September is Suicide Prevention Month, a time to bring attention to a crisis that touches far too many families.

This month is a reminder that life can feel overwhelming as we juggle family, work, friends, and everything in between. Too often, what gets left behind is our own well-being. And when mental health goes unaddressed, the consequences can be devastating.

Suicide rates in the U.S. climbed between 2000 and 2018, dipped briefly, and remain elevated today. On average, one person dies by suicide every 11 minutes. Behind those numbers are real people—neighbors, loved ones, friends—whose struggles too often remain invisible until it’s too late.

Lori Edelson, a psychotherapist and the owner of Birmingham Maple Clinic, joined the show to raise awareness and share how we can spot the warning signs.
 

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By Jamie Ducharme, KFF Health News

After losing 50 pounds on the injectable weight loss medication Zepbound, Kyra Wensley received a surprising letter from her pharmacy benefit manager in April.

Her request for coverage had been denied, the letter said, because she’d had a body mass index of less than 35 when she started Zepbound. The 25-year-old who lives in New York had been taking Zepbound without incident for months, so she was confused: Why was her BMI, which had been around 32 when she started, becoming an issue only now?

Wensley had no interest in quitting an effective drug. “Going right off like that, it’s easier said than done,” she said.

Her doctor fought to keep her on the GLP-1 agonist, the category that includes weight loss and Type 2 diabetes drugs Ozempic, Wegovy, Mounjaro, and Zepbound. But Wensley ultimately had to switch from Zepbound to Wegovy to meet her plan’s requirements. She said she doesn’t like Wegovy as much as her old medication, but she now feels lucky to be on any GLP-1.

Lots of research suggests such medications must be used indefinitely to maintain weight loss and related health benefits. But with list prices of roughly $1,000 a month, public and private payers are struggling to keep up with ballooning demand for GLP-1 weight loss drugs and in some cases are eliminating or restricting their coverage as a result.

North Carolina Medicaid plans to end GLP-1 coverage for weight loss on Oct. 1, just over a year after starting the coverage. Pennsylvania is planning to limit Medicaid coverage to beneficiaries at the highest risk of complications from obesity. And despite recent reports of a potential federal pilot program to extend coverage of GLP-1 obesity drugs under Medicaid and Medicare, all state Medicaid programs are likely to be under pressure due to steep spending cuts in the budget reconciliation package recently signed into law by President Donald Trump.

Already, many GLP-1 users quit within a year, studies suggest — often due to side effects, high costs, or insurance issues. Now a growing number of researchers, payers, and providers are exploring deliberate “deprescription,” which aims to taper some patients off their medication after they have taken it for a certain amount of time or lost a certain amount of weight.

The U.K.’s National Institute for Health and Care Excellence, which creates guidance for the National Health Service, recommends two-year limits on the use of some weight loss medications, such as Wegovy. And the concept was raised in a recent Institute for Clinical and Economic Review report on affordable access to obesity drugs.

A. Mark Fendrick, who directs the Center for Value-Based Insurance Design at the University of Michigan, has argued that if some people using GLP-1s to lose weight were eventually transitioned off, more people could take advantage of them.

“If you’re going to spend $1 billion or $100 billion, you could either spend it on fewer people for a long period of time, or you can spend it on a lot more people for a shorter period of time,” he said.

Fendrick’s employer, the University of Michigan, indeed does that. Its prescription drug plan caps coverage of GLP-1 drugs at two years if they’re used solely for weight loss.

Jamie Bennett, a spokesperson for Wegovy and Ozempic maker Novo Nordisk, declined to comment on the concept of deprescription, noting that its drugs are intended for chronic conditions. Rachel Sorvig, a spokesperson for Zepbound and Mounjaro manufacturer Eli Lilly, said in a statement that users should “talk to their health care provider about dosage and duration needs.”

Studies have shown that people typically regain a substantial amount of weight within a year of stopping GLP-1 medications, and that many people who quit ultimately go back on the drugs.

“There’s no standard of care or gold standard on how to wean right now,” said Allison Adams, an obesity and internal medicine doctor with UK HealthCare in Kentucky.

But the math shows why time-limited coverage is appealing to payers that struggle to pay for beneficiaries’ GLP-1 prescriptions, said Michelle Gourdine, chief medical officer for the pharmacy benefit manager CVS Caremark.

