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California surgeon general sets goal of reducing maternal mortality by 50%

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California surgeon general sets goal of reducing maternal mortality by 50%


California’s surgeon general has unveiled a new initiative to reduce maternal mortality and set a goal of halving the rate of deaths related to pregnancy and birth by December 2026.

Health officials say that more than 80% of maternal deaths nationwide are preventable. California has achieved a much lower rate of such deaths than the U.S., but maternal mortality resurged in recent years amid the COVID-19 pandemic, state data show.

“We have the lowest rate in the country. Now we can do better,” California Surgeon General Dr. Diana E. Ramos said in an interview.

Ramos was joined in announcing the effort Tuesday by First Partner Jennifer Siebel Newsom, the wife of Gov. Gavin Newsom.

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In California, leading causes of such deaths include heart disease, bleeding, “behavioral health” issues such as mental illness and substance use, and infection. More than a fifth of pregnancy-related deaths in California occur the day of delivery, but the majority happen in the days, weeks and months that follow, according to state data.

The crisis has been especially stark among Black women, who have faced a maternal mortality rate more than three times that of white women in California. In Los Angeles County, there has been a public outcry in recent years over the deaths of women like April Valentine, 31, and Bridgette Burks, 32 — Black mothers who left behind devastated families.

Health researchers have faulted numerous factors for the higher rates of maternal mortality among Black women, including the physical effects on the body of enduring years of racism; higher rates of diabetes and other chronic conditions that increase risk; and inequities in the care received by Black patients.

California officials said they are also concerned about rising rates of maternal mortality among Latinos and Asian/Pacific Islander communities in the state.

The “Strong Start & Beyond” initiative, officials said, would help patients understand potential risks before they become pregnant and prompt earlier action to address hazards such as heart disease. It would also alert Californians to doula services and other programs intended to support people before, during and after birth.

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Ramos said California had reached the lowest rate of maternal mortality in the nation through its system of reviewing maternal deaths and other efforts centered on hospitals, physicians and other healthcare professionals. Up until now, “the focus has been primarily on the healthcare setting,” she said.

But “if we keep on doing the same thing — just focusing on the healthcare team — we’re going to get the same results,” Ramos said. Health officials and experts decided they needed to bolster that work, “and that’s why we’re bringing in the patient.”

“It seems so simple, but oftentimes, the pregnant person doesn’t feel like they have a voice or they have the information they need to make informed decisions,” Ramos said.

U.S. Secretary of Health and Human Services Xavier Becerra said in a statement accompanying the launch of the new effort that “reducing maternal mortality isn’t a ‘should,’ it’s a ‘must.’ California gets it.”

The planned strategies outlined in the California Maternal Health Blueprint, released Tuesday, include a new questionnaire that patients can take at home to assess their risk of pregnancy complications and get recommendations for next steps based on their results.

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As an obstetrician-gynecologist, Ramos said she found that it was often at their first prenatal appointment that a patient would first hear, “You’re going to be a high-risk patient.’ And more times than not, patients would say … ‘I wish I would have known that I could have done X, Y or Z to decrease my risk.’”

California officials also want all medical facilities in the state to use an existing screening tool for gauging the risk levels of pregnant patients.

Ramos said those results could help guide where patients go for births. Hospitals with limited resources could refer patients with a higher risk of complications — such as someone who “is going to be at risk for hemorrhage, is going to be at risk for ICU admission” — to the medical facilities best equipped to handle them.

The new effort comes as pregnant patients may face dwindling choices for hospital births: Nationally, roughly 1 in 25 obstetric units closed in 2021 and 2022, according to a March of Dimes report.

Under “the modern fee-for-service healthcare model … hospitals must fund round-the-clock capacity but are only reimbursed when their facilities and staff are in action,” wrote Dr. Anna Reinert, an assistant professor of clinical obstetrics and gynecology at USC’s Keck School of Medicine, in a recent op-ed.

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“So if not enough deliveries are happening, expenses outweigh reimbursement. This drives hospitals to get out of the baby delivery business altogether,” Reinert wrote.

