Science
What to know about chronic venous insufficiency — President Tump's health diagnosis
Earlier this week, President Trump was diagnosed with chronic venous insufficiency, or CVI, after he noted mild swelling in his lower legs. White House physician Dr. Sean P. Barbabella in a memo July 17 said the swelling prompted a full medical evaluation, including ultrasound tests and blood work. Those confirmed CVI, a condition the doctor described as “benign and common — particularly in individuals over the age of 70.”
Barbabella said he found no other signs of more serious cardiovascular issues like blood clots and declared the president to be in “excellent health.”
What is chronic venous insufficiency?
“CVI is when the veins of the body do not work well,” said Dr. Mimmie Kwong, assistant professor of vascular surgery at UC Davis Health, when veins cannot transport blood effectively, causing it to pool, especially in the legs.
CVI is one of the most common vein problems in the U.S. and worldwide, affecting “about one in three adults in the United States,” Kwong said.
That translates to more than 30 million people in the U.S., most often older adults, according to Dr. Ali Azizzadeh, a professor and director of Vascular Surgery at Cedars-Sinai and associate director of the Smidt Heart Institute. He noted the condition is more common in women.
As people age, the veins, such as in their legs, may have a harder time returning blood to the heart, he said.
What causes CVI?
The valves in the veins of the legs are supposed to keep blood moving in one direction: back toward the heart. But when those valves are damaged or weakened, they can stop working properly, leading blood to flow backward and collect in the lower legs.
Individuals who stand or sit for extended periods, or those with a family history of vein issues, may be at a higher risk of developing the condition.
“When the calf muscles are active, they pump the veins that return blood from the legs to the heart,” Azizzadeh explained. “With prolonged inactivity of those muscles, blood can pool in the legs.”
What does CVI feel like?
While CVI isn’t always painful, it can cause discomfort that worsens as the day goes on.
The mornings may feel the best: “The legs naturally drain while you are lying down and sleeping overnight,” said Azizzadeh, “so they will typically feel lightest in the morning.”
As the day progresses and blood starts to pool, people with CVI may experience swelling, heaviness, aching or a dull pain in their legs. The symptoms tend to worsen after prolonged periods of standing or sitting.
If swelling worsens, thickening, inflammation or dry skin can result, with more severe cases developing wounds that do not heal and can even result in amputation, Kwong said.
FILE – President Donald Trump speaks to the media as he leaves the White House, July 15, 2025, in Washington. (AP Photo/Manuel Balce Ceneta, File)
(Manuel Balce Ceneta/AP)
How is CVI treated?
Treatment is more manageable when problematic veins are closer to the surface of the skin, Kwong said. It’s more problematic when deep veins are affected.
The first line of treatment is usually simple lifestyle changes. “We suggest CEE: compression, elevation, and exercise,” Azizzadeh said. Wearing compression stockings can help push blood out of the legs; elevating the legs allows gravity to help drain blood from the legs toward the heart, and regular walking forces calf muscles to pump blood throughout the body.
For people with more serious cases, doctors may recommend a minimally invasive procedure that uses heat to seal off the leaky veins. Common treatments include ablation techniques, surgical removal of veins (phlebectomy), or chemical (sclerosant) injections. “All of these therapies aim to cause the veins to shut down, so they no longer cause the CVI,” Kwong said.
President Trump, left, reaches to shake hands with Bahrain’s Crown Prince Salman bin Hamad Al Khalifa.
(Alex Brandon / Associated Press)
In Trump’s case, the condition appears to be mild and manageable, his doctor said. Barbabella emphasized there was no cause for concern and that the president remains in good overall health. But for millions of Americans living with CVI, recognizing the symptoms and knowing how to manage them can make a big difference in day-to-day comfort and long-term well-being.
Science
How Rising Home Insurance Costs Are Linked to Credit Scores
Two friends bought nearly identical homes last year, in the same northern Minnesota neighborhood, for the same price.
But Tara Novak pays more than twice as much for home insurance as Petra Rodriguez. The only difference? Ms. Novak has a lower credit score.
