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This article talks about the ways gender norms and gender stereotypes affect public health. In the specific example shared in the article girls being taught to be quiet and polite vs the lessons of bravery and strength in boys put them at a greater health risk. The heightened health risks include HIV, STDs, childhood marriages, and violence. Despite the move for equal rights on paper this has certainly not been realized in real everyday life.

https://www.npr.org/sections/goatsandsoda/2017/09/21/552573637/macho-man-little-princess-how-gender-norms-can-harm-kids-everywhere

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Lauren Davis - June 29, 2018 - Race/Class/Gender/Society

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Lauren Davis - June 29, 2018 - Race/Class/Gender/Society

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This articles by the New York Times addresses the topic of gender stereotypes towards children when it comes to the toys they play with.  It reviews and discusses a study completed with children and toys, does their toy choice change after being shown an image based on a particular stereotypes - the results are interesting. Give this a read to better understand why it is important for children to play with toys no matter gender stereotypes.

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Breaking Gender Stereotypes in the Toy Box (Published 2018)

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What toys children play with can influence the skills they learn and the possibilities they see for themselves.

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This article summarized a study of a survey issued to anti-vaxxers that tested their self perceived knowledge about certain things in combination with an actual test of their knowledge on certain subject areas. The study claims that anti-vaxxers (by in large) suffer from an issue known as "meta-ignorance." Also known as "ignorance of your ignorance." I found this article especially funny; especially since in a prior discussion for this class, I (satirically) formed an argument that opposed vaccinations.

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Of all the cognitive biases that we encounter on a daily basis, few could be as culturally relevant as the Dunning-Kruger Effect (DKE). This describes those that have a poor understanding or low level of ability with regards to a certain subject thinking that the very opposite is in fact true. A new Social Science & Medicine study has concluded that anti-vaxxers suffer from the DKE in spades, which makes dealing with them more complex than many have previously thought.

Originally described by social psychologists Justin Kruger and David Dunning back in 1999, it's elucidated most eloquently in a 2011 chapter of a treatise composed by the latter. It's all about meta-ignorance: the person's ignorance of ignorance. "The scope of people's ignorance is often invisible to them," Dunning explains, citing experimental data that first brought the effect to light.

Those suffering from DKE are left with a double burden: "not only does their incomplete and misguided knowledge lead them to make mistakes, but those exact same deficits also prevent them from recognizing when they are making mistakes and other people choosing more wisely."

This new study, spearheaded by postdoctoral researcher Dr Matt Motta at the University of Pennsylvania's Annenberg Public Policy Center, points to anti-vaxxers as a prime example of this phenomenon, after having investigated it for the very first time.

Anti-vaxxer sentiment has been around for some time, but this problem - one that's a genuine threat to the lives of millions, particularly the young - appears to have been on the rise in the last few years. Hinting at why this may be, Motta et al. start their paper with a mention of the President's push to get a prominent anti-vaxxer, Robert Kennedy Jr., to start a committee to look at the safety of vaccines.

Clearly, the spread of misinformation by prominent figures is exacerbating the problem, but what about the anti-vaxxers themselves? What do they believe? Prior studies suggest that members of the public that are anti-vaxxer inclined have disgust-based moral purity "concerns", but does the DKE rear its ugly head too?

The team hypothesized that those with low awareness and understanding of autism will be the most likely to think they are best informed - better than actual experts in the field, in fact - on the subject. In order to test out the extent of this overconfidence, the team surveyed 1,310 US adults, a nationally representative sample.

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This Is The Reason People Believe Anti-Vax Conspiracies, Confirms Study

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Of all the cognitive biases that we encounter on a daily basis, few could be as culturally relevant as the Dunning-Kruger Effect (DKE). This describes those that have a poor understanding or low level of ability with regards to a certain subject thinking that the very opposite is in fact true.

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Hadley Kelly - July 2, 2018Mental/ Social/Emotional/Behavioral Health

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Hadley Kelly - July 2, 2018Mental/ Social/Emotional/Behavioral Health

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Illustrated in the article, “Do Social Ties Affect Our Health?” looks at the relationship between our social relations and individual health outcomes. The article continues to mention current and previous research findings that identify the relations between strong social ties and living a longer life. While also noting that loneliness and social isolation has been linked to poor health conditions, depression and an increased risk of early death.

Do Social Ties Affect Our Health? (2017, September 08). Retrieved July 1, 2018, from https://newsinhealth.nih.gov/2017/02/do-social-ties-affect-our-health

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Exploring the Biology of Relationships

Cuddles, kisses, and caring conversations. These are key ingredients of our close relationships. Scientists are finding that our links to others can have powerful effects on our health. Whether with romantic partners, family, friends, neighbors, or others, social connections can influence our biology and well-being.

Wide-ranging research suggests that strong social ties are linked to a longer life. In contrast, loneliness and social isolation are linked to poorer health, depression, and increased risk of early death.

Studies have found that having a variety of social relationships may help reduce stress and heart-related risks. Such connections might improve your ability to fight off germs or give you a more positive outlook on life. Physical contact-from hand-holding to sex-can trigger release of hormones Substances produced in one part of the body to signal another part to react a certain way. and brain chemicals that not only make us feel great but also have other biological benefits.

Marriage is one of the most-studied social bonds. "For many people, marriage is their most important relationship. And the evidence is very strong that marriage is generally good for health," says Dr. Janice Kiecolt-Glaser, an expert on health and relationships at Ohio State University. "But if a relationship isn't going well, it could have significant health-related consequences."

Married couples tend to live longer and have better heart health than unmarried couples. Studies have found that when one spouse improves his or her health behaviors-such as by exercising, drinking or smoking less, or getting a flu shot-the other spouse is likely to do so, too.

When marriages are full of conflict, though, such health benefits may shrink. In NIH-funded studies, Kiecolt-Glaser and her colleagues found that how couples behave during conflict can affect wound healing and blood levels of stress hormones. In a study of more than 40 married couples, the researchers measured changes to body chemistry over a 24-hour period both before and after spouses discussed a conflict. The troublesome topics included money, in-laws, and communication.

"We found that the quality of the discussion really mattered," Kiecolt-Glaser says. Couples who were more hostile to each other showed much larger negative changes, including big spikes in stress hormones and inflammation-related molecules. "In the more well-functioning marriages, couples might acknowledge that they disagree, or find humor in the situation, but they don't get sarcastic or roll their eyes when the other is talking," Kiecolt-Glaser says. In a related study, blister wounds healed substantially more slowly in couples who were nastier to each other than in those who were kinder and gentler during difficult discussions.

Couples with the "double-whammy" of hostile marriages and depression may also be at risk for weight problems. After eating a high-fat meal and discussing a difficult topic, these troubled couples tended to burn fewer calories than less hostile counterparts. "The metabolism in these couples was slower in ways that could account for weight gain across time," Kiecolt-Glaser says. Compared to the kinder couples, the distressed spouses had signs of more fat storage and other risks for heart disease.

The quality of a marriage-whether supportive or hostile-may be especially important to the health of older couples. Dr. Hui Liu at Michigan State University studied data on the health and sexuality of more than 2,200 older people, ages 57 to 85. Good marriage quality, she found, is linked to reduced risk of developing cardiovascular disease, while bad marriage quality is tied to increased risk, particularly in women. "The association between marriage quality and heart health becomes increasingly strong at older ages," Liu says.

Liu and colleagues are also looking at the links between late-life sexuality and health, including whether sex among the very old is beneficial or risky to heart health. "Some people assume that sex isn't important in older ages, so those ages are often overlooked in research studies related to sex," Liu says. "But our studies suggest that for many older people, sex quality and sex life are important to overall quality of life."

In one recent analysis, Liu and co-workers found that older women who reported having a satisfying sex life were at reduced risk for high blood pressure 5 years later. But the researchers also found that some older men, ages 57 to 85, were at increased risk for certain heart-related problems after 5 years if they reported having frequent (at least once a week) or extremely enjoyable sex. The reasons for these increased risks aren't clear and are still under study. Experts suggest that older men and women talk with their doctors about concerns related to sexual issues or potential health risks. Learn more about sexuality in later life at www.nia.nih.gov/health/publication/sexuality-later-life.

Other types of relationships are important, too. These can include friends, family, neighbors, co-workers, clubs, and religious groups. Studies have found that people who have larger and more diverse types of social ties tend to live longer. They also tend to have better physical and mental health than people with fewer such relationships. Social support may be especially protective during difficult times.

Dr. Sheldon Cohen, a psychologist at Carnegie Mellon University in Pittsburgh, has been exploring the links between relationships and health for more than 3 decades. In one study, his team exposed more than 200 healthy volunteers to the common cold virus and observed them for a week in a controlled setting. "We found that the more diverse people's social networks-the more types of connections they had-the less likely they were to develop a cold after exposure to the virus," Cohen says. He and his team have since found evidence that people with more types of connections also tend to have better health behaviors (such as not smoking or drinking) and more positive emotions.

The scientists have also been exploring whether simply believing you have strong social support may help protect against the harms of stress. "Long-term conflicts with others are a potent stressor that can affect health. But we've found that its effects are buffered by perceived social support," Cohen says. "People who have high levels of conflict and low levels of social support are much more likely to get sick when exposed to a virus. But those with high conflict and high levels of social support seem protected." In addition, hugging seemed to shield against stress. People who reported having more frequent hugs were less likely to develop an infection after viral exposure.

Social ties can have mixed effects on our health. But overall, research suggests that the benefits of interactions with others can outweigh any risks. "It's generally healthy for people to try to belong to different groups, to volunteer in different ways, and be involved with a church or involved in their neighborhood," Cohen says. "Involvement with other people across diverse situations clearly can have a very potent, very positive effect on health."

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Exploring the Biology of Relationships Cuddles, kisses, and caring conversations. These are key ingredients of our close relationships. Scientists are finding that our links to others can have powerful effects on our health. Whether with romantic partners, family, friends, neighbors, or others, social connections can influence our biology and well-being.

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James Winslow - 7/2/2018 Mental/Social/Emotional/ Behavioral Health

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James Winslow - 7/2/2018 Mental/Social/Emotional/ Behavioral Health

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This article by the BBC illustrates some ongoing research with psychedelic drugs that could have great promise for helping people suffering with certain psychiatric conditions. Although the studies are small to ensure proper caution, UK researchers are making great progress and are confident in the future of drugs like psilocybin to treat people for which there may be no other options.

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Think of magic mushrooms and LSD and it's likely that science is not the first thing that springs to mind.

Psychedelic drugs are more likely to be associated with hippies and the counterculture of the 1960s than people in white lab coats and clinical trials.

But that might soon change.

Increasingly, scientists are looking at whether these mind-altering drugs - which also include mescaline and DMT among others - might also have the potential to be mind-healing.

A number of small studies have found psychedelics to show promise in treating mental health disorders like depression, addiction and post-traumatic stress disorder, often where other treatments have failed.

Now UK researchers are about to take part in the first major trials into whether one of these hallucinogenic drugs could be more effective than a leading antidepressant in the treatment of depression.

Researchers at Imperial College London are to compare the magic mushroom compound psilocybin with a leading SSRI (selective serotonin reuptake inhibitors) antidepressant, escitalopram, in a large trial expected to take at least two years.

"[Psychedelics] have a revolutionary potential, and that's not an exaggeration," says Dr Robin Carhart-Harris, who will lead the study.

But it is not the first time scientists have been excited about these mind-bending substances.

More than 50 years ago they rapidly came to scientific attention, before research in the field came to a sudden halt.

Rise and fall of psychedelics

During the 1950s and 60s psychedelics were considered to be a promising potential treatment for numerous mental health disorders, with more than 1,000 studies taking place.

But the drugs quickly became controversial.

Popularised by musicians and other celebrities, the recreational use of psychedelics, and particularly LSD, spread during the 1960s as they became increasingly associated with the countercultural movements of the time.

Press coverage of the drugs often focused on bad trips and the supposed moral degeneracy they induced rather than developments in the scientific field.

