Steven P. Wallace, Paula Leite, Xóchitl Castañeda, Marc Schenker

This report highlights the challenges faced by the 6.3 million children whose parents migrated to the U.S.

Dylan H. Roby, Gina Nicholson, Gerald F. Kominski

This policy brief uses data from the 2007 California Health Interview Survey (CHIS) to examine delays in fulfilling prescribed medication, delays in obtaining needed medical care, visits to emergency rooms and the presence of a usual source of care among insured African Americans in public and commercial HMOs.

Nadereh Pourat

Although structured similarly to health insurance, dental insurance is often more limited in scope and availability.

Nadereh Pourat

Dental insurance plays a key role in oral health. However, while dental insurance typically covers preventive services and significantly reduces the costs for services such as fillings, crowns, and dentures, dental benefits often are not comprehensive and come with significant cost-sharing requirements and annual caps, which may lead to unaffordable out-of-pocket expenditures.

California Pan-Ethnic Health Network

This report examines a range of indicators, from education to housing, to neighborhood safety, to food access, to criminal justice as well as health insurance, among other topics to explore how health inequities can be eliminated in communities of color.

Nadereh Pourat, Cori Reifman, Dylan H. Roby, Ying-Ying Meng, Allison L. Diamant, Gerald F. Kominski

Only 27 percent of non-elderly adults in the United States have a "medical home" –- a place where they regularly receive medical care and advice.

Namratha Kandula, Romana Hasnain-Wynia, Jason A. Thompson, E. Richard Brown, David W. Baker

The authors of this study wanted to determine if perceived experiences of discrimination (both in general and in medical care) were associated with comfort providing race/ethnicity information, and conversely, to worry about providing the information.

Shana Alex Lavarreda, E. Richard Brown

The authors examined how children ages 0-18 who enrolled into or disenrolled from California's Medicaid program (called Medi-Cal,"MC") and State Children's Health Insurance Program (called Healthy Families, "HF") are affected in their access to physician services.

B. Josea Kramer, Rebecca L. Vivrette, Delight E. Satter, Stella Jouldjian, Leander Russell McDonald

Many American Indian and Alaska Native veterans are eligible for healthcare from the Veterans Health Administration (VHA) and from the Indian Health Service (IHS).

Susan H. Babey, Ying-Ying Meng, Malia Jones

In California, 90,000 adults with current asthma have experienced problems understanding their doctors.

Paula Yoon, Maren T. Scheuner, Cynthia Jorgensen, Muin J. Khoury

Family health history reflects the effects of genetic, environmental and behavioral factors and is an important risk factor for a variety of disorders including coronary heart disease, cancer and diabetes.

Judy Y. Chen, Sharon Swonger, Gerald F. Kominski, Honghu Liu, Ji Eun Lee, Allison L. Diamant

The objective of this study is to evaluate the effectiveness and cost-effectiveness of different school-based health insurance strategies to provide coverage to uninsured Korean American children.

Dylan H. Roby, Gerald F. Kominski, Nadereh Pourat

This article explores the barriers to dealing with chronic illness and other factors faced by disease management programs for Medicaid populations.

Sally Adams, Sheila Husting, Elaine Zahnd, Elizabeth Ozer

The authors studied rates and disparities in preventive health topics covered during routine medical care for adolescents, using a California sample.

Nadereh Pourat

Although many Californians have dental insurance, even those with coverage may not be getting the dental care they need, and this is also the case among people who get dental benefits under Medi-Cal.

Steven P. Wallace, Jennifer Lee, May Jawad Aydin

California's population is getting older. By 2026 the elderly population will double to nearly 8 million.

David Miller, Lillian Gelberg, Lorna Kwan, Sevan Stepanian, Arlene Fink, Ronald M. Andersen, Mark S. Litwin

What impact do racial and ethnic disparities have on disadvantaged men in a prostate cancer public-assistance program? In this examination of California's IMPACT program, the authors evaluated racial and ethnic differences in health services utilization and patient-reported health care outcomes.

Steven P. Wallace, Xóchitl Castañeda

This landmark report describes patterns and trends associated with Latin American, in particular, Mexican migration to the United States.

Shana Alex Lavarreda, Melissa S. Gatchell, Ninez A. Ponce, E. Richard Brown, Y. Jenny Chia

This study examines the factors associated with discontinuous health insurance coverage without periods of uninsurance during the past year (ie, switching coverage), and whether it has a detrimental effect on basic access to care.

