In California, 90,000 adults with current asthma have experienced problems understanding their doctors. There are significant disparities in who experiences these communication problems according to education, income, insurance status, English proficiency, race/ethnicity and nativity. In addition, adults with asthma who experience these problems are more likely to go to the emergency department or urgent care facility (ED/urgent care) for asthma care and are less likely to receive asthma management plans from their health care providers. The authors of this policy brief suggest that improvements in education and communication strategies are needed to facilitate understanding between health care providers and asthma patients, especially when patients have limited English proficiency (LEP) or have low health literacy. Support for this policy brief was provided by a grant from The California Endowment.
Although asthma occurs among Californians at all socio-economic levels, it disproportionately affects low-income Californians, who miss more days of work and school, are more likely to have frequent asthma symptoms, and are more likely to go to the emergency department or be hospitalized for asthma care. In this report, the burden of asthma on low-income Californians is examined by geography, race/ethnicity, age and access to care, among other factors. The authors suggest that disparities in asthma prevalence and care are likely due to a number of factors including inadequate access to health insurance coverage, lack of continuity and quality of health care, and an increased likelihood of exposure to asthma triggers and they point to policy and environmental changes that will likely help address these disparities, including adequate health care coverage, quality health care for low-income Californians with asthma, and asthma-friendly environments.
Only 27 percent of non-elderly adults in the United States have a "medical home" –- a place where they regularly receive medical care and advice. Shifting from more costly emergency care to the preventative and coordinated care provided by a medical home impacts costs, access, quality of care and the overall health status of low-income uninsured individuals. In this policy brief, the authors present interim findings on the efforts of ten California counties to explore the medical home model as part of the state's Health Care Coverage Initiative (HCCI), a three-year program to expand health care coverage for eligible low-income, uninsured individuals not otherwise covered by Medi-Cal. Among the innovations described are efforts to create electronic health and medical records, modify e-referrals to two-way communication between primary care physicians and other providers and standardize chronic disease registries. Support for this policy brief was provided by a grant from The California Endowment.
Using data from the 2003 California Health Interview Survey (CHIS), this policy brief examines the racial/ethnic disparities in the burden of asthma among those with active asthma. In addition, the study focuses on disparities in access to care and exposure to indoor environmental triggers that may contribute to the asthma burden experienced by racial and ethnic minorities.
Despite advances in therapy, asthma remains a disease that is not optimally controlled in many Californians. This policy brief examines the economic and social burden of the poor control of asthma and recommends policy changes to reduce those costs. Using data from the California Health Interview Survey (CHIS), the authors found that California's children missed 1.9 million days of school and the state's adult workers missed 2 million days of work due to asthma. As many as 475,000 children and adults in California reported that they went at least once to the emergency room or urgent care center because of asthma. The number is likely to be much higher due to repeat visits. The research adds to a growing body of knowledge about the debilitating personal and economic effects of asthma, a condition linked to pollution, lack of insurance and medical care as well as to risk factors such as smoking.
This policy brief highlights the geographic variations in obesity and overweight rates among California adults for counties, county-groups, Los Angeles Service Planning Areas, as well as for state legislative and Congressional districts. The first of-its-kind sub-county data are useful for policy makers, advocates, and health professionals in understanding the severity of unhealthy weight among adults throughout California and within local communities. Obesity rates were estimated by applying a small-area methodology to multiple data sources, including the 2003 California Health Interview Survey (CHIS 2003), 2000-2002 Current Population Surveys, and the 2000 Census.
Children and adults who suffer from asthma and live near heavy vehicular traffic are nearly three times more likely to visit the emergency room or be hospitalized for their condition than those who live near low traffic areas, according to this policy brief from the UCLA Center for Health Policy Research. For adults with asthma, medium and high traffic exposure increases the likelihood of daily or weekly asthma symptoms by 40 percent and 80 percent, respectively, compared with low traffic exposure. The policy brief also notes that living in areas of heavy traffic is a burden borne disproportionately by asthma sufferers who are ethnic/racial minorities or from low-income households. Researchers were able to link traffic-related air pollution to asthma severity after merging data from Los Angeles and San Diego County respondents to the 2001 California Health Interview Survey with traffic counts provided by the California Department of Transportation.
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