SPRING 2009

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ISSUE

THE

HEALTH

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INNOVATING

COMMON FOR THE

in Silicon Valley

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How far will energy go?That depends on how we use it. At HP, we’re focusing our energy on developing products that use less and conserve more. In fact, we estimate that for every 12 people who use the power-saving features built into HP computers and monitors, the amount of CO2 saved is equal to removing one car from the road. An environmentally sustainable future is possible. We’ve got the energy to make it happen. Go to hp.com/go/forward.

letter from the editor //

TOM ULRICH

image // City of San JoseADDRESS: SHiFT Magazine, One Washington Square, San Jose, CA 95192-0055. PHONE: 408.924.3245Copyright © 2009 SHiFT Magazine, a Social Innovation Institute publication. All rights reserved. Reproduction without permission is prohibited.

The lives of the less fortunate in-spired us to explore the challenges and solutions of health care. Mar-shall, one of the 10,000 Santa Clara County residents who seek emer-gency psychiatric care each year, inhabits the world of troubled ado-lescents captured in Ralph Nichols’ story about teenage suicide.

As bleak as Marshall’s outlook on life appears, Ferrer reminds us that we are a community of problem-solvers.

Adrienne Lawton, associate pas-tor of the First Christian Church in San Jose, and Steve Chehy, a church member who survived a decade liv-ing on the street before moving into a 100-square-foot trailer near City Hall, belong to a chorus of commu-

nity leaders dedicated to caring for the well-being of others. They share their experiences as part of a series called Other Voices.

And Jesse Kimbrel, author of a feature article on childhood obesity, explains how a young boy stays fit the old-fashioned way – by trading video games for wrestling matches with his friend.

While SHiFT explored trying circumstances for many county residents, we also discovered what Abraham Lincoln called “the better angels of our nature.”

Photographer Derek Sijder and I met Ben and Leo on a bright winter morning. Ben straddled a fire hy-drant while Leo sat uncomfortably

in his wheelchair. Both men were homeless, but looking out for each other.

Ben confessed that he’s lived in every shelter in Santa Clara County. Leo admitted that when he can’t find a bed, he parks his wheelchair for the night in a lot downtown.

Amid their tales of woe Ben quipped: “I am writing a book about the homeless. And I’m dedicating it to angels everywhere.”

In that spirit, the staff of SHiFT dedicates this magazine to angels everywhere – members of our com-munity, who without calling attention to themselves – care for us all.

Thomas Ulrich

half century ago, the inte-grated circuit — a silver-gray fleck of common beach sand

— launched an age that generated enor-mous wealth for our community. But for many of us, prosperity has been as elusive as the electrons that drive 21st century commerce – as fleeting as the evening light that shimmers from the rotunda of City Hall.

As designers, photographers and re-porters discovered with this prototype issue of SHiFT, people from many parts of our shining city live in the shadows. Ac-cording to Frederick Ferrer, CEO of The Health Trust and subject of Jessica Fromm’s interview, “behind the valley that people recognize as the high-tech leader and innova-tor of the world is a community in desperate need of help.”

His story and ours describe a tale of two cities, not...

A BETABETABETA

SPRING 2009

ISSUE

ON A HlLL.A SHINING CITY

SHiFT mag.us 3

Literacy, employment, afford-able housing and health care for all – are solutions to these social problems within our reach or just beyond it? Only the next generation of social entrepreneurs knows for sure.

Fuel their dreams and ours with your stories about local leaders who are solving seem-ingly intractable problems in imaginative ways.

Help us harness their passion for community and emerging technology.

Growing tomorrow’s heroes today.

SHiFTmag.usjoin the movement

GIVE | SHARE | SUBSCRIBE

“The test of

our progress is

not whether we

add more to the

abundance of those

who have much; it is

whether we provide

enough for those

who have too little.”

Franklin Delano Roosevelt – 1937

Second inaugural address

Having been a local resident and member of the technology community for more than 30 years, it has become clear to me that we do not occupy this region alone. The invisible communities that share the valley with us are in desperate need to be visible.

The mission of our dedicated team of journalists, photographers and designers from San Jose State University is to bring this invisible community into focus. Our pur-pose is to work together and develop a new social contract for each of the residents in the Silicon Valley.

We will be asking for your help to create the next evolutionary step of the Silicon Val-ley. In our upcoming issues we will introduce

concepts and processes to social innovation, multi disciplinary approaches to address so-cial need, and continue our focus into the invisible Valley residents.

SHiFT is our platform to tap into the Val-ley’s unique qualities of innovation, dynamic high energy and entrepreneurial spirit.

Many of us who are members of the Sili-con Valley technology family, which includes the public sector and infrastructure partners, have been gifted with extraordinary lives. All of us from SHiFT ask that you please share your gift.

Thank you,Richard Okumoto

s a new arrival to the Silicon Valley in January 1972, just one year after Don Hoefler has been credited for the first published use of this phrase, I did not fully under-stand or appreciate the life experience that lay ahead. My graduation from San

Jose State University and admittance to the family of Fairchild Semiconductor in the early 1970s was a profound induction into the world of Silicon Valley.

A

letter from the publisher //

RICH OKUMOTO SPIRITSPIRITSPIRITSPIRITSPIRIT

SH FTTHE OF

Rich Okumoto’s Influences

EducationHe helped develop and will be an instructor for the first General Education Financial Literacy course at SJSU. Rich is also an instructor in the off-campus MBA program at SJSU.

Rich is a Principal with Miller / Okumoto, Inc., a Management Consulting company.

BusinessRich has more than 30 years of experience in Silicon Valley technology companies. He has held the positions of CFO, VP & GM, and CEO.

image // MATTHEW MOUNTFORDSHiFT Magazine is published through San Jose State University’s School of Journalism and Mass Communication department by students and teachers. It is funded by the Social Innovation Institute.

SHiFT mag.us 5

2009//contents

editor in chief

THOMAS ULRICH

publisher

RICHARD OKUMOTO

production & art director

MATTHEW MOUNTFORD

managing editor

MEGAN HAMILTON

section editors

HEIDI ROMSWINCKEL-GUISE

KATIE ALPIZAR

copy editor

KIMBERLY TSAO

writers //

RALPH NICHOLS

JESSICA FROMM

JESSE KIMBREL

Join us today and help create opportunites for everyone in Silicon Valley. That’s what it means to Live United.

www.uwsv.org

SJstate_AD:Layout 1 11/24/08 4:05 PM Page 1

2009//contents

SPRING

BE

TA IS

SU

E

PROFILES

FEATURES14 / / Portra i t of a Fat Kid

Travis , a precocious 8-year-old,

wrest les with chi ldhood obesity the old-

fashioned way—one leg- lock at a t ime

Marshal l navigates a complex world of

county agencies and prescr ipt ion drugs,

explor ing alternatives to teen suicide20 / / The Depressed American Teenager

The Health Trust CEO searches for ways

to br ing health care to the fami l ies who

l ive in the shadows of the Shining City26 / / Interv iew / / Freder ick Ferrer

Hopping the late-night bus and detour ing

down dark al leys, Derek S i jder opens a

window to the world of the homeless32 / / Photo Essay / / The Homeless

Two homeless advocates narrate how

injury and disease in a f lawed health

care system have shaped their l ives38 / / Other Voices / / Advocates

NEWS

LOCAL

10 / / Front l ines

From expanding nearby

hospitals to a less invasive

test for Down syndrome,

scient ists have answers to our

most vexing health problems

NA

TION

AL

STAFF

SH FT

SH FT

SH FTSH FT

SH FTSH FT

SH

editor in chief

THOMAS ULRICH

publisher

RICHARD OKUMOTO

production & art director

MATTHEW MOUNTFORD

managing editor

MEGAN HAMILTON

section editors

HEIDI ROMSWINCKEL-GUISE

KATIE ALPIZAR

copy editor

KIMBERLY TSAO

writers //

RALPH NICHOLS

JESSICA FROMM

JESSE KIMBREL

special thanks //

DEREK SIJDER (contributing photographer)

SUZANNE YADA (contributing designer)

JACK HUSTING (lighting technician)

TIM MITCHELL (design adviser)

front and back cover //

PHOTOGRAPHY BY MATTHEW MOUNTFORD

FEATURING WOLF (A homeless man commonly

seen walking around San Jose. He constantly

adds new items to his exotic hat. Pg 32.)

