Public breastfeeding legal but stigmatized – National Consumers League

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Written by NCL Intern Trang Nguyen

Breastfeeding has long been hailed as the best source of food for infants, providing the perfect mix of nutrition in an easily digestible form and lowering the risk of certain syndromes, diseases, and allergies.

For the mother, breastfeeding reduces uterine bleeding after birth, lowers the risk of breast and ovarian cancer, and helps moms lose their pregnancy weight faster. With those significant advantages, it is no wonder that organizations dedicated to maternal and children’s health and wellness recommend breastfeeding exclusively for the first 6 months, and supplemented with other sources of nutrition for at least 12 months and up to 2 years of age and even beyond. Health experts estimate that if new mothers exclusively breastfeed for at least six months, the U.S. would save $13 billion in healthcare and other costs each year. With those incredible benefits, over the last 25 years, the Surgeons General of the United States have been calling for greater incentives to protect and promote breastfeeding. As a society, we need to do all we can to create an environment in which women feel safe and comfortable breastfeeding.

In the United States, 81.1 percent of mothers begin breastfeeding their babies at birth. Yet, only half of the babies are still breastfed at 6 months of age and roughly 30 percent by 12 months. The fall-off is understandable, given the sadly negative feelings too many Americans attach to breastfeeding in public – ALERT: breastfeeding mothers are just feeding their babies, not engaging in a sexual act! Sadly, many mothers are more likely to stop breastfeeding if it means they can socialize outside of the home without fear of hiding in public bathrooms to feed their children.

Breastfeeding should be welcomed and encouraged in public spaces. We need to encourage mothers to do what is best for their babies by making sure infants continue to be breastfed for the recommended optimal time period. It is a fundamental part of sustaining a new life. Indeed, most mothers make every effort to be discreet. Unfortunately, many mothers are still facing discrimination and harassment for breastfeeding in public.

State and federal laws are lacking in protecting breastfeeding mothers. While 49 states already recognize the importance of breastfeeding and have laws explicitly allowing women to breastfeed in any public and private location where the mother can legally be present (e.g., Massachusetts allows breastfeeding in any place open to the general public such as a park or theater), new moms’ rights are often violated when they are asked to stop or relocate, and they have no recourse. In recent years, there have been far too many incidents of breastfeeding mothers being asked to leave places like a Springfield church, Nordstrom bathroom, courtroom, Target store, and many others, despite the fact they were not doing anything illegal.

Furthermore, only 29 states exempt breastfeeding from public indecency, which means even in states that recognize mothers’ rights to nurse in public, they can still be prosecuted for public indecency. In 2003, Jacqueline Mercado was arrested and temporarily lost custody of her children because she was photographed breastfeeding her 1-year-old. She was prosecuted for “sexual performance of a child,” a second-degree felony punishable by up to 20 years in prison. It took her six months to get the charges dropped and resume her children’s custody. This incident happened in Texas, where “a mother [has been] entitled to breast-feed her baby in any location in which the mother is authorized to be” since 1995.

There are also countless examples of nursing mothers being asked to relocate despite the property having no policies against public breastfeeding. In 2013, Amber Hinds was asked by a lifeguard to relocate herself to the locker room when she was breastfeeding in the county pool. She later called the pool manager and found out they were aware of the Wyoming state law protecting a woman’s right to breastfeed and had no policy against breastfeeding.

Nursing mothers even have to put up with derogatory and humiliating comments from their colleagues and employers when they pump breastmilk in the workplace despite the protection of the law. In 2010, the Affordable Care Act (ACA), Section 4207 amended The Fair Labor Standards Act (FLSA) of 1938 (29 U.S. Code 207) to specify that a mother has the right to take reasonable break time to express breast milk at work for one year after childbirth. Employers must also provide a private space, other than a toilet stall, for that employee to express breast milk. In spite of the benefits nursing has to businesses, including reducing the time a mother may miss work because of baby-related illnesses and encouraging her to come back to work earlier after birth because she is less concern about the effect it would have on the nursing relationship, we still hear heartbreaking stories of how nursing employees are not supported in the workplace. The Washington Post recently shared tales of how women have to pump milk in ant and roach-infested storage rooms, or have the CEO announce everyone of her pumping by playing Joe Budden’s Pump It Up. Under such stress and lack of support, many working mothers, like officer Victoria Clark, had no other choice but to stop breastfeeding altogether.

