can just pull it out,\" she says. “It makes me feel like a superhero. And it's kind of like a superpower to know about sex ed and healthy relationships.”\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/266812920&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/266812920'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Maryjane trained to become a peer health ambassador at \u003ca href=\"http://www.fresnobarriosunidos.org/\" target=\"_blank\">Fresno Barrios Unidos\u003c/a>, a local education and advocacy group.\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>Three years ago, Maryjane wasn’t as informed. She thought kissing equaled sex. She had all kinds of questions, but asking her parents or searching online wasn’t yielding answers. Many of her friends were in the same boat, she says. Some were getting pregnant and dropping out of school.\u003c/p>\n\u003cp>It worried her that some teen moms she knew “weren't sure how they got pregnant or when they even started to get pregnant,” she says. When Maryjane sought to learn more about sex, she says her middle school teacher handed her an “abstinence card” to sign. It stated that the person signing it would avoid sex until marriage.\u003c/p>\n\u003cp>“I didn’t even know what the word abstinence meant,” she says. “It was just one card and that was going to be my sex ed class.\"\u003c/p>\n\u003cfigure id=\"attachment_189989\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"wp-image-189989 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/05/RS19634_WithSiblingsBedroom-qut.jpg\" alt=\"Maryjane Davis in her bedroom with sister Ricci, 12, friend Mary Jane Rodriguez, 11, and sister Lily, 8. Maryjane trained to become a peer health ambassador with a local non-profit to help friends at school learn about how to prevent STDs and unplanned pregnancies.\" width=\"1920\" height=\"1261\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19634_WithSiblingsBedroom-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19634_WithSiblingsBedroom-qut-400x263.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19634_WithSiblingsBedroom-qut-800x525.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19634_WithSiblingsBedroom-qut-768x504.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19634_WithSiblingsBedroom-qut-1440x946.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19634_WithSiblingsBedroom-qut-1180x775.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19634_WithSiblingsBedroom-qut-960x631.jpg 960w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Maryjane Davis in her bedroom with sister Ricci, 12, friend Mary Jane Rodriguez, 11, and sister Lily, 8. Maryjane often carries the binder she's holding to help educate kids at school on sexual health. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>New State Law Requires Comprehensive Sex Ed\u003c/strong>\u003c/p>\n\u003cp>Until last year, public schools in California were not required to teach sex education, although information on HIV/AIDS prevention has been mandatory. At Fresno Unified, the fourth largest school district in the state, students learned about HIV/AIDS prevention and some sex ed. But youth health advocates say the quality and accuracy of that education varied greatly from school to school, leaving many kids without the necessary tools to make informed decisions about their health.\u003c/p>\n\u003cp>Fresno County has the state’s second highest rates of the sexually transmitted infections chlamydia and gonorrhea, according to the California Department of Public Health. The county also has one of the highest rates of teen pregnancy.\u003c/p>\n\u003cp>Barrios Unidos has been filling the gap in education. For years, it has offered teen pregnancy prevention and other sex ed through after school programs. Maryjane signed up for one course and felt empowered by the new information.\u003c/p>\n\u003cp>Maryjane and other students lobbied Fresno Unified to improve its sex ed, and last October, the school board approved a comprehensive program.\u003c/p>\n\u003cp>The Fresno Unified school board’s vote came just two months before a California law requiring all districts to provide comprehensive sexual education and HIV prevention went into effect. The \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160AB329\" target=\"_blank\">California Healthy Youth Act\u003c/a> mandates that curriculum on “human development and sexuality, including education on pregnancy, contraception and sexually transmitted infections” be provided to students at least once in junior high or middle school and once in high school. Parents can refuse the classes on behalf of their children.\u003c/p>\n\u003cp>\u003cstrong>'Full Imprementation' in Fresno Schools\u003c/strong>\u003c/p>\n\u003cp>Science and biology classes at Fresno Unified now teach 7th and 9th graders the Positive Prevention Plus curriculum, the highest-rated sexual health education program approved by the California Department of Education, says Rosario Sanchez, associate superintendent of curriculum and instruction at Fresno Unified.\u003c/p>\n\u003cp>“We are in full implementation,” says Sanchez. “Giving (our students) access to this information is critical, so we can reduce the county stats that are stark.”\u003c/p>\n\u003cp>Fresno Unified, with 73,000 students, now also contracts with Barrios Unidos to provide half of the sex ed courses to high school students.\u003c/p>\n\u003cp>“The education they are getting is very comprehensive and medically accurate,\" says Socorro Santillan, executive director at Barrios Unidos. Students \"will be able to make good decisions for themselves not based on scare tactics, but knowledge.”\u003c/p>\n\u003cp>Fourteen other area school districts are working with the Fresno County Office of Education to provide the classes, says Kayla Wilson, a consultant with FCOE.\u003c/p>\n\u003cp>Over the last two months, Wilson and five nurses have been teaching a similar curriculum to 7th and 9th graders in the Fresno County school districts of Fowler, Mendota and Firebaugh-Las Deltas.\u003c/p>\n\u003cp>Wilson said a lot of her outreach work focuses on speaking with parents and school boards about the curriculum, and addressing parents' and administrators' fears about what the students will be learning. She said no students have opted out so far.\u003c/p>\n\u003cfigure id=\"attachment_189987\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"size-full wp-image-189987\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/05/RS19632_HoldingBinder-qut.jpg\" alt=\"Maryjane Davis, 17, holds the binder with sexual health information that she uses to answer the questions of peers at school in Fresno. She says some teen moms didn't know how they got pregnant.\" width=\"1920\" height=\"1952\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19632_HoldingBinder-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19632_HoldingBinder-qut-400x407.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19632_HoldingBinder-qut-800x813.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19632_HoldingBinder-qut-768x781.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19632_HoldingBinder-qut-1440x1464.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19632_HoldingBinder-qut-1180x1200.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19632_HoldingBinder-qut-960x976.jpg 960w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19632_HoldingBinder-qut-32x32.jpg 32w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19632_HoldingBinder-qut-50x50.jpg 50w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19632_HoldingBinder-qut-64x64.jpg 64w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Maryjane Davis, 17, holds the binder with sexual health information that she uses to answer the questions of peers at school in Fresno. She says some teen moms didn't know how they got pregnant. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>At Maryjane Davis’ home, sex ed has changed the family dynamics. Maryjane's mother, Sara Angulo, was so inspired by her daughter's greater confidence and desire to help other teens after taking the sex ed course at Barrios Unidos that she took her 8- and 12-year-old daughters to age-appropriate sex ed classes at Barrios as well.\u003c/p>\n\u003cp>“I think it's very important that everyone learns,” says Angulo, 38. “There are questions that they won't ask me. But they'll ask someone else, and so it's awesome.”\u003c/p>\n\u003cp>Angulo, who has nine children, says when she was growing up, there was no talk about sex in her family.\u003c/p>\n\u003cp>“It was never, never talked about. I had my first (baby) at a very young age,\" she says. \"It was almost expected to be a teenage mother in my family,” says Angulo.\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>“These girls know enough to (say), ‘I can wait.’”\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/189984/fresno-teen-fights-for-health-with-sex-ed","authors":["8659"],"series":["stateofhealth_2363"],"categories":["stateofhealth_11","stateofhealth_2746"],"tags":["stateofhealth_2615","stateofhealth_2519","stateofhealth_2749"],"featImg":"stateofhealth_189988","label":"stateofhealth_2363"},"stateofhealth_178106":{"type":"posts","id":"stateofhealth_178106","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"178106","score":null,"sort":[1462548646000]},"guestAuthors":[],"slug":"mission-save-beloved-uc-san-francisco-clinic","title":"Mission Neighbors Vow to Save Beloved UCSF Clinic","publishDate":1462548646,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>Facing a budget in the red and a loss of patients, UC San Francisco officials plan to close a beloved family planning clinic for low-income teens and young adults in the city's Mission District.\u003c/p>\n\u003cp>The New Generation Health Center, which has provided free reproductive health care for two decades to patients as young as 13, is scheduled to close its doors on July 31.\u003c/p>\n\u003cp>Health providers say the decision could imperil at-risk Latino and African-American youth who already like and trust New Generation's confidential and prompt services. Concerned residents and others say they want to find funds, or pressure UCSF, to keep the clinic open.\u003c/p>\n\u003cp>Over the last five years, the clinic's finances have been decimated by decreases in grant revenue and a potentially irreversible loss in patients, says \u003ca href=\"https://obgyn.ucsf.edu/san-francisco-general-hospital/rebecca-jackson-md\" target=\"_blank\">Dr. Rebecca Jackson\u003c/a>, a UCSF professor of obstetrics and gynecology and supervisor at New Generation.\u003c/p>\n\u003cp>\"This was an awful, awful, heart-wrenching decision to have to make,\" says Jackson. \"New Gen is a very special place. They really take their mission seriously, which is empowering young people to make decisions in a world and in an age where it’s hard to have a choice.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Jackson and her staff have been working for weeks to transition New Generation's 2,200 patients to nearby clinics with similar services, such as Mission Neighborhood Health Center and 3rd Street Youth Center & Clinic.\u003c/p>\n\u003cfigure id=\"attachment_180822\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"wp-image-180822 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/05/RS19400_IMG_9941-qut.jpg\" alt=\"Dr. Rebecca Jackson, New Generation's main supervisor, and Dr. Valerie French (right), medical director, listen to speakers at the forum. After the meeting, Jackson said she was hopeful New Generation could find more funds to stay open "given the huge outpouring of concerned people and some of them saying we think we can solve this."\" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19400_IMG_9941-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19400_IMG_9941-qut-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19400_IMG_9941-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19400_IMG_9941-qut-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19400_IMG_9941-qut-1440x960.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19400_IMG_9941-qut-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19400_IMG_9941-qut-960x640.jpg 960w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Dr. Rebecca Jackson, New Generation's main supervisor, and Dr. Valerie French (right), medical director, listen to speakers at the forum. After the meeting, Jackson said she was hopeful New Generation could find more funds to stay open \"given the huge outpouring of concerned people and some of them saying 'we think we can solve this.' \" \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Residents Vow to Fight for Clinic\u003c/strong>\u003c/p>\n\u003cp>The news of the closure did not sit well with several Mission residents, students, health providers and youth advocates at a forum with UCSF officials last week.\u003c/p>\n\u003cp>A funeral-like mood pervaded a packed auditorium to discuss the clinic's closure. Jackson and Dr. Sue Carlisle, a UCSF Medical School vice dean, spoke about the financial reasons for the closure and efforts to ensure all patients are matched with \"best fit\" clinics in the area.\u003c/p>\n\u003cp>Still, speaker after speaker called on a new effort to save New Generation, not shutter it.\u003c/p>\n\u003cp>\"What we have to do as a community is not take this and stand together and fight back. We need to hold UCSF accountable,\" said Ronnishia Johnson, who grew up in the nearby Bayview neighborhood. \"From my perspective this is nothing but them turning their backs on the community.\"\u003c/p>\n\u003cp>Nataly Ortiz, who become a mom as a teen, says it's hard for local Latina and undocumented teens to get same or next-day appointments for reproductive health in clinics other than New Generation.\u003c/p>\n\u003cp>\"S\u003cspan style=\"font-weight: 400\">ometimes it’s a very emotional case of being scared of being pregnant at a very young age,\" said Ortiz, who refers patients to New Generation through her work at a neighborhood nonprofit. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\"They need a clinic like this. So for you to take it away, it’s just saying our community doesn’t matter, the people that benefit from this clinic don't matter. But I'm here to tell you, we do matter!\" Ortiz said to UCSF officials. \u003c/span>\u003c/p>\n\u003cfigure id=\"attachment_180898\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"size-full wp-image-180898\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/05/RS19406_IMG_9992-qut.jpg\" alt=\"More than 2,200 patients will be affected by UCSF plans to close the New Generation Health Center on July 31. The youth-oriented family planning clinic will be open for appointments until July 22. \" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19406_IMG_9992-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19406_IMG_9992-qut-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19406_IMG_9992-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19406_IMG_9992-qut-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19406_IMG_9992-qut-1440x960.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19406_IMG_9992-qut-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19406_IMG_9992-qut-960x640.jpg 960w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">More than 2,200 patients will be affected by UCSF plans to close the New Generation Health Center on July 31. The youth-oriented family planning clinic will be open for appointments until July 22. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Affordable Care Act 'Hurting' Family Planning Clinics\u003c/strong>\u003c/p>\n\u003cp>Ironically, the Affordable Care Act (ACA) is partly to blame for New Generation's troubles, says Jackson.\u003c/p>\n\u003cp>Under the ACA, more people have become eligible for Medi-Cal, the state's health insurance program for people who are low income. Many New Generation clients are choosing to get their reproductive services addressed with their new doctor or medical clinic that handles all their health needs. Other family planning and specialty clinics are also feeling this \u003ca href=\"http://www.npr.org/sections/health-shots/2014/02/10/272997468/family-planning-squeezed-in-california-by-health-law\" target=\"_blank\">squeeze\u003c/a>.\u003c/p>\n\u003cp>\"For a lot of people, it's more convenient to get that [reproductive] care at the same time they are getting the rest of their health care,\" Jackson says.\u003c/p>\n\u003cp>Still, she added, \"a small subset\" of patients want to keep reproductive health care separate.\u003c/p>\n\u003cp>One of those patients is Rocio Navarro, a student at Abraham Lincoln High School.\u003c/p>\n\u003cp>\"Where else would I go where I won’t run into my parents, where I won’t run into my aunt, where I won’t run into my neighbors?\" asked Rocio, 15. \"This makes me really mad. The Mission is our neighborhood and that's where this place should stay!\"\u003c/p>\n\u003cp>\u003cb>San Francisco Teen Pregnancy Among Lowest in California\u003c/b>\u003c/p>\n\u003cp>Jackson believes that funders who previously supported New Generation's operations have \"different priorities\" because the city's teen pregnancy rate is very low.\u003c/p>\n\u003cp>Community advocates and school nurses credit resources like New Generation with helping drive that rate down. They worry that dismantling what they see as a well-oiled, efficient system that provides excellent services will chip away at that public health achievement because at-risk teens will fall through the cracks.\u003c/p>\n\u003cp>\"They are still sexually active,\" says Mary-Michael Watts, a nurse at the Mission High School Wellness Center who often refers students to New Generation, and is critical of the closure. \"I applaud these young people that are taking responsibility for not getting pregnant … and they are really safe and competent hands at New Generation.\"\u003c/p>\n\u003cp>UCSF and San Francisco's public health department are planning to hold a second community forum to include more people directly affected by the closure, possibly by the end of this month. No date has been confirmed yet.\u003c/p>\n\u003cp>Last year, UCSF raised more than $600 million in \u003ca href=\"https://www.ucsf.edu/about/facts-figures\" target=\"_blank\">private contributions\u003c/a>, the highest total of any public U.S. university, according to the Council for Aid to Education.\u003c/p>\n\u003cp>Nearly all of those funds go toward specific programs and projects, says Jackson, and like most community clinics, New Generation must survive on its own clinical and grant revenue.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\"I’m hoping maybe now with the community being involved that some new idea will come up or people will be outraged enough they’ll want to fund it to stay open,\" said Jackson.\u003c/p>\n\n","blocks":[],"excerpt":"The New Generation Health Center has provided free reproductive health care for nearly two decades to 2,200 patients a year. ","status":"publish","parent":0,"modified":1462804475,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":31,"wordCount":1105},"headData":{"title":"Mission Neighbors Vow to Save Beloved UCSF Clinic | KQED","description":"The New Generation Health Center has provided free reproductive health care for nearly two decades to 2,200 patients a year. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Mission Neighbors Vow to Save Beloved UCSF Clinic","datePublished":"2016-05-06T15:30:46.000Z","dateModified":"2016-05-09T14:34:35.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"178106 http://ww2.kqed.org/stateofhealth/?p=178106","disqusUrl":"https://ww2.kqed.org/stateofhealth/2016/05/06/mission-save-beloved-uc-san-francisco-clinic/","disqusTitle":"Mission Neighbors Vow to Save Beloved UCSF Clinic","path":"/stateofhealth/178106/mission-save-beloved-uc-san-francisco-clinic","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Facing a budget in the red and a loss of patients, UC San Francisco officials plan to close a beloved family planning clinic for low-income teens and young adults in the city's Mission District.\u003c/p>\n\u003cp>The New Generation Health Center, which has provided free reproductive health care for two decades to patients as young as 13, is scheduled to close its doors on July 31.\u003c/p>\n\u003cp>Health providers say the decision could imperil at-risk Latino and African-American youth who already like and trust New Generation's confidential and prompt services. Concerned residents and others say they want to find funds, or pressure UCSF, to keep the clinic open.\u003c/p>\n\u003cp>Over the last five years, the clinic's finances have been decimated by decreases in grant revenue and a potentially irreversible loss in patients, says \u003ca href=\"https://obgyn.ucsf.edu/san-francisco-general-hospital/rebecca-jackson-md\" target=\"_blank\">Dr. Rebecca Jackson\u003c/a>, a UCSF professor of obstetrics and gynecology and supervisor at New Generation.\u003c/p>\n\u003cp>\"This was an awful, awful, heart-wrenching decision to have to make,\" says Jackson. \"New Gen is a very special place. They really take their mission seriously, which is empowering young people to make decisions in a world and in an age where it’s hard to have a choice.\"\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>Jackson and her staff have been working for weeks to transition New Generation's 2,200 patients to nearby clinics with similar services, such as Mission Neighborhood Health Center and 3rd Street Youth Center & Clinic.\u003c/p>\n\u003cfigure id=\"attachment_180822\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"wp-image-180822 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/05/RS19400_IMG_9941-qut.jpg\" alt=\"Dr. Rebecca Jackson, New Generation's main supervisor, and Dr. Valerie French (right), medical director, listen to speakers at the forum. After the meeting, Jackson said she was hopeful New Generation could find more funds to stay open "given the huge outpouring of concerned people and some of them saying we think we can solve this."\" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19400_IMG_9941-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19400_IMG_9941-qut-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19400_IMG_9941-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19400_IMG_9941-qut-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19400_IMG_9941-qut-1440x960.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19400_IMG_9941-qut-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19400_IMG_9941-qut-960x640.jpg 960w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Dr. Rebecca Jackson, New Generation's main supervisor, and Dr. Valerie French (right), medical director, listen to speakers at the forum. After the meeting, Jackson said she was hopeful New Generation could find more funds to stay open \"given the huge outpouring of concerned people and some of them saying 'we think we can solve this.' \" \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Residents Vow to Fight for Clinic\u003c/strong>\u003c/p>\n\u003cp>The news of the closure did not sit well with several Mission residents, students, health providers and youth advocates at a forum with UCSF officials last week.