Half a Million Older Californians Living Alone Unable to Make Ends Meet

Presents findings on the economic security of Californians age 65 and older, using the 2007 Elder Index, with a focus on those living alone. Analyzes data by race/ethnicity, gender, age, and county and compares income levels with the federal poverty line

More than Half a Million Older Californians Fell Repeatedly in the Past Year

The capacity of Emergency Medical Service (EMS) providers is being shaped to address falls, and there is even universal design education.  There are tools, media toolkits, and online resources.  Nationally there is a Falls Prevention Awareness Day, and in California, there is fall prevention awareness week. The UCLA Center for Health Policy Research published a detailed health policy brief with policy suggestions to help reduce the risk of falls

Included, but Deportable: A New Public Health Approach to Policies That Criminalize and Integrate Immigrants.

There has been a burst of research on immigrant health in the United States and an increasing attention to the broad range of state and local policies that are social determinants of immigrant health. Many of these policies criminalize immigrants by regulating the "legality" of their day-to-day lives while others function to integrate immigrants through expanded rights and eligibility for health care, social services, and other resources.Research on the health impact of policies has primarily focused on the extremes of either criminalization or integration. Most immigrants in the United States, however, live in states that possess a combination of both criminalizing and integrating policies, resulting in distinct contexts that may influence their well-being.We present data describing the variations in criminalization and integration policies across states and provide a framework that identifies distinct but concurrent mechanisms of deportability and inclusion that can influence health. Future public health research and practice should address the ongoing dynamics created by both criminalization and integration policies as these likely exacerbate health inequities by citizenship status, race/ethnicity, and other social hierarchies

Trends in the Health of Older Californians: Data From the 2001, 2003 and 2005 California Health Interview Surveys

Analyzes trends in the health status and use of preventive services among Californians age 65 and over by race/ethnicity, insurance type, and region. Reports rises in doctor visits and in cancer, diabetes, high cholesterol, obesity, and other illnesses

The Elder Economic Security Standard(TM) Index for California, 2007: County Amounts, Comparisons and Components

Provides county-by-county data on how much income retirees need to make ends meet, how it compares with the Federal Poverty Line, and by how much the maximum Supplemental Security Income payment and average Social Security payment each fall short

A Common Denominator: Calculating Hospitalization Rates for Ambulatory Care–Sensitive Conditions in California

IntroductionChronic health conditions are considered ambulatory care-sensitive conditions (ACSC) when the illness is controllable with effective and timely outpatient care that can potentially prevent the need for hospitalizations. Hospitalization rates for ACSC serve as an indicator of the access to and quality of primary care for chronic conditions. Standard methods to calculate hospitalization rates incorporate the total population in the denominator instead of the total population at risk for a hospitalization. By accounting for people with an ACSC, this study compares standard methods to a disease prevalence-adjusted method to highlight the importance of adjusting for ACSC prevalence when using ACSC hospitalizations in assessing primary care outpatient services.MethodsWe combined California Health Interview Survey and hospital discharge data to calculate standard (crude and age-adjusted) and disease prevalence-adjusted hospitalization rates for hypertension and congestive heart failure. To compare rate calculations, we ranked California counties by their hospitalization rate.ResultsCounties had high prevalence and low numbers of hospitalizations for hypertension; their rankings for hospitalization rates for hypertension did not vary, even after accounting for prevalence. In contrast, counties had low prevalence and high numbers of hospitalizations for congestive heart failure; their rankings varied substantially for congestive heart failure after accounting for prevalence.ConclusionBecause the number of people diagnosed with an ACSC is rising and costs to treat these conditions are increasing, our findings suggest that more accurate measures of ACSC hospitalization rates are needed. Incorporating disease prevalence will contribute to ACSC research by improving the validity of hospitalization rates as a measure for quality of primary care services

Health of American Indian and Alaska Native Elders in California

Analyzes the health risks, health status, and utilization of and access to health services among American Indians/Alaska Natives age 55 and older in California, as well as trends in demographics and underlying factors including economic security

The Health of Aging Lesbian, Gay and Bisexual Adults in California

Examines rates of diabetes, hypertension, poor mental health, physical disability, and fair or poor self-reported health status among homosexual adults ages 50 to 70 compared with their heterosexual peers. Recommends enhancing policies and practices

Access to Health Care Across Generational Status for Mexican-Origin Immigrants in California

