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Cohen on Social Impact of Psychiatric Medication

Professor of Social Welfare David Cohen joined the podcast “Courageously.U” to discuss mental health, medication and involuntary confinement. Despite advances in scientific research and medication, most indicators show that the burden of mental health in society has worsened in the last few decades. “Mental illness is not like any other illness,” Cohen said. “We don’t [actually] know what a balanced brain is.” As a 21-year-old clinical social worker, Cohen became interested in the social impact of psychiatric medication, including how medication contributes to stigmatization and stereotypes. “Besides being a scientific failure, the mental health system is a runaway commercial and cultural success,” he said. He explained that there is not enough research available on the side effects and consequences of psychiatric medication, especially in children. “Drugs sedate and quiet people, but we still don’t know if we are curing anything or even treating anything,” Cohen concluded.


Diaz on Diversifying Health Care Field

Latino Policy and Politics Initiative Executive Director Sonja Diaz authored an opinion piece in the California Health Report about disparities in the American health care system. “The COVID-19 pandemic has exposed immense inequities across our health care systems, from coverage gaps to preexisting health conditions,” Diaz wrote. These inequities are felt most acutely by communities of color, she said, calling for urgent action to address the physician shortage and “diversify the field to include more doctors who share language, ethnicity and cultural norms with their patients.” Despite the diversity of the American population, communities of color remain underrepresented in health and medical occupations, which hinders physicians’ abilities to build trust with patients. “Expanding and diversifying our physician pool is a necessary infrastructure investment,” Diaz wrote. She suggested increasing opportunities for Americans to enter health professions by expanding federal scholarships and prioritizing students committed to serving in medically underserved areas for grant funding.


Koslov on Mobilizing to Combat Climate Change

Assistant Professor of Urban Planning Liz Koslov was featured in a Katie Couric Media article about the growing threat of climate change. Many regions are already experiencing the consequences of climate change through frequent wildfires, long periods of drought, and increased frequency and severity of tropical storms. Rising temperatures and humidity have also prompted concerns about the health risks associated with climate change, including heat stroke and heat illness as well as exacerbation of chronic illness. While some changes such as rising sea levels are irreversible, there is still time to reduce greenhouse gas emissions and slow the effects of climate change. The Intergovernmental Panel on Climate Change released a report describing five different climate futures depending on human action to reduce emissions and shift away from fossil fuel use. “There’s so much action happening to try to really transform these conditions,” Koslov said. “If anything, COVID showed us the power of mobilizing on a vast scale.”


Pierce on Safety Hazard of Mobile Homes

Greg Pierce, co-director of the UCLA Luskin Center for Innovation, spoke to ProPublica about the climate gap, which refers to the disproportionate and unequal impacts of the climate crisis. Across the United States, people of color, the poor and the undocumented are more likely to live in hotter places and less likely to have access to potable water. In Thermal, California, the population is 99% Latino, and many residents live in mobile trailer homes without clean running water or air conditioning. How mobile homes are going to fare in the climate crisis is, “quite frankly, not the sexiest to academics,” said Pierce, noting that residents of older manufactured housing are at great risk. In California, mobile homes are disproportionately located in the hottest census tracts, and poor insulation can drive up cooling costs. Furthermore, mobile homes built before 1976 are not up to date with new building and safety standards, creating additional safety hazards.


Torres-Gil on Facing the Vicissitudes of Aging

In an interview with the American Society on Aging, Professor of Social Welfare and Public Policy Fernando Torres-Gil spoke about his research in the field of aging as well as his own life story. After contracting polio as a child, Torres-Gil described his commitment to education despite going in and out of hospitals for years. “My particular disability opened doors that at that time were not available to low-income, ethnic or minority communities,” he said. When Torres-Gil first got involved in gerontology, the field was primarily focused on the aging of white older adults. His research focused on diversity within the older population, and he has also explored aging as an intergenerational issue. “Aging is not just about older persons,” he explained. “Aging is a lifelong process.” He recommended expanding universal healthcare, guaranteeing minimum income and providing retirement security in order to ensure that young people are able to enjoy their longevity.

