Latest news with #YaleSchoolofPublicHealth
Economist
6 days ago
- Health
- Economist
Quantifying Trumpcare
JUST READING the Big Beautiful Bill, with its 330 pages of provisions, is an intimidating undertaking. Working out its consequences is yet more challenging. Nevertheless, researchers at the University of Pennsylvania and the Yale School of Public Health tried to calculate how many more people would die as a result of the law. Analysing the House of Representatives' version of the bill, they came to 42,500 annually by 2034. That is more people than currently die of breast cancer. Adding in the impact of the end of the enhanced subsidies for people buying their own insurance, they reckoned there would be over 51,000 extra deaths a year. The White House has pushed back on the claims of deaths, calling them 'egregious' and 'deranged'.
Yahoo
24-06-2025
- Health
- Yahoo
New study reveals disturbing effects of wildfire smoke on humans: 'Drives home how far-reaching the impacts are'
A new study detailed by The Associated Press revealed that wildfire smoke caused about 15,000 premature deaths in the U.S. over 15 years, with the greatest impact on communities already facing systemic disadvantages. Researchers found that short-term exposure to fine particulate matter from wildfire smoke — the same type that tinted skies orange in major U.S. cities last year — contributed to roughly 15,000 excess deaths from 2006 to 2020. The study, published in the journal Communications Earth & Environment, emphasized that these totals may be underestimated, as wildfires are growing more frequent and intense due to rising global temperatures. "These numbers are really significant," professor Jacob Bendix of Syracuse University said, per The Guardian. "This study drives home how far-reaching the impacts are." While various states experienced these health burdens, the worst outcomes occurred in wildfire-prone areas with lower-income communities that have limited access to clean indoor air, health care, or evacuation resources. Researchers from the Yale School of Public Health found that chronic smoke exposure was linked to long-term health declines and rising mortality rates. The fine particles from wildfires can penetrate deep into the lungs and enter the bloodstream, with effects that last long after fires are extinguished. These issues point to a bigger crisis in the management of air quality. More forests are drying out each year, and fire seasons are stretching longer, meaning more people are exposed to hazardous air for longer periods. This also applies to areas not typically affected by wildfires. Efforts to reduce the risks of wildfire smoke include forest management legislation, investment in early fire detection, funding for clean air shelters, and other steps to reduce greenhouse gases. On a personal level, individuals can install air purifiers, apply seals to windows, and advocate for better emergency planning in their area. Raising awareness about the impact of wildfire smoke and other critical issues is also key to mitigating future problems. Do you worry about air pollution in and around your home? Yes — always Yes — often Yes — sometimes No — never Click your choice to see results and speak your mind. Join our free newsletter for weekly updates on the latest innovations improving our lives and shaping our future, and don't miss this cool list of easy ways to help yourself while helping the planet.
Medscape
18-06-2025
- Health
- Medscape
Heat, Poor Air Quality Ups Heart Attack Risk
Simultaneous exposure to ozone pollution and high temperatures significantly increases the risk for acute myocardial infarction (MI) among adults in the US, according to a recent study published in Circulation . The findings highlight the dangers of joint environmental stressors even at moderate levels and the importance of timely patient counseling. Using nationwide private insurance claims data from 2016 to 2020, researchers from Yale School of Public Health, New Haven, Connecticut, and collaborators identified 270,123 cases of acute MI in people aged 18-64 years. They found joint exposure to ground-level ozone (60 ppb) and high temperatures — roughly 90-95 °F — increased the risk for an MI by 33% compared to cooler, low-ozone days. Even under moderate conditions, such as an ozone count of 50 ppb and typical temperatures around 70 °F, the risk increased by 15%. 'The lag 0f effect means clinicians need to pay close attention to high-pollution and hot days in real time,' said Lingzhi Chu, PhD, a postdoctoral associate in the Department of Environmental Health Sciences at the Yale School of Public Health and colead author of the study 'Clinicians should emphasize to younger patients that moderate levels still pose risks' to cardiovascular health. Mary Johnson, PhD, a principal research scientist of environmental health at the Harvard T.H. Chan School of Public Health in Boston, said the findings bring much-needed attention to a younger demographic. 