Incidents like this show that there is still much to do to protect the rights of nursing mothers. States need to revise their laws, adding legal remedies and removing public breastfeeding from the public indecency list. Meanwhile, public accommodations need to better train their staffs on policies and state laws that protect the rights of mothers to breastfeed in public. Even if this is merely a mistake on the staff’s part, and does not reflect the view of the property or the managing board, it can still leave detrimental consequences for new and inexperienced mothers. Mothers who have been yelled at or singled out in public might feel ashamed of breastfeeding in public and might abandon doing so altogether. Overall, we need to improve the public’s perception of breastfeeding so that nursing mothers will not have to go through emotional stress and abuse to feed their children.

As many women and men continue to fight for the right to breastfeed in public, mothers might equip themselves by better understanding state laws on public breastfeeding at https://www.ncsl.org/research/health/breastfeeding-state-laws.aspx and feeling empowered to state their right to be free of any harassment or discrimination they might face for breastfeeding in public. Even if the law has no enforcement mechanism, it is helpful for breastfeeding mothers to cite their rights when making complaints, calling for support, or contacting legislators.

Health savings accounts: dubious benefits for the wealthy, disastrous for the rest of us – National Consumers League

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Spotlight on Health Care Series, Part 3: As America’s health care system is facing uncertainty, NCL staff is exploring the topic in a new weekly blog series.

The failure to successfully repeal and replace the Affordable Care Act (ACA), if nothing else, exposed a Republican party divided (perhaps irreparably so) on how to reform America’s healthcare system. Despite the GOP’s devastating legislative defeat, we should not underestimate their determination to resuscitate their repeal/replace efforts. 

It’s clear there aren’t too many things the party as a whole agrees on these days, particularly surrounding healthcare, but there are a few ideas that are likely to re-appear in future attempts at healthcare reform. One of those ideas is the expansion of health savings accounts (HSAs). The American Health Care Act (AHCA) was a huge endorsement of HSAs, expanding Americans’ latitude to use them as a primary means to cover their health expenses. 

Under current law, HSAs are married to high deductible health insurance plans (HDHPs). HSAs supplement HDHPs by allowing consumers to set aside funds to pay for out-of-pocket medical expenses. Despite the high deductible, HDHPs are attractive to many consumers as premiums are typically much lower than those of traditional plans. Another draw of HSAs is the tax advantage; the money you contribute is untaxed, the money grows tax-free, and you pay no taxes if/when you take the money out, as long as it’s used on health expenses. Even so, the long-term benefits of HSA-driven healthcare are dubious at best, even for the wealthy who can afford to take full advantage of these accounts. For the rest of us, it could be a disaster.

The healthcare landscape in a system dominated by HSA supplemented-high deductible health plans would be drastically different than that under the Affordable Care Act. The ACA was designed to ensure healthcare for all Americans- and not just access to care, but quality health coverage. The law requires that insurers cover a wide range of benefits, from preventive services to maternity coverage to mental health. Republicans argue that mandating these benefits drives up costs, so they propose skinnier benefit packages to lower premiums and increase “access.” Proponents of HSAs submit that putting more of consumers’ skin in the game will compel them to shop for cheaper care since they are spending their own money rather than an insurer’s. The idea is that this will drive down health care costs, all while bolstering competition in the marketplace and increasing consumers’ flexibility to choose the care they want. Too bad this lofty goal isn’t bound to reality. 

