HealthyCal

It’s not news to residents of the eight-county San Joaquin Valley that the area has been hard hit economically since 2008, when the housing bubble deflated. Many neighborhoods show signs of neglect as people unable to meet their mortgage obligations lose their homes to foreclosure.

Among those facing this prospect in the central part of the state are a growing number of older homeowners. Exactly how many is hard to pin down. Foreclosure figures typically are not broken down by the owner’s age, according to Sean O’Toole, president of ForeclosureRadar, which provides subscribers with foreclosure figures and statistics.

However, a recent study [PDF] by AARP, the grimly titled "Nightmare on Main Street," said that as of December 2011, 600,000 loans for homeowners ages 50 and older were in foreclosure, while 3.5 million loans for the age group were “underwater,” meaning the home’s value was less than the loan.

AARP spokeswoman Christina Klem says older homeowners face a “double-edged sword” in regard to foreclosure as opposed to younger owners: They don’t have as many years to recoup financial losses and those who are seeking work “are unemployed longer.”

Seniors also are more likely to end up in trouble because of scams and requests for financial help from family members, according to foreclosure prevention experts.

“I don’t know how any senior can handle all of this stuff,” sighs Mary Anne Humphrey, 68, who suffers from limited mobility due to a spinal cord injury.

Humphrey is explaining the endless paperwork, social services, doctor appointments, benefit plans and medications she juggles as a disabled senior.

Fortunately, Humphrey is one of 1,200 San Francisco County residents who have received help over the past five years from a unique Bay Area program that keeps older adults and the disabled living independently: the Community Living Fund.

“They just must be overloaded with the paperwork and ins and outs and ‘sign this’ and ‘do that,’ ” she says. “CLF helps with that, with a real comfort. It takes away a lot of stress.”

Spawned in 2007 by the county, the fund is a collaboration with the city of San Francisco and the local Institute on Aging with a single focus: help San Franciscans survive independently outside the four walls of institutional living.

Besides coordinating complex medical care and social services, more specific assistance by case managers includes arranging transportation to doctors, preparing meals, paying bills, installing ramps, buying electric wheelchairs or any other help needed to keep clients living on their own.

With San Francisco’s impressive history of community support for the underserved, the county’s Board of Supervisors created the Community Living Fund in 2007, responding in part to the Olmstead Act of 1999, which requires that disabled citizens wanting to live at home can do so. (The city and county of San Francisco share the same borders.)

It started in 2001 and mostly affected the very young and very old. Peoples’ hair would fall out, their skin would break out in rashes and their eyes would turn red after showers.

“That was how people were hurt on the outside,” said Horacio Amezquita, manager of the San Jerardo Cooperative, which houses about 250 low-income people in Salinas. “On the inside, we don’t know.”

Amezquita, a former farm worker, has lived at the cooperative for 33 years. Many of the residents work on nearby farms that use nitrogen-based fertilizers to help crops grow.

But the fertilizers that keep these farms in business leach into the soil and drinking water.

A report published last year by California Watch and KQED revealed that statewide, the number of wells that exceeded health limits for nitrates increased from nine in 1980 to 648 in 2007. That includes the water supply of more than 2 million Californians.

Nitrate-contaminated water can lead to serious health problems, including methemoglobinemia, or blue baby syndrome, a disease that develops when an infant’s organs, cells and tissues do not receive enough oxygen.

Studies also have linked nitrates with cancer, Crohn’s disease, thyroid disruption and depression, among other illnesses. Regions with the highest nitrate pollution include major agricultural regions, such as the Imperial, Central and Salinas valleys, and other coastal areas in California. Regulators classify nitrates as acute contaminants, which means people can experience severe reactions with only one taste or one glass.

A year after environmentalists lost a regulatory battle to keep the controversial pesticide methyl iodide off the California market, they appear to be winning the ground war against the chemical.

Only six California growers have used methyl iodide – marketed as MIDAS – to zap soil-borne pests and weeds before planting crops like chili peppers, strawberries and walnut trees.

Methyl iodide manufacturer Arysta LifeScience Corp. paid for at least two of the fumigations. The company shared in the cost of a third, according to the grower.

By way of comparison, more than 8,500 soil fumigations took place in California in 2009, the last year for which data is available from the state’s Department of Pesticide Regulation.

“Methyl iodide is a speck on the horizon,” said Les Wright, Fresno County deputy agricultural commissioner.

Growers and agriculture industry groups clamored for methyl iodide registration last year before the Department of Pesticide Regulation gave the chemical its final approval.

They pointed to the coming ban on methyl bromide, one of the most effective and widely used fumigants in the state, and argued that without methyl iodide, California’s billion-dollar agriculture industry would hemorrhage jobs and profits. Methyl bromide is being phased out under the Montreal Protocol; it’s expected to be eliminated altogether by 2015.