Some scientists - notably former Harvard psychologist Timothy Leary - became evangelical about the benefits of the drugs, blurring the boundaries between science and advocacy.

Amid fears about their safety and a growing moral panic, psychedelic drugs were made illegal in the US in 1968.

A further UN convention on the drugs in 1971 effectively ended scientific research, because it led member states to make them illegal and classify them as Schedule 1 drugs - those deemed to have no medicinal benefit.

For decades, research dried up as scientists moved into other areas, not least the study of antidepressants.

'Revising your beliefs'

With special government approval needed for such studies, many scientists turned their attention to the magic mushroom compound psilocybin, a drug that is similar to LSD but without much of the controversy.

Several pioneering studies into psychedelics were carried out during the 1990s.

But it was not until the mid-2000s that the drugs underwent a scientific renaissance, in part because of the work carried out at Johns Hopkins University in the US.

Studies from the university found that psilocybin reduced depression in 80% of patients with life-threatening cancer and, separately, were much more effective at getting people to quit smoking than current treatments when combined with cognitive behavioural therapy.

In 2009, Dr Carhart-Harris became the first UK scientist in more than 40 years to research psychedelics, beginning a series of studies using scanners to see how psilocybin affects the brain.

Among other findings, a study from his team last year found that psilocybin can "reset" the brains of people with untreatable depression.

The paper, published in the journal Scientific Reports, showed psilocybin affected two areas of the brain: The amygdala, which is heavily involved in how we process emotions such as fear and anxiety, and the default-mode network - a collaboration of different brain regions.

How psilocybin affects the brain is not yet fully understood, but Dr Carhart-Harris believes it effectively "heats up" the mind from its rigidity, enabling people to overcome ingrained, self-destructive patterns of thinking.

With support from a therapist, those who have undergone the treatment can then "recalibrate in a healthier way, so you're revising your beliefs and assumptions and addictions", Dr Carhart-Harris says.

But psychedelics are not without risks.

While psilocybin is not thought to be toxic for the body, bad trips can be frightening and can potentially cause people to come to harm because of a loss of control.

They can also exacerbate underlying mental health problems and may lead to psychotic reactions in people who are already predisposed to them.

There are also differences between using the drugs recreationally and in the safety of a scientific trial.

Scientists use pure, medical-grade drugs, offer guidance and support with the experience and exclude people at risk of a psychotic reaction.

And the studies so far have tended to be small and short, without placebo groups to account for the placebo effect.

Dr James Rucker, a clinical lecturer at the Institute of Psychiatry at King's College London, is due to begin trials to improve the evidence around whether psilocybin is safe.

It is an essential step if the drug is ever to be licensed and prescribed by doctors.

But even if the trials show psilocybin is safe and effective, Dr Rucker says it is likely to take a minimum of five years and probably longer before psilocybin could be licensed for use.

The process for getting drugs approved is notoriously slow, expensive and bureaucratic, he says.

'Strings to the bow'

So could psychedelics prove to be a breakthrough treatment, capable of transforming mental health?

Dr Carhart-Harris acknowledges that even if bigger trials confirm psychedelics are effective, they are not going to be for everyone.

"Some people won't want to go to the depths of their soul or face demons or traumas they've experienced, or dark aspects of the human condition that are there in all of us," he says.

Dr Rucker says no treatment in psychiatry is helpful for everyone.

"It's about strings to the bow, and it's about having a range of things you can offer," he says.

"This may be one of those things, but who knows? Let's see what the evidence says."

Follow Alex on Twitter.

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Can psychedelics transform mental health?

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Think of magic mushrooms and LSD and it's likely that science is not the first thing that springs to mind. Psychedelic drugs are more likely to be associated with hippies and the counterculture of the 1960s than people in white lab coats and clinical trials. But that might soon change.

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Patrick Ryan- July2, 2018, Non-infectious/Lifestyle disease

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Patrick Ryan- July2, 2018, Non-infectious/Lifestyle disease

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This is an interest take on how to address hunger in urban populations while also assisting dairy farmers to repurpose the excess and by products of their milk production. Essentially, dairy farmers are learning how to turn their left over skim milk into yogurt and cheese which is then sold at a discount to local food pantries.

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On a beautiful sunny day recently in south Lancaster County, Pa., farmer Abner Stolztfus and seven of his eight children were inside, bottling yogurt in a room next to the barn. "The younger one is only 2 months old, so she's not working out here yet," he said, laughing.

Stolztfus and his family own Cedar Dream dairy farm in the town of Peach Bottom in southeast Pennsylvania. He and his kids milk 50 cows twice a day - at 5 in the morning and 5 in the afternoon. His family has been farming for generations.

"I learned milking cows before I started going to school," he said.

But yogurt is a whole new business for him.

Dairy farmers like Stolztfus have been struggling financially during the past few years. While new technologies have allowed farms to produce more milk, fewer people are consuming it. That's causing milk prices to plummet and creating a surplus that often ends up going to waste. According to the Center for Dairy Excellence, Pennsylvania lost 120 dairy farms in 2016. In that same year, dairy farmers across the country dumped 43 million gallons of excess milk.

So last year, Stolztfus decided to invest almost $200,000 in equipment and learned how to make yogurt from scratch. Today, he produces about 3,000 pounds of milk and yogurt a week. His No. 1 seller is drinkable yogurt, a light but creamy, all-natural yogurt.

Things were not easy at the beginning, though. With an upset market, he struggled to find customers until an unlikely client emerged: Philabundance, the local nonprofit that turns food waste into donations.

Forty percent of all food produced in the United States ends up in landfills. Yet in Philadelphia, one in five residents doesn't have enough to eat. To combat waste and help feed hungry people, Philabundance is rescuing perfectly good milk that was going to be dumped to make cheese and yogurt for families in need. In the process, it helps farmers like Stolztfus.

"We are testing out a new model with him where we work with another farmer to source excess skim milk from his butter production," said Kait Bowdler, director of sustainability at Philabundance. "Every time you produce butter, there's the whey and the skim that's left over, and a lot of that ends up being thrown out."

Skim milk can be processed into other products, such as cheese or yogurt. But because dairy farmers are struggling, they are left with no money to pay for that processing and end up dumping it. The same happens with other types of milk.

"Think about it: Cows still produce the same amount of milk no matter what you use it for, and if a co-op says that you can only produce a certain amount or that they can buy a certain amount, you end up having to throw that out," Bowdler said.

Last year, food banks statewide came up with an idea. Using funding from the Pennsylvania Agricultural Surplus System and donations from the dairy industry, they got 12 tanker loads of surplus milk that a local co-op was going to dump. (Milk-transport trucks can hold anywhere from 5,000 to 8,000 gallons.) They took the rescued milk to local cheesemakers and made thousands of pounds to give away free at food pantries and shelters. For farmers, it meant total revenue of $165,000.

Philabundance purchased 27,680 pounds of that cheese for donations, but then took the idea one step further. It bought more milk to make more of the same cheese, this time to sell in fancy food stores in Philadelphia, under the brand Abundantly Good. For every pound of cheese sold, $1 goes back to the farmer to process milk into free cheese for hungry people.

Giving people in need food of the same high quality as that sold in gourmet stores is what the whole program is really about, Bowdler said.

"It's rebellious in a way, it's saying that people who are poor don't just need to take whatever you give them - we can give them a better product," she said.

According to Philabundance, in a year farmers have received $9,000 from retail sales - the equivalent of selling 18,000 half-pound units. That has allowed them to produce 3,500 pounds of cheese for donations. Because the program is a success, the organization is testing out a new product: excess skim-milk yogurt.

Stolztfus said leftover skim milk by itself looks and tastes like colored water. But with the right equipment and ingredients, it can be transformed into delicious yogurt.

"We pump the skim milk in there [the pasteurizing tank], we heat it up, to about 108 degrees, and we add the culture. We let it incubate for 12 hours, and we stir it back up, add the flavoring, sugars, and mix it up good, and that creates the yogurt," he explained while overseeing bottling of the product.

At the end of the day, Stolztfus transforms 4,500 pounds of skim milk that might have become waste into 4,500 pints of drinkable vanilla yogurt for people in need.

"It's a very good way to get people drinking more milk, getting dairy in them...," Stolztfus said, "It's a very good feeling, it makes me feel really good."

And it helps him pay his bills. For now, Philabundance is paying Stolztfus to process the excess skim milk from butter production into both drinkable and spoonable yogurt. But if the Abundantly Good program grows, the organization will try to sell the yogurt in stores, and have the retail sales pay for food donations.

In July, a new retail product will debut: spiced tomato jam. Proceeds from sales of the jam, produced in collaboration with TBJ Gourmet, will go to provide tomato sauce and soup donations for people in need.
This story comes to us from member station WHYY in Philadelphia.

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Struggling Farmers Turn Excess Milk Into Cheese And Yogurt For The Hungry

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On a beautiful sunny day recently in south Lancaster County, Pa., farmer Abner Stolztfus and seven of his eight children were inside, bottling yogurt in a room next to the barn. "The younger one is only 2 months old, so she's not working out here yet," he said, laughing.

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Hunter Hudson, July 2nd, Environmental Health

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Hunter Hudson, July 2nd, Environmental Health

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This article is about how lead testing of homes may reduce lead poisoning in infants. The article reveals a study that links home lead inspections to reduced blood lead levels in newborns compared to controls where a home inspection was not carried out. Each home inspection also includes a thorough cleaning of the home to remove any lead found, which has shown to be the major issue with this program due to its expense.

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Children are diagnosed with lead exposure only when their health is already endangered. Wouldn't it be better to prevent that danger instead? That's the goal of a project in the city of St. Louis that tests the homes of pregnant women and removes dangerous lead before babies were born.

That SWAT-team approach can reduce children's exposure to toxic lead, according to a new study.

About 250,000 children are poisoned by lead each year, according to current standards, and experts say twice as many are affected. Lead permanently damages a child's brain, lowering IQ and causing lifelong behavior problems and learning disabilities.

Decades of effort to remove lead paint from substandard housing haven't ended the problem - about 24 million houses and apartments in the United States are still thought to have lead paint, according to the federal Centers for Disease Control and Prevention. Prospective parents have no way of knowing if their housing is contaminated without having it tested, an expensive prospect.

So researchers in St. Louis and city officials decided they would make a preemptive strike. In the Heavy Metal Project, low-income pregnant women were offered a free home inspection. If lead was found, it was cleaned up. That included cleaning, covering over old paint, and replacing windows.

The babies whose homes were cleaned up before they were born had less lead in their blood than children whose housing wasn't cleaned. The average blood lead level among the 60 participants was 2.70 micrograms per deciliter, compared to 3.63 for controls. Blood lead levels greater than 5 micrograms per decileter were found in 13.3 percent of study participants, compared to 22.5 percent of controls.

Those last numbers are important, because in January, a federal panel said the standard for dangerous lead exposure in children should be cut in half to 5 micrograms, compared to the current standard of 10 micrograms. That's based on lots of research in the past decade showing that even a small amount of lead exposure messes up a brain.

So what's not to like about this project?

The home cleanups are expensive, costing about $6,500 in homes where windows needed to be replaced, and a little less than $1,000 where they didn't. Half of the homes got replacement windows, for an average of about $3,500.

But many of those homes would have had to have been remediated after children were poisoned, according to Daniel Berg, the study's lead author. He's a physician at Family Care Health Centers in St. Louis. "You're gonig to be doing the work a few years later on a lot of these properties anyway," he told Shots. "We're shifting it to find the hazards before the kids are poisoned. The idea is to prevent it up front."

St. Louis used funds from the federal Department of Housing and Urban Development, which is given to cities with substandard housing for lead remediation.

Berg and his colleagues say they'd like a woman's obstetrician to refer their patients for home lead screening if the doctor thinks there's a risk. The research was published in the American Journal of Obstetrics and Gynecology.

One in 27 children in St. Louis are at risk of being exposed to lead, the authors note. That's a lot more kids than the 1 in 800 who are affected by treated diseases detected by newborn screening, which is commonplace.