California has faced a wave of such closures in the last decade, including at many hospitals in Los Angeles County. A CalMatters analysis found that such closures had disproportionately affected Black, Latino and low-income communities. Among the latest hospitals to announce it would shut down a labor and delivery unit is USC Verdugo Hills Hospital in Glendale, which plans to halt maternity care on Nov. 20.



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Up to 20 billionaires may leave California over tax threat | Fox Business Video

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California’s exodus isn’t just billionaires — it’s regular people renting U-Hauls, too

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California’s exodus isn’t just billionaires — it’s regular people renting U-Hauls, too


It isn’t just billionaires leaving California.

Anecdotal data suggest there is also an exodus of regular people who load their belongings into rental trucks and lug them to another state.

U-Haul’s survey of the more than 2.5 million one-way trips using its vehicles in the U.S. last year showed that the gap between the number of people leaving and the number arriving was higher in California than in any other state.

While the Golden State also attracts a large number of newcomers, it has had the biggest net outflow for six years in a row.

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Generally, the defectors don’t go far. The top five destinations for the diaspora using U-Haul’s trucks, trailers and boxes last year were Arizona, Nevada, Oregon, Washington and Texas.

California experienced a net outflow of U-Haul users with an in-migration of 49.4%, and those leaving of 50.6%. Massachusetts, New York, New Jersey and Illinois also rank among the bottom five on the index.

U-Haul didn’t speculate on the reasons California continues to top the ranking.

“We continue to find that life circumstances — marriage, children, a death in the family, college, jobs and other events — dictate the need for most moves,” John Taylor, U-Haul International president, said in a press statement.

While California’s exodus was greater than any other state, the silver lining was that the state lost fewer residents to out-of-state migration in 2025 than in 2024.

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U-Haul said that broadly the hotly debated issue of blue-to-red state migration, which became more pronounced after the pandemic of 2020, continues to be a discernible trend.

Though U-Haul did not specify the reasons for the exodus, California demographers tracking the trend point to the cost of living and housing affordability as the top reasons for leaving.

“Over the last dozen years or so, on a net basis, the flow out of the state because of housing [affordability] far exceeds other reasons people cite [including] jobs or family,” said Hans Johnson, senior fellow at the Public Policy Institute of California.

“This net out migration from California is a more than two-decade-long trend. And again, we’re a big state, so the net out numbers are big,” he said.

U-Haul data showed that there was a pretty even split between arrivals and departures. While the company declined to share absolute numbers, it said that 50.6% of its one-way customers in California were leaving, while 49.4% were arriving.

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U-Haul’s network of 24,000 rental locations across the U.S. provides a near-real-time view of domestic migration dynamics, while official data on population movements often lags.

California’s population grew by a marginal 0.05% in the year ending July 2025, reaching 39.5 million people, according to the California Department of Finance.

After two consecutive years of population decline following the 2020 pandemic, California recorded its third year of population growth in 2025. While international migration has rebounded, the number of California residents moving out increased to 216,000, consistent with levels in 2018 and 2019.

Eric McGhee, senior fellow at the Public Policy Institute of California, who researches the challenges facing California, said there’s growing evidence of political leanings shaping the state’s migration patterns, with those moving out of state more likely to be Republican and those moving in likely to be Democratic.

“Partisanship probably is not the most significant of these considerations, but it may be just the last straw that broke the camel’s back, on top of the other things that are more traditional drivers of migration … cost of living and family and friends and jobs,” McGhee said.

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Living in California costs 12.6% more than the national average, according to the U.S. Bureau of Economic Analysis. One of the biggest pain points in the state is housing, which is 57.8% more expensive than what the average American pays.

The U-Haul study across all 50 states found that 7 of the top 10 growth states where people moved to have Republican governors. Nine of the states with the biggest net outflows had Democrat governors.

Texas, Florida and North Carolina were the top three growth states for U-Haul customers, with Dallas, Houston and Austin bagging the top spots for growth in metro regions.

