HealthyCal.org

By Jeff Ritterman

A prior edition of HealthyCal.org documented a worrisome trend of rising income inequality within our state, a trend which runs in tandem with the statistics for the country as a whole. The latest research findings show just how worrisome this trend is.

University of California economics professor Emmanuel Saez has analyzed tax returns dating back to World War I. What he found was amazing and startling. We are more unequal now that at any time in the last one hundred years and significantly so. The last time we were this unequal, the stock market crashed and ushered in The Great Depression.

Would a more equal California be a healthier California? The answer appears to be a resounding yes.

There are now hundreds of papers and an excellent book, “The Spirit Level: Why More Equal Societies Almost Always Do Better” by Richard Wilkinson and Kate Pickett (*), which document the health and social costs of rising income inequality. These researchers from the U.K. compare health and social measures for all of the rich countries. The data show that the U. S. is the most unequal of all of the rich countries with the exception of Singapore.

Wilkinson and Pickett document a long list of health concerns and social ills that correlate with increases in income inequality. We don’t live as long as our peers in more equal countries, nor do our infants. We’re fatter, more of our teens get pregnant, we incarcerate more of our citizens, our children score worse on math and science tests, we kill one another more often, and we trust one another less. We even recycle less often.

Correlation, however, does not prove causality. Wilkinson and Pickett address this question at some length. They analyze the data on civic trust and conclude that the overwhelming balance of the evidence supports causality. It appears to be the case that the increasing income disparity causes us to trust one another less. The breakdown in trust causes the social fabric to unravel and we begin to experience life as a Hobbesian struggle of all against all. This results in disease in the individual and dysfunction in our society.

A generation ago, Sir Michael Marmot and colleagues (**) showed convincingly that social class was a far more important determinant of health outcome than cholesterol level, blood pressure, diet, and smoking behavior combined. The message was clear. The social environment is the major determinant of health outcome.

To create a healthier California, clearly we will need to move toward a much more equitable distribution of the income and a significant redistribution of wealth. Doing so will require a major change in our collective consciousness. We each need to work toward that end.

While we work, we need to build resilient caring, loving communities. Rising inequality causes disease and social dysfunction due to the unravelling of the social fabric once we stop trusting one another. The antidote is in our creating The Beloved Community which Dr. King envisioned;

a society based on justice, equal opportunity, and love of one’s fellow human beings.

As explained by The King Center, the memorial institution founded by Coretta Scott King to further the goals of Martin Luther King:

“Dr King’s Beloved Community is a global vision in which all people can share in the wealth of the earth. In the Beloved Community, poverty, hunger and homelessness will not be tolerated because international standards of human decency will not allow it. Racism and all forms of discrimination, bigotry and prejudice will be replaced by an all-inclusive spirit of sisterhood and brotherhood.”(***)

The best medicine for creating healthy communities is Beloved Community Medicine. It is in the building and strengthening of caring and kind social relationships that we can heal our social fabric. Medical research shows that volunteering for community and religious organizations improves the health outcome of the volunteer. We are wired to do good deeds.

As we work toward a more equitable and healthier California, let’s build loving and caring community. The Beloved Community is the Healthy Community.

Jeff Ritterman, MD is a Richmond city councilman. He recently retired from Kaiser Richmond after 30 years as a cardiologist.

*Wilkinson, R, Pickett, K “The Spirit Level: Why Greater Equality Makes Societies Stronger”, Bloomsbury Press, New York 2009.

**Rose, G, Marmot, M, Social class and coronary heart disease. Br Heart J 45(1):13-9. 1981

***The King Center. The Beloved Community of martin Luther King Junior. Available from:http://www.thekingcenter.org/GetInvolved/Default.aspx(accessed March 26, 2011).

By Christine Fry

Last month, when a new study came out raising doubts about whether people actually choose healthier options at fast food restaurants when menus show calorie counts, news reports were quick to call menu labeling laws a failure.

And when research recently showed that a tax on sodas and other sugary drinks could translate to the weight-loss equivalent of less than a pound per person per year, critics called the impact “marginal” and suggested the strategy would be ineffective.

With obesity rates hitting crisis proportions, cities and counties throughout California are adopting novel and largely untested policies to combat the problem. Last year Santa Clara County was the first in the nation to pass a law setting nutrition standards for kids’ fast food meals packaged with toy giveaways. And Los Angeles took a bold step earlier this year when the city council effectively banned new fast food restaurants from opening in South LA, a neighborhood plagued by high poverty and obesity rates.

