TAG: "Public health"

ACOs improving health care in California


Report: ACOs improve quality of care, increase patient satisfaction, may reduce costs.

California has more accountable care organizations (ACOs) than any other state in the country, with particularly rapid growth over the past two years. This is a good thing, according to the Berkeley Forum for Improving California’s Healthcare Delivery System, which released a report today (Feb. 17) with new evidence that ACOs improve the quality of care, increase patient satisfaction and may reduce costs.

“The next few years are likely to bring continued growth and diversity in accountable care models that move increasingly toward being paid for meeting cost and quality targets,” said Stephen Shortell, lead author of the report and chair of the Berkeley Forum. Shortell is also a professor and dean emeritus of the UC Berkeley School of Public Health.

ACOs are defined as medical groups that contract with Medicare and/or commercial insurers to care for a defined population of patients and that are held accountable to meet cost and quality criteria. In a 2013 report, Berkeley Forum leaders called for at least 50 percent of Californians to be receiving care under new payment models that encourage keeping people well by 2022; and having at least 60 percent of Californians receiving their care from integrated care systems, versus only 29 percent today.

“California is fortunate to have many integrated health care delivery systems at various stages of development. The advancement of these systems into accountable care organizations and partnerships should be viewed as an important and very positive innovation in payment and health care delivery,” said Tom Williams, immediate past-president of the Integrated Healthcare Association and vice president of accountable care operations and strategy at Stanford Health Care.

The report presents emerging evidence that suggests that the quality of care that ACOs provide is as good, and on some measures, better than that provided by other models of care. For the analysis, the team compared medical groups with an ACO contract to medical groups without an ACO contract on widely used HEDIS quality of care measures for asthma care, cancer screening, chlamydia screening, diabetes care, heart care and pediatric care. ACOs scored significantly better for cancer screening. In addition, patients receiving care from medical groups with ACO contracts had consistently higher satisfaction scores than patients receiving care from groups without ACO contracts. This included measures of access to care, overall coordination of care, actions to promote health, communication with doctors, helpfulness of office staff and overall ratings of care.

While full cost-savings data are not yet available, preliminary evidence from an ACO contract in Sacramento found savings of $20 million, with no increase in health insurance premiums for California’s CalPERS enrollees. The study also addressed the concern that as ACOs grow in size they may exert pressure to increase prices.

“At this point in time, our analysis indicates there is little evidence to support such concern,” said Richard Scheffler, report co-author and vice chair of the Berkeley Forum.

Based on existing and ongoing study, the report identifies six factors associated with more successful ACOs. These include:

  • Achieving sufficient size to spread costs,
  • Developing new models of caring for high complex/high risk patients,
  • Expanding the use of electronic health records,
  • Developing effective partnerships with post-acute care providers and specialists,
  • Motivating patients and families to become more engaged in their care, and
  • Using standardized and transparent quality of care data for the purposes of public reporting and internal quality improvement.

The Berkeley Forum for Improving California’s Healthcare Delivery System is a partnership between private and public sector leaders in California to address the challenge of developing a more affordable and cost-effective healthcare system that will contribute to improved population health for all Californians. The UC Berkeley School of Public Health serves as a neutral facilitator for discussions and as the analytic staff for this effort.

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Tobacco-smoking parents increase diabetes risk for children exposed in utero


“Smoking of parents is by itself a risk factor for diabetes, independent of obesity or birth weight.”

Credit: iStock

By Michele La Merrill and Kat Kerlin, UC Davis

Children exposed to tobacco smoke from their parents while in the womb are predisposed to developing diabetes as adults, according to a study from the University of California, Davis, and the Berkeley nonprofit Public Health Institute.

In the study, published today (Feb. 9) in the Journal of Developmental Origins of Health and Disease, women whose mothers smoked while pregnant were two to three times as likely to be diabetic as adults. Dads who smoked while their daughter was in utero also contributed to an increased diabetes risk for their child, but more research is needed to establish the extent of that risk.

“Our findings are consistent with the idea that gestational environmental chemical exposures can contribute to the development of health and disease,” said lead author Michele La Merrill, an assistant professor of environmental toxicology at UC Davis.

