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Could a CA bill on tortillas improve maternal health?

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Monday, April 15, 2024

A premature baby in incubator. Photo via iStock California is struggling to provide maternal health for its residents. But as one proposal aims to prevent birth defects, another has received hateful pushback that’s been condemned by both political parties. As CalMatters health reporter Ana B. Ibarra writes, Assemblymember Joaquin Arambula has introduced a bill that would require corn masa flour makers to add 0.7 milligrams of folic acid per pound of flour. Though federal law requires other grain products, such as cereals, breads and pasta, be fortified with folic acid, corn masa flour is not included. The corn flour is a key ingredient used in many classic Latino foods. Arambula, a Fresno Democrat and physician, to CalMatters: “Food is the best way that we can get folic acid into our communities before they’re pregnant. Oftentimes the prenatal vitamins that we give to pregnant people are too late.”  Research has shown that folic acid, which can be found in prenatal and women’s multi-vitamins, promotes healthy cell growth, and can prevent birth defects when taken before and during the early weeks of pregnancy. Since 1998, when the U.S. Food and Drug Administration handed down the requirement, the proportion of babies born with neural tube defects dropped by 35%. But between 2017 and 2019, only about 28% of Latinas reported taking folic acid the month before becoming pregnant, compared to 46% of white women. Women on Medi-Cal, the state’s health insurance program for low-income families, are also less likely to take folic acid before pregnancy compared to women on private insurance.  To learn more about the proposal, read Ana’s story. Another bill related to maternal health, Assembly Bill 2319, was the subject of a racist letter sent to members of the Health Committee, according to lawmakers. The measure would require healthcare providers to undergo training for implicit bias, and for the training to include “recognition of intersecting identities.”  The bill’s co-author, Assemblymember Lori Wilson, said the letter was “vile and hateful.” Assembly Republicans also said the letter had no place in legislative debate: “While we may not always agree on policy, we are united to strongly condemn racism and the evil ideology behind this letter.” Wilson, a Suisun City Democrat who is chairperson of the Legislative Black Caucus, vowed to carry on with the measure. The proposals by Arumbula and Wilson follow state data showing that in 2020 California saw a ten-year high of pregnancy-related deaths. Black expectant mothers are particularly vulnerable: They are three times more likely to die of pregnancy-related complications than others. It’s a point raised by former state Senate leader Toni Atkins in a social media post last week. Meanwhile, maternity wards across the state are closing, creating “maternity care deserts,” and California midwives treating Medi-Cal patients struggle to keep their businesses afloat. A February report from the state auditor also found that state health departments failed to track the effectiveness of a perinatal care program for Medi-Cal patients. Digital Democracy: CalMatters has launched Digital Democracy, a project using the latest technologies to help Californians understand their state government and create more accountability for politicians. The website introduces each of the state’s 120 legislators and explains this year’s policy agenda. In our unprecedented database, you can instantly find any word uttered in a public hearing, every vote cast, every bill introduced and every dollar donated. For more details, see our about and methodology pages and read more from our engagement team. Other Stories You Should Know Builders can challenge impact fees New housing construction in a neighbourhood in Elk Grove on July 8, 2022. Photo by Rahul Lal, CalMatters From CalMatters housing reporter Ben Christopher:It’s about to get more difficult for local governments to slap construction projects with certain fees — and a bit easier for developers to sue governments when they do.  