Californians support soda warning label, new poll shows

by Suzanne Bohan

February 20, 2014

Both Republicans and Democrats robustly support labels warning that sodas and other sugar-sweetened beverages increases the risk of obesity, diabetes and tooth decay, according to a Field Poll released Thursday.

Two-thirds of Republicans and 80 percent of Democrats favored adding the labels to the sugary products, as did three-quarters of independent voters. The findings, which were commissioned by the California Endowment, a private health foundation, bolster prospects for new legislation introduced in California this month, which would require manufacturers of drinks with more than 75 calories of sugar per serving to add this warning:

“State of California Safety Warning: Drinking beverages with added sugar(s) contributes to obesity, diabetes and tooth decay.”

More than a third of U.S. adults and about one in six children between the ages of 2 and 19 are obese, according to the Centers for Disease Control and Prevention.

And regular soda consumers have sharply higher odds of becoming overweight: a 55 percent increase for children and 27 percent for adults. Research shows sugar-sweetened beverages are the largest source of extra “empty” calories in the American diet.

And teens are drinking even more of it. The UCLA Center for Health Policy Research reported recently that almost two-thirds of California teenagers in 2011-12 drank sugary drinks every day, up 8 percent from 2005-07.

The labeling legislation is the first in California to target sodas, and it’s a change in tactic after defeats in trying to get soda taxes passed.

Ballot proposals that would tax soda sales in El Monte in Los Angeles County and Richmond in Northern California failed, after campaigns marked by intense lobbying against them by the soda industry, which maintains that sugary beverages are unfairly implicated in the obesity crisis; lack of physical activity and poor food choices also play a role, the industry has asserted.

But the new Field Poll also shows support may be shifting in favor of a soda tax, as concerns mount about the social and health toll of excess weight. Two-thirds of those polled support a sugary beverage tax, although this time support did split by party lines, with only 47 percent of Republicans favoring a soda tax.

REFERENCES

“Put tax on sodas, add warning labels, majority says in poll.” The Press Enterprise, Feb. 20, 2014

“California lawmaker wants warning labels on sugary drinks.” Sharon Bernstein, Reuters, Feb. 13, 2014

Suzanne Bohan

Blog, Health disparities

Feeling in control? It could add years to your life.

by Suzanne Bohan

February 17, 2014

Margie Lachman, a professor of psychology at Brandeis University, led a recent study on one’s sense of control and life expectancy.

I’ve long wondered if outlook could change one’s life expectancy odds, since part of what accounts for discrepancies in life spans relates to a sense of control. That’s why those higher on the social ladder live longer, even if those just below them on the rung have safe homes, good food, medical care, etc. More control means less stress, better health.

So a new study caught my eye. It reported that for a certain population (those with less than a college degree), a sense of control did indeed influence life spans.

“Health and longevity are not just due to health care access,” said Margie Lachman, a professor of psychology and director of the Lifespan Initiative on Healthy Aging at Brandeis University, who led the study. “Attitudes make a difference. How you construe your circumstances and challenges determine whether you take action or give up, or feel stressed or motivated.” Her comments appeared in a Health Day article, published by the National Institutes of Health.

Lachman and her colleagues looked at data from more than 6,100 U.S. residents who turned in health surveys from 1994 to 1996. They then looked at what happened to them by 2009, and found nearly 600 had died.

As other research has shown, the odds of dying was higher among those who had lower levels of education. But the researchers found that feeling a sense of control counteracted the increased risk.

The study, which was funded by the NIH, appeared online Feb. 3 in the journal Health Psychology.

So what accounts for the difference? “People with a high and low sense of control will see the same situation differently, perhaps as a challenge versus a threat,” Lachman said.

Shevaun Neupert, an associate professor of psychology at North Carolina State University, lauded the study for showing that being poor or uneducated doesn’t need to translate into feeling helpless.

“The idea that someone with low education can have high levels of perceived control and outlive their peers with the same education is a powerful finding,” she stated in the Health Day article.

Blog

Why Timeliness Confers Power

by Suzanne Bohan

February 13, 2014

A community organizer leading a meeting.

On Monday night I sat in on a community organizing action in Del Norte County in Northern California, as part of my reporting on a book project on community health. And organizing community members so they make their voices heard – effectively – is one sure way to improve a community’s well being, as collective voices have great power to bring about change.