The fact of the matter is that HSAs have not been and will not be a feasible means to achieving health care for all. HSAs tend to benefit the wealthy, as those with lower incomes often have minimal, if any, disposable income to set aside in a savings account. In fact, a 2015 study found that people from high-income households were not only significantly more likely to have an HSA, but more likely to max out their contributions than people from low-income households. Considering that nearly half of Americans can’t come up with $400 to cover an emergency expense, we can hardly expect most Americans to have the ability to come up with cash to meet a high deductible. Even the wealthiest among us could go broke should a costly medical emergency occur. Moreover, the idea that HSAs afford consumers more flexibility is misleading — the real flexibility most Americans will have is deciding which health services they will have to forego. Studies have shown that even those who are able to contribute nominally to their accounts ultimately reduce the amount of care they seek, rather than shopping around for cheaper prices. Patients especially avoid things like filling their prescriptions, or proactively seeking preventive care that can mitigate health risks down the line. While the primary goal of the Republicans may be to reduce health care costs, we cannot sacrifice the well-being of the American people in those efforts.

President Trump called on Congress to create a “better healthcare system for all Americans,” however much of what he and his party have put forth only creates a better system for a fortunate few. HSAs are most valuable to those who earn the most and have the most to gain – it is not a solution that works for everyone. We cannot stand for higher cost burdens and coverage cuts across the board, only to give another tax break to the wealthy, and we must not let the Republicans shift us towards a system that will leave millions of low-income and middle-class Americans behind. While the future healthcare landscape is anything but certain, we would all be well served to stay clear-sighted about what could still lie ahead.

Fighting penny soda tax gets pricey – National Consumers League

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Sally GreenbergEditor’s note: The measures discussed in this piece were approved on Election Day, 2016.

It’s hard to believe that corporate America would throw so much money fighting a penny-per-ounce tax on sodas, but that is exactly what’s happening in San Francisco and Oakland. The soft drink industry has thrown $50 million in efforts to fight this tax on sugar-sweetened drinks.

Sweetened beverages have been tied to diabetes, obesity, and tooth decay. Public health experts see measures to raise prices as a way to drive down consumption, which is the last thing Big Soda would want to promote.

These soda tax measures are proliferating. In June, Philadelphia adopted a soda tax, beating back a $10 million industry campaign petitioning it. Berkeley, CA passed its own tax two years ago. Boulder, CO is voting on a 2 cent tax today, and three California cities (San Francisco, Oakland, and Albany) will also have a sugary drink tax on the ballot. This is all happening as consumption of soda is slipping nationally.

These measures are similar: they would impose a tax of a penny per ounce on any drink with added sweetener, including soft drinks, iced teas, and smoothies. The taxes would be imposed on beverage distributors, not at checkout. Evidence from current soda taxes suggests price increases will be passed through to retailers, and, according to the New York Times, the price of a 2-liter bottle might increase 67 cents and a 12-pack of sodas would go up $1.44.

If the soda tax can achieve its dual goal: reducing consumption of sweetened drinks and using the proceeds for community and health initiatives, then this will be a success. NCL supports these efforts, and we wait eagerly to see whether both of these laudable goals will be achieved.

Preventive care benefits: Your health plan’s best kept secret – National Consumers League

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To those who may question the necessity of health insurance, I have two words for you: Preventive care. Seven out of ten deaths among Americans each year are from chronic diseases, many of which are preventable. Preventive health services like physicals, immunizations and other screenings can help find health problems early, when the chances for treatment and cure are better, or even prevent health problems before they start. 

Preventive health services are covered under all health insurance plans with no additional out-of-pocket costs when provided by in-network providers. Your health insurance plan may cover even more services that cost you nothing – to find out more, be sure to contact your health plan.

Unfortunately, many consumers with health insurance don’t take advantage of these services – simply because they don’t know their insurance covers it.  That’s a problem we’re working hard to resolve.

Below we list some of the preventive care benefits available through your health plan: 

For adults:

Immunizations (Vaccines)

It is important for adults to stay up to date on their immunizations.  They can save your life and save your health.  Through your health plan, vaccines for diseases such as chicken pox, tetanus, diphtheria, and pertussis, hepatitis A & B, and the flu are all covered. 