SHiFT mag.us 7

510.557.0034www.JACKandMATTphoto.com

WEDDING PHOTOGRAPHY

JACK&HUSTING MATTMOUNTFORD

See our special contribution to

SHiFT magazine, page 20.

“Choose a job you love, and you’ll never have to work a day in your life.” -Confucious

hile the debate rages on about how to best provide health care for the nation’s

45 million uninsured, the Venice Family Clinic delivers a standard of care that has made it a model for free clinics nationwide.

For nearly four decades, the mission of the nonprofit clinic has remained un-changed — to provide free and com-prehensive primary health care, mental health services, health education and child-development services.

The clinic was started in 1970 in a borrowed storefront dental office. The founders thought that the clinic would be a temporary stopgap for the area’s uninsured until the govern-ment could provide medical insur-ance for everyone. The clinic moved to its current location in Venice Beach in 1984 and its administrators are still waiting for the government to provide health insurance.

Today, Venice Beach is the head-quarters for eight facilities that serve more than 21,000 patients in the surrounding neighborhoods. More patients find their way to the clinic every year as local hospitals close their doors. No less than 15 general acute-care hospitals have closed in Los Angeles County since 2000.

Nearly 500 doctors volunteer their services in a wide array of medical programs such as pediatrics, diabetes, obesity, asthma, cardiology, mental health, vision and dental care.

Homeless families have access to the same physicians who work at UCLA. They also receive hot show-ers and clean clothes in addition to medical and mental health care.

Elizabeth Benson Forer, execu-tive director and CEO, has been with the clinic more than 14 years. She has learned a lot about deal-ing with the burgeoning need for health care that has exploded over the last two decades.

The clinic operates on a budget of approximately $20 million a year with $8 million coming from pri-vate donations and nearly $4 million coming from Los Angeles County, Forer said. Seventy-seven percent of the clinic’s patients have no medi-cal insurance, but they receive the same attention as patients who have the ability to pay.

“We have marvelous physi-cians. Some of our specialists are available to our patients and are not available to the paying pub-lic,” Forer says.

The center offers mental health services for families dealing with issues ranging from domestic vio-lence to substance abuse. A staff of psychiatrists, clinical social work-ers, substance abuse counselors, a domestic violence counselor and an art therapist see patients at the clinic in addition to providing com-munity outreach services and train-ing at schools and other agencies.

The clinic hosts a program for teenagers three times a week called “Sex, Drugs and Rock ‘n’ Roll” where teenagers can discuss problems in a safe, confidential setting, according to Mimi Lind, the associate director of mental health services.

“Typical issues include unplanned pregnancy, anxiety, family problems that lead to depression and panic attacks,” Lind says. “We are able to meet with the teens during their med-ical appointment, which helps since they are ambivalent to show up to a mental health clinic. Teens also tend not to show up for things so we have them as a ‘captured audience’ during their medical appointment.”

Lind says that the clinic is the only medical clinic in the Los Angeles area that offers such a range of free mental health services. She cites an example

of a young woman suffering from dissociative identity disorder. Lind re-ceived help from the leading expert in Los Angeles in the field.

“She is a hard-working beautiful woman from Latin America who un-derwent some of the most horrific abuse I’ve heard in my whole career,” Lind says. “With the guidance of this volunteer psychiatrist, we were able to make great progress and she is now working and doing well.”

W

MODEL clinic profile // RALPH NICHOLS

Chasing a dream for affordable health

WELL-CHILD EXAMWendy Slusser, an attending physician at Venice Family Clinic, per-forms a well-child exam on one of the clinic’s nearly 6,000 pediatric patients.

SHiFT mag.us 9

FRONTLINESSANTA CLARA COUNTY

Income and health caredisparities broaden

According to Working Partnerships USA, the Silicon Valley’s tech-driven econ-omy has been “a double-edged sword” that has contributed to widening income disparities.

The nonprofit organization found that since 2000, the Silicon Valley’s weekly wages grew 32 percent, but the cost of health care has increased by 119 percent.

Lead poisoning prevention program receives more than $1 million in funding

Children who are exposed to lead poisoning may not experience normal neurological growth, which could lead to lower IQs, poor attention spans, and hearing and speech problems.

The Santa Clara Board of Su-pervisors approved a three-year agreement with the California Department of Public Health in August.

The board is giving exactly $1,451,914 to the Childhood Lead Poisoning Prevention Program.

Children’s hospitals welcome state bond act

In November, voters approved the Children’s Hospital Bond Act. The measure will improve and ex-pand eligible children’s hospitals in California. However, it will also cost taxpayers an additional $2 billion. It is expected to generate $980 mil-lion for ailing children.

Veterans’ hospital expands

The Veterans Affairs Palo Alto Health Care System has accelerated a massive reconstruction project on its Palo Alto and Menlo Park campus-es. Both campuses have opened a new emergency room and upgraded their major equipment and technological systems. The health care system plans to reconstruct the nation’s largest veterans’ rehabilita-tive hospital as well as cen-ters focused on bone and joints, blindness and psychiat-rics. The cost is an estimated $1.1 billion.

10 SPRING 2009

Teen Health Van provides health care for youth

The Lucile Packard Children’s Hospital has created health care services on the move. The Teen Health Van, in motion since 1996, visits un-derprivileged communities in the Bay Area and provides health care services to uninsured and homeless youth, aged 12 to 21. The program provides numerous services including HIV test-ing and counseling, health education and various forms of treatment.

A small but experienced staff leads the Teen Health Van around the Bay Area. The staff in-cludes a physician, nurse practitioner, social worker, dietitian and a driver.

Along with treatment and medication, the program educates and informs these teenag-ers about how to take care of themselves. The dietitian provides nutrition discussions about healthy eating. The social worker talks to teenagers about violence and dating to pro-mote healthy relationships and lifestyles.

So far, the Teen Health Van has provided its services to more than 8,000 teenagers. All of these teenagers are uninsured and almost half of them are homeless. Seventy percent of these patients return to the Teen Health Van for follow-up medical care. All treatment,

medication and counseling are free.

Schwarzenegger vetoes health insurance bill

In September, Gov. Schwar-zenegger vetoed a bill that stated health insurance companies could cancel policies when claims become unaffordable. Schwarzenegger said the bill would have raised health insur-ance prices and reduced health care coverage. The governor also stipulated that the bill lacked several consumer protections.

Restaurants will post nutritional info on their menus

Gov. Arnold Schwarzeneg-ger approved legislation that requires large restaurants to pub-licize the nutritional contents of their menus. The bill states that restaurants with more than 20 locations in California need to do so by July 1, 2009.

