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  • California, Oregon Pharmacists Can Prescribe Birth Control Pills: Uncoupling Exams From Prescriptions

    By Sarah Breitenbach, StatelineBirth Control Patch

    Since January, Charley McGrady has been doling out hormonal contraceptive pills and patches to women who come to her Eugene, Oregon, pharmacy without a doctor’s prescription for birth control.

    A new state law allows McGrady to consult women about pregnancy prevention and write prescriptions for contraceptives that previously required a doctor’s signature.

    Oregon’s move to pharmacist-prescribed birth control is an attempt to increase access to the drugs and reduce unintended pregnancies, which make up more than half of all pregnancies in the United States. It also is part of a movement toward team-based medical care, in which doctors and other medical professionals together oversee patients’ care.

    An Ortho Evra birth control patch with the plastic backing still on; Wikimedia Commons

    California pharmacists will begin writing their own prescriptions for birth control next month, and lawmakers in Hawaii, Missouri, South Carolina, Tennessee and Washington are considering legislation that would give pharmacists the power to prescribe contraceptives.

    Pharmacists in several states already can prescribe certain drugs under the supervision of a physician, but laws like those in Oregon and California give them autonomy to prescribe contraceptives on their own after completing a training course.

    The California law is more expansive than Oregon’s. It allows pharmacists to prescribe a vaginal ring and hormonal birth control shots in addition to pills and patches that release hormones through the skin. In California, where about half of pregnancies are unplanned, the law also lets them furnish contraceptives to women under 18. (In Oregon, only pharmacists working directly with a physician can prescribe to women who are under 18.)

    McGrady said she has consulted with 13 patients about birth control at her Safeway pharmacy since the law took effect at the start of the year. She filled prescriptions for 11 of them and referred the remaining two to doctors for further evaluation.

    “They seem to be between insurance, maybe between doctors [or] they just moved here,” she said of the women who have come to see her. “But they have the resources to purchase their birth control.”

    To get a prescription for hormonal birth control, which most commonly uses a combination of estrogen and progestin to prevent ovulation, a woman typically must visit a doctor or clinic.

    Sometimes those visits also include pelvic exams or pap smears that have no medical bearing on whether a woman can get a prescription for birth control, said Paige Clark, a pharmacist with Oregon State University (OSU) College of Pharmacy. Uncoupling the exams from prescriptions improves access to the contraceptives, she said.

    Visiting a doctor for a prescription can be difficult for many women because they lack health insurance to cover the visit, cannot take time off work for an appointment, or have trouble finding a doctor with an opening to see them, Clark said.

    Getting birth control from pharmacies could be easier because they can accommodate walk-in patients and are usually centrally located in communities — 93 percent of Americans live within five miles of a pharmacy.

    “This is really about not putting any barriers between the patient and their direct access to birth control,” Clark said.

    So far 250 of Oregon’s roughly 3,800 pharmacists have completed the OSU-run training and can prescribe birth control, though more are signing up every day and Clark expects to have more than 1,000 pharmacists certified by June.

    It is too early to know if the program is reducing unplanned pregnancy. But Clark reports that, anecdotally, more than 90 percent of patients seen by the newly trained pharmacists are receiving prescriptions for birth control. Others are referred to physicians.

  • Not By the Book: Musing About My Sex Ed Class

    By Joan L. CannonSeicus

    SIECUS’s (the Sexuality Information and Education Council of the United States) SexEdLibrary page

    There seem to be gaps in teaching and learning that are made by those habits of society and custom and plain laziness that we should to try to bridge. Certainly lessons as such are  necessary, but the curriculum needs imagination and revision. While working for certification in  the state where I was teaching as a substitute in a public high school, my class was assigned a  paper on Sex Education.

    It’s only fair to say that my own experience with this was nearly unique. The school I  attended from grades one through twelve did a number of things differently from other institutions. Therefore, the place I’m coming from, as the modern saying is, may be a bit foreign  to begin with. 

    In the seventh grade we had a course called Human Physiology. Our teacher was  known for using college texts and for his rigorous requirements to excel in his classes. Human  physiology used articles from various sources and diagrams from medical texts. Each physical  system was studied separately: the digestive system, circulatory system, skeletal system, nervous  system, reproductive system.  At the time I was in the class, the RH factor in blood types had just  been discovered. 

    Questions were raised and answered. If the teacher thought questions weren’t being asked  that should be answered, he would bring them up. Thus, while learning about the reproductive  systems and how they differed between male and female, we were given information about birth  control as it was available and understood at the time, as well as STDs. The approach was purely  scientific, and the mixed class took it all in without any psychological trauma I can recall.

    To this day, I think that is sex education for the classroom. On the other hand, I  understood what was supposed to be the focus of a paper for a master’s degree in education. By  the time I received the assignment, I was the mother of two teenage boys and a slightly younger  girl. I was irritated, to say the least. It was perfectly clear to me that I couldn’t write anything  reasonable to address the subject in the mode of what was called (may still be) ‘sex education’  in a coeducational public school. The professor had made a tacit challenge to address the  problem at something deeper than the curriculum level, or so I thought.