\u003c/p>\n\u003cp>A funeral-like mood pervaded a packed auditorium to discuss the clinic's closure. Jackson and Dr. Sue Carlisle, a UCSF Medical School vice dean, spoke about the financial reasons for the closure and efforts to ensure all patients are matched with \"best fit\" clinics in the area.\u003c/p>\n\u003cp>Still, speaker after speaker called on a new effort to save New Generation, not shutter it.\u003c/p>\n\u003cp>\"What we have to do as a community is not take this and stand together and fight back. We need to hold UCSF accountable,\" said Ronnishia Johnson, who grew up in the nearby Bayview neighborhood. \"From my perspective this is nothing but them turning their backs on the community.\"\u003c/p>\n\u003cp>Nataly Ortiz, who become a mom as a teen, says it's hard for local Latina and undocumented teens to get same or next-day appointments for reproductive health in clinics other than New Generation.\u003c/p>\n\u003cp>\"S\u003cspan style=\"font-weight: 400\">ometimes it’s a very emotional case of being scared of being pregnant at a very young age,\" said Ortiz, who refers patients to New Generation through her work at a neighborhood nonprofit. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\"They need a clinic like this. So for you to take it away, it’s just saying our community doesn’t matter, the people that benefit from this clinic don't matter. But I'm here to tell you, we do matter!\" Ortiz said to UCSF officials. \u003c/span>\u003c/p>\n\u003cfigure id=\"attachment_180898\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"size-full wp-image-180898\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/05/RS19406_IMG_9992-qut.jpg\" alt=\"More than 2,200 patients will be affected by UCSF plans to close the New Generation Health Center on July 31. The youth-oriented family planning clinic will be open for appointments until July 22. \" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19406_IMG_9992-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19406_IMG_9992-qut-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19406_IMG_9992-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19406_IMG_9992-qut-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19406_IMG_9992-qut-1440x960.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19406_IMG_9992-qut-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/RS19406_IMG_9992-qut-960x640.jpg 960w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">More than 2,200 patients will be affected by UCSF plans to close the New Generation Health Center on July 31. The youth-oriented family planning clinic will be open for appointments until July 22. \u003ccite>(Farida Jhabvala Romero/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Affordable Care Act 'Hurting' Family Planning Clinics\u003c/strong>\u003c/p>\n\u003cp>Ironically, the Affordable Care Act (ACA) is partly to blame for New Generation's troubles, says Jackson.\u003c/p>\n\u003cp>Under the ACA, more people have become eligible for Medi-Cal, the state's health insurance program for people who are low income. Many New Generation clients are choosing to get their reproductive services addressed with their new doctor or medical clinic that handles all their health needs. Other family planning and specialty clinics are also feeling this \u003ca href=\"http://www.npr.org/sections/health-shots/2014/02/10/272997468/family-planning-squeezed-in-california-by-health-law\" target=\"_blank\">squeeze\u003c/a>.\u003c/p>\n\u003cp>\"For a lot of people, it's more convenient to get that [reproductive] care at the same time they are getting the rest of their health care,\" Jackson says.\u003c/p>\n\u003cp>Still, she added, \"a small subset\" of patients want to keep reproductive health care separate.\u003c/p>\n\u003cp>One of those patients is Rocio Navarro, a student at Abraham Lincoln High School.\u003c/p>\n\u003cp>\"Where else would I go where I won’t run into my parents, where I won’t run into my aunt, where I won’t run into my neighbors?\" asked Rocio, 15. \"This makes me really mad. The Mission is our neighborhood and that's where this place should stay!\"\u003c/p>\n\u003cp>\u003cb>San Francisco Teen Pregnancy Among Lowest in California\u003c/b>\u003c/p>\n\u003cp>Jackson believes that funders who previously supported New Generation's operations have \"different priorities\" because the city's teen pregnancy rate is very low.\u003c/p>\n\u003cp>Community advocates and school nurses credit resources like New Generation with helping drive that rate down. They worry that dismantling what they see as a well-oiled, efficient system that provides excellent services will chip away at that public health achievement because at-risk teens will fall through the cracks.\u003c/p>\n\u003cp>\"They are still sexually active,\" says Mary-Michael Watts, a nurse at the Mission High School Wellness Center who often refers students to New Generation, and is critical of the closure. \"I applaud these young people that are taking responsibility for not getting pregnant … and they are really safe and competent hands at New Generation.\"\u003c/p>\n\u003cp>UCSF and San Francisco's public health department are planning to hold a second community forum to include more people directly affected by the closure, possibly by the end of this month. No date has been confirmed yet.\u003c/p>\n\u003cp>Last year, UCSF raised more than $600 million in \u003ca href=\"https://www.ucsf.edu/about/facts-figures\" target=\"_blank\">private contributions\u003c/a>, the highest total of any public U.S. university, according to the Council for Aid to Education.\u003c/p>\n\u003cp>Nearly all of those funds go toward specific programs and projects, says Jackson, and like most community clinics, New Generation must survive on its own clinical and grant revenue.\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>\"I’m hoping maybe now with the community being involved that some new idea will come up or people will be outraged enough they’ll want to fund it to stay open,\" said Jackson.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/178106/mission-save-beloved-uc-san-francisco-clinic","authors":["8659"],"categories":["stateofhealth_11"],"tags":["stateofhealth_2615","stateofhealth_2608","stateofhealth_2519","stateofhealth_2753"],"featImg":"stateofhealth_180819","label":"stateofhealth"},"stateofhealth_180422":{"type":"posts","id":"stateofhealth_180422","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"180422","score":null,"sort":[1462411991000]},"guestAuthors":[],"slug":"gov-brown-signs-major-tobacco-bills-raises-legal-age-to-21","title":"Gov. Brown Signs Major Tobacco Bills, Raises Legal Age to 21","publishDate":1462411991,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>Gov. Jerry Brown signed a sweeping package of tobacco bills into law on Wednesday, including one that will \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520162SB7\" target=\"_blank\">raise the legal age \u003c/a>to buy products from 18 to 21 and another that dramatically\u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520162SB5\" target=\"_blank\"> tightens restrictions\u003c/a> on e-cigarettes.\u003c/p>\n\u003caside class=\"pullquote alignright\">'What this means for California is our youth are less likely to be addicted to this horrible drug of tobacco.'\u003ccite> Sen. Ed Hernandez, author of the new law\u003c/cite>\u003c/aside>\n\u003cp>But the governor \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520162AB10\" target=\"_blank\">vetoed a bill\u003c/a> that would have permitted cities and counties to establish their own tobacco taxes.\u003c/p>\n\u003cp>“Although California has one of the lowest cigarette taxes in the nation,” the governor said in a veto message, “I am reluctant to approve this measure in view of all the taxes being proposed for the 2016 ballot.”\u003c/p>\n\u003cp>California becomes just the second state after Hawaii to raise the lawful age to buy tobacco products, a move that backers applaud as a certain way to curtail harm to adolescents, and reduce the number of adult smokers.\u003c/p>\n\u003cp>Sen. Ed Hernandez, D-West Covina, was the lead author of the bill to raise the tobacco age. In a phone interview, he said he was \"ecstatic.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"What this means for California is now we can know that our youth are less likely to be addicted to this horrible drug of tobacco,\" he said. \"There’s going to be less addiction to tobacco, [and] we’re going to reduce health care costs and save lives.\"\u003c/p>\n\u003cp>The law, which takes effect next month on June 9, applies to all 18 to 20-year-olds, except military personnel. The bill had stalled for months until a compromise was reached to permit service members under 21 to continue purchasing tobacco.\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/262622063\" 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>A major \u003ca href=\"http://www.nationalacademies.org/hmd/Activities/PublicHealth/TobaccoMinimumAge.aspx\" target=\"_blank\">Institute of Medicine report\u003c/a> last year concluded that if all states raised the tobacco age to 21, there would be a 12 percent drop in the number of teen and young adult smokers.\u003c/p>\n\u003cp>\"The biggest drops in tobacco use (will) likely occur among teens ages 15 to 17 -- kids who can’t legally buy tobacco products in California now but who run in the same social circles as 18-year-olds who may illegally purchase tobacco products for younger friends,\" said Larry Cohen, executive director of the Oakland-based Prevention Institute and a longtime advocate for tobacco control policies.\u003c/p>\n\u003cp>Adolescents are at particular risk for nicotine addiction since their brains are still developing, says longtime tobacco critic, Stan Glantz, a professor at the University of California, San Francisco.\u003c/p>\n\u003cp>\"Exposing the developing brain to nicotine, which is in both e-cigarettes and conventional cigarettes, physically changes the brain,\" Glantz said. \"That's why the younger someone starts to smoke, the more addicted they tend to get … and the harder time they have stopping.\u003c/p>\n\u003cp>\u003cstrong>Vaping Banned in Many Public Places\u003c/strong>\u003c/p>\n\u003cp>But Glantz said the new regulations on e-cigarettes may be even more significant. \"There's no question that e-cigarettes aren't as dangerous as cigarettes are,\" he said, \"but they're still dangerous.\"\u003c/p>\n\u003cp>Under \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520162SB5\" target=\"_blank\">the law\u003c/a>, written by Sen. Mark Leno, D-San Francisco, e-cigarettes will be banned in all the same places that traditional cigarettes are -- workplaces, schools, restaurants, hospitals and more. And like other tobacco products, users will need to be 21 to buy e-cigarettes.\u003c/p>\n\u003cp>“The e-cigarette is nothing more than a new delivery system for toxic and addictive nicotine,” Leno said in a statement. “Ensuring that e-cigarettes fall under California’s comprehensive smoke-free laws is critical to protecting public health, especially given the alarming rate at which young people are picking up these devices.\"\u003c/p>\n\u003cp>A \u003ca href=\"http://www.cdc.gov/media/releases/2015/p0416-e-cigarette-use.html\" target=\"_blank\">study\u003c/a> last year from the Centers for Disease Control found that e-cigarette use among middle and high school students had tripled in just one year, from 2013 to 2014.