The law allows people to make healthier food choices and re-duce diseases such as obesity and diabetes. Santa Clara County has already put a similar ordinance in effect.

11SHiFT mag.us

12 SPRING 2009 SHiFT magazine

NEWS BRIEFSNATIONAL

Workers to pay more for health care

It is estimated that 59 percent of compa-nies intend to increase workers’ deductibles, copays and out-of-pocket spending to offset health care costs in 2009, ac-cording to the Mercer consulting firm.

Improvements to college mental health services needed

College students need men-tal health care in unparalleled numbers. Unfortunately, many schools do not have the resourc-es to accommodate the volume of students seeking these services. UCLA psychiatrist Miriam Gross-man believes students are not being asked the right questions at counseling centers. In order to in-crease efficiency, Grossman says the standard questions must be revisited and updated.

Number of HIV cases underreported for years

HIV-infected people have reached epidemic numbers in the United States. The Centers for Disease Control and Pre-vention reported that HIV-positive individuals have been underestimated by 40 percent each year for the last decade. Every year, 53,000 new infections emerge — not the 40,000 reported. Health off icials are urging better education and prevention for Hispanics, blacks, homosexual and bi-sexual men — the groups most affected by this virus.

Child mortality down

The United Nations Children’s Fund reported that since 1990, the mortal-ity rate of children under five has de-creased by 27 percent. The statistic confirms that UNICEF is on the mark to meet a U.N. Millennium Develop-ment Goal, namely reducing the children’s death toll by two-thirds in industrialized countries by 2015.

12 SPRING 2009

SHiFT magazine 13

Less invasive test formulated to detect Down syndrome

While amniocentesis can predict Down syndrome, the test is an uncomfortable pro-cedure that draws amniotic fluid from the uterus. Scientists say the procedure can cause miscarriages.

Researchers have been trying to find an-other medical technique for 30 years. They need not look any farther.

Sequenom, a biotechnology company based in San Diego, formulated a Down syndrome detector, a simple blood test for pregnant women. Sequenom plans to start selling its test in June.

Veterans to receive money for health care a year in advance

Congress hopes to approve a leg-islation that would provide money for veterans’ medical care an entire year in advance. This advanced ap-propriation of money is already in effect for programs such as the U.S. Department of Housing and Urban De-velopment’s vouchers for low-income renters. Veterans’ health care has been late or insufficient for almost two decades.

Liver disease linked to obesity in teens

Some obese teenagers are now suf-fering from a condition called nonalco-holic fatty liver disease, which can lead to cirrhosis and liver cancer.

Biopsies and blood tests are the only ways to detect the disease, but they aren’t usually administered. Early intervention may be the best cure, but it requires vigilance from health pro-fessionals.

Number of U.S. residents without health insurance on the decline

The U.S. Census Bureau re-vealed that the number of peo-ple without health insurance decreased from 47 million to 45.7 million since 2001.

On the flip side, the num-ber of individuals dependent on government health pro-grams has increased.

This suggests that the government may not be able to provide long-term health care to those who need assistance.

13SHiFT mag.us

KKID

American children live in a world of computer screens and PlayStation machines.

Now, meet Travis. A kid actively trying

to gain weight.

59 lbs

Dirty shoes

FATPORTRAIT OF A

photo illustration // MATTHEW MOUNTFORD story // JESSE KIMBREL

BOUNCE

14 SPRING 2009

K

53”

8years

Mosquito bites

15SHiFT mag.us

K

RIDE

LITTLE STUDSurprised by the momentum he was able to produce on this stationary bike, Travis laughs away the fear with his feet strapped to the pedals.

16 SPRING 2009

K“Travis, shut up.”

“Unfortunately, many of the modern con- veniences that have improved our lives also make it easy to slip into unhealthy habits.”

At 5 a.m. on Saturday, Chuck Lindahl and Nada Radonich woke to a thudding sound from a struggle in their 8-year-old son Travis’ room. Chuck didn’t jump out of bed and grab his 12-gauge shotgun. He didn’t even lift his head because he knew the sound all too well and was confident that his wife would resolve the issue. Her solution:

eeping quiet wasn’t an option for Travis. A friend who had stayed the night grappled his lower ex-tremities in a figure-four leg lock. Travis and his friends have been into wrestling recently. Instead of watching it on TV, they strap up and have a go at it themselves. If it weren’t for the two referees sleeping next door, Travis and his friend would get a two-hour workout in before most people even brush their teeth.

Are Travis and his friends a dying breed? Maybe, but they might outlive nearly a quarter of their gen-

eration. Regardless of how rambunctious they are, Travis’ old-school wrecking crew is still partaking in physical activity.

If you ask Travis how old he is, he says, “I am 8,” not 8 and a quarter or 8 and a half. His birthday was on Christ-mas Eve, and he was totally stoked to double the celebrat-ing. Travis celebrated his birthday a week before Christmas with his friends, which tantalized his taste buds for more parties and presents. Currently, Travis weighs 59 pounds at a height of about 53 inches. Is Travis overweight or obese? No. He steps on the scale all the time hoping he’ll get bigger.

The Centers for Disease Control and Pre-vention reports that the percentage of children in the U.S. who are overweight or obese in Travis’ age group has risen from 6.5 percent be-tween 1976 and 1980 to 18.8 percent between 2004 and 2005. The CDC also reports that in 2007, 22.6 percent of Californians were obese, leaving Colorado the only state below a 20 per-cent obesity rate.

The CDC determines people are overweight or obese by their Body Mass Index, which is calculated using height and weight. For children and teens, the BMI formula factors in their age and sex because they are still growing.

Travis sports a BMI of 14.8, which puts him into the 22nd percentile for boys aged 8 years and 2 months, according to the calculator on the CDC’s Web site. The calculator states Travis has a healthy weight.

The California Center for Public Health Advocacy found in 2002 and 2003 that more than 22 percent of children were overweight and 28.4 percent were found to be unfit in Travis’ California legislative district.

“We are inundated with marketing for unhealthy food without proper education of its consequences, and children are increasingly the target,” says Santa Clara County Supervisor Ken Yeager.

Yeager chairs a countywide policy workgroup on early child-hood obesity prevention that he says convenes all elected of-ficials that represent residents of Santa Clara County. He also introduces and encourages others to initiate ideas to promote obesity prevention.

“Locally, certain parts of our county are saturated with fast-food restaurants and lack access to affordable, healthy alternatives. Often, our urban settings provide inadequate resources for safe, inexpensive physical activity opportunities,” Yeager says.

Dr. Virgil Payne, the acting associate dean for the College of Applied Sciences and Arts at San Jose State University, has extensively researched obesity and believes it’s an epidemic, even though recent statistics may indicate a plateau.

Payne says this could be a sign that the nationwide obesity problem can’t get much worse. “There is no one way to resolve the problem,” Payne says. He says causes of obesity are endless, so it can’t be cured with one solution.

Payne says people become overweight from not get-ting enough physical activity and eating incorrectly, but we can blame many of the tools in our day-to-day rou-tines. He says even something like riding a lawn mower, which makes a person’s chores more manageable, can contribute to not expending calories.

Yeager says, “Unfortunately, many of the modern con-veniences that have improved our lives also make it easy to slip into unhealthy habits.”

Perhaps if Travis played a wrestling video game instead of actually wrestling with his friends in the early morning, he would get his wish of becoming bigger and allow his parents to get their full eight hours of sleep.

