Wellness Archives - ºÚÁϳԹÏÍø News /tag/wellness/ ºÚÁϳԹÏÍø News produces in-depth journalism on health issues and is a core operating program of KFF. Thu, 16 Apr 2026 01:55:53 +0000 en-US hourly 1 https://wordpress.org/?v=6.8.6 /wp-content/uploads/sites/8/2023/04/kffhealthnews-icon.png?w=32 Wellness Archives - ºÚÁϳԹÏÍø News /tag/wellness/ 32 32 161476233 Ask a Chatbot: ‘What’s for Dinner?’ /news/chatgpt-ai-chat-bot-meal-planning-nutrition/ Wed, 03 May 2023 09:00:00 +0000 https://khn.org/?post_type=article&p=1653142 Olivia Scholes, 28, of Vancouver, British Columbia, has polycystic ovary syndrome, or PCOS. She is among the who are diagnosed with this hormonal condition, which can cause multiple ovarian cysts, infertility, weight gain, and other issues.

After being diagnosed with PCOS about 10 years ago, Scholes managed her condition in part by trying to consume — or abstain from — certain foods and drinks. But at times, transferring her knowledge from her brain to her plate proved complicated and time-consuming.

“Just because I know that information doesn’t mean that I’m planning my meals with that information all the time,” Scholes said.

Scholes was scrolling through TikTok when she saw a video explaining how was used to build a detailed nutrition and workout plan. That video inspired Scholes to see if the chatbot, an artificial intelligence program trained to give a detailed response to a prompt, could give her meal options tailored to PCOS.

Weight and insulin management can help reduce the impact of PCOS. Because many people with PCOS experience insulin resistance, controlling insulin levels through diet is one of the best steps people can take to help manage the condition.

She started by asking ChatGPT if it knew what foods were best for people with PCOS and insulin resistance, and the chatbot provided a list of foods that met the criteria. Scholes followed up by asking if the system could provide a two-week meal plan that catered to PCOS and insulin resistance, consisting of three meals a day, two snacks a day, and desserts without artificial sweeteners. Within seconds, Scholes had a list of foods, which she then asked ChatGPT to turn into a grocery list.

Although Scholes already knew a lot of information ChatGPT gave her about PCOS and her diet, she said the chatbot transforming that information into planned-out meals would make it easier for her to purchase ingredients for a variety of meals in the future.

“For me, the big help that ChatGPT was, was not only did it take the information that I already knew; it put that information in, like, a tangible space for me,” said Scholes.

A photo of Olivia Scholes outside.
Olivia Scholes has polycystic ovary syndrome, or PCOS, and has dietary restrictions because of it. After seeing TikTok videos of others using ChatGPT for meal planning, she used the chatbot to make a meal plan and grocery list tailored to her condition. (Olivia Scholes)

ChatGPT — developed by the company OpenAI — launched publicly in November and reached 100 million active users in January,

ChatGPT is trained on a large body of text from a variety of sources, such as Wikipedia, books, news articles, and scientific journals. The advanced AI chatbot allows users to enter a text prompt and receive an intelligently generated output that allows for back-and-forth conversations. Other chatbots, such as Google’s and , also from Microsoft, are similar to ChatGPT and can plan meals.

Some health and wellness professionals say ChatGPT’s ability to have conversations can be useful for generating meal plans and ideas for people who have specific health goals and dietary needs.

Scholes using ChatGPT in a TikTok video. That video now has more than 1.3 million views and a comment section flooded with questions about her experience.

In February, Jamie Askey of Lufkin, Texas, made a explaining how to use ChatGPT to generate free meal plans and grocery lists that meet goals for calories and macronutrients, which are the nutrients the body needs in large amounts, like fats, carbohydrates, and proteins. She’s made lots of videos since the beginning of 2021 giving health advice, from easy meal-prep recipes to tips for how to stop binge-eating. And as someone who helps people create meals that contain without cutting out foods people enjoy eating, she was excited about how ChatGPT could potentially ease the process of meal planning.

Her video now has more than 13,000 views on TikTok and people have thanked her in the comments for sharing the tip.

“A great thing about this website is that it’s very conversational,” Askey said of ChatGPT. “So, if you are asking it for a specific type of diet, it can give you that.”

Unlike with Google and other search engines, users do not have to search topics one at a time. The dialogue format makes it possible for ChatGPT to follow an instruction in a prompt, provide a detailed response, and answer follow-up questions.

Users interested in generating meal options might tell ChatGPT “I want you to act as a dietitian” or “I want you to make me a healthy nutrition plan.” The chatbot will then respond with clarifying questions to help it generate an appropriate meal plan. The user may need to provide additional information such as their height, weight, any dietary restrictions, and goals.

Askey, a registered nurse who now works as a , warns that people with chronic illness should be evaluated by a professional before using a chatbot for meal planning.

“The possibilities are endless when you ask this machine what you’re wanting to know from a knowledge standpoint,” Askey said. “But another thing you have to think about is this is not black and white always. There are gray areas and that’s where health history comes into play. That’s where dieting history comes into play.”

ChatGPT users have boasted about the program’s capabilities and are enthused by the idea it could simplify everyday tasks. But the chatbot is not without flaws. One hitch: ChatGPT’s training data cuts off in 2021, meaning some information it provides may be outdated. For meal planning and nutrition, the program not being able to pull the latest health and wellness guidelines can be particularly troublesome for people with certain health conditions.

The model can also generate incorrect information, providing wrong answers or misunderstanding what the user is asking. When Scholes asked the chatbot for two weeks’ worth of meals, the chatbot stopped at day eight.

Some users have also expressed concerns about glitches and bias within the technology that can negatively affect the types of responses it generates. In December 2022, Steven T. Piantadosi, an associate professor of psychology at the University of California-Berkeley, posted a highlighting biases.

OpenAI, the artificial intelligence research company behind ChatGPT, has acknowledged the potential for bias within AI. It said in a that many people are “rightly worried about biases in the design and impact of AI systems.” In that post, the company also outlined some of the steps it is taking to eliminate biases.

Scholes wonders if existing biases against certain types of people could affect her results.

“If ChatGPT is built on any sort of fatphobic stuff, me looking for stuff that is geared towards women who are fat and deal with issues of fatness and PCOS and stuff, what kind of biases are built into that system already?”

For anyone considering using ChatGPT to help generate a meal plan to reach fitness and health goals, Askey said to double-check the program’s work. “AI, it’s not a person,” she said. “So, you always want to double-check.”

ºÚÁϳԹÏÍø News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about .

This article first appeared on ºÚÁϳԹÏÍø News and is republished here under a .

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Black Women Find Healing (But Sometimes Racism, Too) in the Outdoors /public-health/black-women-find-healing-but-sometimes-racism-too-in-the-outdoors/ Wed, 06 Jan 2021 10:01:00 +0000 https://khn.org/?post_type=article&p=1225648 It would be the last hike of the season, Jessica Newton had excitedly posted on her social media platforms. With mild weather forecast and Colorado’s breathtaking fall foliage as a backdrop, she was convinced an excursion at would be the quintessential way to close out months of warm-weather hikes with her “sister friends.”

Still, when that Sunday morning in 2018 arrived, she was shocked when her usual crew of about 15 had mushroomed into about 70 Black women. There’s a first time for everything, she thought as they broke into smaller groups and headed toward the nature trail. What a sight they were, she recalled, as the women — in sneakers and hiking boots, a virtual sea of colorful headwraps, flowy braids and dreadlocks, poufy twists and long, flowy locks — trekked peacefully across the craggy terrain in the crisp mountain air.

It. Was. Perfect. Exactly what Newton had envisioned when in 2017 she founded Black Girls Hike to connect with other Black women who share her affinity for outdoor activities. She also wanted to recruit others who had yet to experience the serenity of nature, a pastime she fell for as a child attending an affluent, predominately white private school.

But their peaceful exploration of nature and casual chatter — about everything from food and family to hair care and child care — was abruptly interrupted, she said, by the ugly face of racism.

“We had the sheriff called on us, park rangers called on us,” recalled Newton, now 37, who owns a construction industry project development firm in Denver.