    So much that I recall from school is outside the formal monologue of a teacher in front of  a class. What sticks effortlessly is what is shown rather than said, demonstrated often  unconsciously before students who are likely unaware they’ve noticed anything at the time. From  this distance, I can say for certain that the facts of reproduction aren’t what constitute the most  important information. Long before feminism became a loaded word, children were absorbing  simplistic stereotypes that were acceptable because not enough people around them ever thought  to do anything but follow the lead of habit.

    Perhaps educators are freed up to some extent by the dictates of political correctness –  one buzz­word after another! – but it should be possible to make future guides for children and  young adults that consider the subtleties of attitude that can make the difference between  courtesy (in the most archaic and literal sense), respect, awareness become the behavior that will  enable the men and women of the future to have a true feeling of fellowship without competition  based on gender.

     If we’re to teach the teachers that way, how can it be done if not in a classroom? Fair  question. The point is that those in charge of helping the growth of other minds could be  instructed on how to offer examples and suggest how people best learn to get along everywhere  sexes are mixed, which is to say, everywhere the journey of their lives leads them.

    Nobody is without sex; nobody fails to notice it. Learning how to be at ease with it is as  necessary as learning how to listen when someone speaks, to remember to check the traffic light   before crossing a street, to make sure coffee isn’t too hot to gulp. Why should one of the most  fundamental skills of living be supposed to find its grounding in a few months in a school classroom?

    ©2016 Joan L. Cannon for SeniorWomen.com

  • Smaller Share of Women Ages 65 and Older are Living Alone; More are Living With Spouse or Children

    BY 

    After rising for nearly a century, share of older women living alone is on decline

    After rising steadily for nearly a century, the share of older Americans who live alone has fallen since 1990, largely because women ages 65 to 84 are increasingly likely to live with their spouse or their children. The likelihood of living alone has grown since 1990 for older men and for women ages 85 and up.

    Between 1900 and 1990, the share of adults ages 65 and older living alone increased nearly fivefold, from 6% to 29%. This growth was spurred by a host of factors, including improved health and longevity among older Americans and the economic security that came with social safety net programs such as Social Security and Medicare. 1

    A new Pew Research Center analysis of U.S. Census Bureau data finds that from 1990 to 2014, the share of older adults living alone declined by 3 percentage points, to 26%. Among older women, the share declined to 32% in 2014 from 38% in 1990. Among older men, the share living alone ticked upward to 18% in 2014 from 15% in 1990.

    One explanation for this trend is that an increase in life expectancy, especially among men, has made it more likely that older women would be living with their spouses rather than as widows.

    Among women ages 65 to 84 – the group that has almost exclusively driven the overall decline in the share of older Americans living alone – the share living alone has declined by 8 percentage points since 1990, reaching 30% in 2014. During the same period, the share of this group living with a spouse increased from 41% to 46%. Women in this age group were also more likely to be unmarried and living with their children or with other relatives or non-relatives in 2014.

    Older men ages 65 to 84, on the other hand, are somewhat less likely to live with a spouse now compared with 1990, though most still do. Living arrangements for men in this age group have grown more diverse as a rising share have divorced and not remarried.

    Most older adults want to age in place

    Overall, women still make up a majority of the 12.1 million older U.S. adults living alone, but their share has fallen significantly over the past quarter century – from 79% in 1990 to 69% in 2014.

    Recent Pew Research Center survey findings underline the extent to which older adults value their independence and wish to live in their own home, even when they can no longer care for themselves. In a survey conducted Oct. 27-Nov. 24, 2014, among 1,692 adults, about six-in-ten adults ages 65 and older (61%) say that if there came a time when they could no longer live on their own, they would stay in their own home and have someone care for them there. And older men and women are equally as likely to say this. Another 17% of older adults say they would move into an assisted living facility, and 8% say they would move in with a family member.

    Older adults living alone feel more financially strapped than those living with others

    The survey findings also underscore the potential downsides of living alone. Older adults who live alone feel more financially strapped than older adults who live with others. 2 When asked to describe their household’s financial situation, only 33% of those living alone say they live comfortably. By contrast, about half (49%) of older adults who live with others say they live comfortably.

    In some ways those who live alone also feel somewhat more socially isolated. A Pew Research Center survey conducted Feb. 23-March 23, 2009, among 2,969 U.S. adults (including 1,328 adults ages 65 and older who responded to questions about their living arrangements) found that older adults living alone are less likely than older adults who live with others to say that, as they’ve aged, they have more time with their family. And men who live alone (but not women) are less satisfied with the number of friends they have than are men who live with others. However, older adults who live alone and those who live with others are equally likely to say they receive the right amount of help from their children.

    This report uses U.S. Census Bureau data to describe trends in living arrangements among older adults over the past 25 years, focusing on differences in gender and age.