One model for community organizing is called PICO (“People Improving Communities through Organizing”), and it’s active in Del Norte.

Without going into the details of how PICO works, I’ll share one rule it stresses that really struck me. The lead organizer explained to the assembled group why PICO-run organizing actions, which typically last an hour, ALWAYS start on time, and ALWAYS end on time. To set the scene of an action, in the audience are power brokers (i.e. elected officials, agency heads, executives, etc.) who are asked to publicly commit to supporting an action deemed critical by the organizers.

The mandate for on-time scheduling is rooted in respect, and the philosophy that “power respects power.” When you start and end on time, you’re respecting other peoples’ time.

But there’s more to it than that, pointed out the leader of Monday’s action: Powerful people are often surprised when rabble-rousers (as they’re sometimes stereotyped) like community organizers are highly organized, and start precisely when promised – with all materials in order. And they’re just as impressed when an action ends when promised.

“Arriving prepared and on time shows you’re a team with power,” said Josh Norris, the lead organizer of a new organizing committee that’s formed in Klamath, Californa.

I’ve always viewed timeliness as a courtesy, but this adds a new dimension. It also confers power. That’s a new reason to follow that old rule of etiquette.

Blog, Health disparities, Health equity

Deadly Discrimination

by Suzanne Bohan

February 9, 2014

David Williams, a Harvard University professor with an expertise on the health effects of racism.

Beware of the small slights in life. Over a lifetime they add up to major loss of health, physical and mental, warns David R. Williams, a professor of public health, sociology and African and African-American studies at Harvard University.

For decades Williams has studied the connection between racism and diminished health. Recently his work percolated up in the news as he’s giving a few talks this week, at the invitation of Canadian health experts eager to close the gap between black and white populations there.

Worldwide, life expectancies are all strongly linked to socioeconomic status – job rank, income and education level. Minority populations typically end up on the lower end of the spectrum, and many nations are working to reduce those life span differences, which reach up to 20 years.

Between 1990 and 2008, the United States began making headway in its quest end the difference, with the most educated blacks gaining 6.7 years in life expectancy. But they still lag in lifespan behind their white counterparts, and Williams points to racism, or what he calls “microaggressions,” as the key hidden factor.

To quantify the effects of racism, Williams developed three statistical tools: The Major Experiences of Discrimination, Everyday Discrimination, and Heightened Vigilance scales.

Everyday discrimination, Williams found, extracts the greatest toll. Black Americans often report poor service in retail outlets or being followed as though they’ll shoplift, being passed over for important positions or promotions, and less attentive treatment from health care professionals, among countless slights. (The Tumblr site, http://microaggressions.tumblr.com, has numerous first-hand examples.)

Among the health ramifications: Greater risk of developing heart disease, depression, and premature delivery, as well as the buildup of abdominal fat, itself linked to diabetes, high blood pressure, and stroke.

Awareness starts the cure, Williams asserts. In a recent article in the (Halifax) Chronicle Herald, he advised pausing before subconsciously categorizing somebody based on the most common traits used to discriminate — race, gender and age. Instead, he suggested making a conscious effort to focus on the person as a unique individual.

1) Harvard prof coming to HRM for talks on racism’s effect on health; The Chronicle Herald, Clare Mellor, staff reporter. February 7, 2014.

Suzanne Bohan

Blog, Health disparities

Lifespans for Rural Americans Lagging Behind Urban Counterparts

by Suzanne Bohan

February 1, 2014

Credit: U.S. Dept. of Transportation

Living in a bucolic rural area may seem like a good prescription for health, but new data shows that rural Americans are paying a price in shortened life expectancy for living in America’s hinterlands. In part it’s because only 17 percent of Americans live in rural areas, and they don’t have quite the advocacy voice of the 83 percent living in urban and suburban areas.

Overall, U.S. life expectancy increased during the past 40 years, from 70.8 years in 1970 to 78.7 years in 2010. But researchers teasing apart those numbers found a disturbing trend – rural residents reaped far smaller gains in lengthened lives than their urban counterparts, and the gap keeps slightly widening. While there’s long been some gap between country residents and city dwellers, in 1971 the rural-urban gap was only 0.4 years. By 2000 that rose to 2 years.