That’s thanks to a unanimous ruling the U.S. Supreme Court handed down Friday. As many court watchers expected, the justices sided with George Sheetz, a septuagenarian retiree who sued El Dorado County over a $23,420 building fee. Sheetz’s lawyers argued that the county should have had to prove that this five-digit fee matched the cost that his manufactured home actually would inflict on local roads and highways. That requirement was established in a four-decade-old court ruling also out of California. El Dorado County, with the backing of both the Gov. Gavin Newsom and President Joe Biden administrations, countered that such a high bar is only required of one-off fees levied by regulators, not fees scheduled for all developments and established by elected bodies, like the county board of supervisors. In its 9-0 ruling, the Supreme Court said that “there is no basis for affording property rights less protection in the hands of legislators than administrators.” A few possible consequences of the ruling: Cities and counties now have to show that impact fees are connected to and “roughly proportionate” to the fiscal impact of a given development. That could have the unintended consequence of slowing down permitting.  Developers may now have a powerful new legal tool to challenge fees that they think are too high. And they are high here. As of 2015, the average impact fee on a single family home in California was more than four times the national average. But it’s too soon to say exactly how all of this will shake out. That’s because the court stopped short of saying exactly how far governments have to go to justify their fees — or whether El Dorado County already cleared that hurdle in this case. Those questions were left to lower courts. State cracks down on water Armona’s new $9 million well and treatment facility to remove arsenic in its water supply. Photo by Larry Valenzuela, CalMatters/CatchLight Local The State Water Resources Control Board is poised to penalize Kings County groundwater agencies for failing to manage overpumping in the region’s water supply — a move that would set a new precedent. As CalMatters water reporter Rachel Becker explains, the board on Tuesday is expected to decide whether to put county agencies on probation for unsuccessfully restricting farmers’ overdrafting of the water supply from the Tulare Lake underground basin. If the board decides to crack down, it will be the first time the state imposes penalties under a landmark 2014 law that requires agencies to achieve groundwater sustainability by 2040.The board’s decision could also signal how the state will approach five other overpumped San Joaquin Valley basins that may face probation as well. Overpumping in Kings County has caused household and community water wells to dry up and land to sink, which endangers canals, aqueducts and flood-controlling levees. And because wells must reach deeper into the ground to extract water, contaminants such as arsenic are released and cause water contamination levels to rise. Putting Kings County agencies on probation could mean imposing state fees totaling as much as $10 million a year, according to a CalMatters analysis. It could also lead to state regulators eventually managing the region’s groundwater. This has small farmers in the region concerned that they’ll be forced out of business due to the state’s steep fees. The basin provides drinking and irrigation water for 146,000 residents and supports a multibillion-dollar agricultural industry. For more on this issue, read Rachel’s story. California’s water crisis, explained: CalMatters has a detailed look at how California might increase its water supply, and a dashboard tracking the state’s water situation. CalMatters Commentary Ideas festival: CalMatters is hosting its first one, in Sacramento on June 5-6. It will include a discussion on broadband access and a session with Zócalo Public Square on California’s next big idea. Featured speakers include Julián Castro, CEO of the Latino Community Foundation, and Barbara McQuade, a former U.S. attorney and MSNBC legal analyst. Find out more from our engagement team and buy tickets here. Other things worth your time: Some stories may require a subscription to read. CA granted federal disaster relief for historic February storms // Los Angeles Times  Ballot measure for America’s highest wage could be victim of past wins // Politico Prop. 22 gains liberal support as case heads to state high court // San Francisco Chronicle PG&E customers were billed for a TV promo campaign // The Sacramento Bee Google blocks some CA news as fight over online journalism bill escalates // Politico Bill to mandate ‘science of reading’ in CA classrooms dies // EdSource CA abortions increased after Roe vs. Wade was overturned // Los Angeles Times The first high-speed rail trains are closer to coming to CA // San Francisco Chronicle Environmental concerns raised by rocket flights // The San Diego Union-Tribune SF jails lock down after alleged assaults on staff // Los Angeles Times SF background check startup Checkr cutting 260 jobs // San Francisco Examiner SF $2B Central Subway has lots of leaks, few riders // The San Francisco Standard Kern County activist faces 18 felony counts over alleged threats // Los Angeles Times Former Windsor mayor’s accusers speak out on no charges // San Francisco Chronicle