    Using data from Pew Research Center surveys, the report also analyzes the well-being of older Americans who live alone, looking at their economic status, their satisfaction with key aspects of their lives, and their relationships with their children and grandchildren.

  • Congressional Hearing on Zika Epidemic, STEM Funding for Women & Minorities, a Bill to Improve Child Care for Military Veterans, Treating Drug Addiction

    On February 9, the House passed, by voice vote, the Female Veteran Suicide Prevention Act (H.R. 2915), sponsored by Rep. Julia Brownley (D-CA). The House Veterans Affairs Committee passed the legislation on September 17, 2015.US Army on obstacle course

    US Army 2nd Lt. Laura Amschler, Headquarter United States Army Europe, goes through the obstacle course during competition in Grafenwoehr, Germany, 2012. Wikimedia Commons

    On February 11, the Senate Judiciary Committee passed, by voice vote, the Comprehensive Addiction and Recovery Act (S. 524), as amended, sponsored by Sen. Sheldon Whitehouse (D-RI).  Among other provisions, the bill would authorize a pilot program to provide grants to improve treatment for pregnant and postpartum women diagnosed with substance abuse disorders. The measure also would require the attorney general to report on grants awarded for family-based substance abuse treatment.

    On February 10, the House Foreign Affairs Subcommittee on Africa, Global Health, Global Human Rights, and International Organizations, and the Subcommittee on Western Hemisphere held a hearing, The Global Zika Epidemic: Emerging in the Americas. The hearing addressed ongoing research to better understand the Zika virus infection and its link to microcephaly, a birth defect. The following witnesses testified:

    • Tom Frieden, director, Centers for Disease Control and Prevention;
    • Anthony S. Fauci, director, National Institute of Allergy and Infectious Diseases, National Institutes of Health; and
    • Ariel Pablos-Mendez, assistant administrator, Bureau for Global Health, U.S. Agency for International Development.

    Bills Introduced

    Child Care

    S. 2539—Sen. Robert Casey Jr. (D-PA)/Finance (2/10/16) — A bill to provide for mandatory funding, to ensure that the families that have infants and toddlers, have a family income of not more than 200 percent of the applicable federal poverty guideline, and need child care have access to high-quality infant and toddler child care by the end of fiscal year 2026, and for other purposes.

    H.R. 4524—Rep. Joseph Crowley (D-NY)/Ways and Means, Education and the Workforce (2/10/16) — A bill to provide for mandatory funding, to ensure that the families that have infants and toddlers, have a family income of not more than 200 percent of the applicable federal poverty guideline, and need child care have access to high-quality infant and toddler child care by the end of fiscal year 2026, and for other purposes.

    Employment

    H.R. 4570—Rep. Grace Meng (D-NY)/Agriculture (2/12/16) — A bill to amend the Department of Agriculture program for research and extension grants to increase participation by women and underrepresented minorities in the fields of science, technology, engineering, and mathematics to redesignate the program as the “Jeannette Rankin Women and Minorities in STEM Fields Program.” *

    Family Support

    H.R. 4540—Rep. Robert Aderholt (R-AL)/Agriculture, Energy and Commerce, and Education and the Workforce (2/11/16) — A bill to provide clarity regarding states’ ability to manage the Supplemental Nutrition Assistance Program (SNAP) and to provide states with funding to treat treat drug addiction in the SNAP population.

    S. 2542—Sen. Shelley Moore Capito (R-WV)/Finance (2/11/16) — A bill to provide for alternative and updated certification requirements for participation under Medicaid state plans of the Social Security Act in the case of certain facilities treating infants under one year of age with neonatal abstinence syndrome, and for other purposes.

    H.R. 4536—Rep. Pat Tiberi (R-OH)/Judiciary (2/11/16) — A bill to prohibit the unlawful disposal of fetal remains, and for other purposes.

    Military

    S. 2515—Sen. Richard Burr (R-NC)/Armed Services (2/9/16) — A bill to ensure criminal background checks of employees of the military child care system and providers of child care services and youth program services for military dependents.

    Veterans

    S. 2521—Sen. Joni Ernst (R-IA)/Veterans’ Affairs (2/9/16) — A bill to improve the treatment at non-Department of Veterans Affairs facilities of veterans who are victims of military sexual assault, and for other purposes.

    S. 2520—Sen. Amy Klobuchar (D-MN)/Veterans’ Affairs (2/9/16) — A bill to improve the care provided by the secretary of Veterans Affairs to newborn children.

    Courtesy of Women’s Policy Inc

    Editor’s Note

    * Women and Minorities in Science, Technology, Engineering and Mathematics Fields Grant Program Funding Opportunity (WAMS); Department of Agriculture, National Institute of Food and Agriculture

     The Women and Minorities in Science, Technology, Engineering and Mathematics Fields Grant Program is a competitive grants program supporting research and extension projects that will increase, to the maximum extent practicable, participation by rural women and underrepresented minorities from rural areas in science, technology, engineering, and mathematics (STEM) fields.