A number of factors likely explain the disparity, said the study’s lead author Gopal K. Singh, Ph.D., of the U.S. Health Resources and Services Administration. “When compared to urban areas, rural areas have higher rates of both smoking and lung cancer, along with obesity, yet reduced access to health care services. Additionally, rural residents have a lower median family income, higher poverty rate and fewer have college degrees.

Reference:

Gopal K. Singh, Mohammad Siahpush. Widening Rural–Urban Disparities in Life Expectancy, U.S., 1969–2009. American Journal of Preventive Medicine, 2014; 46 (2): e19 DOI: 10.1016/j.amepre.2013.10.017

By Suzanne Bohan

Affordable Care Act

Enough young adults signed up for ACA to prevent “death spiral”

by Suzanne Bohan

January 29, 2014

Gail Wilensky, PhD, an economist and Senior Fellow at Project HOPE, an international health foundation, wrote a blog today that sheds light on just who has signed up for the Affordable Care Act (aka Obamacare). This ran in the JAMA Forum, a team of leading health economists, health policy experts and legal scholars who to provide expert commentary and insight.

One statistic stood out that calms concerns that not enough young people have signed up. A number of news stories addressed that question. An excerpt from her blog is below; link to the rest of the post here:

“Two important pieces of information have recently emerged about the 2.2 million individuals who signed up by the end of 2013.

First, slightly less than 25% of these enrollees are in the 18- to 35-year age range. The Obama Administration hopes that by the end of March, when the enrollment period ends, 38% to 40% of all enrollees will be in this age group. More than half of the people who signed up by the end of 2013 are aged 45 to 64 years, an age group that tends to be sicker and more expensive to cover than younger adults.

The administration has said that even with relatively fewer younger enrollees than had been hoped for, there are enough younger people already signed up to prevent an insurance premium “death spiral”—an increase in rates (causing fewer people to sign up for insurance) that can occur if sicker individuals enroll in disproportionate numbers.”

Blog

Dr. Martin Luther King on health care equity. It’s related, but different from health equity.

by Suzanne Bohan

January 21, 2014

Martin Luther King, Jr., speaking at a rally.
Source: National Archives

In 1966, Dr. Martin Luther King ad-libbed a line in a speech in Chicago to the Medical Committee for Human Rights, saying, “Of all the forms of inequality, injustice in health care is the most shocking and inhumane.”

Almost 50 years later, as attention increasingly turns toward shrinking the gap in disease rates and life expectancy between those lowest on the socioeconomic ladder and those on the top rungs, King’s words are cited more frequently. They’re repeated to show how this towering public figure saw health care as a civil right, as much as voting or equality in education.

Community advocates speak out about health disparities in Los Angeles in Dec. 2013.

Sometimes, though, King’s words are slightly misquoted. It’s a small change, but I’ve twice seen the word “care” dropped, with the quote simply stating, “Of all the forms of inequality, injustice in health is the most shocking and inhumane” (underline added). It’s a small but very significant change, in that the latter implies King was speaking of health disparities from all known causes, such as low social status, poor educational attainment, lack of social cohesion, unemployment and underemployment, or living in substandard housing in crime-ridden areas.

While he’d certainly agree that health inequities are an anathema, in citing health care King was in fact only addressing a limited spectrum of what creates gaps in life expectancy as wide as 20 years between nearby U.S. neighborhoods. Not as much was known then about the multiple social sources of poor health, and how sick neighborhoods create sickness. And he was speaking of the appalling racism that black patients faced in hospitals and clinics.

Still, on average only 15 to 20 percent of the disparities in illnesses and death among U.S. populations are connected to access to health care, according to a 2008 article in the Journal of the American Medical Association. Genetics accounts for another 15 to 20 percent of life expectancy.

The rest has to do with how you live your life, and – critically – the kinds of resources you have available to live well. That’s the real focus of the health disparities movements, creating healthier neighborhoods, homes, schools and workplaces so people can thrive. Certainly adding more clinics and health care practitioners is part of the equation, but they can only go so far toward preventing illness and promoting health. And that’s why more activists are taking on health disparities linked to where you live and play.

As for background on Dr. King’s 1966 speech, this Huffington Post article shows the dogged work a civil rights lawyer did to verify that King actually spoke those words, since there’s no written record.