California is struggling to provide maternal health for its residents. But as one proposal aims to prevent birth defects, another has received hateful pushback that’s been condemned by both political parties. As CalMatters health reporter Ana B. Ibarra writes, Assemblymember Joaquin Arambula has introduced a bill that would require corn masa flour makers to add […]

A premature baby in incubator. Photo via iStock
A premature baby in incubator. Photo via iStock
A premature baby in incubator. Photo via iStock

California is struggling to provide maternal health for its residents. But as one proposal aims to prevent birth defects, another has received hateful pushback that’s been condemned by both political parties.

As CalMatters health reporter Ana B. Ibarra writes, Assemblymember Joaquin Arambula has introduced a bill that would require corn masa flour makers to add 0.7 milligrams of folic acid per pound of flour. Though federal law requires other grain products, such as cereals, breads and pasta, be fortified with folic acid, corn masa flour is not included. The corn flour is a key ingredient used in many classic Latino foods.

  • Arambula, a Fresno Democrat and physician, to CalMatters: “Food is the best way that we can get folic acid into our communities before they’re pregnant. Oftentimes the prenatal vitamins that we give to pregnant people are too late.” 

Research has shown that folic acid, which can be found in prenatal and women’s multi-vitamins, promotes healthy cell growth, and can prevent birth defects when taken before and during the early weeks of pregnancy. Since 1998, when the U.S. Food and Drug Administration handed down the requirement, the proportion of babies born with neural tube defects dropped by 35%.

But between 2017 and 2019, only about 28% of Latinas reported taking folic acid the month before becoming pregnant, compared to 46% of white women. Women on Medi-Cal, the state’s health insurance program for low-income families, are also less likely to take folic acid before pregnancy compared to women on private insurance. 

To learn more about the proposal, read Ana’s story.

Another bill related to maternal health, Assembly Bill 2319, was the subject of a racist letter sent to members of the Health Committee, according to lawmakers.

The measure would require healthcare providers to undergo training for implicit bias, and for the training to include “recognition of intersecting identities.” 

The bill’s co-author, Assemblymember Lori Wilson, said the letter was “vile and hateful.”

Assembly Republicans also said the letter had no place in legislative debate: “While we may not always agree on policy, we are united to strongly condemn racism and the evil ideology behind this letter.”

Wilson, a Suisun City Democrat who is chairperson of the Legislative Black Caucus, vowed to carry on with the measure.

The proposals by Arumbula and Wilson follow state data showing that in 2020 California saw a ten-year high of pregnancy-related deaths. Black expectant mothers are particularly vulnerable: They are three times more likely to die of pregnancy-related complications than others. It’s a point raised by former state Senate leader Toni Atkins in a social media post last week.

Meanwhile, maternity wards across the state are closing, creating “maternity care deserts,” and California midwives treating Medi-Cal patients struggle to keep their businesses afloat. A February report from the state auditor also found that state health departments failed to track the effectiveness of a perinatal care program for Medi-Cal patients.


Digital Democracy: CalMatters has launched Digital Democracy, a project using the latest technologies to help Californians understand their state government and create more accountability for politicians. The website introduces each of the state’s 120 legislators and explains this year’s policy agenda. In our unprecedented database, you can instantly find any word uttered in a public hearing, every vote cast, every bill introduced and every dollar donated. For more details, see our about and methodology pages and read more from our engagement team.


Other Stories You Should Know


Builders can challenge impact fees

New housing construction in a neighbourhood in Elk Grove on July 8, 2022. Photo by Rahul Lal, CalMatters

From CalMatters housing reporter Ben Christopher:

It’s about to get more difficult for local governments to slap construction projects with certain fees — and a bit easier for developers to sue governments when they do. 

That’s thanks to a unanimous ruling the U.S. Supreme Court handed down Friday.

As many court watchers expected, the justices sided with George Sheetz, a septuagenarian retiree who sued El Dorado County over a $23,420 building fee.

Sheetz’s lawyers argued that the county should have had to prove that this five-digit fee matched the cost that his manufactured home actually would inflict on local roads and highways. That requirement was established in a four-decade-old court ruling also out of California.

El Dorado County, with the backing of both the Gov. Gavin Newsom and President Joe Biden administrations, countered that such a high bar is only required of one-off fees levied by regulators, not fees scheduled for all developments and established by elected bodies, like the county board of supervisors.

In its 9-0 ruling, the Supreme Court said that “there is no basis for affording property rights less protection in the hands of legislators than administrators.”

A few possible consequences of the ruling:

  • Cities and counties now have to show that impact fees are connected to and “roughly proportionate” to the fiscal impact of a given development. That could have the unintended consequence of slowing down permitting. 
  • Developers may now have a powerful new legal tool to challenge fees that they think are too high.

And they are high here. As of 2015, the average impact fee on a single family home in California was more than four times the national average.

But it’s too soon to say exactly how all of this will shake out. That’s because the court stopped short of saying exactly how far governments have to go to justify their fees — or whether El Dorado County already cleared that hurdle in this case. Those questions were left to lower courts.

State cracks down on water

The water treatment facility in Armona on April 4, 2024. Armona, a small unincorporated community home to farmworkers in Kings County, had substantial arsenic contamination until a new $9 million well was installed more than 1,200 feet deep. Photo by Larry Valenzuela, CalMatters/CatchLight Local
Armona’s new $9 million well and treatment facility to remove arsenic in its water supply. Photo by Larry Valenzuela, CalMatters/CatchLight Local

The State Water Resources Control Board is poised to penalize Kings County groundwater agencies for failing to manage overpumping in the region’s water supply — a move that would set a new precedent.