    The goal of the WAMS program is to develop and implement robust collaborations to increase the representation, participation, and entrepreneurial skills and abilities of rural women and underrepresented minorities from rural areas in STEM careers, thereby contributing to economic prosperity in rural areas across the nation. Funded projects will meet this goal and lead to the development of a robust and diverse food and agricultural STEM work force that is highly competent in the application of STEM knowledge and skills, with increased participation of women and minorities from rural areas across a broad spectrum of rural, local, state or national communities. 

    The WAMS Grant Program provides funding that may only be used for research and extension activities in the training, outreach and mentoring of rural women and underrepresented minorities from rural areas in STEM fields relevant to USDA mission. It is an expectation that investment of public funds through the WAMS Grant Program will lead to:

      • Gains in STEM knowledge, skills and capabilities, as well as new participants in USDA mission science through outreach activities, new careers or entrepreneurial enterprise;
      •  Increased documentation of outputs, significant activities, including dissemination activities, events, services or products that contribute toward achieving the goals and objectives of WAMS;
      • Increased change in knowledge, actions or conditions; and, 
      • Increased capacity for carrying out the USDA mission by rural women and underrepresented minorities. 

  • Ripples in the Fabric of Spacetime: “Bells That Are Ringing in the Universe”

    LIGO Control Room

    The LIGO Hanford, Washington Control Room. Photo taken by Tobin Fricke, 2005. Wikimedia Commons

    By Bjorn Carey

    An international team of scientists excitedly announced that they had directly observed gravitational waves, often described as ripples in the fabric of spacetime. The discovery of gravitational waves confirms a prediction that Albert Einstein made nearly 100 years ago to shore up his general theory of relativity.

    The detection was made by the twin Laser Interferometer Gravitational-wave Observatory (LIGO) detectors, an experiment led by researchers at Caltech and MIT that includes more than 1,000 affiliated scientists, including several Stanford physicists and engineers who have played key roles in the program since it was launched. The instrument systems that made the detection possible were built in part on a legacy of interdisciplinary technological advances made by Stanford scientists.

    “LIGO is by far the most precise measurement machine that man has ever built,” said Robert L. Byer, the William R. Kenan, Jr. Professor of Applied Physics at Stanford, and an original member of the LIGO team. “It’s finally sensitive enough to see the bells that are ringing in the universe.”

    The ringing bell that LIGO heard early in the morning of Sept. 14, 2015, was the result of two massive black holes merging together 1.3 billion light-years away. As the two black holes spiraled around each other, they radiated energy in the form of gravitational waves. While they merged into one even more massive black hole, they released three solar masses of energy.

    “This was a huge signal,” said Martin Fejer, a professor of applied physics. “It’s more energy than our sun will release in its entire lifetime, and it all happened in about a fifth of a second as these two massive black holes coalesced.”Ligo Observatories

    Although the peak power output of the event was about 50 times that of the whole visible universe, it required an extremely sensitive device to detect the ensuing gravitational waves. LIGO consists of twin instruments, located 1,865 miles apart in Louisiana and Washington. Each of these instruments involves a single laser, each directed into two 4-kilometer-long arms that run perpendicular to one another.

    Two LIGO United States observatories; Hanford, WA and Livingston, LA. Wikipedia

    As a gravitational wave passes through a detector, it distorts spacetime such that one arm lengthens, and the other shortens. By comparing the disturbances at the two detectors, the scientists can confirm the direct detection of a gravitational wave.

    The detection itself was something of a surprise; the detectors were undergoing final commissioning at the time, and weren’t scheduled to enter full-time detection mode for a few days. Brian Lantz, the lead scientist for seismic isolation and alignment systems for Advanced LIGO, was sitting at his desk when the detection appeared in the experiment’s online notebook, and it immediately caught his attention.

    The scientists had also been on the lookout for a signal that matched gravitational waves from co-orbiting neutron stars, a more anticipated event. But this signal was significantly more energetic and shorter in duration than what would be expected from neutron stars.

  • Creating a National Style: Painting Norway, Nikolai Astrup’s Lush, Wild Landscapes and Traditional Way of Life at Home

    Midsummer, After 1917

    Nikolai Astrup, Midsummer, After 1917

    Dulwich Picture Gallery, England is presenting an exhibition of paintings and prints by Nikolai Astrup (1880-1928), one of Norway’s finest twentieth-century artists. Along with Edvard Munch, Astrup expanded the artistic possibilities of woodcuts to capture the lush, wild landscapes and traditional way of life of his home in western Norway, powerfully capturing the myths and folklore of the country.
     
    The exhibition brings Astrup’s unique vision of Norway to London.  Arranged thematically the show will highlight the artist’s radically innovative approach to landscape painting and printmaking. The parsonage where he grew up and his beautiful farmstead at Sandalstrand (now known as Astruptunet), along with the lake (Jølstravatnet) that lay between them and the mountains surrounding them inspired a unique and extraordinary body of work. Bringing together a focused display of over 120 oil paintings, woodcuts and archive material, many on public display for the first time, Painting Norway: Nikolai Astrup (through 15 May 2016) offers a unique opportunity to discover an artist driven by the desire to create a national style — something quintessentially Norwegian in feeling and in subject-matter.
     
