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First Edition: January 17, 2018

Kaiser Health News - 1 hour 44 min ago
Today's early morning highlights from the major news organizations.
Categories: Health Care

When Food Stamps Pass As Tickets To Better Health

Kaiser Health News - 3 hours 8 min ago

Rebeca Gonzalez grew up eating artichokes from her grandmother’s farm in the central Mexican state of Tlaxcala. But for years after emigrating to the U.S., she did not feed them to her own kids because the spiky, fibrous vegetables were too expensive on this side of the border.

When she prepared meals at her family’s home in Garden Grove, Calif., Gonzalez would also omit avocados, a staple of Mexican cuisine that is often costly here.

“I saw the prices and I said, ‘No, never mind,’” said Gonzalez, a 47-year-old child care worker who receives about $500 a month in food stamps.

But those items are no longer out of reach for her family. Since enrolling last year in a program that rewards food stamp beneficiaries for buying more fresh produce, Gonzalez has regularly filled her shopping cart with the fruits and vegetables of her childhood — not only avocados and artichokes, but pomegranates, various types of squash and more.

Participation in the program, called “Más Fresco,” or “More Fresh” in English, gives Gonzalez an additional $40 a month to spend on produce, allowing her to broaden the palates of her three U.S.-born children. “The good thing is my family likes to try the new vegetables,” she said. “Now I can buy them because I have the extra money.”

The University of California-San Diego is administering Más Fresco and studying its results with a $3.4 million grant from the U.S. Department of Agriculture, which has funded similar efforts in other states, including Illinois, Georgia, Pennsylvania, Minnesota and New Mexico. The dollars invested in those states have been aimed at inducing food stamp recipients to buy more produce at farmers markets or at mobile markets that visit low-income neighborhoods.

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Más Fresco is open to Southern Californians in Los Angeles, Orange and San Diego counties who are enrolled in the Supplemental Nutrition Assistance Program, or SNAP — the official name for food stamp benefits.

The goal of the four-year program, like that of its counterparts in other states, is to improve diets and overall health by making fresh produce more affordable.

“We know food insecurity and, unfortunately, chronic disease go hand in hand,” said Joe Prickitt, a UC-San Diego dietitian who is senior director of Más Fresco. “For SNAP participants, there’s a real cost barrier to buying fruits and vegetables. They say they’re just too expensive.”

Rebeca Gonzalez holds a copy of her grocery receipt and her Northgate González loyalty card. The loyalty card tracks her purchases and redemptions through Más Fresco, a program that urges food stamp recipients to buy produce. (Courtney Perkes for KHN)

Since Más Fresco began in February 2017, it has enrolled 1,153 participants, who receive an average of $329 a month in food stamps and typically live in households of five or six people. Ninety percent of them are Latinos, but adults from any ethnic background can join provided they are willing to shop at a participating Northgate González Market – an Anaheim, Calif.-based Latino grocery chain that is Más Fresco’s retail partner.

For every dollar worth of food stamps enrollees spend on fresh produce in a given month, they receive a one-to-one match, up to $10, $20 or $40, which they can spend only on more fruits and vegetables. The UC-San Diego researchers who are studying the program varied the maximum reward amounts and assigned them randomly to participants to help determine the optimal dollar level for changing people’s dietary habits.

The six participating Northgate stores — two in each of the three participating counties — use loyalty cards to tally produce purchases and distribute the credits. The amount of credit participants have earned and redeemed is itemized at the bottom of their receipts, and the credit carries over from month to month.

Research has shown that affordability is an obstacle to healthier eating for people of modest means. A 2013 study by researchers at Harvard and Brown universities estimated that a healthful diet costs about $550 a year more per person than an unhealthy one. “For many low-income families, this additional cost represents a genuine barrier to healthier eating,” the authors concluded. “Yet, this daily price difference is trivial in comparison with the lifetime personal and societal financial burdens of diet-related chronic diseases.”

A 2016 report by the U.S. Department of Agriculture revealed that food stamp recipients spend a smaller percentage of their grocery budgets on fruits and vegetables than other Americans do.

Financial incentives like the ones being tested in California can help narrow that gap.

A 2011 study of an incentive program in Massachusetts found that people on food stamps who got an extra 30 cents for every dollar they spent on fruits and vegetables consumed nearly a quarter-cup, or 26 percent, more fresh produce per day than recipients who did not get such an incentive.

Last week, Más Fresco began to enroll a second round of up to 2,000 people who will receive the incentive for one year. The current participants will continue in the program through June.

Prickitt said he hopes that even after their financial incentives end, participants will retain what they have learned about healthy eating and continue buying produce.