“This lady who was horseback riding was upset that we were hiking on her trail. She said that we’d spooked her horse,” she said of a woman in a group of white horseback riders they encountered. “It just didn’t make any sense. I felt like, it’s a horse and you have an entire mountain that you can trot through, run through, gallop through or whatever. She was just upset that we were in her space.”

Eventually, two Jefferson County sheriff’s deputies, with guns on their hips, approached, asking, “What’s going on here?” They had been contacted by rangers who’d received complaints about a large group of Black women being followed by camera drones in the park; the drones belonged to a national television news crew shooting a feature on the group. (The segment aired weeks later, but footage of the confrontation wasn’t included.)

“‘Move that mob!’” attendee Portia Prescott recalled one of the horseback riders barking.

“Why is it that a group of Black women hiking on a trail on a Sunday afternoon in Colorado is considered a ‘mob?’” Prescott asked.

(Left to right) Theresa Odello, Jessica Newton, Jan Garduno, Ashanta Cyprian, Joy Eloi and Jewyl Newton follow park volunteer Lynn Wilson during a hike through Bear Creek Regional Park in Colorado Springs, Colorado, on Oct. 24. (Kevin Mohatt for KHN)

A man soon arrived who identified himself as the husband of one of the white women on horseback and the manager of the park, according to the Jefferson County Sheriff’s Office incident report, and began arguing with the television producers in what one deputy described in the report as a “hostile” manner.

The leader of the horseback tour told the deputies that noise from the large group and the drones startled the horses and that when she complained to the news crew, they told her to deal with it herself, the report said. The news crew told deputies that the group members felt insulted by the horseback riders use of the term “mob.” The woman leading the horseback riders, identified in the incident report as Marie Elliott, said that she did not remember calling the group a mob, but she told the officers she “would have said the same thing if the group had been a large group of Girl Scouts.”

In the end, Newton and her fellow hikers were warned for failing to secure a permit for the group. Newton said she regrets putting members in a distressing — and potentially life-threatening — situation by unknowingly breaking a park rule. However, she suspects that a similarly sized hiking group of white women would not have been confronted so aggressively.

“You should be excited that we are bringing more people to use your parks,” added Newton. “Instead, we got slammed with [threats of] violations and ‘Who are you?’ and ‘Please, get your people and get out of here.’ It’s just crazy.”

Mike Taplin, spokesperson for the Jefferson County Sheriff’s Office, confirmed that no citations were issued. The deputies “positively engaged with everyone, with the goal of preserving the peace,” he said.

Newton said the “frustrating” incident has reminded her why her group, which she has revamped and renamed , is so needed in the white-dominated outdoor enthusiasts’ arena.

With the tagline “Find your tribe,” the group aims to create a sisterhood for Black women “on the trails, on waterways and in our local communities across the globe.” Last summer, she secured nonprofit status and expanded Vibe Tribe’s focus, adding snowshoeing, fly-fishing, zip lining and kayaking to its roster. Today, the Denver-based group has 11 chapters across the U.S. (even Guam) and Canada, with about 2,100 members.

Jessica Newton (right) and her 14-year-old daughter, Joy Eloi, hike through Bear Creek Regional Park in Colorado Springs, Colorado, on Oct. 24. Newton formed an adventure group to encourage other Black women to enjoy the outdoors and it now has chapters across the U.S. and Canada. (Kevin Mohatt for KHN)
Members of Vibe Tribe Adventures pause during a hike through Bear Creek Regional Park in Colorado Springs, Colorado, on Oct. 24. (Kevin Mohatt for KHN)

Research suggests her work is needed. The most recent National Park Service survey found that . Newton said that must change — especially given the opportunities parks provide and the health challenges that disproportionately plague Black women. Research shows they experience higher rates of chronic preventable health conditions, including diabetes, hypertension and cardiovascular disease. A that racial discrimination also may increase stress, lead to health problems and reduce cognitive functioning in Black women. Newton said it underscores the need for stress-relieving activities.

“It’s been at several colleges that if you are outdoors for at least five minutes, it literally ,” said Newton. “Being around nature, it’s like grounding yourself. That is vital.”

Newton said participation in the group generally tapers off in winter. She is hopeful, though, that cabin fever from the pandemic will inspire more Black women to try winter activities.

Atlanta member Stormy Bradley, 49, said the group has added value to her life. “I am a happier and healthier person because I get to do what I love,” said the sixth grade teacher. “The most surprising thing is the sisterhood we experience on and off the trails.”

Patricia Cameron, a Black woman living in Colorado Springs, drew headlines this summer when she hiked 486 miles — from Denver to Durango — and to draw attention to diversity in the outdoors. She founded the Colorado nonprofit in 2019.

“One thing I caught people saying a lot of is ‘Well, nature is free’ and ‘Nature isn’t racist’ — and there’s two things wrong with that,” said Cameron, a 37-year-old single mother of a preteen.

“Nature and outside can be free, yes, but what about transportation? How do you get to certain outdoor environments? Do you have the gear to enjoy the outdoors, especially in Colorado, where we’re very gear-conscious and very label-conscious?” she asked. “Nature isn’t going to call me the N-word, but the people outside might.”

Cameron applauds Newton’s efforts and those of other groups nationwide, like Nature Gurlz, , , , , and , that have a similar mission. Cameron said it also was encouraging that the Outdoor Industry Association, a trade group, sparked by George Floyd’s death to help address a “long history of systemic racism and injustice” in the outdoors.

Efforts to draw more Black people, especially women, outdoors, Cameron said, must include addressing barriers, like cost. For example, Blackpackers provides a “gear locker” to help members use pricey outdoor gear free or at discounted rates. She has also partnered with businesses and organizations that subsidize and sponsor outdoor excursions. During the pandemic, Vibe Tribe has waived all membership fees through this month.

Jessica Newton (left), founder of Vibe Tribe Adventures, and her 14-year-old daughter, Joy Eloi, listen during first aid training at Bear Creek Regional Park. (Kevin Mohatt for KHN)
Bear Creek Regional Park recreation coordinator Theresa Odello gives a lesson on first aid and wilderness training to members of Vibe Tribe Adventures. (Kevin Mohatt for KHN)

Cameron said she dreams of a day when Black people are free from the pressures of carrying the nation’s racial baggage when participating in outdoor activities.

Vibe Tribe member and longtime outdoor enthusiast Jan Garduno, 52, of Aurora, Colorado, agreed that fear and safety are pressing concerns. For example, leading up to the presidential election she changed out of her “Let My People Vote” T-shirt before heading out on a solo walk for fear of how other hikers might react.

Groups like Vibe Tribe, she said, provide camaraderie and an increased sense of safety. And another plus? The health benefits can also be transformative.

“I’ve been able to lose about 40 pounds and I’ve kept it off,” explained Garduno.

ºÚÁϳԹÏÍø News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about .

This article first appeared on ºÚÁϳԹÏÍø News and is republished here under a .

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I Found My Secret to Feeling Younger and Stronger. The Pandemic Stole It Away. /aging/volunteering-fountain-of-youth-how-to-help-during-pandemic/ Fri, 11 Dec 2020 10:01:54 +0000 https://khn.org/?p=1056427 Back in early January, before COVID-19 was as familiar as the furniture, I went in for my annual physical. My doctor looked at my test results and shook his head. Virtually everything was perfect. My cholesterol was down. So was my weight. My blood pressure was that of a swimmer. A barrage of blood tests turned up zero red flags.

“What are you doing differently?” he asked, almost dumbfounded.

After all, I’m a 67-year-old balding guy who had spent much of his life as a desk-bound journalist dealing with nasty ailments like hernias (in my 30s), kidney stones (40s) and shingles (50s).

I ruminated over what had changed since my last physical. Sure, I exercise more than 90 minutes daily, but I’ve been doing that for five years. And yes, I watch what I eat, but that’s not new. Like most families with college-age kids, mine has its share of emotional and financial stresses — and there’d been no let-up there.

Only one thing in my life had registered any real change. “I’m volunteering more,” I told him.

I’d been spending less time in my basement office and more time out doing some good with like-minded people. Was this the magic elixir that seemed to steadily improve my health?

All signs pointed to “yes.” And I was feeling great about it.

