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Childbirth Is Deadlier for Black Families Even When They’re Rich, Expansive Study Finds

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Childbirth Is Deadlier for Black Families Even When They’re Rich, Expansive Study Finds

In the US, the richest moms and their newborns are the most definitely to outlive the yr after childbirth — besides when the household is Black, in keeping with a groundbreaking new research of two million California births. The richest Black moms and their infants are twice as more likely to die because the richest white moms and their infants.

Analysis has repeatedly proven that Black moms and infants have the worst childbirth outcomes in the US. However this research is novel as a result of it’s the primary of its dimension to point out how the dangers of childbirth fluctuate by each race and parental revenue, and the way Black households, no matter their socioeconomic standing, are disproportionately harmed.

“This can be a landmark paper, and what it makes actually stark is how we’re leaving one group of individuals method behind,” stated Atheendar Venkataramani, a College of Pennsylvania economist who research racial well being disparities and was not concerned within the analysis.

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The research, printed final month by the Nationwide Bureau of Financial Analysis, consists of almost all of the infants born to first-time moms from 2007 to 2016 in California, the state with probably the most annual births. For the primary time, it combines revenue tax knowledge with delivery, demise and hospitalization data and demographic knowledge from the Census Bureau and the Social Safety Administration, whereas defending identities.

That strategy additionally reveals that untimely infants born to poor dad and mom usually tend to die than these born into the richest households. But there’s one group that doesn’t achieve the identical safety from being wealthy, the research finds: Black moms and infants.

Are you a Black dad or mum who lately gave delivery? Inform us about it.

“It means that the well-documented Black-white hole in toddler and maternal well being that’s been mentioned lots lately isn’t just defined by variations in financial circumstances,” stated Maya Rossin-Slater, an economist learning well being coverage at Stanford and an creator of the research. “It suggests it’s far more structural.”

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If something, the research’s findings understate the hazards of childbirth in a lot of the US, a wide range of researchers stated, as a result of California’s maternal mortality charge has been declining over the past decade, as deaths have gone up in the remainder of the nation.

Wealthy Households Have Extra Untimely Infants. However These Infants Are Much less More likely to Die.

Maybe unexpectedly, infants born to the richest 20 p.c of households are the least wholesome, the research finds. They’re extra more likely to be born untimely and at a low delivery weight, two key threat elements for medical problems early in life. It’s because their moms usually tend to be older and to have twins (that are extra widespread with using fertility therapies), the researchers discovered.

However even with these early threat elements, these infants are the most definitely to outlive each their first month and first yr of life.

The same sample emerged when it got here to the well being of the dad and mom themselves: Wealthy and poor moms had been equally more likely to have high-risk pregnancies, however the poor moms had been thrice as more likely to die — even inside the similar hospitals. Wealthy girls’s pregnancies “aren’t solely the riskiest, but additionally probably the most protected,” the paper’s authors wrote.

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A pair of charts exhibiting the connection between a mom’s revenue and charges of untimely births and toddler mortality. The primary chart exhibits that as a girl’s revenue rises, the probability of preterm delivery rises. The second chart exhibits that as a girl’s revenue rises, charges of toddler mortality fall.


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Charges of preterm delivery rise with a girl’s revenue …

… however charges of

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toddler mortality fall.

Preterm births per 100,000

Toddler Deaths per 100,000

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Charges of preterm delivery rise with a girl’s revenue …

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Preterm births per 100,000

… however charges of

toddler mortality fall.

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Toddler Deaths per 100,000

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This discovering means that the American medical system has the flexibility to save lots of most of the lives of infants with early well being dangers, however that these advantages will be out of attain for low-income households.

Assets outdoors the medical system additionally play a task. Separate analysis on youngsters with leukemia, for instance, has discovered that even when handled on the similar hospital and utilizing the identical protocol, these from high-income households fared higher than these from poorer households.

“It’s not simply in regards to the medical care that youngsters are receiving,” stated Anna Aizer, a well being economist at Brown College. “There are all types of different issues that go into having wholesome infants. For those who’re a higher-income mother who can take day off work, who doesn’t have to fret about paying hire, it’s not stunning you’ll be capable of handle any well being problems higher.”

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Cash Protects White Moms and Infants. It Doesn’t Shield Black Ones.

The researchers discovered that maternal mortality charges had been simply as excessive among the many highest-income Black girls as amongst low-income white girls. Toddler mortality charges between the 2 teams had been additionally comparable.