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Yin on National Burden of Medical Debt

Associate Professor of Public Policy Wesley Yin spoke to Verywell Health about the results of his research on the burden of medical debt in the United States. “Medical debt has become the largest source of debt and collections than all other sources combined,” Yin said, referring to recent research he co-authored that found 17.8% of individuals in the U.S. had medical debt in collections as of June 2020. “It just speaks to how important the expansion of Medicaid has been towards financial security, financial well-being, as well as reducing disparities in these communities,” he said. When medical bills are left unpaid, it can negatively impact an individual’s credit score and make it more difficult to qualify for loans. In order to curb medical debt, Yin recommended extending subsidies that would allow patients to purchase more affordable insurance plans with a smaller deductible. He also suggested expanding Medicaid, an approach that has been shown to reduce state spending.

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U.S. Sick and Medical Leave Policies Widen Racial Inequalities, Study Finds

Paid sick and medical leave is a powerful tool for preventing the spread of COVID-19 and other diseases and ensuring all workers have access to treatment, yet tens of millions of American workers lack coverage. The U.S. is one of just 11 countries in the world without a national, permanent paid medical leave policy, according to new research led by Jody Heymann, distinguished professor of public health, public policy and medicine. Further, unpaid leave provided by the U.S. Family and Medical Leave Act (FMLA) is restricted by eligibility rules that have created marked racial and gender gaps, said Heymann, who directs the WORLD Policy Analysis Center at the UCLA Fielding School of Public Health. The study, published in Health Affairs, included these findings:

  • In the private sector, 18.7% of Latinas, compared to just 8.4% of white men, lack access to FMLA leave because of its minimum annual hours requirement.
  • Requiring one year with the same employer excludes higher shares of Black (22%), Indigenous (22.9%) and self-identified multiracial (27.7%) workers than white workers (19%).
  • Over a third of private-sector workers are employed by a business with fewer than 50 employees, making them ineligible for FMLA benefits.

The study’s analysis of data from 181 countries found that providing paid sick and medical leave to all workers — including the self-employed, a group commonly excluded from key social security and labor protections — is readily achievable. “Only by ensuring we design our paid leave policies to reach every worker can we protect public health and take one important step toward rectifying the longstanding and devastating racial and socioeconomic inequalities that have only intensified during this pandemic,” Heymann said.


 

High Temperatures Increase Workers’ Injury Risk, Whether They’re Outdoors or Inside The finding reflects another consequence of climate change, according to new study led by R. Jisung Park of UCLA Luskin Public Policy

A UCLA study published today shows that hot weather significantly increases the risk of accidents and injuries on the job, regardless of whether the work takes place in an indoor or outdoor setting.

The report is based on data from California’s workers’ compensation system, the nation’s largest.

“The incidence of heat illnesses like heat exhaustion and heat stroke definitely go up on hotter days,” said the study’s lead researcher R. Jisung Park, an assistant professor of public policy at UCLA Luskin. “But what we found is that ostensibly unrelated incidents — like falling off a ladder or being hit by a moving truck or getting your hand caught in a machine — tend to occur more frequently on hotter days, too.”

By comparing records from more than 11 million California workers’ compensation claims from 2001 to 2018 to high-frequency local weather data, Park and his co-authors isolated the impact of hotter days on the number of injury claims.

The study shows that on days with high temperature above 90 degrees Fahrenheit, workers have a 6% to 9% higher risk of injuries than they do on days with high temperatures in the 50s or 60s. When the thermometer tops 100, the risk of injuries increases by 10% to 15%.

Those findings are particularly alarming in the context of climate change, which is expected to produce more high-temperature days each year. The researchers estimate that high temperatures already cause about 15,000 injuries per year in California.

“Heat is sometimes described as a silent killer,” said Nora Pankratz, a UCLA postdoctoral scholar. “But if you look into the data and do the statistical analysis, you find that heat has a significant impact on mortality and health outcomes.”

 

It’s not surprising that hot weather would lead to injuries and illness among workers in predominantly outdoor industries such as agriculture, utilities and construction. But the data consistently show that industries in which most people work indoors are affected as well. In manufacturing, for example, days with high temperatures above 95 degrees have an injury risk that is approximately 7% higher than days with high temperatures in the low 60s.

“A lot of manufacturing facilities are not air conditioned,” said Stanford University postdoctoral scholar A. Patrick Behrer, the study’s other co-author. “Because you’re inside, you don’t necessarily think about the temperature as being a major threat.”

The reality is that overheated workers face numerous risks, regardless of where the work occurs.

“Heat affects your physiology,” Park said. “It affects your cognition. It affects your body’s ability to cope. It seems possible that what we’re observing in the data for these workers is that they’re more likely to make mistakes or errors in judgment.”

