Food Environments Near Home and School Related to Consumption of Soda and Fast Food

Outlines how retail food environments affect adolescents' consumption of sugar-sweetened beverages and fast food, including county-by-county variations. Discusses implications for health outcomes and policy recommendations improve food environments

Adolescent Physical Education and Physical Activity in California

Based on 2007 California Health Interview Survey data, examines participation in physical education and other physical activity among adolescents ages 12 to 17 by gender and county, and implications for health outcomes. Makes policy recommendations

Obesity and Diabetes: Two Growing Epidemics in California

Analyzes the 2001-07 increase in obesity and diabetes prevalence by race/ethnicity, age, income, education, and years lived in the United States. Outlines policy implications of the disproportionate effect on people of color, the poor, and less educated

Diabetes in California: Findings From the 2001 California Health Interview Survey

Examines the prevalence of diabetes in California, with particular attention paid to disparities between different population groups. Includes access to medical care, diabetes care and management, and identifying at-risk populations

Low-Income Adolescents Face More Barriers to Healthy Weight

Examines the causes behind the higher prevalence of obesity among low-income adolescents, including unhealthy food environments, few opportunities for physical activity, and irregular family meals. Makes policy recommendations to address such disparities

California Adolescents Increasingly Inactive

Explores the health benefits of regular exercise; the extent to which adolescents in California are getting adequate levels of physical activity; and factors that affect high rates of inactivity. Provides policy recommendations

A Patchwork of Progress

Outlines changes in childhood obesity and overweight rates in California between 2005 and 2010 by county. Considers implications of regional variations, including public policy options for promoting healthy diets and physical activity

Designed for Disease: The Link Between Local Food Environments and Obesity and Diabetes

Examines the link between a community's retail food environment -- the ratio of fast-food outlets and convenience stores to grocery stores and produce vendors, with income level as a factor -- and the prevalence of adult obesity and diabetes

Is Incarceration a Contributor to Health Disparities? Access to Care of Formerly Incarcerated Adults

Despite the disproportionate prevalence of incarceration in communities of color, few studies have examined its contribution to health disparities. We examined whether a lifetime history of incarceration is associated with recent access to medical and dental care. We performed a secondary data analysis of the 2007 Los Angeles County Health Survey, a population-based random-digit-dialing telephone survey of county households. Any history of incarceration in a prison/jail/detention center as an adult was assessed for a random subsample. Bivariate and multivariate logistic regression analyses examined whether incarceration history was associated with access to care, controlling for other characteristics. Ten percent of our study population reported a history of incarceration. While persons with an incarceration history were similar to their peers with regard to health and insurance status, their access to medical and dental care was worse. Incarceration history was independently associated with disparities in access to care. Interventions to improve the health of communities affected by high rates of incarceration could include efforts that enable access to care for formerly incarcerated adults

Cost Analysis and Policy Implications of a Pediatric Palliative Care Program

ContextIn 2010, California launched Partners for Children (PFC), a pediatric palliative care pilot program offering hospice-like services for children eligible for full-scope Medicaid delivered concurrently with curative care, regardless of the child's life expectancy.ObjectivesWe assessed the change from before PFC enrollment to the enrolled period in 1) health care costs per enrollee per month (PEPM), 2) costs by service type and diagnosis category, and 3) health care utilization (days of inpatient care and length of hospital stay).MethodsA pre-post analysis compared enrollees' health care costs and utilization up to 24 months before enrollment with their costs during participation in the pilot, from January 2010 through December 2012. Analyses were conducted using paid Medicaid claims and program enrollment data.ResultsThe average PEPM health care costs of program enrollees decreased by $3331 from before their participation in PFC to the enrolled period, driven by a reduction in inpatient costs of$4897 PEPM. PFC enrollees experienced a nearly 50% reduction in the average number of inpatient days per month, from 4.2 to 2.3. Average length of stay per hospitalization dropped from an average of 16.7 days before enrollment to 6.5 days while in the program.ConclusionThrough the provision of home-based therapeutic services, 24/7 access to medical advice, and enhanced, personally tailored care coordination, PFC demonstrated an effective way to reduce costs for children with life-limiting conditions by moving from costly inpatient care to more coordinated and less expensive outpatient care. PFC's home-based care strategy is a cost-effective model for pediatric palliative care elsewhere