'This study is important because it focuses on a younger age group that is often overlooked in cardiovascular research,' said Johnson, who was not involved in the study. 'Typically, you don't think about heart attacks happening in people in the young adult category.' Johnson also noted the value of examining heat and ozone together. 'We've seen studies showing impacts from temperature and from ozone individually,' she said, 'but looking at them together, and especially looking at differences between men and women, is important.' Different Risks by Sex According to the study, women showed increased vulnerability on days with both high ozone and temperatures around 90-95 degrees, while men experienced heightened risk even when only one factor was elevated. The difference in exposure-response patterns by sex was statistically significant ( P = .016). Chu said clinicians should tailor counseling based on patient demographics. 'The sex difference that males are vulnerable to mild exposures is critical,' Chu said. 'Young men need targeted proactive counselling.' While the researchers did not assess comorbidities like hypertension or diabetes, Chu acknowledged these conditions could affect risk. 'The potential pathophysiology suggests hypertension, diabetes, or obesity may compound risks, but further research is warranted,' Chu said. Johnson said these findings should challenge assumptions in primary care because these clinicians often are the first to encounter patients of the age group studied. 'Just because you're young and healthy does not necessarily rule out the risk of a cardiac event,' she said. 'Especially if there's a combination of poor air quality and elevated temperature.' Communicating Practical Prevention Acute MI is a leading cause of morbidity and mortality globally, with approximately 800,000 cases annually in the US. Adults younger than 55 years, and particularly women, account for a growing share of acute MIs. Chu recommended several practical prevention strategies clinicians can share with patients: Adjusting the timing of outdoor activities, staying hydrated, and using cooling methods such as fans or air conditioning. She also acknowledged the challenge clinicians face in educating patients without overwhelming them. 'Clinicians may consider framing mitigation as simple behavior changes rather than drastic life changes to prevent patient overwhelm,' she said. 'Some of these simple changes — like checking air quality apps, closing windows on high-ozone days, or staying hydrated — support overall health, not just cardiovascular health.' Johnson agreed. 'While we can't individually control wildfires or ozone formation, everyone can be aware of ozone levels and temperature before going outside or doing anything physically strenuous,' she said. Health Equity Concern The study relied on data from individuals with private insurance, a limitation both Chu and Johnson acknowledged. 'That population has access to care,' Johnson said. 'But what about the uninsured or underinsured? They may be more at risk because they often live in areas with worse air quality and lack resources to adapt, like access to cooling systems or healthcare.' She added that events like sudden cardiac death may be underreported in uninsured populations. 'They don't go to the emergency room. They die before they get there,' Johnson said. 'So the real risk may actually be higher than what this study captured.' Johnson said the findings also highlight a critical shift in how clinicians should view environmental risk. 'It's accurate to say we can no longer think about air pollution and environmental risks as being linked only to chronic conditions,' said Johnson. 'There are acute consequences, too, and this study illustrates that clearly.' A study published last month in the journal Epidemiology found prolonged exposure to the particulate matter in wildfire smoke was associated with small increases in the risk for several cardiovascular diseases, especially hypertension. As climate change drives more frequent heat waves and worsens air quality, both Chu and Johnson said clinicians are on the front lines of patient education and prevention. 'Clinicians are key players in translating environmental health research into actionable prevention,' Chu said. 'This study reinforces the need to think beyond traditional risk factors.' Chu and Johnson reported no relevant financial conflicts of interest.
Boston Globe
16-06-2025
- Health
- Boston Globe
A member of RFK Jr.'s MAHA movement and a public health expert met on Zoom. Here's what happened next.
