SACRAMENTO, Calif. - More patients with terminal illnesses in California are making their decisions to end their suffering using the state's aid-in-dying law.

The number last year was 405, compared to 337 people the year before, according to a new report from the California Department of Public Health.

Samantha Trad, California state director of the nonprofit Compassion & Choices says the law is working as intended. But she believes it would be even more effective if California doctors were allowed to make exceptions to the waiting period, like they can in Oregon.

"The main doctor who ends up writing the prescription can actually waive the mandatory minimum 15 day waiting period in Oregon," says Trad, "if the patient is unlikely to survive the waiting process."

A study done by Kaiser Permanente of Southern California showed that one third of patients who request the medication die before completing the lengthy application process.

The new report from the state also found big disparities in who actually uses the law. The patients are 87% white.

Just over 1% are Black. Four percent are Hispanic. And 6.4% percent are Asian American.

Patricia González-Portillo, national Latino communications and constituency director with Compassion & Choices, says the low number of Latino patients may be the result of this group, in particular, ending up in religious hospitals that don't allow their doctors to participate in medical aid-in-dying.

"There are some Latinos that don't want to suffer at the end of life," says González-Portillo. "They want that option to be able to take a medication, surrounded by their loved ones, and die peacefully. Not be forced to suffer at the end of life. We want those options."

She says Compassion & Choices is currently running a series of public service announcements on TV and social media across the state, to raise awareness in communities of color of the option of medical aid-in-dying. These are also posted on the organization's YouTube channel.

A popular fishing site on the Columbia River for members of the Yakama Nation has been listed as Superfund site by the federal government.

Now comes the hard part.

Toxins near Bonneville Dam at a place called Bradford Island prompted the U.S. Environmental Protection Agency to put the area on the National Priority List in March.

Laura Klasner Shira, environmental engineer for Yakama Nation Fisheries, said the area near Bradford Island is a toxic soup for resident fish, with chemicals like PCBs among the most hazardous.

"The take-home when you start to look at all the individual effects of each of these chemicals or chemical groups is that it really affects multiple systems, it affects multiple organs, it can cause cancer," Shira outlined. "It's especially harmful to small children, fetuses and immune and thyroid-compromised persons."

The U.S. Army Corps of Engineers dumped electronics near the island for decades, leading to the current toxic situation. People are advised not to eat nonmigratory fish up to a mile from the dam. Today at noon, Columbia Riverkeeper is hosting a webinar, featuring Shira and speakers from the EPA and the Corps of Engineers, on what Bradford Island's Superfund listing means for the region.

Shira pointed out the Yakama Nation took the lead in calling for Bradford Island to be placed on the National Priority List with the states of Oregon and Washington backing up those calls.

"It was very important to have NPL listing because we thought it could lead to a more protective cleanup," Shira explained. "But we also realized that with NPL listing, it's going to require a lot of work still."

Shira stressed despite their leadership, the Yakama Nation has been cut out of recent discussions on cleanup. The Corps of Engineers said the process has to go through regulators first, including the states, the EPA and Corps, but is inviting the public to be involved later. She added it is discouraging because it is an ancestral site for tribal members, where fishing has gone on since time immemorial.

Shira also noted fishing continues there, making cleanup a pressing issue.

"A lot of members aren't going to change their diets because of a fish advisory," Shira asserted, "Or they might accidentally catch a resident fish and their culture teaches them that every fish is a gift from the creator."

A pilot program launched by the Todd County School District and the county's local health department offers free mental-health case-management services to all public-school students.

Abby Dill, Axis program supervisor for the Todd County Health Department, said anxiety, depression and self-harm are on the rise among Kentucky youths. She explained there are not enough therapists and counselors in rural communities to meet the growing need, and said in the aftermath of the pandemic, students are struggling with emotional well-being.

"Doing a case-management model allowed us to do a needs assessment," Dill pointed out. "And really provide wraparound services and work with people in our rural community to tap into services that existed and see where service gaps existed, so we could build on those within our program."

Research from the Annie E. Casey Foundation shows the state saw a 28% increase in children's anxiety or depression between 2016 and 2020. And recent data shows more than one in seven Kentucky high school students reported having seriously considered suicide. If you or someone you know is experiencing a mental-health crisis, contact the national Suicide and Crisis hotline by calling or texting 988 to get help from a trained crisis counselor.

Mark Thomas, superintendent of the Todd County Public School District, said the Axis program also helps students access food, clothing, housing and transportation, and substance-abuse treatment.

"It's one of those ideas of 'it takes a village to raise a child.' We incorporate that," Thomas emphasized. "And then we also think of ourselves as a family. We're all one big family looking out for the best interests of each other, not just our children, but also with our staff."

Allison Adams, vice president for policy at the Foundation for a Healthy Kentucky, said Thomas and Dill were recently recognized for their efforts with a Kentucky Healthy Champions Award. She added across the state, individuals are coming up with solutions to improve their communities.

"There's opportunities to lift up people in your communities who are working to influence health," Adams stressed. "Think about who that person is in your community and consider nominating them for the Healthy Kentucky champion class of 2023."

Cardiopulmonary Resuscitation can save lives after a heart attack, but in some communities, too few people know how, or are hesitant to, perform the procedure.

Research indicates women of color, particularly Hispanic women, have a lower chance of surviving a heart attack outside a hospital. So, the American Heart Association has launched an initiative to raise CPR awareness in Hispanic communities and help overcome any stigma surrounding it.

Dr. Kelly Epps-Anderson, interventional cardiologist at the INOVA Heart and Vascular Institute and president of the board of directors of the American Heart Association-Greater Washington Region, said in an emergency, where you live can determine whether you survive.

"Hispanic and Latino and Black people are at higher risk for out-of-hospital cardiac arrest with a poor prognosis, in part due to long-standing societal policies that have resulted in limited access to quality health care and to education."

She explained public service announcements for the "Heroes Saving Hearts" program tie in with Hispanic Heritage Month, encouraging people to learn lifesaving techniques. She added the study found both cultural and educational barriers to performing hands-only CPR.

Epps-Anderson noted other barriers to learning or using CPR include fear or distrust of police, financial concerns, immigration status, language barriers, and even the possibility of violence. Some of these are heightened when the person having the heart attack or stroke is a woman.

"Only 39% of women in cardiac arrest actually receive CPR from strangers in public, compared to 45% in men," Epps-Anderson reported. "We don't know exactly why, but we think that the problem may be that there are fears around inappropriate touching or hurting a woman."

Epps-Anderson pointed out hands-only CPR is as effective as conventional CPR during the first few minutes of a cardiac arrest, and can double or triple a person's chance of survival.

"We know that Hispanic and Latino communities who are familiar with the methods are significantly more confident that they can perform either type of CPR than the general population," Epps-Anderson emphasized.