As cities and counties launch new interventions such as these, researchers can begin collecting data to evaluate each strategy’s effectiveness. But it’s time to rethink the way we determine whether these efforts are worthwhile.

Take the latest research on menu labeling laws, published last month in the International Journal of Obesity. Researchers compared food receipts at fast food restaurants in several low-income neighborhoods around New York City before and after the city began requiring the restaurants to display calorie information to customers. According to the study, the additional nutrition details had little effect on consumer orders.

Does this mean menu labeling laws don’t work? More to the point, does it mean that new policy initiatives -– like menu labeling and soda taxes -– aren’t worth pursuing if they don’t produce significant behavior and weight changes right away?

Think about everything that’s making us gain weight in the first place. It’s not just drinking soda or eating unhealthy foods. It’s not just driving to work and driving our children to school. It’s not just living in neighborhoods without quality public transit or parks or sidewalks, without a grocery store or a farmers’ market.

But all of these realities, taken together, reflect communities and social norms -– which take decades to establish –- where choosing healthy foods or activities can be difficult, if not impossible.

Because we can’t pinpoint a single cause that’s led us to the obesity crisis we now face, no single policy intervention will have a major effect on solving the problem. But seemingly small declines (like the pound per person per year that one policy could produce) become huge when you’re talking about multiple policies and their effect on 300 million people across the nation in less than a decade. Meanwhile, new policies aimed at changing consumer behavior will reinforce each other, making healthy choices easier at every turn and helping to establish new attitudes about eating and physical activity.

Even with a combination of obesity prevention policies, we’re not likely to see drastic improvements right away. It took years – and many groundbreaking, controversial laws that Californians take for granted now – to create a sea change in public perceptions and behavior around smoking. Tobacco-related illnesses have plummeted as a result. Doing the same for obesity will take time, incremental progress, and laws tackling the problem from every direction.

Christine Fry is a policy associate at Public Health Law & Policy, a nonprofit research and training center based in Oakland, California.
Photo by vsmoothe via flickr.com

Five Californians will receive the 2011 James Irvine Foundation Leadership Awards for successfully addressing some of the state’s most difficult problems. Now in its sixth year, the awards celebrate extraordinary leaders who are applying innovative and effective solutions to significant state issues. The awards, including $125,000 for each recipient, aim to publicize proven solutions that can inform policymaking and better the lives of more Californians. See their stories and video profiles by clicking below.

Tim Carpenter

Ever since I was a kid, I’ve liked older people. I grew up in a large Irish Catholic family, and storytelling was like a competitive sport, played at the dinner table. Older people told better stories than younger people, so I ended up at that end of the table and I guess I never left.

I was still enjoying listening to older people’s stories about 15 years ago, when I walked into my first senior housing community and sat next to a resident who turned out to be a former chief salesman for Preston Tucker, the maverick automaker. After listening to his amazing life story for hours, I asked what he was doing now, and he said, “Tim, I’m dying here.”

I knew what he meant: the standard fare of doughnuts and bingo provided at that time by most retirement communities amounted to a starvation diet for mind, body and spirit. The chronic boredom associated with such routines has not only harmed the health of elders, as research studies show, but also entailed extra cost for the rest of us, when the seniors end up requiring costlier types of care.

All this helps explain why my talk with that one older gentleman helped inspire me to develop EngAGE, a pioneering, college-style array of programs for senior housing residents. Our nationally acclaimed nonprofit is now serving thousands of seniors in 20 retirement communities in Southern California, with waiting lists so long that unless we can speed up development, my own kids probably couldn’t get in.

Click here to read more.

Watch a video profile of Carpenter:

By Dr. Judith Broder

About six years ago, I was preparing to retire. Starting to cut back on my clinical psychiatry practice, I was looking forward to spending more time with my grandchildren and traveling with my husband, Donald.

But then Donald and I happened to walk along the beach in Santa Monica, just as a veterans’ group was putting up hundreds of little white crosses in the sand, commemorating deaths of U.S. soldiers in Iraq and Afghanistan. I gasped, stunned by the enormity of the losses. And then I started thinking about all the soldiers who have been returning home alive, and maybe physically well, but traumatized by all they have seen and endured.

As a therapist, I knew I had the tools to help, and also that I couldn’t ignore the need.

So rather than retire, I soon embarked on a new career, as the founder of a new nonprofit organization called The Soldiers Project, which provides free mental health care for veterans and their families.

Read more here.

