Advocates Use Research, Studies and Polls To Inform Health Policy
 cross the state, nonprofit organizations are developing and disseminating research tools to address the health needs of California’s most vulnerable populations. By informing policymakers and community stakeholders on issues such as diversity in the health care workforce, environmental toxins in children’s products, and the opinions of ethnic and immigrant communities about health issues affecting their lives, these organizations are helping to improve policies that affect the health of the people of California.
 “Thorough and sound research is the bedrock of informed public policy decision making,” said Gary L. Yates, president and CEO of The California Wellness Foundation (TCWF). “Reports on the critical health needs of California’s underserved communities arm policymakers and opinion leaders with essential information that can transform local lessons into widespread health policy improvements.”
TCWF has provided grants for core operating support to many organizations that are addressing specific health concerns with the tools of public policy reports, research and polls. The following are several examples of how these organizations are working to inform policymakers as they consider local, regional or statewide legislation.
Best Practices for Recruiting Minority Nurses
The Tomas Rivera Policy Institute (TRPI) at the University of Southern California has conducted more than 150 studies on issues affecting the Latino population since its inception in 1985. In March 2003, TCWF awarded a two-year, $100,000 grant in support of a project titled “Increasing Latino Participation in the Nursing Profession: A Statewide Benchmarking Project.”
Research has shown that minority health care providers are more likely to provide health care to underserved communities, so increasing the retention of Latino nursing students could have an important impact on the ability of these communities to access quality care. Statewide, Latinos make up 20 percent of pre-licensure nursing program participants, but only 4 percent of the workforce. To address this gap, TRPI conducted research to describe the policy context that influences nursing education in the state and to identify novel ways that exemplary programs address barriers that limit the number of Latinos entering the nursing profession.
“If policymakers had a real idea about the barriers Latinos face in entering the nursing workforce, it could make a real difference in the decisions they make,” said Hayley Buchbinder, TRPI research manager who interviewed more than 50 nursing students, faculty and alumni at nine different nursing programs throughout the state as part of the study.
Buchbinder found that many exemplary programs were supported by an administration and leadership that implemented specific policies to promote diversity. Such policies include finding innovative approaches to funding, collaboration between public and private partners, placing minority role models in recruitment and retention positions, and a payroll system that allows staff to donate portions of their paychecks to a minority scholarship through the ease of direct deposit.
The results of TRPI’s findings will be disseminated in a report to policymakers and stakeholders throughout the state this summer at two regional briefings. TRPI also plans to post the report online, issue a news release, and also announce its release on a widely circulated electronic mailing list.
“In a state as ethnically and racially diverse as California, a health workforce that mirrors the population is a critical component of improved health care access and quality,” said Saba Brelvi, TCWF program director. “By informing policymakers and stakeholders of best practices in the field of health care workforce diversity, this report will help inform public policy for nursing programs in the years ahead.”
Opinion Polling Among Immigrant Communities
Since April 2002, Pacific News Service’s New California Media (NCM) project has conducted multilingual polls to gauge the views of non-English-speaking immigrant populations normally excluded from mainstream public opinion surveys. In September 2004, TCWF awarded NCM a two-year, $100,000 grant to conduct public opinion polls on health issues facing California’s ethnic communities.
“To track public opinion in the United States without accessing immigrant, ethnic and non-English-speaking communities is to discount the voice of a large segment of the population,” said Brahmani Houston, NCM communications coordinator.
A common thread in NCM’s polls is how the ethnic media are a major source for information about health care issues. Its first poll — conducted in 12 languages among 2,000 adult immigrants in California, with a margin of error of plus or minus 3 percent — found that the ethnic media are a primary news and information source for California’s immigrant communities. A subsequent poll found that, after doctors, the ethnic media are the primary source of information about health care for ethnic Californians.
This poll also revealed that, as a group, immigrants rank health care as the most important issue facing California, surpassing employment and education. The poll also found that many are unaware of their legal right to a language interpreter when receiving health care.
An upcoming NCM poll will survey 800 ethnic Californians between the ages of 18 and 25 on what they perceive as health challenges confronting their families and communities.
 “California is one of the most ethnically diverse states in the country,” said Ruth Holton Hodson, TCWF director of public policy. “For state policymakers to adequately address the health needs of non-English-speaking communities, it is important that they have specific, culturally sensitive data on the attitudes, opinions and customs of their diverse constituents.”
Conducted by nationally recognized pollster Sergio Bendixen, NCM’s polls receive wide coverage in California and nationwide by major media outlets such as The Wall Street Journal, New York Times and Washington Post, and through NCM’s network of more than 700 ethnic media organizations.
With each poll, NCM holds briefing sessions and press conferences about the findings for policymakers, opinion leaders, the media and health advocacy groups. As a result, the polls have proven to be an effective way to educate policymakers about the concerns of immigrants and ethnic communities.
“We have been requested at times to give presentations on the polls, sometimes months later, by groups ranging in focus from advocacy to policy to corporate business,” said NCM’s Houston. “I regularly get requests for data that is a couple years old, mainly because it is the only study of its kind out there.”
Research on Environmental Health Hazards
 Many consumers assume that if a chemical is used in products marketed to them, it must have been proven safe. This is not always the case. There are more than 85,000 chemicals on the market, 90 percent of which lack complete health and safety data. In fact, research conducted by environmental and public health groups has found that chemicals present in many common products used by children may be toxic.
In March 2004, TCWF awarded a three-year, $135,000 grant to Environment California Research and Policy Center, Inc. (ECRPC), to continue to educate the public and policymakers about the health effects of toxic chemicals and to advocate for policies that reduce their use. Formed in 2003, the Los Angeles-based organization has extensive experience in identifying threats to the environment and using careful research to implement a focused strategy to achieve measurable objectives.
“The efforts of environmental groups such as ECRPC educate the public and decisionmakers and help Californians make their voices heard in local, state and national debates over the quality of our environment and our lives,” said Sujatha Jahagirdar, ECRPC clean air and clean water advocate.
In 2003, ECRPC led the charge in the state policy arena to highlight the dangers of polybrominated diphenyl ethers, or PBDEs. Their research found that these toxic flame-retardant chemicals, present in foam furnishings, textiles and electronic components, can build up in breast milk and may be linked to neurological damage in infants.
Through a strategic campaign consisting of research reports, media outreach, advocacy and key coalition partners, ECRPC informed the public and decisionmakers about the emerging threat from this substance, about which little was previously known outside the environmental health community.
Primary outreach efforts included the dissemination of reports through one-on-one meetings with decisionmakers and the media. To augment coverage of these publications, ECRPC also produces and distributes background footage, or “B-roll” tapes, to television news stations; submits letters to the editor and op-eds to major newspapers; and employs a large e-mail distribution network composed of more than 85,000 Californians.
Another recent report, “Growing Up Toxic: Chemical Exposures and Increases in Development Disease,” chronicles threats to fetal and infant development, with a focus on the toxic chemicals included in everyday products. Based on this research, ECRPC will focus its next campaign on those chemicals found in popular baby toys on the market.
“By educating policymakers and consumers on the toxic health risks associated with numerous household products, ECRPC is creating momentum for stronger public policies that will promote the health of all Californians,” said Fatima Angeles, TCWF program director. “When they study the effects of chemicals whose safety has not previously been determined, they provide valuable data to guide decision making.”
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