A similar project in Philadelphia, the Lead Safe Homes Study, didn't show the improvements found in St. Louis. That may be because the St. Louis project fixed the homes before the children were born, while the other project started work after the children were born.

Screening of homes is the only way to prevent damage to children's health, Jerome Paulson, a pediatrician at Childrens National Medical Center in Washington, D.C., told Shots in January. "We really need to screen houses, not kids."

The present system, says Paulson, uses "children as a means to identify substandard housing. To me, that's immoral."

But even that imperfect system may be imperiled. Congress has cut funding for lead testing of children from $30 million to $2 million. The money is given to local health departments to pay for children's blood tests. The health deparmtments are now scrambling to figure out how to keep providing the tests.

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To Protect Children From Lead, Fix Pregnant Women's Homes

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Lead poisoning in children can be reduced by cleaning up pregnant women's homes, according to a new study. That would be better than waiting until children are exposed to identify the problem, experts say. But the cleanups are expensive, and money is tight.

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This article addresses the breakup of families at the southern border and the role the Office of Refugee Resettlement plays in providing care and, now, how DHS has the primary role in providing health services to families. DHS and ICE are not agencies properly equipped to provide the treatment necessary, and we see children and toddlers going without basic necessities in some instances while detained in detention centers.

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The White House's plan to indefinitely detain immigrant families together threatens the care of young children, experts worry, by placing them with an agency with little experience in handling such complex needs.

Previously, the administration's "zero-tolerance" immigration stance meant splitting children from parents, including 2,322 children 12 and under, and placing the children in facilities run by the Department of Health and Human Service.

The policy of detaining families "during the pendency of their immigration cases" was announced Friday night in a Justice Department court filing. But experts and former government officials warn the new approach - which places parents and children in the custody of the Department of Homeland Security for months or even longer - won't improve the situation.

The DOJ declined to comment. DHS did not immediately respond to requests for comment.

"We're seeing a repeat pattern of this administration," said Sarah Pierce, a policy analyst with the Migration Policy Institute and former immigration attorney. "The president makes laws and policies and the administration then struggles to implement what he does."

For longer detentions, DHS will need resources for young children that the agency doesn't generally set up, such as educational facilities.

"They even need diapers, formula and bottles," Pierce said. "We're talking about the basics for caring for children."

Making matters more complicated, DHS' family facilities could be at capacity within days under the indefinite detention policy. The White House has also asked the Department of Defense to make detention facilities available.

"DHS' primary focus - [its facilities] were designed to hold these people, and not let them out," said Peter Boogaard, a former DHS spokesman under the Obama administration. "It is not in any way designed to protect the health and well-being of families and young children."

While the Obama administration grappled with a sudden influx of families in 2014, the detention of families triggered litigation under the 1997 Flores settlement agreement, which required that families be detained together at DHS facilities and the children be released within 20 days. The Obama administration then began releasing the families under the agreement.

"Most of these families were released before the 20 days were up," Pierce said.

The Department of Justice has also requested the Flores settlement be modified to permit longer detention of families being prosecuted, including children.

People who are stopped by the U.S. Border Patrol receive some baseline health screenings. And the Office of Refugee Resettlement, the HHS program in charge of "unaccompanied alien children," typically provides some medical care for children detained at the border, including consultations with child psychologists and social workers.

In recent weeks, ORR - which took responsibility for children who had been separated from their parents - has come under fire for providing reportedly substandard care, including reports that children's psychiatric records and case files were being used in immigration court. Many experts have also suggested ORR couldn't handle the number of kids being detained, and lacked expertise in caring for the many 12-and-under children detained who were separated from their families.

Still, unlike DHS, many noted, ORR has some expertise in providing children's health services. Boogaard said he was unfamiliar with any protocols to ensure kids receive adequate vaccinations, or consultations with child psychologists and social workers.

"They are not resourced and not staffed to be able to deal with the unique challenges of dealing with children," he said.

U.S. Immigration and Customs Enforcement, the DHS agency that operates detention centers, redirected questions to its website on standards for family centers. It says residents will have access to "health care education and maintenance services that are determined by the health care authority to be necessary and appropriate," including "prevention, diagnosis, and treatment of medical, dental, and mental health conditions."

Advocates and watchdog organizations, though, suggest that hasn't been the case.

A recent Human Rights Watch report argued "dangerously substandard medical care" had contributed to eight out of the 15 deaths documented in records released by ICE from December 2015 to April 2017. Medical reviewers also noted instances of poor medical care in six of the other deaths.

"ICE's record of providing inadequate care to adults does not bode well if the agency is put in charge of providing care to increasing numbers of children," said Alison Parker, who directs HRW's U.S. program.

Meanwhile, children currently crossing the border have particularly intense health needs - in no small part because many are fleeing violent circumstances. Lengthy detention can add to that trauma, experts said.

"Historically thinking about what family detention has looked like in this country, we have reason to be concerned," said Shadi Houshyar, who directs early childhood and child welfare initiatives at Families USA, an advocacy group. "Detention is no place for children."

Prior to the 2015 ruling, she added, children in detention facilities were found "dehydrated, and not eating, and having intestinal problems." Many new mothers, she added, experienced depression and trouble nursing.
KHN's coverage of children's health care issues is supported in part by the Heising-Simons Foundation.

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Immigrant Families Placed In Detention Centers Face Health Care Challenges

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The White House's plan to indefinitely detain immigrant families together threatens the care of young children, experts worry, by placing them with an agency with little experience in handling such complex needs. Previously, the administration's "zero-tolerance" immigration stance meant splitting children from parents, including 2,322 children 12 and under, and placing the children in facilities run by the Department of Health and Human Service.

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Aspen Becker, 7/3/2018, Environmental Health

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Aspen Becker, 7/3/2018, Environmental Health

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This article details an announcement from the Denver Department of Public Health and Environment about the release of its new Food Action Plan. Through the plan they aim to reduce food insecure households by 55%, cut the volume of food waste in residential garbage collection by 57%, and reduce the environmental toll that happens when food is discarded.

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The Denver Department of Public Health & Environment (DDPHE) announced today the release of its Food Action Plan, a set of strategic projects to increase food equity in the city. The plan serves as an action-oriented companion piece to the Denver Food Vision, an aspirational view of advancing our food system in Denver.

Using the Food Vision as our guiding document, the Food Action Plan was created to fulfill the goals set forward in the Food Vision after 18 months of community engagement. The Food Vision framework is organized by four interrelated focus areas: Inclusive, Vibrant, Healthy and Resilient. Among other goals articulated in the focus areas, the Food Vision aims to reduce the number of food insecure households by 55 percent (Healthy) and cut the volume of food waste in residential garbage collection by 57 percent citywide by 2030 (Resilient).

In addition to contributing toward those goals, the Food Action Plan addresses many city objectives, including those set out in our 2020 Sustainability Goals, Climate Action Plan 2050, and the Community Health Improvement Plan.

"These are bold ambitions that require extensive collaboration and commitment," said Denver Public Health & Environment Executive Director Bob McDonald. "We will continue to work in partnership with the entire community - businesses, individuals, other government agencies, and nonprofits - to achieve these innovations."

As part of our initial release of the Food Action Plan, we are pleased to announce our first project-a collaborative effort with the Natural Resources Defense Council (NRDC), funded by The Rockefeller Foundation, to reduce the amount of food being wasted in Denver homes and businesses.

"When food goes to waste, so does everything it takes to get it to our plates-from water to energy and money," said Elizabeth Balkan, food waste director at NRDC. "The good news is, Denver-and cities nationwide-are uniquely positioned to tackle this problem. In the process, they can make their communities more resilient, economically vibrant and equitable."

Together with NRDC, the City and County of Denver will integrate multiple strategies to prevent food from going to waste, rescue surplus food for those in need, and recycle food scraps. This includes:

Participating in a public education campaign aimed at cutting food waste from its largest sources, especially consumers.

Engaging businesses through challenges and city-level technical assistance by DDPHE's Certifiably Green Denver Program, which works with local businesses to increase sustainable practices.

Encouraging surplus food donation by local businesses, engaging public health inspectors, and various forms of stakeholder engagement to address the food rescue resources gap.

Encouraging and incentivizing organics recycling and composting by residents.

"Understanding the drivers of and potential for wasted food in Denver was an important first step in advancing a more sustainable citywide food system," said Devon Klatell, Senior Associate Director and Initiative Strategy Lead for Food at The Rockefeller Foundation. "NRDC found that an additional 7.1 million meals could be rescued every year, which would close Denver's meal gap by 46%. The report findings, coupled with a strong set of public and private sector partners, provide the tools needed to rescue and deliver more nutritious foods to people in Denver and beyond."

Up to 40 percent of the U.S. food supply-worth $218 billion-goes uneaten each year. It's a problem that costs the average family of four $1,800 annually. This takes an enormous environmental toll in terms of water, energy, agricultural chemicals, and labor that go to waste when food is discarded. Unbelievably, at the same time, one in eight Denver residents does not have a reliable supply of food.

Last fall, NRDC, with support from The Rockefeller Foundation, released a pair of reports that looked at food waste and food rescue potential in Denver. Among other things, it found more than four pounds of food per person on average was wasted at home every week in Denver, and 76 percent of that could have been eaten. It also revealed up to 7.1 million additional meals annually could be donated in Denver beyond current donations, under optimal conditions.

DDPHE is excited to share our Denver Food Action Plan, as it kicks off a series of projects with an array of partners across the community and the nation, all with one focus in mind. We will continue to roll out projects that are part of this plan in the weeks and months to come. Our Food Vision showed us what was possible to increase food equity here in Denver, and the Food Action Plan provides us a path to achieve this bold goal.

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Denver Releases Action Plan to Reduce Wasted Food, Feed More Residents in Need

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The Denver Department of Public Health & Environment (DDPHE) announced today the release of its Food Action Plan, a set of strategic projects to increase food equity in the city. The plan serves as an action-oriented companion piece to the Denver Food Vision, an aspirational view of advancing our food system in Denver.

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Clare Mikhail 7/4/2018 Infectious/Communicable Diseases 

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Clare Mikhail 7/4/2018 Infectious/Communicable Diseases 

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In this Ted Talk from January 2018 Fredros Okumu discusses why he studies mosquitoes. He characterizes mosquitoes as the most dangerous animal in the world and speaks to his unconventional meathods researching them. I found this interesting given where we are with the Zika epidemic.

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Fredros Okumu: Why I study the most dangerous animal on earth -- mosquitoes

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What do we really know about mosquitoes? Fredros Okumu catches and studies these disease-carrying insects for a living -- with the hope of crashing their populations. Join Okumu for a tour of the frontlines of mosquito research, as he details some of the unconventional methods his team at the Ifakara Health Institute in Tanzania have developed to target what has been described as the most dangerous animal on earth.

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This is an interesting discussion from NPR that shows that while we think childhood obesity rates are going down, they actually haven't improved since 1999. There are many factors going into this spike of childhood obesity from fad diets to food insecurity and even genetics.

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Childhood obesity was on the decline, or so it seemed. Both scientific journals and media outlets, including from NPR as late as 2012, have reported within the last decade that its numbers were moving down. The numbers have moved - in the wrong direction, according to a prominent new study which shows the highest spike in obesity among children 2 - 5 since 1999 and recent NPR coverage.

Listeners pointed to fad diets, genetics and food insecurity as reasons they've encountered childhood obesity. Dr. David Ludwig of Boston Children's Hospital has been studying these factors for decades. He spoke with NPR's Lulu Garcia-Navarro about these factors and what science got wrong about obesity.
This interview has been lightly edited for clarity.
Interview Highlights
On how the media got the numbers so wrong
The false numbers saying childhood obesity was on the decline seemed to make senseafter Michelle Obama's Let's Move! program and other prominent public health measures - public health experts had hoped that obesity prevalence would respond to these efforts. Unfortunately, as we now know from these new statistics, those efforts were a mirage rather than a true glimmer.