And states are “between a rock and a hard place,” said Kody Kinsley, who until January led North Carolina’s Health and Human Services Department. “They’re going to have to look at every single thing and trim dollars everywhere they can.”

Pennsylvania was looking for cost-saving strategies even before the new federal tax-and-spending law, according to Brandon Cwalina, press secretary for the state’s Department of Human Services. Pennsylvania projects it will spend $1.3 billion on GLP-1 drugs this year.

Plans could see real savings, Fendrick said, if they covered GLP-1s for initial weight loss then moved people to cheaper options — such as more affordable drugs or behavioral health programs — to maintain it.

Plenty of companies are eager to sell insurers, employers, and individuals on behavioral alternatives. One is Virta Health, which advertises its nutrition-focused weight management program as “a proven approach for deprescribing GLP-1s when clinically appropriate.” A Virta-funded study assessed 154 people with Type 2 diabetes who stopped using GLP-1 medications but continued following Virta’s program, concluding that their weight did not significantly increase after a year.

Researchers affiliated with a European weight management company also recently reported that slowly tapering off the medications may help maintain weight loss.

For employers and insurers, the “initial question” was whether to cover GLP-1s for obesity, said Virta CEO Sami Inkinen. “Now, basically, everyone’s coming to the middle and asking, ‘How do we responsibly cover these drugs?’”

Part of responsible coverage, Inkinen said, is providing other forms of support to patients who stop using GLP-1 medications, by choice or otherwise.

For some people, however, maintaining weight loss without a GLP-1 remains a challenge, even with other options available.

Lily, who lives in Michigan, lost almost 80 pounds in roughly 18 months on Wegovy. But she had to quit the drug when she turned 26 and left her parents’ insurance plan this year. The plan her employer offers stopped covering GLP-1s for weight loss right around the time she joined.

Lily, who asked to be identified by only her first name because she is not out to her family as transgender, has tried other medications since then, and previously tried lifestyle programs to control her weight. But she said nothing works as well for her as Wegovy.

She has regained 20 pounds since going off the drug at the beginning of the year and worries that number will continue to rise, potentially contributing to future health problems.

“Just give people the drugs,” she said. “It seems cheaper and safer in the long run.”

©2025 KFF Health News. Distributed by Tribune Content Agency, LLC.

By GEOFF MULVIHILL, Associated Press

The governors of Arizona and Maine on Friday joined the growing list of Democratic officials who have signed orders intended to ensure most residents can receive COVID-19 vaccines at pharmacies without individual prescriptions.

Unlike past years, access to COVID-19 vaccines has become complicated in 2025, largely because federal guidance does not recommend them for nearly everyone this year as it had in the past.

Here’s a look at where things stand.

Pharmacy chain says the shots are available in most states without individual prescriptions

CVS Health, the biggest pharmacy chain in the U.S., says its stores are offering the shots without an individual prescription in 41 states as of midday Friday.

But the remaining states — Arizona, Florida, Georgia, Louisiana, Maine, North Carolina, Oregon, Utah and West Virginia, plus the District of Columbia — require individual prescriptions under the company’s interpretation of state policies.

Arizona and Maine are likely to come off that list as the new orders take effect there.

“I will not stand idly by while the Trump Administration makes it harder for Maine people to get a vaccine that protects their health and could very well save their life,” Maine Gov. Janet Mills said in the statement. “Through this standing order, we are stepping up to knock down the barriers the Trump Administration is putting in the way of the health and welfare of Maine people.”

Democratic governors have been taking action

At least 14 states — 12 with Democratic governors, plus Virginia, where Republican Glenn Youngkin is governor — have announced policies this month to ease access.

In some of the states that have expanded access — including Delaware and New Jersey this week — at least some pharmacies were already providing the shots broadly.

But in Arizona and Maine, Friday’s orders are expected to change the policy.

While most Republican-controlled states have not changed vaccine policy this month, the inoculations are still available there under existing policies.

In addition to the round of orders from governors, boards of pharmacy and other officials, four states — California, Hawaii, Oregon and Washington — have announced an alliance to make their own vaccine recommendations. Of those, only Oregon doesn’t currently allow the shots in pharmacies without individual prescriptions.