Depression screenings

Too many people suffer from mental health conditions, such as depression, and the consequences can be devastating on individuals and families alike. Taking a depression screening is one of the most efficient and effective ways to determine whether you are experiencing symptoms of depression and get you on the path to treatment. Depression screenings are fully covered by your health plan. 

Cancer screenings

Nearly everyone has felt the impact of cancer – either themselves or a friend or loved one.  Screenings are one of the most powerful weapons against cancer. When many cancers are found early, chances of survival increase exponentially. Important preventive cancer screenings include cervical cancer screening, breast cancer mammography screening, and colorectal cancer screening. Lung cancer screening is also covered for adults aged 55-80 who are current smokers or have quit smoking in the last 15 years. 

For women:

Well-woman visits

Well-woman visits are key to women’s health and help identify health concerns before they become life-threatening. These visits usually include your annual physical examination, as well as any necessary screenings (such as pap tests, blood pressure and cholesterol screenings), evaluations, counseling, and immunizations based on your age and risk factors. 

Services for pregnant women or women who may become pregnant

In addition to the preventive services available to all women, there is also a list of services available for mothers-to-be. Breastfeeding support and counseling, gestational diabetes screenings, anemia screenings, and even folic acid supplements for women who may become pregnant are all covered under your health plan – at no additional cost to you. 

For children:

Autism screenings

The American Academy of Pediatrics recommends that children are screened for autism at their 18- and 24-month well-child visits. This type of screening can quickly identify children with developmental and behavioral challenges when early treatment may be most effective. 

Vision screenings

Good vision is essential to a child’s development, success, and overall well-being. Their vision should be checked when they are first born, while they are a baby, and through their preschool and school years. If problems with a child’s vision are not detected early, their vision may become limited in ways that cannot be rectified later in life. And it can also affect school performance and learning.  But with early detection, it is usually possible to treat vision problems effectively. Thankfully, vision screenings for all children are covered through your health plan. 

Be on the lookout for new resources from the National Consumers League (NCL) and America’s Health Insurance Plans (AHIP) to help consumers get the most out of their health insurance benefits.

What you need to know about your health insurance benefits – National Consumers League

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stethoscope_heart_92.jpgIt’s no secret that choosing a health insurance plan isn’t as easy as ordering at a restaurant. Even after purchasing a plan, actually understanding what exactly you’ve purchased is yet another stressful task. Health insurance can confuse even the savviest consumers. Read on for a few tips every consumer should know when it comes to health insurance benefits.


Your health plan most likely offers essential health benefits.

All plans purchased through the Affordable Care Act (ACA) marketplace and the majority of health plans provided by employers are required to provide a core group of medical services called essential health benefits. These services include:

  • Ambulatory patient services
  • Emergency services
  • Hospitalization
  • Pregnancy, maternity, and newborn care 
  • Mental health and substance use disorder services, including behavioral health treatment
  • Prescription drugs
  • Rehabilitative and habilitative services and devices
  • Laboratory services
  • Preventive and wellness services and chronic disease management
  • Pediatric services, including oral and vision care

To find the full list of services your plan covers and how much those services cost, check your Summary of Benefits and Coverage (SBC). You can request a copy of this document through your insurance company or access it via your online account through your insurance provider’s website.

Staying in network will save you money.

Visits to health care providers or facilities within your plan’s network are generally much cheaper than visits to out-of-network providers or facilities. The type of insurance policy you have plays a role in who participates in your plan’s network and how much you will pay if you choose to visit an out-of-network provider not covered by your plan. For example, HMO (Health Maintenance Organization) plans require you to select one primary care physician who will coordinate all of your health care services. With this plan, out-of-network providers are typically not covered at all, expect for true medical emergencies.

On the other hand, PPO (Preferred Provider Organization) plans allow you to visit any provider or specialist, in-network or out-of-network, and without a referral. Though your PPO plan may cover your out-of-network visit, you will pay more out-of-pocket for those services. Regardless of the type of plan you enroll in, be mindful of the providers in your network, as it can have a huge effect on your out-of-pocket costs.

All qualified health plans have cost-sharing limits.