The study analyzed data from 1,800 daughters of women who had participated in the Child Health and Development Studies, an ongoing project of the Public Health Institute. The CHDS recruited women who sought obstetric care through Kaiser Permanente Foundation Health Plan in the San Francisco Bay Area between 1959 and 1967. The data was originally collected by PHI to study early risk of breast cancer, which is why sons were not considered in this current study.

In previous studies, fetal exposure to cigarette smoke has also been linked to higher rates of obesity and low birth weight. This study found that birth weight did not affect whether the daughters of smoking parents developed diabetes.

“We found that smoking of parents is by itself a risk factor for diabetes, independent of obesity or birth weight,” said La Merrill. “If a parent smokes, you’re not protected from diabetes just because you’re lean.”

The study was supported through funding from the National Institute of Environmental Health Sciences, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, and the California Breast Cancer Research Program Special Research Initiative.

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UC plans to require vaccinations for incoming students


The plan is being phased in over three years.

Credit: iStock

By Alec Rosenberg

The University of California will require incoming students to be screened for tuberculosis and vaccinated for measles, mumps, rubella, chicken pox, meningococcus, tetanus and whooping cough, under a plan set to take effect in 2017.

Currently, the UC system only requires students to be vaccinated against hepatitis B, though several campuses have additional requirements.

The plan — designed to help protect the health of students and campus communities — has been in the works for a year. But the need is more pressing than ever, given the current multistate measles outbreak and the re-emergence of other vaccine-preventable diseases among those not completely immunized.

“I’m really excited that there’s support and momentum for this new immunization plan,” said Dr. Gina Fleming, medical director for the UC Student Health Insurance Plan. “We know that these preventive measures are effective.”

Three-year phase-in

The plan is being phased in over three years. The first phase focuses on building awareness among students about the upcoming requirement, with all fall 2015 incoming UC students receiving notification of the recommended vaccines and the process for making them mandatory. The intent of the plan is to set a baseline for all of UC, but does not prevent individual campuses from setting immunization standards for all students, or implementing the plan more rapidly.

It was developed based on recommendations from the California Department of Public Health, and in consultation with UC’s student health center directors, vice chancellors for student affairs and the UC system senior vice president for health sciences and services.

It will require that by 2017 all incoming students show documentation not only for hepatitis B vaccination but also for TB screening and four more vaccines: measles, mumps and rubella; meningococcus; varicella (chicken pox); and tetanus, diphtheria and pertussis (whooping cough).

“The University of California is committed to protecting the health and well-being of our students,” said Mary Knudtson, executive director of the UC Santa Cruz Student Health Center and chair of the UC Immunization Policy Committee. “Therefore, all of the UC campuses are implementing procedures to ensure that students are educated about, and receive, vaccinations to prevent potentially dangerous illnesses and undergo screening to identify those who may have infectious tuberculosis.”

Starting in fall 2016, all incoming UC students will be expected to have their required vaccines and enter the data into the university’s electronic medical record platform. But the plan is not to enforce the requirement until the following year. Starting in fall 2017, UC students who do not meet the vaccination requirement will have a hold put on their registration. The rationale for the phased approach is to ensure that the process runs smoothly before potentially impacting students’ ability to register for classes.

All UC campuses have experienced cases of vaccine-preventable diseases in recent years — something not unique among college campuses, which have varying vaccination requirements. For example, only about half of states have laws requiring all college students to be vaccinated against measles, according to a U.S. Centers for Disease Control and Prevention database.

“Despite the fact that many people receive the recommended vaccines, there are still documented cases of outbreaks of vaccine-preventable diseases in California and on the campuses each year amongst those who were not properly immunized,” Knudtson said. “All students are strongly encouraged to obtain the vaccines recommended by the California Department of Public Health prior to starting classes.”

Breaking down barriers

While getting such vaccines has long been considered a good public health practice, the cost of vaccines and the difficulty for student health staff to obtain and verify the information have been barriers to implementation.

Two developments have broken down those barriers, Fleming said. Now that the Affordable Care Act provides insurance coverage for vaccines, the cost of vaccination is less of a problem. Also, a new electronic medical record platform soon will allow UC students to directly enter their vaccination date. Four campuses will be piloting the module for entering vaccination data this fall, and the remaining campuses anticipate being able to use it by fall 2016.