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Two charts exhibiting the connection between a mom’s revenue and charges of toddler mortality by race. The primary chart exhibits that as a Black mom’s revenue will increase, the speed of toddler mortality typically drops. The identical is true within the second chart for white moms, however at a lot decrease charges than for Black girls.





The richest Black girls have toddler mortality charges at about the identical degree because the poorest white girls.

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Toddler deaths per 100,000 for moms who’re …

Fee for richest

Black moms

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Fee for poorest

white moms

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The richest Black girls have toddler mortality charges at about the identical degree because the poorest white girls.

Toddler deaths per 100,000

for moms who’re …

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Fee for richest

Black moms

Fee for poorest

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white moms

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The infants born to the richest Black girls (the highest tenth of earners) tended to have extra threat elements, together with being born untimely or underweight, than these born to the richest white moms — and greater than these born to the poorest white moms. It’s proof that the hurt to Black moms and their infants, no matter socioeconomic standing, begins earlier than childbirth.

“As a Black toddler, you’re beginning off with worse well being, even these born into these rich households,” stated Sarah Miller, a well being economist on the College of Michigan. She was an creator of the research with Professor Rossin-Slater and Petra Persson of Stanford, Kate Kennedy-Moulton of Columbia, Laura Wherry of N.Y.U. and Gloria Aldana of the Census Bureau.

Black moms and infants had worse outcomes than those that had been Hispanic, Asian or white in all of the well being measures the researchers checked out: whether or not infants had been born early or underweight; whether or not moms had birth-related well being issues like eclampsia or sepsis; and whether or not the infants and moms died. There was not sufficient knowledge to take a look at different populations, together with Native Individuals, however different analysis has proven that they face antagonistic outcomes nearing these of Black girls and infants in childbirth.

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Charts that present the connection between a mom’s revenue by group. The teams are Hispanic moms and Asian moms. Usually, charges for Hispanic moms and Asian moms observe extra intently with these of white moms than Black moms.


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Toddler deaths per 100,000 for moms who’re …

Toddler mortality charges for Hispanic and Asian moms observe extra intently to charges of white moms than Black moms.

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Toddler mortality charges for Hispanic and Asian moms observe extra intently to charges of white moms than Black moms.

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Toddler deaths per 100,000

for moms who’re …

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Even earlier than the brand new paper, analysis discovered that Black girls with probably the most assets, as measured by schooling and sophistication mobility, didn’t profit throughout childbirth the best way white girls did. The brand new research demonstrates that disparities aren’t defined by revenue, age, marital standing or nation of delivery. Relatively, by exhibiting that even wealthy Black moms and infants have a disproportionately greater threat of demise, the info suggests broader forces at play within the lives of Black moms, Professor Rossin-Slater stated.

“It’s not race, it’s racism,” stated Tiffany L. Inexperienced, an economist targeted on public well being and obstetrics on the College of Wisconsin-Madison. “The info are fairly clear that this isn’t about biology. That is in regards to the environments the place we reside, the place we work, the place we play, the place we sleep.”

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There’s clear proof that Black sufferers expertise racism in well being care settings. In childbirth, moms are handled otherwise and given totally different entry to interventions. Black infants usually tend to survive if their medical doctors are Black. The expertise of the tennis star Serena Williams — she had a pulmonary embolism after giving delivery, but stated well being care professionals didn’t deal with it at first — drew consideration to how not even probably the most well-known and rich Black girls escape this sample.

However this knowledge exhibits how the consequences of racism on childbirth begin lengthy earlier than individuals arrive on the hospital, researchers throughout disciplines say, and proceed after they go away. The stress of experiencing racism; air air pollution in Black communities; and inequitable entry to paid household go away, for instance, have all been discovered to have an effect on the well being of moms and infants.

“Even when it’s not in regards to the direct disrespect that’s occurring between the affected person and the care supplier, there are numerous methods systemic racism makes its method into the well-being of a pregnant or birthing individual,” stated Dr. Amanda P. Williams, the scientific innovation adviser on the California Maternal High quality Care Collaborative.

California Is a Finest-Case Situation. It Nonetheless Lags Behind Different Rich Components of the World.