Every year, however, the Montreal Protocol grants critical-use exemptions for growers who don’t have alternatives to methyl bromide. Methyl bromide is costly because of dwindling supplies, so many growers are also using other chemicals.

Pao Fang talks matter-of-factly about leaving Laos for a military camp in Thailand circa 1975, when the Laotian Civil War ended. Anti-communists – many of them Hmong trained by the CIA to fight North Vietnamese troops in a “secret war” outside Vietnam’s borders – faced retribution from Laos’ new rulers.

Fang’s brother was a captain in the U.S.-backed guerrilla army, and he sent Fang to study in Vientiane in the hope that the youngster would not be drafted. Eventually, Fang fled to Thailand along with thousands of other Hmong, then on to Orange County and Fresno.

“My mom, my older brother, more than 20 members of my family were killed on the way,” he said of the journey across the Laos-Thailand border that led to his freedom. “The Vietnamese attacked us along the way.”

Despite such dramatic journeys, the resettled Hmong returned to everyday life and found livelihoods in the United States. Fresno County, along with St. Paul, Minn., is home to the greatest Hmong refugee concentration in the country.

Yet many Hmong, a “hill people” unassimilated in greater Southeast Asia and in the Asian American community, retain their Old World notions of health and healing. That means a reliance more on herbal remedies and shamanism than embracing basic Western medical care.

“It’s all new to our people. As a nation, we did not have health care assets in Laos, except some people go to the military hospital,” said Fang, executive director of Lao Family Community of Fresno, whose goal is to “empower refugees with the knowledge and skills to adapt to their new lives.”

As the nation’s elderly population increases, nursing homes across the country have seen a demographic shift in their residents. More Hispanic, black and Asian seniors are moving into nursing homes, while white seniors choose other options.

A study by Brown University researchers published in the journal Health Affairs found that this nationwide trend is driven in part by changing demographics, such as the rapid growth of elderly minority populations.

But the study also found that the increase in the proportion of minority nursing home residents indicates a lack of access to home- and community-based alternatives, which generally are preferred for long-term care. Whites seniors, who have greater economic resources on average, are finding better housing alternatives as they reach old age.

“We know those alternatives are not equally available, accessible or affordable to everybody, certainly not to many minority elders,” said Zhanlian Feng, an assistant professor at Brown University's Center for Gerontology and Health Care Research and the study’s lead author. “Most elders would rather stay in their homes or some place like home, but not a nursing home unless they have to.”

Environmentalists say a newly uncovered memo shows how the California Department of Pesticide Regulation gave in to industry pressure when it approved the controversial soil fumigant methyl iodide for use in California agriculture at levels more than 100 times higher than those its own scientists recommended.

The Feb. 16, 2010, memo by an executive of methyl iodide manufacturer Arysta LifeScience said maximum exposure levels that the state’s scientists had recommended for workers and people who live near agricultural fields were unacceptable to the company because they were too low.

“It is essential to revisit the toxicology assessment to come up with less conservative assumptions,” wrote John Street, the company’s global head of development and registration.

The memo was addressed to Jim Wells of Environmental Solutions Group, a Sacramento-based consulting firm that Arysta hired to help win regulatory approval for methyl iodide in California. Wells served as director of the Department of Pesticide Regulation in the 1990s.

Street recommended a range of exposure levels Arysta would support and laid out the calculations state pesticide regulation managers could make to arrive at those levels.

Eight months later, DPR managers overruled their own toxicologists – and a panel of expert scientists the department had commissioned to review the toxicologists’ work – and approved the use of methyl iodide at so-called regulatory target levels nearly identical to the lowest levels Street said would be acceptable to Arysta.

Oakland teenager Daisy Armstrong held the audience at the city’s First Unitarian Church captive with her spoken-word performance.

“She makes money any way she knows how,” Armstrong said in a cadence between a croon and a chant, her voice filling the church without help from a microphone. “She just turned 13. Shouldn’t know what a naked man looks like.”

That poem, she explained after finishing her recitation to thunderous applause, was based on the experience of a 14-year-old acquaintance who was prostituted on the streets of Oakland.

The audience so moved by her performance was all too familiar with the story Armstrong recounted. They were mostly service providers, but also law enforcement officers, judges and attorneys, and many of them work to stamp out the problem of prostituted children in the city.

They gathered at the church on a recent fall afternoon to listen to Julian Sher, investigative reporter and author of "Somebody’s Daughter: The Hidden Story of America’s Prostituted Children and the Battle to Save Them." His book is part of a recent trend of attention to the problem of child sex trafficking in the United States.

“Oakland may be the crucible of the problem,” Sher said. “But it may also be the solution.”

A stretch of International Boulevard in East Oakland is notorious as a hub of child sex trafficking.