The issue of immunization has evolved into a hot topic of discussion in California and across the nation in recent weeks after a measles outbreak that started at Disneyland. On Wednesday, state Senators Richard Pan and Ben Allen announced they will introduce legislation that would eliminate the ability for parents of school children to opt out of vaccinating their kids based on a personal belief.

UC’s plan will allow exemptions for medical or religious purposes, Fleming said. In the coming months, officials will discuss how to handle requests for other exemptions and how to validate the vaccination information.

“We need to be mindful of the population we’re serving,” Fleming said.

UC’s plan might be extended to already enrolled students and additional vaccines could be added later, such as meningococcus B, Fleming said. Vaccines recommended for preventive care include vaccines for hepatitis A, HPV, influenza, polio and pneumococcal pneumonia.

Officials are determining whether additional approvals are needed to adopt the plan, Fleming said, even as they move forward with implementation.

Meanwhile, leadership in student affairs and student health centers are working with other campus departments to inform students about the plan.

“That’s really a critical piece,” Fleming said. “We can’t expect students to adhere to a requirement that they haven’t heard about. They need to know what the plan is.”

Related link:
Associated Press: Los Alamos National Lab creates website for measles fight

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Forecasting the flu better


Combination of ‘big’ and traditional data improves power of prediction.

By Inga Kiderra, UC San Diego

Three UC San Diego researchers say they can predict the spread of flu a week into the future with as much accuracy as Google Flu Trends can display levels of infection right now.

The study – appearing in Scientific Reports, an online journal from the publishers of Nature – uses social network analysis and combines the power of Google Flu Trends’ “big data” with traditional flu monitoring data from the U.S. Centers for Disease Control and Prevention (CDC).

“Our innovation,” said corresponding author Michael Davidson, a doctoral student in political science at UC San Diego, “is to construct a network of ties between different U.S. health regions based on information from the CDC. We asked: Which places in years past got the flu at about the same time? That told us which regions of the country have the strongest ties, or connections, and gave us the analytic power to improve Google’s predictions.”

Google Flu Trends (GFT) is very good, Davidson said, at showing where in the U.S. people are searching for information on flu and flu-like symptoms. And these data are valuable because they come in real time, he said, about two weeks ahead of when the CDC can issue its reports. But GFT has also made some infamous errors – errors that probably reflect widespread public concerns about flu more than actual confirmed illness.

By weighting GFT predictions with a social network derived from CDC reports on laboratory-tested cases of flu, the researchers were able to refine and improve GFT’s predictions.

The researchers are optimistic their work will soon be put to public use. “We hope our method will be implemented by epidemiologists and data scientists,” Davidson said, “to better target prevention and treatment efforts, especially during epidemics.”

Davidson’s co-authors are Dotan A. Haim, who is also a political science graduate student at UC San Diego, and Jennifer M. Radin, of the UC San Diego/San Diego State University Joint Doctoral Program in Public Health.

The study was funded in part by the Robert Wood Johnson Foundation and the James S. McDonnell Foundation.

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Kids of melanoma survivors need better protection from sun’s harmful rays


UCLA study is first to include Latinos, whom have often been left out of skin cancer prevention research.

Credit: Sean Brenner, UCLA

By Reggie Kumar, UCLA

UCLA researchers have found that children of melanoma survivors are not comprehensively adhering to sun protection recommendations, despite them being at an increased risk for developing the disease as adults.

In the study led by Beth Glenn, associate director of the UCLA Jonsson Comprehensive Cancer Center’s Healthy and At-Risk Populations Research Program, researchers asked parents about their attitudes toward melanoma prevention, how at risk for melanoma they believed their child to be, and their current use of sun protection strategies for their child. They found that about three-quarters of parents relied on sunscreen to protect their child against sun exposure, but less than a third of parents reported that their child wore a hat or sunglasses or attempted to seek shade when exposed to the sun.

Additionally, Glenn said, 43 percent of parents surveyed reported that their child experienced a sunburn in the past year. This is concerning because sunburns are a major risk factor for melanoma.

The UCLA researchers used the California Cancer Registry (which tracks all cases of cancer across the state) to identify and survey 300 melanoma survivors with children ages 17 and younger during a three-year period. The study targeted both non-Latino white melanoma survivors and for the first time Latino melanoma survivors as well.