Then just as I realized how important volunteering is to my health and well-being, the novel coronavirus appeared. As cases climbed, society shut down. One by one, my beloved volunteer gigs in Virginia disappeared. No more Mondays at Riverbend Park in Great Falls helping folks decide which trails to walk. Or Wednesdays serving lunch to the homeless at a community shelter in Falls Church. Or Fridays at the Arlington Food Assistance Center, which I gave up out of an abundance of caution. My modest asthma is just the sort of underlying condition that seems to make COVID-19 all the more brutal.

Writer Bruce Horovitz stands at the refrigerator at the Arlington Food Assistance Center in Arlington, Virginia, on Feb. 28, where he was giving out eggs and milk as part of the food distribution. Horovitz credited volunteering with improving his overall physical and mental health, but stopped when the pandemic hit in March. (Lynne Shallcross/KHN)

It used to be that missing even one day of volunteering made me feel like a sourpuss. After almost eight months without it, I’m downright dour.

Science helps explain why.

“The health benefits for older volunteers are mind-blowing,” said Paul Irving, chairman of the Center for the Future of Aging at the Milken Institute, and distinguished scholar in residence at the USC Leonard Davis School of Gerontology, whose lectures, books and podcasts on aging are turning heads.

When older folks go in for physicals, he said, “in addition to taking blood and doing all the other things that the doctor does when he or she pushes and prods and pokes, the doctor should say to you, ‘So, tell me about your volunteering.’”

Athat pooled data from 10 studies found that people with a higher sense of purpose in their lives — such as that received from volunteering — were less likely to die in the near term. Another , an academic journal by MIT Press for the American Academy of Arts & Sciences, concluded that older volunteers had reduced risk of hypertension, delayed physical disability, enhanced cognition and lower mortality.

“People who are happy and engaged show better physiological functioning,” said Dr. Alan Rozanski, a cardiologist at Mount Sinai St. Luke’s Hospital, a senior author of the Psychosomatic Medicine study. People who engage in social activities such as volunteering, he said, often showed better blood pressure results and better heart rates.

That makes sense, of course, because volunteers are typically more active than, say, someone home on the couch streaming “Gilligan’s Island.”

Volunteers share a dirty little secret. We may start it to help others, but we stick with it for our own good, emotionally and physically.

At the homeless shelter, I could hit my target heart rate packing 50 sack lunches in an hour to the beat of Motown music. And at the food bank, I could feel the physical and emotional uplift of human contact while distributing hundreds of gallons of milk and dozens of cartons of eggs during my three-hour shifts. When I’m volunteering, I dare say I feel more like 37 than 67.

Writer Bruce Horovitz gives a carton of eggs to a client at the Arlington Food Assistance Center in Arlington, Virginia, on Feb. 28. (Lynne Shallcross/KHN)
Horovitz had upped his weekly volunteering from one day a week to three days a week before COVID-19 hit. (Lynne Shallcross/KHN)

None of this surprises Rozanski, who looked at 10 studies over the past 15 years that included more than 130,000 participants. All of them, he said, showed that partaking in activities with purpose — such as volunteering — reduced the risk of cardiovascular events and often resulted in a longer life for older people.

Dr. David DeHart knows something about this, too. He’s a doctor of family medicine at the Mayo Clinic in Prairie du Chien, Wisconsin. He figures he has worked with thousands of patients — many of them elderly — over his career. Instead of just writing prescriptions, he recommends volunteering to his older patients primarily as a stress reducer.

“Compassionate actions that relieve someone else’s pain can help to reduce your own pain and discomfort,” he said.

At age 50, he listens to his own advice. DeHart volunteers with international medical teams in Vietnam, typically two trips a year. He often brings his wife and children to help, too. “When I come back, I feel recharged and ready to jump back into my work here,” he said. “The energy it gives me reminds me why I wanted to be a doctor in the first place.”

I think of my personal rewards from volunteering as cosmic electricity — with no “off” button. The good feeling sticks with me throughout the week — if not the month.

When will it be safe to resume my volunteering activities?

I’m considering my options. The park is offering some outdoor opportunities involving cleanup, but that lacks the interaction that lifts me. I’m tempted to go back to the food bank because even Charles Dinkens, an 85-year-old who has volunteered next to me for years, has returned after eight months away. “What else am I supposed to do?” he posed. The homeless shelter isn’t allowing volunteers in just yet. Instead, it’s asking folks to bag lunches at home and drop them off. Oh, they’re also looking for people to “call” virtual games of bingo for residents.

Virtual bingo just doesn’t float my boat.

Truth be told, there is no one-size-fits-all way to safely volunteer during the pandemic, said Dr. Kristin Englund, staff physician and infectious disease expert at the Cleveland Clinic. She suggests that volunteers — particularly those over 65 — stick with outdoor options. It’s better in a protected space where the general public isn’t moving through, she said, because “every time you interact with a person, it increases your risk of contracting the disease.”

Englund said she’d consider walking dogs outside for a local animal shelter as one safe option with some companionship. “While we do know that people can give COVID to animals,” she said, “it’s unlikely they can give it back to you.”

Meanwhile, my next annual physical is coming right up in January. It’s got me to wondering if my labs will be quite as pristine as they were the last go-round. I’ve got my doubts. Unless, of course, I’ve resumed some sort of in-person volunteering by then.

Last year, an elderly woman staying at the homeless shelter pulled me aside to thank me after I handed her lunch of tomato soup and a turkey sandwich. She set down her tray, took my hand, looked me smack in the eye and asked, “Why do you do this?”

She was probably expecting me to say I do it to help others because I care about those less fortunate than me. But that’s not what came out.

“I do it for myself,” I said. “Being here makes me whole.”

ºÚÁϳԹÏÍø News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about .

This article first appeared on ºÚÁϳԹÏÍø News and is republished here under a .

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Lifetime Experiences Help Older Adults Build Resilience to Pandemic Trauma /aging/seniors-resilience-pandemic-trauma-wellness-wisdom-experience/ Wed, 07 Oct 2020 09:00:55 +0000 https://khn.org/?p=1185058 Older adults are especially vulnerable physically during the coronavirus pandemic. But they’re also notably resilient psychologically, calling upon a lifetime of experience and perspective to help them through difficult times.

New research calls attention to this little-remarked-upon resilience as well as significant challenges for older adults as the pandemic stretches on. It shows that many seniors have changed behaviors — reaching out to family and friends, pursuing hobbies, exercising, participating in faith communities — as they strive to stay safe from the coronavirus.

“There are some older adults who are doing quite well during the pandemic and have actually expanded their social networks and activities,” said , a professor of psychological and brain sciences at Washington University in St. Louis. “But you don’t hear about them because the pandemic narrative reinforces stereotypes of older adults as frail, disabled and dependent.”

Whether those coping strategies will prove effective as the pandemic lingers, however, is an open question.

“In other circumstances — hurricanes, fires, earthquakes, terrorist attacks — older adults have been shown to have a lot of resilience to trauma,” said , an assistant professor at Yale University School of Public Health who studies the mental health effects of traumatic events.

“But COVID-19 is distinctive from other disasters because of its constellation of stressors, geographic spread and protracted duration,” she continued. “And older adults are now cut off from many of the social and psychological resources that enable resilience because of their heightened risk.”

The most salient risk is of severe illness and death: have occurred in people 65 and older.

Here are notable findings from a new wave of research documenting the early experiences of older adults during the pandemic:

Changing behaviors. Older adults have listened to public health authorities and taken steps to minimize the risk of being infected with COVID-19, according to a .

Results come from a survey of 1,272 adults age 64 and older administered online between May 4 and May 17. More than 80% of the respondents lived in New Jersey, an early pandemic hot spot. Blacks and Hispanics — as well as seniors with lower incomes and in poor health — were underrepresented.

These seniors reported spending less face-to-face time with family and friends (95%), limiting trips to the grocery store (94%), canceling plans to attend a celebration (88%), saying no to out-of-town trips (88%), not going to funerals (72%), going to public places less often (72%) and canceling doctors’ appointments (69%).

Safeguarding well-being. In , , an associate professor of psychology at the University of Michigan-Dearborn, addresses how older adults have adjusted to altered routines and physical distancing.