All qualified health plans have an out-of-pocket maximum, which is the most you have to pay personally for covered services over the course of a year. All the money you pay for your deductible, coinsurance, and copays (but not premiums) goes toward your out-of-pocket maximum. Once you reach this limit, your insurance plan pays 100 percent for all covered medical services. Understanding how all potential out-of-pocket costs work together can be a little complicated, so here’s an example:

  • Suppose you are in a serious accident and have acquired $30,000 in medical expenses. Your health insurance plan offers a $2,000 deductible, 20 percent coinsurance, and a $5,000 out-of-pocket maximum for the year.
  • You would first be responsible for paying your deductible ($2,000).
  • After paying your deductible, you are responsible for your 20 percent coinsurance on the remaining $28,000 until you reach your out-of-pocket maximum.
  • Since 20 percent of $28,000 is $5,600, you would only be responsible for paying an additional $3,000 since your out-of-pocket maximum is $5,000. Your insurance plan would then pay 100 percent for all covered medical services thereafter.   

Be on the lookout for new resources from the National Consumers League (NCL) and America’s Health Insurance Plans (AHIP) to help consumers choose and get the most out of their health insurance benefits.

Five commonly asked consumer health insurance questions – National Consumers League

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doctor_patient_crop.jpgWith the Affordable Care Act (ACA) becoming law in 2010, more Americans now have access to health care coverage than ever before. However, many consumers are still puzzled about how to select a plan, what services are covered, or why they need health insurance altogether. If health insurance talk leaves you disillusioned or just plain confused, don’t give up. Below, we answer five of the most commonly asked consumer questions about health insurance. 

Why do I need health insurance?

It is in your best interest to have some form of health insurance. Why, you ask?

  • To protect your health
    While you may seem perfectly healthy now, sudden injuries or illnesses can occur in an instant. Without health insurance, you could be faced with thousands of dollars in medical costs, which could pose a significant financial burden well into the future. With health insurance, you also have access to preventive services such as physicals, immunizations, and other screenings that can help prevent diseases and identify problems earlier when they are easier to treat.
  • It’s required by law  
    Under the ACA, individuals are required to have health insurance (unless you qualify for an exemption). If you choose not to enroll, you will have to pay a tax penalty. 

How do I know what type of insurance plan is right for me and my family?

When shopping for a health insurance plan, here are some things to take into consideration:

  • Premiums: Each health insurance plan has a monthly premium that you must pay to maintain your coverage.  
  • Coverage/access to providers: Every plan has a different set of services, prescription drugs, and doctors that it agrees to cover. Every plan also uses a specific network of hospitals and health care providers to facilitate your care. Before choosing a plan, check that the services and prescription drugs you need are covered, and ensure that your current providers are within your plan’s network to avoid incurring additional costs down the line. 
  • Out-of-pocket costs: Out-of-pocket costs are health care expenses  you must pay yourself and that are not reimbursed by your insurance plan.

 Copayment, deductibles, coinsurance … What’s the difference?

  • A copayment or “copay” is a fixed amount ($10, for example) that you pay each time you visit a health care provider or fill a prescription.
  • A deductible is the amount you are responsible for paying for covered medical services before your health insurance plan starts to pay for covered medical expenses.
  • Coinsurance is usually a percentage of a total bill that you are responsible for paying after you’ve paid your deductible (for example, you pay 20 percent and your plan pays 80 percent). 

What is a health savings account, and what can I use those funds for?                                                                         

Health savings accounts (HSA) allow you to deposit pre-tax funds to pay for qualified medical expenses. They are typically combined with qualifying high-deductible health plans (HDHP). While HSA funds cannot be used to pay for monthly premiums, HSA-eligible HDHPs are attractive to many consumers because the premiums are generally lower. HSA funds can be used as needed to pay for prescription drug costs and fees such as copays, deductibles, and coinsurance. Learn more about health savings accounts here.

If my insurance company denies coverage for a service, is there anything I can do? 