    Astrup was trained in the painterly naturalist tradition by fellow Norwegians Harriet Backer (1845-1932) and Christian Krohg (1852-1925) in Oslo and Paris but it was during study tours in Europe that he identified the importance of the innocent, untutored eye in recording truth in nature. His exposure to the naïve style of Henri ‘le Douanier’ Rousseau (1844–1910) and Maurice Denis (1870–1943) reinforced this conviction and encouraged Astrup to return to his home district of Jølster where he would create his own individual response to the landscape, shaped by the impressions and images remembered from his childhood years.
     
    After welcoming visitors to this beautiful slice of Norway with landscapes providing an almost 360 degree view of the area surrounding his father’s parsonage at Ålhus, the exhibition explores the radical innovations in printmaking and painting that came to define Astrup’s career, highlighting key motifs in his oeuvre, from the distinctive Northern light and atmosphere to the famous Midsummer Eve festival which informed his series of striking bonfire paintings.
     
    Ian A. C. Dejardin, the Sackler Director of Dulwich Picture Gallery and co-curator of the show, said: “Hailed even as an art student as the great new hope of Norwegian art at the turn of the twentieth century, Astrup deserves to be celebrated outside his native Norway. In painting he rejected the stylistic trickery of aerial perspective, resulting in canvasses of intense immediacy and brightness of color; in prints he followed his own innovative path, laboriously reworking his woodcuts so that every print is a unique work of art, and — as a final work of art in its own right — he built himself a home, Sandalstrand, on the precipitous shore of the lake that must be one of the most beautiful artists’ homes in the world. A remarkable man, and a great artist — yet this is the first ever show in this country devoted to him. It will be, as we intend all exhibitions at Dulwich Picture Gallery to be, a revelation.”
     
    The exhibition opens with the rugged, wild mountainscapes and lake that dominated Astrup’s home village of Ålhus counterbalanced with domestic views of his father’s parsonage, the garden and the farmstead. These works celebrate the specific qualities of the light of the north, notably the midsummer nights, as in the woodcut A Clear Night in June (1905–7), or inclement weather, as in Rainy Atmosphere beneath the Trees at Jølster Parsonage (before 1908). A deliberate flattening of the landscape and rejection of aerial perspective in works such as Farmstead in Jølster (1902) illustrate Astrup’s avowed determination to represent both foreground and background with equal intensity.

  • Rev Up Those Engines: Plan For Motoring/Air Travel Summer Vacations But Energy Uncertainty Is Always a Factor

    Travel to the Statue of Liberty 2015

    Editor’s Note: I was not an economics reporter for Time but generally reliable sources at the magazine were an imperative. Last year we published a similar report when uncertainty about gasoline prices was high. We then, as now, used the US Energy Information Administration for reliable forecasts.

    The EIA’s monthly short-term energy outlook for February and  beyond: 

    Summer Work Travel participants jumping in front of the Statue of Liberty; US Department of State. Wikimedia Commons

    • North Sea Brent crude oil prices averaged $31/barrel (b) in January, a $7/b decrease from December and the lowest monthly average price since December 2003. Brent crude oil prices averaged $52/b in 2015, down $47/b from the average in 2014. Growth in global liquids inventories, which averaged 1.8 million barrels per day (b/d) in 2015, continues to put downward pressure on Brent prices.
    • Brent crude oil prices are forecast to average $38/b in 2016 and $50/b in 2017. Forecast West Texas Intermediate (WTI) crude oil prices are expected to average the same as Brent in both years. However, the current values of futures and options contracts continue to suggest high uncertainty in the price outlook. For example, EIA’s forecast for the average WTI price in May 2016 of $36/b should be considered in the context of recent Nymex contract values for May 2016 delivery (Market Prices and Uncertainty Report) suggesting that the market expects WTI prices to range from $21/b to $58/b (at the 95% confidence interval).
    • The US retail regular gasoline price is forecast to average $1.98/gallon (gal) in 2016 and $2.21/gal in 2017, compared with $2.43/gal in 2015. In January, the average retail regular gasoline price was $1.95/gal, a decrease of 9 cents/gal from December and the first time monthly gasoline prices averaged below $2/gal since March 2009. EIA expects the monthly average retail price of US regular gasoline to reach a seven-year low of $1.82/gal in February 2016, before rising during the spring.
    • US crude oil production averaged an estimated 9.4 million b/d in 2015, and it is forecast to average 8.7 million b/d in 2016 and 8.5 million b/d in 2017. EIA estimates that crude oil production in January was 70,000 b/d below the December level, which was 9.2 million b/d.
    • Natural gas working inventories were 2,934 billion cubic feet (Bcf) on January 29, 20% higher than during the same week last year and 18% higher than the previous five-year average (2011-15) for that week. EIA forecasts that inventories will end the winter heating season (March 31) at 2,096 Bcf, which would be 41% above the level at the same time last year. Henry Hub spot prices are forecast to average $2.64/million British thermal units (MMBtu) in 2016 and $3.22/MMBtu in 2017, compared with an average of $2.63/MMBtu in 2015.