Her data comes from an online survey of 825 adults age 60 and older on March 22 and 23 — another sample weighted toward whites and people with higher incomes.

Instead of inquiring about “coping” — a term that can carry negative connotations — Whitehead asked about sources of joy and comfort during the pandemic. Most commonly reported were connecting with family and friends (31.6%), interacting on digital platforms (video chats, emails, social media, texts — 22%), engaging in hobbies (19%), being with pets (19%), spending time with spouses or partners (15%) and relying on faith (11.5%).

“In terms of how these findings relate to where we are now, I would argue these sources of joy and comfort, these coping resources, are even more important” as stress related to the pandemic persists, Whitehead said.

Maintaining meaningful connections with older adults remains crucial, she said. “Don’t assume that people are OK,” she advised families and friends. “Check in with them. Ask how they’re doing.”

Coping with stress. What are the most significant sources of stress that older adults are experiencing? In Whitehead’s survey, older adults most often mentioned dealing with mandated restrictions and the resulting confinement (13%), concern for others’ health and well-being (12%), feelings of loneliness and social isolation (12%), and uncertainty about the future of the pandemic and its impact (9%).

Keep in mind, older adults expressed these attitudes at the start of the pandemic. Answers might differ now. And the longer stress endures, the more likely it is to adversely affect both physical and mental health.

Managing distress. The COVID-19 Coping Study, a research effort by a team at the University of Michigan’s Institute for Social Research, offers an early look at the pandemic’s psychological impact.

Results come from an online survey of 6,938 adults age 55 and older in April and May. Researchers are following up with 4,211 respondents monthly to track changes in older adults’ responses to the pandemic over a year.

Among the : 64% of older adults said they were extremely or moderately worried about the pandemic. Thirty-two percent reported symptoms of depression, while 29% reported serious anxiety.

Notably, these types of distress were about twice as common among 55- to 64-year-olds as among those 75 and older. This is consistent with research showing that people become better able to regulate their emotions and manage stress as they advance through later life.

On the positive side, older adults are responding by getting exercise, going outside, altering routines, practicing self-care, and adjusting attitudes via meditation and mindfulness, among other practices, the study found.

“It’s important to focus on the things we can control and recognize that we do still have agency to change things,” said , a co-author of the study and assistant professor of epidemiology at the University of Michigan School of Public Health.

Addressing loneliness. The growing burden of social isolation and loneliness in the older population is dramatically evident in new results from the University of Michigan’s , with 2,074 respondents from 50 to 80 years old. (It found that, in June, twice as many older adults (56%) felt isolated from other people as in October 2018 (27%).

Although most reported using social media (70%) and video chats (57%) to stay connected with family and friends during the pandemic, they indicated this didn’t alleviate feelings of isolation.

“What I take from this is it’s important to find ways for older adults to interact face to face with other people in safe ways,” said , chief health officer at the University of Michigan. “Back in March, April and May, Zoom family time was great. But you can’t live in that virtual universe forever.”

“A lot of well-intentioned families are staying away from their parents because they don’t want to expose them to risk,” Malani continued. “But we’re at a point where risks can be mitigated, with careful planning. Masks help a lot. Social distancing is essential. Getting tested can be useful.”

Malani practices what she preaches: Each weekend, she and her husband take their children to see her elderly in-laws or parents. Both couples live less than an hour away.

“We do it carefully — outdoors, physically distant, no hugs,” Malani said. “But I make a point to visit with them because the harms of isolation are just too high.”

ºÚÁϳԹÏÍø News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about .

This article first appeared on ºÚÁϳԹÏÍø News and is republished here under a .

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When the Pandemic Closes Your Gym, ‘Come for the Party, Stay for the Workout’ /public-health/when-the-pandemic-closes-your-gym-come-for-the-party-stay-for-the-workout/ Wed, 02 Sep 2020 09:00:29 +0000 NEW YORK — Evaristo “Risto” Grant counted down from 10 as his clients held their plank positions and shook with the effort. Michael Jackson’s “Wanna Be Startin’ Somethin’” blared in the background. Grant paced around his clients on their yoga mats, shouting words of encouragement.

It looked and sounded like any normal gym session. Except it wasn’t. Grant’s gym consisted of a few yoga mats and equipment underneath a strip of scaffolding in Carl Schurz Park, which borders the East River in Manhattan. People on their evening quarantine walks strolled by, many glancing with amusement at the signs Grant had taped to the scaffolding: “Get your sexy back … no more cookies!” and “Come for the party, stay for the workout!”

Grant, 57, was despondent for the first few weeks of quarantine last spring. New York City was quickly becoming the of the coronavirus pandemic, and everyone hunkered down at home. As a personal trainer who works for himself, Grant watched his income crumble.

Then, a lightbulb went off. Grant used some savings to buy face shields, disinfectant, hand sanitizer and some additional equipment. He set up shop in the park, which is just a few blocks from his house, and started to attract new clients.

“This is an opportunity to meet people and get prospective clients for the future,” Grant said. “I just talk to people, connect, share and inspire, hopefully.”

One new client is Elizabeth Pompa, a 53-year-old real estate agent living on the Upper East Side. Pompa, who used to teach Lotte Berk Technique dance-based exercise classes, has always valued fitness and personal training. Her husband struck up a conversation with Grant while working out next to him and later suggested Pompa give Grant a try. Since then, she’s seen Grant once a week.

“He pushes me, but in a great way,” Pompa said. “I know I’m not going to get hurt with him. For that hour, I forget everything that’s going on around me.”

Casey Grillo, a 40-year-old nurse practitioner, comes to Grant’s sessions twice a week. At the start of the pandemic, she would not have considered working out with others in person. But she said now that she and others know how to take the appropriate measures to stay safe, she’s comfortable at Grant’s sessions.

Grant holds small classes Sunday through Thursday, charging his clients $25 per session. And he teaches private clients on Fridays for $85. At every session, he wears a face shield and reminds clients to stay 6 feet apart. He disinfects equipment after every use and offers hand sanitizer to those who want it.

Grillo said she’s noticed a larger community of fitness enthusiasts getting their exercise outside. She admires everyone’s creativity.

“I’ve seen people use canned goods and water bottles and gallon jugs for weights,” Grillo said. “It’s really encouraging to see people still staying active.”

Grant is not the only personal trainer using Carl Schurz as gym space. Patrick Narain, a 36-year-old trainer and martial arts instructor, has been teaching classes in Carl Schurz, Astoria Park and Central Park. At the beginning of the pandemic, he mostly did virtual classes from home without charging people. It was tough, he said, staying financially afloat on solely the tips he got from online clients. Now he’s getting $15 from each class participant.

As for many people, Narain said the pandemic and subsequent quarantine have caused him anxiety.

“I find myself worrying too much about others and not really paying attention to taking care of myself,” Narain said. “It really caused me a lot of stress, to the point where I couldn’t really feel my right side.”

Evaristo “Risto” Grant leads a training session on Aug. 5, 2020, at a makeshift outdoor gym he set up underneath some scaffolding in New York City’s Carl Schurz Park in the wake of the pandemic. Grant disinfects equipment after each use and offers hand sanitizer. (Elizabeth Lawrence/KHN)
Evaristo “Risto” Grant leads a workout session on Aug. 5, 2020, in New York City’s Carl Schurz Park. He holds small classes at his makeshift outdoor gym Sunday through Thursday and teaches private clients on Fridays. (Elizabeth Lawrence/KHN)

His stress slowly improved as he worked with another instructor to teach small classes in the park. He’s enjoying the fresh air and open space, though he’s careful not to push clients too hard in the heat.

Devin Paul, another trainer, also transitioned his business smoothly to the outdoors. He’d worked with a gym until the quarantine started, and now he’s training his own clients in Carl Schurz and in Jackie Robinson Park in Harlem.

Paul, 46, has found that since he’s working for himself, he’s making more money and working fewer hours. He said his minimum fee for a private lesson is $100.

“I’m at a point in my life where I don’t think I’m going to go back when the gyms open,” Paul said. “I can have a better peace of mind just doing everything on my own.”

Paul plans to rent a training studio when the weather turns too cold to work outside.

