Tag Archives: washington state

Reporter looks at Spokane’s efforts to address disparities

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism, and he has blogged for Covering Health ever since.

Reporting for The Spokesman-Review in Spokane, Wash., Shawn Vestal started by observing massive life-span disparities in the city and surrounding area (mapped by neighborhood), then started looking for causes.

Vestal begins with a fairly predictable correlation.

The difference between the longest-lived neighborhood in the county (Southgate) and the shortest-lived one (downtown) is about 18 years: an entire American childhood. But it is not simply a matter of extremes; neighborhood by neighborhood, there is a gradual rise in years of expected life that tracks the rise in neighborhood wealth.

But the story expands quickly, encompassing a variety of indicators and causes, some standard, some quite unique. Vestal even finds a project in which high school students compared beer and tobacco advertising and other visual signals between two nearby neighborhoods – a pair which just happen to have a decade’s difference in life expectancy between them.

Vestal describes what they found.

One startling comparison involved a pair of Conoco stations. The Comstock station has bushes and treed landscaping and a vintage Coke sign; the East Central station has not a single bit of greenery – not counting a stubborn weed or two – and an enormous red sign: “CHEAPEST BEER & CIGARETTES.”

Other unique Spokane efforts – many of which are geared toward improving entire neighborhoods, not just individual families – include a regular community open house to discuss health issues, city park cleanups, and streetlight repair.

Investigation delves into Wash.’s prescription drug problem

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism, and he has blogged for Covering Health ever since.

Everything time we think prescription drug abuse stories have peaked, something comes along to push the story further. This time, InvestigateWest’s Carol Smith sets herself apart by starting from square one and clearly explaining the origins and dimensions of Washington’s particularly nasty drug issues, tracing back each facet of the problem to its source and spotlighting what makes the Evergreen State unique.prescription-drugs

Washington has been one of the hardest hit states in the country, in part because of aggressive prescribing practices. That, coupled with lack of oversight of doctors who over-prescribe, has led to the spectacular run-up in the number of deaths from prescription overdoses.

The backdrop for her work is an epidemic that shows no signs of abating, despite a recently implemented state law Smith calls “a bold attempt to reduce overdose deaths by launching the first-ever dosing limits for doctors and others who prescribe these medicines.”

Prescription drug abuse is at epidemic levels throughout the state, and elsewhere in the country, despite lawmakers’ attempts to get a grip on it. Washington now has one of the highest death rates in the nation. Deaths from prescription drug overdoses in this state have skyrocketed nearly twenty-fold since the mid-1990s, and now outstrip those from traffic accidents.

Why caused it to leap so quickly? Smith tracks down several key tipping points. “There’s plenty of blame to go around for what caused the epidemic,” she writes. “Aggressive marketing of opiates by drug companies, nonexistent tracking of overprescribing, lack of insurance coverage for alternative treatments for pain, and demand by patients for quick fixes, to name a few.”

She drills down into many of those causes, with my personal favorites being two key origin stories:

  • How marketing by OxyContin maker Purdue Pharma led to relaxed guidelines for chronic pain treatment and a “1999 law specified ‘No disciplinary action will be taken against a practitioner based solely on the quantity and/or frequency of opiates prescribed,’” both of which helped cause a jump in prescriptions.
  • How “the rise in the death rates of Medicaid patients tracks along with the state’s cost-saving decision to move many of its poorest residents to the cheapest, most potent pain reliever available: Methadone.”

See the upper right-hand sidebar for more stories from the six-month investigation.

Seattle hospitals love building costly ERs

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism, and he has blogged for Covering Health ever since.

The Puget Sound emergency room construction boom is in full swing, and Seattle Times reporter Carol Ostrom has taken a pointed look at the cost-related consequences of local hospital expansion.

She examines why hospitals are opting for more and glitzier ERs over lower-cost alternatives such as clinics and urgent care facilities. She also considers why state efforts to guide hospitals toward more efficient spending have failed, and explains how hospitals justify their actions. If you don’t have time for the full story, here’s a relatively tame excerpt:

The ER building boom has prompted a backlash from some lawmakers and advocates of affordable health care, who complain that nearly all Washington hospitals get substantial tax breaks and construction financing through tax-exempt bonds.

Free-standing ERs, these critics charge, are cash cows for hospitals, strategically built in affluent areas to lure busy, well-insured patients and collect fat reimbursements.

Blame trucks, not just factories, for industrial pollution in Seattle

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism, and he has blogged for Covering Health ever since.

Spurred by a few recent studies, InvestigateWest’s Robert McClure and KCTS-Seattle’s Jenny Cunningham launched an investigation to figure out just what has made Puget Sound’s air some of the most toxic in the nation. Their work centered on the heavily polluted, industrial Seattle neighborhoods of Georgetown and South Park, where residents “face an onslaught of toxic airborne pollutants that according to a recent study exceed regulatory caution levels by up to 30 times.”

Where is this toxic air coming from? The answer may surprise you. The majority of the pollution, government regulators and scientists say, comes not from the large concentration of industrial facilities in South Park and Georgetown. Rather, it’s from the cars, trucks and buses whizzing by these neighborhoods – especially those with diesel engines. Fumes from ships in Elliott Bay and the Duwamish, as well as diesel-powered equipment at the Port of Seattle and elsewhere, add to the toxic mix. In the fall and winter, wood smoke from fireplaces becomes a significant contributor.

The problems here have implications in other neighborhoods, too: Anywhere people are living close to major roadways, they’re likely breathing unhealthy air, studies show. Anyone living within about 200 yards of a major roadway is thought to be at increased risk, with the first 100 yards being the hottest pollution zone.

Watch the full episode. See more KCTS 9 Connects.

Reporters looking to localize the story will probably want to scroll first to the “The Effects” section, which gets into the practical science of how this sort of pollution takes its toll. You’ll probably also enjoy Cunningham’s sidebar on what she learned in reporting the piece (it’s at the bottom of the page). If you’re also looking to understand the regional and national regulatory structure which governs diesel and related emissions, the “Solutions” subheading is also worth a pit stop.

For more on the big picture issues impacting health in South Seattle, see Carol Smith’s recent piece on the related Superfund site.

Should Seattle Superfund site address health as well as pollution?

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism, and he has blogged for Covering Health ever since.

InvestigateWest’s Carol Smith writes in the Seattle Post-Intelligencer and InvestigateWest.org that the focus on the environmental disaster of Seattle’s industrial Duwamish River obscures another, equally potent, long-simmering health crisis. For the folks who live near the Superfund site, pollutants from the river are just one of many health risks. Access to groceries and health care is limited, and obesity and poverty rates are higher than surrounding neighborhoods while expected lifespans are years shorter. As Superfund recommendations begin to take shape, the health side of the cleanup is bubbling to the forefront.

While there’s been exhaustive analysis of the environmental impact of historical polluters on the river and the health of creatures that live in it, as well as theoretical risk assessments of individual pollutants on human health, relatively little attention has been paid to the actual health status of residents living within the 32-square-mile Superfund site. Nor has there been consideration of the cumulative impact of the many health hazards they face.

The big question, Smith writes, is “Should the area be held to a higher cleanup threshold because the people living in its midst are already more vulnerable to the health risks posed by the toxic chemicals in their environment? ”

The answer might lie in the area’s status as an “environmental justice neighborhood,” which means it is “subject to the 1994 executive order by President Clinton that directed federal agencies to address inequities in communities where low-income or minority communities were experiencing health disparities caused by their environment.”