Payne says hypokinetic diseases caused by lack of motor activities can lead to certain types of cancer, diabetes, stroke, physiological conditions and heart disease, which is the

17SHiFT mag.us

No. 1 killer in America by a long shot. Yeager supports this claim by referencing the CDC, which says that “one in three U.S. chil-dren born in 2000 could develop diabetes during their lifetime.”

Payne says preventing obesity before it happens is one way to attack it because people who lose weight tend to gain it back. If children learn early in their lives, even in preschool, how to eat right and stay physically active, their chances of being overweight or obese will decrease.

t the end of the day, Travis is still a ball of energy. While his father lifts weights, Travis runs on a nearby treadmill. Travis chooses to run because he thinks it’s fun.

The CDC recommends that parents exercise every day and encourage their children to join in.

“Parents must be involved and be good role models,” Yeager

says. “Improving your own habits will set an example for a healthy lifestyle.”

Dr. Matthew Masucci, a kinesiology assistant professor at SJSU, says it might be a good idea for parents to encourage all types of physical activity rather than just sticking to standard team sports. Team activities work great for some children, but not all kids enjoy sports and tend to get discouraged when they don’t do well.

Masucci uses dodgeball to explain his ideology. When kids play dodgeball, the stronger competitors eliminate the weaker players. This leads to a group of discouraged kids sitting on the sidelines, watching the stronger participants enjoy the game.

Masucci says if parents encourage their children to try new sports and activities, the chances that their kids will find physical activities they enjoy doing will increase. He says some children

A

LIFT

1 2.2

18 SPRING 2009

respond better to individual sports such as skateboarding, golf and cycling, which still promote social behavior. He also men-tions that sports and physical activities teach young people how to stay active as well as encourage good eating habits.

“Everyone needs to find daily activities that they enjoy,” Yea-ger says. “Sports can offer an outlet for people of all ages to engage in physical activity in a fun and meaningful way. If being involved with sports encourages our kids to be active in a safe environment that can also build self-esteem, I believe that sports can help prevent obesity.”

Payne says the amount of time children sit in front of a TV hasn’t increased, but the hours they spend in front of a screen is escalating. He says the time children devote to playing video games and staring at computers in combination with watching television is worrisome.

One attempt to incorporate physical activ-ity into a video game according to Masucci is the Nintendo Wii. The Wii keeps its players active because the controller is motion sensi-tive, making the player use body movements to control the game. This popular console is Travis’ weapon of choice. Travis doesn’t play video games all that often, but when he does, he uses the Wii. He plays with his older sisters, and by the end of a tennis match, they are often sweating.

While the Wii may successfully attempt to get kids involved in physical activities, Payne says the obesity epidemic is still “dire and desperate.” However, it is en-couraging that many people are working hard to find solutions.

One of the programs Payne mentioned is Healthy Silicon Valley, an obesity pre-vention collaborative in Santa Clara Coun-

ty. It features different sectors including after-school programs, community

and education, among others, ac-cording to the program’s website.

he Santa Clara County After School Collaborative “is a network of community-based organizations, school district

and site staff, local government and concerned citizens who work, or have a stake in, public and privately funded after-school programs,” according to the Healthy Silicon Valley Web site. The SCCASC promotes healthy nutrition and physical activity.

Mara Wold, the Region V Healthy Start and After School Part-nership’s co-regional lead, works with the SCCASC and says the partnership brings in outside vendors, such as dance or karate instructors, and teaches them how to run an after-school program.

These are just some of the local organizations leading the fight against the obesity epidemic.

Yeager mentions that The Department of Public Health “is currently working on a program called the (Early) Childhood Feed-ing Practices Collaborative that focuses on teaching parents and children about the appropriate eating habits for young children.”

He says that “the Pediatric Healthy Lifestyle Center of the Santa Clara Valley Health and Hospital System provides a multi-disciplinary approach to address obesity issues with children that emphasizes the adoption of lifelong healthy habits and disease prevention rather than weight loss.”

Currently, Yeager encourages residents to take part in Santa Clara County’s Healthy Trails Challenge, which he says is “a fun way to increase physical activity by enjoying the beauty of our county parks.”

“As a county supervisor, I obviously cannot mandate what hap-pens in residents’ homes, but I can work to provide education and healthy options,” Yeager says. “Success comes from each individual that takes a positive step toward a healthier lifestyle.”

According to Yeager, a growing number of health experts be-lieve that “if the obesity epidemic continues on its current path, it is likely that parents will outlive their children. We need to act now to reverse this crisis.”

Perhaps Travis is lucky to have a mom willing to tote his lean 59-pound body all over Santa Cruz County so he can kick around the soccer ball three times a week. Maybe most kids don’t enjoy a piano lesson every Friday afternoon. Travis’ ways of staying active may be too much to ask of every kid, but a page out of his book would be a good thing. //

average additional dollars people who gain 20 pounds or more will increase their medical bills each year

maximum average achievable heart beats per minute while play-ing a Wii130

1530

5001,830

percentage of children who are obese

percentage of poor children who are obese

calories burned per week when playing a Wii

1 2.23X

increase in child obesity since 1980

an online community for parents with obese children

redapplefoundation.org

sidebar sources // PIC.TVNEWS.BBC.CO.UK

HEALTHYAMERICANS.ORGCHILDRENSHOSPITAL.NET

hours a week the average video gamer sits and clicks

T

19SHiFT mag.us

With teen suicide rates on the rise, psychologists and counselors nationwide are rushing to f nd a cure-all cocktail for Generation YAMERICAN TEENAGERDepressed

the

SPRING 200920

images // MATTHEW MOUNTFORD makeup & wardrobe // MEGAN HAMILTON lighting technician // JACK HUSTING

model // EMMA NORTHCOTT

story // RALPH NICHOLS

With teen suicide rates on the rise, psychologists and counselors nationwide are rushing to f nd a cure-all cocktail for Generation YAMERICAN TEENAGERDepressed

SHiFT mag.us 21

Marshall, 13, scans his top friends on his MySpace welcome page before signing off. He adjusts the earbuds to his iPod Shuffle and drops his skateboard down on the blacktop. It’s raining but Marshall’s not worried about getting wet. He’s cruising west down Capitol Expressway looking for the nearest freeway overpass to jump off and kill himself.he conflicting diagnoses and potpourri of medications prescribed for Marshall are typical

of what teenagers and their families face while dealing with debilitating mental disorders, according to government surveys. Marshall’s first suicide attempt started a cycle of hospi-talizations, psychiatric visits, rewritten prescriptions and return trips to the hospital, which has become a refuge for the troubled teenager.

He likes to pick up girls in the hospital, saying “Bipolar girls are easy.”“I met one bipolar girl who was also schizophrenic,” Marshall says. Marshall is one of an estimated 6 million American children who suffer from some form

of mental illness. Many of them suffer from depression, the most common reason behind suicide for youth, according to the American Psychological Association. For those between ages 15 and 24, more than 4,200 committed suicide in 2005, according to the latest data available from the U.S. Centers for Disease Control and Prevention. In a 2004 report from the National Institute of Mental Health, depression and other mental disorders were risk factors for suicide along with substance abuse.

Unfortunately, Marshall’s first suicide attempt was not his last. Months after failing to jump off a bridge, he swallowed pills hoping to go to sleep and never wake up. Marshall was first diagnosed with attention deficit hyperactivity disorder. Another psychiatrist was convinced the San Jose teenager suffered from Asperger’s syndrome, a high-functioning form of autism. Yet another psychiatrist prescribed Prozac for depression.