When you look at short-term studies, movement in the result numbers can go up and down without any real meaning. Looking back, public health experts now know that the changes we thought we saw were really just statistical flukes, and that obesity rates among children are the highest ever.
On the different ways that children are susceptible to obesity
Usually, what makes an adult gain weight will make a child gain weight, too - but there are some unique factors that apply to kids. Home environments and parenting practices are key for keeping children healthy. It's not enough to just tell a child what to eat; as parents, we need to model it ourselves.

We need to create an environment that's conducive to healthy weight for everyone, but we've created an environment that's done the opposite.
On how that "opposite" environment came to be
We didn't get the science right.

We told people to cut back on foods with fat, but many of those foods are actually healthy: Avocado, nuts and olive oil don't produce excessive weight gain, and are quite filling. We told people to load up on processed carbohydrates, and gave sugary beverages a pass.

Foremost, we need to get the science right. Then we have to adjust our government's policies by putting public health over the political interests of the food industry.
On why children of color experience different rates of obesity
Rates of childhood obesity are unfortunately rising among everybody, and they're increasing fastest among children of color. That may have a lot to do with socioeconomic factors: In our modern world, it takes money to pursue a healthy diet and engage in safe, physical recreation activities after school and on the weekends. For low-income families, the obstacles to a healthy diet and lifestyle can be excessively high.
On public health policy changes in the Trump administration
There are many concerns with food and obesity policy today. First is that our current policy lacks a vision for how we can bring together all of the necessary forces to attack the causes of childhood obesity. It's not enough to give kids good, preventative healthcare in their childhood pediatric visits once a year.

Kids need decent food at school, and unfortunately, many of the improvements made in school lunch programs are now being revised. Kids also need the opportunity to move their bodies every day, but for many kids, physical education classes are just once or twice a week.
On what actions anyone can take to build a healthier world
We all have to work together to make the world healthier for everyone. We can do that with the ballot, by voting for legislators that are willing to put public health ahead of special interest. Food science isn't rocket science - we know the steps needed to achieve a healthy lifestyle, we've just lacked political will.

Until we can create an environment that supports everyone's health, it's up to parents to create a bastion of health in their homes.
NPR&#x27;s Emily Sullivan produced this story for digital.

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The Call-In: Childhood Obesity Rates Are At Their Highest Since 1999

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Childhood obesity was on the decline, or so it seemed. Both scientific journals and media outlets, including from NPR as late as 2012, have reported within the last decade that its numbers were moving down.

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Infectious/Communicable Diseases

This article reflects on the 2017-2018 influenza season, which was especially severe. The article touches on some of the challenges associated with the influenza vaccine, ranging from determining the strains to include to production limitations. The author also introduces the concept of a "universal vaccine," which would last for more than a year and offer more robust protection.

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The 2017-2018 influenza season in the United States was one of the most severe in recent memory. High rates of flu occurred all over the country simultaneously, in contrast to most seasons of the past decade, when certain states would peak with flu activity while others remained relatively quiet (see Chart). This sustained and widespread high level of flu activity resulted in a jump in hospitalizations. Death rates were highest in the over-65 age group, which is typical, but the second most affected group comprised those aged 50 to 64 years old; normally, the second highest death rates occur in children, from birth through age 4 years. ¹ The ferociousness of the flu season overall, combined with above-average impacts on younger baby boomers, made 2017-2018 one for the record books.

"It was certainly a severe season," Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases, told Contagion®. "Within the past 10 years, not counting the H1N1 (swine flu) pandemic of 2009, and just looking at seasonal influenzas, there's no doubt that this has been the worst season we've had in the last decade." According to data from the US Centers for Disease Control and Prevention (CDC), flu seasons that are considered serious typically occur when influenza A (H3N2) is especially prevalent, as it was this year. During a serious season, there can be up to 35 million cases of flu, with 700,000 hospitalizations and 56,000 fatalities.

Part of the problem is that receiving the seasonal flu vaccine is far from a guarantee of avoiding the flu. Unlike with vaccines against diseases such as measles and polio, which offer 100% protection, getting a seasonal flu shot gives you a better chance of not contracting the flu or of having a less severe case if you do contract it.

"This year's interim overall vaccine effectiveness against both influenza A and B viruses was 36%," said CDC spokesperson Kristin Nordlund. "That means a vaccinated person's risk of having to go to the doctor because of an influenza illness was reduced by more than a third. The vaccination effectiveness against H3N2 viruses was 25%, 67% against H1N1, and 42% against influenza B viruses." Nordlund said these numbers are in line with those of past seasons, when effectiveness of the vaccination against H3N2 viruses was roughly 30%. Against H1N1 and influenza B viruses, it's been 50% to 60% effective.

Although those aged 65 and older bore the brunt of hospitalizations and deaths from flu this past season, as they do every year-estimates are that 71% to 85% of all flu deaths every year occur in people in this age group- the group at next highest risk was those aged 50 to 64, the younger baby boomer cohort. This represented a deviation from the norm, in which the youngest children are the most vulnerable, after the elderly.

Why did middle-aged individuals find themselves felled by the flu in higher numbers than in other years? Dr. Fauci suggested it had to do with imprinting, or the very first flu virus to which people in this age group were exposed as young children. "Your first exposure will influence how you respond for the rest of your life," he said. "You have a better response to what you were initially exposed to." In other words, there's a good possibility that from the mid-1950s to the mid-1960s, when individuals in this age group were born, the viruses floating around were not H3 viruses different strains, such as H2. This could have resulted in individuals in this age group having a comparatively poor response to the strains circulating this past season.

Compounding the problem is that each seasonal flu vaccine is created using data from past flu outbreaks, data that is more than a year old by the time the next flu season is underway. This lag time often results in a mismatch between the strains of the virus that are in the vaccine and the strains that are actually prevalent.

"The virus protection would be 80% or 90% if we would be infected by the strains that are in the vaccine," said Peter Palese, PhD, chair of the Microbiology Department at the Icahn School of Medicine at Mt. Sinai in New York.

UNIVERSAL VACCINE ON THE HORIZON?

Given the incompleteness of the protection afforded by the seasonal flu vaccine, researchers are eager to provide people with a universal flu vaccine, one that would offer comprehensive protection against many strains of influenza for far longer than a year. "It's really important that we understand that this flu vaccine that we're using today is largely based on World War II technology," Michael Osterholm, PhD, MPH, director of the Center for Infectious Disease Research and Policy at the University of Minnesota and co-author of Deadliest Enemy: Our War Against Killer Germs (Little, Brown and Company, 2017), told Contagion®. "We just really have an outdated vaccine. That's a real challenge that we have. The good news is that we do believe that the technology is there and that we can get better vaccines."

The majority of current seasonal vaccines are made using chicken eggs. The virus is injected into the eggs, allowed to replicate, then harvested and rendered inactive for use in vaccines. One challenge of using this technology is the availability of enough eggs. ² Another is the fact that being grown inside of an egg can alter a virus enough that the immune system is spurred to create antibodies, rendering the vaccine less effective. An alternative is cell-based flu vaccines, which involve growing the viruses inside the cells of live animals (mammals). This technology means more vaccines can be created in less time and the viruses are not at risk of mutating in the way they with eggs. However, availability of cell-based flu vaccines is still quite limited. ³

The big hope, of course, is a universal vaccine that will erase the need for the yearly shot. Dr. Palese is one of the researchers at the forefront of universal flu vaccine development. "My lab initiated the technology, which is referred to as reverse genetics," he said, describing the process of creating influenza virus in the lab. "One of the things we succeeded [in] was to reconstruct the extinct 1918 virus in the laboratory." This reconstruction, he explained, is used to create more effective vaccine strains in the future. His team is 1 of 3 at Mt. Sinai that's working on a universal vaccine designed to offer lifetime immunity to the flu-or at least for a couple of decades.

Although different strains of influenza emerge from year to year, compromising the effectiveness of the seasonal vaccine, certain parts of the virus remain identical from strain to strain. Palese and colleagues are focusing on these unchanging components of the virus and designing a universal vaccine that will target them. The goal is to make the universal vaccine "like a stealth bomber," he said. "We are trying to fool the immune system." So far, the vaccine has worked well when tested on ferrets, but large-scale availability for humans is a long way off. Two phase 1 trials that began this past fall and are expected to last more than a year have generated a lot of buzz in the scientific community. "We have good reason to believe....that it should work in humans," Dr. Palese said. But when might such a universal vaccine be on offer to every consumer? "Ask me something easier," he was quick to reply.

Despite the imperfection of the current egg-based seasonal flu vaccine, doctors and public health officials continue to stress the importance of receiving it in the absence of anything better. "It is noteworthy that the overall vaccine effectiveness for children 6 months through 8 years old was 59%," said the CDC's Nordlund. "To put this more simply, that means a vaccinated child's risk of having to go to the doctor because of an influenza illness was reduced by half. The vaccine effectiveness against H3N2, specifically, was also greatest among children 6 months through 8 years: 51%. Even with vaccine effectiveness in the range of 30% to 60%, flu vaccination prevents millions of illnesses and tens of thousands of flu-related hospitalizations each year."

Those numbers will have to suffice for now, according to Dr. Osterholm, who says he doesn't see any major advances happening in the next few years. "It's very possible we may be able to have a very highly effective universal flu vaccine, but we're a long ways off," he said, citing a lack of funding. Senator Edward Markey (D-MA) recently introduced the Flu Vaccine Act, with the goal of a $1-billion investment over a 5-year period toward a universal vaccine, or $200 million per year. Congress instead allocated $100 million for fiscal year 2018. ⁴ It's an improvement over the $64 million spent in fiscal year 2017, but not enough, in Dr. Osterholm's opinion: "Right now we're still really nibbling at the edges, at best, in terms of our seriousness [about putting money toward the development of a vaccine]."
Ms. Saloman is a health writer with more than 20 years of experience working for both consumer-and physician-focused publications. She is a graduate of Brandeis University and the Medill School of Journalism at Northwestern University. She lives in New Jersey with her family.
References:

1. CDC. 2017-2018 influenza season week 16 ending April 21, 2018. CDC website. cdc.gov/flu/weekly/weeklyarchives2017-2018/Week16.htm. Accessed on May 1, 2018.

2. CDC. How influenza (flu) vaccines are made. CDC website. cdc.gov/flu/protect/vaccine/how-fluvaccine-made.htm. Updated November 7, 2017. Accessed on April 30, 2018.

3. CDC. Cell-based flu vaccines. CDC website. cdc.gov/flu/protect/vaccine/cell-based.htm. Updated November 7, 2017. Accessed on April 30, 2018.

4. Senator Markey secures funding in omnibus budget for his call for a universal flu vaccine [press release]. Boston, MA: Office of Ed Markey; March 23, 2018. markey.senate.gov/news/press-releases/senator-markey-secures-funding-in-omnibus-budget-for-his-call-for-a-universal-flu-vaccine. Accessed April 30, 2018.

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Flu Season 2017-2018: A Look at What Happened and What's to Come

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The 2017-2018 influenza season in the United States was one of the most severe in recent memory. High rates of flu occurred all over the country simultaneously, in contrast to most seasons of the past decade, when certain states would peak with flu activity while others remained relatively quiet (see Chart).

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This article details how France is attempting to curb the country's long time love of smoking. In 2007, smoking inside establishments was banned and now, a series of policy changes are going to increase taxes on cigarettes. By 2020, a pack will cost $12, as opposed to $9 as it stands now. France hopes that this will deter a habit that has been romanticized and is culturally ingrained in many Parisians.

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Kenzo Tribouillard | AFP | Getty Images

PARIS - The glamorous image of cool Parisians lighting up Gauloises while lingering at an outdoor cafe may soon go up in smoke. The French government is stubbing out the country's love affair with tobacco.

"In France, tobacco kills 200 people every day," Health Minister Agnes Buzyn said in May. "We need to continue this fight against one of the biggest scourges of public health."