As CalMatters water reporter Rachel Becker explains, the board on Tuesday is expected to decide whether to put county agencies on probation for unsuccessfully restricting farmers’ overdrafting of the water supply from the Tulare Lake underground basin. If the board decides to crack down, it will be the first time the state imposes penalties under a landmark 2014 law that requires agencies to achieve groundwater sustainability by 2040.

The board’s decision could also signal how the state will approach five other overpumped San Joaquin Valley basins that may face probation as well.

Overpumping in Kings County has caused household and community water wells to dry up and land to sink, which endangers canals, aqueducts and flood-controlling levees. And because wells must reach deeper into the ground to extract water, contaminants such as arsenic are released and cause water contamination levels to rise.

Putting Kings County agencies on probation could mean imposing state fees totaling as much as $10 million a year, according to a CalMatters analysis. It could also lead to state regulators eventually managing the region’s groundwater.

This has small farmers in the region concerned that they’ll be forced out of business due to the state’s steep fees. The basin provides drinking and irrigation water for 146,000 residents and supports a multibillion-dollar agricultural industry.

For more on this issue, read Rachel’s story.

California’s water crisis, explained: CalMatters has a detailed look at how California might increase its water supply, and a dashboard tracking the state’s water situation.


CalMatters Commentary

Ideas festival: CalMatters is hosting its first one, in Sacramento on June 5-6. It will include a discussion on broadband access and a session with Zócalo Public Square on California’s next big idea. Featured speakers include Julián Castro, CEO of the Latino Community Foundation, and Barbara McQuade, a former U.S. attorney and MSNBC legal analyst. Find out more from our engagement team and buy tickets here.


Other things worth your time:

Some stories may require a subscription to read.


CA granted federal disaster relief for historic February storms // Los Angeles Times 

Ballot measure for America’s highest wage could be victim of past wins // Politico

Prop. 22 gains liberal support as case heads to state high court // San Francisco Chronicle

PG&E customers were billed for a TV promo campaign // The Sacramento Bee

Google blocks some CA news as fight over online journalism bill escalates // Politico

Bill to mandate ‘science of reading’ in CA classrooms dies // EdSource

CA abortions increased after Roe vs. Wade was overturned // Los Angeles Times

The first high-speed rail trains are closer to coming to CA // San Francisco Chronicle

Environmental concerns raised by rocket flights // The San Diego Union-Tribune

SF jails lock down after alleged assaults on staff // Los Angeles Times

SF background check startup Checkr cutting 260 jobs // San Francisco Examiner

SF $2B Central Subway has lots of leaks, few riders // The San Francisco Standard

Kern County activist faces 18 felony counts over alleged threats // Los Angeles Times

Former Windsor mayor’s accusers speak out on no charges // San Francisco Chronicle

Read the full story here.
Photos courtesy of

Nearly Half of Americans Still Live With High Levels of Air Pollution, Posing Serious Health Risks, Report Finds

The most recent State of the Air report by the American Lung Association found that more than 150 million Americans breathe air with unhealthy levels of ozone or particle pollution