Many elements of the US have a lot greater maternal mortality than California, and fewer insurance policies to assist households. California was the primary state to supply paid household go away. It has probably the most beneficiant public insurance coverage applications for pregnant girls. The state has invested in particular applications geared toward lowering maternal deaths and racial disparities in childbirth.

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But even on this best-case American state of affairs, moms and infants fare worse in contrast with one other wealthy nation the researchers examined: Sweden. At each revenue degree, Swedish girls have more healthy infants. This held true for the highest-income Swedish girls and people from deprived populations, together with low-income and immigrant moms.


A pair of charts exhibiting the connection between delivery outcomes in Sweden and California. The primary chart exhibits that Swedish girls have heavier infants at each revenue degree. The second chart exhibits that Swedish girls have decrease charges of preterm delivery than California girls at each revenue degree.

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Swedish girls have heavier infants at each revenue degree …

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… and much decrease situations of preterm delivery.

Preterm births per 100,000

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Swedish girls have heavier infants at each revenue degree …

… and much decrease situations of preterm delivery.

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Preterm births per 100,000

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In the US, incomes extra commonly interprets into superior entry to the quickest, costliest well being care. However even with that benefit, the richest white Californians on this research nonetheless gave delivery to much less wholesome infants than the richest Swedish girls. Their newborns had been extra more likely to be untimely or underweight. The 2 teams had roughly equal maternal demise charges.

“That discovering actually does strongly recommend that it’s one thing in regards to the care mannequin,” stated Dr. Neel Shah, chief medical officer of Maven Clinic for girls’s and household well being and a visiting scientist at Harvard Medical Faculty. “We have now the expertise, however the mannequin of prenatal care in the US hasn’t actually gotten an replace within the final century.”

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A chart exhibiting the place the U.S. falls on the spectrum of maternal mortality amongst peer international locations. The U.S. is final in a rating that features New Zealand, Norway, the Netherlands, Germany, Sweden, Switzerland, Australia, Britain, Canada and France, in that order.




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Fee of maternal mortality in chosen international locations

5 deaths

per 100,000

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births

Fee of maternal mortality in chosen international locations

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5 deaths

per 100,000

births

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Source: O.E.C.D. knowledge for 2018, besides 2017 for Switzerland and Britain.; 2016 for New Zealand; 2012 for France. Paper

Sweden, like most European international locations, has common medical health insurance with low out-of-pocket prices for the affected person. Midwives ship most infants in Sweden and supply many of the prenatal care, which has been linked to decrease C-section charges and decrease charges of preterm births and low delivery weights. It has lengthy paid leaves and backed youngster care.

Like California, Sweden has additionally began focused efforts to cut back maternal deaths. When officers there acknowledged that African immigrants giving delivery had been dying extra regularly, they started piloting a “tradition doula” program, with doulas who had been immigrants themselves serving to pregnant girls navigate the nation’s well being system.

Native maternal well being applications may start to assist cut back racial disparities in the US, too, as may a extra numerous medical workforce, analysis suggests. Nonprofits and universities have experimented with methods to deal with racism and poverty, with applications like money transfers for low-income pregnant girls and initiatives to enhance the environments of Black communities.

By the point a girl is pregnant, Professor Miller stated, “it’s nearly too late.”

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“Well being goes to rely on exposures all through her life, well being care she’s obtained, environmental elements,” she stated. “So much goes on previous to the being pregnant that impacts the well being of the mom and child.”

Concerning the knowledge

The researchers collected delivery certificates knowledge for all infants born to first-time moms in California from 2007 to 2016. The ultimate pattern included 1.96 million births. They collected hospitalization and demise data for infants for one yr from the California Division of Well being Care Entry and Info, in addition to hospitalization data for moms for 9 months earlier than the delivery and a yr after. They collected maternal demise data for a similar interval from a Social Safety Administration knowledge set. They supplied delivery data to the Census Bureau, which assigned nameless identification codes to entry I.R.S. knowledge and decide new dad and mom’ incomes within the two years earlier than the delivery. (Toddler mortality data had been obtainable solely till 2012. Maternal mortality knowledge covers an extended interval than in authorities data, which typically embody knowledge for six weeks after a delivery, and most definitely seize some deaths unrelated to childbirth.)

In Sweden, the researchers collected comparable well being and mortality knowledge from the Nationwide Board of Well being and Welfare. The ultimate pattern included 463,865 births. Analogous maternal morbidity knowledge was unavailable. They linked infants to their dad and mom and picked up dad and mom’ demographic and monetary knowledge from Statistics Sweden. Sweden has a smaller hole between the best and lowest earners than the US.