In recent years, France has moved to feature gruesome photos of diseased lungs on cigarette packs, among other deterrent measures such as government reimbursement of cessation aids. Steep taxes are on track to push the cost of a pack of cigarettes from about $9 to $12 by 2020.
More from USA Today: Mom's lifestyle could be key to childhood obesity, study suggests Coffee linked to longer life in latest study, suggesting it's part of a healthy diet Young Americans are the loneliest, surprising study from Cigna shows
The measures appear to be working.

The number of daily smokers in France dropped to 12.2 million last year from 13.2 million in 2016, according to the latest figures released in May by the French Health Ministry.

Still, 27 percent of the French continue to light up daily, one of the highest rates of smoking in the European Union, behind Greece and Bulgaria. Sweden has the lowest proportion at 7 percent, according to the EU.

In the USA, 14 percent of the population smokes cigarettes, according to the Centers for Disease Control and Prevention.

"We must drop down to the rates of Anglo-Saxon countries, to around 15-16 percent," Buzyn said.

That's not an easy goal in France, since it would mean changing the long-entrenched cafe culture the French seem reluctant to give up.

Tucked in the residential neighborhood behind Montmartre Hill - an area once frequented by Pablo Picasso and other artists - is the 1930s-era cafe La Renaissance, known by residents for its laid-back atmosphere and by movie buffs for being featured in Quentin Tarantino's film "Inglourious Basterds."

No matter the weather, the outdoor tables are always packed with customers puffing away while chatting with friends or watching the world go by.

Since smoking was outlawed inside public spaces in 2007, smokers have had to light up outdoors, though some venues allow smokers to indulge in their habit inside after officially closing for the day.

"Smoking is one of life's pleasures and part of the ritual of meeting among friends," said Benjamin Gourio, 44, a communication consultant who said he has no plans to give up his two-pack-a-day habit. "I have been smoking since I was 16. It was pleasurable to meet with friends after school and have a smoke."

His sister, Sylvie Gourio, 46, has no regrets about quitting her pack-a-day habit, which she started while in high school, like many in France. "I had to stop smoking, because I didn't have a choice. My doctor warned me I faced living with respiratory failure if I didn't give up," she said.

Two years ago, she began a program with a government-backed organization that offers free support to quit smoking. The group offers regular counseling sessions, nicotine patches and chewing gum.

As a result, she has been smoke-free ever since and discovered a few unexpected benefits.

"I have recovered my sense of smell. It's nice to be able to smell freshly baked bread at the boulangerie," she said, referring to France's small bakeries. "I have also taken up sports, like running, swimming and judo, which in a way have replaced my cigarette addiction."

It's a trend that increasingly resonates with French urban millennials, who are far more health-oriented and environmentally aware than older generations. Vegan and gluten-free cafes, along with juice bars are fast replacing traditional bistros as favorite hangouts in Paris. These days it's not unheard of to swap a leisurely lunch - once a staple of French life - to go to the gym.

"The new generations have a different attitude and will change the image of the 1960s French, sitting at a cafe with a drink and a cigarette," said Christophe Cutarella, an addiction psychiatrist and member of the scientific board at the Ramsay Generale de Sante Foundation, a hospital group.

The changes in behavior are reflected in the declining number of younger smokers. Last year, the number of male smokers ages 18 to 24 dropped to 35%, compared with 44% in 2016.

Whipping out a cigarette has become less cool, said Emmanuelle Beguinot, director of anti-smoking association CNCT.

"Even if tobacco consumption remains important in France," she said, "its image is not what it used to be."

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France is trying to end the nation's longtime love affair with cigarettes

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Kenzo Tribouillard | AFP | Getty Images PARIS - The glamorous image of cool Parisians lighting up Gauloises while lingering at an outdoor cafe may soon go up in smoke. The French government is stubbing out the country's love affair with tobacco. "In France, tobacco kills 200 people every day," Health Minister Agnes Buzyn said in May.

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Emma Jones - Environmental Health - July 6, 2018

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Emma Jones - Environmental Health - July 6, 2018

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"Social and Environmental Change Drives a World of Newly Emerged Infections"

Due to climate change and rapid urbanization of the developing world and rural areas creates conditions that cause new diseases, new strains of diseases, and diseases that we thought were eradicated are coming back. We need interdisciplinary research and cooperation between medical professionals, epidemiologists, environmentalists, and climatologists to tackle this problem.

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"In an unchanging world, you don't see a lot of emerging disease," epidemiologist William Karesh told Scientific American contributor Lois Parshley during her reporting for this special section, The Future of Medicine 2018. The world, of course, is changing fast. In the U.S., growing economic inequality is driving a resurgence of deadly hepatitis, Legionnaires' and other infections. Globally, climate change and unchecked urbanization are creating conditions in which diseases emerge faster and spread farther. As the six articles in this special report show, hope resides with interdisciplinary collaborations-epidemiologists, climatologists, ecologists, and others working together to solve medical problems with deep social roots.

Read the Report
American Epidemic Infections by the Numbers Vaccine Inequality Beyond the Flu Shot Catching Fever A World of Trouble

This article was originally published with the title "Emerging Disease in a Changing World"

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Social and Environmental Change Drives a World of Newly Emerged Infections

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"In an unchanging world, you don't see a lot of emerging disease," epidemiologist William Karesh told Scientific American contributor Lois Parshley during her reporting for this special section, The Future of Medicine 2018. The world, of course, is changing fast. In the U.S., growing economic inequality is driving a resurgence of deadly hepatitis, Legionnaires' and other infections.

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Melissa Lowe- Law/Policies/Politics- July 7, 2018

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Melissa Lowe- Law/Policies/Politics- July 7, 2018

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Italy has changed its expectations for vaccination of school children states a NYT article "Proof of Children’s Vaccinations? Italy Will Now Take Parents’ Word for It". Parents now do not need to supply a doctor's note to prove that their child has been vaccinated. It's supposed to help enroll children in school whose parents may not have their documents in order. However, public health officials have serious concerns about the impact of missing vaccinations on the spread of measles and other diseases in Italy. It will be interesting to see what the long term impact of such a decision will be.

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Leading up to the elections this March, the two parties that now run Italy - the Five Star Movement and the far-right League - repeatedly expressed skepticism about the benefits of vaccines. Their program for government includes plans to revise a 2017 law that made 10 vaccines mandatory for Italian schoolchildren.

The law was introduced to raise the country's immunization coverage after a measles outbreak in Europe that year with more than 14,000 cases. Italy, with over 4,500 instances, was second only to Romania in the number of cases.

The Five Star Movement says it wants the highest possible level of immunizations, but it has also long advocated overhauling the law, which it considers too restrictive. In 2015, the group proposed a law to limit vaccinations, which it considers linked to cancer, leukemia, allergies, inflammation and autism, despite scientific evidence to the contrary.

Beppe Grillo, a comedian who was a founder of the Five Star Movement, argued in his comedy shows several years ago that vaccines should not be compulsory and that the inoculation of viruses can be dangerous.

The League's leader, Matteo Salvini, has also often said that 10 vaccines are "too many" and that the choice over whether to vaccinate children should be left to parents.

"Vaccination yes, obligation no," he said at a rally last week.

"We need to be safe from measles, but other vaccines seem to me absolutely superfluous," Mr. Salvini said, adding that he had his own children vaccinated.

Asked by reporters how the government would provide education to children who have autoimmune conditions or who are undergoing lifesaving therapies, who would be unable to attend school unless every child in their class was vaccinated, Education Minister Marco Bussetti, also from the League, replied, "Surely they won't be abandoned."

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Proof of Children's Vaccinations? Italy Will Now Take Parents' Word for It

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Leading up to the elections this March, the two parties that now run Italy - the Five Star Movement and the far-right League - repeatedly expressed skepticism about the benefits of vaccines. Their program for government includes plans to revise a 2017 law that made 10 vaccines mandatory for Italian schoolchildren.

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Virginia and New York are the first 2 states to require mental health education in their schools. It will be implemented in the fall with the hopes to bring awareness and knowledge surrounding mental health. In New York, their curricula will focus on recognition of signs/symptoms, discussion of negative coping mechanisms (e.g. alcohol, drugs),  recovery and available services. As mental illness is pervasive in our society, especially among our youth, I hope this makes an impact and other states are able to follow suit.

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NPR's Ailsa Chang talks to Sen. Creigh Deeds (D- Va.), one of the sponsors of the new state law requiring mental health education in schools.

AILSA CHANG, HOST:

This week, New York and Virginia become the first two states to require mental health education in public schools. This comes as the Centers for Disease Control and Prevention report a 30 percent rise in suicide rates in the U.S. in the past two decades.

Virginia state Senator Creigh Deeds knows the reality behind these statistics all too well. In 2013, his son repeatedly stabbed him and then killed himself. He was 24 years old. Senator Deeds was one of the sponsors of the new Virginia law, and he joins us now to talk about it. Senator Deeds, thank you very much for speaking with us.

CREIGH DEEDS: Thanks for having me.

CHANG: I read that this decision to sponsor this law came after you listened to a presentation from high schoolers in your district.

DEEDS: Yes. And I was really blown away by their thoughtfulness, by their passion. These young people had seen bullying in school. They'd seen their peers under pressure who had either died by suicide or come close to dying by suicide. And specifically, they had really pretty well thought out about why it was important to target ninth- and 10th-graders and why health class was the place to talk about mental health.

CHANG: And what do you think ninth- and 10th-graders need to know about mental health?

DEEDS: OK, they need to know the basics about how mental illness affects a person. They need to know what the warning signs are, what to look for in their peers and in themselves. You know, 70 percent of those people who struggle with mental illness first experience an episode sometime between 14 and 24. So that's - in 10th grade is exactly the right time when people ought to be given the tools they need to be able to understand these illnesses.

CHANG: It sounds like there was no controversy as to how important this was. But who ultimately would come up with the details of the curriculum?

DEEDS: The board of education. The parameters around this were drawn by this legislation, and they're pretty broad parameters. But the details have to be worked out by the board of education and to have be built into the curriculum for ninth- and 10th-graders. And I'm hopeful that some work will be done this summer so we can begin the program in the fall.

CHANG: And will teachers get additional training to develop more of an expertise in mental health issues?

DEEDS: I think they will have to. I'm very hopeful that some of our institutions of higher learning when they're training health teachers can do a better job of incorporating some awareness of mental illnesses in their curriculum.

CHANG: But has the state Legislature provided extra funds to provide that training?

DEEDS: We haven't done it yet. I mean, at some point - this year we invested more money in mental illness and behavioral health issues than we ever have before - $192 million over the biennium. So we've taken a major step this year. The last few years, we've done some pretty important things in terms of recognizing what we need to do to provide more services to those people and families that struggle. But we're not where we should be, and very few states are.

CHANG: As we mentioned, this is obviously an issue that resonates quite deeply and quite personally with you. You said after your son died that the state had failed your son, that he was turned away from an institution before he took his own life. What are some things you feel people still do not understand about mental illness?

DEEDS: Well, at the end of the day, sometimes they don't know how to react to someone who is struggling. And sometimes just our language - there was recently a headline in a local newspaper about a loony bin. Sometimes we just insult those people who struggle. Mental health issues need to be given the same dignity as physical health issues.

CHANG: Senator Creigh Deeds, thank you very much for joining us.

DEEDS: Thank you, ma'am.

Copyright © 2018 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information.

NPR transcripts are created on a rush deadline by Verb8tm, Inc., an NPR contractor, and produced using a proprietary transcription process developed with NPR. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR's programming is the audio record.

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New Virginia Law Mandates Mental Health Education In Public Schools

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NPR's Ailsa Chang talks to Sen. Creigh Deeds (D- Va.), one of the sponsors of the new state law requiring mental health education in schools. AILSA CHANG, HOST: This week, New York and Virginia become the first two states to require mental health education in public schools.

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Arianna Roberts, July 8, 2018, Laws/Policies/Politics

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Arianna Roberts, July 8, 2018, Laws/Policies/Politics

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Two things may happen in 2019: the cost of health insurance may go up, and people with pre-existing health conditions may have fewer insurance coverage options. These are potential consequences of the government's recent announcement that they are delaying the payment of $10.4 billion to health insurance companies. The money is supposed to be paid to them as a "risk adjustment" for the higher costs they incur from insuring unhealthier people.