Nearly Half of Americans Still Live With High Levels of Air Pollution, Posing Serious Health Risks, Report Finds The most recent State of the Air report by the American Lung Association found that more than 150 million Americans breathe air with unhealthy levels of ozone or particle pollution Lillian Ali - Staff Contributor April 25, 2025 12:50 p.m. For 25 of the 26 years the American Lung Association has reported State of the Air, Los Angeles—pictured here in smog—has been declared the city with the worst ozone pollution in the United States. David Iliff via Wikimedia Commons under CC BY-SA 3.0 Since 2000, the American Lung Association has released an annual State of the Air report analyzing air quality data across the United States. This year’s report, released on Wednesday, found the highest number of people exposed to unhealthy levels of air pollution in a decade. According to the findings, 156 million Americans—or 46 percent of the U.S. population—live with levels of particle or ozone pollution that received a failing grade. “Both these types of pollution cause people to die,” Mary Rice, a pulmonologist at Harvard University, tells NPR’s Alejandra Borunda. “They shorten life expectancy and drive increases in asthma rates.” Particle pollution, also called soot pollution, is made up of minuscule solid and liquid particles that hang in the air. They’re often emitted by fuel combustion, like diesel- and gasoline-powered cars or the burning of wood. Ozone pollution occurs when polluting gases are hit by sunlight, leading to a reaction that forms ozone smog. Breathing in ozone can irritate your lungs, causing shortness of breath, coughing or asthma attacks. The 2025 State of the Air report, which analyzed air quality data from 2021 to 2023, found 25 million more people breathing polluted air compared to the 2024 report. The authors link this rise to climate change. “There’s definitely a worsening trend that’s driven largely by climate change,” Katherine Pruitt, the lead author of the report and national senior director for policy at the American Lung Association, tells USA Today’s Ignacio Calderon. “Every year seems to be a bit hotter globally, resulting in more extreme weather events, more droughts, more extreme heat and more wildfires.” Those wildfires produce the sooty particles that contribute to particulate pollution, while extreme heat creates more favorable conditions for ozone formation, producing smog. While climate change is contributing to heavy air pollution, it used to be much worse. Smog has covered cities like Los Angeles since the early 20th century. At one point, these “hellish clouds” of smog were so thick that, in the middle of World War II, residents thought the city was under attack. The Optimist Club of Highland Park, a neighborhood in northeast Los Angleles, wore gas masks at a 1954 banquet to highlight air pollution in the city. Los Angeles Daily News via Wikimedia Commons under CC-BY 4.0 The passage of the Clean Air Act and the creation of the federal Environmental Protection Agency (EPA) in 1970 marked a turning point in air quality, empowering the government to regulate pollution and promote public health. Now, six key air pollutants have dropped by about 80 percent since the law’s passage, according to this year’s report. But some researchers see climate change as halting—or even reversing—this improvement. “Since the act passed, the air pollution has gone down overall,” Laura Kate Bender, an assistant vice president at the American Lung Association, tells CBS News’ Kiki Intarasuwan. “The challenge is that over the last few years, we’re starting to see it tick back up again, and that’s because of climate change, in part.” At the same time, federal action against climate change appears to be slowing. On March 12, EPA administrator Lee Zeldin announced significant rollbacks and re-evaluations, declaring it “the greatest day of deregulation our nation has seen.” Zeldin argued that his deregulation will drive “a dagger straight into the heart of the climate change religion.” Included in Zeldin’s push for deregulation is a re-evaluation of Biden-era air quality standards, including those for particulate pollution and greenhouse gases. The EPA provided a list of 31 regulations it plans to scale back or eliminate, including limits on air pollution, mercury emissions and vehicles. This week, the EPA sent termination notices to nearly 200 employees at the Office of Environmental Justice and External Civil Rights. “Unfortunately, we see that everything that makes our air quality better is at risk,” Kate Bender tells CBS News, citing the regulation rollbacks and cuts to staff and funding at the EPA. “If we see all those cuts become reality, it’s gonna have a real impact on people’s health by making the air they breathe dirtier.” Get the latest stories in your inbox every weekday.

Nearly Half of Americans Breathe Unhealthy Air, New Report Finds

By I. Edwards HealthDay ReporterFRIDAY, April 25, 2025 (HealthDay News) —Breathing the air in nearly half of the United States could be putting...

FRIDAY, April 25, 2025 (HealthDay News) —Breathing the air in nearly half of the United States could be putting your health at risk.A new American Lung Association report shows that 156 million people live in areas with unhealthy air.The group’s annual "State of the Air" report found that smog and soot pollution are getting worse, not better. The report looked at air quality data from 2021 to 2023. It found that 25 million more people than in the group's last report were breathing "unhealthy levels of air pollution." That's more than in any other "State of the Air" report in the last decade, the association said.Since the Clean Air Act became law in 1970, air pollution has gone down overall, said Laura Kate Bender, an assistant vice president at the lung association, told CBS News."The challenge is that over the last few years, we're starting to see it tick back up again and that's because of climate change, in part," she said. "Climate change is making some of those conditions for wildfires and extreme heat that drive ozone pollution worse for a lot of the country."The city with the worst year-round and short-term particle pollution? Bakersfield, California, for the sixth year in a row.What's more, it was ranked third worst for high ozone days. In contrast, Casper, Wyoming, was listed as the cleanest city for year-round particle pollution, CBS News said.Here are the top 10 cities with the worst year-round particle pollution, according to the association:Bakersfield-Delano, Calif. Visalia, Calif. Fresno-Hanford-Corcoran, Calif. Eugene-Springfield, Ore. Los Angeles-Long Beach, Calif. Detroit-Warren-Ann Arbor, Mich. San Jose-San Francisco-Oakland, Calif. Houston-Pasadena, Texas Cleveland-Akron-Canton, Ohio Fairbanks-College, Ark. The report warned that pollution isn't just an issue in the west. Extreme heat and wildfires are spreading pollution across the country.In fact, smoke from Canada's wildfires in 2023 caused unhealthy air quality even in the eastern parts of the U.S., the report pointed out.Some of the findings came as a surprise, according to Kevin Stewart, the association’s environmental health director."I think we knew that the wildfire smoke would have an impact on air quality in the United States," he told CBS News. "I think we were surprised at the Lung Association by how strong the effect was, especially in the northeastern quadrant of the continental United States." Last month, the U.S. Environmental Protection Agency (EPA) announced it will roll back 31 environmental rules, including ones pertaining to vehicle emissions, CBS News reported.Bender said that puts decades of progress at risk."Unfortunately, we see that everything that makes our air quality better is at risk," she said. "The EPA is at risk — the agency that is protecting our health — through staff cuts, funding cuts. The regulations that have cleaned up our air over time are at risk of being cut. If we see all those cuts become reality, it's gonna have a real impact on people's health by making the air they breathe dirtier."Lee Zeldin, the EPA administrator, argued that, instead, the deregulation will drive "a dagger straight into the heart of the climate change religion to drive down cost of living for American families, unleash American energy, bring auto jobs back to the U.S. and more," according to CBS News."This air pollution is causing kids to have asthma attacks, making people who work outdoors sick and unable to work, and leading to low birth weight in babies," Kezia Ofosu Atta, the Lung Association’s advocacy director, told CBS News.The report also found that Black Americans are more likely to suffer serious health problems from air pollution.SOURCE: CBS News, April 23, 2025Copyright © 2025 HealthDay. All rights reserved.

