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In Texas Measles Outbreak, Signs of a Riskier Future for Children

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In Texas Measles Outbreak, Signs of a Riskier Future for Children

Every day, as Dr. Wendell Parkey enters his clinic in Seminole, a small city on the rural western edge of Texas, he announces his arrival to the staff with an anthem pumping loudly through speakers.

As the song reaches a climax, he throws up an arm and strikes a pose in cowboy boots. “Y’all ready to stomp out disease?” he asks.

Recently, the question has taken on a dark urgency. Seminole Memorial Hospital, where Dr. Parkey has practiced for nearly three decades, has found itself at the center of the largest measles outbreak in the United States since 2019.

Since last month, more than 140 Texas residents, most of whom live in the surrounding Gaines County, have been diagnosed and 20 have been hospitalized. Nine people in a bordering county in New Mexico have also fallen ill.

On Wednesday, local health officials announced that one child had died, the first measles death in the United States in a decade.

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It may not be the last. Large swaths of the Mennonite community, an insular Christian group that settled in the area in the 1970s, are unvaccinated and vulnerable to the virus.

The outbreak has struck at a remarkable juncture. Vaccine hesitancy has been rising in the United States for years and accelerated during the coronavirus pandemic. Now the nation’s most prominent vaccine skeptic, Robert F. Kennedy Jr., has been named its top health official, the secretary of health and human services.

Mr. Kennedy has been particularly doubtful of measles as a public health problem, once writing that outbreaks were mostly “fabricated” to send health officials into a panic and fatten the profits of vaccine makers.

At a cabinet meeting on Wednesday, Mr. Kennedy minimized the crisis in West Texas, saying that there had been four outbreaks so far this year (there have been three, according to federal health officials) and 16 last year.

Following widespread criticism, Mr. Kennedy posted a social media message on Friday saying he did “recognize the serious impact of this outbreak on families, children, and healthcare workers.”

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Vaccine fears have run deep in these parts for years, and some public health experts worry that the current outbreak is a glimpse at where much of America is headed. Researchers think of measles as the proverbial canary in a coal mine. It is among the most contagious infectious diseases, and often the first sign that other pathogens may be close behind.

“I’m concerned this is a harbinger of something bigger,” said Dr. Tony Moody, a pediatric infectious disease expert at the Duke University School of Medicine. “Is this simply going to be the first of many stories of vaccine-preventable disease making a resurgence in the United States?”

On the front lines of the outbreak, simple answers aren’t easy to come by.

Measles was officially declared eliminated in the United States in 2000. Not long ago, it had become so rare that many American doctors never saw a case.

But as the outbreak spread, Dr. Parkey learned to spot the signs of infection in the examination room even before he saw the telltale rashes.

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School-age children often zipped around the room or pestered their mothers or asked him for lollipops. The children stricken with measles sat still, vacant looks in their eyes.

On Monday, Dr. Parkey walked into a hospital room where an unvaccinated 8-year-old boy sat with that distant stare. His mother had scheduled an appointment after she noticed his barking cough the night before.

By the time they arrived at the clinic, the boy’s eyes were red and crusted. He had a low-grade fever and a blotchy pink rash covering his chest and back.

Dr. Parkey tried the usual banter: “Do you have a girlfriend?” The boy looked past him, glassy eyes trained on the wall.

“Which of your uncles is your favorite?” Dr. Parkey asked. The boy let out a dry cough and slumped further into his seat. He spoke only once, to request a cup of water.

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Over the next 24 hours, if the boy’s illness followed the typical progression, he was likely to get sicker. His fever would spike, and the rash would fan out over his torso and thighs.

If he was lucky, the worst would pass within a few days. If he was not, the virus might find its way into his lungs and cause pneumonia, potentially making it difficult to breathe without an oxygen mask.

Measles might even invade his brain, causing swelling and possible convulsions, blindness or deafness.

Doctors have few options to alter its course once the virus infects someone. There is no treatment that will stop it, only medicines to make the patient more comfortable.

Dr. Parkey wrote prescriptions for cough syrup and antibiotics for the boy. A nurse swabbed the back of his throat for a sample to be shipped to the state health department in a box of dry ice, adding to the county’s growing case count.

