Archive for November, 2016

Kaiser Permanente’s self-help handbook

posted on November 28, 2016

Lincoln Cushing, Heritage writer


healthwise1-medIn the 1970s, people sought to take back control of their communities and their bodies from a medical establishment they considered racist, sexist, and generally not helpful to a multitude of Americans.

A seminal tract in this emerging “self-help” movement, Women and Their Bodies, was published in 1970, followed by a revised version called Our Bodies, Our Selves in 1971. By 1973, it was so popular that Simon & Schuster published the first commercial, expanded edition. It has since been translated into 30 languages, with millions of copies in print.

It was in that context that Healthwise, an Idaho nonprofit, was founded in 1975 by Don Kemper, MPH (who retired this year), with a simple mission: “Help people make better health decisions.” The next year it published the first Healthwise Handbook.

Kaiser Permanente worked with Healthwise to publish its own version of the Healthwise Handbook: A Self-Care Guide For You And Your Family, in 1994. It was a cornerstone of Kaiser Permanente’s Self-Care Program, designed to give people the skills and information necessary to safely identify and treat minor health problems at home.

healthwise2-medThe format for all maladies, from asthma to tick bites to depression, includes a description of what to look for, how to prevent it, home treatment options, and when to call Kaiser Permanente.

In 2000, the Kaiser Permanente Healthwise Handbook was honored with a silver award from the National Health Information Awards program for the publication’s consumer health information. The Spanish version of the handbook, La Salud En Casa: Guia Practica de Healthwise y Kaiser Permanente, received a bronze award. The handbooks were chosen for having the best consumer health information in the Health Promotion/Disease and Injury Prevention Information class.

The Healthwise Knowledgebase self-help medical encyclopedia was an early health resource featured on Kaiser Permanente Online, and later print editions offered a broad range of links to key self-care resources, such as the Kaiser Permanente Healthphone, KP Online, and other recommended health websites. In Northern California, primary care physicians and staff were issued two copies along with tips on how to encourage members to use the Handbook. And in 2001, in partnership with the California State Library, Kaiser Permanente donated a collection of Healthwise Handbooks to every public library in the state.


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Special thanks to Kaiser Permanente physician Dr. Stephen Tarzynski for donating this title to the Kaiser Permanente archives, and to librarian Thomas Shreves for facilitating that transfer.

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Rosie the Riveter Park Ranger Betty Reid Soskin receives lifetime achievement award

posted on November 16, 2016

Lincoln Cushing, Heritage writer


img_3306At a deeply moving event held on October 9, 94-year-old Betty Reid Soskin was honored as someone whose “artistic vision, moral force and intellectual clarity gives voice to the people of California, their needs and desires, sufferings, struggles and triumphs.”

Soskin is a political activist raised in Oakland and Berkeley, and currently America’s oldest park ranger at the Rosie the Riveter World War II Home Front National Historical Park in Richmond, Calif. Her participation and activism in the creation of the park itself was instrumental in the ways Rosie the Riveter incorporates and memorializes the African-American history of Richmond and the greater Bay Area region.

Ever since 2002, the California Studies Association has presented the Carey McWilliams Award to a writer, scholar or artist who lives up to the best tradition of McWilliams’ work. McWilliams (1905-1980) was a vibrant, controversial, and influential intellectual, lawyer, and journalist who, among his other accomplishments, served as editor of The Nation for 20 years.

In choosing Soskin as this year’s Carey McWilliams awardee, CSA recognized her creative and political work in contributing to historical knowledge of California, and especially the experiences of African Americans during and after World War II.

The history of Kaiser Permanente is rooted in the World War II home front, and the national park where Ms. Soskin works shares that pioneering message with the world. Accompanying Ms. Reid at the award was Tom Leatherman, superintendent of four National Park Service historic sites in the East Bay.

Follows are excerpts from Ms. Reid’s acceptance speech. The full text can be found here:


“The National Park Service [celebrating its centennial] only has five years on me!

In 1942 I came into Richmond as a clerk in a Jim Crow segregated union hall… that would be decades before the racial integration of the labor movement. So, in order to comply with [Henry J.] Kaiser’s wishes, labor created what was called “auxiliaries” – a fancy name for Jim Crow, One in Sausalito, one in West Oakland, the other at Richmond – Boilermaker’s Auxiliary #36, which is where I went every day.

If you’d asked me at the time, I would have told you all the shipyard workers were black. They were the only people I saw every day. The people who came up to my window to have their addresses changed, which is what I was doing on 3×5” file cards to save the world for democracy. And, as we all know, it worked…

There were lots of steps in that process. But only Henry Kaiser would dare to bring in a workforce of 98,000 black and white southerners into a city with a population of 23,000. He did that not only because he knew he could revolutionize shipbuilding by introducing the mass production techniques Henry Ford used in the auto industry, but he knew where the greatest pool of available workers lay in the country – in five southern states: Mississippi, Oklahoma, Arkansas, Texas, and Louisiana.

He brought people into a city who would not be sharing drinking fountains, schools, hospitals, housing, even cemeteries – any kind of public accommodations – for another 20 years back in their places of origin. That’s would not be happening until the 1960s. This was 1942. With no chance for diversity training or focus groups! … That social change, set up in those days, has significance for all our lives. Social change continues to radiate out from where we are into the rest of the country. We have been leading since 1942. And that’s the story I get to tell.