     Now on to Henry Hub Natural Gas futures … Don’t you just love research?

    By the way, here’s another learning bit to absorb from Investopedia:

    Definition of ‘Henry Hub’: A natural gas pipeline located in Erath, Louisiana that serves as the official delivery location for futures contracts on the NYMEX. The Henry Hub is owned by Sabine Pipe Line LLC and has access to many of the major gas markets in the United States. 

  • Demand-Price Parking: Cities Try $6, $8 Hourly Parking to Cut Congestion, Pollution

    By Rebecca Beitsch, Stateline, Pew Trusts
    Chinatown in Washington, D.C.© The Pew Charitable Trusts

    A woman pays for parking in Chinatown, where Washington, DC,  plans to start demand-price parking. A handful of major cities are charging differing hourly rates for street parking in hopes of reducing congestion and spurring the economy

    A handful of major cities across the US are changing how they charge for some of the most valuable property they manage — on-street parking spaces.

    Parking spaces haven’t always been seen as valuable by cities, though motorists seeking them in popular commercial areas do. Many cities charge just a few dollars an hour, while motorists circle looking for the spaces, adding to congestion, pollution, and angry and distracted driving.

    Now, some major cities are seeking to take advantage of their supply and motorists’ demand with so-called demand-price parking. Rather than charge a flat rate for each spot in every area of the city, they are demanding motorists pay $4, $6 or up to $8 an hour for a spot on a busy street, close to shops and restaurants, while keeping hourly prices lower on less busy streets just a few blocks over.

    The cities —   among them — also can adjust their rates by time of day, cheaper in the morning and higher in the evening, when people are more likely to be shopping and dining. The model is similar to surge pricing used by ride-hailing services like Uber.

    Proponents say the goal isn’t to boost parking revenue. It’s designed to encourage turnover, thereby easing congestion and boosting the economy, by having a price that’s high enough on busy streets so that one or two spaces are always available and low enough on nearby streets to entice drivers to park a little farther away and walk a block or two.

    “Transportation performs better because there is less congestion, and the economy performs better because merchants have one or two spaces open near their business,” said Donald Shoup, a professor at UCLA who promotes demand-price parking.

    In most instances, motorists don’t need to worry about having to carry rolls of quarters with them to plug parking meters. Existing smart meters allow people to pay using their credit cards or smartphones and some systems alert a user’s phone when their time in a space is close to running out. Many cities with demand-price parking also have mobile apps to tell drivers where parking is cheapest and which blocks have spots open.

    The switch to demand-price parking doesn’t come without some sticker shock for motorists.

    Washington, DC is instituting a pilot program this year that would charge as much as $8 an hour in a popular downtown area near its sports arena — a sharp increase over the $2 an hour the city currently charges there.

    “The people who can ill afford it are going to be the ones paying $8,” said AAA Mid-Atlantic’s John Townsend, of Washington’s planned pricing.

    People who have to work after the city’s subway and bus system shuts down will be the ones hurt by making on-street parking a luxury afforded by few, he said.

    Shoup of UCLA does not see it that way. Poor people can save money by parking farther away at lower rates, he said. “Right now, they can’t do that. This will really help low-income people.”

    To achieve their ends, cities set various rates. And they can adjust them.

    Los Angeles and San Francisco have a maximum hourly rate of $6. Seattle caps it at $4. Washington is authorized to go as high as $8, but has yet to set a top rate. In cities with programs, the hourly parking price may be as low as 50 cents or a dollar on less busy streets.

    “The pilot program is to see if there’s price sensitivity,” said Sam Zimbabwe, associate director of planning for the District of Columbia’s Department of Transportation. “It’s not to trap people into paying more than they want to pay.”

    The goal is more or less the same in each city: to make sure street parking stays within a certain occupancy rate, usually about 80 percent.

    Although some streets will always have occupancy rates above that level, it can be used as a benchmark to help cities decide whether to raise or lower the price, which they can do block by block.

    In San Francisco, for example, over two years the prices on busy Chestnut Street increased 75 percent to $3.50 an hour, while one block over on Lombard, prices decreased by 50 percent, to $1 an hour.

    “You don’t have to discourage many, just one or two,” said Peer Ghent, with the Los Angeles Department of Transportation. If a few educated consumers head toward cheaper spots and pass on the close ones, “now someone who is willing to pay that can just park instead of cruising.”

    Los Angeles and San Francisco review their data every couple of months to set prices to achieve the occupancy rate they seek. Washington plans to assess its pricing quarterly. Seattle does so once a year.