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For decades, the doctors at Seminole Memorial Hospital had been having conversations with patients about the importance of childhood vaccines.

Even on busy days with back-to-back appointments, staff members sat down with parents to discuss fears about side effects and to recount the horrors of many preventable diseases.

Go to an old cemetery, Dr. Parkey often told his patients — look at how many children died before vaccines arrived. In many families, though, minds were made up, and the conversations rarely broke through.

The largest school district in Gaines County reported that just 82 percent of kindergartners received the measles, mumps and rubella (M.M.R.) vaccine in 2023. One of the smaller school districts reported that less than half of the students had received the shot.

For a virus as contagious as measles — which spreads through microscopic droplets that can linger in the air for two hours — experts say that at least 95 percent of a community must be vaccinated in order to stave off an outbreak.

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Gaines County, a dusty expanse the size of Rhode Island dotted with cotton fields and whirring pump jacks, had not hit that mark in many years.

Although there is no religious doctrine that bans vaccination, the county’s tightknit Mennonites often avoid interacting with the medical system and hold to a long tradition of natural remedies, said Tina Siemens, a Seminole historian who has written several books about the community in West Texas.

In recent years, concerns about childhood vaccines appeared to rise even in the broader Seminole community, especially after Covid-19, several doctors said. An outbreak began to feel inevitable.

“I’d never seen measles, but I knew it was coming,” Dr. Parkey said.

In this respect, Gaines County is not so different from much the country.

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Before the pandemic, 95 percent of kindergartners in the United States had received the M.M.R. vaccine, according to federal tallies. The figure sank below 93 percent last year. Immunization rates against polio, whooping cough and chickenpox fell in similar proportions.

When the cases in Texas first surfaced, local doctors and health officials hoped that the outbreak would make the M.M.R. vaccines an easier sell. If parents saw what measles did to children, the thinking went, they would understand what the vaccine was designed to protect them from.

But there has been no stampede to vaccination. In Seminole, a city of about 7,200 people, almost 200 residents have received shots at pop-up clinics.

“Hopefully, at least the next generation will change their minds about vaccines,” Dr. Parkey said. “Just maybe not this one.”

One mother told Dr. Leila Myrick, a family medicine physician at Seminole Memorial, that the measles outbreak had helped solidify her decision not to vaccinate her children. She’d heard from a friend that the virus was similar to a bad flu.

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Even some parents who recognized the dangers that measles posed to their children still felt that vaccines were riskier.

Ansley Klassen, 25, lives in Seminole with her husband and four young children, three of whom are fully unvaccinated. She considered bringing her children to a vaccine clinic when measles cases first started popping up.

Mrs. Klassen, who is about five months pregnant, knew she didn’t want to risk getting measles. She had been scrubbing counters with Lysol wipes and keeping her children away from others as much as possible.

But on social media, she had seen a deluge of frightening posts about the side effects of vaccines: stories of children developing autism after a shot or dying from metal toxicity. (Both claims have been debunked by scientists.)

“There are stories that you can read about people multiple hours after they got the vaccine having effects, and that’s scary to me,” she said. “So I’m like, is it worth the risk? And right now I can’t figure that out.”

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These anecdotes — regardless of whether they are factual — are part of what has made vaccine hesitancy such an intractable problem in the age of social media, said Mary Politi, a professor at the Washington University School of Medicine who studies health decision-making.

Stories about children who don’t have serious side effects from vaccines and never contract vaccine-preventible illnesses don’t go viral on TikTok, she noted.

“It’s not that they’re trying to make a bad choice or do something against evidence,” she said. “People are trying to do the best thing they can for their families, and they don’t know who to trust.”

Mrs. Klassen didn’t consider herself staunchly anti-vaccine. Her oldest daughter, now 6, had received all of her vaccines up to a year.

But she didn’t trust everything doctors were telling her, either. She thought the Covid-19 vaccine had been developed too quickly and pushed too forcefully, making her skeptical that the authorities were telling the truth about the measles shot.