If your insurance company does not authorize payment for a medical service, you have the right to appeal that decision. Before sending an appeal, carefully review your health coverage and the correspondence from your insurance company. Have copies of your medical records, letters from your providers, and any other pertinent information that supports your appeal. If your plan still denies payment of your claim after your initial appeal, you may opt for an external review conducted by an independent third party.

To answer questions like these, the National Consumers League (NCL) and America’s Health Insurance Plans (AHIP) are teaming up to provide consumers with even more helpful information about how to choose and use health insurance benefits.

 

 

From patient To consumer: Reimagining health care from a consumer perspective – National Consumers League

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family-on-bikes.jpgThe following Huffington Post op-ed was published August 18, co-authored by NCL’s Sally Greenberg and Marilyn Tavenner, the President and CEO of America’s Health Insurance Plans.

Navigating our health care system is no easy task. For decades, consumers have been forced to contend with a fragmented health system that makes decision making an all-consuming challenge. Whether it’s choosing a provider, knowing where to get information about cost or quality of doctors, or understanding a dictionary of complex health care terms, many consumers often feel left to fend for themselves in a system that is working against them.

For many individuals, it’s hard to know where to start. A recent state analysis by Rice University in Texas found that 42 percent of consumers who bought their own insurance felt like they lacked a clear understanding of their health insurance plans. Nearly a quarter of those surveyed who had employer-sponsored coverage still struggled with understanding their benefits.

We need to find a way to change this. While we all recognize the seismic shift underway as the age of consumerism in health care finally takes hold, we have to ask ourselves if we are truly practicing what we preach. We all have a responsibility to provide consumers with the transparent, actionable information they need to make smart choices about their care.

The good news is that online and mobile apps are making it increasingly easy for consumers to access information on their own time and with relative simplicity. Health plans have rolled out provider cost and quality calculators, and websites like FAIR Health make it possible for patients to see what a typical doctor’s visit or MRI will cost before they even walk into a provider’s office.

But even with this push towards more available data, we know that individuals and families still struggle when it comes to understanding and using their insurance benefits. Commonly searched online terms around insurance include, “what are deductibles?”, “finding a doctor,” and “how much will I pay in premiums?” Consumers are clearly telegraphing the need for simple, easy-to-understand information about their coverage.

Recently, our two organizations came together to compare notes on how we could collaborate to improve consumers’ health care experience. As a first step, we agreed that while there is a wealth of information in the market available for consumers, it is often poorly organized, out-of-date, or like the health care system itself, requires consumers to search multiple places for the information they need. Our first joint project will bring critical information together and present it in ways that are useful for consumers. We will rely on AHIP’s considerable knowledge of health insurance and NCL’s more than 100 years of consumer education to make information accessible, understandable, and actionable.

Our work builds upon what we have learned over the past several years on the frontlines of this health care transformation. A recent report from McKinsey found that although consumers are beginning to research their health plan choices, many of them are not yet aware of key factors they should consider before selecting coverage, such as the type of health plan and provider network, level of coverage, premiums, cost-sharing, covered services, drug formularies and tiers, and health status and anticipated utilization. Even once they have their insurance plan, many consumers may not be aware of all the benefits that are included, including free preventive services, disease management programs, fitness plans – and equally important, the tools they have available to get the best value for their health care dollars.

As consumers prepare for the upcoming open enrollment periods for Medicare and the Exchanges, AHIP and NCL will share new consumer resources and information answering some of the important questions about insurance coverage and health care ranging from how to choose a health plan to how to choose a doctor, as well as consumers’ rights if they feel they’ve been inappropriately denied a product or service that should be covered by their plan.

We know that health care isn’t always simple, but if we are to be successful in moving towards a patient-centered health system, we have to start by making health care information more accessible and usable for consumers. While this partnership is a first step, our hope is that our combined efforts will encourage and support the important work underway to improve consumers’ experience with the health system and the wellbeing of the country as a whole.

This article originally appeared in the Huffington Post.