The conversations are the brainchild of Brinda Adhikari, a journalist and former television producer who grew increasingly concerned about Americans' mistrust of institutions after Donald Trump's reelection. 'These are two groups that talk a lot about each other,' said Adhikari, who has worked for ABC News and the podcast 'The Problem with Jon Stewart.' 'I just don't see a lot of spaces where they talk to each other or with each other.' The conversations are captured on Adhikari's weekly podcast, ' Advertisement Despite the high stakes, the goal wasn't to change anyone's mind, said Adhikari, who lives in Brooklyn. She hoped both sides would discover shared concerns and better understand their opponents' perspectives. Those common worries included the risks of corporate influence in science and medicine, the possible harms Medicaid cuts could cause, and the safety of Americans' food. 'I didn't expect the areas of agreement would be so obvious that we would actually find spaces to work together almost immediately,' said Megan Ranney, dean of the Yale School of Public Health, who participated in the conversations. Advertisement Though 'We really came into this feeling ostracized,' said Elizabeth Frost, a panelist who led Kennedy's Ohio presidential campaign operation. 'What really surprised me is a lot of people in public health feel the same way.' The two groups, five MAHA representatives and the same number of public health experts, met twice in May. A third conversation involved a few of the same panelists, plus MAHA representatives from Georgia. Some meetings took on the tenor of estranged family members working to heal rifts. MAHA is grounded in a deep skepticism of establishment medicine. Many gravitated toward the movement after feeling let down by doctors they had trusted. Public health experts derive their knowledge from establishment medicine: They rely on hard-won data and the scientific method for their conclusions. One side feels ignored or dismissed. The other is frustrated and dismayed by how little sway scientific evidence and expertise hold with some MAHA adherents. Advertisement 'Scientists try their best to be open-minded, and ... we push and test each other to make sure that we're coming up with new ideas and using the best methods possible and getting as close to truth as we can,' Ranney said during the podcast. She then asked Frost, 'What would help folks to feel like science was being done with and for them?' 'There was a lot of outrage for having any questions about the way that the COVID pandemic was handled,' Frost responded. 'People on the MAHA side of it felt very demonized and very othered, that they weren't allowed to be a part of the conversation.' The MAHA movement coalesced around Kennedy's presidential campaign last year, though it adopted its name only after he suspended his campaign for president and endorsedTrump and his Make American Great Again movement. MAHA emphasizes personal choice in health, with a focus on addressing chronic illness, food quality, and distrust of the pharmaceutical industry. It also is associated with opposing longstanding, and well-proven, public health cornerstones, including the importance of widespread vaccination and water fluoridation to improve dental health. It's proven to have surprising appeal to members of both political parties, drawing liberals, MAGA Republicans, and independents, said Frost. As a result, members' beliefs are highly heterodox. Antivax sentiments are far from uniform, and dissatisfaction with overall policies in the Trump administration isn't unusual. Mark Harris, another Ohio MAHA leader, described himself as an independent thinker. He disapproves of proposed deep cuts to Medicaid and was among the first in his friend group to recognize how serious COVID would be. He did take the COVID-19 vaccine, he said. Advertisement 'I do believe in herd immunity,' he said in an interview. 'I believe in vaccines being very helpful in achieving that.' He emphasized during one of the podcasts, though, that the word vaccine implies permanent protection against an illness, and seems like a misnomer when applied to the COVID shots. COVID shots reliably offer long-term protection against serious illness and death but don't keep the virus entirely at bay over more than a few months. 'I completely agree with you,' said Paul Offit, one of the nation's most prominent vaccine experts and a member of the Food and Drug Administration's Vaccine Advisory Committee. 'Very early we should have made that very clear what the vaccine can and can't do.' The two sides also generally agree on why so many Americans have lost faith in the medical establishment. Access is expensive and difficult. Insurance coverage can appear arbitrary and confusing. Interactions with physicians are often through overcrowded emergency departments or with harried primary care physicians with barely the time to spend 10 minutes with a patient. Public health officials are not often visible, trusted figures in a community until an emergency arrives, leaving them with limited credibility, noted Craig Spencer, associate professor of the practice of health services, policy and practice at Brown University. Many public health officials wish scientific evidence spoke for itself, particularly when it comes to the power of vaccines. Polio is virtually unheard of in the United States. Measles was eliminated in this country before lower vaccination rates allowed it to resurface. The absence of these illnesses makes it hard for people who didn't live before widespread inoculation to fully believe in the value of vaccines, Spencer said, and data alone can't compete with a powerful messenger. Advertisement People like Kennedy have stepped in to fill that communication gap. Many of his ideas aren't supported by science, Spencer said, but his ability to command an audience is enviable. 