Michelle Wilhelm, Ying-Ying Meng, Rudolph P. Rull, Paul English, John Balmes, Beate Ritz

Despite extensive evidence that air pollution affects childhood asthma, state-level and national-level tracking of asthma outcomes in relation to air pollution is limited.

Sue Holtby, Elaine Zahnd, Y. Jenny Chia, Nicole Lordi, David Grant, Mirabai Rao

This report provides a summary of the statewide findings from the 2005 California Health Interview Survey (CHIS), with highlights of changes from 2003 to 2005.

Roberta Wyn, Theresa A. Hastert, Erin Peckham

This report examines important health concerns of nonelderly women (ages 18-64) in California, including their health status, selected health behaviors, health insurance coverage, usual source of care and access to health care.

Daniel J.B. Mitchell

In January, 2007, California Governor Arnold Schwarzenegger proposed a state universal health care plan modeled after the Massachusetts individual mandate program.

Bowen Chung, Loretta Jones, Larry X. Campbell, Henrietta Glover, Lillian Gelberg, Donna T. Chen

The intricacies and time-sensitivity of conducting high-quality and clinically relevant health-related human subject research in post-disaster situations challenges traditional approaches to protecting study participants from exploitation and harm.

Nadereh Pourat

These two fact sheets show that nearly one-third of young children 11 years of age or younger have never visited a dental provider or have not visited a dental provider in more than one year.

Ninez A. Ponce, Susan D. Cochran, Vickie M. Mays, Y. Jenny Chia, E. Richard Brown

The health coverage of low-income workers represents an area of continuing disparities in the United States system of health insurance.

Nadereh Pourat, Guoyu A. Tao, Cathleen M. Walsh

This article examines the rates of self-reported Chlamydia trachomatis (CT) screening among young women and to examine the independent association of type of insurance and specific health plans with these rates.

Chizobam Ani, Mohsen Bazargan, Shahrzad Bazargan-Hejazi, Ronald M. Andersen, David W. Hindman, Richard S. Baker

This study examines the correlates of self-diagnosis of chronic medical and mental health conditions in under-served minority populations.

Gerald F. Kominski, Nadereh Pourat, Dylan H. Roby, Meghan E. Cameron

Using interviews with 965 California workers injured on the job, the authors examined the factors associated with their return to work as well as their self-reported degree of recovery.

Nadereh Pourat

This report examines dental care utilization of California children and finds that disparities in dental visits exist, including lower rates of visits for Latino and African American children and those without dental insurance.

Steven P. Wallace, L. Cricel Molina

The federal poverty guideline, used to determine income eligibility for many public programs, covers less than half of the basic costs experienced by adults age 65 and older in the state.

Erum Nadeem, Jane M. Lange, Dawn Edge, Marie Fongwa, Thomas Belin, Jeanne Miranda

This study examines the extent to which stigma-related concerns about mental health care account for the underuse of mental health services among low-income immigrant and U.S.-born ...

Steven P. Wallace, Xóchitl Castañeda, Sylvia Guendelman , D. Imelda Padilla-Frausto, Emily Felt

A collaboration of the UCLA Center for Health Policy Research, the UC Berkeley School of Public Health and the Health Initiative of the Americas, this report explores the health care challenges faced by Latin American immigrants, and Mexican immigrants in particular.

Steven P. Wallace, Veronica F. Gutierrez, Xóchitl Castañeda

This article explores the link between immigration and preventive health care services, particularly among adults of Mexican origin.

Melissa S. Gatchell, Shana Alex Lavarreda, Ninez A. Ponce

This fact sheet looks at the health insurance types and the status of people who use community health centers, public hospitals, and clinics, also called the "safety net," as their usual source of health care.

Joshua S. Yang, Steven P. Wallace

New expansions of health insurance in California are unlikely to attract additional undocumented immigrants to the state, according to a new policy brief from the UCLA Center for Health Policy Research.

E. Richard Brown, Shana Alex Lavarreda, Ninez A. Ponce, Jean Yoon, Janet Cummings, Thomas Rice

This report from the UCLA Center for Health Policy Research shows that job-based health insurance coverage -- the backbone of the state's system of health insurance – continues to decline.

