PI's Weekly Media Digest: Federal nutrition policy update, the California Values Act, and more
Community environments
The Healthy, Hunger-Free Kids Act first went into effect four years ago, and a new USDA report finds that 97% of districts are meeting the improved nutritional standards. Civil Eats reports that the School Nutrition Association – as part of its campaign to overturn the Healthy, Hunger-Free Kids Act – tends to emphasize and inflate implementation problems, from food waste to revenue concerns over more expensive ingredients and more labor-intensive food preparation. The Healthy, Hunger-Free Kids Act is a target of congressional Republicans, threatening both the nutritional standards and the act’s extension of free school breakfast programs to schools with high rates of students living in poverty. Vox reports that Republicans are also looking to challenge the new Nutrition Facts label, which would provide information on added sugars and clarity on portion sizes, currently scheduled to go into effect next year.
New research from the University of Connecticut Rudd Center for Food Policy finds that black children and teens see up to 50% more junk-food ads than their white peers.
A Brookings Institution analysis of new Census data shows that high levels of segregation by race and income persist and that “neighborhood integration is not keeping pace with the declines that occurred during the decades that immediately followed the Civil Rights Era.” Whites continue to reside in majority-white neighborhoods. And in cities where large black and Hispanic populations live, those communities tend to be intensely segregated, especially in cities where concentrated poverty has risen.
Under the Obama administration, the Department of Housing and Urban Development has prioritized housing for former prisoners reentering society, recognizing that housing insecurity is challenge for people who have been incarcerated and can increase the likelihood of recidivism and that secure housing can help families reunite and help former prisoners find employment, releasing legal guidance last year informing public housing authorities that arrest records “may not be the basis for denying admission, terminating assistance or evicting tenants.” Advocates worry that the Trump administration will make reentry and finding secure housing more difficult.
A new Urban Institute report proposes that a national tax on sugar, rather than a national tax on soda, would more effectively reduce sugar consumption and reduce the consumer burden of tax-by-fluid-ounce soda taxes, while placing more pressure on manufacturers to cut sugar.
Health Equity
New research shows that early-childhood education programs that start at birth and care for children until age five have even greater economic and health benefits to society than preschool programs that start later. Low-income children in such zero-to-five programs were more likely to graduate from high school, less likely to be incarcerated than their counterparts who stayed home or enrolled in low-quality programs, had higher IQs, and were healthier during the course of their lives. For every dollar invested, the programs studied generated a societal benefit of $6.30.
As Mother Jones reports, concerned by the hateful rhetoric that has accompanied President-elect Donald Trump's transition to the White House, a group of 1,200 historians and other scholars have put out a powerful statement urging Americans to stand guard against civil rights abuses. The statement notes, "Looking back to history provides copious lessons on what is at stake when we allow hysteria and untruths to trample people's rights. We know the consequences, and it is possible, with vigilance and a clear eye on history, to prevent tragedy before it is too late."
Meanwhile, across the country, mayors are mounting a concerted resistance effort to Trumps’ hardline immigration stance by reassuring millions of immigrants they’ll remain safe. Federal funding for more than 30 sanctuary cities—including San Francisco, Ashland, New Orleans, and Santa Fe—has been threatened by Trump.
An analysis by the White House Council of Economic Advisors found that in the 18 states (plus D.C) that had hiked minimum wages after 2014, low-income workers who are supposed to benefit from them did, without any collateral damage.
The Los Angeles Times details the ways in which Black Lives Matter has helped transform gestures of art and expression into incredible political acts over the past three years, from choreographed die-ins at crowded train stations to human chains on major highways.
Colorlines interviewed Dr. Hanna-Attisha, who conducted the first research that unearthed high levels of lead in Flint children's blood, to assess the state of the water crisis. She notes that while water testing is improving, the parts of town that are predominantly poor and people of color have yet to gain access to clean drinking water. There has also been significant PTSD and trauma, as families worry about what will happen to their children with lead poisoning.