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She prayed about it and ultimately decided to forgo the vaccine. “The trust I have in the medical system is not there,” she said.

It’s not just unvaccinated people who are at risk during the current outbreak.

Measles increases the likelihood of stillbirths and serious complications in pregnant women, yet they cannot receive the vaccine or booster.

Andrea Ochoa, a nurse’s assistant at Seminole Memorial who is six months into her first pregnancy, said she thought about taking time off from her job but ultimately decided to stay so she could keep her health insurance.

She wore an N95 mask during her entire shift, which sometimes made her so lightheaded that she sat in her car for a break. She showered as soon as she was home.

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“I hope it doesn’t get worse,” Ms. Ochoa said of the outbreak. “I don’t know what choice I would make.”

Five vaccinated residents also have contracted measles, state health officials said. At the clinic, Dr. Parkey recently cared for a teacher who was vaccinated but immunocompromised.

A serious measles infection kept the teacher curled in a fetal position on the couch for a week, her eyes so swollen that she opened them only for brief runs to the bathroom, she recalled in an interview. She asked not be named to protect her privacy.

The West Texas measles outbreak is far from the largest in the United States in recent years. In 2019, outbreaks in at least two dozen states sickened more than 1,250 people.

A vast majority of those infections occurred in “underimmunized, close-knit communities,” the C.D.C. noted. More than 930 patients were infected in Orthodox Jewish communities in New York.

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Federal, state and local officials swung into action with vaccination campaigns that led to more than 60,000 M.M.R. immunizations in the affected communities. They reached out to religious leaders, local doctors and advocacy groups.

And in areas like Williamsburg, Brooklyn, officials went further, issuing mandates requiring vaccination.

The campaign in West Texas has been less forceful. Management of outbreaks like this one falls to state health officials, and they ask for help from the C.D.C. and other federal resources as necessary.

The C.D.C. is providing some technical assistance, but Texas health officials said they did not need more help from the agency. They have not declared a public health emergency, as officials did in parts of New York State, nor have they moved to mandate vaccination.

“We can’t force anybody to take a drug — that’s assault,” said Dr. Ron Cook, a health official in nearby Lubbock, at a news conference on Friday.

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Zachary Holbrooks, the local public health official for four Texas counties, including Gaines, said that type of mandate would be deeply unpopular in the state, where individual freedom is a strongly held value.

Texas public schools require children to have received certain vaccines, including the M.M.R. shot. But in this state, as in many others, parents can apply for an exemption for “reasons of conscience,” including religious beliefs.

In January, as the first cases of measles began spreading in Gaines County, state legislators introduced several bills designed to weaken school vaccination requirements.

“I don’t want to see a baby’s lips turn blue because they can’t breathe,” Mr. Holbrooks said. “I don’t want anybody to suffer from long-lasting disability because they got measles.”

“But if you choose to live in Texas,” he added, “you can exercise that option.”

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Plan to kill 450,000 owls pushes past major obstacle with Republicans both for and against

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Plan to kill 450,000 owls pushes past major obstacle with Republicans both for and against

A controversial plan to kill one owl species to save another cleared a major hurdle.

The full Senate on Wednesday struck down a GOP effort to prevent the cull of up to 450,000 barred owls in the Pacific Northwest over three decades, ending a saga that created strange political bedfellows.

It’s a major win for environmentalists and federal wildlife officials who want to protect northern spotted owls that have been crowded out by their larger, more aggressive cousins. In recent weeks they got an unlikely ally in loggers who said scuttling the U.S. Fish and Wildlife Service plan could hinder timber sales.

But it’s a blow to an equally unusual alliance that includes right-wing politicians and animal rights advocates who argue the cull is too expensive and inhumane. The Trump administration leaned on Republican lawmakers to get out of the way, scrambling partisan lines.

Sen. John Kennedy, a conservative from Louisiana, sought to nix the owl-killing plan via the Congressional Review Act, which can be used to overturn recent rules by federal agencies.

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Kennedy said Interior Secretary Doug Burgum, whose portfolio includes timber production, recently called him and told him to abandon the resolution. This month logging advocates said that stopping the cull would jeopardize timber production goals set by the Trump administration.

