Category Archives: Prevention

Doctors order fewer preventive services for Medicaid patients – study finds

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Blue doctorMichelle Andrews
KHN

Gynecologists ordered fewer preventive services for women who were insured by Medicaid than for those with private coverage, a recent study found.

The study by researchers at the Urban Institute examined how office-based primary care practices provided five recommended preventive services over a five-year period.

The services were clinical breast exams, pelvic exams, mammograms, Pap tests and depression screening.

The study used data from the National Ambulatory Medical Care Survey, a federal health database of services provided by physicians in office-based settings.

It looked at 12,444 visits to primary care practitioners by privately insured women and 1,519 visits by women who were covered by Medicaid between 2006 and 2010.

That difference reflects the fact that the share of women who are privately insured is seven times larger than those on Medicaid, the researchers said. Pregnancy-related visits and visits to clinics were excluded from the analysis.

Overall, 26 percent of the visits by women with Medicaid included at least one of the five services, compared with 31 percent of the visits by privately insured women. Continue reading

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Use extreme caution this Fourth of July

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FireworksFrom the Office of the Insurance Commissioner 

This year’s Fourth of July festivities in Washington are complicated by the statewide drought we are experiencing.

As a result, many local and state government officials are asking Washington citizens to forego fireworks, even where they are legal.

Many municipalities in Washington have banned the use of fireworks.

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Nudging students to make healthier choices

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applesBy Tara Bostock
Public Health – Seattle and King County

It turns out that encouraging students to make healthier choices in the lunchroom can be accomplished affordably and without a major overhaul of the cafeteria.

Research shows that small changes like making the salad bar the highlight of the lunchroom, displaying fruit in attractive baskets, or placing healthy foods by the cash register can influence what students select to eat.

In Washington State, the Kent School District is leading the way by changing their cafeterias to

How the Kent School District is bringing behavioral economics principles to their lunchrooms.

encourage students to pick healthier foods. With the help of funding from the Community Transformation Grant, the District partnered with the Cornell Center for Behavioral Economics in Child Nutrition Programs to run a pilot program reaching over 6,000 students in six secondary school cafeterias.

The goal: to increase the number of students choosing healthy foods like fruit, vegetables, white milk, or healthy entrées. And the District saw positive changes.

How does behavioral economics work in the lunchroom?

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What preventive services must be provided for free under the Affordable Care Act?

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Preventive Services Covered Under the Affordable Care A

stethoscope doctor's bag chest x-rayIf you have a new health insurance plan or insurance policy beginning on or after September 23, 2010, the following preventive services must be covered without your having to pay a copayment or co-insurance or meet your deductible. This applies only when these services are delivered by a network provider.

  • Covered Preventive Services for Adults
  • Covered Preventive Services for Women, Including Pregnant Women
  • Covered Preventive Services for Children

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‘Free’ contraception means ‘free,’ Obama administration tells insurers

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Birth control patch - Photo by John Heilman, MD under creative commons licesnse

Birth control patch – Photo by John Heilman, MD (CC)

By Phil  Galewitz
KHN

Free means free.

The Obama administration said Monday that health plans must offer for free at least one of every type of prescription birth control — clarifying regulations that left some insurers misinterpreting the Affordable Care Act’s contraceptive mandate.

“Today’s guidance seeks to eliminate any ambiguity,” the Health and Human Services Department said. “Insurers must cover without cost-sharing at least one form of contraception in each of the methods that the Food and Drug Administration has identified … including the ring, the patch and intrauterine devices.”

The ruling comes after reports by the Kaiser Family Foundation and the National Women’s Law Center, an advocacy group, found many insurers were not providing no-cost birth control for all prescription methods. (KHN is an editorially independent project of the Kaiser Family Foundation.) Continue reading

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Free child car seat check-up events in King County

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Child safety seat car seat From Public Health – Seattle & King County

Child safety seats can save lives, but they need to be used properly to be effective.

Parents and caregivers can get support in fitting their children securely in car seats at five free child car seat check-up events in upcoming months, beginning Friday, April 24, 2015. Public Health – Seattle & King County is hosting the events.

Event details

Parents and caregivers will have their child safety seat checked by a certified child safety seat technician for safe installation and educational materials will be on hand. Soon-to-be parents and caregivers are welcome as well.