In a recent New York Times series on children with mental disorders, Dr. E. Jane Costello, a professor of medical psychology at Duke University, said that the “system of diagnosis” for psychiatry is 200 to 300 years behind other branches of medicine.

While experts often disagree on the diagnosis of a mental illness, many agree that the number of children with mental disorders is on the rise. The number of American children with serious mental disorders has tripled since the early 1990s, according to government surveys. According to The Times, a Yale University analysis of 1.7 million insurance claims showed that the rates of bipolar disorder more than doubled among boys ages 7 to 12 from 1995-2000 and have continued to rise since then.

In Santa Clara County, approximately 10,000 people receive emergency psychiatric ser-vices each year, according to Bruce Copley, deputy director of the Santa Clara County Mental Health Services. The Emergency Psychiatric Services unit is often the first stop for those needing to see a mental health professional. EPS professionals determine a person’s mental health and if longer-term hospitalization is needed.

Copley says the county is doing a better job today than 10 years ago assessing children who need psychiatric services. He says practitioners diagnose children with Asperger’s syn-drome and how trauma -- psychological, physical or sexual -- affects a child’s development.

Santa Clara County contracts with approximately 28 agencies to provide psychological services for adults and children, Copley says. Budget cuts have impacted county services over the years.

THE DEPRESSED AMERICAN TEENAGER

22 SPRING 2009

for the nearest freeway overpass to jump off and kill himself.

TROUBLED TEENSBipolar disorder affects

approximately 5.7 million American adults ages

18 and older in a given year.

23SHiFT mag.us

The county is bracing for a $300 mil-lion deficit this year.

Mental health professionals working at the county’s EPS unit have a very difficult job, says Dr. Matthew Gerst, a clinical psycholo-gist who worked with a county-contracted agency before going into private practice.

“There are very talented psychia-trists and a very talented staff working with a very difficult mission — deter-mining who is dangerous to themselves or others and who is not,” Gerst says.

In the 1990s, approximately 50 to 70 percent of kids seen by Santa Clara County EPS professionals were hospital-ized for long-term treatment.

Now, most adults and children seen at EPS are released within 24 hours, Copley says. Many children often receive follow-up treatments from their school psycholo-gists, a link in the line of mental health care professionals on the lookout for youth who are a danger to themselves or others.

“I typically see a student for a few months and then make a referral. If the student is homicidal or suicidal, I don’t have to wait,” says Steve Kaplan, a psychologist

with the Huntington Beach Union High School District for the last 24 years. “I’m often the first stop for many kids with mental health problems. Some kids I see also have an outside therapist. I try to work on a student’s school problems, but parental prob-lems always seem to find a way into our counseling sessions.”

In 24 years of seeing troubled kids, Kaplan has many success stories, but he most vividly recalls the kids who didn’t get better.

“I know of one student I counseled who is in prison for murder. I also know of four others who have killed themselves or killed others,” Gerst says. “Remember, kids don’t come and tell me how wonderful their [lives have] been. It’s usually years of unhappiness.”

Kaplan counsels many kids like Marshall who have learned to use their psychological problems to score points with girls. Marshall ad-mits he has feigned suicidal feelings several times to be hospitalized.

“The hospital’s an escape when things get hard at school or at home, or I just want to be around other kids who are like me,” Marshall says. “Most of the other kids are worse off than me. One guy took 85 Tylenol PM pills and now has permanent liver and kidney damage. Another kid cut into the side of his face to make it look like the Joker’s face on Batman.”

Kaplan also says he’s recently been working with more autistic and Asperger’s students. Kids were rarely diagnosed with As-perger’s syndrome 30 to 40 years ago, according to Faye Kimura, a licensed clinical psychologist in San Jose.

Doctors are also looking at bipolar disorder differently today than 15 to 20 years ago, according to The Times. This disease, characterized by symptoms of aggression and explosive rage, was once called “manic depression.” Before the 1990s, it was not

thought to occur before late adolescence, according to the Times. Today, young children are being diagnosed with the disorder.

Unlike children with bipolar disorder, Marshall has never been aggressive toward others. He’s only been a danger to himself, pri-marily when he’s unable to manage overwhelming feelings of low self-esteem. Marshall’s been diagnosed with chronic depression and has taken a daily pharmaceutical cocktail of Wellbutrin, an antidepressant, and Abilify, a mood stabilizer intended to make the argumentative teenager less rigid in his thinking.

Marshall’s psychiatrist credits the drugs with helping him end the cycle of visits for EPS followed by a stint in an area residential treatment center. To help Marshall control his moods, he visits a fam-ily therapist weekly with his parents and brother. He also sees a clini-cal psychologist and psychiatrist, as well as his school psychologist.

Marshall’s initial suicidal impulses were triggered by bullying and teasing at school, a secret the troubled teenager kept carefully hid-den from his family until that rainy night he set out to kill himself. Marshall left his parents a suicide note explaining it wasn’t their fault.

“The hospital’s an escape when things get hard at school or at home, or I just want to be around other kids who are like me.”

THE DEPRESSED AMERICAN TEENAGER

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He was fed up with the teasing and felt he’d never fit in at school.Peer pressure is often a root cause for kids’ depression, accord-

ing to Carol Black, a psychologist for the East Side Union High School District. Black has seen many teens like Marshall who suf-fer from low self-esteem, which is often exacerbated by cruelness from other kids. Boys are not the only ones subject to teasing, bullying and depression. Adolescent girls are twice as likely to experience depression, according to the New York Times.

Depression often begins with changes in eating or sleeping habits. An adolescent can have difficulty concentrating or mak-ing decisions. In more severe cases such as Marshall’s, kids may contemplate suicide or have a preoccupation with death.

Treating depression with a combination of antipsychotic drugs is becoming increasingly common despite uncertainty about side effects and the drugs’ overall effectiveness. In 2007, the Food and Drug Administration began requiring drug manufacturers to include warnings that antidepressants can cause suicidal thoughts and behavior in children. The New York Times also reported

that 1.6 million children and teenagers were given at least two psychiatric drugs in combination during the same year.

FDA warnings on suicide converge directly with a burgeoning market for antidepressants, the third most commonly prescribed class of drug in 2003. In 2001 alone, 180 million prescriptions were issued for antidepressants, according to the San Jose Mercury News.

A link between antidepressants and suicidal behavior in some children and teenagers first surfaced in studies five years ago. However, health care experts cannot agree on a tangible link. A 10-year study in the January 2006 issue of the American Journal of Psychiatry disputed the new FDA warnings on suicidal behav-ior and antidepressants. The study did find a higher rate of suicide attempts for adolescents (314 per 100,000) than for adults (78 per 100,000) who take antidepressants.

The mix of diagnoses and drugs that are intended to help teenagers like Marshall still carry the risk of doing more harm. Researchers continue to seek solutions, but for Marshall, time may be running out. //

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men arefour times more likely to die by suicide than women

one out of three depressed people also suffer from some form of substance abuse or dependence

25SHiFT mag.us

FREDERICKFERRER?

WHAT’S

MINDIN THE

OF

illustrations // MATTHEW MOUNTFORD & DEREK MOSER story // JESSICA FROMM

hen Frederick Ferrer became the CEO of The

Health Trust two years ago, he took on the daunting

task of making Silicon Valley the healthiest region in the country.

The Health Trust, a nonprofit com-munity-benefit foundation, is pumping $30 million into the Silicon Valley com-munity this year and spearheading a three-pronged program to whip neighborhoods into shape. Through The Health Trust’s trio of initiatives, Ferrer is on a crusade to pro-mote healthy living, healthy communities and healthy aging.