\u003c/p>\n\u003cp>Brown signed three other bills:\u003c/p>\n\u003cul>\n\u003cli>An \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520162AB7\">expansion of smoke-free workspaces\u003c/a> to include hotel lobbies, bars, banquet rooms and employee break rooms\u003c/li>\n\u003cli>Expansion of eligibility for \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520162AB9\">tobacco prevention funds to charter schools\u003c/a>\u003c/li>\n\u003cli>Increases \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billAnalysisClient.xhtml?bill_id=201520162AB11\">tobacco retailer license fees\u003c/a> from a one-time $100 fee to an annual $265 fee\u003c/li>\n\u003c/ul>\n\u003cp>Anti-tobacco groups are now focusing their efforts on an effort to gather signatures for a November ballot initiative that would raise cigarette taxes from the current $0.87 per pack to $2.\u003c/p>\n\u003cp>While California is seen as tough on tobacco, it ranks \u003ca href=\"https://www.tobaccofreekids.org/research/factsheets/pdf/0097.pdf\">36\u003csup>th\u003c/sup> in the country\u003c/a> on per-pack taxes. A \u003ca href=\"http://www.sfgate.com/politics/article/Prop-29-cigarette-tax-backers-concede-defeat-3656640.php\">2012 ballot initiative to raise taxes by $1 per pack\u003c/a> failed by less than half a percentage point after the tobacco industry spent $47 million to defeat it.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>A statewide Field Poll last year found that \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/08/26/california-voters-back-tobacco-tax-hike-poll-shows/\">two-thirds of California voters support\u003c/a> an increase in tobacco taxes.\u003c/p>\n\n","blocks":[],"excerpt":"Another new law will ban vaping in public places just as smoking is banned.","status":"publish","parent":0,"modified":1462487532,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":23,"wordCount":820},"headData":{"title":"Gov. Brown Signs Major Tobacco Bills, Raises Legal Age to 21 | KQED","description":"Another new law will ban vaping in public places just as smoking is banned.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Gov. Brown Signs Major Tobacco Bills, Raises Legal Age to 21","datePublished":"2016-05-05T01:33:11.000Z","dateModified":"2016-05-05T22:32:12.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"180422 http://ww2.kqed.org/stateofhealth/?p=180422","disqusUrl":"https://ww2.kqed.org/stateofhealth/2016/05/04/gov-brown-signs-major-tobacco-bills-raises-legal-age-to-21/","disqusTitle":"Gov. Brown Signs Major Tobacco Bills, Raises Legal Age to 21","path":"/stateofhealth/180422/gov-brown-signs-major-tobacco-bills-raises-legal-age-to-21","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Gov. Jerry Brown signed a sweeping package of tobacco bills into law on Wednesday, including one that will \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520162SB7\" target=\"_blank\">raise the legal age \u003c/a>to buy products from 18 to 21 and another that dramatically\u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520162SB5\" target=\"_blank\"> tightens restrictions\u003c/a> on e-cigarettes.\u003c/p>\n\u003caside class=\"pullquote alignright\">'What this means for California is our youth are less likely to be addicted to this horrible drug of tobacco.'\u003ccite> Sen. Ed Hernandez, author of the new law\u003c/cite>\u003c/aside>\n\u003cp>But the governor \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520162AB10\" target=\"_blank\">vetoed a bill\u003c/a> that would have permitted cities and counties to establish their own tobacco taxes.\u003c/p>\n\u003cp>“Although California has one of the lowest cigarette taxes in the nation,” the governor said in a veto message, “I am reluctant to approve this measure in view of all the taxes being proposed for the 2016 ballot.”\u003c/p>\n\u003cp>California becomes just the second state after Hawaii to raise the lawful age to buy tobacco products, a move that backers applaud as a certain way to curtail harm to adolescents, and reduce the number of adult smokers.\u003c/p>\n\u003cp>Sen. Ed Hernandez, D-West Covina, was the lead author of the bill to raise the tobacco age. In a phone interview, he said he was \"ecstatic.\"\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>\"What this means for California is now we can know that our youth are less likely to be addicted to this horrible drug of tobacco,\" he said. \"There’s going to be less addiction to tobacco, [and] we’re going to reduce health care costs and save lives.\"\u003c/p>\n\u003cp>The law, which takes effect next month on June 9, applies to all 18 to 20-year-olds, except military personnel. The bill had stalled for months until a compromise was reached to permit service members under 21 to continue purchasing tobacco.\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/262622063&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/262622063'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>A major \u003ca href=\"http://www.nationalacademies.org/hmd/Activities/PublicHealth/TobaccoMinimumAge.aspx\" target=\"_blank\">Institute of Medicine report\u003c/a> last year concluded that if all states raised the tobacco age to 21, there would be a 12 percent drop in the number of teen and young adult smokers.\u003c/p>\n\u003cp>\"The biggest drops in tobacco use (will) likely occur among teens ages 15 to 17 -- kids who can’t legally buy tobacco products in California now but who run in the same social circles as 18-year-olds who may illegally purchase tobacco products for younger friends,\" said Larry Cohen, executive director of the Oakland-based Prevention Institute and a longtime advocate for tobacco control policies.\u003c/p>\n\u003cp>Adolescents are at particular risk for nicotine addiction since their brains are still developing, says longtime tobacco critic, Stan Glantz, a professor at the University of California, San Francisco.\u003c/p>\n\u003cp>\"Exposing the developing brain to nicotine, which is in both e-cigarettes and conventional cigarettes, physically changes the brain,\" Glantz said. \"That's why the younger someone starts to smoke, the more addicted they tend to get … and the harder time they have stopping.\u003c/p>\n\u003cp>\u003cstrong>Vaping Banned in Many Public Places\u003c/strong>\u003c/p>\n\u003cp>But Glantz said the new regulations on e-cigarettes may be even more significant. \"There's no question that e-cigarettes aren't as dangerous as cigarettes are,\" he said, \"but they're still dangerous.\"\u003c/p>\n\u003cp>Under \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520162SB5\" target=\"_blank\">the law\u003c/a>, written by Sen. Mark Leno, D-San Francisco, e-cigarettes will be banned in all the same places that traditional cigarettes are -- workplaces, schools, restaurants, hospitals and more. And like other tobacco products, users will need to be 21 to buy e-cigarettes.\u003c/p>\n\u003cp>“The e-cigarette is nothing more than a new delivery system for toxic and addictive nicotine,” Leno said in a statement. “Ensuring that e-cigarettes fall under California’s comprehensive smoke-free laws is critical to protecting public health, especially given the alarming rate at which young people are picking up these devices.\"\u003c/p>\n\u003cp>A \u003ca href=\"http://www.cdc.gov/media/releases/2015/p0416-e-cigarette-use.html\" target=\"_blank\">study\u003c/a> last year from the Centers for Disease Control found that e-cigarette use among middle and high school students had tripled in just one year, from 2013 to 2014.\u003c/p>\n\u003cp>Brown signed three other bills:\u003c/p>\n\u003cul>\n\u003cli>An \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520162AB7\">expansion of smoke-free workspaces\u003c/a> to include hotel lobbies, bars, banquet rooms and employee break rooms\u003c/li>\n\u003cli>Expansion of eligibility for \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520162AB9\">tobacco prevention funds to charter schools\u003c/a>\u003c/li>\n\u003cli>Increases \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billAnalysisClient.xhtml?bill_id=201520162AB11\">tobacco retailer license fees\u003c/a> from a one-time $100 fee to an annual $265 fee\u003c/li>\n\u003c/ul>\n\u003cp>Anti-tobacco groups are now focusing their efforts on an effort to gather signatures for a November ballot initiative that would raise cigarette taxes from the current $0.87 per pack to $2.\u003c/p>\n\u003cp>While California is seen as tough on tobacco, it ranks \u003ca href=\"https://www.tobaccofreekids.org/research/factsheets/pdf/0097.pdf\">36\u003csup>th\u003c/sup> in the country\u003c/a> on per-pack taxes. A \u003ca href=\"http://www.sfgate.com/politics/article/Prop-29-cigarette-tax-backers-concede-defeat-3656640.php\">2012 ballot initiative to raise taxes by $1 per pack\u003c/a> failed by less than half a percentage point after the tobacco industry spent $47 million to defeat it.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>A statewide Field Poll last year found that \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/08/26/california-voters-back-tobacco-tax-hike-poll-shows/\">two-thirds of California voters support\u003c/a> an increase in tobacco taxes.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/180422/gov-brown-signs-major-tobacco-bills-raises-legal-age-to-21","authors":["240"],"categories":["stateofhealth_14","stateofhealth_2746"],"tags":["stateofhealth_2615","stateofhealth_2519","stateofhealth_127"],"featImg":"stateofhealth_180423","label":"stateofhealth"},"stateofhealth_177742":{"type":"posts","id":"stateofhealth_177742","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"177742","score":null,"sort":[1461864465000]},"guestAuthors":[],"slug":"for-hispanic-and-black-teens-birth-rates-plummet","title":"For Hispanic And Black Teens, Birth Rates Plummet","publishDate":1461864465,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>The nation's falling teen birth rate saw an even bigger drop over the past decade, with dramatic declines among Hispanic and black teens.\u003c/p>\n\u003caside class=\"pullquote alignright\">Among Hispanic girls ages 15-19, birth rates are down a whopping 51 percent since 2006\u003c/aside>\n\u003cp>Birth rates are down a whopping 51 percent among Hispanics age 15 to 19 since 2006, and down 44 percent among black teens, according to a \u003ca href=\"http://www.cdc.gov/nchs/data/nvsr/nvsr64/nvsr64_12.pdf\" target=\"_blank\">survey of census data\u003c/a> by the Centers for Disease Control and Prevention. Teen pregnancy rates among whites also feel by a third.\u003c/p>\n\u003cp>\"It's really a one-two punch,\" says study co-author Shanna Cox, associate director for science for the CDC's Division of Reproductive Health. \"Teens are having less sex, and among the teens who are having sex, they're using more effective methods of birth control.\"\u003c/p>\n\u003cp>The study finds the use of long-acting contraceptives like IUDs and implants jumped from 1 percent of teens a decade ago to 7 percent in 2014. While teen birth rates for minorities are still nearly double that for whites, the CDC finds that disparity has shrunk in many areas.\u003c/p>\n\u003cp>Still, Cox says the study also shows that teen birth rates can vary widely by place, even by county within the same state, and that there's a strong connection with socioeconomic factors.