Rebeca Gonzalez says she can now afford pomegranates for her family because of the extra money she receives through Más Fresco, an incentive program for purchasing produce. (Courtney Perkes for KHN)

Food policy experts note that many other factors can influence a family’s food choices, including lack of time.

“If parents are working more than one job or children are in more than one school or activity, how do you teach the skills of how you can prepare food, even on a busy weeknight?” said Dean Sidelinger, a pediatrician and child health medical officer for San Diego County.

Some advocates for healthful diets have argued that government should not only encourage people to buy healthier food but also discourage unhealthful habits.

A 2014 Health Affairs study by Stanford University researchers showed that banning the purchase of soda with food stamps would reduce rates of obesity and diabetes, while a credit of 30 cents on the dollar for buying fresh produce alone would not.

In 2017, more than a dozen researchers from different universities urged SNAP to eliminate diet-related health disparities among programs for low-income people. They noted, for example, that the federal food-assistance program known as Women, Infants and Children, or WIC, excluded soda and candy but that people could still buy those products with food stamps.

“There are generations of unhealthy people who are overweight with diabetes and hypertension,” said Jim Floros, president and CEO of the San Diego Food Bank, which has advertised the Más Fresco program to its clients. “That’s completely linked back to a poor diet, which is linked back to poverty.”

Rebeca Gonzalez, who moved to the U.S. at age 18, decided to overhaul her family’s eating habits after her husband, Javier Landeros, was diagnosed with diabetes two years ago. Instead of buying cookies, she now keeps chopped fruits and veggies in the fridge for snacks.

She said she wants to instill the same healthy habits her grandmother passed on to her.

“I know she gave us good food,” Gonzalez said, “because she lived 105 years.”

Categories: Health Care

If Poor Neighborhood = Poor Health, Relocation Is One Solution

Kaiser Health News - 3 hours 13 min ago

When low-income Americans are concentrated in substandard homes in struggling or violent neighborhoods, it has tangible consequences for well-being. Research confirms that moving families into less segregated neighborhoods improves overall health, and some communities are giving families vouchers to relocate. Kaiser Health News correspondent Sarah Varney and PBS Newshour producer Jason Kane filed this story that begins in St. Louis.

Categories: Health Care

Assessing Kentucky’s Pre-Waiver Medicaid Expansion Success

Center on Budget and Policy Priorities - Tue, 01/16/2018 - 2:43pm

The Department of Health and Human Services (HHS) has approved a waiver that will let Kentucky make harmful changes to its Medicaid program for adults, including imposing a work requirement, as we explain in a new paper. The state doesn’t need a waiver to help low-income Kentuckians improve their health and well-being; it’s already made dramatic progress toward these goals since it expanded Medicaid under the Affordable Care Act (ACA) in 2014.

Categories: Benefits, Poverty

On the Shelf – More D.C. Regulations

In Custodia Legis - Tue, 01/16/2018 - 12:32pm

Recently, it seems as though we have had a run on 1940s D.C. regulations.  In November, I wrote about the city’s 1941 building height restrictions, and yesterday, Ann Hemmens (again) brought me a copy of the 1944 Police Regulations a patron had requested.  I perused the index of the latter and found the entry “Sheep: droves of, on streets.” Being a fan of articles written about archaic laws still on the books, I decided to investigate.

Pictured below is what was located on the page listed in the index of the 1944 publication (Article VII).

Police Regulations of the District of Columbia, Art. VII (1944). Photo by Betty Lupinacci.

Back then it may have been a common sight to see “sheep driven or conducted between the hours of 6 a.m. and 10 a.m.,” but aside from the occasional deer on Connecticut Avenue, in all my years in D.C. I’ve never encountered a “drove of beeves” (a term I had to look up) or other livestock roaming within the city limits., District of Columbia Municipal Regulations. Screenshot by Betty Lupinacci

So are these regulations still in force?

A quick search for D.C. police regulations determined that the last promulgation was in 1981.  Wanting something more recent, I went to the D.C. Municipal Regulations online and entered the uninspired search term “sheep.” (And while I know at some point I want to go back to see how the five “definitions” that appeared in the results differ, I only focused on the last item in the list seen here.)


Lo and behold, not only are these regulations still valid, almost verbatim, but they are now re-arranged into thirteen sections from the original eight.

DCMR, Title 24, Sect. 9.  Photo by Betty Lupinacci

So if you need to get a herd of animals from Takoma to Foggy Bottom, remember:

  • Only “drive” during the morning rush (6 a.m. to 10 a.m.);
  • Stay 150 yards behind your neighbor’s herd;
  • Don’t halter more than 6 animals together; and
  • Get a permit.

And please, let me know when and where.  I want to be able to say I was there!