The Atlantic covers a new study that found that people born in the 1940s had a 92% change of earning more than their parents did, and for people born in the 1980s, the chances are just 50-50. According to the study authors, this gap is due to the slow growth of gross domestic product since the 1950s and the growing unequal distribution of wealth, which gives the wealthiest 1% of the country the power shape politics, who are in turn less inclined to invest in services for the poor that would help them get ahead.
A new report by Human Rights Watch documents the levels of discrimination that LGBTQ kids still face in school — not just from other students but even teachers, administrators, and the laws and policies schools enforce as well. The report notes, “Data showed that an alarming 42.8 percent of lesbian, gay, and bisexual youth respondents had seriously considered suicide in the previous year, and 29.4 percent had attempted suicide, compared with 14.8 percent of heterosexual youth who had seriously considered suicide in the previous year and 6.4 percent of heterosexual youth who had attempted suicide.” Mother Jones reports on the progress, and lack thereof, in each of the states in regards to their stand on LGBTQ rights, including the major victories, and setbacks, of 2016. Finally, Rewire suggests six ways for health-care professionals to create a safer and more affirming environment for trans people. A survey released this week by the National Center for Transgender Equality found that 23 percent of trans people avoided going to the doctor because they feared discrimination; one-third of respondents had at least one negative experience with their provider, including having to educate the provider on trans people in order to receive appropriate care; and 13 percent were “denied coverage for services often considered to be gender-specific, including routine sexual or reproductive health screenings,” while 7 percent were denied coverage for other routine health-care services.
The Atlantic covers the struggles and triumphs of America’s first black doctors. In 2008, the American Medical Association issued an official apology and acknowledged its past history of racial inequality toward black physicians.
California
The New York Times reports on a new bill sponsored by Kevin de Leon, the California Values Act, which would prohibit state and local resources from being used for immigration enforcement. De Leon said, “Nothing in the bill would obstruct the federal government. This is not a nullification of federal laws or a rebellion against the Constitution. It’s upholding the Fourth Amendment, preventing unreasonable search and seizure, so mothers and fathers can go to work and children go to school without fear of losing one another. It’s upholding the First Amendment, so day laborers can solicit work on a sidewalk. It’s allowing the local police to keep the trust and cooperation of crime victims and witnesses, who will not fear every encounter as a prelude to deportation.”
Violence Prevention and Unintentional Injury
As part of its ongoing coverage of shootings in Chicago, the New York Times looks at some of the community conditions in areas with high homicide rates. "Residents along Walnut Street and at other crime scenes told of a fractured community — isolated by this city’s entrenched segregation, hollowed out by joblessness and poverty, and battered by resignation and indifference...In places like this, cycles reinforce themselves: Poverty and joblessness breed an underground economy that leads to jail and makes it harder to get jobs. Struggling, emptying schools result in the closings of the very institutions that hold communities together. Segregation throws up obstacles to economic investment. And people and programs with good intentions come and go, thwarting hopes, reinforcing frustrations while never quite addressing the underlying problems, anyway."
“Stand your ground” laws have spread rapidly across the country over the past decade, from just Florida in 2005 to 23 states by 2016. A 2016 review of the research, published in Epidemiologic Reviews, found that most big studies looking at “stand your ground” and similar “castle doctrine” laws — which only remove the duty to retreat in your home — actually correlated with increases in homicides.
ThinkProgress details the extensive violence, human right violations, and humiliation tactics that Standing Rock water protectors are still being subjected to behind the front lines, even as the media moves on.
ABC News covers the near-record low number of shootings in New York City this year. Possible reasons include refined police tactics or other factors such as gentrification. As BMSG notes however, “coverage from ABC News… ignores the socioeconomic factors that lead to violence, and instead of addressing the problem at its root, confronts the problem in its aftermath.”
The Huffington Post dispels the myth that domestic violence spikes during the holiday season. Experts believe this perception is based on a public lack of understanding about how abuse works. According to a 2010 report by the National Resource Center on Domestic Violence, there is no “reliable, national study linking the holidays with an increase in domestic violence." The author notes, “Domestic violence is not simply isolated acts of physical violence, but rather a pattern of behavior. Perpetrators use a range of tactics ― including emotional, verbal, economic and sexual abuse ― to control and intimidate victims.”