Umbilical Cord Could Contain Clues For Child's Future Health

By Dennis Thompson HealthDay ReporterFRIDAY, April 25, 2025 (HealthDay News) -- Doctors might be able to predict a newborn's long-term health...

By Dennis Thompson HealthDay ReporterFRIDAY, April 25, 2025 (HealthDay News) -- Doctors might be able to predict a newborn's long-term health outlook, by analyzing their umbilical cord blood, a new study says.Genetic clues found in cord blood can offer early insight into which infants are at higher risk for health problems like diabetes, stroke and liver disease later in life, researchers will report at the upcoming Digestive Disease Week meeting in San Diego.“We’re seeing kids develop metabolic problems earlier and earlier, which puts them at higher risk for serious complications as adults,” lead researcher Dr. Ashley Jowell, a resident physician in internal medicine at Duke University Health System in Durham, N.C., said in a news release. “If we can identify that risk at birth, we may be able to prevent it.”For the study, researchers performed genetic analysis on the umbilical cord blood of 38 children enrolled in a long-term study based in North Carolina.The analysis looked for chemical patterns in infants’ DNA that switch genes on or off. When these switches occur in critical parts of DNA, their health effects can persist through fetal development and into later life.The research team compared these DNA changes to the kids’ health at ages 7 to 12, and identified multiple areas where genes in cord blood predicted health problems in childhood.For example, changes in a gene called TNS3 were linked to fatty liver, liver inflammation or damage, and excess belly fat as measured by waist-to-hip ratio, results show.Changes in other genes were connected to blood pressure, waist-to-hip ratio, and liver inflammation or damage, researchers said.“These epigenetic signals are laid down during embryonic development, potentially influenced by environmental factors such as nutrition or maternal health during pregnancy,” co-researcher Dr. Cynthia Moylan, an associate professor in the division of gastroenterology at Duke University Health System, said in a news release.Researchers noted that the sample size was small, but the links so powerful that these findings warrant further investigation. A larger follow-up study funded by the National Institutes of Health is underway.“If validated in larger studies, this could open the door to new screening tools and early interventions for at-risk children,” Moylan added.Jowell said disease may be preventable even with these markers."Just because you're born with these markers doesn't mean disease is inevitable," she said. "But knowing your risk earlier in life could help families and clinicians take proactive steps to support a child’s long-term health."Researchers are scheduled to present their findings May 4. Findings presented at medical meetings are considered preliminary until published in a peer-reviewed journal.SOURCE: American Gastroenterological Association, news release, April 25, 2025Copyright © 2025 HealthDay. All rights reserved.

Biden let California get creative with Medicaid spending. Trump is signaling that may end

California uses Medicaid to pay for a range of nontraditional health care services, including housing. The Trump administration wants to scale back those programs.