The Patient Protection and Affordable Care Act (ACA) of 2010 expands health insurance coverage to a substantial number of persons without health insurance. In California, Latinos, especially Mexican immigrants, have one of the highest rates of uninsurance, making the ACA particularly important for that group. Using the 2007 California Health Interview Survey, this study examines how the generation in the U.S. of individuals of Mexican-origin is associated with their access to health insurance, doctor visits, and emergency room visits in California compared to that of U.S.-born non-Latino Whites. Results indicate that third generation Mexican Americans have similar levels of being insured, having a doctor visit, and having an ER visit compared to Whites, controlling for demographic, socioeconomic, and health status. First generation (immigrant) Mexicans have the least access to health care services with lower odds than Whites of accessing care across all measures. Second generation Mexican Americans also have lower odds than Whites, however, the differences are not as pronounced as for the first generation. This study finds that there are important differences in access to health care among Mexican Americans by generational status, with the greatest disparities for the generations closest to the immigrant experience. Implementation of the ACA will benefit Mexican Americans across generational statuses, but gaps will likely remain for first and second generation Mexican Americans.Le Patient Protection and Affordable Care Act (ACA), voté en 2010, étend la couverture d'assurance-maladie à un grand nombre de personnes qui en étaient jusqu’à présent dénués. Cette loi est particulièrement importante pour les Latinos de Californie, et en particulier pour les immigrés mexicains, le groupe ethnique qui présente l'un des taux de non-assurance les plus élevés. En se basant sur l'enquête 2007 California Health Interview Survey, cette étude examine le lien entre la génération des individus d'origine mexicaine vivant aux Etats-Unis et leur accès à l'assurance-maladie, aux médecins et aux urgences en Californie comparé aux Blancs non latinos nés aux Etats-Unis. Les résultats indiquent que les Américains d’origine mexicaine de troisième génération ont des taux similaires de non-assurance, de visites chez le médecin et de visites aux urgences à ceux des Blancs, pour des statuts démographique, socioéconomique, et de santé comparables. Les Mexicains de première génération (immigrants) sont ceux qui ont le moins accès aux services de santé avec moins de chances que les Blancs d'accéder aux soins pour tous les groupes de mesures. Les Américains d’origine mexicaine de deuxième génération ont également moins accès aux soins que les Blancs mais les différences sont moins prononcées que pour la première génération. Cette étude montre qu'il existe des différences notables au niveau de l'accès aux soins entre les Américains d’origine mexicaine en fonction du degré de génération, les disparités les plus importantes concernant les générations les plus proches de la date d'arrivée dans le pays. L'application de l'ACA va bénéficier aux Américains d’origine mexicaine des différentes générations mais des écarts vont probablement perdurer pour les première et deuxième générations.La Ley de Protección al Paciente y Cuidado Asequible (ACA por sus siglas en inglés) de 2010 amplía la cobertura del seguro de salud a un importante número de personas que carece de dicho seguro. En California, los latinos, especialmente los inmigrantes mexicanos, registran una de las tasas más altas de no-asegurados, lo que convierte a ACA en una ley especialmente importante para ellos. Usando la Encuesta de Salud de California de 2007, este estudio examina como la generación a la que pertenecen los individuos de origen mexicano en California afecta su acceso a seguro médico, a consultas médicas y a consultas en la sala de emergencias en comparación con los blancos no-latinos nacidos en Estados Unidos. Controlando demografía, nivel socioeconómico y estado de salud, los resultados indican que la tercera generación de estadounidenses de origen mexicano tienen un nivel similar de cobertura, consultas médicas y atención en salas de emergencias comparados con los blancos. La primera generación de mexicanos (inmigrantes) registra el menor acceso a los servicios de cuidados de salud y menor probabilidad que los blancos de acceder a cuidados en todas las categorías. La segunda generación de estadounidenses de origen mexicano también tienemenos probabilidades que los blancos, aunque las diferencias no son tan pronunciadas como en la primera generación. Este estudio concluye que existen importantes diferencias en el acceso al cuidado de salud entre los estadounidenses de origen mexicano dependiendo de la generación a la que pertenecen, con las diferencias más grandes en la generación más cercana a la experiencia migratoria.. La implementación de ACA beneficiará a las distintas generaciones de estadounidenses de origen mexicano, aunque probablemente sigan existiendo deficiencias para la primera y segunda generación

Affinity of Arctomeles dimolodontus and other Old-World Badgers (Melinae: Mustelidae: Carnivora)

Mustelids, members of the weasel family, are the most species rich and ecologically diverse family within the order Carnivora. However, fossil mustelids are poorly understood due to their rarity in the fossil record. Fossils of “Eurasian” badgers in particular, subfamily Melinae, only include three stem and two crown genera: Arctomeles, Arctonyx, Ferinestrix, Meles, and Melodon. Today, melines are restricted to the Old World, but fossils of stem taxa have also been discovered in North America. Here, I discuss the occurrence of the fossil meline Arctomeles dimolodontus currently known only from the Gray Fossil Site of East Tennessee, USA, and its phylogenetic position within stem Melinae. A total of 34 dental characters across 8 taxa were selected because some taxa, such as Arctomeles sotnikovae and Ferinestrix vorax, are known only from teeth (or cranial fragments). A search of all possible trees using PAUP (set for maximum parsimony) yielded a single most parsimonious tree. Topology of that tree suggests that Ferinestrix is nested within crown group Melinae, rather than the stem group, and is the sister to extant Arctonyx, the hog badger. Results also suggest that Arctomeles sotnikovae does not group within the monophyletic clade formed by A. dimolodontus and A. pliocaenicus, but instead nests A. sotnikovae as a closely related, but separate, lineage to Melodon. Based on these findings, we propose that the ancestral stock of crown Melinae is more closely related to Arctomeles than Meles as previous research has suggested. Furthermore, the dental morphology within stem Melinae is relatively conservative for a generalized diet, although exceptions exist in some derived forms, such as Arctonyx and Ferinestrix, which may explain why PAUP nested the two as sister taxa. Arctonyx is an exclusively Old-World lineage, so it is likely that the Arctonyx-Ferinestrix clade had an Old-World origin, after which Ferinestrix migrated into North America and Arctonyx remained in the Old World. This begs the question: why do some melines migrate into North America while other contemporary forms do not? All stem meline genera have occurrences from Eurasia, yet only Arctomeles and Ferinestrix are known to have migrated into North America. This is likely because of the environmental constraints on where these different genera can live, but much remains unknown about the ecology of fossil melines to know for certain. Further study of this disparity can lead to a greater understanding of how the earth’s climate has changed since the Neogene and how this change impacts flora and fauna