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The Trump administration said Saturday that it is temporarily halting billions of dollars of payments designed to help insurers meet the Affordable Care Act requirement that they provide coverage regardless of whether a person is healthy or sick.

The administration said it was withholding $10.4 billion in the so-called "risk adjustment" payments, citing a district court ruling from earlier this year in New Mexico. While the administration says it is required to stop payments because of the court decision, insurers say the move could result in higher premiums for millions of individuals and small businesses.

The risk adjustment program plays an important role in the ACA by pooling risk for insurers, transferring funds from insurers who enroll healthier members for relatively less, to those that take on higher costs in order to enroll sicker members. The idea is to insulate insurance companies from the cost of enrolling people with pre-existing conditions, and remove the incentive for insurance companies to cherry pick healthy people.

The New Mexico ruling found fault with the formula used by the government to calculate the payments, saying it was " arbitrary and capricious." But another district court in Massachusetts upheld the formula.

The announcement came as insurers were awaiting an annual report that usually comes at the end of June, informing them of whether they owe money into the risk adjustment program or will be paid out for the previous year. Insurers say the sudden halting of those payments creates uncertainty at a critical time, as they are currently developing their premiums for 2019.

Insurance companies responded quickly on Saturday with their disapproval. In a statement America's Health Insurance Plans, the trade association for health insurance companies, said they are "very discouraged by the new market disruption brought about by the decision to freeze risk adjustment payments."

The Blue Cross Blue Shield Association also released a statement condemning the move:

"Without a quick resolution to this matter, this action will significantly increase 2019 premiums for millions of individuals and small business owners and could result in far fewer health plan choices. It will undermine Americans' access to affordable coverage, particularly for those who need medical care the most."

"Insurers hate uncertainty, and when faced with it tend to raise premiums to hedge their bets," says Larry Levitt, Senior Vice President at the Kaiser Family Foundation. He says halting the risk adjustment program will disrupt the individual markets, and might even cause insurers not to participate next year.

"When the rules of the game change after the fact - insurers don't necessarily see the federal government as a particularly reliable partner right now," Levitt says. "This is one of several steps the Trump administration has taken to undermine the ACA."

Levitt says the administration's announcement was "a little perplexing," given that the legal fight over the conflicting rulings in New Mexico and Massachusetts is still ongoing.

"Normally you would expect an administration to look for ways to minimize the uncertainty and minimize the effect as these cases play out," he says. "So it seems like an extreme step to halt this program nationally based on a decision by one district court judge."

But to Rodney Whitlock, Vice President of Health Policy at ML Strategies and former Republican congressional aide, it's not perplexing at all.

"What you have to keep in mind is ultimately the intent of the administration," Whitlock says. "The executive order the president signed, not long after he got to the White House after the [Inaugural] Parade was effectively, 'We're declaring war on the Affordable Care Act.'" Whitlock says, the goal has been to make the marketplace as inhospitable as possible for participating plans, and this is just one more step in that direction.

Indeed, a series of actions by the administration have undermined the ACA. Last month the Department of Justice decided not to defend the law in a court challenge in Texas, jeopardizing the part of the law that protects people with pre-existing conditions from being denied coverage, as NPR reported. Last year, the administration halted important subsidies for insurers.

"They can't just say, 'Well, we're new, we don't like what the previous guys did, so we're going to do something different,'" Whitlock says. The administration has to have a legal justification for their actions.

The pro-ACA group Protect Our Care issued a statement from its executive director, Brad Woodhouse, Saturday after the administration announced its decision regarding risk penalty payments, characterizing the move as further chipping away at the Affordable Care Act.

"The Trump administration just keeps pushing their destructive repeal-and-sabotage agenda, no matter the cost to the American people," the statement reads. "Following through with this latest act of sabotage could raise rates for all consumers even more - on top of the rate hikes they have already caused - and is without a doubt an escalation in the Trump administration's war on people with pre-existing conditions."

The administration is taking legal steps to challenge the ruling in New Mexico, says Levitt. But, he adds that there's "something of a pattern now of the Trump administration using legal cases as hooks to undermine the ACA."

"I think insurers are going to be watching very closely what the administration says in court, and whether this is a sign of further steps to undermine the law, or a good faith effort to try to comply with the judge's order," he says.

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Trump Administration Freezes Payments Required By The Affordable Care Act

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The Trump administration said Saturday that it is temporarily halting billions of dollars of payments designed to help insurers meet the Affordable Care Act requirement that they provide coverage regardless of whether a person is healthy or sick.

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Joshua W. Morrison - Environmental Health - July 7, 2018

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Joshua W. Morrison - Environmental Health - July 7, 2018

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The High Costs of Not Reaching Out Climate Change Goals

This article discusses researchers' attempts to estimate the economic impact of exceeding the UN's recommended for a global temperature increase. The UN recommends keeping the global temperature increase below two degrees celsius. These researchers estimate that exceeding this increase could cost the global economy $14 trillion annually by 2100.

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Failure to meet the United Nations' 2ºC warming limits will lead to sea level rise and dire global economic consequences, new research has warned.

Published today in Environmental Research Letters, a study led by the UK National Oceanographic Centre (NOC) found flooding from rising sea levels could cost $14 trillion worldwide annually by 2100, if the target of holding global temperatures below 2ºC above pre-industrial levels is missed.

The researchers also found that upper-middle income countries such as China would see the largest increase in flood costs, whereas the highest income countries would suffer the least, thanks to existing high levels of protection infrastructure.

Dr Svetlana Jevrejeva, from the NOC, is the study's lead author. She said: "More than 600 million people live in low-elevation coastal areas, less than 10 meters above sea level. In a warming climate, global sea level will rise due to melting of land-based glaciers and ice sheets, and from the thermal expansion of ocean waters. So, sea level rise is one of the most damaging aspects of our warming climate."

Sea level projections exist for emissions scenarios and socio-economic scenarios. However, there are no scenarios covering limiting warming below the 2°C and 1.5°C targets during the entire 21st century and beyond.

The study team explored the pace and consequences of global and regional sea level rise with restricted warming of 1.5 ºC and 2 ºC, and compared them to sea level projections with unmitigated warming following emissions scenario Representative Concentration Pathway (RCP) 8.5.

Using World Bank income groups (high, upper middle, lower middle and low income countries), they then assessed the impact of sea level rise in coastal areas from a global perspective, and for some individual countries using the Dynamic Interactive Vulnerability Assessment modelling framework.

Dr Jevrejeva said: "We found that with a temperature rise trajectory of 1.5°C, by 2100 the median sea level will have risen by 0.52m (1.7ft). But, if the 2°C target is missed, we will see a median sea level rise of 0.86m (2.8ft), and a worst-case rise of 1.8m (5.9ft).

"If warming is not mitigated and follows the RCP8.5 sea level rise projections, the global annual flood costs without adaptation will increase to $14 trillion per year for a median sea level rise of 0.86m, and up to $27 trillion per year for 1.8m. This would account for 2.8 per cent of global GDP in 2100."

The projected difference in coastal sea levels is also likely to mean tropical areas will see extreme sea levels more often.

"These extreme sea levels will have a negative effect on the economies of developing coastal nations, and the habitability of low-lying coastlines," said Dr Jevrejeva. "Small, low-lying island nations such as the Maldives will be very easily affected, and the pressures on their natural resources and environmental will become even greater.

"These results place further emphasis on putting even greater efforts into mitigating rising global temperatures."

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global warming; floods; climate; oceanography; resource shortage; ocean policy; environmental policies; poverty and learning

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Rising sea levels could cost the world $14 trillion a year by 2100

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Failure to meet the United Nations' 2ºC warming limits will lead to sea level rise and dire global economic consequences, new research has warned. A study found flooding from rising sea levels could cost $14 trillion worldwide annually by 2100, if the target of holding global temperatures below 2ºC above pre-industrial levels is missed.

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This article discusses how there is a lack of mental health care for minority populations. There are many challenges in trying to get the care for mental health that many minority populations require since there is a lack of care even though they are more at risk for such diseases. The plan to resolve this issue involves resolving the stigma around mental health and funding research on improving minority health care.

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As physicians, we care for patients with acute and chronic diseases every day, doing whatever we can to help them achieve the best health outcomes possible and live long, productive lives. But as leaders of the two largest physician organizations dedicated to health advocacy for racial minority populations in the United States , we know that far too many of the patients our members treat will have less access to the care they need, and see poorer outcomes, than non-minorities.

We see these disparities across all conditions, but one of our greatest challenges is in helping patients in minority communities live with serious mental illness. One in six U.S. adults has an illness like depression, bipolar disorder, or anxiety disorder, but African Americans are 10 percent more likely , and Latinos 40 percent more likely, to experience serious psychological distress than non-Hispanic whites. And those minority populations are only half as likely to receive needed treatment or counseling as non-Hispanic whites. Statistics are even worse for American Indians and Alaska Natives.

Compounding this problem, p eople with serious mental illnesses die on average 10 to 20 years earlier than others. A primary reason for this is preventable medical conditions, like those linked to obesity and smoking. People with serious mental illnesses often don't get the care they need to address these comorbid conditions, making a difficult situation far worse.

So how do we make a dent in these discouraging statistics? It will require a multi-pronged approach.

We must urgently address the stigma associated with mental illness, still taboo in minority communities. We can do this with more funding for culturally and linguistically appropriate educational programs, including in our schools, awareness campaigns, preventive care, and treatment and support services, including those delivered through the community health centers so vital to many in minority communities.

We need to invest more in research specifically focused on improving minority mental health care and outcomes. This includes ensuring that relevant clinical trials are accessible to our communities, which isn't always the case. And it means supporting the kind of studies that engage patients and others in our communities from start to finish. This makes it more likely researchers will ask the right questions, focus on outcomes that matter most to patients, and produce useful results that can help them make better health care decisions. This is especially important in studies looking at improving care and outcomes for people living both with mental illness and other chronic physical conditions.

These are no small challenges, but we're optimistic that there is broad public support for dealing with these issues aggressively. A recent survey commissioned by Research!America , for example, found 74 percent of respondents said it was either very or somewhat important for the federal government to fund research on social determinants of health - things like education, housing, income, access to healthy food and health care - to address health disparities. And 73 percent said it was very or somewhat important to conduct research to address the disproportionate impact many serious health problems - such as diabetes, heart disease, and infant mortality - have among minorities or people with lower incomes.

To provide leadership for these efforts, our organizations recently joined with three others: the Association of American Indian Physicians, Association of Black Cardiologists, and National Council of Asian Pacific Islander Physicians, to The Minority Physicians' Alliance.

Each of our organizations will continue to work in our own capacities as we always have, because we know it will take expert attention for each under-served community to achieve health equity - but it will also require collective expertise and the reduction of existing siloes. We will continue to home in on issues that cross over our communities in order to maximize impact. We can't do it all, but we welcome all physicians and health care providers to further this mission by amplifying our collective voice.
Dr. Elena Rios is president and CEO of the National Hispanic Medical Association. Dr. Doris Browne is president of the National Medical Association.

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To improve minority mental health, research must put patients first

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As physicians, we care for patients with acute and chronic diseases every day, doing whatever we can to help them achieve the best health outcomes possible and live long, productive lives.

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Researchers are hoping to use the compounds that are found in flea and tick medicines for dogs and cats on humans. Their hope is that during times when mosquitos are transmitting extremely harmful diseases, such as Zika, humans can take these drugs to reduce the rate of infection.

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TUESDAY, July 3, 2018 -- Medicines that protect pets from fleas and ticks may help lower people's risk of mosquito-borne diseases such as Zika, researchers report.

"Insect-borne infectious diseases remain primary causes of severe illnesses and fatalities worldwide, and new approaches to preventing outbreaks of these diseases are critically needed," said researcher Peter Schultz, chief executive officer of Calibr and Scripps Research Institute.

Through experiments with mosquitoes and computer modeling, the investigators found that drugs called isoxazolines -- used in veterinary products to defend pets from fleas and ticks -- also kill species of disease-carrying mosquitoes that feed on human blood.