These events are ones of many ongoing child safety seat check-up events in the Puget Sound area. Check the Washington Safety Restraint Coalition website for locations and schedules. Continue reading

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Getting warmer: let’s talk water safety

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infant-swimming

By James Apa
Public Health – Seattle & King County

With summer approaching in the Northwest, layers of clothing slowly peel away, and thoughts turn to the water. Soon, local rivers, lakes and pools will start to fill with kids and families.

I talked with Tony Gomez, our Violence and Injury Prevention Manager (and local water safety guru), to understand potential hazards on the water, and how to keep these experiences fun and safe. 

Q: Every year, we hear local reports of tragic drownings in the news. How common are they, and where do most happen?

A: Last year, we had 15 unintentional drowning deaths in King County, and we see about 100 statewide per year. From when I started this work 30 years ago, drownings have dropped significantly, in large part because of good prevention work. But it’s still too many. Continue reading

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Why I love family-run restaurants: Insights from a food inspector

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cropped-eyob-in-idBy Eyob Mazengia, PhD, RS, Food Protection Program
Public Health – Seattle & King County

When I started as a food inspector, I was assigned to the International District. And I liked it. It was almost like walking into a new culture, a new era.

What fascinated me was that as a public health worker, I had permission to walk into people’s personal spaces. I liked the smells, the sounds of their languages, their wall hangings and the way things looked.

It was a privilege, really, to be allowed into their personal spaces. Going on food inspections in the I.D., it was like walking into 3-4 different countries every day, without traveling outside the neighborhood.

Over the years, I established good relationships with the restaurant establishments. They were no longer just restaurant operators—they were mothers, fathers, grown kids. They’re not just businesses—there’s a family behind every door, people who had often gone through difficult times to be here.

And as I got to know them, I could recognize the sacrifices they made to give their children better opportunities in the U.S., and what they left behind. Even those born and raised here, you could recognize the sacrifices they were making. Continue reading

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Colorado’s pregnancy prevention breakthrough

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Flag_of_ColoradoBy Christine Vestal
Stateline

President Barack Obama hailed a landmark achievement in his State of the Union address last month: Teen pregnancies in the U.S. have hit an all-time low.

But the U.S. still has a teen birthrate of 31.2 per 1,000 teens, nearly one-and-a-half times the rate in the United Kingdom, which has one of the highest rates in Western Europe.

Colorado may have found a way to close the gap. The state’s teen birthrate dropped 40 percent between 2009 and 2013, driven largely by a public health initiative that gives low-income young women across the state long-acting contraceptives such as intrauterine devices (IUDs) and hormonal implants.

Colorado has a successful model for stemming teen pregnancies. But will state lawmakers continue paying for it?

Backed by $23.5 million from the Susan Thompson Buffett Foundation, Colorado attracted national recognition for its program after Democratic Gov. John Hickenlooper announced the results of a cost-savings study last summer.

The state saved $42.5 million in 2010 alone, an average return of $5.85 in avoided Medicaid costs for prenatal, delivery and first year of infant care for every $1 spent on the program.

More important, Hickenlooper said, the initiative “has helped thousands of young Colorado women continue their education, pursue their professional goals and postpone pregnancy until they are ready to start a family.”

According to program supervisor Greta Klingler, Illinois, Nevada, New Jersey, New York, Ohio, Virginia and Wisconsin have asked Colorado to share its techniques and lessons learned. Illinois is already adopting some of Colorado’s methods in a statewide Medicaid program for unwanted pregnancy prevention, she said. The U.S. Centers for Disease Control and Prevention is also seeking more details from Colorado.

Bill Albert, chief program officer at the National Campaign to Prevent Teen and Unplanned Pregnancy, pointed to the promise of state-based programs that rely on low-maintenance, highly effective methods of contraception coupled with good counseling.

“We’ve made progress, but if we’re going to continue making progress, efforts going forward will have to be as innovative and up-to-date as possible,” Albert said.

But Colorado’s program will end this June when its private grant runs out, unless lawmakers approve state funding to keep it going for another year. A $5 million funding bill was introduced this month with bipartisan sponsorship, but it won’t necessarily be an easy win, especially in the Republican-led state Senate.   Continue reading

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Standing up to senior falls: local program promotes independence and safety at home

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By Alan Abe, Emergency Medical Services Division
Public Health – Seattle & King County

ems-falls

Do you know someone over 65 who has fallen? Have you reached that age and are concerned about your risk?