Grant said the personal trainer community has had one another’s backs through it all. He’s been a part of the industry for 17 years, ever since a fellow fitness enthusiast told him he’d be a “natural.” He’s seeing trainers he’s known for a long time using parks to their advantage, being creative and making things work.

“We just try to help each other out and stand for each other,” Grant said.

Pre-pandemic, Grant had been doing well financially with his model of meeting up with clients at gyms and getting new ones through referrals. Still, he’s taking the pandemic as an opportunity to reevaluate his operation.

“We have to really think about how to create something for the future and see the glass as half full and be optimistic because you’ll never know what you create when you put your mind to it,” he said.

For the foreseeable future, he’s sticking around at his makeshift gym throughout the week, hoping to entice people to “get your sexy back.”

ºÚÁϳԹÏÍø News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about .

This article first appeared on ºÚÁϳԹÏÍø News and is republished here under a .

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Employers’ Dream Of Controlling Health Costs Turns To Workers’ Sleep /public-health/improving-workers-sleep-to-increase-productivity-and-save-on-health-care-costs-employers-screen-for-sleep-apnea/ Fri, 17 Jan 2020 10:00:28 +0000 https://khn.org/?p=1037848 Charlie Blakey had a sense he was sleeping poorly since he often would wake up tired and hear from his wife how loudly he breathed during the night.

So he jumped at the chance when his employer, Southern Co., an Atlanta-based electric utility, offered to test him in 2018 for sleep apnea, a potentially serious disorder in which people repeatedly stop breathing while asleep.

After he tested positive, the utility arranged for him to have a machine that provides continuous airflow through a mask while he sleeps — at no cost to him. Within weeks, Blakey, of Augusta, Georgia, noticed a difference.

“Without a doubt, it’s helped me feel more refreshed when I get up,” said Blakey, 38, a safety and health specialist at the company.

About 4,000 of Southern’s 30,000 employees have been screened for sleep apnea in the past three years, and 1,500 are being treated. Southern officials said the program is saving money on health costs — $1.2 million in 2018 alone — because it reduces medical services for dangerous conditions such as heart disease that are complicated by sleep apnea.

Sleep is the latest in an ever-growing list of wellness issues — such as weight loss, exercise and nutrition — that firms are targeting to improve workers’ health and lower medical costs.

Whether all these sleep programs deliver on their promises is not yet clear. A study published last year in the Journal of the American Medical Association followed nearly 33,000 employees of BJ’s Wholesale Club for 18 months and found the wellness program in health spending.

Harry Liu, a researcher at the Rand Corp. who studies job-based wellness initiatives, said that while studies show “improving sleeping habits can reduce absenteeism and improve productivity,” it’s uncertain if employers’ efforts will have long-term effects for individual workers.

A study published by researchers at the University of Minnesota, Harvard Medical School and other institutions in October found that 1,200 commercial truck drivers who participated in an employer sleep apnea screening and treatment program in health costs compared with drivers who were not treated. An earlier study of members of a health plan serving Union Pacific employees also found among workers who were diagnosed with sleep apnea and got treatment.

About 1 in 4 large employers offer programs to help workers get better sleep and more than half plan to implement such efforts by 2021, according to a by benefits firm Willis Towers Watson. Most businesses hire contractors to manage the programs.

Benefits officials say promoting a good night’s sleep for employees is as important as making sure their blood sugar and cholesterol are under control.

Despite the public’s concerns about privacy, employers say workers have been eager to reveal information about how they sleep to company vendors. To protect employees’ medical privacy, the data on individual workers does not go to their bosses; companies receive only aggregated data to measure program spending and effectiveness.

Katie Kirkland, director of benefits at Southern, said a lack of sleep may promote an unhealthy lifestyle of not exercising or eating a poor diet.

In addition to reducing medical costs, the company was motivated to offer its program because state transportation department rules require that some employees who operate heavy equipment and have certain health conditions be tested for sleep apnea and get treated if diagnosed.

With a diagnosis of apnea, a patient is typically prescribed a continuous positive airway pressure (CPAP) machine. But Kirkland said many workers needed help sustaining treatment because of difficulties in learning to sleep with a mask.

“With sleep apnea, there is a high drop-off rate, where you pay a lot for the equipment and then it doesn’t get used,” she said. “We found it’s a much better experience with the personal coaching.”

When the company took on the issue, it made sense to offer the help to its entire labor force, Kirkland added.

Beyond sleep apnea, some employers also help workers with insomnia.

The Hartford Financial Services Group, based in Hartford, Connecticut, contracts with London-based Sleepio to offer employees a sleep questionnaire and online tutorial to deal with specific sleep issues.

Sandra Trisdale, a sales consultant with the company in San Diego, said she’s sleeping better after finishing a six-week online course on how to fall asleep faster.

Tips Trisdale used include room-darkening window shades and getting a noise machine to drown out other noises. She also learned the importance of trying to go to sleep and wake up at the same time each day. The program had her keep a diary to track how the changes she made affected her sleep.

“It was tremendously helpful,” Trisdale said, “and I got to see how making some small changes led to some big results.”

According to the Hartford, the 2,000 workers who completed its six-week education program have gained an average of seven hours of sleep per week.

Judy Gordon, wellness director at the company, said a preliminary analysis suggests the sleep program is saving the company money through fewer medical claims.

The company began looking into sleep issues after it found employees with an insomnia diagnosis have more than double the average health costs of those without one. In addition, she said, employees who sleep better are likely to be more productive at work.

“There is a business reason to look at insomnia,” Gordon said.

Remedying sleep issues can also , she said.

Case Western Reserve University in Cleveland also recently began working with its employees on sleep. About 185 workers took part in a voluntary four-week program last year that provided sleeping tips and asked employees to keep a record of how they slept each night. Claude “Bud” Morris, a maintenance worker, said the program helped by nudging him to turn off electronics an hour before bedtime.

Officials at the Washington Suburban Sanitary Commission, a government agency that provides drinking water for parts of Maryland near the District of Columbia, feared sleep problems were plaguing many of their employees who often work late nights or early mornings. When they looked over workers’ medical and pharmacy claims, they found 226 of 1,600 employees had been diagnosed with sleep apnea and most of them had at least one chronic disease such as asthma or diabetes.

“It wasn’t rocket science to tell sleep was an issue,” said Lee McDonough, the commission’s wellness program manager.

Many of the employees with sleep apnea who had started on a CPAP machine quit using it regularly because of difficulty wearing the mask.

“They would take it and throw it in a corner and not get better,” McDonough said.

The commission contracted with FusionHealth of Suwanee, Georgia, which tests employees for sleep apnea and provides doctors and respiratory therapists to counsel individuals on how to wear the mask. The company also monitors employees remotely and follows up with regular phone calls and emails.

After 16 months using the service, the commission found the extra level of personal support helped many employees sleep better.

“The human touch combined with the technology has helped employees stick with it and given them a fighting chance to get better,” McDonough said.

ºÚÁϳԹÏÍø News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about .

This article first appeared on ºÚÁϳԹÏÍø News and is republished here under a .

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What The 2020s Have In Store For Aging Boomers /aging/what-the-2020s-have-in-store-for-aging-boomers/ Thu, 16 Jan 2020 10:00:02 +0000 Within 10 years, all of the nation’s 74 million baby boomers will be 65 or older. The most senior among them will be on the cusp of 85.

Even sooner, by 2025, the number of seniors (65 million) is expected to surpass that of children age 13 and under (58 million) for the first time, according to .

“In the history of the human species, there’s never been a time like [this],” said Dr. Richard Hodes, director of the National Institute on Aging, referring to the changing balance between young people and old.

What lies ahead in the 2020s, as society copes with this unprecedented demographic shift?

I asked a dozen experts to identify important trends. Some responses were aspirational, reflecting what they’d like to see happen. Some were sobering, reflecting a harsh reality: Our nation isn’t prepared for this vast demographic shift and its far-reaching consequences.

Here’s what the experts said:

A crisis of care. Never have so many people lived so long, entering the furthest reaches of old age and becoming at risk of illness, frailty, disability, cognitive decline and the need for personal assistance.

Even if scientific advances prove extraordinary, “we are going to have to deal with the costs, workforce and service delivery arrangements for large numbers of elders living for at least a year or two with serious disabilities,” said Dr. Joanne Lynn, a legislative aide on health and aging policy for Rep. Thomas Suozzi (D-N.Y.).