But community leadership wasn’t any-thing new to Ferrer. A nationally recognized expert in child development and nonprofit leadership strategies, he has been immersed in Santa Clara County health and neighborhood issues for more than two decades.

W F

He earned his bachelor’s degree from Santa Clara Uni-versity, his master’s from San Jose State University and is a graduate of Harvard University’s Strategic Perspectives in Nonprofit Management program.

An authority on family support, Ferrer held past posi-tions as executive director of San Jose’s Estrella Family Services, chair and commissioner of the FIRST 5 Commis-sion of Santa Clara County and board member of United Way Silicon Valley. He was honored with the Children’s Discovery Museum’s Kindred Spirit Award and the Ameri-can Leadership Forum Silicon Valley’s John Gardner Leader-ship Award.

To some, the nonprofit’s health-centered agenda may seem beyond reach with an economic recession rippling through the Silicon Valley population.

Not so, Ferrer says. Solutions that highlight the impor-tance of a positive, healthy environment, good nutrition, health care and employer responsibility promote people’s overall well-being.

“I’ve been working in the local community since I was in col-lege,” Ferrer says. “There is a strength to the kind of strategic thinking around where solutions are. They’ll surprise us. There are some ‘elegant solutions’ here, things you can do something about.”

rederick Ferrer senses an invis-ible Silicon Valley where life isn’t

all Segways and sushi. Behind the Valley that people recognize as the high-tech leader and innovator of the world is a community in desperate need of help.

Economic and social gaps are the biggest challenges The Health Trust faces. Its mis-sion is to make health a priority in the most vulnerable and underserved communities.

“There are two cities here. We have great wealth, but we also have poverty. We have a tremendous sense of health dispar-ity if we look at low-income and minority communities.”

Ferrer returns to the concept of disparity throughout our hour-long conversation in his

immaculately modern office in Campbell. He is the type of guy who will pause to say “Bless you” if you sneeze, and refers to everybody as “folks.” Sitting behind his large granite-topped desk, Ferrer positions his daily schedule and a copy of San Jose Magazine neatly in front of him. On a shelf behind him sit a cluster of gleaming awards.

The Health Trust initiates community projects by en-couraging smart planning, donating funds to other non-profits, providing Meals on Wheels and supporting HIV/AIDS patients.

When people think of Silicon Valley, they imagine edu-cated citizens with “health insurance, good health care and their own doctors. They eat good food, exercise and hold all the resources needed to stay healthy,” he says.

Countless individuals in our local community don’t enjoy access to these basic health resources. Because some people are constantly surrounded by violence, racism or the effects of poverty, “they live in environments which don’t support their health and wellness.”

Health insurance, primary care, good nutrition and exercise are not available to families in many of San Jose’s communi-ties. In Santa Clara County, an estimated 32 percent of all em-ployed workers are paid $15 an hour or less, below the minimum

One CEO. Two cities. And a multi-million dollar plan to

combine them.

27SHiFT mag.us

Healthy and SafeCommunities

// FREDERICK FERRER28 SPRING 2009

earnings needed to meet a basic standard

of living without going on welfare. Personal health

suffers when people are liv-ing paycheck to paycheck, according to the 2008 report “Life in the Valley Economy” by Working Partnerships USA.

“There’s a huge disparity in health outcomes for folks who live in those communities, who have lower education, who have lower incomes, who live in certain geographic areas of our com-munities. They’re the folks who have the biggest risks.”

ccording to Ferrer, obesity and environmental stress stem from unsafe neighborhoods and limited access to nutritional food.

It isn’t individual choice that makes people unhealthy. To Fer-rer, environment determines if people are going to be unhealthy, whether they realize it or not.

“If you’re a single mom living on the East Side of San Jose, you have children who are not going outside because it’s not safe to play. There are no parks. You don’t have access to any good groceries. All you have are liquor stores and junk food and convenience markets. It’s not individual choice that’s making you unhealthy.”

Ferrer believes people are unaware of this chasm in the com-munity at large. The fact that the very rich and the very poor are generally more integrated in the Bay Area than other parts of the nation also plays a part in making inequality easier to ignore.

“You say, ‘Well, everyone looks fine.’ But when you really go to certain geographies and populations, you start to see that the disparities are huge. They are alive and well here in Silicon Valley,” Ferrer says.

Last year, 53 percent of the nation’s underinsured adults went without critical health care solely because of costs, according to recent reports. Neglecting medical care includes not seeing a doctor when sick, not being able to pay to fill prescriptions and not following up on recommended treatments or tests. In California, 58 percent of people in fair or poor health reported avoiding needed care because they couldn’t afford it.

But why is the health of some communities inadequate? One answer he gives is the relationship between environment, stress and poor health.

If you’re living in a community with a constant threat of violence, racism, crime and pollution, those factors affect your well-being in ways that are just as detrimental as genetic diseases or cultural backgrounds.

Violent crime contributes to community stress. Once considered the safest big city in the nation, San Jose’s crime is on the rise. Violent crimes per 100,000 residents grew 4 percent from 373 in 2006 to 387 in 2007. San Jose’s homicide count in 2007 grew to 33 reported murders, its highest level since 1997.

Twenty-two percent of San Jose residents reported crime as the most serious issue facing the city in 2007. That was up from just 14 percent in 2005.

Ferrer notes that when a person faces these challenges to the safety of their environment, it wreaks “havoc on your body in ways you don’t even know. You’re not necessarily even aware that this stress is having cardiovascular effects.”

“We don’t always appreciate the effects of endemic environ-mental stress in low-income communities. They manifest them-selves in illness, and finally, into disease.”

He sees these social determinants as silent killers, carriers of chronic health problems such as hypertension, coronary heart dis-ease, type 2 diabetes, some cancers and most commonly, obesity.

Obesity rates continue to climb steadily among adults in Santa Clara County. Nearly 54 percent of all county residents ages 18 and older are now considered above the recommended body weight. That’s up from 51.6 percent in 2000. This trend is rising in children and adolescents.

“This generation will live a shorter life than their parents did,” Ferrer says.

When observing these health and stress patterns, he empha-sizes that making healthy decisions often hinges on how close you are to the nearest 7-Eleven. You can witness examples of this every day.

“I saw something this morning,” Ferrer says. “I was driving by Willow Glen High School. Soda has been banned on the cam-pus. There’s a liquor store right up the street from the school. You see a line of kids going into the liquor store, and they’re all coming out with sodas. They’re literally drinking sodas on their way to school.”

Ferrer believes it all comes down to convenience. Students would be forced to make healthier choices if the liquor store wasn’t at that location and didn’t offer the convenience of buying sugar-laden drinks on their way to school.

According to a recent report, six out of 10 middle and high school students surveyed in Santa Clara County consumed soda and fried potatoes in the last 24 hours. Likewise, surveys indi-cated that less than one-third of adults in the county consume the recommended five servings of fruits and vegetables per day.

Ferrer counts on his fingers the top three obstacles for good nutrition.

“If you’re living in an environment where you have a conve-nience store, a liquor store and a Jack in the Box, you are not going to get any access to healthy produce.”

That’s no surprise, considering that fast food restaurants are by far the most common retail food outlets in Santa Clara County. The ratio of fast food restaurants and convenience stores to super-markets, produce stores and farmers markets in the county is 4.32 to 1.30, according to the 2008 Working Partnerships USA report.