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We wish to hear from Black dad and mom and their medical suppliers about childbirth

The New York Instances is investigating disparities in hospital therapy for brand spanking new dad and mom. We wish to hear from Black dad and mom who’ve given delivery inside the final 5 years, and the medical suppliers (comparable to doulas, midwives, nurses and medical doctors) who deal with them. We is not going to publish any a part of your submission with out contacting you first.

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Judge halts ban on syringe programs as El Dorado County legal battle continues

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Judge halts ban on syringe programs as El Dorado County legal battle continues

El Dorado County cannot enforce its ban on programs that hand out clean syringes as a legal battle continues between the county and the California Department of Public Health, a Superior Court judge has ruled.

Judge Gary S. Slossberg granted a preliminary injunction to prevent El Dorado County from enforcing an ordinance that makes it unlawful to operate syringe programs in its unincorporated areas.

The judge said he was not weighing in on the heated arguments for or against syringe programs, which provide sterile needles to people who use drugs, but whether the Department of Public Health had a “reasonable probability” of prevailing in its argument that the county ordinance clashes with state law.

Friday’s decision does not end the courtroom dispute over whether the ban passed by the El Dorado County Board of Supervisors was preempted by state law, as public health officials have argued, or opposing claims by county officials that the syringe program was improperly approved by the state. Slossberg said Friday that the preliminary injunction is meant to remain in place pending a later trial.

The Department of Public Health filed suit against El Dorado County and its county seat of Placerville this year contending that their bans on syringe programs defied the state health and safety code.

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The state health department first authorized the nonprofit Sierra Harm Reduction Coalition to operate a syringe program in the county four years ago. State officials have long endorsed such programs as a proven way to prevent HIV and hepatitis C from running rampant as people share contaminated syringes.

California law gives the public health agency the power to approve syringe programs anywhere that deadly or disabling infections might spread through used needles, “notwithstanding any other law.”

Local bans on syringe programs have nonetheless sprung up across California as city and county officials argue that handing out free syringes does more harm than good. El Dorado County leaders passed their rule in December, which was followed in February by a similar ordinance in Placerville.

The lawsuit lodged by the California Department of Public Health drew objections from El Dorado County leaders: Earlier this year, Dist. Atty. Vern Pierson called it “madness” and argued that California officials were “seeking to impose the normalization of hardcore drug use.”

In a cross-complaint filed against the Department of Public Health, the county said that the syringe program approved by the state had caused “profound nuisance and public safety impacts,” including a “drastic increase in discarded needles,” and that overdoses had risen since it started.

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The county said in a legal filing that since the ban went into effect, “there has been a reduction of syringe waste, decreased incidents of public nuisance, and a resulting reduction of the burdens on law enforcement.”

It also accused the public health department of failing to follow state requirements when it approved the syringe program.

The judge did not weigh in on the cross-complaint lodged by El Dorado County at the Friday hearing. In a court filing, California officials said studies show that syringe programs provide important resources for needle disposal and play a crucial role in preventing overdoses. They credited the Sierra Harm Reduction Coalition with handing out thousands of boxes of Narcan, a brand of naloxone, a medication that reverses the effects of an opioid overdose.

The Department of Public Health argued in a legal filing that stopping the syringe program would be likely to ramp up HIV and hepatitis C infections among people who use drugs, increasing state costs for their care; lead to more deaths from drug overdoses; and reduce access to options for syringe disposal, among other harmful effects.

Because of the bans, “our most vulnerable, stigmatized, and marginalized community members are actively being denied lifesaving interventions,” Sierra Harm Reduction Coalition interim executive director Shilo Jama said in a court filing.

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Slossberg said that although he was preventing the El Dorado County ordinance from being enforced, the county might have other mechanisms to address nuisance issues that were not addressed by the decision.

Pierson, the district attorney, said in a statement Friday that “we will propose narrowing the ordinance” in response to comments made by the judge.

The California Department of Public Health said in a statement that it was “pleased with the court’s decision that upholds that state’s role in protecting the public’s health while this case proceeds.”

The Friday ruling applies only to the ordinance passed by El Dorado County. Attorney Mona Ebrahimi, who represents the city of Placerville, said a hearing involving the city had been postponed.