See a video profile of Broder.

Dr. Steven Pantilat

When I was still in training, I met a patient who transformed my perspective of modern medicine without ever saying a word. She was a young mother who was dying of leukemia while the doctors who were training me gave her repeated blood transfusions, trying in vain to prolong her life even as they made it impossible for her to leave the hospital.

To my surprise, this young woman was never told the truth about her illness, which would at least have given her the choice of spending her last days at home with her two-year-old daughter. Her doctors focused on her blood count, rather than her quality of life or emotional well-being.

Sadly, as I’d learn, that patient was no exception. More than half of all Americans who die each year, including some 125,000 Californians, meet their ends in hospitals, where they often endure painful, costly and unwanted procedures. But I’m convinced society can and must do better for all people with serious illness.

I’ve since become an internist and researcher at the University of California, San Francisco, where for the past 12 years, I’ve championed a kind of medicine known as palliative care. This approach is aimed at restoring realism to doctor-patient relationships and keeping our focus where it should be: on relieving physical and emotional suffering and helping our patients have the best possible quality of life.

Read more.

See a video profile:

Dori Rose Inda

In 2002, I founded the Watsonville Law Center to serve the local farm-worker community. For many years, workers have come to our office with heart-wrenching injuries: a hand amputated by machinery, a back broken falling from a tree. The hard-laboring men and women who grow fresh food for California tables endure physically grueling conditions and a high risk of accidents from heavy machinery and pesticide exposure.

California law guarantees all sick and injured workers medical care and financial support through the legally mandated workers’ compensation system. Yet many of the state’s 5 million low-wage workers lack access to the state-required care.

This is why, with committed community partners, I established the Agricultural Workers’ Access to Health Project. By providing education, medical treatment and legal services to agricultural and other low-wage workers, our program aims to help improve access to the medical treatment and financial aid that their employers are legally required to provide.

Read more.

Watch a video profile:

Martha Ryan

In the late 1980s, I worked as a nurse in refugee camps in Uganda and Somalia, tending to some of the world’s poorest women. Then I moved back to San Francisco and was shocked by the poverty I discovered right here at home. What surprised me the most was to see pregnant women and children living in homeless shelters, or even making do on the streets.

I decided against returning to Africa, as I’d planned, and in 1989 I founded the Homeless Prenatal Program, an innovative social services center that has since helped thousands of mothers and children overcome poverty, addiction and homelessness.

Read more.

See the video profile:

By Tim Carpenter

Ever since I was a kid, I’ve liked older people. I grew up in a large Irish Catholic family, and storytelling was like a competitive sport, played at the dinner table. Older people told better stories than younger people, so I ended up at that end of the table and I guess I never left.

I was still enjoying listening to older people’s stories about 15 years ago, when I walked into my first senior housing community and sat next to a resident who turned out to be a former chief salesman for Preston Tucker, the maverick automaker. After listening to his amazing life story for hours, I asked what he was doing now, and he said, “Tim, I’m dying here.”

I knew what he meant: the standard fare of doughnuts and bingo provided at that time by most retirement communities amounted to a starvation diet for mind, body and spirit. The chronic boredom associated with such routines has not only harmed the health of elders, as research studies show, but also entailed extra cost for the rest of us, when the seniors end up requiring costlier types of care.

All this helps explain why my talk with that one older gentleman helped inspire me to develop EngAGE, a pioneering, college-style array of programs for senior housing residents. Our nationally acclaimed nonprofit is now serving thousands of seniors in 20 retirement communities in Southern California, with waiting lists so long that unless we can speed up development, my own kids probably couldn’t get in.

On any given day, you’ll find EngAge project residents engrossed in a writing workshop, a yoga class, a sculpture seminar, a cooking class or making a movie. One of our star students wrote her first screenplay at 63, soon after moving into our flagship site, the Burbank Senior Artists Colony. The resulting film, “Bandida,” which has since been profiled on Showtime’s national TV show, “This American Life,” tells the story of an old lady who robs a convenience store.

Just as the research predicts, EngAGE participants typically report that their health is improving, instead of declining, as residents of other senior housing often complain. I’ve been thrilled to watch program participants’ attitude shift, from a dread of their elderly years to excited anticipation of how they might take advantage of them.

Recently, one university research team found that my program has achieved a 25 percent reduction in the number of seniors requiring higher levels of care, such as full-time nursing. The savings totaled $18 million.