Across the country, people with weaker credit histories are paying far more for home insurance than owners with spotless records.
Where the home insurance rate gap between “fair” and “excellent” credit is higher
Home insurance premiums have risen rapidly in recent years, fueled by climate change, building costs and inflation. The price shock has rippled into the real estate market, dragging down home prices in areas vulnerable to disasters and leading insurers to abandon homeowners in risky places.
But these dynamics obscure another problem: The home insurance market has cleaved in two along a boundary defined more by a customer’s personal history than by the risk of a disaster hitting their home.
Americans with weaker credit histories, usually from missed payments or high amounts of debt, now pay significantly more for insurance, regardless of where they live, two new studies have found. While those with poor credit histories often can’t purchase homes at all, people with “fair” scores, which range from around 580 to 669, are paying twice as much in some places as people with “excellent” scores of about 800 or higher. And the gap is growing.
Insurers use a metric based on credit history known as an insurance score to set rates, and the figure tracks closely with a customer’s credit score.
The penalty for having a “fair” credit history versus an “excellent” one
States with the biggest pricing gaps
That can mean owners of identical homes, like Ms. Novak and Ms. Rodriguez, pay wildly different rates to insure them. For most people, it’s now just as expensive to have a credit score of “fair” as it is to live in an area likely to experience a disaster like a hurricane or wildfire. About 29 percent of consumers have credit scores that are categorized as “fair” or “poor.”
“There’s so many reasons people have bad credit,” Ms. Novak said. “It’s not like I’ve ever not paid a bill on time. I’m a stickler on my bills, I’m a stickler on my rent, never been late. This is not fair.”
“The choice to use credit scores in pricing means that those lower-credit home owners in risky areas are effectively subsidizing more affluent high-credit homeowners who also live in risky areas,” said Nick Graetz, assistant professor of sociology at the University for Minnesota, who wrote one of the recent papers. “So in a lot of ways, you can keep your insurance price down if you’re high income, high credit — even if you live on the coast of Florida.”
A handful of states have banned insurers from using credit data because of concerns about fairness and the potential for discrimination against low-income people and people of color, but the majority allow it.
For those with both weaker credit and high disaster risk, the combination can set them up for a downward spiral: disasters tend to be followed by decreases in credit scores as people use credit cards and bank loans to recover. That can lead to higher insurance rates, pushing monthly housing costs further out of reach.
“When a disaster hits, there’s a loss of income that occurs, and then that can impact someone’s credit score because they can’t pay their debt, they can’t pay their rent, they can’t pay their mortgage,” said Lance Triggs, executive vice president at Operation HOPE, a financial literacy nonprofit. “And now they’re faced with higher insurance premiums post-disaster.”
A working paper released today by the National Bureau of Economic Research found that homeowners with the lowest credit scores paid, on average, $550 more in 2024 for home insurance than those with the highest scores.
The findings broadly track with data from Quadrant Information Services analyzed by The New York Times, which found that, on average, lower credit scores meant higher premiums across every state that allowed the practice. Dr. Graetz used the same data set for his research, which he did in collaboration with the Consumer Federation of America and the Climate and Community Institute.
When a windstorm last year hit the home of Audrey Thayer, a city council member in Bemidji, Minn., it ripped the siding off her house and stripped shingles from her roof.
Ms. Thayer’s insurance did not cover all the damage. As she fought her insurer for more money, she opened new credit cards and bank loans to repair her home. Her credit score dropped as she tried to find a new insurance plan.
Ms. Thayer, a member of the White Earth Nation, said she was not aware that her credit score could affect her home insurance rates, even though she teaches about credit ratings at a nearby tribal college. “Most of the folks here do not have good credit,” said Ms. Thayer, whose community is one of the poorest in the state. “I did not know what a credit score was until I was 35 or so.”
In Texas, the advocacy group Texas Appleseed found that some insurers charge people with poor credit up to 12 times as much as people with excellent credit for certain policies, said Ann Baddour, the director of the nonprofit’s Fair Financial Services Project.