But Kennedy was not persuaded.

“The secretary needed to call somebody who cared what he thought, because I think he’s wrong,” Kennedy said on the Senate floor. “I think he and the other members of the administrative state at the Department of the Interior decided to play God.”

Flanked by pictures of owls and bumbling cartoon hunter Elmer Fudd, Kennedy praised barred owls for their “soulful eyes” and “incredibly soft” feathers. But he acknowledged they’re better hunters than spotted owls. Barred owls, which moved over from eastern North America, are outcompeting spotted owls for food and shelter in their native territory.

Louisiana Senator John Kennedy spearheaded a resolution to overturn the Biden-era plan to cull barred owls, even after he said the Trump administration told him to back down.

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(Senate Banking Committee)

Ultimately the resolution failed 72 to 25, with three lawmakers not voting. Nearly all those who voted in favor of the resolution were Republican, but even more Republicans voted against it. The Fish and Wildlife Service approved the barred owl cull last year under the Biden Administration.

“I feel a lot of relief because this was one of the most major threats to the long-term, continued existence of the northern spotted owl in many years,” said Tom Wheeler, executive director of the Environmental Protection Information Center. “We’ve passed this hurdle, which isn’t to say there aren’t other hurdles or road bumps up ahead, but this feels good.”

Wheeler described the failed effort as a “nuclear threat” — if the resolution had passed, the Fish and Wildlife Service would have been blocked from pursuing any similar rule, unless explicitly authorized by Congress.

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Now Wheeler said he and his allies will continue to push for the owl cull to be carried out, and for federal funding to support it.

Animal welfare advocates like Wayne Pacelle, president of Animal Wellness Action and Center for a Humane Economy, are dismayed.

“What this means is that not only are barred owls at extreme risk of large-scale shooting, but spotted owls and old-growth forests are at risk from chainsaws,” Pacelle said of the failed resolution.

Pacelle’s camp vowed to continue the fight. A lawsuit challenging the hunt they filed against the federal government last fall is moving forward. And they’ll try to ensure money doesn’t flow to the program.

In May, federal officials canceled three related grants in California totaling more than $1.1 million, including one study that would have included lethally removing barred owls from more than 192,000 acres in Mendocino and Sonoma counties.

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However, there are other projects to kill barred owls in the Golden State, according to Peter Tira, a spokesperson for the California Department of Fish and Wildlife.

One $4.3-million grant issued by the state agency will support barred owl removal in the northwestern part of the state, along with other research. Another grant issued by NASA to a university involves killing barred owls in California as well as creating a tool to prioritize areas where the raptors need to be managed.

It’s not clear how or if the government shutdown, now stretching into its 31st day, is affecting the projects, Tira said in an email.

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Families pay thousands for an unproven autism treatment. Researchers say we need ethical guidelines for marketing the tech

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Families pay thousands for an unproven autism treatment. Researchers say we need ethical guidelines for marketing the tech

Over the last decade, clinics have popped up across Southern California and beyond advertising something called magnetic e-resonance therapy, or MERT, as a therapy for autism.

Developed by the Newport Beach-based company Wave Neuroscience, MERT is based on transcranial magnetic stimulation, a type of brain stimulation that’s approved by the Food and Drug Administration to treat depression, obsessive-compulsive disorder, migraines and smoking addiction.

Clinics licensing MERT have claimed that their trademarked version of the treatment can also produce “miraculous results” in kids with autism, improving their sleep, emotional regulation and communication abilities. A six-week course of MERT sessions typically costs $10,000 or more.

The FDA hasn’t approved MERT for this use. However, prescribing drugs or devices for conditions they aren’t approved for, which is known as off-label prescribing, is a legal and common practice in medicine.

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But when such treatments are offered to vulnerable people, a group of researchers argue in a new peer-reviewed editorial in the medical journal Transcranial Magnetic Stimulation, they should be evidence-based, clearly explained to patients and priced in a way that reflects the likelihood that they will work as advertised.

Most clinics advertising off-label TMS as a therapy for autism don’t meet those standards, the researchers say.