This finding has important implications for Golden State taxpayers, as an increasing number of state residents head into their golden years. California is already home to nearly 3.4 million people over the age of 65, with that number expected to double by 2025. At least half of these seniors live on low to moderate incomes. Keeping them healthy and independent can save thousands of dollars per person per month in expenses that would otherwise be shouldered by their families or Medicare and Medi-Cal.

Another way EngAGE has proved thrifty is with its self-sustaining business model. The organization gets most of its revenue from developers, who must compete for contracts for subsidized senior residences. To qualify for federal tax credits, the developers’ plans must include social services programs, and EngAGE’s high-quality offerings give them a competitive edge.

In recent years, EngAGE has been adding three to five new sites each year, and this demand is sure to grow. So thanks largely to that outspoken car salesman, I’m happy to say that thousands of Californians are now taking much better advantage of their later years.

Tim Carpenter is the founder and executive director of EngAge, and a 2010 recipient of the James Irvine Foundation Leadership Awards.

Watch a video profile of Carpenter:

photo by Cory Doctorow

By Robert S. Ogilvie

As the battle plays out over Governor Jerry Brown’s proposal to eliminate redevelopment agencies statewide, one thing is clear: the way we go about revitalizing low-income neighborhoods in California is likely to change. But we must find a way to preserve two of the most powerful tools redevelopment agencies currently hold.

There’s no question that redevelopment projects can make low-income neighborhoods healthier. Everything from upgrading streets and building parks to attracting new grocery stores and developing affordable housing has an impact on residents’ health. These projects create safer and more appealing areas to walk and play, make it easier to buy fresh produce, and reduce local pollution and other environmental hazards.

In San Bernardino, redevelopment funds are helping to bring a regional express bus to the city’s downtown core, part of a project that includes contamination clean-up and transit-oriented development. In San Francisco’s low-income Bayview Hunter’s Point neighborhood, redevelopment support was key to establishing a grocery store and providing business incentives to transform a liquor store into a market filled with produce. And in the heavily industrial city of Richmond, community advocates worked with the redevelopment agency to improve local air quality by rerouting diesel truck traffic out of residential neighborhoods.

The governor’s plan to eliminate redevelopment agencies doesn’t have to mean the end of funding for projects like these. But city and county leaders need to work now to preserve the redevelopment tools that are most critical for creating healthier communities, no matter what the future holds for the agencies themselves.

Right now, redevelopment agencies have exclusive access to two major financing tools: (1) the power to issue infrastructure bonds without a public vote, and (2) a dedicated revenue stream, collected as a portion of the increased tax revenue produced by redevelopment projects.

These financing tools have made countless public health improvements possible: helping corner store owners afford refrigeration units so they can stock fresh fruits and vegetables; building pedestrian corridors for children to walk safely to school; and developing mixed use, transit-oriented communities that allow senior citizens to age in place. Accomplishing this without redevelopment funds would have required a two-thirds vote of the electorate, a difficult hurdle to overcome even in the best economic times.

Eliminating redevelopment agencies and the powers they currently have would put cities and counties in a bind, cutting off a flexible funding stream intended to help make blighted communities healthier and more sustainable. Redevelopment agencies as we know them may face an uncertain future, but their most powerful tools should be preserved.

Regardless of the outcome of Gov. Brown’s proposal, anyone working to create healthier communities has a role to play in making sure these financing tools are preserved and targeted to improving community health. Because cities are creatures of the state, any reform or reconstitution would have to be directed by state law – so it’s critical that the governor and the legislature devise new ways for cities and counties to fund new infrastructure projects.

We need to explore new possibilities for tools that work. Our ability to create a healthier California depends on it.

Robert S. Ogilvie is a program director at Public Health Law & Policy, an Oakland-based research and training center. Join Public Health Law & Policy, the Public Health Institute, and the California Center for Public Health Advocacy on March 17 in Sacramento for a discussion on the future of healthy redevelopment in California. See http://www.phlpnet.org/php/news/march-17-new-ideas-redevelopment-californ for details.

By Dr. Judith Broder

About six years ago, I was preparing to retire. Starting to cut back on my clinical psychiatry practice, I was looking forward to spending more time with my grandchildren and traveling with my husband, Donald.

But then Donald and I happened to walk along the beach in Santa Monica, just as a veterans’ group was putting up hundreds of little white crosses in the sand, commemorating deaths of U.S. soldiers in Iraq and Afghanistan. I gasped, stunned by the enormity of the losses. And then I started thinking about all the soldiers who have been returning home alive, and maybe physically well, but traumatized by all they have seen and endured.