'They've done such an incredible job just being out there,' he said of MAHA leaders and influencers. 'Even if they're saying some things, a lot of things that I wouldn't agree with, they're out there and that is instilling trust." During the podcast, Frost described how angry she was that people with COVID had been denied ivermectin and hydroxychloroquine. Offit responded with a layman's explanation of the evidence that the drugs aren't effective against the virus and, in the case of hydroxychloroquine, may do harm. Yet in the interview Frost didn't sound especially convinced, saying she gives the most weight to what her physician recommends. That wasn't evidence of the podcast's failure, Adhikari said. 'That you're going to sit down with someone whom you've never met and act as though you could say something to them within a two hour conversation that will completely change something that is a deep-rooted value for them, it's just not reasonable,' she said. 'What I am trying to do is to build the bridge, to trust each other enough to even be at the same table.' Jason Laughlin can be reached at
Boston Globe
22-05-2025
- Health
- Boston Globe
4 key takeaways from a new White House report on children's health
The report provides little in the way of specific solutions to address these issues, though the commission is also expected to release recommendations later this year. What the document does offer is the clearest articulation yet of Kennedy's 'Make America Healthy Again' movement and what the broad coalition hopes to accomplish in the coming months and years. Here's what the new report tells us. Get Starting Point A guide through the most important stories of the morning, delivered Monday through Friday. Enter Email Sign Up The report paints a bleak picture of American childhood. Advertisement The report presents today's children as stressed, sleep-deprived and addicted to their screens. It describes rising rates of conditions like obesity, diabetes and mental illness as a crisis that threatens the nation's health, economy and military readiness. 'Today's children are the sickest generation in American history in terms of chronic disease,' the report says. And it lashes out against technology companies and social media platforms that it says have helped create a 'technology-driven lifestyle.' It cites Jonathan Haidt, whose bestselling book 'The Anxious Generation' links the rise of smartphones and social media to worsening mental health among children -- a theory that some researchers have criticized for relying on inconclusive research. The report also notes that rates of loneliness among children have risen over the past several decades, a concern that researchers and public health experts have also raised for years. Advertisement It takes aim at vaccines. The report reiterates many of Kennedy's frequent talking points about vaccines -- with one notable exception. It does not suggest, as he has for decades, that childhood vaccines may be responsible for the rise in autism diagnoses among American children. But it implies that the increase in routine immunizations given to children may be harmful to them, which many scientists say is based on an incorrect understanding of immunology. The shots administered to children today are more efficient, and they contain far fewer stimulants to the immune system -- by orders of magnitude -- than they did decades ago, experts say. Vaccines are also largely responsible for the sharp drop in deaths among children younger than 5. 'The growth of the vaccination schedule does reflect the fact that we can prevent a lot more suffering and death in children than we could generations ago,' said Jason Schwartz, an associate professor of health policy at the Yale School of Public Health. 'Rather than celebrating that, it's often seen as a reason for skepticism or concern,' he said. The report also repeats Kennedy's assertion that childhood vaccines have not been tested in clinical trials involving placebos. In fact, new vaccines are tested against placebos whenever it is necessary, feasible and ethical to do so. Advertisement Some European countries, including Britain, do not mandate vaccinations as most American states do, the report notes. While that's true, misinformation and mistrust have led to record numbers of measles cases in Europe and have cost Britain its measles elimination status. The report notes correctly that surveillance systems in the United States for detecting side effects related to vaccines have serious shortcomings. But detection of rare side effects requires huge amounts of data, which is difficult to collect from the nation's fragmented health care system. The report urges federal agencies to 'build systems for real-world safety monitoring of pediatric drugs' -- which presumably include vaccines -- but it is unclear how those initiatives would differ from the systems already in use. It puts a major emphasis on ultraprocessed foods. The report says that 'the food American children are eating' is causing their health to decline. 