    The differing approaches are largely a result of technology. Los Angeles relies on in-ground sensors to assess turnover, and San Francisco uses data from smart meters. Seattle sends people out to count by hand.

    “Our program is kind of the low-tech way to achieve similar goals to San Francisco and L.A.,” said Mary Catherine Snyder, parking strategist with the Seattle Department of Transportation. The city places green ‘value’ signs on blocks to direct drivers to a better deal.

    The cities that have used demand-price parking have seen a slight drop in the average price of parking within the designated areas and an increase in citywide parking revenue, a change some city parking officials attributed to the improving economy.

    In San Francisco, parking revenue went up 7 percentage points higher in the program area than in the rest of the city. Los Angeles also had a slight increase in revenue while the average price of parking went from $1.95 an hour to $1.81 an hour in the designated areas.

    Whether demand-price parking has reduced congestion and pollution is still open to question.

    Shoup of UCLA said searching for a parking spot can add to pollution. He pointed to a study of a 15-block area on the Upper West Side of Manhattan that found people looking for a street parking spot drove an average of more than a third of a mile before finding one. Within a year that would add up to 366,000 miles and 325 tons of carbon dioxide.

    Demand-price parking can reduce unnecessary driving and pollution, he said.

    Ghent from Los Angeles said congestion is influenced by so many factors, it’s hard to tell what effect demand-price parking has had in his city.

    But Hank Willson, San Francisco’s manager of parking policy, said city employees cruised the streets on bikes, measuring the distance traveled before finding an available space. They traveled 30 percent fewer miles after demand-price parking was imposed — something Willson said suggests drivers would generate less pollution.

    Other factors, such as placards that allow disabled drivers to park for free, often with no time limit, can make it difficult for the pricing model to achieve its goals.

    While many of the placards are used legitimately, some states have turned to various methods of policing who gets the placards to prevent abuse. Michigan, for example, created a two-tier placard system in which only people with severe mobility disabilities would get placards that allow them to park for free.

    Shoup said he hopes that more states will follow Michigan’s lead and crack down on handicapped parking abuse — a move he said would allow demand parking systems to work better. “It’s a terrific sand in the gears of the program,” he said.

    The Pew Charitable Trusts is driven by the power of knowledge to solve today’s most challenging problems. Pew applies a rigorous, analytical approach to improve public policy, inform the public and invigorate civic life.

     

  • Dr. Robert Califf of the FDA Calls for Sweeping Review of Agency Opioid Policies

    Opium poppy

    In response to the opioid abuse epidemic, Dr. Robert Califf, the FDA’s Deputy Commissioner for Medical Products and Tobacco, along with other FDA leaders, called for a far-reaching action plan to reassess the agency’s approach to opioid medications. The plan will focus on policies aimed at reversing the epidemic, while still providing patients in pain access to effective relief.

    Opium Poppy Botanical Drawings (Papaver somniferum)

    The FDA will:

    • Re-examine the risk-benefit paradigm for opioids and ensure that the agency considers their wider public health effects
    • Convene an expert advisory committee before approving any new drug application for an opioid that does not have abuse-deterrent properties;
    • Assemble and consult with the Pediatric Advisory Committee regarding a framework for pediatric opioid labeling before any new labeling is approved; 
    • Develop changes to immediate-release opioid labeling, including additional warnings and safety information that incorporate elements similar to the extended-release/long-acting (ER/LA) opioid analgesics labeling that is currently required;
    • Update Risk Evaluation and Mitigation Strategy requirements for opioids after considering advisory committee recommendations and review of existing requirements;
    • Expand access to, and encourage the development of, abuse-deterrent formulations of opioid products;
    • Improve access to naloxone and medication-assisted treatment options for patients with  opioid use disorders; and
    • Support better pain management options, including alternative treatments.

    As one of the cornerstones of this plan, “We are determined to help defeat this epidemic through a science-based and continuously evolving approach,” said Califf. “This plan contains real measures this agency can take to make a difference in the lives of so many people who are struggling under the weight of this terrible crisis.”

    In addition, the FDA will convene independent advisory committees made up of physicians and other experts when considering for approval any new opioid drugs that do not contain abuse-deterrent properties. The FDA will also convene a meeting of its standing Pediatric Advisory Committee to make recommendations regarding a framework for pediatric opioid labeling and use of opioid pain medications in the pediatric population.
     
    The FDA is also strengthening the requirements for drug companies to generate postmarket data on the long-term impact of using ER/LA opioids. The agency expects this to result in the most comprehensive data ever collected in the field of pain medicine and treatments for opioid use disorder. The data will further the understanding of the known serious risks of opioid misuse, abuse, overdose and death.

    Opioids are a class of drugs that include prescription medications such as oxycodone, hydrocodone, and morphine, as well as the illicit drug heroin. 
     
    Drug overdose deaths, driven largely by overdose from prescription opioids and illicit drugs like heroin and illegally-made fentanyl, are now the leading cause of injury death in the United States – surpassing motor vehicle crashes. 

