CIRS Blog about Rural California

By Ron Shinkman

Amidst great uncertainty about federal health policy, Covered California announced Tuesday that insurance premiums on the state-run exchange will rise on average 12.5 percent next year, an increase that is slightly lower than in 2017. The agency reiterated that it has a containment plan should the Trump administration cease to provide cost-sharing subsidies for lower-income exchange enrollees.

All 11 insurers currently offering coverage on the state’ exchange will return in 2018, although Anthem Blue Cross will withdraw from Southern California.

The premium hike for 2018 is down from the 13.2 percent average increase for this year, but still much higher than the low single-digit rate hikes announced for 2015 and 2016.

Covered California Executive Director Peter V. Lee noted that if consumers shop around for different plans in each tier of coverage, they could keep their rate increases down to 3.3 percent.

“For consumers, no increase is a good increase, but Covered California did a good job in these uncertain times,” said Betsy Imholz, director of special projects for Consumers Union in San Francisco.

Imholz credited the exchange for taking a tough negotiating stance with the health insurers and ensuring that competition remains in place in most of the state. According to Lee, 82 percent of Covered California’s enrollees will have three or more health plans to choose from.    

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Changing Demographics

A Spring 2017 Washington Post survey found that rural Americans are uneasy about the changing demographics of the U.S. and believe their Christianity is under attack as the federal government caters to urban residents. For example, 42 percent of rural residents agree that immigrants are mostly a drain on the U.S., compared with 16 percent of urban residents. Two-thirds of rural residents say cracking down on illegal migrants would improve job prospects in their areas.

Rural was defined as non-metro counties and counties near population centers with up to 250,000 people, so that a quarter of Americans were considered rural in the poll. Pollsters say that the underlying issue is fairness, with rural residents skeptical of whom the federal government favors and helps.

Rural areas have had a weaker recovery from the 2008-09 recession than urban areas, and job growth has not returned to 2007 levels, prompting rural youth to leave for education and jobs and not return. A third of rural residents said that jobs and drug abuse were the biggest problems confronting their community, compared with 10 percent of urban residents.

The Wall Street Journal reported on May 26, 2017 that the total rural population declined in each of the past five years. Births in rural counties are declining, deaths are rising, and the median age of 41 is higher than the median 35 in large metro areas. Male labor force participation in rural counties is declining, and there are 60 disabled workers per 1,000 working age residents in rural counties, double the 30 per 1,000 rate in large metro areas.

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By Claudia Boyd-Barrett

The future is hot.

As climate change heats up the globe, Californians can expect to face longer and more extreme heat waves like the ones sweeping through parts of the state this summer, experts warn.

Seniors, who are more prone to heat stress than younger adults, will be among those most affected by rising temperatures. With the over-65 population projected to expand rapidly in the coming decades, the accompanying hotter weather could place an enormous burden on emergency and health care infrastructure.

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June 23, 2017

After reflecting on this topic, I realized that the best summary available is the paper which Profs. Marc B. Schenker and Stephen A. McCurdy wrote with Heather E. Riden and myself titled Improving the health of agricultural workers and their families in California: current status and policy recommendations, published by the University of California Global Health Institute in February 2015.

 

Instead, I’ve decided to focus today on how Marc’s leadership and influence broadened the scope of research at the California Institute for Rural Studies (CIRS). In turn, the ultimate impacts of CIRS became greater than any of us could have ever imagined.

 

Prof. Marc Schenker and I met for the first time on June 6, 1990, at a Conference on Health Concerns of Living and Working in Agricultural California, sponsored by UC Cooperative Extension and the School of Public Health, UC Berkeley. CIRS was asked to bring community folks to the conference as panelists to discuss specific topics of current concern, and, as well, contribute an overview presentation about rural California. CIRS arranged for farm worker advocates, leaders from predominantly Mexican-American rural areas, and staff of agencies providing health services for farm workers to participate in the conference.

 

As a few who are here today were aware in 1990, it was risky of Marc to seek to engage me in his new initiative. Some eleven years earlier, I was part of an effort led by California Rural Legal Assistance, inspired by the late Ralph Abascal, to sue the Regents of the University of California for ignoring the needs of a great many rural Californians, most importantly, farmworkers, but also small-scale producers, organic farmers and the rural poor. We were not seeking monetary damages, rather we wanted major changes this public institution’s priorities.

 

Although we prevailed in Alameda County Superior Court, the lawsuit was thrown out by the California State Supreme Court ten years later. But, from the filing of the lawsuit, very quietly, the University of California helped to start or support the Small Farm Center, the Sustainable Agriculture Research and Education Program, and the Student Experimental Farm. Moreover, the controversial Alternatives in Agriculture course, begun in 1977, was added to the formal curriculum of the College of Agriculture.

 

It was in this context that Marc’s invitation was most welcome. Bob Spear had let it be known that one of the purposes of the conference was to scope the possible creation of a Center for Agricultural Health and Safety at UC Davis as part of the newly authorized Agricultural Worker Safety program of the National Institute for Occupational Safety and Health. After the conference, Marc asked CIRS to become a coinvestigator of the new Center and prepare a research proposal as part of his grant proposal for which he was Principal Investigator.

 

Quite frankly, in 1990, I could never have imagined what the relationship with Marc’s initiative would eventually yield. When the first NIOSH grant was awarded to the Western Center for Agricultural Health and Safety, in one of the very first discussions with him, we agreed to collaborate in undertaking a population-based survey of farmworker health that would include a modest physical examination.

 

We approach a farmworker clinic in Parlier, a well-known farmworker community. Joined by a few folks from Marc’s research group, and by Dave Runsten from the CIRS staff, we went to Parlier where Arcadio Viveros, Executive Director of the United Health Centers clinic, and Mayor of Parlier, welcomed us and agreed to cooperate.

I clearly recall one of the first comments Marc made to me about our work.

 

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Water

The California Department of Water Resources reported in April 2017 that 90 inches of precipitation fell in the northern Sierra mountains, breaking the previous record set in 1982-83. California has one of the most variable climates in North America.

Most precipitation occurs during the winter months, and melting snow is moved from mountains in the north to farmers and urban consumers in the center and southern parts of the state via a system of dams and canals. The Sierra Nevada snowpack usually provides a third of the state's water supply.

Governor Jerry Brown proposed to move water around the environmentally sensitive Delta where the Sacramento and San Joaquin rivers empty into the San Francisco Bay by building twin tunnels expected to cost $16 billion. The California WaterFix is controversial, generally opposed by Delta residents and farmers. The water agencies south of the Delta are expected to decide by September 2017 whether they will help to pay for the project to move water around the Delta to pumps near Tracy.

Cadiz Inc owns about 50 square miles of land above a major aquifer in the Cadiz Valley, and wants to sell the water to southern California cities. The Mojave Desert Land Trust and most environmentalists oppose the project, but the Trump administration appears to favor allowing Cadiz to pump 50,000 acre feet of water a year from the aquifer.

California's fire season began in July 2017, with major fires around the state burning the grasses and shrubs that resulted from the record rainfall of 2016-17.

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