Chipotle’s misdirected food safety efforts – National Consumers League

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92_chipotle_stock_photo.jpgBy Ali Schklair, Linda Golodner Food Safety & Nutrition Fellow 

Back in August, Chipotle launched its ‘G-M-Over it’ campaign. In the name of food safety, it pledged to eliminate all genetically modified ingredients from its food supply. But the hype didn’t last long. By September, Chipotle was facing a class-action lawsuit challenging the validity of their GMO ban. Plaintiffs argued that the meat and dairy products served at the chain come from animals that feed on GMO corn and soy, not to mention the corn syrup used in Chipotle’s juices and soft drinks.

Fast-forward to December, and Chipotle was being linked to numerous foodborne illness outbreaks. Over a six-month period, 500 people were sickened and 20 were hospitalized from norovirus, salmonella, or one of two different strains of E. coli. 2016 isn’t looking much better for Chipotle. A federal grand jury has served the company with a subpoena asking for documents relating to the norovirus outbreak at a Simi Valley, CA location. At this point, it is safe to say that Chipotle has greatly misdirected its food safety efforts.

Outbreaks at restaurants are serious. In 1993 an E. Coli outbreak at the fast food restaurant Jack In The Box infected 732 people. The bacterium originated from undercooked beef patties in hamburgers. The outbreak involved 73 Jack In The Box restaurants in California, Idaho, Washington, and Nevada and has been described as “far and away the most infamous food poison outbreak in contemporary history.” Four children died, and 178 other victims were left with permanent injury, including kidney and brain damage. The FDA implemented new guidelines and regulations after the Jack In The Box tragedy, including setting temperatures for cooking beef to destroy pathogens.

The Centers for Disease Control (CDC) estimates that approximately 48 million Americans are infected by foodborne diseases each year. Consumers are twice as likely to get sick from food prepared at a restaurant. Since pathogens can grow and spread anywhere throughout the supply chain, it’s often hard to track the source of an outbreak. When restaurants have multiple supply sources, as does Chipotle, it is even harder to identify the origin. As discussed in a recent New Yorker article, “while Chipotle has said that it is introducing more stringent testing and reassessing its food-handling practices, its reliance on local suppliers means that the task of insuring the integrity of its supply chain will be harder.” Not only will Chipotle have to revamp its food safety protocols, but it may also need to reconsider its entire local sourcing model—something that is a draw for many devoted Chipotle customers.

Where does that leave consumers who eat out? The CDC suggests taking these four precautionary steps when picking a restaurant or dining out:

  1. Check inspection scores. Search online to see how the restaurant scored on their state health department health inspection.
  2. Make sure the restaurant is clean. Look around to see how used plates and utensils are handled. If you can see it, notice how food is being prepared and how cooking spaces are cleaned.
  3. Check that your food is cooked properly. Look at your meat to determine whether it is cooked thoroughly, and send it back if it appears too pink or raw in texture.
  4. Handle your leftovers properly. Refrigerate leftovers no more than an hour after leaving the restaurant. Eat leftovers within 3 to 4 days, and discard if you see signs of deterioration – like mold or a bad smell or texture – on leftovers.

The CDC and Food Safety News offer plenty more helpful information about avoiding food borne illness.

So Simple, So Hard tackles adherence challenges in CA – National Consumers League

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“So Simple, So Hard” was the theme of the medication adherence conference the National Consumers League (NCL) held on September 15 in Sacramento, California. Sponsored by the Agency for Healthcare Research and Quality (AHRQ), the speakers and attendees explored the challenges and barriers to medication adherence – why it is so hard – and highlighted the tools and strategies to make it simpler and to improve adherence and health outcomes, especially among underserved populations.

NCL gathered more than 80 stakeholders in Sacramento, including health care professionals, community health workers, advocates, industry representatives, policymakers, and researchers. Throughout the day, conference participants heard from researchers and experts on adherence, and engaged with each other about possible collaborations and solutions.