Experts caution we’re not ready.

“The cost of long-term care [help in the home or care in assisted-living facilities or nursing homes] is unaffordable for most families,” said Jean Accius, senior vice president of thought leadership at AARP. He cited data from the : While the median household income for older adults was just $43,696 in 2019, the annual median cost for a private room in a nursing home was $102,204; $48,612 for assisted living; and $35,880 for 30 hours of home care a week.

Workforce issues are a pressing concern. The need for health aides at home and in medical settings is soaring, even as low wages and poor working conditions discourage workers from applying for or staying in these jobs. By 2026, of this kind will be required and hundreds of thousands of jobs may go unfilled.

“Boomers have smaller families and are more likely to enter old age single, so families cannot be expected to pick up the slack,” said Karl Pillemer, a professor of human development at Cornell University. “We have only a few years to plan different ways of providing care for frail older people to avoid disastrous consequences.”

Living better, longer. Could extending “healthspan,” the time during which older adults are healthy and able to function independently, ease some of these pressures?

The World Health Organization calls this “healthy life expectancy” and publishes this information by country. Japan was the world’s leader, with a healthy life expectancy at birth of 74.8 years in 2016, the most recent year for which data is available. In the U.S., healthy life expectancy was out of a total average life expectancy of .

Laura Carstensen, director of Stanford University’s Center on Longevity, sees some cause for optimism. “Americans are beginning to exercise more” and eat more healthful diets, she said. And scientific studies published in recent years have shown that behavior and living environments can alter the trajectory of aging.

“With this recognition, conversations about aging societies and longer lives are shifting to the potential to improve quality of life throughout,” Carstensen said.

Other trends are concerning. Notably, more than one-third of older adults are , while 28% are , putting them at higher risk of physical impairments and chronic medical conditions.

Rather than concentrate on treating disease, “our focus should shift to health promotion and prevention, beginning in early life,” said Dr. Sharon Inouye, a professor at Harvard Medical School and a member of the planning committee for the National Academy of Sciences’ .

Altering social infrastructure. Recognizing the role that social and physical environments play in healthy aging, experts are calling for significant investments in this area over the next decade.

Their wish list: make transportation more readily available, build more affordable housing, modify homes and apartments to help seniors age in place, and create programs to bring young and old people together.

Helping older adults remain connected to other people is a common theme. “There is a growing understanding of the need to design our environments and social infrastructure in a way that designs out loneliness” and social isolation, said Dr. Linda Fried, dean of Columbia University’s Mailman School of Public Health.

On a positive note, a worldwide movement to create “” is taking hold in America, with 430 communities and six states joining an effort to identify and better respond to the needs of older adults. A companion effort to create “” is likely to gain momentum.

Technology will be increasingly important as well, with aging-in-place likely made easier by virtual assistants like Alexa, video chat platforms like Skype or FaceTime, telemedicine, robotic caregivers and wearable devices that monitor indicators such as falls, according to Deborah Carr, chair of the sociology department at Boston University.

Changing attitudes. Altering negative attitudes about aging — such as a widespread view that this stage of life is all about decline, loss and irrelevance — needs to be a high priority as these efforts proceed, experts say.

“I believe ageism is perhaps the biggest threat to improving quality of life for [older] people in America today,” Harvard’s Inouye said. She called for a national conversation about “how to make the last act of life productive, meaningful and fulfilling.”

Although the “” barbs that gained steam last year testify to persistent intergenerational tension, there are signs of progress. The World Health Organization has launched a global campaign to combat ageism. Last year, became one of the first U.S. cities to tackle this issue via a public awareness campaign. And a “ developed by the FrameWorks Institute is in use in communities across the country.

“On the bright side, as the younger Baby Boom cohort finally enters old age during this decade, the sheer numbers of older adults may help to shift public attitudes,” said Robyn Stone, co-director of LeadingAge’s LTSS (long-term services and supports) Center @UMass Boston.

Advancing science. On the scientific front, Dr. Pinchas Cohen, dean of the Leonard Davis School of Gerontology at the University of Southern California, points to a growing recognition that “we can’t just apply one-size-fits-all guidance for healthy aging.”

During the next 10 years, “advances in genetic research and big data analytics will enable more personalized — and effective — prescriptions” for both prevention and medical treatments, he said.

“My prediction is that the biggest impact of this is going to be felt around predicting dementia and Alzheimer’s disease as biomarker tests [that allow the early identification of people at heightened risk] become more available,” Cohen continued.

Although dementia has proved exceptionally difficult to address, “we are now able to identify many more potential targets for treatment than before,” said Hodes, of the National Institute on Aging, and this will result in a “dramatic translation of discovery into a new diversity of promising approaches.”

Another potential development: the search for therapies that might slow aging by targeting underlying molecular, cellular and biological processes — a field known as “.” Human trials will occur over the next decade, Hodes said, while noting “this is still far-reaching and very speculative.”

Addressing inequality. New therapies spawned by cutting-edge science may be extraordinarily expensive, raising ethical issues. “Will the miracles of bioscience be available to all in the next decade — or only to those with the resources and connections to access special treatment?” asked Paul Irving, chairman of the Milken Institute’s Center for the Future of Aging.

Several experts voiced concern about growing . Its most dramatic manifestation: The rich are living longer, while the poor are dying sooner. And the gap in their life expectancies is widening.

Carr noted that if the current poverty rate of 9% in the older population holds over the next decade, “more than 7 million older persons will live without sufficient income to pay for their food, medications and utilities.” Most vulnerable will be black and Latina women, she noted.

“We now know that health and illness are affected by income, race, education and other social factors” and that inequalities in these areas affect access to care and health outcomes, Pillemer said. “Over the coming decade, we must aggressively address these inequities to ensure a healthier later life for everyone.”

Working longer. How will economically vulnerable seniors survive? Many will see no choice but to try to work “past age 65, not necessarily because they prefer to, but because they need to,” Stone said.

Dr. John Rowe, a professor of health policy and aging at Columbia University, observed that “low savings rates, increasing out-of-pocket health expenditures and continued increases in life expectancy” put at risk of running out of money in retirement.

Will working longer be a realistic alternative for seniors? Trends point in the opposite direction. On the one hand, the suggests that by 2026 about 30% of adults ages 65 to 74 and 11% of those 75 and older will be working.

On the other hand, age discrimination makes it difficult for large numbers of older adults to keep or find jobs. According to a , 61% of older workers reported witnessing or experiencing age discrimination.

“We must address ageism and ageist attitudes within the workplace,” said Accius, of AARP. “A new understanding of lifelong learning and training, as well as targeted public and private sector investments to help certain groups transition [from old jobs to new ones], will be essential.”

ºÚÁϳԹÏÍø News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about .

This article first appeared on ºÚÁϳԹÏÍø News and is republished here under a .

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KHN’s ‘What The Health?’: Trump Turns To Medicare /courts/podcast-khn-what-the-health-trump-turns-to-medicare/ Thu, 03 Oct 2019 18:07:26 +0000

Can’t see the audio player? .


President Donald Trump tried to change the subject from his impeachment investigation by going to Florida to unveil changes to the Medicare program before an audience of seniors. The changes consist largely of enhanced benefits in private Medicare Advantage plans, which Republicans have long championed as replacements for government-run Medicare benefits.

Meanwhile, the Trump administration this week also issued guidance allowing states to add “wellness” programs to plans on the individual insurance market. The program, part of the original Affordable Care Act, was never implemented by the Obama administration. However, numerous studies have shown that wellness programs that raise or lower premiums based on participation or health goals neither save money nor improve health significantly.

This week’s panelists are Julie Rovner of Kaiser Health News, Alice Miranda Ollstein of Politico, Kimberly Leonard of the Washington Examiner and Rebecca Adams of CQ Roll Call.