Ferrer considers poverty another significant factor in making unhealthy decisions.

A

Healthier Food

Health Care

29SHiFT mag.us

“If you have a low-income paycheck and four kids, you’re go-ing to say, ‘I can buy this whole package of doughnuts, or I can buy one orange.’ You’re not going to make that choice. You’re not buying that orange.”

Ferrer is deeply troubled. Unless a serious intervention con-cerning environment and prevention happens, our nation will never maintain enough insurance, hospitals or doctors to take care of society’s ills.

Community foundations such as The Health Trust are finding themselves on the front lines of health and emergency assistance in Silicon Valley. Quality health insurance continues to be out of reach for many with layoffs, foreclosures, food and gas prices running rampant and government funding dwindling to nothing.

Last fall, The Heath Trust initiated a community project that offered health screenings and tests for the uninsured at the Berryessa Flea Market. Each October, the open-air health fair and clinic serves the public, particularly flea-market vendors.

“We recognize that for many folks, screening at the flea market is their only medical care. In the richest community in the world, at the height of innovation, in the technology giant of the world, we have people getting health care at the flea market.”

But just offering immediate relief services isn’t the answer, and it’s not The Health Trust’s primary goal. It’s vital to The Health Trust’s mission that the entire community — from schools to government to employers — take responsibility in increasing the health of the entire community.

Silicon Valley businesses and corporations can help in two ways.

“One, by making sure that they are good employ-ers. When employers take good care of their workforce with health insurance, wellness polices and trying to be active and engaged, that covers a lot of folks,” Ferrer says. “Secondly, corporations could also be generous in supporting activities that are for the general community wellness.”

Ferrer gives examples such as company-sponsored mara-thons that free up employees to volunteer in the community,

and general corporate giving to nonprofits.“If everyone started with their own workforce, we’d have a

huge impact across the county,” Ferrer says. “I know everyone can’t afford that, and that’s why The Heath Trust has a role in helping smaller businesses and municipalities.”

The Heath Trust’s Campbell offices exemplify employer respon-sibility. Located in the office is a Wellness Room, a common space for the Trust’s employees. The room contains a fully stocked gym where trainers lead fitness classes many times a week.

“My staff has no excuse to not work out … we have it on-site, during the work day and at the end of the work day, for free. We take all of the barriers away,” Ferrer says.

As leaders in the community, Silicon Valley companies should take care of their employees as well as the community, he says.

So, does Santa Clara County really stand a chance at becoming the healthiest region in the country? Ferrer thinks that at this moment in history, Silicon Valley is in a perfect position to show the nation how to really make a community healthy.

“With the resources and the innovation and the willpower, we can do anything. That notion made this valley very strong in terms of our leadership and technology. We have that bravado and that attitude. We’re innovators in so many areas. If we can’t do it here, then what are they going to do anyplace else in the world?

“We’re in the perfect place to do all of this work and to be a model to the country. We have the ingenuity here to make things exciting and make things a reality.”

Ferrer says that because The Health Trust maintains an envi-ronment and prevention-focused agenda, they offer a clearer path to finding solutions.

“I guess the surprise for me is that there are solutions that could actually work. You don’t have to get overwhelmed and depressed about everything. We actually should go do this. So, let’s go.” //

“In the richest community in the world, at the height of innovation, in the technology giant of the world, we have people getting health care at the flea market.”

This year, The Health Trust will launch a package of workplace wellness services for Silicon Valley corporations, agencies and nonprofits. Physical inactivity, obesity and other health-related problems are es-timated to cost California businesses an estimated $28 billion in lost productivity, workers’ compensation, as well as direct and indirect medical costs each year. Local businesses who have won awards for their

workplace wellness include Cisco Systems, Sun Microsystems, BD Biosciences, Kaiser Permanente and Broncus Technologies in Mountain View.

Award-winning wellness programs in-cluded the following: employee sporting tournaments ranging from basketball and volleyball to horseshoes and table tennis, nutrition education, cooking classes and farmers market tours, health fairs, stress

reduction seminars and health clinic screen-ings, interactive wellness Web sites, free fitness and health classes and physical activ-ity breaks.

The Health Trust is currently funding outreach to Silicon Valley businesses to en-courage them to participate in the 2009 Fit Business Awards program, of which they are a sponsor.

—Courtesy of www.healthtrust.org

The Health Trust: CORPORATE MAKEOVER

30 SPRING 2009

he perks and services Google of-fers to its employees are the stuff of legend. Everything from gour-

met food to aerobic kickboxing class-es, film series, guest lectures (Barack Obama was a recent speaker), hobby-ist gatherings (fire-stick twirling, any-one?), shuttle-bus service, on-site oil changes, haircuts, laundry and medi-cal checkups are offered on Google’s Mountain View campus.

Googleplex, as it is called, seems more like a fancy private school than a corporate headquarters. Decked out in colorful bursts of blue, red, yellow and green, the campus has 8,000-plus people working on-site daily. Employ-ees are predominately young, fit and casually dressed. Wandering from bright, posh coffee-and-juice bars to gourmet cafeterias, they wear jeans, sneakers and Crocs. Workers con-vene at lounges in their high-tech home, tapping away on laptops with their earbuds in, like college students at the library.

They’re also a very international set. Walking through the Googleplex hallways, you can hear Hindi, French, Spanish and English.

Scattered around the campus are a fleet of light blue cruisers, company bikes that anybody can just pick up and ride. There’s even a financial incentive for buying a hybrid car. Out of 10 cars parked in a row of the Google employ-ee parking lot, six were hybrids.

Claire Stapleton, a public affairs as-sociate at Google, says that the Friday town hall-style meetings with top ex-ecutives Larry Page, Sergey Brin and Eric Schmidt, exemplify employer re-sponsibility.

“We call it TGIF, and it’s a cool cul-tural thing that says a lot about Google

in that anyone can get up and ask anything they want,” Staple-ton says. “Sometimes it’s really mundane questions like, ‘Why don’t we have Smartwater in the micro kitchen?’ Sometimes there are really interesting and probing questions about strategy or transparency. It’s basically just trying to get in the minds of the leadership.”

A pretty, 23-year-old brunette, Stapleton’s eyes light up as she proudly mentions that she’s made personalized name cards for all the new Google employees to wear, in-scribed with their names and inter-esting personal facts. For example, “I’m the world’s fastest Rubik’s cube solver.” Twenty minutes later, she’s chugging down a large glass of vio-lently green wheatgrass juice in one of Google’s campus eateries.

Daniel Ratner, a mechanical engi-neer on Google’s Street View team, says he joined the company three years ago, after working at a corpo-rate start-up for a number of years. Like most Google employees, Rat-ner is well-spoken and unwaveringly chipper. In his early 30s, he sports a scruffy beard, a brown company T-shirt and cargo pants. Ratner says that after joining Google, he can’t imagine working anywhere else.

“I still can’t believe people do that, when they put people in cubicles and deprive them of sunlight. It’s hard to be a human being, day in and day out for eight hours, to kind of feel normal in that setting. Google does a great job of trying to keep you connected to all those things and that way, you have a better chance to be balanced.”

Listening to Stapleton and Ratner

chat excitedly about who is organiz-ing a bike ride tomorrow and which campus cafe is serving matzo ball soup today, you wonder, with all these ex-tracurricular distractions, does Google have trouble keeping employees in their seats to do their work?

“I find it actually easier having this stuff around me, to not have that urge that I had at my previous job to be like, ‘Eh, I want to go home,’” Ratner says.