'It's terrific to see such a clear, direct admission from the government that we are failing our children's health -- and that our food is one dominant driver,' said Dr. Dariush Mozaffarian, the director of the Food Is Medicine Institute at Tufts University. Nearly 70% of the calories consumed by children and adolescents in the United States come from ultraprocessed foods. These industrially manufactured foods and drinks, like sodas, chicken nuggets, instant soups and packaged snacks, have been linked with a greater risk of obesity, Type 2 diabetes, heart disease and other conditions. The report appropriately calls out an excess of ultraprocessed foods and not enough fruits and vegetables as problems with children's diets, Mozaffarian said, but it 'misses the massive problem of high salt,' which can cause high blood pressure in children. He also said he wished it had focused more on the 'many other severe deficiencies in the American diet,' like a lack of legumes, nuts, minimally processed whole grains, fish, yogurt and healthy plant oils. Advertisement Marion Nestle, an emerita professor of nutrition, food studies and public health at New York University, said that overall, the report 'did a phenomenal job' describing how ultraprocessed foods are harming children's health. The question, she said, is how the administration will fix the problems that are articulated in the report. 'In order for them to do anything about this, they're going to have to take on corporate industry,' including agriculture, food and chemical industries, she said. Food manufacturers, for example, could make healthier foods and stop marketing 'junk food' to children, she said. Such changes would most likely require federal regulations, she said, because historically, companies have resisted making them voluntarily. The report highlights a lack of government funding for nutrition research as part of the problem -- a point scientists have been making for years. The situation has worsened during President Donald Trump's second term, however, as many diet researchers have had federal grants abruptly terminated. Kevin Hall, whose research on ultraprocessed foods is prominently cited in the new report, left his post at the National Institutes of Health in April, citing censorship. The report points a finger at synthetic chemicals but pulls some punches. The commission's report accurately describes worsening health among American children, said Dr. Philip Landrigan, a pediatrician and epidemiologist who directs the Program for Global Public Health and the Common Good at Boston College. And it notes a number of synthetic chemicals, like pesticides and microplastics, that may play a role. 'The first 18 pages of the report are brilliant,' Landrigan said. Advertisement But he said it understated the known risks of many chemicals. For example, the report's authors downplay the hazards of phthalates, used to make plastics, and of certain pesticides that have been deemed dangerous to children's health but remain widely used. 'They mentioned correctly that phthalates can trigger hormone dysregulation, but they could have also said that phthalates produce birth defects of the male reproductive organs and can lead to infertility,' Landrigan said. While the report mentions concerns about crop-protection tools such as pesticides, 'that's really an understatement,' Landrigan said. He noted that studies of the widely used insecticide chlorpyrifos show 'clearly that it causes brain damage in kids and reduces children's IQ and causes behavioral problems.' The pesticide was banned from household use 25 years ago because of the risks to children, and banned from use on all crops three years ago. But the Environmental Protection Agency recently permitted its use on fruits like apples and oranges because of lawsuits brought by the manufacturer and growers' associations. The report also stopped short of calling two common pesticides used on many food crops, glyphosate and atrazine, unsafe after pushback from farmers, industry lobbyists and Republican lawmakers. Landrigan and colleagues from the Consortium for Children's Environmental Health recently advocated in The New England Journal of Medicine for a national approval process for all existing and new chemicals. Independent scientific assessments would be required to show the chemicals were not toxic to anyone, especially children, and postmarketing surveillance would be required. Yet the federal agencies that could regulate chemical exposures have been gutted in recent layoffs. Dr. Georges Benjamin, executive director of the American Public Health Association, pointed out that the report called for 'gold-standard research,' even as the administration had drastically cut funding for science and halted payments to universities like Harvard and Columbia. Advertisement 'They're not walking the walk,' he said. 'They're just talking.' This article originally appeared in The New York Times.