Higher costs have serious implications for low-income homeowners who live in the path of hurricanes, said Nadia Erosa, the operations manager at Come Dream Come Build, a nonprofit community housing development organization. After the Brownsville, Texas, region saw intense flooding last spring, some residents turned to companies offering high-interest loans to fund repairs, she said, raising the risk of the disaster-credit spiral.
“Delinquencies are going up because people cannot afford their payment,” she said.
The price of risk
Before they can get a mortgage, homebuyers are usually required by lenders to purchase home insurance.
“Households with insurance have fewer financial burdens, fewer unmet needs, they recover faster, they’re more likely to rebuild,” said Carolyn Kousky, an economist and founder of Insurance for Good, a nonprofit that focuses on finding new approaches to risk management. “Yet the people who need insurance the most are the least able to afford it.”
Insurance companies consider a variety of factors when setting the premium for a property. They might examine the age of the roof, or the area’s vulnerability to hurricanes or wildfires. They factor in how much it would cost to rebuild the house if it were damaged.
Insurers have argued that credit history is also worth considering because people with low scores tend to file more claims than those with excellent scores, an assertion that is backed up by the working paper published in the National Bureau of Economic Research today. This likely happens because people with weaker credit histories tend to have less income, and when their home is damaged, they file insurance claims for smaller fixes that a wealthier homeowner might pay for out of pocket.
Paul Tetrault, senior director at the American Property Casualty Insurance Association, a trade organization, said credit scores are a valid way to price premiums.
But others argue that using credit information to price insurance doesn’t make sense.
Because a homeowner pays for insurance upfront, “it’s not like you’re really extending a loan to the customer where you would be worried about the risk of repayment,” Ms. Kousky said. She points out that insurance companies can opt not to renew a homeowner’s policy if they believe it is too risky — a tactic they have been using with increasing frequency.
The NBER analysis found that homeowners who want to pay less for insurance should pay off debt to raise their credit score rather than replace roofs and make other improvements to avoid damage when disaster strikes.
Others believe that even if credit scores are accurate predictors of future claims, they shouldn’t be used to set premiums because that can perpetuate or worsen disparities. For example, people in their mid-20s who are Black, low-income, or grow up in impoverished regions have significantly lower credit scores than their peers, a July working paper from Opportunity Insights, a not-for-profit organization at Harvard University, found.
“When the government and the financial system mandate that we buy a product, there’s a special obligation to make sure the pricing is fair,” said Doug Heller, director of insurance at the Consumer Federation. “To me that is an absolutely solid reason, just like we don’t allow pricing based on race or income or ethnicity or religion.”
A natural experiment
A handful of states, including California and Massachusetts, have banned or limited the use of credit scores in setting home insurance premiums, despite opposition from the insurance industry.
In Nevada, where a temporary pandemic-related rule prevented insurers from using credit history to increase premiums for existing customers from 2020 to 2024, companies refunded approximately $27 million to nearly 200,000 policyholders, said Drew Pearson, a spokesman for the Nevada Division of Insurance.
Perhaps the clearest example of the effects of these bans comes from Washington State, which banned the use of credit information in setting home insurance premiums starting in June 2021. The rule immediately faced legal challenges, and was in effect for just a few months until it was overturned in court.
But the episode allowed researchers to evaluate the effect of credit factors on insurance premiums. When the rule took effect, people with the lowest credit scores saw a decrease in premiums of about $175 annually while those with the highest scores saw an increase of about $100, the NBER analysis found.
“We could see the dynamics of insurance pricing for the same households over time,” said Benjamin Keys, a professor at the University of Pennsylvania’s Wharton School, who co-authored the paper.
What homeowners paid before and after a ban on credit-based pricing in Washington State
Values compared with premiums paid by homeowners with “medium” credit scores (717 to 756)
In Minnesota, where Tara Novak, Petra Rodriguez and Audrey Thayer live, a state task force looked at ways to lower insurance costs for residents. It recently considered a ban or limit on the use of credit scores to set rates, but did not move forward with a recommendation.