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This one thing may derail your shot at healthy aging, scientists say

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This one thing may derail your shot at healthy aging, scientists say

Before you settle in to binge the new season of “The Bear” or watch Team USA go for the gold at the Paris Olympics, think twice about the amount of time you spend on the couch in front of the TV. Your future self may thank you.

A new study by Harvard researchers links the popular pastime of sitting and watching television to the likelihood of reaching one’s senior years in a state of good health: the more time spent doing the former, the lower the odds of achieving the latter.

The problem doesn’t seem to be with sitting in general. After controlling for a variety of risk factors such as diet quality and smoking history, the researchers found no relationship between time spent in a chair at work and the chances of aging well. Ditto for sitting in cars or at home doing something besides watching TV, such as reading, eating meals or paying bills.

Yet for every additional two hours spent in front of the boob tube, a person’s chance of meeting the researchers’ definition of healthy aging declined by 12%, according to their study published this week in JAMA Network Open.

That does not bode well for the United States, where 62% of adults between the ages of 20 and 64 say they watch TV for at least two hours a day, as do 84% of senior citizens.

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The findings are based on data from more than 45,000 women who participated in the Nurses Heath Study. All of them were at least 50 years old and had no major chronic diseases back in 1992, when they answered a slew of questions about their health and what they did all day.

For instance, the nurses were asked how much time they spent standing or walking around at work or at home. They were asked about various types of exercise, including jogging, swimming laps, playing tennis and doing yoga. They were asked if they mowed their own lawns.

And they were asked how many hours they spent doing all kinds of sitting.

A couple watches a movie on TV at their home in Norwalk while sharing a bowl of popcorn.

(Francine Orr / Los Angeles Times)

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You might not be surprised to learn that the most popular type of sitting was sitting while watching television. More than half of the women — 53% — said they watched between six and 20 hours of TV a week. (The median among this group was around 15.4 hours per week.) Another 15% of the women said they watched between 21 and 40 hours of TV each week, and 2% watched even more.

The nurses were tracked for 20 years or until they died, whichever came first. By the end of the study period, 41% of them were still free of 11 major health conditions, including cancer, diabetes, heart failure, chronic obstructive pulmonary disease and multiple sclerosis. In addition, 44% of the nurses were in good mental health, 52% had no memory impairments and 16% had no physical impairments.

Only 8.6% of the women met all four of those criteria, which was what it took to achieve healthy aging.

On the whole, the women who watched more TV tended to be older, were more likely to be smokers or drinkers, consumed more calories and had higher body mass index scores than women who watched less TV. The more devoted TV watchers were also more likely to have high blood pressure and high cholesterol.

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Once the researchers accounted for these and a host of other differences, they found that the women who spent an hour or less each week sitting in front of the TV were the most likely to achieve healthy aging. Compared to them, women who watched TV for two to five hours per week were 9% less likely to be healthy agers; those who watched for six to 20 hours per week were 19% less likely; those who watched for 21 to 40 hours per week were 40% less likely; and those who watched for at least 41 hours a week were 45% less likely.

The researchers also found that replacing TV time with pretty much anything else — including sleep, for women who got no more than seven hours of shut eye per night — would increase their odds of healthy aging. The more vigorous the new activity, the bigger the boost.

Although the actual percentage of women who succeeded in healthy aging was low, the study authors estimated that another 61% of the women could have joined that rarefied group if they had done four things:

  • Spent at least three hours per day engaged in light physical activity at work.
  • Invested at least 30 minutes a day in moderate to vigorous physical activity.
  • Kept their weight in the normal range instead of being overweight or obese.
  • Limited their TV-watching time to less than three hours a day.

The study didn’t show that excess TV time caused any of the nurses to miss out on healthy aging, only that there was a significant inverse correlation between the two. Still, there’s good reason to suspect that their favorite sedentary behavior bore at least some of the responsibility.

Previous studies have linked prolonged sitting — especially while watching television — to a variety of health problems, including diseases like breast cancer, colorectal cancer, type 2 diabetes, cardiovascular disease and early death. (That particular study found that compared to sitting for less than three hours a day, sitting for at least twice that long was associated with a 17% increased risk of premature death for men and a 34% increased risk of premature death for women.)

But the researchers from Harvard’s T.H. Chan School of Public Health have taken things a step further, said Dr. I-Min Lee, an epidemiologist at Brigham & Women’s Hospital in Boston who studies how physical activity can prevent chronic diseases and extend life.