Categories: Research & Litigation

Kentucky Waiver Will Harm Medicaid Beneficiaries

Center on Budget and Policy Priorities - Tue, 01/16/2018 - 10:08am

HHS approved Kentucky’s waiver under new criteria, which no longer include increasing and strengthening coverage or improving health outcomes for low-income people. 

Categories: Benefits, Poverty

Viewpoints: Require Brain Exams For Presidents’ Physicals; Ensure Healthy Life For Babies; Are We Ready To Halt Spread of Disease?

Kaiser Health News - Tue, 01/16/2018 - 9:15am
A selection of opinions on health care from news outlets around the country.
Categories: Health Care

Parsing The Policies: Is It Safe to Give Medicaid Work Requirements A Try? Are They Going To Backfire?

Kaiser Health News - Tue, 01/16/2018 - 9:15am
Last week's decision by the Trump administration to add work requirements to the Medicaid program drew both praise and criticism from opinion writers across the country.
Categories: Health Care

State Highlights: Mass. Lawmakers Urge Investigation Of Nursing Home Company; Measles Exposure Possible At Chicago’s O’Hare Airport

Kaiser Health News - Tue, 01/16/2018 - 9:15am
Media outlets report on news from Massachusetts, Illinois, California, Connecticut, New York and Minnesota.
Categories: Health Care

Community Meeting Highlights Rift Between Nashville General And Meharry Medical College

Kaiser Health News - Tue, 01/16/2018 - 9:15am
Recent developments between Nashville General Hospital and Meharry Medical College officials could impact inpatient care at the city's only public hospital. Outlets also report on hospital and health system news from Maryland, Ohio and Illinois.
Categories: Health Care

Hype Of Precision Medicine Getting Too Far Ahead Of The Facts, Experts Worry

Kaiser Health News - Tue, 01/16/2018 - 9:15am
"We're getting better, but like many things in life, there's hope and hype. And that's also the reality with precision medicine right now," says Ben Park, an oncology professor at the Sidney Kimmel Comprehensive Cancer Center at Hopkins. In other public health news: breast cancer, skin lightening, in-womb surgery, musical therapy, salty diets, and more.
Categories: Health Care

Vicious Flu Season Reveals Weaknesses In Health System That Don’t Bode Well For Future Pandemics

Kaiser Health News - Tue, 01/16/2018 - 9:15am
This season's severe virus is straining hospitals. But if something as foreseeable as the flu is too much for the medical system to handle, what does that say about future public health crises?
Categories: Health Care

Maps Of Opioid-Related HIV Outbreak Shows The Multiple Times It Could Have Been Stopped

Kaiser Health News - Tue, 01/16/2018 - 9:15am
New visualizations of Indiana's HIV outbreak that was linked to the opioid crisis give a clearer picture of who was affected and how it spread.
Categories: Health Care

Veteran Suing VA Hospital Claiming Doctor Left Scalpel In His Body After Surgery

Kaiser Health News - Tue, 01/16/2018 - 9:15am
U.S. Sen. Richard Blumenthal, a Connecticut Democrat, says he was appalled and stunned by the “egregious medical malpractice case" and is asking for a detailed explanation of the incident.
Categories: Health Care

Congressional Budget Cuts Leave Safety-Net Hospitals Facing Shortfalls

Kaiser Health News - Tue, 01/16/2018 - 9:15am
The hospitals are facing $3.6 billion in federal funding reductions and could be left with other cuts too if Congress doesn't extend some programs that could be affected by the budget stalemate. Also caught up by the congressional inaction is the Children's Health Insurance Program.
Categories: Health Care

With Individual Mandate Scrapped, Employers Say ‘It’s Our Turn’

Kaiser Health News - Tue, 01/16/2018 - 9:15am
Employers have long-chafed at what they see as the onerous rules that came with the Affordable Care Act. But now that Congress has killed the individual mandate, employers say that their requirements should be the next to go. In other news: Sen. Lamar Alexander (R-Tenn.)says he expects bipartisan legislation aimed at stabilizing the marketplace to pass in the coming months; the Trump administration could approve short-term insurance plans soon; and a look at the health law and enrollment in the states.
Categories: Health Care

Bill Would Allow 72-Hour Hold On Patients Seeking Help With Addiction

CommonHealth (WBUR) - Tue, 01/16/2018 - 8:18am
A bill proposed by Gov. Charlie Baker contains a provision that would allow a 72-hour involuntary hold on those seeking addiction treatment.
Categories: Health Care

First Edition: January 16, 2018

Kaiser Health News - Tue, 01/16/2018 - 6:29am
Today's early morning highlights from the major news organizations.
Categories: Health Care


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