Latinos have often been left out of skin cancer prevention research due to a common misconception that sun protection is not important for this group.

“Sunburns were common among the children in our study despite their elevated risk for skin cancer. Also, children of Latino survivors were just as likely as children of non-Latino white survivors to have experienced a recent sunburn, which highlights the importance of including this group in our work,” said Glenn, associate professor of Health Policy and Management in the UCLA Fielding School of Public Health.

The survey results will be used to apply for additional funding to develop an intervention program that combines a text message reminder system with educational materials and activities for parents and children. The intervention program is designed to help melanoma survivors more effectively monitor and properly protect their child against UV radiation.

“Protecting kids against the sun’s harmful rays at an early age is vitally important. Our goal is to develop an intervention that will help parents protect their children today and help children develop sun safe habits that will reduce their risk for skin cancer in the future,” said Glenn.

The study will be published online Jan. 13 in the journal Cancer Epidemiology, Biomarkers & Prevention.

The research was supported in part by the National Cancer Institute.

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Public housing type a strong predictor of kids’ use of ER


Investments in living conditions could foster better health, reduce health care spending.

By Juliana Bunim, UC San Francisco

San Francisco children living in non-redeveloped public housing are 39 percent more likely to repeatedly visit emergency rooms, according to new research from UC San Francisco and UC Berkeley.

“The average emergency department (ED) visit costs two to five times more than an office visit, and many children visit EDs for potentially preventable reasons,” said Nancy Adler, Ph.D., senior author of the research, and vice chair of the department of psychiatry and director of the Center for Health and Community at UCSF. “There is a clear need to better understand the range of social and economic factors that lead to these high visit rates, and understand the link between housing and health.”

The paper, San Francisco Children Living In Redeveloped Public Housing Used Acute Services Less Than Children in Older Public Housing, appears in the December issue of the journal Health Affairs.

The researchers looked at the number of children under age 18 with public insurance who sought emergency care from any of three large San Francisco medical systems including San Francisco General Hospital, UCSF Medical Center and Sutter Health, and linked that information to whether they lived in non-redeveloped public housing, redeveloped HOPE VI public housing or nonpublic housing the same neighborhood as public housing.

HOPE VI is an initiative by the U.S. Department of Housing and Urban Development to revitalize the worst public housing projects in the United States into mixed-income developments.

From 1998 to 2006, the San Francisco Housing Authority revitalized five obsolete public housing sites with 1,149 units of new public and affordable housing with 2,607 bedrooms. Eight more sites are planned under the City’s HOPE SF Program.

“Low-income children living in redeveloped HOPE IV public housing were less likely to have repeat visits to the emergency room than their peers living in older public housing,” said Adler. “This suggests that investing in physical infrastructure may not only provide better housing but also foster better health among children and reduce spending on acute care services.”

The researchers were not able to identify which aspects of housing played a role in the children seeking emergency care.

“It could be that renovated environments have fewer toxins and allergens like lead and mold, or fewer injury-inducing hazards, or that there are more social services,” said lead author Ellen Kersten, a Ph.D. candidate in the UC Berkeley Department of Environmental Science, Policy and Management. “We are currently doing more in-depth analysis of the diagnosis codes assigned to children at the time of their hospital visits to understand if and how children’s health conditions differ by housing type.”

Co-authors of the study are Kaja Z. LeWinn, Ds.C., and Laura Gottlieb, M.D., in the department of psychiatry at UCSF, and Douglas Jutte, M.D., M.P.H., in the School of public health at UC Berkeley.

Funding was provided by the John D. and Catherine T. MacArthur Foundation Research Network on Socioeconomic Status and Health, and from the Lisa and John Pritzker Family Foundation.

Related link:
UC Berkeley: Study links revitalized public housing to fewer ER visits

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Is life in America hazardous to immigrants’ health?


Over time, the health status of immigrant groups tends to decline.

By Dan Gordon, UCLA

America is a nation of immigrants drawn from all parts of the world by the promise of freedom and a good life. But a substantial body of evidence suggests that for the newly arrived, life in the United States can be hazardous to their well-being.