E. Richard Brown, Nadereh Pourat, Steven P. Wallace

This fact sheet uses information from the 2005 California Health Interview Survey to determine how many of the 4.8 ...

Gerald F. Kominski, Nadereh Pourat, Dylan H. Roby, Meghan E. Cameron

This report was produced by the UCLA Center for Health Policy Research under contract to the California Division of Workers' Compensation (DWC), Department of Industrial Relations, which is required to perform an annual study of access to medical treatment for injured workers.

Hongjian Yu, Ying-Ying Meng, Carolyn A. Mendez-Luck, Mona Jhawar, Steven P. Wallace

UCLA Center for Health Policy Research

This fact sheet uses data from the 2005 California Health Interview Survey to view the state's uninsurance problem by county.

Ying-Ying Meng, Susan H. Babey, Theresa A. Hastert, E. Richard Brown

Using data from the 2003 California Health Interview Survey (CHIS), this policy brief examines the racial/ethnic disparities in the burden of asthma among those with active asthma.

Jean Yoon, E. Richard Brown, Shana Alex Lavarreda, Sungching Glenn

Despite marginal improvements in job-based health insurance for adults and public program enrollment for children, one in five (6.5 ...

Shana Alex Lavarreda, E. Richard Brown, Jean Yoon, Sungching Glenn

Using data from the 2005 California Health Interview Survey, researchers found that more than half of the uninsured children in California are eligible for public programs but are not enrolled, a further sign of the limitations in current health insurance arrangements.

Elena Zúñiga, Xóchitl Castañeda, Al Averbach, Steven P. Wallace

This report focuses on the population of Mexican ancestry in the United States and in California, with an emphasis on immigrants.

Nadereh Pourat, Jas Nihalani, Romni Neiman, George Rutherford, Barry Handon, E. Richard Brown, Gail Bolan

In California, chlamydia and gonorrhea are the most common reportable sexually transmitted diseases (STDs).

Jennifer R. Kincheloe, Janice Frates, E. Richard Brown

With the goal of developing a comprehensive predictive model of eligible children's enrollment in California's Medicaid (Medi-Cal [MC]) and State Children's Health Insurance Program (SCHIP; Healthy Families [HF]) programs, the authors examined the effects of multiple family-level factors and contextual county-level factors on children's enrollment in Medicaid and SCHIP using data from the 2001 California Health Interview Survey, data on outstationed eligibility workers (OEWs), and administrative data from state agencies and local health insurance expansion programs for fiscal year 2000–2001.

Jennifer R. Kincheloe, E. Richard Brown, Janice Frates, Kathleen Thiede Call, Wei Yen, Jim Watkins

This journal article reports the results of the Robert Wood Johnson Foundation-funded California Medicaid Undercount Experiment (CMUE) to estimate the extent of underreporting of Medicaid in the California Health Interview Survey (CHIS) and its effect on estimates of uninsurance.

Ninez A. Ponce, Ron D. Hays, William E. Cunningham

Ponce NA, Hays R, Cunningham W. Linguistic Disparities in Health Care Access and Health Status among Older Adults.

Sue Holtby, Elaine Zahnd, Nicole Lordi, Christy McCain, Jenny Chia, John Kurata

Many Californians are still struggling to reach good health, according to this report from the California Health Interview Survey (CHIS), the country's largest population-based state health survey.

Nadereh Pourat, Jay C. Ripps

The continued decline of employment-based coverage in California and more than 6.6 million uninsured residents are major reasons for concern, since health insurance is the primary means by which health care for employed persons and their families is financed in the state.

Gerald F. Kominski, Meghan E. Cameron, Dylan H. Roby

More than 96 percent (nearly 24 million) of insured Californians report "good" or better satisfaction with their health care.

Gerald F. Kominski, Cori Reifman, Meghan E. Cameron, Dylan H. Roby

More than 1 million adult HMO members in California with limited English proficiency are at risk for problems accessing health care services and receiving quality treatment.

Ninez A. Ponce, Leighton Ku, William E. Cunningham, E. Richard Brown

Ponce NA, Ku L, Cunningham W, Brown ER. Language Barriers to Health Care Access Among Medicare Beneficiaries.