In summary California uses Medicaid to pay for a range of nontraditional health care services, including housing. The Trump administration wants to scale back those programs. In 2022, California made sweeping changes to its Medi-Cal program that reimagined what health care could look like for some of the state’s poorest and sickest residents by covering services from housing to healthy food. But the future of that program, known as CalAIM, could be at risk under the Trump administration.  In recent weeks, federal officials have signaled that support for creative uses of Medi-Cal funding is waning, particularly uses that California has invested in such as rent assistance and medically tailored meals. Medi-Cal is California’s name for Medicaid. The moves align with a narrower vision of Medicaid espoused by newly confirmed Centers for Medicare and Medicaid Services head Dr. Mehmet Oz, who said during his swearing-in ceremony that Medicaid spending was crowding out spending on education and other services in states with the federal government “paying most of the bill.” “This one really bothers me. There are states who are using Medicaid — Medicaid dollars for people who are vulnerable — for services that are not medical,” Oz said. It also fits with broader GOP calls to slim down the federal government. Medicaid is under scrutiny as part of a GOP-led budget process in the House of Representatives that calls for $880 billion in cuts over 10 years to programs including Medicaid. “The messaging that we want to go back to the basics of Medicaid puts all of these waiver programs in jeopardy,” said John Baackes, former chief executive of L.A. Care, the state’s largest Medi-Cal health insurer. CalAIM is authorized under a federal waiver that allows states to experiment with their Medicaid programs to try to save money and improve health outcomes. Under the waiver, California added extra benefits for high-cost users to help with food insecurity, housing instability,  substance use and behavioral health challenges. Roughly half of all Medi-Cal spending can be attributed to 5% of high-cost users, according to state documents. But in March, the federal government rescinded guidelines supporting Medi-Cal spending for social services. It also sent states a letter in April indicating that the Centers for Medicare and Medicaid Services would no longer approve a funding mechanism that helps support CalAIM, although that money will continue until 2026. Together, these moves should worry states that operate programs like CalAIM, said Kathy Hempstead, senior policy officer at the Robert Wood Johnson Foundation. “Under the Biden administration states were encouraged to experiment with things like that: To prescribe people prescriptions to get healthy food, to refer people to community-based services,” Hempstead said. “This administration is not receptive at all to … that vision of the Medicaid program.” In a press release, CMS said it is putting an end to spending that isn’t “directly tied to health care services.” “Mounting expenditures, such as covering housekeeping for individuals who are not eligible for Medicaid or high-speed internet for rural healthcare providers, distracts from the core mission of Medicaid, and in some instances, serves as an overly-creative financing mechanism to skirt state budget responsibilities,” the press release states. These signals from the federal government apply to future applications for Medicaid changes, and do not change California’s current programs or funding. The state’s CalAIM waiver expires at the end of 2026, and another similar waiver that supports California’s efforts to improve behavioral health care expires in 2029. According to a statement from the Department of Health Care Services, the agency that oversees Medi-Cal, all programs “remain federally approved and operational.” “We appreciate our Medi-Cal providers and community partners, and together we will push full steam ahead to transform our health system and improve health outcomes,” the department said. Physician assistant Brett Feldman checks his patient, Carla Bolen’s, blood pressure while in her encampment at the Figueroa St. Viaduct above Highway 110 in Elysian Valley Park in Los Angeles on Nov. 18, 2022. Photo by Larry Valenzuela, CalMatters/CatchLight Local Paul Shafer, co-director of the Boston University Medicaid Policy Lab, said decades of public health research show that people have worse health outcomes that require more expensive treatment when their social needs aren’t met. “We’ve spent the last few decades in public health and health policy, arguing that so much of health and medical costs is driven by environmental factors — people’s living conditions, income, etc.” Shafer said. But, Shafer said, programs like CalAIM are relatively recent and the research hasn’t had enough time to show whether paying for non-traditional services saves money. For example, California’s street medicine doctors who take care of people who are homeless say that their patients often cycle in and out of the emergency room — the most expensive point of service in the health care system. They have no place to recover from medical procedures, no address to deliver medications, and the constant exposure to the elements takes years off of their lives, doctors say.  CalAIM gives them options to help their clients find housing.  The federal government’s decision not to fund programs like this in the future is a “step backward,” Shafer said.  “I think we can all read the tea leaves and say that that means they’re sort of unlikely to be renewed,” he said. Supported by the California Health Care Foundation (CHCF), which works to ensure that people have access to the care they need, when they need it, at a price they can afford. Visit www.chcf.org to learn more. more on california health care They live in California’s Republican districts. They feel betrayed by looming health care cuts March 11, 2025March 12, 2025 California has big plans for improving mental health. Medicaid cuts could upend them April 7, 2025April 7, 2025