Examples of isoxazolines include fluralaner (Bravecto) and afoxolaner (NexGard), which are marketed for dogs and cats.

The researchers concluded that giving isoxazoline drugs to less than a third of people in regions where there are seasonal outbreaks of insect-borne diseases could prevent up to 97 percent of all infections.

The researchers explained that this is not a vaccine. A person taking the drug could still get infected by a bite. But the insect would die before transmitting the disease to others, thus limiting spread of the infection.

"Our findings suggest that isoxazolines might be effective at controlling outbreaks of diseases carried by mosquitoes and other insects in regions with limited medical infrastructure," Schultz said in a Scripps news release.

The study, published July 2 in the Proceedings of the National Academy of Sciences, was led by scientists at Calibr, a nonprofit drug discovery institute associated with Scripps Research Institute and TropIQ Health Sciences, a Dutch social enterprise.

"Research on insect-borne diseases has predominantly focused on control of insect populations through use of insecticides and prevention of bites through distribution of bed nets, but these approaches have not been fully effective in controlling outbreaks," said Koen Dechering, CEO of TropIQ Health Sciences.

Also, "vaccines are largely lacking for most diseases and drugs to treat people who have contracted the disease are losing efficacy because of emerging resistance," Dechering said.

Schultz and his team added that more research is needed to test the safety and the effectiveness of isoxazolines in humans.

More information

The World Health Organization has more on mosquito-borne diseases.

Copyright © 2018 HealthDay. All rights reserved.

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Flea fighters may stem spread of diseases like Zika

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TUESDAY, July 3, 2018 -- Medicines that protect pets from fleas and ticks may help lower people's risk of mosquito-borne diseases such as Zika, researchers report. "Insect-borne infectious diseases remain primary causes of severe illnesses and fatalities worldwide, and new approaches to preventing outbreaks of these diseases are critically needed," said researcher Peter Schultz, chief executive officer of Calibr and Scripps Research Institute.

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Race/Class/Gender/Society
This is a RadioLab episode which discusses the implications and possibilities in using race as a diagnostic tool. Following the first drug approved for a specific race, BiDil; this topic certainly has many dangers and pit falls that could occur. This is a relevant podcast which looks at an issue which may become more prominent in the near future.

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Race and Medicine | Radiolab | WNYC Studios

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BiDil was the first drug approved by the FDA for a specific racial group. We want to know what the ramifications are for using skin color as a diagnostic tool for diseases and disorders that can't be seen. Producer Soren Wheeler talks to Dr. Jay Cohn, developer of BiDil and cardiac specialist.

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The civil war in South Sudan reached a cease-fire agreement on Saturday but was violated just hours after it was signed. This was a glimmer of hope in a dire situation where many of the poorest citizens are facing famine, disease, and economic disparity. The hope is that the cease-fire will be a message that humanitarian assistance will not be interrupted to these individuals as they are most susceptible to changes in their environment.

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U.N. aid chief Mark Lowcock told reporters in Geneva last month that the level of suffering in South Sudan is "on an unimaginable scale" and getting worse.

And U.S. Ambassador to the United Nations Nikki Haley wrote in an op-ed for The Washington Post that the country's leaders have "failed" the children of South Sudan.

Last week, there were signs of hope for a better future in the world's newest nation. The president of South Sudan and his former vice president signed a cease-fire in the civil war that has ravaged the country for nearly five years.

The cease-fire went into effect last Saturday. Within hours, it had already been violated.

But aid organizations are hoping that one part of the cease-fire will remain intact: providing humanitarian access to the suffering people of South Sudan.

Near-famine levels of hunger have already swept across large portions of the country and, with the onset of the rainy season, life-saving aid is becoming extremely costly to deliver.

Health workers are also bracing for an uptick in water-related illnesses, like cholera, malaria and diarrhea, which can be especially deadly when people are malnourished.

About 63 percent of the population (more than 7 million people) is "severely hungry," according to the World Food Program (WFP). Just under 2 million people have been forced to flee their homes and are internally displaced within the country, while another 2.5 million have fled to neighboring countries as refugees.

South Sudan is now the largest producer of refugees on the continent and the third largest in the world, after Syria and Afghanistan, according to the UN refugee agency. About 65 percent of the refugees are under the age of 18.

In addition, aid workers are being abducted and killed, while 19,000 children are estimated to serve in armed forces and groups in a conflict that began when President Salva Kiir Mayardit accused his then-deputy Riek Machar of plotting a coup in December 2013. What began as a political dispute quickly took on ethnic undertones between Kiir's Dinka - the country's ethnic majority - and Machar's Nuer, the second-largest ethnic group.

Even before gaining independence in 2011, the people of South Sudan had suffered through decades of another devastating civil war.

"I think it's worth noting that Oxfam's worked in [the area that is now] South Sudan for more than three decades," said Noah Gottschalk, Oxfam's humanitarian policy lead in D.C. "No one's ever seen it as bad as it is now. And I think that's saying an enormous amount. People who've lived through war and displacement and the deaths of close relatives are now finding themselves in an even worse situation than in the past."

In Pibor, for example - a county in the eastern part of the country - the Famine Early Warning Network (FEWSNET) reported in April that even though the official hunger level is "emergency," more than 20 percent of households could be classed as hitting famine levels. The situation in Pibor is so dire that, according to the the U.K.-based Oxfam, some people are eating grasses and weeds out of desperation, although they are not safe for consumption and are making them sick.

Even in other areas that are facing less severe levels of hunger, people are beginning to exhaust their usual coping mechanisms. They're having to sell household assets, like cattle and goats, according to Oxfam, while children roam the streets in search of food, Reuters has reported.

"People in South Sudan are incredibly resilient and incredibly strong," Gottschalk told NPR. "But they're being stretched further than ever before."

According to Gottschalk, the current crisis is the culmination of many negative trends.

"It's quite a complicated situation," said Chris McElhinney, the country director in South Sudan for Irish charity GOAL Global. "What we're seeing is a continued deterioration of the humanitarian requirements in the country and the needs that people face."

As is often the case, crises beget crises - and in South Sudan, the civil war catalyzed an economic collapse. By 2017, oil production - which makes up more than 99 percent of the country's export revenue and about 60 percent of its gross domestic product (GDP) - had dropped to half its pre-war levels. According to the World Bank, GDP per capita fell from $1,111 in 2014 to less than $200 last year. In response to the fiscal deficit, the government printed more banknotes and, unsurprisingly, inflation soared.

At its highest, in September 2016, year-on-year inflation was 550 percent, according to the National Bureau of Statistics. By September 2017, it had lowered to 102 percent. But inflation continues to perpetuate the hunger crisis, as prices rise and the value of the South Sudanese pound drops. Last year, the WFP estimated that a bowl of bean stew that costs a New Yorker $1, would cost a South Sudanese $321.

To fight the hyperinflation, the government last year decided to increase work permit fees for aid workers from $100 to $10,000.

On top of that, South Sudan is one of the most dangerous places in the world to be an aid worker. More than 100 aid workers, mostly South Sudanese, have been killed since the war began.

According to the FEWSNET report, the only thing keeping some areas of the country from hitting a more severe hunger level is humanitarian assistance. But now that the rainy season has begun, not only are people running out of their harvested reserves, but roads to more than half the country, the lifeline for aid, could become inaccessible. This means that air drops are often the only means of delivery. It's a solution, but an expensive one.

In order to prevent South Sudan in 2018 from being worse than 2017 - when famine was officially declared in two Counties - the U.N.'s humanitarian response plan is calling for $1.72 billion.

"It's a staggering amount of money," McElhinney said.

Last year's humanitarian response plan raised $1.17 billion of the $1.6 billion it asked for. So far for 2018, donor countries, organizations and individuals - including the U.S., U.N. agencies and the World Bank - have contributed $706 million (just over 40 percent of what's needed). Objectively, that is a lot of money - just not nearly enough for the immense needs in South Sudan.

Especially for South Sudan's children, whose health, development and safety are being impacted the most, education is critical. A UNICEF report in December estimated that three out of four children are not in schools.

"Often we think about food, water, shelter as the things that people need to survive," Gottschalk said. "But for a country to survive, education is needed as well."

Joanne Lu is a freelance journalist who covers global poverty and inequity. Her work has appeared in Humanosphere, The Guardian, Global Washington and War is Boring. Follow her on Twitter .

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'Unimaginable' Suffering In South Sudan. Is There Any Hope?

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U.N. aid chief Mark Lowcock told reporters in Geneva last month that the level of suffering in South Sudan is "on an unimaginable scale" and getting worse. And U.S. Ambassador to the United Nations Nikki Haley wrote in an op-ed for The Washington Post that the country's leaders have "failed" the children of South Sudan.

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Hadley Kelly- July 11, 2018Mental/Social/Emotional/Behavioral Health 

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Hadley Kelly- July 11, 2018Mental/Social/Emotional/Behavioral Health 

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TED Talk host, Guy Winch questions, “why don’t we see a health professional when we feel emotional pain: guilt, loss, loneliness?” Winch identifies the need in practicing, “emotional hygiene” by taking our emotional pain as serious as physical pain. He continues to note the importance to take the time to check in with one’s self and to be more aware of our emotional state.

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Why we all need to practice emotional first aid

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We’ll go to the doctor when we feel flu-ish or a nagging pain. So why don’t we see a health professional when we feel emotional pain: guilt, loss, loneliness? Too many of us deal with common psychological-health issues on our own, says Guy Winch. But we don’t have to. He makes a compelling case to practice emotional hygiene — taking care of our emotions, our minds, with the same diligence we take care of our bodies.

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Race/Class/Gender/Society
In this Ted Talk David Williams talks about one of the pitfalls and dangers of racism. He talks about how his scale to measure the affect of discrimination looks past income and education. The discussion on factors such as implicit bias, residential segregation and negative stereotypes sustain health disparities.

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Why does race matter so profoundly for health? David R. Williams developed a scale to measure the impact of discrimination on well-being, going beyond traditional measures like income and education to reveal how factors like implicit bias, residential segregation and negative stereotypes create and sustain inequality. In this eye-opening talk, Williams presents evidence for how racism is producing a rigged system -- and offers hopeful examples of programs across the US that are working to dismantle discrimination.

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What happens inside the brain of a gambling addict when they make a bet - and can the secret to their addiction be found within the brain itself? BBC Panorama filmed a unique experiment designed to find out. Wendy Bendel's partner killed himself after struggling with a 20-year gambling addiction. In a confession he wrote for Wendy he singled out the high-stakes, high-frequency fixed-odds betting terminals (FOBTs) found in bookmakers across the UK. These machines offer gamblers a choice of games, and combine potentially high stakes with the chance of a win every 20 seconds.

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Inside the brain of a gambling addict - BBC News

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Infectious/Communicable Disease.
Measles outbreak endangers isolated Amazonian tribe. According to the Brazilian Ministry of Health, Venezuelans crossing the border have brought measles into Brazil. All 995 reported measles cases were in the border states of Amazonas and Roraima.

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measles outbreak threatens isolated amazonian tribe - cnn

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Measles outbreak threatens isolated Amazonian tribe

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A measles outbreak has hit an isolated Amazonian tribe, the Yanomami, on the border of Venezuela and Brazil, hospitalizing 23 tribe members and threatening hundreds more.

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This article notes the implications of Trump's decision to withdraw the US from the Paris agreement. In addition to not helping a united global front on reducing carbon emissions, the decision means that the Paris agreement will be underfunded as the US had agreed to provide money for poor countries in need of climate assistance. Without the US contribution (about a third of overall funding) , the program is scrambling to financially back it's promises.

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Donald Trump's decision to withdraw the US from the Paris agreement has created serious problems for global efforts to tackle climate change, Ban Ki-moon has said.

The former UN secretary general said Trump's move was politically damaging to international action to limit carbon emissions and had created difficulties in delivering financial aid from richer to poorer countries to help the latter cope with a warming world.