When they get here, immigrants are on average healthier than their native-born American counterparts. But the longer they stay, the worse they fare on measures such as heart disease, hypertension, diabetes and mental health.

Faculty at the UCLA Fielding School of Public Health are working on identifying factors contributing to the declining health status of immigrant groups that’s occurring over time and through the generations.

Part of it has to do with an unfamiliarity with U.S. society and its complicated health care system. Many immigrants lack health insurance. But Marjorie Kagawa-Singer, a professor at the Fielding School who focuses on the delivery of care that appropriately considers a patient’s culture, notes that it’s more than just cost.

“If someone is new to this country, doesn’t speak the language and has to learn to navigate our system, it’s like plopping us in the middle of Siberia and expecting us to figure out what we need,” she said.

For example, many immigrants across the educational and cultural spectrum hold beliefs about disease and how the body works that diverge from the biomedical model practiced in the U.S., Kagawa-Singer added, and many health care practitioners are uneducated on those differences.

“When you have problems in both health literacy among patients and cultural competence among practitioners, you get this ‘perfect storm’ of people who will not be able to utilize the health care system even when it’s offered,” said Kagawa-Singer.

Since 2000, Kagawa-Singer has headed the Los Angeles site of the Asian American Network for Cancer Awareness, Research and Training, the first federally funded cancer prevention and control research initiative focusing on Asian Americans. In lectures and short courses on cultural competence, Kagawa-Singer advises health professionals to demonstrate their trustworthiness and compassion.

“It’s not the health problem you’re treating, it’s the person,” she said. “When patients recognize you’re making the effort and respecting their dignity, they’re going to be much more forgiving and willing to teach and learn.” The challenge, she noted, is that the U.S. health care system is designed for short encounters, despite the fact that it may take longer to get to know and understand patients from different backgrounds.

Adopting the American diet

Public health experts have postulated that immigrants decline in health as they assimilate and adopt the health habits of their new communities — including high-fat diets and processed foods, along with reduced physical activity. To some extent, though, that equation has changed with globalization of the food supply, said May C. Wang, a Fielding School professor who focuses on early childhood obesity.

“Most low-income countries now have access to the processed foods we’ve been eating for the past few decades,” Wang noted. But even when immigrants’ tastes are similar to those of non-immigrants, immigrants with minimal financial means face considerable challenges to eating well. “Education alone doesn’t work in a community that doesn’t have the ability to access healthy food,” Wang said. “And in the very poorest communities, trying to change the environment by placing healthier foods where people live, work and go to school is challenging.”

The problem is compounded for immigrant groups, she explained, because they tend to have fewer social ties, are constricted by language barriers and often lack the know-how to pursue resources that could help them.

Wang works closely with the Public Health Foundation Enterprises Women, Infants, and Children (WIC) Program, the largest local WIC agency in the country. It serves 300,000-plus families a year, the vast majority of them non-English-speaking immigrants. The overall childhood obesity rate has plateaued or declined in the U.S. in recent years, Wang noted, but the obesity rate among the mostly immigrant Latino children remains substantially higher than for other groups. Among the low-income, preschool-aged Latino children enrolled in L.A. County’s WIC program in 2011, nearly 22 percent were obese.

To better understand the impact of various strategies to improve diet and reduce early childhood obesity, said Wang, “We are examining the social and physical environments in which immigrants live and how these affect their ability to put into practice nutrition knowledge they acquire from participation in the WIC program.”

The work aligns with the University of California Global Food Initiative, which seeks to harness the resources of all 10 UC campuses to address a critical issue of our time: How to sustainably and nutritiously feed a world population expected to reach eight billion by 2025.

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UC Merced researchers delve into valley fever from all angles


Team working toward better treatments and perhaps a vaccine for ‘silent epidemic.’

Before it infects humans who breathe it in, the fungus that causes valley fever changes shapes in the environment. Once infected, some people fight it off while others die.

If scientists can determine how that shape-shift happens, they might be able to stop it, said professor Clarissa Nobile, one of a large, interdisciplinary team at UC Merced working to tackle the valley fever challenge from every imaginable angle.

If researchers can figure out why people react differently to the fungus, it could lead to better treatments, professor David Ojcius said.