Suzanne Bohan
January 20, 2014 – MLK Day

Uncategorized

Del Norte Parents Push for More Vocational Training

by Suzanne Bohan

December 3, 2013

This “School Success Express” bus toured California to support a new law that gives school districts more say in how money is spent.

On a recent November evening, Del Norte County residents streamed into the Crescent City Cultural Center, a rustic-themed building with soaring wood-beamed ceilings that’s one of the Northern California city’s best gathering places.

A large yellow school bus also pulled up, with “School Success Express” and images of students printed on its side. It carried residents from Smith River, an agricultural community 14 miles north. Many riding it had no transportation there otherwise.

Healthful drinks on tap for Crescent City “School Success Express” event.

A free buffet dinner, catered by Perlita’s Authentic Mexican Restaurant, and free childcare made it much easier for parents to attend the Wednesday evening event, sponsored by the California Endowment. After dinner the serious business began of brainstorming ways to spend an historic new source of state money for schools in low-income communities, such as Del Norte County.

This wasn’t an idle exercise – feedback from parents on how to spend this new infusion is required by the law.

It’s called the “Fair School Funding Law”, and California Gov. Jerry Brown championed it through the legislative process. In a public ceremony, he signed it into law on July 1. It restores local schools districts’ control over funds that were previously earmarked for scores of state-mandated programs, and – critically – gives extra funds to schools with a high number of low-income students, English learners and foster youth.

For the Del Norte County Unified School District, that means the annual budget for educating 4,100 students will go from $21 million in the current school year to $31 million by 2020, or $1.5 million annually for the next seven years, said Don Olson, district superintendent.

It won’t end the big funding gaps between state school districts, with districts in wealthier areas getting more than $21,000 per student, while those in areas with lower property tax revenues get about $6,000 per student. (1) But it narrows the gap.

After several speeches by local leaders, the crowd of about 250 broke into groups to discuss the most urgent needs for improving schools. Themes such as smaller class sizes were common here and in the other 11 other such community gatherings sponsored by the California Endowment. And some spoke of better college preparation.

Del Norte residents listen to Chris Howard, a local business leader, talk about the boon to the community from the new school funding law.

But the value of the new local control of spending was clear inside that Crescent City meeting hall, when table after table also mentioned the importance of vocational training.

Jobs are scarce in the area, and for some learning a trade is a viable path toward a good-paying job in the rural coastal county, population 28,000.

One man said he got his pilot’s license years ago from the local high school. A woman talked about teaching students gardening and cooking skills, while others discussed agricultural field trips and teaching farming skills, such as learning to operate large farming equipment.

“Life skills” also came up, like teaching kids communication skills to do well in an interview, etiquette classes, setting goals and even simply counting change.

“Not all kids college-bound,” commented one man.

The new plans for the funds take effect July 1, 2014. I’ll report then on what the Del Norte school district, with parent input, decides.

—

(1) California school district spending and test scores, California Watch, June2011.
http://schoolspending.apps.cironline.org

Health disparities

Sleep patterns and social disparities

by Suzanne Bohan

November 1, 2013

Only those living in neighborhoods that are part of gang territory can understand the challenge of getting a good night’s sleep. Gun shots going off at all hours aren’t uncommon, residents have told me, and after sundown road racing and squealing tires break the quiet. For many, anxiety never fully recedes that a stray bullet will strike their home or someone will break in, even if they have an alarm system.

A novel new study, reported in the The Stony Brook Statesman, shows just how hard it is getting those recommended 8 hours. Dr. Lauren Hale, associate professor of Preventive Medicine at Stony Brook, analyzed the relationship between sleep patterns and economic, social and health disparities.

Hale found that the more socially disadvantaged an individual is, in terms of income and education, the more likely that person will report a sleeping problem. She compared African-Americans and Caucasians.

Blacks are twice as likely to be short sleepers when compared to their white counterparts. A 2007 Chicago-based study similarly found that African-American men get one less hour of sleep per night compared to white males.

High school graduates are 40 percent more likely to be short sleepers, compared to college graduates, the study reported.

Losing one hour of sleep, night after night, has a substantial health effect. The National Institutes of Health said sleep deficiency is linked to many chronic health problems, such as heart disease, high blood pressure, diabetes, stroke, obesity and depression. It also leads to more injuries and accidents.