Vaccines have become politically contentious

In past years, the federal government has recommended the vaccines to all Americans above the age of 6 months.

This year, the U.S. Food and Drug Administration approved them for people age 65 and over but said they should be used only for children and younger adults who have a risk factor such as asthma or obesity.

That change came as U.S. Health Secretary Robert F. Kennedy fired the entire Advisory Committee on Immunization Practices in June, accusing of them of being too closely aligned with the companies that make the vaccines. The replacements include vaccine skeptics.

Arizona Gov. Katie Hobbs, a Democrat, framed her order Friday as “protecting the health care freedom” of people in the state.

One state has taken another stance on vaccines

Florida’s surgeon general, Dr. Joseph Ladapo, announced this month that the state could become the first to eliminate requirements that children have a list of vaccinations.

Since then, though, the state health department said that the change likely wouldn’t take effect until December and that without legislative action, only some vaccines — including for chickenpox — would become optional. The measles and polio shots would remain mandatory.

Associated Press writer Patrick Whittle in Maine contributed to this report.

By Lena H. Sun, Rachel Roubein, Dan Diamond
The Washington Post

Trump health officials plan to link coronavirus vaccines to the deaths of 25 children as they consider limiting which Americans should get the shots, according to four people familiar with the situation who spoke on the condition of anonymity to describe confidential information.

The findings appear to be based on information submitted to the federal Vaccine Adverse Event Reporting System, which contains unverified reports of side effects or bad experiences with vaccines submitted by anyone, including patients, doctors, pharmacists or even someone who sees a report on social media. The Centers for Disease Control and Prevention emphasizes that the database is not designed to assess whether a shot caused a death, a conclusion that requires thorough investigations by scientists and public health professionals.

Trump health officials plan to include the pediatric deaths claim in a presentation next week to an influential panel of advisers to the CDC that is considering new coronavirus vaccine recommendations, which affect access to the shots and whether they’re free.

The plan has alarmed some career scientists who say coronavirus vaccines have been extensively studied, including in children, and that dangers of the virus itself are being underplayed. CDC staff in June presented data to the same vaccine committee showing that at least 25 children died who had covid-associated hospitalizations since July 2023 and that number was likely an undercount. Of the 16 old enough for vaccination, none was up-to-date on vaccines.

Food and Drug Administration Commissioner Marty Makary confirmed on CNN last week that officials were investigating reports of possible child deaths from the vaccine, including reviewing autopsy reports and interviewing families. Such a review could take months, according to health officials, and it is unclear when those investigations began.

The pediatric deaths presentation to the CDC’s Advisory Committee on Immunization Practices (ACIP) is not final, according to one person familiar with the matter, who spoke on the condition of anonymity to describe ongoing policy discussions. The full methodology for the analysis was not immediately clear.

“FDA and CDC staff routinely analyze VAERS and other safety monitoring data, and those reviews are being shared publicly through the established ACIP process,” HHS spokesperson Andrew Nixon said in an email. “Any recommendations on updated COVID-19 vaccines will be based on gold standard science and deliberated transparently at ACIP next week.”

The FDA in August approved the latest coronavirus vaccines for people ages 65 and older or who have risk factors for severe disease, but the CDC vaccine panel can recommend the shots more narrowly or broadly. The committee is weighing a plan to recommend the shot for those 75 and older but instruct people who are younger to speak to a physician before they get the vaccine, according to two people familiar with the matter who spoke on the condition of anonymity to share policy discussions. Another option would not recommend the vaccine to people under the age of 75 without preexisting conditions, the people said.

But limiting access for people ages 65 to 74 has raised concerns about a political backlash, said one federal health official who spoke on the condition of anonymity to share private conversations. According to CDC estimates, nearly 43 percent of people in that age group received the 2024-2025 version of the coronavirus vaccine.

Many countries do not recommend annual coronavirus vaccination for healthy children because they rarely die from covid and most experience mild symptoms. U.S. officials have justified yearly shots based on data showing infants and toddlers faced elevated risk of hospitalization and that significant shares of those who were hospitalized had no underlying conditions. They have also said vaccines offer children protection against long covid.