"United States is a big problem now. I think the United States' decision to withdraw from this Paris agreement really creates a serious problem," Ban said in an interview with the Guardian.

"They [the Trump administration] have given serious damage to the political side. All the countries are very serious and concerned about this [the US declaring its withdrawal from the climate deal]."

Although Trump indicated in a recent interview that the US may not leave the global accord, Ban said the remarks were not clear. He said the apparent shift in position may have been the result of lobbying from European leaders such as the French president, Emmanuel Macron.

Ban said he hoped Trump would take better advice. "What President Trump has been saying is politically shortsighted and scientifically based on wrong advice; I don't know who advised him," he said.

While Europe has been seen as a champion of global climate talks and international efforts to rein in temperature rises, Ban said he was worried this role could be put at risk by political strife.

"I am concerned because of the divisions that are now happening within the EU, not to mention this Brexit, and political difficulties and issues such as refugees," he said.

He said he hoped Macron and Angela Merkel would take on a leadership role and he had pressed the French president on the issue during an hour-long meeting in December.

Ban said Britain had a duty to keep up action on climate change despite Brexit. "They [the UK government] still have a political and moral responsibility on this issue," he said.

The US saying it would withdraw from the Paris agreement had imperilled the $100bn-a-year of climate aid the world's richest countries have pledged to the poorest by 2020, Ban said.

"Without the US, we have a lot of difficulties, particularly mobilising financing," he said, adding that he was particularly concerned about the one-third of funding the US would normally provide to committees administering billions of dollars in climate money.

"Who will make up all this losses which will not be paid by the US? That's a serious problem now," he said.

He said the private sector may have to play a greater role than previously envisaged, and he was working with the World Bank president, Jim Yong Kim, the former UN secretary general Kofi Annan and the former UN climate chief Christiana Figueres to address the challenge.

Despite these setbacks to climate action, Ban said he was encouraged that China was still fully committed to reducing emissions. "President Xi Jinping clearly mentioned that China is fully onboard, understanding that the climate is changing," Ban said of a meeting with the Chinese leader in November.

Another promising sign was the We Are Still In campaign, a group of US cities, states and businesses that have pledged to stick to the Paris targets regardless of Trump. "This is a groundswell of people," Ban said.

He said he would dedicate his life beyond the UN to continuing climate change advocacy.

Despite the US's backtracking, Ban said he remained confident the world could meet the target of limiting temperature increases to less than 2C above pre-industrial levels, and the aspiration to keep them under 1.5C. "I am quite optimistic we will make it happen," he said.

Ban was recently appointed president of the Seoul-based Global Green Growth Institute, which he hopes to expand beyond its 28 member countries.
Topics

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Ban Ki-moon: US has caused serious damage to Paris climate efforts

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Donald Trump's decision to withdraw the US from the Paris agreement has created serious problems for global efforts to tackle climate change, Ban Ki-moon has said. The former UN secretary general said Trump's move was politically damaging to international action to limit carbon emissions and had created difficulties in delivering financial aid from richer to poorer countries to help the latter cope with a warming world.

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July 13
Race/class/gender/society
I have already posted this week but I came across his article and wanted to share it. This article titled “what if the government gave everyone a paycheck?” Was published in the New York Times this week. It looks into the idea of universal income and the impact it would have on poverty. In the US a basic income of $1000 monthly would eliminate poverty in the country for over 41 MILLION Americans.

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Nonfiction

GIVE PEOPLE MONEY
How a Universal Basic Income Would End Poverty, Revolutionize Work, and Remake the World
By Annie Lowrey
263 pp. Crown. $26.

THE WAR ON NORMAL PEOPLE
The Truth About America's Disappearing Jobs and Why Universal Basic Income Is Our Future
By Andrew Yang
284 pp. Hachette Books. $28.

If climate change, nuclear standoffs, Russian trolls, terrorist threats and Donald Trump in the White House don't cause you feelings of impending doom, you might think about artificial intelligence. I'm not just referring to big-brained robots taking over civilization from us smaller-brained humans, but the more imminent possibility they'll take over our jobs.

It's already happening. Robots and related forms of artificial intelligence are rapidly supplanting what remain of factory workers, call-center operators and clerical staff. Amazon and other online platforms are booting out retail workers. We'll soon be saying goodbye to truck drivers, warehouse personnel and professionals who do whatever can be replicated, including pharmacists, accountants, attorneys, diagnosticians, translators and financial advisers. Machines may soon do a better job than doctors at scanning for cancer.

This doesn't mean a future without jobs, as some doomsayers predict. But robots will almost certainly push down wages in all the remaining human-touch jobs (child care, elder care, home health care, personal coaches, sales and so on) that robots can't do because they're not, well, human. Even today, with technology having already displaced many workers, there's no jobs crisis. The official rate of unemployment is at a remarkably low 3.8 percent. Instead, we have a good jobs crisis. The official rate hides millions of people working part time who would rather have full-time jobs, along with millions more who are too discouraged to look for work (many ending up on disability), college grads overqualified for their jobs and a growing army of contingent workers with zero job security. Blanketing all are stagnant or declining wages and vanishing job benefits. Today's typical American worker earns around $44,500 a year, not much more than what the typical worker earned in 1979, adjusted for inflation. Nearly 80 percent of adult Americans say they live from paycheck to paycheck, many not knowing how big their next paycheck will be.

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Advancing technologies aren't the only cause of this predicament, but notwithstanding Trump's claim to the contrary, technology is a bigger culprit than trade. The economy keeps growing yet most economic gains are going to a few - largely financiers and, increasingly, inventors and owners of the digitized devices that are replacing good jobs. Our economic system isn't designed for this. If the trend continues, it's unclear who will even earn enough to buy all the future robots.

Economic change on this scale doesn't happen without something cracking. The shift from farm to factory featured decades of bloody labor conflict; the move from factory to office and other sedentary jobs caused more upheaval. What will happen when robots push most people out of steady work and into lower-wage gig jobs? I doubt we'll see a revolution. A more likely scenario is a slow slouch toward authoritarianism and xenophobia. We may already be there.

What's the answer? Here in the Bay Area where I live, where inventors and engineers are busily digitizing everything, many civic and business leaders are touting something called a universal basic income, or U.B.I. It's universal in the sense that everyone would receive it, basic in that it would be just enough to live on and cash income rather than voucher-based, like food stamps or Section 8 housing. To the rest of America, a U.B.I. may seem like a pipe dream, but from my vantage point some form of it seems inevitable.

Several recent books have provided good background briefings for what a U.B.I. could be, including those by the labor leader Andy Stern, the Facebook co-founder Chris Hughes and the Belgian academics Philippe Van Parijs and Yannick Vanderborght. To these offerings, Andrew Yang, an entrepreneur, adds his own, somewhat breathless version in "The War on Normal People." Annie Lowrey, a contributing editor for The Atlantic, provides a similarly upbeat, although more measured, assessment in "Give People Money. " Both are useful primers on the case for a U.B.I.

The two books cover so much of the same terrain that I'm tempted to wonder whether they were written by the same robot, programmed for slightly different levels of giddy enthusiasm. Both cite Martin Luther King Jr., Richard Nixon and Milton Friedman as early supporters of a U.B.I. Both urge that a U.B.I. be set at $1,000 a month for every American. Both point out that with poverty currently defined as an income for a single adult of less than $12,000 a year, such a U.B.I. would, by definition, eliminate poverty for the 41 million Americans now living below the poverty line. It would also improve the bargaining power of millions of low-wage workers - forcing employers to increase wages, add benefits and improve conditions in order to retain them. If a U.B.I. replaced specific programs for the poor, it would also reduce government bureaucracy, minimize government interference in citizens' lives and allow people to avoid the stigma that often accompanies government assistance. By virtue of being available to all, a U.B.I. would not only guarantee the material existence of everyone in a society; it would establish a baseline for what membership in that society means.

U.B.I.'s critics understandably worry that it would spur millions to drop out of the labor force, induce laziness or at least rob people of the structure and meaning work provides. Both Yang and Lowrey muster substantial research to rebut these claims. I'm not sure they need it. After all, $12,000 a year doesn't deliver a comfortable life even in the lowest-cost precincts of America, so there would still be plenty of incentive to work. Most of today's jobs provide very little by way of fulfillment or creativity anyway.

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A U.B.I. might give recipients a bit more time to pursue socially beneficial activities, like helping the elderly or attending to kids with special needs or perhaps even starting a new business. Yang suggests it would spur a system of "social credits" in which people trade their spare time by performing various helpful tasks for one another. (I.R.S. be warned.) Surely a U.B.I. would help compensate many people - especially women - for the unpaid labor they already contribute. As Lowrey points out, some 40 million family caregivers in America provide half a trillion dollars of unpaid adult care annually. Child care has become so expensive that one of every three stay-at-home mothers today lives below the poverty line (compared with 14 percent in 1970).

But how could America possibly afford a U.B.I.? A $1,000-a-month grant to every American would cost about $3.9 trillion a year. That's about $1.3 trillion on top of existing welfare programs - roughly the equivalent of the entire federal budget, or about a fifth of the entire United States economy. Both Yang and Lowrey come up with laundry lists of potential funding sources - from soaking the rich (raising the top tax bracket to 55 percent, enlarging the estate tax and implementing new taxes on wealth, financial transactions and perhaps even the owners of the robots and related devices that are displacing jobs), to instituting a carbon tax or a value-added tax.

Whatever the source of funds, it seems a safe bet that increased automation will allow the economy to continue to grow, making a U.B.I. more affordable. A U.B.I. would itself generate more consumer spending, stimulating additional economic activity. And less poverty would mean less crime, incarceration and other social costs associated with deprivation. "You know what's really expensive?" Yang asks. "Dysfunction. Revolution."

If these measures still aren't enough to foot the bill, Lowrey suggests making a U.B.I. less universal by taxing away U.B.I. payments to high-income earners and reducing other forms of social insurance (for example, eliminating food stamps and welfare programs). As a last resort, she writes, a U.B.I. could be implemented as a kind of negative income tax, by which government simply ensures that every person or household has a certain minimum yearly income. This is what Richard Nixon and Milton Friedman had in mind. Lowrey figures that the cost of such a guarantee would approximate the current total costs of the earned-income tax credit, supplemental security income, housing assistance, food stamps and school lunches. She notes that the simplest way to achieve this would be to transform existing antipoverty programs into unconditional cash transfers.

But there's a logical flaw in her argument. Once a U.B.I. is no longer universal or even basic (what if the poor are worse off when other forms of assistance are stripped away?), it's hard to see the point of having it in the first place. More troubling is Lowrey's blurring of the distinction between a U.B.I. that redistributes resources from the superrich to the growing number of vulnerable lower-income Americans and one that merely turns programs for the poor into cash assistance. The latter may be warranted, but it wouldn't touch America's growing scourge of inequality and economic insecurity, which will be made worse as robots take over good jobs.

A core challenge in the future will be how to redistribute money from the ever richer owners of the robots and related technologies to the rest of us, who are otherwise likely to become poorer and less secure. This is not just an economic challenge but also a political one. As we know from recent history, vast fortunes translate directly into political power, and such power effectively resists redistribution. Sadly, neither of these authors discusses how to deal with this paradox.

A world inhabited only by robots, their billionaire owners and a large and increasingly restive population is the plotline for countless dystopian fantasies, but it's a reality that appears to be drawing closer. If we continue on the path we're on, we will need to make fundamental choices about how to support human livelihoods and ensure equal participation in our economy and society. Most basically, we will have to confront the realities of vastly unequal economic and political power. Even if we manage to enact a U.B.I., it will not be nearly enough.

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What if the Government Gave Everyone a Paycheck?

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Nonfiction GIVE PEOPLE MONEY How a Universal Basic Income Would End Poverty, Revolutionize Work, and Remake the World By Annie Lowrey 263 pp. Crown. $26. THE WAR ON NORMAL PEOPLE The Truth About America's Disappearing Jobs and Why Universal Basic Income Is Our Future By Andrew Yang 284 pp. Hachette Books.