Senior falls are all too common, with results that are often serious and sometime even grave.

Nearly 24,000 seniors died nationally in 2012 due to falls, nearly doubling in ten years. And over 2.4 million people – almost four times the population of Seattle – were hospitalized.

What’s driving this toppling trend? More of us are living longer, and as a society, we’re getting older. And with the aging of the baby boomer generation, this trend will continue.  By 2030, the US Census Bureau estimates that there could be about 75 million people over 65 in the United States.

As we age, we tend to collect conditions that make us more vulnerable to falls: diabetes, heart disease, stroke, arthritis and Parkinson’s disease.

So, what can we do about it? We know that 60% of senior falls happen in the home, so if we improve safety and reduce risks there, we can make a big difference.

That’s where King County Emergency Medical Services/Medic One comes in. They have developed the One Step Ahead Fall Prevention Program to help at-risk seniors stay healthy, independent and safe in their homes.

How does the program work? Continue reading

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States with looser immunization laws have lower immunization rates

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By Christine Vestal
Stateline

The U.S. Centers for Disease Control and Prevention issued a health advisory  this month about an ongoing measles outbreak, with more than 102 cases in 14 states so far. The highly contagious disease can cause severe health complications, including pneumonia, encephalitis, and death.

By 2000, measles had been nearly wiped out in the U.S., with fewer than 60 cases per year – most connected with foreign travel. Public health officials declared victory, the result of effective state-based immunization campaigns requiring kids to be vaccinated before they enter public schools.

Since then, however, the number of cases has risen along with the number of parents who have received religious or philosophical exceptions to state rules. In 2014, there were at least 23 outbreaks and more than 600 cases.

Measles graphic 2

The federal government’s goal is to immunize at least 90 percent of all children before they enter school to keep measles and other childhood diseases at bay.  Although the national average immunization rate (91.1 percent) exceeds that number, several states fall below it.

“To have pockets where community immunity is below 90 percent is worrisome as they will be the ones most vulnerable to a case of measles exploding into an outbreak,” said Litjen (L.J) Tan, chief strategy officer of the Immunization Action Coalition, which advocates for higher levels of immunization.

State immunization rates vary widely, with generally lower rates of inoculation occurring in states that make it relatively easy to get an exception. Lawmakers in California, Oregon, and Washington state are trying to tighten their laws to allow fewer nonmedical exemptions.

Laws allowing religious exemptions have been around longer than those allowing philosophical or “personal belief” exemptions, said Joy Wilson, of the National Conference of State Legislatures.

In many but not all states, philosophical exemptions are easier to get than religious exemptions, which typically require parents to cite and explain the religious doctrine in question.  Overall, states with philosophical exemptions have 2.5 times the rate of opt-outs than states with only religious exemptions.

SLN_Feb09_vaccinationRates

Stateline logo Stateline is a nonpartisan, nonprofit news service of the Pew Center on the States that provides daily reporting and analysis on trends in state policy.

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Measles outbreak sparks bid to strengthen California’s vaccine law

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Boy gets shot vaccine injectionBy Jenny Gold
KHN

State lawmakers in California introduced legislation Wednesday that would require children to be fully vaccinated before going to school, a response to a measles outbreak that started in Southern California and has reached 107 cases in 14 states.

California is one of 19 states that allows parents to enroll their children in school unvaccinated through a “personal belief exemption” to public health laws. The outbreak of measles that began in December in Anaheim’s Disneyland amusement park has spread more quickly in communities where many parents claim the exemption.

State Sens. Dr. Richard Pan and Ben Allen have proposed eliminating the personal belief exemption altogether in California.

“Every year that goes by we are adding to the number of unvaccinated people and so that’s putting everyone at greater risk,” said Pan, who is also a pediatrician. “We shouldn’t have to wait until someone sickens and dies to act.”

The exemption isn’t new — it’s been around since the 1960s. But the number of parents taking the exemption went way up in the past decade. In some schools in California, more than half of children have an exemption.

If their law passes, all of those children would be required to get fully vaccinated in order to go to school. Pan says the most parents in the state would support that. Continue reading

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