A notable exception in California was San Diego and San Francisco, which were the only California cities in the top 25 metros with a net inflow of one-way U-Haul customers.

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California loses $160M for delaying revocation of 17,000 commercial driver’s licenses for immigrants

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California loses 0M for delaying revocation of 17,000 commercial driver’s licenses for immigrants


California will lose $160 million for delaying the revocations of 17,000 commercial driver’s licenses for immigrants, federal transportation officials announced Wednesday.

Transportation Secretary Sean Duffy already withheld $40 million in federal funding because he said California isn’t enforcing English proficiency requirements for truckers.

The state notified these drivers in the fall that they would lose their licenses after a federal audit found problems that included licenses for truckers and bus drivers that remained valid long after an immigrant’s visa expired. Some licenses were also given to citizens of Mexico and Canada who don’t qualify. More than one-quarter of the small sample of California licenses that investigators reviewed were unlawful.

But then last week California said it would delay those revocations until March after immigrant groups sued the state because of concerns that some groups were being unfairly targeted. Duffy said the state was supposed to revoke those licenses by Monday.

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Duffy is pressuring California and other states to make sure immigrants who are in the country illegally aren’t granted the licenses.

“Our demands were simple: follow the rules, revoke the unlawfully-issued licenses to dangerous foreign drivers, and fix the system so this never happens again,” Duffy said in a written statement. “(Gov.) Gavin Newsom has failed to do so — putting the needs of illegal immigrants over the safety of the American people.”

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Newsom’s office did not immediately respond after the action was announced Wednesday afternoon.

After Duffy objected to the delay in revocations, Newsom posted on X that the state believed federal officials were open to a delay after a meeting on Dec. 18. But in the official letter the Federal Motor Carrier Safety Administration sent Wednesday, federal officials said they never agreed to the delay and still expected the 17,000 licenses to be revoked by this week.

Enforcement ramped up after fatal crashes

The federal government began cracking down during the summer. The issue became prominent after a truck driver who was not authorized to be in the U.S. made an illegal U-turn and caused a crash in Florida that killed three people in August.

Duffy previously threatened to withhold millions of dollars in federal funding from California, Pennsylvania, Minnesota, New York, Texas, South Dakota, Colorado, and Washington after audits found significant problems under the existing rules, including commercial licenses being valid long after an immigrant truck driver’s work permit expired. He had dropped the threat to withhold nearly $160 million from California after the state said it would revoke the licenses.

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Federal Motor Carrier Safety Administration Administrator Derek Barrs said California failed to live up to the promise it made in November to revoke all the flawed licenses by Jan. 5. The agency said the state also unilaterally decide to delay until March the cancellations of roughly 4,700 additional unlawful licenses that were discovered after the initial ones were found.

“We will not accept a corrective plan that knowingly leaves thousands of drivers holding noncompliant licenses behind the wheel of 80,000-pound trucks in open defiance of federal safety regulations,” Barrs said.

Industry praises the enforcement

Trucking trade groups have praised the effort to get unqualified drivers who shouldn’t have licenses or can’t speak English off the road. They also applauded the Transportation Department’s moves to go after questionable commercial driver’s license schools.

“For too long, loopholes in this program have allowed unqualified drivers onto our highways, putting professional truckers and the motoring public at risk,” said Todd Spencer, president of the Owner Operator Independent Drivers Association.

The spotlight has been on Sikh truckers because the driver in the Florida crash and the driver in another fatal crash in California in October are both Sikhs. So the Sikh Coalition, a national group defending the civil rights of Sikhs, and the San Francisco-based Asian Law Caucus filed a class-action lawsuit on behalf of the California drivers. They said immigrant truck drivers were being unfairly targeted.

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Immigrants account for about 20% of all truck drivers, but these non-domiciled licenses immigrants can receive only represent about 5% of all commercial driver’s licenses or about 200,000 drivers. The Transportation Department also proposed new restrictions that would severely limit which noncitizens could get a license, but a court put the new rules on hold.





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