Chattanooga Just Became North America's First National Park City. Here's What That Means

The designation was awarded by a London-based charity that aims to make cities more like national parks: "greener, healthier and wilder"

Chattanooga Just Became North America’s First National Park City. Here’s What That Means The designation was awarded by a London-based charity that aims to make cities more like national parks: “greener, healthier and wilder” Sarah Kuta - Daily Correspondent April 23, 2025 4:20 p.m. Chattanooga was once one of the most polluted cities in the country. Now, it's North America's first National Park City. larrybraunphotography.com via Getty Images Chattanooga has been named North America’s first National Park City, a designation that acknowledges the city’s abundant green spaces and commitment to environmental stewardship. The city in southeast Tennessee, home to roughly 190,000 residents, is now the third National Park City in the world, following behind London and Adelaide, Australia. The title comes from the National Park City Foundation, a London-based charity that envisions a better future by thinking of cities more like national parks. The movement is not connected to the National Park Service, the federal agency that manages America’s national parks, monuments, historic sites and other protected lands. “[National parks] are special places where we have a better relationship with nature, culture and heritage and can enjoy and develop ourselves,” according to the foundation. “Combining the long-term and large-scale vision of national parks with cities has the potential to shift our collective understanding of what and who a city is for.” In Chattanooga, city leaders have used the initiative to encourage residents to “think about Chattanooga as a city in a park, rather than a city with some parks in it,” says Tim Kelly, the mayor of Chattanooga, in a video announcing the designation. “The outdoors is our competitive advantage,” he adds. “It’s at the heart of our story of revitalization, and it’s at the core of our identity as Chattanoogans. We’ve always known how special Chattanooga’s connection to the outdoors is, and now it’s going to be recognized around the world.” Chattanooga has been working toward the designation for nearly two years, per a statement from the city. In late 2023, officials collected more than 5,600 signatures of support and created a National Park City charter. Then, they filed an application describing how Chattanooga met the nonprofit’s criteria—such as being “a place, vision and community that aims to be greener, healthier and wilder.” Last month, delegates from the foundation visited Chattanooga to experience it first-hand. They toured an urban farm, explored several parks and met with various community leaders, per NOOGAtoday’s Haley Bartlett. The foundation’s experts were impressed by Chattanooga’s “culture of outdoor activity,” its “unrivaled access to nature,” its commitment to “inclusive and sustainable development” and its food and agriculture scene, among other factors. “We saw first-hand the extraordinary breadth and depth of engagement with the Chattanooga National Park City vision informed by outstanding experts in design, ecology, culture and arts,” says Alison Barnes, a trustee of the foundation, in a statement. “National Park City status introduces a new chapter for a city with a long history of revitalization and renewal through connecting its unique landscape and the history of its people.” Chattanooga has come a long way since 1969, when the federal government declared it the worst city in the nation for particulate air pollution. Hazy skies were the norm back then, as factories and railroads spewed unregulated emissions into the air, according to the Chattanooga/Hamilton County Air Pollution Control Bureau. Air pollution was so bad that residents sometimes had to drive with their headlights on in the middle of the day. But the pollution was more than just an eyesore. It was also causing the city’s residents to become sick—and sometimes die—from diseases like tuberculosis. Eventually, voters approved aggressive new rules to reduce emissions. By 1989, Chattanooga’s air quality had improved so much that it met all federal health standards. Today, it’s a vibrant, outdoorsy city with more than 100 parks and more than 35 miles of trails—plus many more within a short drive. The once-neglected riverfront downtown has been revitalized, and Chattanooga has experienced steady population growth in recent years. What does the National Park City designation mean for the city’s future? That remains to be seen. But officials hope it will help guide policy decisions and “help city government and community partners prioritize connecting more people to the outdoors that have long defined our identity,” according to a statement from the Chattanooga Area Chamber. It will also encourage citizens and leaders to embrace “all aspects of outdoor life,” from forests and lakes to native plants, according to the chamber. Mark McKnight, who serves as the president and CEO of Chattanooga’s Reflection Riding Arboretum and Nature Center, hopes that the new status will “yield some really cool stuff that we can’t even imagine today.” “Hopefully, we’re having this conversation in ten years, and it’s like, ‘Oh, wow, we never knew we would get to there,’” he tells the Chattanooga Times Free Press’ Sam Still. Get the latest stories in your inbox every weekday.

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