As a therapist, I knew I had the tools to help, and also that I couldn’t ignore the need.

So rather than retire, I soon embarked on a new career, as the founder of a new nonprofit organization called The Soldiers Project, which provides free mental health care for veterans and their families.

In recent years, thousands of combat veterans have been coming home from missions in Iraq and Afghanistan with hidden wounds that include post-traumatic stress disorder, brain injuries, anxiety, sleeping problems and depression. It’s important to call them ‘wounds’ since they’re no less serious than losing an eye or leg.
Left untreated, moreover, these emotional troubles can lead to more visible problems, such as child abuse, car crashes, crime and suicide.

To address this broadening crisis, The Soldiers Project has rapidly grown into a network of 700 volunteer mental health professionals, who have provided close to 10,000 hours of care to 900 veterans in six California counties, as well as New York, Boston, Seattle and Chicago. The therapy is free and completely confidential, lasting as long as the clients need it.

Veterans are not the only ones to benefit. Every returning veteran has a family that may be affected in some way by their problems.

I estimate that at least one third of my project’s clients are family members and partners of the soldiers, who are often unprepared for the challenges their loved ones face on their return from war. The project’s therapists also conduct public lectures to raise awareness about veterans’ mental health issues. Some 3,500 Californians so far have attended these events.

Within the Soldiers Project, I’ve also launched a program called “Adopt A College,” in which volunteers work closely with community colleges and veterans’ representatives to support returning soldiers. Volunteers serving as liaisons between our project and the colleges help educate staff members and faculty about returning troops’ potential psychological problems, while also referring soldiers in need of our services to our therapists.

Through a partnership with Brandman University in Irvine, Adopt A College now operates at seven Los Angeles area community colleges, and I plan soon to expand it to four more colleges, in Los Angeles and Sacramento.

A 2008 Rand Corporation survey found that one in five recent U.S. veterans reported symptoms of major mental illness. But I worry that many veterans aren’t speaking out, which means the true rate of problems may be much higher. Many soldiers fear the stigma attached to asking for help and worry that their records won’t be kept confidential. Others suffer from post traumatic stress, and thus can’t bear to be near large, busy buildings such as Veterans Administration hospitals. Still others may be gay and lesbian, and thus wouldn’t be able to be honest with military therapists under the “don’t ask, don’t tell” policy.

The Soldiers Project offers a special safety net for all these veterans and others, even as it collaborates with the military to keep reaching out to returnees in need. A group of therapists routinely attend yellow-ribbon events run by the National Guard, for instance, to get out the word about the project’s services. Military members have also helped train the project’s therapists in understanding the culture of the armed forces.

California is now home to some 160,000 recent veterans, more than in any other state, and this population is bound to increase as the military winds down the war in Afghanistan. I’m glad the Soldiers Project will be there to help them return to life in peacetime.

Dr. Judith Broder is founder and director of The Soldiers Project, and a 2011 recipient of the James Irvine Foundation Leadership Awards.

See a video profile of Broder:

By Dr. Steven Pantilat

When I was still in training, I met a patient who transformed my perspective of modern medicine without ever saying a word. She was a young mother who was dying of leukemia while the doctors who were training me gave her repeated blood transfusions, trying in vain to prolong her life even as they made it impossible for her to leave the hospital.

To my surprise, this young woman was never told the truth about her illness, which would at least have given her the choice of spending her last days at home with her two-year-old daughter. Her doctors focused on her blood count, rather than her quality of life or emotional well-being.

Sadly, as I’d learn, that patient was no exception. More than half of all Americans who die each year, including some 125,000 Californians, meet their ends in hospitals, where they often endure painful, costly and unwanted procedures. But I’m convinced society can and must do better for all people with serious illness.

I’ve since become an internist and researcher at the University of California, San Francisco, where for the past 12 years, I’ve championed a kind of medicine known as palliative care. This approach is aimed at restoring realism to doctor-patient relationships and keeping our focus where it should be: on relieving physical and emotional suffering and helping our patients have the best possible quality of life.

The problem today is that medicine is typically focused on treating disease and extending lives at all costs. The system is set up to pay doctors to do things to people — to cut things out and put scopes in. What’s different about palliative care is the recognition that sometimes those aren’t the goals the patient wants. So rather than focusing on a disease that needs treatment, palliative care focuses on the needs of the whole person, giving them high-quality, individualized care that is more in line with what they and their families want.