Gregory D. Stevens, Michael Seid, Neal Halfon

Stevens GD, Seid M, Halfon N. Enrolling Vulnerable, Uninsured but Eligible Children in Public Health Insurance: Association With Health Status and Primary Care Access.

Steven P. Wallace

Hurricane Katrina was a natural disaster that caused much preventable death and misery, especially in New Orleans.

Nadereh Pourat, Dylan H. Roby, Roberta Wyn, Marvin Marcus

This report uses data derived from a survey of 13,600 general dentists throughout California and constructs a picture of private dental practice in California; including staffing levels, wage and benefits, patient populations, and experiences in utilizing Allied Dental Health Professionals (ADHP).

J. Y. Chen, Allison L. Diamant, Nadereh Pourat, Marjorie Kagawa-Singer

Chen JY, Diamant A, Pourat N, Kagawa-Singer M. Racial/ethnic disparities in the use of preventive services among the elderly.

Gail G. Harrison, Marjorie Kagawa-Singer, Susan B. Foerester, Henry Lee, Loan Pham Kim, Allyn Fernandez-Ami, Tu-Uyen Nguyen, Valerie Quinn, Dileep G. Bal

Harrison GG, Kagawa-Singer M, Foerster SB, Lee H, Pham Kim L, Nguyen TU, Fernandez-Ami A, Quinn V, Bal DG.

Mona Jhawar, Steven P. Wallace

Chronic diseases are the leading causes of death in California and have become among the most common, costly, and often preventable of all health problems.

Jennifer R. Kincheloe, E. Richard Brown

This report provides estimates of program participation expressed as the ratio of children who are enrolled in either the MC or the HF programs to the total number who are eligible to participate in the programs and who do not have private or employer sponsored health insurance coverage.

Elena Zúñiga, Steven P. Wallace, Salvador Berumen, Xóchitl Castañeda

The fundamental purpose of "Mexico-United States Migration: Health issues" is to present a general overview of the conditions faced by Mexican residents in the United States concerning their health care. Good ...

Steven P. Wallace, Veronica F. Gutierrez, Xóchitl Castañeda

The following two fact sheets viewing, respectively, demographics of Mexican immigrants to the United States and the health service disparities among that population are the products of a joint research effort conducted by the UCLA Center for Health Policy Research and the California-Mexico Health Initiative at the California Policy Research Center, University of California Office of the President.

E. Richard Brown, Shana Alex Lavarreda, Thomas Rice, Jennifer R. Kincheloe, Melissa S. Gatchell

This report from the UCLA Center for Health Policy Research shows that job-based health insurance coverage -- the backbone of the state's system of health insurance -- is declining.

Steven P. Wallace

Wallace, Steven P. The Public Health Perspective on Aging. Generations. 29:2(2005), 5-10.

Thomas Rice, Shana Alex Lavarreda, Ninez A. Ponce, E. Richard Brown

Rice, T., Lavarreda, S.A., Ponce, N.A., & Brown, ER. The impact of private and public health insurance on medication use for adults with chronic diseases.

Carolyn A. Mendez-Luck, Hongjian Yu, Ying-Ying Meng, Mona Jhawar, Steven P. Wallace

This policy brief highlights the geographic variations in self-reported poor/fair health status, asthma and hypertension rates among uninsured Californians for counties, county-groups, Los Angeles Service Planning Areas, as well as for state legislative and Congressional districts.

Mona Jhawar, Carolyn A. Mendez-Luck, Hongjian Yu, Ying-Ying Meng, Y. Jenny Chia, Steven P. Wallace

This policy brief highlights regional variations of rates among California children ages 0-5 and ages 6-17 from limited income families (below 300% FPL) who were uninsured and not eligible for Medi-Cal or Healthy families in 2001.

Steven P. Wallace, Veronica F. Gutierrez

This Binational Health Week fact sheet documents the problems of access to preventive care faced by Mexican immigrants.

Veronica F. Gutierrez, Steven P. Wallace, Xóchitl Castañeda

This Binational Health Week fact sheet describes the demographics and basic health status of the nine million Mexican immigrants living in the U.S.

Sue Holtby, Elaine Zahnd, Wei Yen, Nicole Lordi, Christy McCain, Charles A. DiSogra

This report summarizes selected findings from the 2001 California Health Interview Survey. A broad range of health topics are addressed.