Ms. Rodriguez said she doesn’t think it’s fair that her friend Ms. Novak should have to pay so much more for insurance to live in an identical house.
A credit score doesn’t capture anything about a person’s habits, or what they’re like as a tenant, or even years of on-time rent payments, she said. “It’s not who you are,” she said.
Methodology
Home insurance policy rates were supplied by Quadrant Information Services, an insurance data solutions company. The rates shown are representative of publicly sourced filings and should not be interpreted as bindable quotes. Actual individual premiums may vary.
‘States with the biggest pricing gaps’Rates shown are based on a home insurance policy with $400,000 of dwelling coverage and a $100,000 liability limit on a new home, for a homeowner age 50 or younger. Rates are averaged for all the individual company filings represented in the sample, which add up to a majority of the market share in each state but do not cover all active insurers in the state. Rates are also averaged to the state level from zip code level data.
‘The credit penalty in each state’Each insurance company incorporates credit history information differently, often using proprietary methods, so the scores do not map directly to FICO credit scores.
‘What homeowners paid before and after a ban on credit-based pricing in Washington State’Data shown are based on observations of real home insurance policies and homeowner credit scores from ICE McDash analyzed by the researchers of Blonz, Hossain, Keys, Mulder and Weill (2026). The price comparisons across credit score tiers controlled for variance in disaster risk, insurance policy characteristics, geography, and other year to year fluctuations.
Science
Earth is warming faster than previously estimated, new study shows
Planetary warming has significantly accelerated over the past 10 years, with temperatures rising at a higher rate since 2015 than in any previous decade on record, a new study showed.
The Earth warmed around 0.35 degrees Celsius in the decade to 2025, compared to just under 0.2C per decade on average between 1970 and 2015, according to a paper published on Friday in the scientific journal Geophysical Research Letters. This is the first statistically significant evidence of an acceleration of global warming, the authors said.
The past three years have been the hottest on record, compared to the average before the Industrial Revolution. In 2024, warming went past 1.5C, the lower limit set by the Paris Agreement. That target refers to temperature increases over 20 years, but breaching it for one year shows efforts to slow down climate change have been insufficient, the scientists who wrote the new paper said.
The findings shed light on an ongoing debate among researchers. While there is consensus that greenhouse gas emissions have caused the planet to heat up since pre-industrial times, that warming had been steady for decades. But record-breaking temperatures in recent years have led scientists to question whether the pace of temperature gains is accelerating.
Demonstrating that was difficult due to natural fluctuations in temperatures. The researchers filtered out the “noise” to make the “underlying long-term warming signal” more clearly visible, said Grant Foster, a co-author of the study and a U.S.-based statistics expert.
Researchers isolated phenomena including the El Niño weather phase, volcanic eruptions and solar irradiance. When looking at temperature increases without their influence, the authors concluded the evidence is “strong” that the accelerated warming was not due to an unusually hot 2023 and 2024, but that since 2015 global temperatures departed from their previous, slower path of warming.
The new report adds to a growing body of work that indicates climate change is having a quicker and larger impact on the planet than scientists have understood. A separate paper published this week found that many studies on sea-level increases underestimate how much water along the coast has already risen.
“If the warming rate of the past 10 years continues, it would lead to a long-term exceedance of the 1.5C limit of the Paris Agreement before 2030,” said Stefan Rahmstorf, the lead author of the warming study and a researcher at the Potsdam Institute for Climate Impact Research. “How quickly the Earth continues to warm ultimately depends on how rapidly we reduce global CO2 emissions from fossil fuels to zero.”
Millan writes for Bloomberg.
Science
The neuro disease rat lungworm has reached California
A disease that can cause neurological illness and meningitis in people, rat lungworm, has been found in wild opposums, rats and a zoo animal in San Diego County, indicating its establishment in California for the first time.
Researchers reported their findings in the journal Emerging Infectious Diseases, published by the U.S. Centers for Disease Control and Prevention. The authors, who include veterinarians, researchers and wildlife biologists, urged physicians and other healthcare workers in the region to consider lungworm infection when patients come in with nervous system disorders.
