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Tanio, N_SJV_EIJ_Q3

ntanio
In response to

 Teve Brown of NOAA said the valley suffers from cows + cards. At Harris Ranch a large industrial cattle farm trucks drive 6,000miles/day for 60 loads of feed producing nitrogen oxides (NOx). NOx combines with the ammonia from cow manure and urine to from ammonium nitrate which accounts for more that 1/2 of the areas most polluted days of PM2.5.

In addition, Interstate is a major thorough bringing more traffic pollution and farming practices including nitrogen fertilizer contributes 1/3 of NOx in California air.  The SJV also holds 9000 oil wells and because all the light oil has been drilled, the current production is described as the "thickest, dirtiest petroleum" in the nation.

Intersecting factors: landscape (bowl shape of the Valley); economic (agriculture that contributes to PM2.5); transportation corridor that add more traffic pollution; and state-wide wildfires that bring more particulate pollution which is trapped; and political environment in which area elects representatives  (ex: Devin Nunes) who deny global warming and reject environmental protection.

Tanio_SJV_setting

ntanio
In response to

The setting for this article is the San Joaquin Valley which encompasses 2/3rds of the Central Valley CA. Because of it's fertle farmland, it supplies 1/4 of the food to "American plates."

In terms of setting, like other valley's in CA (ex: San Gabriel Valley) and the whole LA Basin, the SJV's bowl-like landscape (mountain ranges on 3-sides) results in temperature inversion that traps smo closer to the ground during Wintertime.

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Sara_Nesheiwat
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In response to

The Emergency Medical Treatment and Labor Act is a law requiring that anyone coming into the emergency department will be stabilized and treated no matter what their insurance situation is. In terms of women's health, it is important to note that this means for active labors, medical treatment is necessary and required, no matter the health insurance of the patient. The purpose of this law to prevent certain patients from being turned away in an emergency situation or refused medical treatments if they are unable to pay, putting their health at risk.

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Sara_Nesheiwat
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EMTALA was enacted by Congress in 1986 and was part of the Consolidated Omnibus Budget Reconciliation Acts of 1985. Congress saw different cases around America where doctors were refusing medical care to patients who could not make a deposit at the time of their admittance to the ER. An example of this is a patient Eugene Barnes, who in 1985 suffered a stab wound and ultimately ended up dying because 6+ doctors refused to help him without payment or some form of compensation. This made national news and other cases began to come to light, such as at Baptist Hospital in Miami and many other areas. News outlets began to follow these cases and this caught attention of government officials. Shortly after, EMTALA was enacted.

http://www.pitt.edu/~kconover/ftp/emtala-draft.pdf

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Sara_Nesheiwat
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This was touched upon a little in a previous question. Many cases of patient dumping were popping up around America. Patients in need  of emergency medical care were being cast aside, ignored and delayed due to their inability to pay. In addition to the stab patient, Eugene Barnes that sparked this law, there were dozens of other cases where patients needed to be transferred to larger hospitals but the hospital refused to take patients without insurance, so the patients died. There were cases of people being asked right before surgery for a deposit, and being unable to pay were discharged with no surgery. There was also a very high rate of dead babies that were arising due to the fact that mothers in labor were being turned away because the patient was uninsured. It was then realized by the government that there were no legal duties for a hospital to treat people who are in emergency situations but cannot pay, only ethical and moral duties, which apparently weren't enough in some cases. This led to the birth of the EMTALA, requiring medical attention to all ED patients as well as transfers if needed to stabilize, including mothers in labor.

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Sara_Nesheiwat
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This policy greatly helped sculpt emergency medicine and public health. By giving the right to the patient to have emergency medical treatment required without proof of insurance or payment, astronomically influenced the amount of patients being turned away and their possibilty of developing worse illnesses or dying. In a paper I read, a young doctor in the late 70s and early 80s remembers watching a woman in labor give birth in the doorway of the hospital and proceed to borht her child in the parking lot after being turned away for not having insurance. By requiring hospitals and doctors to see that all ED patients get care, no patient was at risk of dying or complicating their baby's health and birth due to a lack of insurance, ultimately increasing public health efforts. Not all hospitals turned away their patients, but enough did to make it a public health concern and get Congress involved. EMTALA changed emergency medicine protocols but also public health expectations and actions.

http://www.hhnmag.com/articles/5010-the-law-that-changed-everything-and…