Among the takeaways from this week’s podcast:

  • Trump’s speech Thursday comes amid the backdrop of his fierce opposition to the Affordable Care Act and is seen as an effort to highlight the administration’s goal to promote private Medicare health plans. But Democrats and other administration critics point out that these Medicare Advantage policies are more expensive than traditional Medicare and tighten restrictions on doctors and hospitals.
  • Trump’s speech also has the potential to remind voters that the administration has been fighting to overturn the ACA in court, which would upend many of its consumer protections, including the guarantee of coverage for people with preexisting medical problems.
  • The administration proposal on wellness programs has raised concerns among some consumer groups that the programs might make insurance more expensive for some people who cannot meet the health standards in those programs.
  • Federal officials are redistributing funding for the Title X program after Planned Parenthood and some state health departments pulled out. Those agencies objected to the administration’s rule that participating organizations could not refer women for abortions. But finding new groups to take the money may prove difficult since not many are able to handle the work or the large numbers of clients that Planned Parenthood once did.
  • With several state challenges to abortion rights working their way through the court system, it seems likely that the Supreme Court will adjudicate an abortion case during the 2020 presidential campaign season.
  • A federal court in California is weighing a suit by immigration advocates to overturn the Trump administration’s rule that would hamper legal immigrants’ efforts to gain citizenship if they have used government benefits like Medicaid or food stamps.

Also this week, Rovner interviews KHN’s Cara Anthony, who wrote the latest KHN-NPR “Bill of the Month” feature about a biopsy that was more expensive than expected. If you have an outrageous medical bill you would like to share with us, you can do that here.

Plus, for extra credit, the panelists recommend their favorite health policy stories of the week they think you should read too:

Julie Rovner: NPR’s “,” by Nell Greenfieldboyce

Alice Miranda Ollstein: AL.com and ProPublica’s “,” by Connor Sheets

Kimberly Leonard: The Los Angeles Times’ “,” by Emily Baumgaertner

Rebecca Adams: The Washington Post’s “,” by Amy Goldstein


To hear all our podcasts,Ìýclick here.

And subscribe to What the Health? on ,Ìý,Ìý,Ìý, or .

ºÚÁϳԹÏÍø News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about .

This article first appeared on ºÚÁϳԹÏÍø News and is republished here under a .

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Obesity Plagues Hispanics And Blacks In Colorado, Nation’s ‘Healthiest’ State /public-health/obesity-plagues-hispanics-and-blacks-in-colorado-nations-healthiest-state/ Thu, 08 Aug 2019 09:00:22 +0000 https://khn.org/?p=977482 LEADVILLE, Colo. — Colorado stands out on , a cool green rectangle surrounded by more alarming shades of yellow, orange and red.

But upon closer inspection, Colorado weighs in as two states: one dangerously heavy and one fit and trim.

There are the mostly well-educated, affluent whites, many of whom were drawn to Colorado by high-paying tech jobs and myriad outdoor opportunities.

By contrast, the adult obesity rates among minorities are much higher — 29.9% for blacks and 27.7% for Latinos, far worse than the 21.6% rate for non-Hispanic whites. While those figures beat the nation’s overall obesity rate of 39.8%, a large portion of state residents still struggle to eat healthily and live active lifestyles.

(Courtesy of the Centers for Disease Control and Prevention)

“People see and hear, ‘Oh, Colorado, healthiest state in the nation,’” said Wendy Peters Moschetti, director of food systems for LiveWell Colorado, a statewide nonprofit promoting healthy eating. “But when you dig deeper, there’s the Colorado paradox. Colorado is importing health.”

Few places illustrate that contrast as clearly as Leadville, a Lake County town of 2,759 nestled among the Rocky Mountains, and best known as the home of an eponymous 100-mile ultramarathon. Though Lake County is near the glamorous resorts of Vail and Breckenridge, Leadville and its surroundings are filled with trailer parks, home to the workers who make the tourism economy hum.

Many other states, counties and cities register similar disparities on the scales of obesity, healthy eating and exercise. The overarching statistics mask underlying problems, making it hard to attract attention and resources for those in need.

“Lots of people think of Leadville as really healthy. How can Leadville have an obesity problem?” said Katie Baldassar, director of the local public health department’s Lake County Build a Generation project. “What we really see in Colorado is an equity problem. And we see that in Leadville.”

Screen Time Versus Mountain Time

The adults here commute to jobs in the ski towns on the well-to-do sides of mountain passes. “They clean hotel rooms over in Vail. They work construction over in Breckenridge,” Baldassar said. “And they’re experiencing the double-headed monster of food scarcity and obesity.”

Their children attend public schools, where 70% of students are Hispanic. Despite the outdoor opportunities that surround them, nearly twice as many students in Lake County fail to meet physical activity guidelines as those in the more affluent Summit and Eagle counties nearby. Obese children tend to become obese adults.

And so, in early July, a group of 8- and 9-year-olds, formally known as Crew 5 of the Rockies Rock summer program, trudged up a mountain trail toward Mosquito Gulch. Many of the children had never gone hiking or fishing before joining the program, and most would have been spending a more sedentary summer without it.

“Probably watching my tablet or TV,” said Leonandro Lopez, 9, who led the other kids in song during the hike. “I don’t like getting my body moving.”

The Get Outdoors Leadville! program takes kids outdoors for seven hours a day, five days a week, exposing them to the outdoor recreation that draws tourists to the mountain city. (Markian Hawryluk/KHN)

The program is run by Get Outdoors Leadville!, which receives funding from state lottery dollars. Most of the families pay the lowest tuition on its sliding scale, about $30 to $50 for a two-week session.

Participants get healthy meals and snacks through the program, a key benefit in a county where 67% of kids qualify for free or reduced-price lunches during the school year, and 24% live below the poverty line.

The program takes kids outdoors for seven hours a day, five days a week, exposing them to the outdoor recreation that draws tourists to Leadville.

“We hope that our participants get familiar with these local places,” said Cisco Tharp, healthy kids director for Get Outdoors Leadville! “And can tell their families, ‘Hey, we can go here and we can do this.’”

Lake County’s obesity levels mirror those in the rest of the state, with Hispanics faring worse than many of their neighbors.

“It’s a common characteristic of the way we observe obesity levels throughout the country,” said John Auerbach, CEO of Trust for America’s Health, a nonprofit that issues an annual state-by-state obesity report. “Obesity is more likely to be prevalent among those with lower incomes and among certain populations of color, in particular, African Americans, Latinos and American Indians.”

That is true in part because these populations may have less access to healthy foods, beverages or safe community spaces for physical activity, said Dr. Ruth Petersen, who runs the Centers for Disease Control and Prevention’s Nutrition, Physical Activity and Obesity division. Minority neighborhoods see more marketing of unhealthy foods and beverages, while fresh fruits and vegetables are often nonexistent — or more expensive than in wealthier neighborhoods that can attract supermarkets.

Groceries in Leadville cost 18% more than the national average, according to a recent community food assessment, while incomes in Lake County languish far below the state average. The sole grocery store in Leadville stocks bottles of oxygen for tourists struggling with the thin air, but has barely half an aisle of fresh produce.

Swiss Chard And Playgrounds

County residents are trying to make healthier food and exercise more accessible.

The Cloud City Conservation Center is growing vegetables locally, a significant challenge given the 10,000-foot elevation and short growing season. The farm consists of a pair of greenhouses — a geodesic dome and a hangar-like tunnel — draped in plastic sheeting.

The Cloud City Conservation Center grows vegetables in Leadville, Colo., in a pair of greenhouses, and sells the produce through a community-sponsored agricultural program that provides 30 families with a weekly box of fresh vegetables. Ten of the spots are set aside for low-income families in a community where fresh produce is otherwise expensive and limited. (Markian Hawryluk/KHN)

The farmers grow plants that provide the best harvest in the least space, including Swiss chard and lettuce, cabbages and peas. That means no tomatoes, although that’s what everybody wants.

“The vegetables that grow best in this climate may be less popular, but they are the best for you,” said Kendra Kurihara, Cloud City’s executive director.

Cloud City sells its produce through a community-sponsored agricultural program that provides 30 families with a weekly box of fresh vegetables. Ten of the spots are set aside for low-income families, who get twice the value for food stamp dollars. But the demand exceeds the supply, with 45 families stuck on a waiting list.

Schools have also revamped recess and the playgrounds.

Just six years ago, students at the Lake County Intermediate School would race to finish their lunch the fastest, knowing the first kids out the door had the best chance to get one of the eight swings, the only usable piece of equipment on the school’s playground.