According to a review by the Associated Press and USA Today, new CDC data understate accidental shooting deaths of kids by 83 percent (141 minors killed by unintentional gun discharges, rather than 77). Mark Rosenberg, former director of the CDC's National Center for Injury Prevention and Control, notes, "I think people 30 years from now are going to look back at this time and say, 'My God, how did we, as parents, as a nation, tolerate these deaths? These shooting deaths where a toddler kills a sibling or where a child is gunned down by a gun that they found in their home - how did we ever put up with that? We use the word 'accident' and lull ourselves into this deadly complacency that says, 'This is just the cost of having firearms in our country'. It's not."
Mental health and wellbeing
An NPR report describes the 21st Century Cures Act as the "most significant piece of mental health legislation since the 2008 law requiring equal insurance coverage for mental and physical health," citing provisions to address the opioid epidemic, increase the supply of mental health professionals and strengthen mental health parity laws. But the report also says that proposed changes to the Affordable Care Act and Medicaid could undermine these gains by reducing coverage for mental health care. In addition, funding for the provisions of the new act will require Congressional approval.
The rise in newborns addicted to opioids is particularly pronounced in rural areas, where the problem is compounded by limited resources to address the problem. The New York Times reports on a study published in JAMA, which found that, from 2004 to 2013, the proportion of newborns born dependent on drugs increased nearly sevenfold in hospitals in rural counties, to 7.5 per 1,000 from 1.2 per 1,000. By contrast, the uptick among urban infants was nearly fourfold, to 4.8 per 1,000 from 1.4 per 1,000. One possible contributor to the problem is the prescription of opioids to expectant mothers for back or abdominal pain.
STAT News covers the opioid crisis in Cherokee Nation, including a quadrupling of drug-related deaths since 1999, access to healthcare, and the struggles of support networks where addiction is widespread.
Health Systems Transformation
According to a new JAMA study, patients who were screened at health clinics and then helped getting food, medication and other necessities saw subsequent improvements in blood pressure and cholesterol levels. The article notes, “Recognition is growing among clinicians, researchers, payers and policymakers that a broad array of social determinants—economic stability, environment, education, community and access to food—can sway mortality, morbidity, life expectancy, healthcare costs and other health-related outcomes.” The piece goes on to cite an estimate published in the New England Journal of Medicine in 2007 that suggested that premature death was determined 40% by behavioral patterns, 30% by genetic predisposition, 15% by social circumstances, 5% by environmental exposure and just 10% by healthcare.
In ACA news, enrollment in private health insurance plans under the ACA sign-ups has quickened despite repeal threats, reaching more than 4 million through Dec. 10. A new Kaiser Family Foundation analysis finds that 52 million adults under 65 – or 27 percent of that population -- have pre-existing health conditions that would likely make them uninsurable if they applied for health coverage that existed in most states before the ACA. A new report from the White House Council of Economic Advisers found ACA coverage expansions are preventing 24,000 premature deaths per year and premiums have risen far slower than pre-ACA trends would have predicted ($3,600 lower than would have been expected had premium growth remained on the pace before the ACA was signed into law). On Monday HHS said that 125,000 hospital patient deaths were prevented between 2010 and 2014, partly through ACA reforms. Finally, California Healthline details how repeal of the ACA would affect Californians’ health coverage, noting, “…over 5 million Californians — about 12.9 percent of the state’s population — had coverage they could lose if the main pillars of the federal law were scrapped.”
The Washington Post reports on new data from the nonpartisan National Bureau of Economic Research that shows after five decades since President Johnson created Medicaid, children who received health insurance through the program are healthier, living longer and working more. The federal government has now recouped much of the original cost of insuring those poor families because their children have grown up to pay more in taxes and rely less on welfare and other public benefits. According to the nonpartisan Tax Policy Center, repealing the ACA would likely remove almost 13 million people from Medicaid's rolls. The study estimates that between 1980 and 1999, Medicaid saved about 345,000 lives.
Health Affairs published a new national study that uses sixteen years of data from a large cohort of US communities to show how preventable death rates fell where population health activities were expanded through multisector networks.