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Regardless of race, teen birth rates are higher where unemployment is higher and education and income rates are lower. The CDC and the Department of Health and Human Services have been working with nine communities with some of the highest teen birth rates in the country to develop broad efforts to address all of this.\u003c/p>\n\u003cp>\"So for example, we can work with job skills training,\" Cox says. \"We can work with sports, community service.\" The goal, she says, is \"really thinking about ways we can promote teens finishing school, planning for their future and being engaged in their communities.\"\u003c/p>\n\u003cp>The report names other efforts that have been effective in reducing teen birth rates:\u003c/p>\n\u003cblockquote>\u003cp>Examples of activities included presenting community-specific teen birth data to civic leaders; encouraging health care providers to offer evening and weekend hours and low-cost services to increase access; having teen-focused, culturally appropriate materials available during health care visits; and implementing evidence-based teen pregnancy prevention programs to reach teens of both sexes both inside and outside of schools (e.g., through Job Corps, alternative schools, churches and community colleges.)\u003c/p>\u003c/blockquote>\n\u003cp>Last year the federal government expanded these kinds of efforts to 84 communities.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The recent decline is part of a longer downward trend in teen birth rates since 1991. But teen pregnancy in the U.S. remains higher than in many other developed countries.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Teen+Birth+Rates+Plummet+For+Hispanic+And+Black+Girls&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n","blocks":[],"excerpt":"Teenagers are having less sex and getting better about using contraceptives, a survey finds. ","status":"publish","parent":0,"modified":1461864592,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":13,"wordCount":462},"headData":{"title":"For Hispanic And Black Teens, Birth Rates Plummet | KQED","description":"Teenagers are having less sex and getting better about using contraceptives, a survey finds. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"For Hispanic And Black Teens, Birth Rates Plummet","datePublished":"2016-04-28T17:27:45.000Z","dateModified":"2016-04-28T17:29:52.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"177742 http://ww2.kqed.org/stateofhealth/?p=177742","disqusUrl":"https://ww2.kqed.org/stateofhealth/2016/04/28/for-hispanic-and-black-teens-birth-rates-plummet/","disqusTitle":"For Hispanic And Black Teens, Birth Rates Plummet","nprByline":"Jennifer Ludden\u003cbr />\u003ca href=\"http://www.npr.org/sections/health-shots/\">NPR Shots\u003c/a>","nprStoryId":"476017134","nprApiLink":"http://api.npr.org/query?id=476017134&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"http://www.npr.org/sections/health-shots/2016/04/28/476017134/teen-births-rate-plummet-for-hispanic-and-black-girls?ft=nprml&f=476017134","nprRetrievedStory":"1","nprPubDate":"Thu, 28 Apr 2016 13:10:00 -0400","nprStoryDate":"Thu, 28 Apr 2016 13:08:00 -0400","nprLastModifiedDate":"Thu, 28 Apr 2016 13:10:40 -0400","path":"/stateofhealth/177742/for-hispanic-and-black-teens-birth-rates-plummet","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>The nation's falling teen birth rate saw an even bigger drop over the past decade, with dramatic declines among Hispanic and black teens.\u003c/p>\n\u003caside class=\"pullquote alignright\">Among Hispanic girls ages 15-19, birth rates are down a whopping 51 percent since 2006\u003c/aside>\n\u003cp>Birth rates are down a whopping 51 percent among Hispanics age 15 to 19 since 2006, and down 44 percent among black teens, according to a \u003ca href=\"http://www.cdc.gov/nchs/data/nvsr/nvsr64/nvsr64_12.pdf\" target=\"_blank\">survey of census data\u003c/a> by the Centers for Disease Control and Prevention. Teen pregnancy rates among whites also feel by a third.\u003c/p>\n\u003cp>\"It's really a one-two punch,\" says study co-author Shanna Cox, associate director for science for the CDC's Division of Reproductive Health. \"Teens are having less sex, and among the teens who are having sex, they're using more effective methods of birth control.\"\u003c/p>\n\u003cp>The study finds the use of long-acting contraceptives like IUDs and implants jumped from 1 percent of teens a decade ago to 7 percent in 2014. While teen birth rates for minorities are still nearly double that for whites, the CDC finds that disparity has shrunk in many areas.\u003c/p>\n\u003cp>Still, Cox says the study also shows that teen birth rates can vary widely by place, even by county within the same state, and that there's a strong connection with socioeconomic factors.\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>Regardless of race, teen birth rates are higher where unemployment is higher and education and income rates are lower. The CDC and the Department of Health and Human Services have been working with nine communities with some of the highest teen birth rates in the country to develop broad efforts to address all of this.\u003c/p>\n\u003cp>\"So for example, we can work with job skills training,\" Cox says. \"We can work with sports, community service.\" The goal, she says, is \"really thinking about ways we can promote teens finishing school, planning for their future and being engaged in their communities.\"\u003c/p>\n\u003cp>The report names other efforts that have been effective in reducing teen birth rates:\u003c/p>\n\u003cblockquote>\u003cp>Examples of activities included presenting community-specific teen birth data to civic leaders; encouraging health care providers to offer evening and weekend hours and low-cost services to increase access; having teen-focused, culturally appropriate materials available during health care visits; and implementing evidence-based teen pregnancy prevention programs to reach teens of both sexes both inside and outside of schools (e.g., through Job Corps, alternative schools, churches and community colleges.)\u003c/p>\u003c/blockquote>\n\u003cp>Last year the federal government expanded these kinds of efforts to 84 communities.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The recent decline is part of a longer downward trend in teen birth rates since 1991. But teen pregnancy in the U.S. remains higher than in many other developed countries.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Teen+Birth+Rates+Plummet+For+Hispanic+And+Black+Girls&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/177742/for-hispanic-and-black-teens-birth-rates-plummet","authors":["byline_stateofhealth_177742"],"categories":["stateofhealth_2746"],"tags":["stateofhealth_2615","stateofhealth_2749"],"featImg":"stateofhealth_177757","label":"stateofhealth"},"stateofhealth_176688":{"type":"posts","id":"stateofhealth_176688","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"176688","score":null,"sort":[1461620232000]},"guestAuthors":[],"slug":"suicide-rates-climb-in-u-s-especially-among-adolescent-girls","title":"Suicide Rates Climb In U.S., Especially Among Adolescent Girls","publishDate":1461620232,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>In the '80s and '90s, America's suicide trend was headed in the right direction: down.\u003c/p>\n\u003cp>\"It had been decreasing almost steadily since 1986, and then what happened is there was a turnaround,\" says \u003ca href=\"https://www.researchgate.net/profile/Sally_Curtin\" target=\"_blank\">Sally Curtin\u003c/a>, a statistician with the National Center for Health Statistics, part of the Centers for Disease Control and Prevention.\u003c/p>\n\u003caside class=\"pullquote alignright\">Though they make up a very small portion of total suicides, the rate in girls ages 10-14 jumped the most, tripling over 15 years.\u003c/aside>\n\u003cp>The suicide rate has risen by a quarter, to 13 per 100,000 people in 2014 from 10.5 in 1999, according to \u003ca href=\"http://www.cdc.gov/nchs/products/databriefs/db241.htm\" target=\"_blank\">an analysis\u003c/a> by Curtin and her colleagues that was released Friday.\u003c/p>\n\u003cp>She says it's heartbreaking to work with these data. While other causes of death are on the decline, suicide just keeps climbing — and it's doing so for every age group under 75.\u003c/p>\n\u003cp>\"I've been losing sleep over this, quite honestly,\" says Curtin. \"You can't just say it's confined to one age group or another for males and females. Truly at all ages people are at risk for this, and our youngest have some of the highest percent increases.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>There is one age group that really stands out — girls between the ages of 10 and 14. Though they make up a very small portion of the total suicides, the rate in that group jumped the most — it experienced the largest percent increase, tripling over 15 years from 0.5 to 1.7 per 100,000 people.\u003c/p>\n\u003cp>And, Curtin points out, in any given year, there are a lot more suicide attempts than there are suicide deaths. \"The deaths are but the tip of the iceberg,\" she says.\u003c/p>\n\u003cp>Until the suicide trend reversed upward, there had been a number of improvements in the past few decades.\u003c/p>\n\u003cp>In the late '80s, things were probably looking up partially due to \u003ca href=\"http://www.ncbi.nlm.nih.gov/books/NBK54346/\" target=\"_blank\">new antidepressants\u003c/a> that were more effective and had fewer side effects, says \u003ca href=\"http://profiles.columbiapsychiatry.org/profile/maoquendo\">Dr. Maria Oquendo\u003c/a>, a psychiatry professor at Columbia University Medical Center and president-elect of the American Psychiatric Association. \"We saw this very encouraging decrease in suicide deaths,\" she says, and the parallel between antidepressant prescription and a decline in suicide was mirrored in \u003ca href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3804897/\">other\u003c/a> countries. \"It was really very remarkable, and somehow that trend toward decreasing suicide rates abruptly stopped in 1999.\"\u003c/p>\n\u003cp>What changed? One possibility is economic stagnation, which left more people out of jobs and probably made it harder for people to access health care and treatment. There was also a switch from the use of cocaine and crack to use of \u003ca href=\"http://www.cdc.gov/vitalsigns/heroin/\" target=\"_blank\">heroin\u003c/a> and prescription \u003ca href=\"http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6450a3.htm\" target=\"_blank\">painkillers\u003c/a>, which can be lethal in case of an overdose.\u003c/p>\n\u003cp>And there's also the matter of health insurance — a lot of people weren't covered or didn't have access to treatment for depression, the most common \u003ca href=\"http://afsp.org/about-suicide/risk-factors-and-warning-signs/\" target=\"_blank\">risk factor\u003c/a> for suicide. (Since 2014, however, the Affordable Care Act has \u003ca href=\"http://kff.org/uninsured/fact-sheet/key-facts-about-the-uninsured-population/\" target=\"_blank\">led to a substantial increase\u003c/a> in insurance coverage.)\u003c/p>\n\u003cp>\"Now, the other thing that we were anticipating with some dread was the aftermath of the black box on antidepressants,\" says Oquendo, referring to a \u003ca href=\"http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/2004/ucm108363.htm\" target=\"_blank\">warning label\u003c/a> that in 2004 the Food and Drug Administration required for commonly prescribed antidepressants.