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“This study expands what we know because it looked at ‘healthy aging,’” said Lee, who was not involved in the study. “‘Health’ is not just the absence of disease; it includes dimensions of physical and mental health, function and well-being.”

All of the study subjects were women, but the biological mechanisms are likely to apply to men as well, Lee said. Even so, it would be good to actually test this relationship in men, as well as in people from a wider range of racial and ethnic backgrounds, she said. (The group of women in the original Nurses Health Study was overwhelmingly white.)

The youngest of the Baby Boomers are now turning 60, and the proportion of the U.S. population that’s at least 65 is projected to increase from roughly 17% today to nearly 21% in 2050, according to the U.S. Census Bureau.

“Population aging is an important public health issue,” the study authors wrote, and strategies to promote healthy aging “are urgently needed.”

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Column: The abortion pill is safe. Is your uterus?

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Column: The abortion pill is safe. Is your uterus?

Huge sigh of relief.

In a ruling that I happily admit surprised me, the Supreme Court on Thursday affirmed the obvious: Women should have the right to safe medication abortions.

But ladies, our uteri are not safe yet.

For now, in a unanimous decision, the justices have tossed a case that would have prevented the drug mifepristone from being used by women seeking to end pregnancies.

So mify, as the drug is commonly called, is safe. But this is far from the end of the MAGA war on women.

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Let’s be clear on this: The ruling wasn’t actually about the drug. It was about the folks who brought the suit, a bunch of doctors who really didn’t have much of a reason to keep millions of women from accessing care other than they didn’t like the care those women wanted.

That’s not actually a reason to sue, even by Samuel Alito and Clarence Thomas standards.

So this ruling is about “standing” and the fact that these docs didn’t have it. Already, antiabortion activists are lining up other cases with defendants whose legal footing is much more solid.

And the Supreme Court is hardly the only front in this war for women’s rights. Here’s three other ways the far-right wants to control female bodies:

First, “fetal personhood” has bubbled up as a scary push by the religious right.

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Alito hinted at this concept in the Dobbs ruling, which knocked out Roe vs. Wade, when he referred to an embryo as an “unborn human being.”

In Alabama, we saw this take greater life recently when state Supreme Court judges ruled that embryos created during in vitro fertilization should be considered protected human life (though the state Legislature for now has protected the procedure).

And this week, the Southern Baptist Conference, which speaks for more than 10 million Protestant Americans, announced it would now opposes IVF on those embryos-are-life grounds.

If courts do recognize the idea of fetal personhood, it would pave the way for abortion to be considered not just illegal, but murder. It would also give a state the right to police pregnant women in any way it deems necessary to protect the “unborn child.”

We are already seeing some states attempting to prosecute women for abortions under strict new abortion laws and dozens of states (such as Kansas) either have outright legal language broadly giving fetuses rights or language that edges right up to it. We are closer to this than you think.

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The second front on the war on women is contraception.

Though it seems insane and inane to most of us to forbid women from taking the pill or an emergency medication in the immediate aftermath of intercourse to prevent pregnancy, some folks do want to ban it as a form of abortion.

There is a logic to it. If all abortion is illegal, then anything affecting the embryo after conception is off limits.

Finally, there’s former President Trump.

I’ve written before about the Comstock Act, an obscure and angry old law that many speculated the Supreme Court justices might dredge up in this mifepristone case.

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That law (which is on the books, but not enforced) theoretically makes it illegal to mail anything that could be used in an abortion — so not just the medication. Hard-liners could argue that anything shipped to an abortion clinic to help it operate could be verboten, even latex gloves.

MAGA types are already floating the frightening notion that if Trump were elected, he could simply bypass courts and Congress and order his Department of Justice to enforce the Comstock Act — ending abortion access without technically ending abortion access.

This week, Trump send a recorded message to the Danbury Institute, an ultraconservative organization that has advocated for abortion to be prosecuted as homicide and called it “child sacrifice.”

He didn’t mention abortion, but there’s this:

“These are gonna be your years, because you’re gonna make a comeback like just about no other group,” he said. “I know what’s happening, I know where you’re coming from and where you’re going, and I’ll be with you side by side.”

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So while Thursday’s ruling is a welcome win in the fight to keep women equal, it’s a victorious battle.

The war continues.

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