Scientists know the fungus is distributed through dust, but if they can monitor levels in real time, they can build a warning system, professor Wei-Chun Chin said.

And if researchers can determine where at-risk groups get information, they can create social marketing campaigns that make sure that what people are hearing is accurate, visiting professor Carol Sipan said.

These four researchers have expertise in microbiology, immunology, bioengineering and public health. They’re part of the UC Merced team working toward better treatments and perhaps a vaccine for what the Centers for Disease Control calls a “silent epidemic.”

“We’re the glue that pulls this whole thing together,” said professor Paul Brown, director of UC Merced’s Health Sciences Research Institute.

The glue began to gel about a year after the institute was established. That’s when faculty members from all three of UC Merced’s schools came together to attack this potentially debilitating, but poorly understood, illness endemic to the San Joaquin Valley.

“We haven’t really had a research university in the region that could do this, that could pull it all together. We do now,” Brown said.

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Many seniors who fall repeatedly don’t seek medical attention


Study finds health care workers also often fail to counsel seniors on preventing future falls.

More than half a million older Californians — 12.6 percent of the state’s senior population — fall more than once a year, but nearly 60 percent of them fail to seek medical attention afterward, according to a new study by the UCLA Center for Health Policy Research.

The study also found that among those who did seek treatment, 40 percent did not receive counseling from a medical provider about how to prevent future falls.

Falls are the leading injury-related cause of death and need for medical care among Californians age 65 and older, according to the study. In 2012, more than 1,800 seniors died after falling and seniors’ fall-related injuries resulted in more than 72,000 hospitalizations.

“There is a cost in terms of both lives and resources when doctors fail to talk to seniors who have already fallen about how to prevent future falls,” said Steven Wallace, associate director of the Center for Health Policy Research and author of the study.

Using data from the 2011–12 California Health Interview Survey, the study found older seniors are twice as likely as younger seniors to have multiple falls: nearly 1 in 5 people 85 and older reported that they fell more than once a year, compared with 1 in 10 of those aged 65 to 74. Nearly a quarter of seniors who have suffered a stroke, and almost 20 percent of those with any disability, had multiple falls. Twenty-six percent of seniors with moderate mental impairment had multiple falls, as did 38 percent with severe mental impairment.

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Expanding palliative care in California could save billions of dollars


Berkeley Forum report highlights three programs that give patients greater choice of care.

Click image to view report

A report released today (Nov. 19) by the Berkeley Forum finds that California hospital spending could be reduced by billions of dollars over the next eight years if patients’ wishes about palliative care were honored.

The Berkeley Forum — a collaborative effort involving executive leadership of major health insurers, health care delivery systems and the state of California with health policy experts from the School of Public Health at UC Berkeley — previously issued a vision of increased choice and better value for patients nearing end of life.

The new report builds on that vision, highlighting three major programs that give patients in California greater choice of care outside the hospital. The programs’ interdisciplinary teams incorporate patient goals and wishes when planning treatment, resulting in patient-centered care that tends to move people out of intensive hospital settings and into care in the community.

“Our review shows that offering more choices to patients can not only increase satisfaction with care and improve outcomes, but also divert spending from expensive and unwanted services,” said Eric Kessell, policy director for the Berkeley Forum and lead author on the report.

The study also found that by expanding access to community-based palliative care to over 100,000 Californians a year through 2022, more than $5.5 billion could be moved from high-cost, unwanted hospital services while honoring patient wishes for care at home and in other community settings.

“The wishes of patients, their families and loved ones should be honored at the end of life,” said Richard Scheffler, co-chair of the Berkeley Forum. “Many of them do not want to die in a hospital. This report gives them other choices.”

In order to achieve this vision, conversations about palliative care will need to be incorporated throughout the health care delivery system, with increased use of nurse practitioners and other health care professionals, and a tripling of physicians certified in hospice and palliative medicine.

Stephen Shortell, chair of the Berkeley Forum, said, “The increased interest in palliative care is part of a larger movement toward greater patient and family engagement in all aspects of their care over the life course.”

“Expanding palliative care in California is the right thing to do on every level. It is what patients want, it improves outcomes, it lowers costs and most importantly provides compassionate relief to those suffering.”