The meeting kicked off with presentations on adherence research and health disparities, and continued with a variety of strategies and tools to improve adherence that could be utilized in health care practices or organizations. Takeaways from the presentations included the following:

  • One size does not fit all – adherence intervention work best when tailored for the patient
  • Quality of communication and a sense of collaboration between patients and health care professionals impact adherence, especially among people of color   
  • Adherence rates are unique to each medication a patient takes 
  • Cultural considerations are vital to understanding barriers to adherence
  • Always consider the health literacy of the patient
  • Determining the reasons for poor adherence is essential to developing effective interventions   

Specific strategies and solutions:

  • Medication synchronization
  • Comprehensive medication review
  • Tools for translating medication labels into the patient’s native language
  • Best practices and tools for more culturally competent clinical care

The conference provided a forum for participants to interact, connect, and lay the groundwork to develop partnerships for collaborative initiatives. We will be following up with all conference participants to determine the benefits of the conference and learn of any connections and /or collaborations developed.  

At NCL, we view poor adherence, with its devastating effect on health outcomes, as a public health problem. Since 2011, we have been leading Script Your Future – a public education campaign to increase awareness among patients, their family caregivers, and health care professionals of the importance of taking medication as directed.

As leaders of Script Your Future, NCL convened an AHRQ research dissemination conference to further explore possible solutions to this public health problem. The adherence issue is complex and taking medications is NOT so simple, especially for ethnic and racial minorities who often face health disparities. Collaboration among stakeholders who are dedicated to keeping the patient at the center of the discussion, is a critical first step toward developing and implementing effective medication adherence strategies to help people better self-manage their care.  

Conference participants and others are encouraged to distribute information from the conference to interested colleagues and through their networks. We look forward to hearing how others are sharing the information, tools, and resources from the conference, and the possible collaborations that will grow out of the meeting.   

* Funding for this conference was made possible in part by grant number 1R13HS023948-01A1 from the Agency for Healthcare Research and Quality (AHRQ). The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government

Obesity doesn’t discriminate, but should preventive care be more personalized? – National Consumers League

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obesity.jpgBy Ali Schklair, Linda Golodner Food Safety & Nutrition Fellow 

It isn’t news that obesity is an urgent problem in our country. According to a recent study by the CDC, over one third of US adults are obese. Education and health professionals have presented numerous strategies to combat this growing epidemic. Still, in order to enact real change, there needs to be a greater focus on how overweight and obesity affects specific populations.

Growing up with a brother with disabilities, I was exposed to the many challenges my family faced trying to help him develop healthy habits. Nutrition and weight were always difficult issues to manage. As a kid, my brother was very skinny. He was taking a medication that sped up his metabolism and suppressed his appetite. My parents would beg him to eat anything, even if the food was mostly fat and sugar. But as he got older, changed medications, and moved out of the house, he began to gain weight. Traditional weight loss methods have not worked for him. My brother faces a unique set of challenges, but he certainly isn’t alone. 

Obesity rates for adults with disabilities are 58 percent higher than they are for adults without disabilities. Additionally, obesity rates for children with disabilities are 38 percent higher than they are for children without disabilities. These numbers put adults and children with disabilities at a much higher risk of developing weight-related diseases such as heart disease, stroke, type 2 diabetes, high blood pressure, and certain types of cancers.

So why are these rates so high? As is the case with my brother, many people with disabilities are prescribed medications that cause sluggishness or weight gain. Also, any physical disability affecting motor or balance issues, sight, or stamina can make getting enough exercise challenging. Many people with disabilities are sensitive to the taste, color, texture, and smell of certain foods, which can lead to limited food repertoires.

Along with physical or medical challenges, there are lifestyle differences that make weight loss for adults with disabilities especially difficult.  Adults with disabilities often rely on support staff, family members, job coaches, and nurses to help them through their day. Many adults with disabilities also have little control over their finances. This means food is often chosen and cooked for them, usually the quickest and easiest options.

The disability population faces a range of obstacles when it comes to addressing the obesity epidemic. But it is not just people with disabilities that face unique challenges. In its polling, the CDC has outlined how socioeconomic status, sex, and ethnicity can all contribute to the prevalence of obesity. Once we are better able to understand the barriers to eating healthy and getting adequate physical exercise, we can tailor strategies to address the unique needs of differing populations.