\u003c/p>\n\u003cp>The label says that in people under age 26, the medications can actually increase the risk of suicidal thoughts and actions. Research \u003ca href=\"http://www.nejm.org/doi/full/10.1056/NEJMp1408480\" target=\"_blank\">has suggested\u003c/a> that the warning scared doctors away from prescribing antidepressants to people of all ages.\u003c/p>\n\u003cp>\"And some of the increment in suicide deaths in the younger populations is potentially linked to an understandable reluctance by physicians who see these youngsters to prescribe antidepressants, even when they're aware that the individual is suffering from depression,\" says Oquendo. Research has shown that the benefits of prescribing antidepressants to mentally ill children tend to \u003ca href=\"http://www.nimh.nih.gov/health/topics/child-and-adolescent-mental-health/antidepressant-medications-for-children-and-adolescents-information-for-parents-and-caregivers.shtml\" target=\"_blank\">outweigh\u003c/a> the risk of suicidal tendencies.\u003c/p>\n\u003cp>But why such a sharp rise among adolescents, particularly girls? \"We don't know what's going on, to be quite honest,\" says \u003ca href=\"https://www.linkedin.com/in/arielle-h-sheftall-9504bb67\" target=\"_blank\">Arielle Sheftall\u003c/a>, who works at the Center for Suicide Prevention and Research at the Research Institute at Nationwide Children's Hospital in Columbus, Ohio. \"We have thoughts, that maybe it's this, maybe it's that. It's really hard to pinpoint one specific risk factor that really, truly is driving this trend.\"\u003c/p>\n\u003cp>She and her colleagues \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/25984947\" target=\"_blank\">study\u003c/a> the risk factors that might push a depressed child or teen to attempt suicide. One \u003ca href=\"http://www.sciencedirect.com/science/article/pii/S0193953X08000191\" target=\"_blank\">hypothesis\u003c/a> about what's going on with girls is pretty surprising: earlier puberty.\u003c/p>\n\u003cp>\"It's usually been referred to as the storm-and-stress period of life because there's just a lot of change happening all at one time,\" says Sheftall.\u003c/p>\n\u003cp>\u003cimg class=\"aligncenter size-full wp-image-176694\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/04/Screen-Shot-2016-04-25-at-2.27.51-PM.png\" alt=\"Screen Shot 2016-04-25 at 2.27.51 PM\" width=\"1514\" height=\"1098\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/04/Screen-Shot-2016-04-25-at-2.27.51-PM.png 1514w, https://ww2.kqed.org/app/uploads/sites/27/2016/04/Screen-Shot-2016-04-25-at-2.27.51-PM-400x290.png 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/04/Screen-Shot-2016-04-25-at-2.27.51-PM-800x580.png 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/04/Screen-Shot-2016-04-25-at-2.27.51-PM-768x557.png 768w, https://ww2.kqed.org/app/uploads/sites/27/2016/04/Screen-Shot-2016-04-25-at-2.27.51-PM-1440x1044.png 1440w, https://ww2.kqed.org/app/uploads/sites/27/2016/04/Screen-Shot-2016-04-25-at-2.27.51-PM-1180x856.png 1180w, https://ww2.kqed.org/app/uploads/sites/27/2016/04/Screen-Shot-2016-04-25-at-2.27.51-PM-960x696.png 960w\" sizes=\"(max-width: 1514px) 100vw, 1514px\">\u003c/p>\n\u003cp>Boys tend to hit peak puberty around 13 years old, and girls around 11 years old, though some studies show that girls are starting their periods earlier.\u003c/p>\n\u003cp>\"Research has shown that puberty, unfortunately, is associated with the onset of psychological disorders, specifically depression,\" says Sheftall.\u003c/p>\n\u003cp>And depression is a big risk factor for suicidal thoughts and actions. So, because of the shifting age of puberty onset, girls might be opening the door to anxiety, depression and other psychiatric disorders earlier on in life.\u003c/p>\n\u003cp>Sheftall and Oquendo say the hypothesis hasn't been carefully studied, but it's possible. Another potential factor is that girls attempting suicide could be using more lethal methods, resulting in more deaths.\u003c/p>\n\u003cp>\"It's frustrating because you want to never ever see these trends increase,\" says Sheftall. \"That's what we kind of have dedicated our lives and research to: What is causing these increases to occur?\"\u003c/p>\n\u003cp>For now, there are still more questions than answers.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>If someone shows the \u003c/em>\u003ca href=\"http://afsp.org/about-suicide/risk-factors-and-warning-signs/\" target=\"_blank\">warning signs\u003c/a>\u003cem> of suicide: Do not leave the person alone, remove any firearms, alcohol, drugs or sharp objects that could be used in a suicide attempt, call the U.S. National Suicide Prevention Lifeline at 1-800-273-TALK (8255), and take the person to an emergency room or seek help from a medical or mental health professional.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Suicide+Rates+Climb+In+U.S.%2C+Especially+Among+Adolescent+Girls&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n","blocks":[],"excerpt":"After a decline throughout the '90s, suicide rates have reversed course. Suicide has increased in almost every age group over the past 15 years.","status":"publish","parent":0,"modified":1461620365,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":27,"wordCount":1009},"headData":{"title":"Suicide Rates Climb In U.S., Especially Among Adolescent Girls | KQED","description":"After a decline throughout the '90s, suicide rates have reversed course. Suicide has increased in almost every age group over the past 15 years.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Suicide Rates Climb In U.S., Especially Among Adolescent Girls","datePublished":"2016-04-25T21:37:12.000Z","dateModified":"2016-04-25T21:39:25.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"176688 http://ww2.kqed.org/stateofhealth/?p=176688","disqusUrl":"https://ww2.kqed.org/stateofhealth/2016/04/25/suicide-rates-climb-in-u-s-especially-among-adolescent-girls/","disqusTitle":"Suicide Rates Climb In U.S., Especially Among Adolescent Girls","nprImageCredit":"Eva Bee","nprByline":"Rae Ellen Bichell","nprImageAgency":"Ikon Images/Getty Images","nprStoryId":"474888854","nprApiLink":"http://api.npr.org/query?id=474888854&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"http://www.npr.org/sections/health-shots/2016/04/22/474888854/suicide-rates-climb-in-u-s-especially-among-adolescent-girls?ft=nprml&f=474888854","nprRetrievedStory":"1","nprPubDate":"Sun, 24 Apr 2016 08:33:00 -0400","nprStoryDate":"Fri, 22 Apr 2016 00:02:00 -0400","nprLastModifiedDate":"Sun, 24 Apr 2016 08:33:17 -0400","nprAudio":"http://pd.npr.org/anon.npr-mp3/npr/me/2016/04/20160422_me_suicide_rates_climb_in_us_especially_among_adolescent_girls.mp3?orgId=1&topicId=1128&d=229&p=3&story=474888854&t=progseg&e=475226628&seg=7&ft=nprml&f=474888854","nprAudioM3u":"http://api.npr.org/m3u/1475228397-c4b6d7.m3u?orgId=1&topicId=1128&d=229&p=3&story=474888854&t=progseg&e=475226628&seg=7&ft=nprml&f=474888854","path":"/stateofhealth/176688/suicide-rates-climb-in-u-s-especially-among-adolescent-girls","audioUrl":"http://pd.npr.org/anon.npr-mp3/npr/me/2016/04/20160422_me_suicide_rates_climb_in_us_especially_among_adolescent_girls.mp3?orgId=1&topicId=1128&d=229&p=3&story=474888854&t=progseg&e=475226628&seg=7&ft=nprml&f=474888854","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>In the '80s and '90s, America's suicide trend was headed in the right direction: down.\u003c/p>\n\u003cp>\"It had been decreasing almost steadily since 1986, and then what happened is there was a turnaround,\" says \u003ca href=\"https://www.researchgate.net/profile/Sally_Curtin\" target=\"_blank\">Sally Curtin\u003c/a>, a statistician with the National Center for Health Statistics, part of the Centers for Disease Control and Prevention.\u003c/p>\n\u003caside class=\"pullquote alignright\">Though they make up a very small portion of total suicides, the rate in girls ages 10-14 jumped the most, tripling over 15 years.\u003c/aside>\n\u003cp>The suicide rate has risen by a quarter, to 13 per 100,000 people in 2014 from 10.5 in 1999, according to \u003ca href=\"http://www.cdc.gov/nchs/products/databriefs/db241.htm\" target=\"_blank\">an analysis\u003c/a> by Curtin and her colleagues that was released Friday.\u003c/p>\n\u003cp>She says it's heartbreaking to work with these data. While other causes of death are on the decline, suicide just keeps climbing — and it's doing so for every age group under 75.\u003c/p>\n\u003cp>\"I've been losing sleep over this, quite honestly,\" says Curtin. \"You can't just say it's confined to one age group or another for males and females. Truly at all ages people are at risk for this, and our youngest have some of the highest percent increases.\"\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>There is one age group that really stands out — girls between the ages of 10 and 14. Though they make up a very small portion of the total suicides, the rate in that group jumped the most — it experienced the largest percent increase, tripling over 15 years from 0.5 to 1.7 per 100,000 people.\u003c/p>\n\u003cp>And, Curtin points out, in any given year, there are a lot more suicide attempts than there are suicide deaths. \"The deaths are but the tip of the iceberg,\" she says.\u003c/p>\n\u003cp>Until the suicide trend reversed upward, there had been a number of improvements in the past few decades.\u003c/p>\n\u003cp>In the late '80s, things were probably looking up partially due to \u003ca href=\"http://www.ncbi.nlm.nih.gov/books/NBK54346/\" target=\"_blank\">new antidepressants\u003c/a> that were more effective and had fewer side effects, says \u003ca href=\"http://profiles.columbiapsychiatry.org/profile/maoquendo\">Dr. Maria Oquendo\u003c/a>, a psychiatry professor at Columbia University Medical Center and president-elect of the American Psychiatric Association. \"We saw this very encouraging decrease in suicide deaths,\" she says, and the parallel between antidepressant prescription and a decline in suicide was mirrored in \u003ca href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3804897/\">other\u003c/a> countries. \"It was really very remarkable, and somehow that trend toward decreasing suicide rates abruptly stopped in 1999.\"\u003c/p>\n\u003cp>What changed? One possibility is economic stagnation, which left more people out of jobs and probably made it harder for people to access health care and treatment. There was also a switch from the use of cocaine and crack to use of \u003ca href=\"http://www.cdc.gov/vitalsigns/heroin/\" target=\"_blank\">heroin\u003c/a> and prescription \u003ca href=\"http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6450a3.htm\" target=\"_blank\">painkillers\u003c/a>, which can be lethal in case of an overdose.\u003c/p>\n\u003cp>And there's also the matter of health insurance — a lot of people weren't covered or didn't have access to treatment for depression, the most common \u003ca href=\"http://afsp.org/about-suicide/risk-factors-and-warning-signs/\" target=\"_blank\">risk factor\u003c/a> for suicide. (Since 2014, however, the Affordable Care Act has \u003ca href=\"http://kff.org/uninsured/fact-sheet/key-facts-about-the-uninsured-population/\" target=\"_blank\">led to a substantial increase\u003c/a> in insurance coverage.)\u003c/p>\n\u003cp>\"Now, the other thing that we were anticipating with some dread was the aftermath of the black box on antidepressants,\" says Oquendo, referring to a \u003ca href=\"http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/2004/ucm108363.htm\" target=\"_blank\">warning label\u003c/a> that in 2004 the Food and Drug Administration required for commonly prescribed antidepressants.