A group of parents banded together, hoping to raise $1,000 to buy balls and jump-ropes. With foundation help and private fundraising, they ended up with a $500,000 playground redesign. When the designers asked the children what they wanted, the kids asked for more swings.

“That was all they knew,” Baldassar said. “They couldn’t imagine anything else.”

The playground they built features giant rope spider webs for climbing, slides built for speed, hanging lily pads for balancing — and, yes, swings. It was a turning point for the school district, she said, that has paid dividends with higher test scores and improved academic performance.

Still, Joan Brucha, Healthy Eating Active Living unit manager at the Colorado Department of Public Health and Environment, said funding for obesity prevention work in Colorado comes to about 27 cents per state resident. “You can’t make meaningful change on that level,” she said.

According to the CDC, the U.S. spends 31 cents per person on obesity prevention efforts. CDC officials say they target limited resources to areas where obesity rates are highest.

And that makes it a lot harder for Colorado to make its case. Funding from the state tobacco tax also is available to counter obesity, but it’s not enough to make a difference in Lake County or the rest of the state.

In 2011, Democratic Gov. John Hickenlooper set a goal of reducing obesity rates by 10% by 2020. Just months from the deadline, the state isn’t anywhere close to achieving it.

ºÚÁϳԹÏÍø News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about .

This article first appeared on ºÚÁϳԹÏÍø News and is republished here under a .

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In The Battle Of The Fitness Trackers, The Most Steps Might Not Win /public-health/fitness-trackers-step-count-how-much-is-too-much/ Tue, 30 Jul 2019 09:00:47 +0000 When Sonia Anderson got her first Fitbit step tracker, her poor pooch, Bronx, had no idea of all the steps that were coming.

The device — which counts every step Anderson takes and displays those steps on an app — was a Christmas gift from her daughters two years ago.

At the time, Bronx, a Yorkshire terrier, was younger and could still manage the additional walks up and down the trails along the sprawling apartment complex in Alexandria, Va., where Anderson lives. Anderson was on a mission to clock 10,000 steps a day.

More recently, as Bronx hit age 13, the dog started coming to dead stops during these long treks, as if to ask: What’s going on here?

Sonia Anderson and Landy Sorenson often walk together on Friday mornings while volunteering at a local food bank. The friends track each other’s progress on their cellphone apps and compete to see who logs the most steps. (Bruce Horovitz/KHN)

Like many other folks 50 and older, the 63-year-old Anderson has been commandeered by the step-tracker craze that began about a decade ago, and her dog is an unwilling victim.

Anderson has bought into the $26 billion global step tracker industry and matches her daily count with her Fitbit-wearing friend, Landy Sorensen, 43. The two women have become inseparable Fitbit fanatics and competitors at the Arlington Food Assistance Center, where they amass additional steps every Friday morning while volunteering in the food bank. Now, they diligently count each other’s steps on their cellphone apps in real time — and compete to record just one more step than the other.

“My Fitbit made me a friend I’d have never had,” Anderson said.

It might also help her live longer, according to a recent Harvard University study published in the Journal of the American Medical Association. The study concluded that among older women, as few as 4,400 steps per day helped to lower mortality rates.

With more steps per day, mortality rates decreased before leveling off at 7,500 steps, the study found.

In other words, the magic marketing number of 10,000 daily steps embraced by so many wearers of these devices — from Fitbits to Garmins to Samsungs to Apple Watches — may be about 2,500 steps more than necessary.

Truth be told, even the woman behind the study — who concedes that she, too, is enamored of her step tracker — can’t say how many steps are the right number for each walker.

“No one size fits all,” said I-Min Lee, an associate epidemiologist at Brigham and Women’s Hospital in Boston and a professor at Harvard Medical School.

But no matter how many steps you take, merely wearing and using a fitness tracker — particularly for older women, older men and other people who tend to be somewhat inactive — “can be beneficial not only to your health but to your quality of life,” Lee said.

Of course, some folks go over the top with their trackers — and proudly post their more unusual stats on social media sites such as Reddit. Like the vegan fitness buff who posted a video about logging 50,000 steps a day for five days. And the warehouse stocker who said that he slogged 20,000 steps a day on the job. And there’s also the guy who credits his Fitbit for helping him slim his 40-inch waist to a svelte 34 inches.

Clocking miles is even popular with workers who are on the clock. C-SPAN network, for instance, ran a month-long walking challenge sponsored by its health insurance plan, Cigna. The step competition among C-SPAN departments, which ended July 3, totaled 22,862,341 steps walked by 74 participants from 12 teams, spokesman Howard Mortman said. That’s an average 9,966 steps per day per person. More specifically, he said, that’s a total 1,028,805 calories burned — and 294 pounds lost. (For the record, the cable network’s digital media team won.)

For Anderson and Sorensen, fitness tracking has created a special bond — and a way to keep close tabs on each other. Like the day when Sorensen noticed that Anderson had suddenly doubled her step output. She immediately texted her and discovered that Anderson was on a European vacation and that her sightseeing had doubled her daily count. Another time, when Anderson noticed that Sorensen had barely logged 2,000 steps, she sent a concerned text asking: “Are you OK?”

“I thought it was so sweet of her to check in on me,” said Sorensen, who said the problem was actually a battery issue. “This is the kind of connection I wouldn’t otherwise have.”

Sorensen averages about 15,000 steps daily — roughly between 5 and 7 miles — and often tucks her early-generation Fitbit into a specially designed gold bracelet, so folks can’t even see she’s wearing one. When she wears this bracelet to formal affairs, no one suspects she’s tracking her footwork, she said.

Sonia Anderson, 63, checks her Fitbit. A recent Harvard University study published in the Journal of the American Medical Association concluded that, among older women, as few as 4,400 steps per day helped to lower mortality rates. (Scott Suchman for KHN)
Recently, Yorkshire terrier Bronx, who is 13, has started coming to dead stops during long walks. Anderson now carries him most of the way. (Scott Suchman for KHN)

Harvard’s Lee said she first got interested in wearable devices five years ago during a workplace program that promoted healthy lifestyles for doctors. Lee received a free device — whose familiar brand name she prefers not to publicize — and was asked to form a team of walkers. Lee, 59, is hesitant to discuss her step count because she believes the sheer act of regularly exercising is far more important than the sum total of steps. But, after some cajoling, she said she averages about 15,000 steps per day.

Studies show that 150 minutes of moderate activity, such as walking, can lower the risk of heart disease and stroke, improve sleep, help reduce weight gain and improve bone health.

Perhaps no one knows that better than Tom Holland.

He’s an exercise physiologist and sports nutritionist who has regularly appeared on “Good Morning America” as a fitness coach.

He also has worked as a personal trainer with thousands of clients — many of whom use step trackers. He’s a huge fan of fitness trackers because they get people moving.

“The fitness tracker is the first step to getting people off the couch,” he said. At the same time, he is put off by the much-ballyhooed 10,000-step daily goal, which he said is arbitrary.

“We need real numbers to shoot for,” he said. Holland, who recently turned 50, prefers recommending smaller amounts of exercise — not big feats such as 10,000 steps. “I’m a big believer in excessive moderation. Don’t do a lot a little bit — do a little bit a lot.”

Unless, of course, it involves himself.

Like the 70,000, or so, steps he clocked in a recent 50-kilometer trail run. Because Holland also is a triathlete, he not only uses a Fitbit from time to time but also sometimes slaps on “smart” sunglasses or T-shirts or shorts that track fitness data. Most often, however, he wears a Garmin fitness tracker that measures his steps, his sleeping habits and his heart rate.

“I’m not an addict,” he said jokingly, “but if you see me passed out on the side of the road, check my tracker, please.”

As for Anderson’s little dog, Bronx, he sometimes gets extra incentive to go on those walks. Occasionally, Anderson brings along her daughter’s English bulldog, Winston, whose namesake is the British statesman Winston Churchill. Perhaps, in a cosmic nod to future step trackers of all kinds, it was Churchill who said it best: “I never worry about action, but only inaction.”

ºÚÁϳԹÏÍø News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about .

This article first appeared on ºÚÁϳԹÏÍø News and is republished here under a .

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