CIRS Blog about Rural California

Much has been written about the disproportionately high incidence of health problems such as diabetes and obesity among African Americans and Latinos when compared to non-Hispanic whites. But health disparities among smaller minority groups such as American Indians and Pacific Islanders have received far less attention.

new report out of University of California Riverside aims to change that. Led by Andrew Subica, an assistant professor of social medicine, population and public health, the study examines seven years worth of data on health trends among American Indians and Alaskan natives, native Hawaiians and other Pacific Islanders and multiracial adults living in California.

The findings paint a startling picture of ill health among these small and historically neglected populations. Not only do their rates of diabetes and obesity surpass those of non-Hispanic white people, but many are just as or even more likely to suffer from these diseases than African Americans and Latinos.

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By Linda Childers

Olivia Basurto was concerned when her nine-year-old son Samuel came home from school with a rash on his arms. After trying to treat the pink bumps with over-the-counter creams, and having no success, Basurto called to make an appointment with a dermatologist.

She quickly learned that in her small rural town of Pixley (population 3,310), in the Central Valley, physician specialists are a rare commodity. The nearest specialist was either in Porterville or Fresno, located almost an hour away, and they had a three-month wait.

But then, the Pixley Medical Clinic, a rural health clinic that provides family practice medicine to residents of Pixley and the surrounding cities, asked Basurto if she would be open to a telemedicine appointment with a dermatologist. The doctor, a retired dermatologist volunteer with The MAVEN Project, could assess her son’s rash and offer medical advice.

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The San Joaquin Valley Air Pollution Control District, the state's largest, wants to delay implementation of the tighter standards on particulates required by the federal Clean Air Act. The District, which covers eight counties with four million residents from San Joaquin to Kern, is a natural bowl with mountains on three sides that has been unable to improve regional air quality.

Fresno County had 25 unhealthy air warnings in 2016. One consequence is asthma, as especially children have trouble breathing. Many children carry inhalers to school and elsewhere.

California is responsible for one percent of global emissions of greenhouse gases. Governor Jerry Brown in July 2017 persuaded the Legislature to support the extension of the state's 2012 cap-and-trade program to reduce greenhouse gas emissions from 431 million metric tons in 2020 to 260 million metric tons in 2030 (AB 398). California emitted 440 million metric tons of greenhouse gases in 2015 and Brown warned of "mass migrations, vector diseases, forest fires, Southern California burning up" if the state failed to reduce them.

The extension of cap-and-trade could raise gas prices up to $0.75 a gallon and provide funds for the bullet train that aims to link northern and southern California. The California's Air Resources Board, which will implement AB 398, projects an increase in the number of electric cars from 250,000 in 2017 to 4.2 million in 2030. CARB is targeting manure on dairies to reduce methane emissions.

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By Alyssa Morones

Maria Castro * has worked in Kern County’s fields for 14 years, since her family moved to Delano, Calif., from Mexico when she was 16 years old. She started working as a grape harvester two days after her arrival.

She soon noticed a weird scent on her clothes that wouldn’t come off, even after washing. Her brother-in-law told her it was sulfur that growers applied to fields to help the grapes grow faster.

“They never really tell us the names of the pesticides,” said Castro, “or their dangers.”

But Castro learned first-hand about the health issues that come with exposure to pesticides.

She’s noticed that soon after chemical applications on or near where she’s working, she feels nauseous and dizzy. Sometimes she vomits. She said she’s seen co-workers faint.

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By Ron Shinkman

Amidst great uncertainty about federal health policy, Covered California announced Tuesday that insurance premiums on the state-run exchange will rise on average 12.5 percent next year, an increase that is slightly lower than in 2017. The agency reiterated that it has a containment plan should the Trump administration cease to provide cost-sharing subsidies for lower-income exchange enrollees.

All 11 insurers currently offering coverage on the state’ exchange will return in 2018, although Anthem Blue Cross will withdraw from Southern California.

The premium hike for 2018 is down from the 13.2 percent average increase for this year, but still much higher than the low single-digit rate hikes announced for 2015 and 2016.

Covered California Executive Director Peter V. Lee noted that if consumers shop around for different plans in each tier of coverage, they could keep their rate increases down to 3.3 percent.

“For consumers, no increase is a good increase, but Covered California did a good job in these uncertain times,” said Betsy Imholz, director of special projects for Consumers Union in San Francisco.

Imholz credited the exchange for taking a tough negotiating stance with the health insurers and ensuring that competition remains in place in most of the state. According to Lee, 82 percent of Covered California’s enrollees will have three or more health plans to choose from.    

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