The researchers found that heat-related workplace injuries are more likely to be suffered by men and lower-income workers. In addition, younger people suffer more heat-related injuries, possibly in part because they’re more likely to hold jobs with greater physical risks on construction sites, in manufacturing plants or at warehouses.

For an office worker at a computer desk, nodding off on a hot summer afternoon is unlikely to cause an injury. “But if you have a huge chainsaw in your hand, you’re not in a great situation,” Park said.

Among the paper’s other conclusions:

  • The number of heat-related injuries actually declined after 2005, when California became the first state to implement mandatory heat illness prevention measures for outdoor workplaces on days when temperatures exceed 95 degrees.
  • The financial costs of heat-related injuries may be between $750 million and $1.25 billion per year in California alone, considering health care expenditures, lost wages and productivity, and disability claims.
  • Inequalities in the labor market are exacerbated in part by the fact that low-income communities tend to be situated in hotter parts of the state. People in the state’s lowest household income tier are approximately five times more likely to be affected by heat-related illness or injury on the job than those in the top income tier, the study found.

The UCLA Luskin Center for Innovation, where Park is associate director of economic research, provided funding for the study. It is available now through the Institute of Labor Economics, which disseminates working versions of potentially influential research prior to publication in academic journals. Park previewed the findings  July 15 during testimony at a Congressional hearing organized by the House Select Committee on the Climate Crisis.

The new study echoes the results of a 2019 study that focused on how extreme temperatures raise injury risk in Texas and in the U.S. mining industry. Park, whose prior research includes a finding that student learning is negatively impacted by warm temperatures, said there has been “an explosion of research just in the last five to 10 years that illustrates, using data, the serious consequences of climate change for health, productivity and economic growth. This likely adds to that urgency of reducing greenhouse gas emissions now.”

Pankratz got involved in the study while working at UCLA Luskin as a postdoctoral scholar, having previously researched the impact of heat on businesses while working toward her Ph.D. in the Netherlands. 

Worldwide, she said, there is growing interest in the concept of adaptation — the pragmatic changes that can be made by governments and businesses to cope with the reality of climate change.

“For a long time, the focus has been on mitigation — what can we do to prevent climate change,” she said. “But as it becomes more and more obvious that there is policy inertia on mitigation, it’s important to think about what we can do to adapt and to work as well as possible in a warmer world.”

The study authors, all of whom have backgrounds in economics, realize that the desire to protect workers from heat may be complicated by economic reality. 

Behrer said policymakers could stipulate that workers not be exposed to the heat on days above 100 degrees, for example, without proscribing a specific strategy to be used by individual business owners.

“Then firms have the option either to use air conditioning or come up with some other method of climate control for their facilities,” he said, noting that some might change work hours or shorten the work day during heat waves. “It allows them to decide the most cost-effective way for them to meet the objective of reducing workplace injuries.”

 

Astor Promotes Culture of Care, Safety in Schools

Professor of Social Welfare Ron Avi Astor’s new report on increasing school safety and reducing weapons on campuses was covered by KNX1070 and CBS LA. The study found that fostering supportive environments in schools plays a key role in reducing the presence of weapons and creating safe campuses. Astor and his team analyzed surveys from 890,000 California students to better understand how factors such as the level of crime in a school’s surrounding neighborhood, students’ feelings of belongingness at their school, and student relationships with teachers and staff can affect the potential for weapons-carrying and violence. They found that measures such as metal detectors, security cameras and active shooter drills increase fear of violence, diminish students’ well-being and disproportionately affect students of color. Instead, Astor proposed prioritizing a culture of care and elevating the voices of students and teachers. “We must create opportunities to hear their voices and explore local solutions that make their schools safer,” he said.


Turner on Increasing Opportunities for Shade

Assistant Professor of Urban Planning V. Kelly Turner was featured in a National Geographic article about the importance of shade in cities like Los Angeles that are growing hotter due to climate change. Urban design in Los Angeles has prioritized access to the sun, with many city codes determining how much shadow buildings can cast. However, climate change has increased the frequency and severity of heat waves, increasing the risk of heat-related death and illness. Furthermore, predominantly Black and brown neighborhoods have fewer parks and trees and less access to shade than white neighborhoods. While asphalt and concrete absorb and release captured heat, contributing to the urban heat island effect, planting trees and creating shade can keep buildings cooler, lowering the risk of heat-related illness. “The really simple thing, if you care about making people more comfortable, is just to offer more opportunities for shade,” Turner said.