We are all ready to have these conversations now, we are ready at our park. And across the country, that’s beginning to happen. It’s possible now because, as Tom [Leatherman] says, it’s not just the environmental movement, or protecting the wildlife, or the protection of historic wildlands. What we are dealing with now, ever since about 1970, is the history and culture of this country. It’s now possible to revisit almost any era in this nation – the heroic places, the contemplative places, the scenic wonders, the shameful places, and the painful places, in order to own that history so that we may process it in order to forgive ourselves in order that we may all be able to move into a more compassionate future. And the National Park Service is leading that fight.”


A film project sponsored by the Rosie the Riveter Trust to capture Betty Reid Soskin’s irreplaceable Home Front insights is in process, for which Kaiser Permanente has provided crucial seed funding.  A preview of this documentary-in-progress can be seen here. Donations can be made here; gifts made between now and December 15th will be doubled up by another generous donor.

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[Thanks to Lisbet Tellefsen for the recording from which this transcript was made. Photos are by Bryan Gibel]

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Race, gender, and infection – the case for private hospital rooms

posted on November 4, 2016

Lincoln Cushing, Heritage writer


The Southern Permanente Hospital (Fontana), 1944-08-25

Two-bed ward, The Southern Permanente Hospital (Fontana), 1944-08-25

When Kaiser Permanente opened its showcase modern Oakland hospital in 2014, news releases boasted that it had “all private rooms.” Which caused me to wonder – what is the history of private rooms in our facilities?

The first facilities expansion built for our flagship hospital in Oakland in 1943, which served the Kaiser Richmond shipyard workers, included single, double, and quadruple bedrooms. Similarly, the 1943 hospital at the Fontana, Calif., steel mill had rooms for one, two, and four patients.

It’s a logical assumption that the main reason for single rooms is medical.

“To isolate: to separate; to protect; to prevent.” This has long been the industry rationale given for single-patient rooms to reduce “nosocomial infections,” those acquired within a hospital by patients and personnel because of contamination or infection.

But there are other, non-medical reasons as well.

Fontana hospital architectural drawings, 1943-02-26; The Southern Permanente Hospital

Detail of floor plan, Southern Permanente hospital at Fontana, February 1943

When the original Fontana steel mill hospital became inadequate for the increased volume of patients, a 1952 prospectus for moving the Kaiser hospital to the city of Fontana specifically called out for private rooms:

Rationale for plans to build all 25 “general beds” as private rooms:

With 2 bedrooms, beds are wasted because some people need single occupancy.

1. Demand (executives, private rich, etc.)

2. Very ill and dying patients need privacy.

3. Wrong sex in one of the beds, so can’t admit other sex.

4. Racial problems — some colored and white people refuse to share rooms.

In an oral history, staff pediatrician Alice Friedman, MD, described the brand-new 1953 Kaiser Permanente Walnut Creek hospital, and revealed yet another reason:


Detail of floor plan, Oakland Permanente Foundation hospital expansion, April 1943

The rooms were designed for one person only, one bed in other words. There were a few two-bed rooms and otherwise, it was all one. The only reason for the two-bed rooms was because of Blue Cross coverage [for non-Kaiser Permanente patients] at that time. It covered two beds in a room and not a private room.

Adrienne Alcantara, principal media architect planner for Kaiser Permanente’s National Facilities Services organization, explains some of the issues that confronted hospital design during that period:


Detail, floorplan of Redwood City, 1968

Dr. Sidney Garfield’s main contribution in hospital design was the creation of separate corridors for visitors and staff. Visitors could enter a patient room from an outside walkway, staying out of the way of busy medical staff moving along the interior corridor.

But not all of the rooms in the new hospitals were private. A “mini-pod” served by a nursing station would be based on a 4-room cluster, with two private rooms and two semi-private rooms. The Kaiser Permanente hospital design template from the 1960s tried to achieve this ratio of 50 percent private room space.


Detail, floorplan of South Sacramento, 1985

As needs changed, so did designs:

In the 1970s more configurations were chosen based on local needs. For example, South Sacramento was built with a 30/70 private to semiprivate ratio, while nearby Roseville was 80/20. This was known as the “gateways hospital.”

In the late 1990s some nursing units – such as Perinatal and ICU – found that they needed more private rooms.

One factor in the room design equation was the cost and inconvenience of having to move patients in shared rooms
when situations changed (such as one patient became more ill). Sometimes a shared room was untenable because of patient behavior – the most common complaint in shared rooms is snoring. Also, health care competitors were moving toward more single rooms.


Detail, floorplan of Roseville, 1995

In 2002, the “template hospital” model was initiated, with similar plans serving several new facilities. The first three hospitals included Modesto, Antioch, and Irvine, which were designed with 100 percent private rooms. This became the standard ratio for all new hospitals or nursing unit remodels to follow. Some facilities have had to incorporate a few semiprivate rooms to compensate for variable peak bed capacity demands.

From gender privacy to nonmember insurance to snoring – so many reasons that private rooms make sense.


Detail, floorplan of Antioch, 2007.



All modern floorplans courtesy Adrienne Alcantara.

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