— David Feinberg, president of the UCLA Health System, CEO of the UCLA Hospital System and UC Health’s representative on the Berkeley Forum

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Are children better off than they were 25 years ago?


UCLA publishes comprehensive analysis of children’s rights around the world.

Jody Heymann, UCLA

Twenty-five years ago this month, the countries that compose the United Nations reached a landmark agreement that laid the foundation for much-needed strengthening of children’s rights and protections in nearly every country around the world.

Today, the Convention on the Rights of the Child remains the only formal global effort to improve children’s rights and the most widely ratified human rights treaty in history. Only three U.N. member nations have not ratified the treaty: Somalia, South Sudan and the United States.

“The Convention on the Rights of the Child is a promise from our global community to all children,” said Dr. Jody Heymann, founding director of the World Policy Analysis Center and dean of the UCLA Fielding School of Public Health. “Everyone deserves to know whether their country is fulfilling that promise and how it compares to other countries facing similar opportunities and constraints.”

To mark the 25th anniversary of the CRC on Nov. 20, the center assessed 190 U.N. countries’ progress toward fulfilling the CRC’s commitment to children in critical areas such as the right to education, protection from child labor and child marriage, and discrimination of children with disabilities.

How are the world’s children faring?

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UCLA’s Healthy Campus Initiative helps inspire nationwide college program


Partnership for a Healthier America launches Healthier Campus Initiative.

An “instant recess” at UCLA dovetails with the Healthy Campus Initiative.

By Rebecca Kendall, UCLA

Less than two years after UCLA launched its groundbreaking Healthy Campus Initiative, a prominent organization is introducing a national health and wellness program for colleges and universities.

The Partnership for a Healthier America, which works with the private sector and Michelle Obama to make healthier choices easier, announced its Healthier Campus Initiative today (Nov. 16) in New Orleans at the American Public Health Association’s annual conference. UCLA is one of 20 colleges and universities that are part of the program, which will reach more than 500,000 students and 126,000 faculty and staff. UCLA is the only postsecondary institution in California that is participating.

According to the organization’s CEO, UCLA was one of the important inspirations for the program. “The Healthier Campus Initiative was born out of a collaboration between the Partnership for a Healthier America and the nation’s leading nutrition, physical activity and campus wellness experts, including leaders at UCLA,” said Lawrence Soler.

“Over the past few years, UCLA has become a leader in the movement to create a healthier environment for its students, faculty and staff, and this initiative would not have been possible without UCLA’s early insights, input and support.”

UCLA’s Healthy Campus Initiative is a campuswide effort that draws upon the campus’s world-renowned research and teaching to find new and innovative ways to promote healthy living at UCLA and share that education and research with other communities.

Each of the participating universities has pledged to adopt guidelines for food and nutrition, physical activity and programming over the next three years.

“The PHA agreement gives us an opportunity to help evaluate our progress toward our goals,” said Dr. Wendy Slusser, associate vice provost for the HCI and a clinical professor at the David Geffen School of Medicine at UCLA and the UCLA Fielding School of Public Health. “It will also introduce us to other university leaders across the U.S. and enhance our learning of best practices and our ability to leverage resources to promote health and wellness on our campuses and in our communities.”

Slusser attended the announcement joined by UCLA colleagues and philanthropist Jane Semel, who with her husband, Terry Semel, envisioned and supported UCLA’s Healthy Campus Initiative.

PHA’s Healthier Campus Initiative comprises 23 guidelines, many of which UCLA has already implemented as part of its campus mandate. Others were new initiatives prompted by PHA discussions. Among them are offering a minimum of one “wellness meal,” which meets nutritional guidelines set by PHA, at each mealtime; offering a minimum of five types of fruits, five types of vegetables and two 100 percent whole grain products at both lunch and dinner; and implementing a program at dining venues to encourage healthier food consumption.

UCLA has also moved to add more local and sustainable food as part of its commitment to the PHA program. Currently, UCLA serves 17 percent locally sourced food in its dining operations; the campus’s goal is to achieve 20 percent by 2020.

The focus on healthy, sustainable food at UCLA is in line with the University of California Global Food Initiative, which was also shaped in part by leaders of UCLA’s HCI. The systemwide initiative was introduced by UC President Janet Napolitano in July at an event held at UCLA’s student-run community garden.

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