Autism is “the biggest off-label business … [and] the one that is the greatest concern,” said Dr. Andrew Leuchter, director of UCLA’s TMS Clinical and Research Service.

Leuchter is one of three researchers with TMS expertise who recently called for the establishment of ethical guidelines around off-label TMS marketing in the field’s primary journal.

Written with Lindsay Oberman, director of the Neurostimulation Research Program at the National Institute of Mental Health, and Dr. Holly Lisanby, founder of the NIMH Noninvasive Neuromodulation Unit and dean of Arizona State University’s School of Medicine and Advanced Medical Engineering, the editorial singles out MERT as an “example of off-label TMS where there is negligible evidence of efficacy.”

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“There is extremely limited scientific evidence at present that any form of TMS has efficacy and safety in improving the core symptoms of language, social skills, or behavioral disturbances associated with [Autism Spectrum Disorder],” the editorial states. “Websites and other promotional materials that fail to acknowledge this limited evidence-base can create a risk of bias and potential for false expectations.”

Dr. Erik Won, Wave’s president and chief medical officer, did not respond to requests for comment.

A Times investigation last year found there are no large scientific studies demonstrating that MERT is significantly better than a placebo at improving speech and communication challenges associated with autism. Wave has not conducted any clinical trials on MERT and autism.

Won said last year that Wave is working to obtain funding “for further studies and ultimately an FDA indication.”

Websites for clinics offering MERT often feature written testimonials from parents describing what they saw as positive changes in their children’s moods or spoken-language abilities after treatment sessions.

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Without data, however, there is no way to know whether a patient’s anecdotal experience is typical or an outlier, according to Zoe Gross of the Autistic Self Advocacy Network, a nonprofit group run by and for autistic adults.

“Be wary of therapies that are sold to you with testimonials. If you go to a clinic website and they have dozens of quotes from parents saying, ‘This changed my child’s life in XYZ ways,’ that isn’t the same as evidence,” Gross told The Times last year.

A therapy could have only a 1% success rate, she said, and still yield dozens of positive testimonials once thousands of people have tried it.

For families unsure of whether a particular commercial therapy might be valuable for their child, “ask the advice of a clinician or an autism scientist who is not connected to the facility providing a service, just to get a frank appraisal of whether it’s likely to be helpful or likely to be worth the money,” said James McPartland, director of the Yale Center for Brain and Mind Health, who is currently studying the relationship between TMS and social perception in autistic adults. “Before you want to ask someone to spend resources on it, you want to have a certain degree of confidence [that] it’s going to be useful.”

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Most of California’s public K-12 students go to school on campuses with virtually no shade

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Most of California’s public K-12 students go to school on campuses with virtually no shade

The vast majority of urban, public grade schools in California are paved-over “nature deserts” sorely lacking in trees or shade — leaving most of the state’s 5.8 million school-age children to bake in the sun during breaks from the classroom as rising global temperatures usher in more dangerous heat waves.

That’s the conclusion of a team of California researchers from UCLA, UC Davis and UC Berkeley who studied changes in the tree cover at 7,262 urban public schools across the Golden State between 2018 through 2022.

The ongoing joint project, which drew from urban tree canopy maps developed by study partners the California Department of Forestry and Fire Protection and the U.S. Forest Service, revealed that 85% of the schools lost about 1.8% of tree cover on average in that four-year span.

The situation appears to be just as worrisome today, the team said.

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The researchers also collaborated with the nonprofit Green Schoolyards America, which found in its own 2024 study that California’s public K-12 schoolyards have a median tree cover of just 6.4%. And more than half of that canopy exists only as decoration at school entrances, in parking lots and along campus perimeters.

“Extreme heat is becoming a major public health concern in California and across the country, and trees can play a really big role in helping us cool down those schools and also build climate resilience,” said Kirsten Schwarz, the research lead at UCLA.

Results from the 2018 to 2022 study, which was funded by the U.S. Forest Service, were recently published in the journal Urban Forestry and Urban Planning.

While 15% of the schools surveyed saw gains in tree cover thanks in part to schoolyard greening projects — particularly in the Central Valley, around Sacramento and in Imperial County — many individual schools surveyed experienced big losses in net tree cover in that time. In some cases, those added up to more than 40%.