E. Richard Brown, Shana Alex Lavarreda, Ying-Ying Meng, Ronald M. Andersen, Andrew B. Bindman, Lillian Gelberg

Where Californians live within the state plays an important role in determining their access to health care.

Roberta Wyn, Victoria D. Ojeda

This study examines the health insurance coverage, health status, and access to care of California women ages 18-64.

Ninez A. Ponce, Susan H. Babey, David A. Etzioni, Benjamin A. Spencer, E. Richard Brown, Neetu Chawla

This in-depth report describes cancer screening in California based on data from the 2001 California Health Interview Survey (CHIS 2001), the largest state-level health survey in the nation.

Delight E. Satter, Nilka Rios Burrows, Melissa S. Gatchell, Maile Tauali'i, D. Tecumseh Welch

This fact sheet examines diabetes prevalence, co-morbidities of diabetes, health insurance status, and access to care for American Indians and Alaska Natives (AIANs) in California and offers policy recommendations in response to these findings.

Ninez A. Ponce, Melissa S. Gatchell, E. Richard Brown

This fact sheet examines cancer screening rates for several Asian ethnic subgroups -- Chinese, Filipino, Japanese, Vietnamese, Korean, South Asian, and Cambodian -- to identify specific populations at risk for not receiving preventive care.

Antronette Yancey, Melissa S. Gatchell, E. Richard Brown, William McCarthy, Allison L. Diamant

This fact sheet examines diabetes prevalence and risk factors among African Americans in California and offers several policy recommendations in response to these findings.

Ying-Ying Meng, Susan H. Babey, Elizabeth Malcom, E. Richard Brown, Neetu Chawla

This in-depth report describes asthma in California based on data from the 2001 California Health Interview Survey (CHIS 2001), the largest state-level health survey in the nation.

Steven P. Wallace, Veronica F. Gutierrez, E. Richard Brown

This health policy fact sheet presents information on selected indicators of the health status and access to health care of Mexican immigrants in California.

Steven P. Wallace, Nadereh Pourat, Vilma Enriquez-Haass, Sripipatana Alek

This report provides detailed profiles of the health behavior, health status, preventive care, access to services, and demographics for Californians age 65 and over.

Susan H. Babey, Ninez A. Ponce, David A. Etzioni, Benjamin A. Spencer, E. Richard Brown, Neetu Chawla

This policy brief reports on cancer screening in California based on data from the 2001 California Health Interview Survey (CHIS 2001), the largest state-level health survey in the nation.

Gerald F. Kominski, Dylan H. Roby

This study examines how recent trends toward concentration within the hospital industry among hospital chains and the increase in for-profit ownership affects access to affordable healthcare in Los Angeles.

Neetu Chawla, Michael A. Rodriguez, Susan H. Babey, E. Richard Brown

This fact sheet examines diabetes management and access to care among Latinos with diabetes in California.

Moira Inkelas, Neal Halfon, Kim Uyeda, Gregory D. Stevens, Sue Holtby, Janel Wright, E. Richard Brown

This report, prepared jointly by the UCLA Center for Healthier Children, Families and Communities, the UCLA Center for Health Policy Research, and the Public Health Institute, is the first of its kind to reveal key measures of health and well being for California's three million children under age 6.

Gerald F. Kominski, Deborah Glik, Cori Reifman

Carolyn A. Mendez-Luck, Steven P. Wallace, Hongjian Yu, Ying-Ying Meng, Y. Jenny Chia, E. Richard Brown

This policy brief highlights the differences in uninurance rates among the new California Assembly and Senate districts resulting from redistricting based on the 2000 Census.

Delight E. Satter, Andrea Zubiate, Steven P. Wallace

Asthma and Chronic Obstructive Pulmonary Disease (COPD) are among the 10 leading chronic conditions causing restricted activity.

Allison L. Diamant, Susan H. Babey, E. Richard Brown, Neetu Chawla

Allison L. Diamant, Susan H. Babey, E. Richard Brown, Neetu Chawla

This report, prepared by the UCLA Center for Health Policy Research, is the first on diabetes prevalence among Californians using data from the 2001 California Health Interview Survey (CHIS 2001).

Nadereh Pourat, Gabrielle Lessard, Armine Lulejian, Lida M. Becerra, Rini Chakraborty

This fact sheet is a joint effort of the UCLA Center for Health Policy Research and the National Immigration Law Center (NILC) using the 2001 California Health Interview Survey data.

Jennifer Aguayo, E. Richard Brown, Michael A. Rodriguez, Lia Margolis

This is a joint publication of the UCLA Center for Health Policy Research and the Latino Coalition for a Healthy California (LCHC).

Gerald F. Kominski, Pamela L. Davidson, Crystal L. Keeler, Natasha Razack, Lida M. Becerra, Rabeya Sen

The profile of California’s 17.7 million children and adults who are enrolled in HMO plans is more diverse than previously thought, according to the UCLA Center for Health Policy Research report. The ...

Anne Markus, Dylan H. Roby, Sara Rosenbaum

This study examines the characteristics of health centers that serve an unusually high rate of uninsured patients.

E. Richard Brown, Ninez A. Ponce, Thomas Rice, Shana Alex Lavarreda

This report examines health insurance coverage in California based on the 2001 California Health Interview Survey (CHIS 2001) data.

Gerald F. Kominski, Paul A. Simon, Alex Ho, Jeff Luck, Yee Wei Lim, Jonathan E. Fielding

This study was designed to assess the burden of disease and injury in the Los Angeles County population using Disability-Adjusted Life Years (DALYs), a composite measure of premature mortality and disability that equates to years of healthy life lost.

Ninez A. Ponce, Tomiko Conner, B. Patricia Barrera, Dong Suh

Nadereh Pourat, Ronald M. Andersen, Steven P. Wallace

Pourat N, Andersen R, Wallace S. Postadmission Disparities in Nursing Homes Stays of Whites and Minority Elderly.

Steven P. Wallace, Valentine M. Villa, Vilma Enriquez-Haass, Carolyn A. Mendez-Luck

Linda Burhansstipanov, Delight E. Satter

This commentary provides a brief overview of American Indian and Alaskan populations in the United States and selected data issues.

E. Richard Brown, Roberta Wyn, Hongjian Yu, Abel Valenzuela, Liane Dong

California Policy Research Center, UCLA Center for Health Policy Research

E. Richard Brown, Roberta Wyn, Stephanie Teleki

U.S. metropolitan areas are characterized by pronounced disparities in rates of health insurance coverage and access to care.

Los Angeles County Department of Health Services, UCLA Center for Health Policy Research

A. E. Benjamin, Steven P. Wallace, Valentine M. Villa, Kathy McCarthy

Roberta Wyn, Stephanie Teleki, E. Richard Brown

UCLA Center for Health Policy Research, The Kaiser Family Foundation

Co-published by UCLA Center for Health Policy Research & The Kaiser Family Foundation. Drawn from "Racial and Ethnic Disparities in Access to Health Insurance and Health Care." ...

UCLA Center for Health Policy Research, The Kaiser Family Foundation

Co-published by UCLA Center for Health Policy Research & The Kaiser Family Foundation. Drawn from "Racial and Ethnic Disparities in Access to Health Insurance and Health Care." ...

UCLA Center for Health Policy Research, The Kaiser Family Foundation

Co-published by UCLA Center for Health Policy Research & The Kaiser Family Foundation. Drawn from "Racial and Ethnic Disparities in Access to Health Insurance and Health Care." ...

UCLA Center for Health Policy Research, The Kaiser Family Foundation

Co-published by UCLA Center for Health Policy Research & The Kaiser Family Foundation. Drawn from "Racial and Ethnic Disparities in Access to Health Insurance and Health Care." ...

E. Richard Brown, Victoria D. Ojeda, Roberta Wyn, Rebecca Levan

Racial and ethnic groups in the United States continue to experience major disparities in health status.

Nadereh Pourat, James Lubben, Hongjian Yu, Steven P. Wallace

Pourat N, Lubben J, Yu H, Wallace S. Perceptions of Health and Utilization of Ambulatory Care: Differences Between Korean and White Elderly.

Los Angeles County Department of Health Services, UCLA Center for Health Policy Research

This report is the product of a collaborative effort between the Los Angeles County Department of Health Services and the UCLA Center for Health Policy Research.

A. E. Benjamin, Steven P. Wallace, Valentine M. Villa, Kathy McCarthy

Delight E. Satter

Approximately 1.9 million people self-identified as AIAN in the 1990 Census. There are 554 federally recognized Indian tribes in the U.S; ...