    “Agencies from across the Department of Health and Human Services and throughout the federal government are united in aggressively addressing this public health crisis,” said U.S. Health and Human Services (HHS) Secretary Sylvia M. Burwell. “The FDA is a vital component to combating this epidemic, and the innovation and modernization they have committed to undertaking is an important part of the overall efforts at HHS.”

    This renewed effort falls within the context of a broad national campaign that includes a major initiative led by HHS. Secretary Burwell has made addressing opioid abuse, dependence, and overdose a priority, and work is underway within HHS on this important issue. The evidence-based initiative focuses on three promising areas: informing opioid prescribing practices; increasing the use of naloxone, building on the FDA’s recent approvals of injectable and intranasal naloxone; and using medication-assisted treatment to move people out of opioid addiction. The FDA’s call to action is also supportive of the Centers for Disease Control and Prevention’s current work on guidelines for prescribing of opioids for the treatment of chronic pain outside of end of life care.

    “Things are getting worse, not better, with the epidemic of opioid misuse, abuse and dependence,” added Califf. “It’s time we all took a step back to look at what is working and what we need to change to impact this crisis.”

    The agency will provide updates on progress with the goal of sharing timely, transparent information on a regular basis.

    The FDA, an agency within the U.S. Department of Health and Human Services, protects the public health by assuring the safety, effectiveness, and security of human and veterinary drugs, vaccines and other biological products for human use, and medical devices. The agency also is responsible for the safety and security of our nation’s food supply, cosmetics, dietary supplements, products that give off electronic radiation, and for regulating tobacco products.

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    Page Last Updated: 02/05/2016 

  • Who is the Expert on Marriage? A Typical Breadth of Experience by Today’s Younger Generation

    By Joan L. Cannon

    Not for the first time I saw a call for a contest for manuscripts on marriage. As a theme/subject for nonfiction it’s an appealing and challenging topic, but a part of the guidelines stopped me, so to speak, in my tracks.

    Mr. and Mrs. I.N. Phelps Stokes

    “Document and make sure of your sources.” I immediately envisioned an exclamation mark after that clause, or perhaps an emoticon indicating wondering amusement. I wondered if the editors were seeking social scientists or psychologists who work from statistics and anecdote.

    Why wouldn’t they look to the real experts on marriage: those who have experienced it and been not just happy, but fulfilled by it? That instruction about what could end up as footnotes, at first reverberated like a joke. Only at first. Most young people of my generation  had some practice for future relationships that began in their teens. Nothing old or new in that. Most had a lot less practice, and often none, for the physical side of matrimony before entering it than they would today. By and large, none of us had anything like the typical breadth of field experienced by today’s younger generation.

    John Singer Sargent,  1897;  Mr. and Mrs. I. N. Phelps Stokes. Oil on canvas; Metropolitan Museum of Art

    Since our youth was involved with a war that altered almost every aspect of life, perhaps Society’s accustomed sway was somewhat reassuring, at least to some of us. There was a kind of desperation like that of the previous generation’s experience with the previous great war, but still, some holds were barred to young people that now would be viewed with amused pity by the current analogous age group.

    No couples with whom I was acquainted ever lived with a partner before tying the proverbial knot, though several certainly spent weekends together. Maybe that was a factor in how some of us learned (albeit unwittingly) to decide how to make a choice of a permanent partner. Now I’m tempted to discuss my own decisions, but if I were to do that, I wouldn’t be writing about Marriage as such. Hence, an example.

    In one case, a girl’s meeting with a rather handsome young man, two or three years her senior, took place at a confirmation class at the church near their homes. Imagine a thirteen-year-old being asked to a movie by a sixteen-year-old. Imagine a virginal if not totally naïve girl and a young man with a good deal of ‘street smarts,’ a student at one of the prestigious special public high schools in Manhattan. Imagine what it might have been like for her when he had enlisted in the Navy, then came home to date as he had before, along with his shipmates. The drinking age was lowered to eighteen, and no bar would turn away uniformed service men.

    As it turned out, this was one of those practice-for-marriage times. When, after the war, they met again, each thought they might pick up where they had left off, and both discovered too much had changed. To be honest, they discovered that their separate experiences were too divergent. They were really no longer a couple.

    In another case, college seniors who had known each other casually for four years are thrown together by circumstance after graduation. He had been pining for two years after a classmate who was fond of him but in no way serious. The young woman in question had wished for months that she might be the object of his affections, but with no hope, though he was cordial and friendly. Both were working in the same city, so she and her parents became logical places for weekend visits and occasional dinners. In the course of several months, he became more attentive. In less than a year, to her delight, he declared he wanted to make her his wife.

    They went to his home, and his parents arranged an engagement party, published the engagement announcement in the local paper, and his father ordered him to the local jeweler to buy a ring.

    A few months passed, and she became unavoidably aware that all the chemistry was on her side. He continued to be intellectual, amusing, kind, hardworking — in short, everything but physically passionate. For her, this, too, turned out to be another practice for marriage.