The NIH gives strategies for getting a full night’s rest, although the list doesn’t address the unique challenges faced by these neighborhoods.

Health disparities

Don’t Hammer with Facts to Shift Thinking – Share Stories

by Suzanne Bohan

October 31, 2013

Colin Powell speaking on “Meet the Press,” using a story to dispel a common myth about Muslims.

As a journalist covering climate change, I would invariably hear from skeptics of climate change. They didn’t believe the facts that virtually every credible scientist is certain of – human activity is releasing enough carbon dioxide and methane to dangerously warm the planet. And no amount of discussion really makes any difference, as we’ve seen play out on news pages and news shows.

I see a similar trend in the current topic I’m researching – health disparities between the wealthiest and poorest. The essence is some people dismiss the idea that social and nonprofit supports for the poorest areas are justified – that America is the land of opportunity for all, and everyone is responsible for their fate. While there’s truth to that, they also ignore the enormous obstacles from birth on facing those born in poor areas – especially if you’re black or brown – obstacles with which wealthier or middle-class people never contend. Examples include poor school quality, limited access to good food and safe parks, and chronic stress from living in unsafe neighborhoods, to name a few.

Social scientists puzzle over the phenomenon, and a Boston Globe article titled “How facts backfire” noted that people often form opinions based on beliefs. These beliefs “can have an uneasy relationship with facts,” Joe Keohane, the writer, noted. “And rather than facts driving beliefs, our beliefs can dictate the facts we chose to accept.”

At an Oct. 2013 conference in Los Angeles, Maya Wiley, the founder and president of the Center for Social Inclusion, showed a powerful way of getting around this cognitive dissonance. She used the example of Gen. Colin Powell on a “Meet the Press” interview sharing a story about a soldier’s death to dispel the fabrication that President Obama is Muslim and, more to the point, that therefore being Muslim is bad.

Below is the transcript of that 2008 interview with Tom Brokaw, during which Powell explains his endorsement of Obama’s presidential bid. And here’s the link to the video (scroll to minute 4):

“I’m also troubled by, not what Senator McCain says, but what members of the (Republican) party say. And it is permitted to be said such things as, “Well, you know that Mr. Obama is a Muslim.” Well, the correct answer is, he is not a Muslim, he’s a Christian. He’s always been a Christian. But the really right answer is, what if he is? Is there something wrong with being a Muslim in this country? The answer’s no, that’s not America. Is there something wrong with some seven-year-old Muslim-American kid believing that he or she could be president? Yet, I have heard senior members of my own party drop the suggestion, “He’s a Muslim and he might be associated with terrorists.” This is not the way we should be doing it in America.

I feel strongly about this particular point because of a picture I saw in a magazine. It was a photo essay about troops who are serving in Iraq and Afghanistan. And one picture at the tail end of this photo essay was of a mother in Arlington Cemetery, and she had her head on the headstone of her son’s grave.

And as the picture focused in, you could see the writing on the headstone. And it gave his awards – Purple Heart, Bronze Star – showed that he died in Iraq, gave his date of birth, date of death. He was 20 years old. And then, at the very top of the headstone, it didn’t have a Christian cross, it didn’t have the Star of David, it had crescent and a star of the Islamic faith. And his name was Kareem Rashad Sultan Khan, and he was an American. He was born in New Jersey. He was 14 years old at the time of 9/11, and he waited until he can go serve his country, and he gave his life.

Now, we have got to stop polarizing ourselves in this way.

Powell didn’t use facts to persuade viewers, Wiley emphasized. He told a story with universal resonance, and invoked patriotic values to chide those who would judge people based on their religion.

“He takes you there gently and emotionally,” Wiley said. ‘And what he’s done is he’s humanized one of the most demonized segments of our society and he’s blown (the prejudices) apart. I say you humanize first, and then go out after the wedge issue.”

Californians support soda warning label, new poll shows

Feeling in control? It could add years to your life.

Why Timeliness Confers Power

Deadly Discrimination

Lifespans for Rural Americans Lagging Behind Urban Counterparts

Enough young adults signed up for ACA to prevent “death spiral”

Dr. Martin Luther King on health care equity. It’s related, but different from health equity.

Del Norte Parents Push for More Vocational Training

Sleep patterns and social disparities

Don’t Hammer with Facts to Shift Thinking – Share Stories

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