Throughout the country, to date, my team and I have trained 180 teams of doctors, nurses, chaplains and social workers in this approach. The teams learn how to meet with patients and their families starting from the time a patient is diagnosed with a life-threatening illness, and to continue to manage that person’s care right up until the end of his or her life. More than 140 of these groups are now operating in hospitals, where together they tend to as many as 35,000 patients a year.

A growing body of evidence points to the benefits of this approach. Recent studies show patients who received palliative care had less pain and a better quality of life and were less depressed and more satisfied with their treatment than those who received traditional care. Remarkably, palliative care has even helped patients live longer ,by 25 percent, according to a recent study in the New England Journal of Medicine. And at the same time, palliative care is often healthier for the patient’s family members, who are less likely to become depressed if their loved one receives palliative care.

At a time when national health costs are soaring, it’s important to keep in mind that palliative care is also more cost efficient. Research shows that by providing realistic options and ensuring that care is consistent with what patients and families want, medical centers can reduce unwanted and unhelpful interventions and save thousands of dollars for every patient cared for by a palliative care service. For people living with chronic illness, the holistic approach of palliative care where a team looks after a patient can insure that they receive not only the medical but also the social, practical, psychological and emotional support they need to get well and stay well.

Despite all we know about the benefits of palliative care, unfortunately today it remains unavailable at more than six in ten California hospitals and is rarely available outside the hospital. In the near future, however, I hope to see many more doctors and nurses trained in this wise and compassionate approach, with better coverage from insurance firms to allow patients to receive both palliative care and disease-focused care at the same time. I’m convinced that palliative care should be a standard part of medicine, in every insurance plan and every hospital.

Dr. Steven Pantilat is the director of the palliative care program at the University of California, San Francisco and a 2011 recipient of the James Irvine Foundation Leadership Awards.

See a video profile of Dr. Pantilat:

By Dori Rose Inda

In 2002, I founded the Watsonville Law Center to serve the local farm-worker community. For many years, workers have come to our office with heart-wrenching injuries: a hand amputated by machinery, a back broken falling from a tree. The hard-laboring men and women who grow fresh food for California tables endure physically grueling conditions and a high risk of accidents from heavy machinery and pesticide exposure.

California law guarantees all sick and injured workers medical care and financial support through the legally mandated workers’ compensation system. Yet many of the state’s 5 million low-wage workers lack access to the state-required care.

This is why, with committed community partners, I established the Agricultural Workers’ Access to Health Project. By providing education, medical treatment and legal services to agricultural and other low-wage workers, our program aims to help improve access to the medical treatment and financial aid that their employers are legally required to provide.

As a result of these efforts, we have assisted nearly 900 workers in Monterey, Santa Cruz and San Benito counties to access medical care and financial support for job-related injuries and illnesses.

While I’m proud of this accomplishment, my hope of even broader change has led to meetings with directors of clinics and legal services from Oakland, Anaheim and the Central Valley in order to encourage and support these regions to replicate our project locally. I also facilitate a statewide collaborative of more than 25 public agencies, nonprofits, attorneys and employers who work together to improve the workers’ compensation system so that taxpayers and law-abiding businesses no longer subsidize illegally uninsured companies.

Among other achievements, the collaborative has dramatically helped employees who work for companies that skirt the law by not providing insurance. Previously, injured workers from such companies often faced a two-year delay before receiving workers’ compensation benefits. Yet now, in Salinas and Anaheim, that wait is on average less than two months.

In another promising effort, Kaiser Permanente has partnered with us to transform Watsonville’s community health center, Salud Para La Gente, to serve as a workers’ compensation provider. The clinic has become a model of how we can shift the cost of treating injured and ill workers away from federal, state and municipal coffers, which normally fund community health centers, to the employer-funded workers’ compensation program where it belongs. By my calculation, replicating this program throughout the state could save California taxpayers as much as $100 million a year.

Employers who already obey state law and pay for workers’ compensation coverage have good reason to appreciate these efforts. Each year these businesses pay into the Uninsured Employers Benefits Trust Fund to compensate injured workers with illegally uninsured employers. As more employers get the required insurance, law-abiding businesses can pay less.

While the Agricultural Workers’ Access to Health Project certainly has a financial benefit, its wider impact has been to create healthier workplaces and improve the lives of California workers and their families.

Dori Rose Inda is the founder and director of the Agricultural Workers’ Access to Health Project and the recipient of a 2011 James Irvine Foundation Leadership Award.

Watch a video profile: