How Has Access to Care for Medi-Cal Enrollees Fared Relative to Employer-Sponsored Insurance 4 Years After the Affordable Care Act Expansion?

Background: The number of Californians covered by Medi-Cal increased more than 50% between 2013 and 2018, largely due to expansion under the Affordable Care Act (ACA). This rapid expansion of Medicaid rolls prompted concerns that Medi-Cal enrollees would face greater difficulty accessing health care.

Objective: Examine whether gaps in access to care between Medi-Cal and employer-sponsored insurance (ESI) present in 2013 (prior to ACA implementation) had changed by 2018 (several years post implementation).

Civic Engagement Among California High School Teens.

This policy brief describes civic engagement among California adolescents in high school. Using data from the California Health Interview Survey (CHIS), the study found that the most common civic engagement activity among California high school teens is volunteering. Latino teens and those from low-income families have lower rates of civic engagement.

Disparities in Health Care Access and Health Among Lesbians, Gay Men, and Bisexuals in California.

This policy brief examines differences in health care access, health behaviors, and health outcomes by sexual orientation among California adults. Using data from the California Health Interview Survey, the study finds that although lesbian, gay, and bisexual women and men have similar or better rates of insurance coverage compared to straight women and men, they are more likely to experience delays in getting needed health care. Lesbians, bisexual women, and bisexual men have higher rates of smoking and binge drinking than straight women and men; however, gay men are less likely to consume sugary beverages and to be physically inactive.

Few California Children and Adolescents Meet Physical Activity Guidelines.

This policy brief describes physical activity among California children and adolescents. Using data from the California Health Interview Survey (CHIS), the study found that only 31 percent of children ages 5-11 and 18 percent of adolescents ages 12-17 meet the physical activity guidelines of engaging in at least one hour of physical activity every day. Neighborhood characteristics, including safety and proximity to parks, are related to physical activity levels among youth.

Walking Among California Adults.

This policy brief describes two types of walking among California adults: walking for transportation and walking for leisure. Using data from the 2013-14 California Health Interview Survey, the study found that the prevalence of both types of walking has increased since 2003. The prevalence of walking for both transportation and leisure varies with age, income, race/ethnicity, and neighborhood safety and cohesion.

Sugary Beverage Consumption Among California Children and Adolescents.

This policy brief examines patterns of sugary beverage consumption among children and adolescents in California. Using data from the California Health Interview Survey (CHIS), this study found that while sugary beverage consumption decreased among adolescents ages 12-17 between 2011-12 and 2013-14, it increased among children under age 12 between 2009 and 2013-14. The trend among children under age 12 may be attributed to a shift in sugary beverage consumption from soda to sports and energy drinks.

Exploring the differences between pet and non-pet owners: Implications for human-animal interaction research and policy.

There is conflicting evidence about whether living with pets results in better mental and physical health outcomes, with the majority of the empirical research evidence being inconclusive due to methodological limitations. We briefly review the research evidence, including the hypothesized mechanisms through which pet ownership may influence health outcomes. This study examines how pet and non-pet owners differ across a variety of socio-demographic and health measures, which has implications for the proper interpretation of a large number of correlational studies that attempt to draw causal attributions.

Prediabetes in California: Nearly Half of California Adults on Path to Diabetes.

In California, more than 13 million adults (46 percent of all adults in the state) are estimated to have prediabetes or undiagnosed diabetes. An additional 2.5 million adults have diagnosed diabetes.

Lunchtime School Water Availability and Water Consumption Among California Adolescents.

Purpose: To examine the potential impact of California SB 1413, which required school districts to provide free, fresh drinking water during mealtimes in food service areas by July 1, 2011, on greater water consumption among California adolescents.

Methods: Data were drawn from the 2012 and 2013 state-representative California Health Interview Survey. A total of 2,665 adolescents aged 12-17 years were interviewed regarding their water consumption and availability of free water during lunchtime at their school.

Role models and social supports related to adolescent physical activity and overweight/obesity.

Positive role models, social and community activities, and school support are protective social factors that promote youth health and well-being. Latino, African-American, Asian, multi-racial, and low-income adolescents are less likely to experience these protective social factors compared to other groups, which may contribute to health disparities. Adolescents who identify a role model, volunteer, participate in organizations outside of school, or experience high levels of teacher or other adult support at school engage in greater physical activity and are more likely to have a healthy weight.

Neighborhood, family and individual characteristics related to adolescent park-based physical activity.

Background: Local parks are an important community resource that may influence levels of physical activity among youth. However, few population-based studies have investigated park-based physical activity among youth.

Purpose: This study examines sociodemographic, family, and neighborhood characteristics associated with park-based physical activity among adolescents.

School-based program options to promote physical activity: a response.

This commentary is a response to PM-14-1065R1 and addresses issues raised regarding research presented in PM-14-443.

How can schools help youth increase physical activity? An economic analysis comparing school-based programs.

Objective: For optimal health, physical activity should be an integral and routine part of daily life. Youth spend a significant amount of time at school yet rarely achieve the recommended 60 min of moderate and vigorous physical activity in physical education (PE) classes or recess. This study assessed the following types of school-based opportunities to improve physical activity for youth: after-school programs, before-school programs, PE classes, extended-day PE, and short physical activity breaks during the school day.

Diabetes tied to a third of California hospital stays, driving health care costs higher.

Increasing diabetes prevalence has been found to be a primary driver of increased health care costs in the United States. This policy brief examines the impact of diabetes on hospitalizations and related hospitalization costs in California. Using 2011 hospital patient discharge data and annual financial data from the Office of Statewide Health Planning and Development (OSHPD), this study found that patients with diabetes represented 31 percent of hospitalizations in California in 2011 among patients 35 years or older, including 39 percent of African-American and Asian-American patients and 43 percent of Latino patients.

Physical activity, park access, and park use among California adolescents.

In California, 2.15 million adolescents (62.9%) do not engage in at least 60 minutes of physical activity five or more days per week.

Adolescent sedentary behaviors: correlates differ for television viewing and computer use.

Purpose: Sedentary behavior is associated with obesity in youth. Understanding correlates of specific sedentary behaviors can inform the development of interventions to reduce sedentary time. The current research examines correlates of leisure computer use and television viewing among adolescents in California.

Asthma-related school absenteeism and school concentration of low-income students in California.

Introduction: Asthma is one of the leading causes of school absenteeism. Previous studies have shown that school absenteeism is related to family income of individual students. However, there is little research examining whether school absenteeism is related to school-level concentration of low-income students, independent of family income.

Food environments near home and school related to consumption of soda and fast food.

In California, more than 2 million adolescents (58%) drink soda or other sugar-sweetened beverages every day, and more than 1.6 million adolescents (46%) eat fast food at least twice a week. Adolescents who live and go to school in areas with more fast food restaurants and convenience stores than healthier food outlets such as grocery stores are more likely to consume soda and fast food than teens who live and go to school in areas with healthier food environments.

Adolescent physical education and physical activity in California.

In California, more than 1.3 million adolescents (38%) do not participate in physical education (PE) at school, and this rate increases dramatically with age, from just 5% at age 12 to 77% at age 17. In addition, only 19% of teens meet current physical activity recommendations.

The unusually poor physical health status of Cambodian refugees two decades after resettlement.

To better document the health status of Cambodian refugees, the physical health functioning, disability, and general health status of Cambodian refugees was compared to that of non-refugee Asian immigrants with similar demographic characteristics. Data were collected between October 2003 and February 2005, from 490 face-to-face interviews conducted with a stratified probability sample of households from the Cambodian community in Long Beach, California. Data on the health status of the general adult population (n = 56,270) was taken from the California Health Interview Survey, a telephone interview of a representative sample California residents.

Income disparities in obesity trends among California adolescents.

Objectives: We assessed income-specific trends in obesity rates among a diverse population of California adolescents.

Methods: We used data from 17,535 adolescents who responded to the California Health Interview Survey between 2001 and 2007 to examine disparities in obesity prevalence by family income and gender.

Results: Between 2001 and 2007, obesity prevalence significantly increased among lower-income adolescents but showed no statistically significant differences among higher-income adolescents after adjustment for age, gender, and race/ethnicity.

Obesity and diabetes: two growing epidemics in California.

The prevalence of both diabetes and obesity has grown significantly in California. Six million adults are obese and an additional 9.3 million are overweight.

Bubbling over: soda consumption and its link to obesity in California.

Background The prevalence of overweight and obesity has increased dramatically in both adults and children in the last three decades in the n California, 62% of adolescents ages 12-17 and 41% of children ages 2-11 drink at least one soda or other sweetened beverage every day. In addition, 24% of adults drink at least one soda or other sweetened beverage on an average day. Adults who drink soda occasionally (not every day) are 15% more likely to be overweight or obese, and adults who drink one or more sodas per day are 27% more likely to be overweight or obese than adults who do not drink soda, even when adjusting for poverty status and race/ethnicity.