\u003c/p>\n\u003cp>The label says that in people under age 26, the medications can actually increase the risk of suicidal thoughts and actions. Research \u003ca href=\"http://www.nejm.org/doi/full/10.1056/NEJMp1408480\" target=\"_blank\">has suggested\u003c/a> that the warning scared doctors away from prescribing antidepressants to people of all ages.\u003c/p>\n\u003cp>\"And some of the increment in suicide deaths in the younger populations is potentially linked to an understandable reluctance by physicians who see these youngsters to prescribe antidepressants, even when they're aware that the individual is suffering from depression,\" says Oquendo. Research has shown that the benefits of prescribing antidepressants to mentally ill children tend to \u003ca href=\"http://www.nimh.nih.gov/health/topics/child-and-adolescent-mental-health/antidepressant-medications-for-children-and-adolescents-information-for-parents-and-caregivers.shtml\" target=\"_blank\">outweigh\u003c/a> the risk of suicidal tendencies.\u003c/p>\n\u003cp>But why such a sharp rise among adolescents, particularly girls? \"We don't know what's going on, to be quite honest,\" says \u003ca href=\"https://www.linkedin.com/in/arielle-h-sheftall-9504bb67\" target=\"_blank\">Arielle Sheftall\u003c/a>, who works at the Center for Suicide Prevention and Research at the Research Institute at Nationwide Children's Hospital in Columbus, Ohio. \"We have thoughts, that maybe it's this, maybe it's that. It's really hard to pinpoint one specific risk factor that really, truly is driving this trend.\"\u003c/p>\n\u003cp>She and her colleagues \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/25984947\" target=\"_blank\">study\u003c/a> the risk factors that might push a depressed child or teen to attempt suicide. One \u003ca href=\"http://www.sciencedirect.com/science/article/pii/S0193953X08000191\" target=\"_blank\">hypothesis\u003c/a> about what's going on with girls is pretty surprising: earlier puberty.\u003c/p>\n\u003cp>\"It's usually been referred to as the storm-and-stress period of life because there's just a lot of change happening all at one time,\" says Sheftall.\u003c/p>\n\u003cp>\u003cimg class=\"aligncenter size-full wp-image-176694\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/04/Screen-Shot-2016-04-25-at-2.27.51-PM.png\" alt=\"Screen Shot 2016-04-25 at 2.27.51 PM\" width=\"1514\" height=\"1098\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/04/Screen-Shot-2016-04-25-at-2.27.51-PM.png 1514w, https://ww2.kqed.org/app/uploads/sites/27/2016/04/Screen-Shot-2016-04-25-at-2.27.51-PM-400x290.png 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/04/Screen-Shot-2016-04-25-at-2.27.51-PM-800x580.png 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/04/Screen-Shot-2016-04-25-at-2.27.51-PM-768x557.png 768w, https://ww2.kqed.org/app/uploads/sites/27/2016/04/Screen-Shot-2016-04-25-at-2.27.51-PM-1440x1044.png 1440w, https://ww2.kqed.org/app/uploads/sites/27/2016/04/Screen-Shot-2016-04-25-at-2.27.51-PM-1180x856.png 1180w, https://ww2.kqed.org/app/uploads/sites/27/2016/04/Screen-Shot-2016-04-25-at-2.27.51-PM-960x696.png 960w\" sizes=\"(max-width: 1514px) 100vw, 1514px\">\u003c/p>\n\u003cp>Boys tend to hit peak puberty around 13 years old, and girls around 11 years old, though some studies show that girls are starting their periods earlier.\u003c/p>\n\u003cp>\"Research has shown that puberty, unfortunately, is associated with the onset of psychological disorders, specifically depression,\" says Sheftall.\u003c/p>\n\u003cp>And depression is a big risk factor for suicidal thoughts and actions. So, because of the shifting age of puberty onset, girls might be opening the door to anxiety, depression and other psychiatric disorders earlier on in life.\u003c/p>\n\u003cp>Sheftall and Oquendo say the hypothesis hasn't been carefully studied, but it's possible. Another potential factor is that girls attempting suicide could be using more lethal methods, resulting in more deaths.\u003c/p>\n\u003cp>\"It's frustrating because you want to never ever see these trends increase,\" says Sheftall. \"That's what we kind of have dedicated our lives and research to: What is causing these increases to occur?\"\u003c/p>\n\u003cp>For now, there are still more questions than answers.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>If someone shows the \u003c/em>\u003ca href=\"http://afsp.org/about-suicide/risk-factors-and-warning-signs/\" target=\"_blank\">warning signs\u003c/a>\u003cem> of suicide: Do not leave the person alone, remove any firearms, alcohol, drugs or sharp objects that could be used in a suicide attempt, call the U.S. National Suicide Prevention Lifeline at 1-800-273-TALK (8255), and take the person to an emergency room or seek help from a medical or mental health professional.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Suicide+Rates+Climb+In+U.S.%2C+Especially+Among+Adolescent+Girls&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/176688/suicide-rates-climb-in-u-s-especially-among-adolescent-girls","authors":["byline_stateofhealth_176688"],"categories":["stateofhealth_2746"],"tags":["stateofhealth_2615","stateofhealth_2582","stateofhealth_68","stateofhealth_112"],"featImg":"stateofhealth_176689","label":"stateofhealth"},"stateofhealth_124183":{"type":"posts","id":"stateofhealth_124183","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"124183","score":null,"sort":[1450293423000]},"guestAuthors":[],"slug":"girls-given-drugs-that-cause-birth-defects-dont-get-contraception-counseling","title":"Girls Given Drugs That Cause Birth Defects Don't Get Contraception Counseling","publishDate":1450293423,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>Most teenage girls who are prescribed drugs known to cause birth defects don’t receive adequate counseling about contraception, putting them at risk for negative pregnancy outcomes, according to a study published Wednesday in the \u003ca href=\"http://pediatrics.aappublications.org/content/early/2015/12/14/peds.2015-1454?sso=1&sso_redirect_count=1&nfstatus=401&nftoken=00000000-0000-0000-0000-000000000000&nfstatusdescription=ERROR%3a+No+local+token\" target=\"_blank\">journal Pediatrics.\u003c/a>\u003c/p>\n\u003caside class=\"pullquote alignright\">'There is room for great improvement.'\u003ccite>Stephani Stancil, lead author of study\u003c/cite>\u003c/aside>\n\u003cp>The medications are given to treat a wide range of conditions, including acne and anxiety.\u003c/p>\n\u003cp>More than 70 percent of female patients in the study who were prescribed such medications did not receive counseling about preventing pregnancy or given prescriptions for contraceptives or referral for such care.\u003c/p>\n\u003cp>“There is room for great improvement,” said lead author Stephani Stancil, a nurse practitioner in the division of adolescent medicine and clinical pharmacology at Children’s Mercy Hospital in Kansas City, Missouri. “We hope the study is a good first step to increase education to prescribers and patients and families to make healthier reproductive choices.”\u003c/p>\n\u003cp>The study examined electronic medical records from female patients between 14 and 25 years old who received the drug prescriptions during office visits between 2008 and 2012 at a major Midwestern academic pediatric medical center.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Nearly 1,700 girls and women received 4,506 prescriptions for so-called teratogenic medications -- meaning those that can cause birth defects -- during 4,100 office visits.\u003c/p>\n\u003cp>The study found some disparities. White patients were more likely to receive contraception counseling than minority patients, the study said. The study did not suggest reasons for that, but doctors not involved in the research say it could be due to general health care disparities and a cultural or language gap between doctors and patients.\u003c/p>\n\u003cp>Older patients, those ages 16 to 25, in the study were more likely to receive counseling about contraception than the 14- and 15-year-olds, perhaps driven by doctors’ expectation that older teens were more likely to be sexually active, researchers wrote.\u003c/p>\n\u003cp>But statistics show this assumption about teenage sexual behavior may be off-base. The Centers for Disease Control and Prevention's 2013 \u003ca href=\"https://nccd.cdc.gov/youthonline/App/Results.aspx?TT=A&OUT=0&SID=HS&QID=QQ&LID=XX&YID=2013&LID2=&YID2=&COL=S&ROW1=N&ROW2=N&HT=QQ&LCT=LL&FS=S1&FR=R1&FG=G1&FSL=S1&FRL=R1&FGL=G1&PV=&TST=False&C1=&C2=&QP=G&DP=1&VA=CI&CS=Y&SYID=&EYID=&SC=DEFAULT&SO=ASC\" target=\"_blank\">Youth Risk Behavior Surveillance System\u003c/a> showed that 35 percent of adolescent females in grades 9 to 12, ages 14 to18, were classified as currently sexually active, having had sex in the previous three months, researchers said.\u003c/p>\n\u003cp>Young patients take drugs that can cause birth defects to treat all sorts of conditions, including common ones.\u003c/p>\n\u003cp>In the study, the most commonly prescribed were:\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>isotretinoin\u003c/strong> -- used to treat severe acne\u003c/li>\n\u003cli>\u003cstrong>diazepam\u003c/strong> -- used to treat treat anxiety disorders or seizures\u003c/li>\n\u003cli>\u003cstrong>methotrexate\u003c/strong> -- used to treat certain cancers, arthritis and inflammatory bowel disease\u003c/li>\n\u003cli>\u003cstrong>topiramate\u003c/strong> -- used to treat seizures\u003c/li>\n\u003cli>\u003cstrong>enalapril\u003c/strong> -- used to treat high blood pressure and heart conditions.\u003c/li>\n\u003c/ul>\n\u003cp>The pediatricians who most frequently prescribe the drugs are from the neurology, hematology-oncology and dermatology specialties, the study said, but others use them to treat teens for other conditions as well.\u003c/p>\n\u003caside class=\"pullquote alignright\">The drugs in question are given to treat a wide range of conditions, including acne and anxiety.\u003c/aside>\n\u003cp>\u003ca href=\"http://www.childrenshospitaloakland.org/main/find-a-doctor/gleghorn-elizabeth-md-118.aspx\" target=\"_blank\">Dr. Elizabeth Gleghorn\u003c/a>, a pediatric gastroenterologist and division chief at UCSF Benioff Children’s Hospital Oakland who was not involved in the study, said she counsels patients about the risk of birth defects when prescribing methotrexate to help treat inflammatory bowel disease.\u003c/p>\n\u003cp>“We are very aware of our drugs that are known or thought to cause birth defects,\" she said. “We talk about it to patients.”\u003c/p>\n\u003cp>But with adolescent patients, it can be a tricky situation to navigate with the whole family involved, she said.\u003c/p>\n\u003cp>“At what point do you unceremoniously kick the family out and find out if the patient is sexually active, counsel her, and bring her family back in?”\u003c/p>\n\u003cp>She said some parents feel they are the only ones who should be discussing sex with their children.\u003c/p>\n\u003cp>So Gleghorn will sometimes start out discussing the topic in a general way by saying, “In the case of women who are pregnant, this drug could be dangerous.”\u003c/p>\n\u003cp>She says the subject can be met with strong reactions from patients and families. She recalled that the mother of a teenage girl patient became hysterical when Gleghorn raised the issue of methotrexate causing birth defects.