T

MODEL biz: profile // JESSICA FROMM

Redefining humanity, one cubicle at a time

MOBILE WORKERA man works on his laptop in a chair at the Googleplex in Mountain View, Calif.

31SHiFT mag.us

32 SPRING 2009

33SHiFT mag.us

F A C E S

HOM E L E S So f t h e

photo

DEREKessay //

SIJDER

OASIS DOWNTOWN YOUTH CENTERWolf looks over a pair of pants on Nov. 8, 2008

at the Oasis Downtown Youth Center. The center opens its doors to the homeless every Saturday, pro-viding clothing, blankets, food and church sermons.

34 SPRING 2009

LUCY St. James Park // Nov. 22, 2008

35SHiFT mag.us

eing homeless is something I never thought would happen to me,” says Steve Chehy (page

38), a homeless man living in San Jose. He lost his home after he was unable to pay off a loan, and he feels like he’ll never be able to live in a house again.

By the end of January 2007, the Santa Clara County Homeless Census and Survey estimated 7,202 homeless people in Santa Clara County. Only 29 percent of those people claimed to live in shelter facilities, leaving 71 per-cent unsheltered. More than half had been homeless for one year or more, while almost 21 percent indicated they had been homeless for more than three years, like Chehy.

Chehy lives in a camper he bought with his Social Se-curity money. After being kicked out of his house, he was forced to live on the streets.

Only 55 percent of homeless people claimed to receive some form of government assistance. Toward the end of 2007, the same census estimated 18,056 people were classified as being homeless at some point in time through-out that year. That number represented approximately one percent of the total population in Santa Clara County.

When the Obama administration injects billions into the economy, will the ripple of aid make its way to Santa Clara County’s homeless citizens? In the next issue of SHiFT, we will dive deeper into the expanding disparity between eco-nomic and social classes to find everyday solutions that our community can come together and solve.

ROB AND LARRYSt. James Park // Nov. 22, 2008 Three times a week they work together collecting cans.

BOBBYThe Oasis Downtown Youth Center // Nov. 15, 2008

“B

36 SPRING 2009

BOBBY A former United

Farm Worker has been homeless for “too long to

remember.”

37SHiFT mag.us

JOHN PIERCE (above)4th and Santa Clara // Nov. 22, 2008

BRUCE ANDREW KELLEY and VERONICA ANNCOMER (below)Oasis Downtown Youth Center // Nov. 15, 2008

38 SPRING 2009

voice // STEVE CHEHYSteve lives in his trailer with his dog,

Molly, in a church parking lot in San Jose.

Losing it ALL profile // KATIE ALPIZER

One man’s journey from middle class to nowhere

“To get that surgery, I went completely broke. To be eligible for Medi-Cal, you can’t own anything. If something else happens, I am at its mercy.”

G rowing up in a middle-class family, you think life is fun, it’s

a party and it’s all good — until something happens. My dad got cancer.

I don’t think my dad ever made more than $25,000 a year. Yet he could afford a four-bedroom house, a nice yard, and we were comfortable. He got cancer and had to take an early retirement. My mom started working to help out. I dropped out of college and went home to get a job to help her with the bills.

When I went home, I could see my dad was barely getting by. I self-medicated, turning to alcohol and drugs. I couldn’t deal with it. It hurt too bad to watch my dad be that way. When he passed away, I helped my mom get back on her feet and get the house in order. After she was settled, I left my family in Florida and went back to California to resume school. I got together with my college roommate in the summer of 1978. We planned a trip to Hawaii before we went back to school. While I was there, I found out my mom had cancer. I returned home.

My mom died the day after I got home. She was holding on just for me. I was mad at God. I was mad at the world. I was mad at the doctors. When I finally got my head around the whole thing, I moved back to Cali-fornia. I never made it back to school and began working in construction.

While working in construction, I hurt my back and began self-medicating

more. I bought a house in Monterey. I owned my home from 1987 to 1992. I lost it because I could not pay the bal-loon payment on my foreclosure loan. I was thrown out of my own home and became utterly destitute. I didn’t have any place to go so I started camp-ing. Being homeless and a drug addict (which I never thought I would be) perpetuated the homelessness. You cannot see yourself coming out of it.

Unfortunately, I had to have surgery because of my injured back. I could barely walk and took all sorts of pills. Right now I am on Social Security because of the disabilities associated with my back. I barely have enough to make ends meet. I am living in my motor home, which I bought with some of my Social Security money. The motor home is running but slowly falling apart.

To get that surgery, I went com-pletely broke. I didn’t have insur-ance and had to get on Medi-Cal. To be eligible for Medi-Cal, you can’t own anything. If something else happens, I am at its mercy. It’s just a flawed system. If I get off of Medi-Cal, I won’t be able to afford my medication. If I get a job, then I lose my medical care. I could not get private insurance with my pre-existing condition.

Now I feel really stuck.

39SHiFT mag.us

voice // ADRIENNE LAWTONAdrienne is an associate pastor of the First Christian Church and the board president of CHAM Deliverance Ministry in San Jose.

The realities of life on the medical wait-list

CANCER-free?

“Let’s compare the waiting periods: three months — two days — three months — two days. What is wrong with this picture?”

I

profile // HEIDI ROMSWINCKEL-GUISE

am alive today. I was the one who

had to push to have a biopsy of the 2-centi-meter lump in my chest. Unfortunately, the needle-aspiration biopsy failed to discover the cancer.

When I asked for the lump to be removed, I was told I should call the Breast Clinic and schedule an ap-pointment. Four months later, I discovered the sec-ond, 2-centimeter lump. The cancer had moved into my lymph nodes. The Breast Clinic informed me that the wait was three months. I expressed that the suggestion had to border criminal neglect. The scheduler turned defensive.

I explained that I had understood the overload of patients and had worked for five years in that hospi-tal as the first African-American and female to be hired full-time and per-manently in the Protective Services Department at the Santa Clara Val-ley Medical Center. I expressed that three months could be a death sen-tence for me, and that many others might suffer and possibly die because of this untimely practice.

The scheduler apologized. She said she had private insurance and had she needed aid, she’d have been in the hospital in two days.

Let’s compare the waiting periods: three months — two days — three months — two days.

What is wrong with this picture?

Thank God I had two miracle cancel-lations and a wonderful surgeon who treated me like gold. The first cancella-tion sent me back to the same doctor who missed the cancer in the first place.

The first lump now had discoloration, puckering and pain. That Friday, the doctor said, “If you do not hear from the Breast Clinic by Monday, call and I will push them.” I called that Tuesday, and the doctor was on vacation.

By May 8, however, I was in the Breast Clinic with my excellent surgeon. By mid-June, I had the first surgery. By mid-July, I had the second surgery. I was now, technically, cancer-free.

I had received an infection from an IV port in March of 2007, and I needed a primary care doctor. I placed my name on a six-month waiting list for Valley Medical Center. I have not been called a year and a half later.

I had also placed myself on the list for the Asian Americans for Community Involvement Health Center. I received a call four months later.

I fell through the cracks, and I believe the infection is the reason for the ex-cruciating pain of what has recently been diagnosed as fibromyalgia.

I will be watched for cancer for the next five years. I have fought cancer and the ramifications of the treat-ments for more than two years. I could not have fought in a better place than at CHAM Deliverance Min-istry, my loving support system.

I thank God I am alive today.

ma

g.u

sSHFT

“If you unclench your fist, we will offer the hand of

friendship.”Barack Obama – 2009

Inaugural address

ma

g.u

s