Among the state’s largest school districts, San Francisco had the greatest canopy loss, 16.3%. On the other end of the spectrum, Sacramento had the greatest gain at 7.5%, followed by Long Beach, which saw a 4% canopy increase.

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Schools in Los Angeles showed a small net loss of 0.5%. The researchers cautioned not to read too much into that modest figure, because longstanding disparities in tree cover and shade across the city still expose schools in poorer neighborhoods away from the ocean to greater sun and intense outdoor heat than schools that benefit from their proximity to cooling ocean breezes and lingering marine cloud cover.

As part of the continuing data collection, the team conducted new field research in a subset of schools this summer — some in Southern California, some in the Bay Area and some in the Central Valley. Due to research agreements with the different districts, Schwarz said she could not disclose the exact locations.

Researchers from UCLA performed a complete tree inventory for 16 schools in each district, counting all of the trees they found on a campus, mapping their exact locations, identifying the many different species they came across, measuring trees at the base and crown and assessing the overall health of each tree.

Accompanying the UCLA researchers to a selection of schools in each district were researchers from UC Davis who took heat measurements.

They brought portable weather stations and sensors, as well as swatches of different paving materials such as grass, mulch, turf, rubber and concrete to each site. The researchers took thermal images, captured air temperatures and measured the humidity around the surface materials at different times of day when kids are most likely to be outside at school. This allowed the team to examine the microclimates that are specific to those campuses over an extended span.

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It’s important to measure outdoor temperatures on school property because children spend so much of their time at school during the academic year and because their smaller statures place them at increased risk from heat radiating from pavement, said Alessandro Ossola, an urban plant scientist who leads the UC Davis team.

Children also haven’t fully developed the ability to regulate their body temperature they way adults can, making them more vulnerable to extreme heat and potentially hindering their ability to learn.

In addition, Ossola stressed that for children who live in places without grass or safe parks and playgrounds, school might be the one place where they can experience cooling outdoor environments and unpaved surfaces.

“With that information combined — looking at the complete tree inventory and looking at the really extensive heat measurements on an individual campus — we can better understand the cooling benefits of those trees,” Schwarz said. “We can also look at what tree species that are there and how well-adapted they are to future climate change.”

Schwarz said the team also interviewed locals at each location to find who is taking care of the trees at schools, what barriers exist that prevent good tree maintenance and what programs are in place to make tree care easier.

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There are many obstacles to making campuses more hospitable. Schwarz cited a 2024 policy report by her UCLA team that examined the greening of inadequately shaded schools and policies that make it difficult to carry out improvements. In some cases, a lack of staffing, bureaucratic hurdles, state seismic safety standards that encourage building outward rather than vertically and funding models that prioritize low-maintenance campuses stood in the way of schoolyard greening, that report said.

Schwarz, an urban ecologist, said she was surprised to learn about the extent to which regulations requiring non-grass surfaces for sports and outdoor physical education dictated the design of some schoolyards.

Other schools have to choose between conflicting long-term priorities, the student report said: Plans for the future construction of additional classrooms to accommodate growing student enrollments can outweigh the desire to create shadier open spaces.

The tree canopy researchers plan to present each participating school with a tree inventory, analysis of findings, policy recommendations and suggestions for incorporating their study into classroom lessons and parent outreach.

The researchers said their main motivation in initiating the study was to help communities get the most from $150 million in Cal Fire grants approved by the state Legislature that schools can apply for to plant grass and trees on their campuses and reduce the harm of heat-radiating surfaces such as asphalt.

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“That’s a really key part of this conversation about schoolyard greening, because de-paving is that critical first step,” Schwarz said. “The overarching goal is, how can we maximize these investments that we’re making in school greening?”

Ossola said that in some ways, Californians who want to improve their children’s schoolyards are playing catchup even with community will and funding sources in place. It can take decades for young trees planted today to mature enough to provide the necessary cooling effects that can make children safer on a warming planet.

“This is a critical investment that we should’ve done 20 or 50 years ago,” Ossola said. “Now we’re kind of missing the bus.”

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