\u003c/p>\n\u003cp>“It raised fears of her daughter’s reproductive future, and went to the basis of her anxiety that her daughter wouldn’t have a normal life living with a chronic illness,” Gleghorn said.\u003c/p>\n\u003cp>But Gleghorn says she counsels patients that when a woman decides to become pregnant, she would go off methotrexate and perhaps use a different medication that poses less risk to a fetus.\u003c/p>\n\u003cp>One adolescent girl insisted she was never going to have sex and never going to have kids, so the risk of birth defects wasn’t a problem, Gleghorn said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“So I told her, ‘It may not be an issue for you right now, but I am telling you so you know for the future.’ ”\u003c/p>\n\n","blocks":[],"excerpt":"More than 70 percent of female patients in the study were not counseled about birth control when prescribed these risky drugs.","status":"publish","parent":0,"modified":1450399829,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":25,"wordCount":829},"headData":{"title":"Girls Given Drugs That Cause Birth Defects Don't Get Contraception Counseling | KQED","description":"More than 70 percent of female patients in the study were not counseled about birth control when prescribed these risky drugs.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Girls Given Drugs That Cause Birth Defects Don't Get Contraception Counseling","datePublished":"2015-12-16T19:17:03.000Z","dateModified":"2015-12-18T00:50:29.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"124183 http://ww2.kqed.org/stateofhealth/?p=124183","disqusUrl":"https://ww2.kqed.org/stateofhealth/2015/12/16/girls-given-drugs-that-cause-birth-defects-dont-get-contraception-counseling/","disqusTitle":"Girls Given Drugs That Cause Birth Defects Don't Get Contraception Counseling","path":"/stateofhealth/124183/girls-given-drugs-that-cause-birth-defects-dont-get-contraception-counseling","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Most teenage girls who are prescribed drugs known to cause birth defects don’t receive adequate counseling about contraception, putting them at risk for negative pregnancy outcomes, according to a study published Wednesday in the \u003ca href=\"http://pediatrics.aappublications.org/content/early/2015/12/14/peds.2015-1454?sso=1&sso_redirect_count=1&nfstatus=401&nftoken=00000000-0000-0000-0000-000000000000&nfstatusdescription=ERROR%3a+No+local+token\" target=\"_blank\">journal Pediatrics.\u003c/a>\u003c/p>\n\u003caside class=\"pullquote alignright\">'There is room for great improvement.'\u003ccite>Stephani Stancil, lead author of study\u003c/cite>\u003c/aside>\n\u003cp>The medications are given to treat a wide range of conditions, including acne and anxiety.\u003c/p>\n\u003cp>More than 70 percent of female patients in the study who were prescribed such medications did not receive counseling about preventing pregnancy or given prescriptions for contraceptives or referral for such care.\u003c/p>\n\u003cp>“There is room for great improvement,” said lead author Stephani Stancil, a nurse practitioner in the division of adolescent medicine and clinical pharmacology at Children’s Mercy Hospital in Kansas City, Missouri. “We hope the study is a good first step to increase education to prescribers and patients and families to make healthier reproductive choices.”\u003c/p>\n\u003cp>The study examined electronic medical records from female patients between 14 and 25 years old who received the drug prescriptions during office visits between 2008 and 2012 at a major Midwestern academic pediatric medical center.\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>Nearly 1,700 girls and women received 4,506 prescriptions for so-called teratogenic medications -- meaning those that can cause birth defects -- during 4,100 office visits.\u003c/p>\n\u003cp>The study found some disparities. White patients were more likely to receive contraception counseling than minority patients, the study said. The study did not suggest reasons for that, but doctors not involved in the research say it could be due to general health care disparities and a cultural or language gap between doctors and patients.\u003c/p>\n\u003cp>Older patients, those ages 16 to 25, in the study were more likely to receive counseling about contraception than the 14- and 15-year-olds, perhaps driven by doctors’ expectation that older teens were more likely to be sexually active, researchers wrote.\u003c/p>\n\u003cp>But statistics show this assumption about teenage sexual behavior may be off-base. The Centers for Disease Control and Prevention's 2013 \u003ca href=\"https://nccd.cdc.gov/youthonline/App/Results.aspx?TT=A&OUT=0&SID=HS&QID=QQ&LID=XX&YID=2013&LID2=&YID2=&COL=S&ROW1=N&ROW2=N&HT=QQ&LCT=LL&FS=S1&FR=R1&FG=G1&FSL=S1&FRL=R1&FGL=G1&PV=&TST=False&C1=&C2=&QP=G&DP=1&VA=CI&CS=Y&SYID=&EYID=&SC=DEFAULT&SO=ASC\" target=\"_blank\">Youth Risk Behavior Surveillance System\u003c/a> showed that 35 percent of adolescent females in grades 9 to 12, ages 14 to18, were classified as currently sexually active, having had sex in the previous three months, researchers said.\u003c/p>\n\u003cp>Young patients take drugs that can cause birth defects to treat all sorts of conditions, including common ones.\u003c/p>\n\u003cp>In the study, the most commonly prescribed were:\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>isotretinoin\u003c/strong> -- used to treat severe acne\u003c/li>\n\u003cli>\u003cstrong>diazepam\u003c/strong> -- used to treat treat anxiety disorders or seizures\u003c/li>\n\u003cli>\u003cstrong>methotrexate\u003c/strong> -- used to treat certain cancers, arthritis and inflammatory bowel disease\u003c/li>\n\u003cli>\u003cstrong>topiramate\u003c/strong> -- used to treat seizures\u003c/li>\n\u003cli>\u003cstrong>enalapril\u003c/strong> -- used to treat high blood pressure and heart conditions.\u003c/li>\n\u003c/ul>\n\u003cp>The pediatricians who most frequently prescribe the drugs are from the neurology, hematology-oncology and dermatology specialties, the study said, but others use them to treat teens for other conditions as well.\u003c/p>\n\u003caside class=\"pullquote alignright\">The drugs in question are given to treat a wide range of conditions, including acne and anxiety.\u003c/aside>\n\u003cp>\u003ca href=\"http://www.childrenshospitaloakland.org/main/find-a-doctor/gleghorn-elizabeth-md-118.aspx\" target=\"_blank\">Dr. Elizabeth Gleghorn\u003c/a>, a pediatric gastroenterologist and division chief at UCSF Benioff Children’s Hospital Oakland who was not involved in the study, said she counsels patients about the risk of birth defects when prescribing methotrexate to help treat inflammatory bowel disease.\u003c/p>\n\u003cp>“We are very aware of our drugs that are known or thought to cause birth defects,\" she said. “We talk about it to patients.”\u003c/p>\n\u003cp>But with adolescent patients, it can be a tricky situation to navigate with the whole family involved, she said.\u003c/p>\n\u003cp>“At what point do you unceremoniously kick the family out and find out if the patient is sexually active, counsel her, and bring her family back in?”\u003c/p>\n\u003cp>She said some parents feel they are the only ones who should be discussing sex with their children.\u003c/p>\n\u003cp>So Gleghorn will sometimes start out discussing the topic in a general way by saying, “In the case of women who are pregnant, this drug could be dangerous.”\u003c/p>\n\u003cp>She says the subject can be met with strong reactions from patients and families. She recalled that the mother of a teenage girl patient became hysterical when Gleghorn raised the issue of methotrexate causing birth defects.\u003c/p>\n\u003cp>“It raised fears of her daughter’s reproductive future, and went to the basis of her anxiety that her daughter wouldn’t have a normal life living with a chronic illness,” Gleghorn said.\u003c/p>\n\u003cp>But Gleghorn says she counsels patients that when a woman decides to become pregnant, she would go off methotrexate and perhaps use a different medication that poses less risk to a fetus.\u003c/p>\n\u003cp>One adolescent girl insisted she was never going to have sex and never going to have kids, so the risk of birth defects wasn’t a problem, Gleghorn said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“So I told her, ‘It may not be an issue for you right now, but I am telling you so you know for the future.’ ”\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/124183/girls-given-drugs-that-cause-birth-defects-dont-get-contraception-counseling","authors":["11105"],"categories":["stateofhealth_13"],"tags":["stateofhealth_2615","stateofhealth_2608","stateofhealth_2519"],"featImg":"stateofhealth_124667","label":"stateofhealth"}},"programsReducer":{"possible":{"id":"possible","title":"Possible","info":"Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. 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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. 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You ask the questions. You decide what Bay Curious investigates. And you join us on the journey to find the answers.","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Bay-Curious-Podcast-Tile-703x703-1.jpg","imageAlt":"\"KQED Bay Curious","officialWebsiteLink":"/news/series/baycurious","meta":{"site":"news","source":"kqed","order":"4"},"link":"/podcasts/baycurious","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/bay-curious/id1172473406","npr":"https://www.npr.org/podcasts/500557090/bay-curious","rss":"https://ww2.kqed.org/news/category/bay-curious-podcast/feed/podcast","google":"https://podcasts.google.com/feed/aHR0cHM6Ly93dzIua3FlZC5vcmcvbmV3cy9jYXRlZ29yeS9iYXktY3VyaW91cy1wb2RjYXN0L2ZlZWQvcG9kY2FzdA","stitcher":"https://www.stitcher.com/podcast/kqed/bay-curious","spotify":"https://open.spotify.com/show/6O76IdmhixfijmhTZLIJ8k"}},"bbc-world-service":{"id":"bbc-world-service","title":"BBC World Service","info":"The day's top stories from BBC News compiled twice daily in the week, once at weekends.","airtime":"MON-FRI 9pm-10pm, TUE-FRI 1am-2am","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/BBC-World-Service-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.bbc.co.uk/sounds/play/live:bbc_world_service","meta":{"site":"news","source":"BBC World Service"},"link":"/radio/program/bbc-world-service","subscribe":{"apple":"https://itunes.apple.com/us/podcast/global-news-podcast/id135067274?mt=2","tuneIn":"https://tunein.com/radio/BBC-World-Service-p455581/","rss":"https://podcasts.files.bbci.co.uk/p02nq0gn.rss"}},"code-switch-life-kit":{"id":"code-switch-life-kit","title":"Code Switch / Life Kit","info":"\u003cem>Code Switch\u003c/em>, which listeners will hear in the first part of the hour, has fearless and much-needed conversations about race. Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />","airtime":"SUN 9pm-10pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Code-Switch-Life-Kit-Podcast-Tile-360x360-1.jpg","meta":{"site":"radio","source":"npr"},"link":"/radio/program/code-switch-life-kit","subscribe":{"apple":"https://podcasts.apple.com/podcast/1112190608?mt=2&at=11l79Y&ct=nprdirectory","google":"https://podcasts.google.com/feed/aHR0cHM6Ly93d3cubnByLm9yZy9yc3MvcG9kY2FzdC5waHA_aWQ9NTEwMzEy","spotify":"https://open.spotify.com/show/3bExJ9JQpkwNhoHvaIIuyV","rss":"https://feeds.npr.org/510312/podcast.xml"}},"commonwealth-club":{"id":"commonwealth-club","title":"Commonwealth Club of California Podcast","info":"The Commonwealth Club of California is the nation's oldest and largest public affairs forum. 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