The discovery highlights “a notable expansion of the range of this parasite in North America,” they said.
The CDC website says the risk to the general public of getting this infection is low, but it can be deadly.
If ingested, the worms can cause severe headaches, stiff neck, the sensation of tingling or painful skin, low-grade fever, nausea, vomiting, coma and sometimes death. People who eat freshwater crab, prawns, frogs, snails and slugs are at greatest risk. However, people can also get the disease by eating un-rinsed produce that’s been slimed by a snail or slug, or eating a slug or snail that was chopped up in produce. The worms need moisture, however; if the produce is dry, the worms will die.
Domestic animals, including dogs and cats, are also at risk.
Officials with the California Department of Public Health were not ready to call the disease endemic, or established, in the state.
“Additional surveillance and testing will be necessary to determine whether the detections of rat lungworm in the animals evaluated in San Diego County represent an isolated introduction of the parasite or ongoing local transmission,” spokeswoman Elizabeth Manzo wrote in a statement to The Times.
The department said it is not aware of rat lungworm outside San Diego County, and has seen no human cases.
“However, the San Diego study affirms that the parasite can be introduced to California through movement of infected animals from endemic areas,” the statement said. “Because some species of snails and slugs present in California are capable of serving as hosts for rat lungworm, and the presence of the parasite in other parts of the state is unknown, it is advised to take certain food safety precautions. Persons should not consume any raw or undercooked wild snails or slugs, and should thoroughly wash all produce before consuming.”
The worms that cause the disease, Angiostrongylus cantonensis, are native to Southeast Asia. They’ve been found in the U.S. since the 1960s — including in isolated human and zoo animal cases in California — and are established in Hawaii as well as in much of the southeastern U.S.
It is believed they came overseas via rats on boats.
The worms favored environment is the moist, warm bed of a rat’s lung. When a rat is infected, the worms cause respiratory distress, priming the rodent to cough. Worm-filled sputum is then ejected into the rat’s mouth, and swallowed. The rat then poops the worms out, and animals such as slugs and snails eat the poop. When a rat eats an infected invertebrate, the cycle begins again.
Occasionally, another animal, such as a raccoon or dog, or a person, will accidentally eat an infected animal, or the slime of one, and contract the disease.
The discovery of the worm in San Diego County rodents and opossums was made by staff at the San Diego Zoo and a local wildlife rehabilitation center, Project Wildlife, which is run by the San Diego Humane Society.
In December 2024, a 7-year-old male parma wallaby, born and raised at the zoo, began showing concerning neurological behaviors: incessant head shaking, blindness, a lack of muscle coordination and paralysis in his hind legs. He was euthanized after 11 days in the zoo infirmary.
When zoo staff examined the body, they found six rat lungworms in the marsupial’s brain, along with a lot of damage.
Because the diagnosis was so unusual, zoo staff examined the bodies of 64 free-ranging roof rats that had either been euthanized in the course of regular pest control or found dead on the property. Two, a little more than 3%, had lungworms. Their feces had them too: “numerous live … larvae with coiled posterior ends.” The larvae, roughly 300 in each poop sample, were each about the size of a grain of sand.
Officials at the San Diego Zoo did not respond to requests for comment.
Curiously, at the same time the zoo investigation was underway, staff from Project Wildlife had been dealing with sick opossums brought to them from around the county. Tests of 10 dead animals showed seven carried the lungworms.
Many people and animals remain asymptomatic when they’re infected. Symptoms typically appear within hours or days after ingestion and can last up to eight weeks. The worms will eventually die.
Because the disease has so many varied symptoms, health officials say it can go undiagnosed and untreated. Health officials from Hawaii, where the disease is endemic, say if lungworms are suspected, it’s best to be treated as soon as possible — even before lab results come back.
The CDC too notes that treatment works best when the disease is caught early, and can consist of high doses of corticosteroids, lumbar punctures for symptomatic relief of headaches, and antiparasitic medications, such as albendazole.
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