Health and Human Services Secretary Robert F. Kennedy Jr., a longtime critic of coronavirus vaccines, in May directed health officials to stop recommending the shots for otherwise healthy children. The CDC later instructed parents to consult a doctor before getting their children coronavirus vaccines. The American Academy of Pediatrics recommends annual coronavirus vaccines for all children ages 6 to 23 months and for older children if their parents want them to have protection.

Next week’s vaccine advisory panel’s meeting is critical because the recommendations determine whether insurers must pay for the immunizations, pharmacies can administer them and doctors are willing to offer them. Kennedy purged the membership of the panel earlier this year and appointed his own picks, most of whom have criticized coronavirus vaccination policy. He is considering adding additional critics of covid shots to the committee.

The previous vaccine panel was already considering a more targeted approach to coronavirus vaccination, recommending the shot for high-risk groups, but allowing others, including children, to get the vaccine if they wanted.

Tracy Beth Hoeg, one of Makary’s top deputies who was a critic of broad childhood coronavirus vaccination before joining the FDA, has been one of the officials looking into vaccine safety data, according to five people familiar with the matter who spoke on the condition of anonymity to describe private information.

The planned pediatric death presentation included attempts to interview some families, but it’s not clear what other information was used. Some of those same families had been previously interviewed by the CDC officials as part of vaccine safety tracking, according to one person familiar with the matter.

Harleen Marwah, a pediatrician at Mass General Brigham for Children who recently reviewed data on the coronavirus vaccine and its safety and efficacy in children, said new studies since June identified “no new safety concerns.” Marwah conducted the research on behalf of the Vaccine Integrity Project, a new initiative based at the University of Minnesota to provide scientific evidence to inform vaccine recommendations.

The CDC has been monitoring coronavirus vaccine safety data since the first shots rolled out in the United States. Much stricter requirements were put in place for reporting adverse events than for other vaccines because the vaccines were initially fast-tracked under the FDA’s emergency response authority.

Death rates among all ages after mRNA coronavirus vaccination were below those for the general population, according to data presented to the CDC vaccine committee in June.

Noel Brewer, a public health professor at the University of North Carolina and one of the vaccine advisers terminated by Kennedy, said the focus on vaccine harms ignores the harms of coronavirus.

“They are leveraging this platform to share untruths about vaccines to scare people,” Brewer said. “The U.S. government is now in the business of vaccine misinformation.”

By Nada Hassanein, Stateline.org

Pharmacies in Black and Latino neighborhoods are less likely to dispense buprenorphine — one of the main treatments for opioid use disorder — even though people of color are more likely to die from opioid overdoses.

The drug helps reduce cravings for opioids and the likelihood of a fatal overdose.

While the nation as a whole has seen decreases in opioid overdose deaths in recent years, overdose deaths among Black, Latino and Indigenous people have continued to increase.

Many medical and health policy experts fear the broad domestic policy law President Donald Trump signed in July will worsen the problem by increasing the number of people without health insurance. As a result of the law, the number of people without coverage will increase by about 10 million by 2034, according to the Congressional Budget Office.

About 7.5 million of the people who will lose coverage under the new law are covered by Medicaid. Shortly before Trump signed the bill into law, researchers from the University of Pennsylvania and Boston University estimated that roughly 156,000 Medicaid recipients will lose access to medications for opioid addiction because of the cuts, resulting in approximately 1,000 more overdose deaths annually.

Because Black and Hispanic people are overrepresented on the rolls, the Medicaid cuts will have a disproportionate effect on communities that already face higher barriers to getting medications to treat addiction.

From 2017 to 2023, the percentage of U.S. retail pharmacies regularly dispensing buprenorphine increased from 33% to 39%, according to a study published last week in Health Affairs.

But researchers found the drug was much less likely to be available in pharmacies in mostly Black (18% of pharmacies) and Hispanic neighborhoods (17%), compared with mostly white ones (46%).

In some states, the disparity was even worse. In California, for example, only about 9% of pharmacies in Black neighborhoods dispensed buprenorphine, compared with 52% in white neighborhoods.

The researchers found buprenorphine was least available in Black and Latino neighborhoods across nearly all states.

Barriers to treatment

Dr. Rebecca Trotzky-Sirr, a family physician who specializes in addiction medicine, said many communities of color are “pharmacy deserts.” Even the pharmacies that do exist in those neighborhoods tend to “have additional barriers to obtain buprenorphine and other controlled substances out of a concern for historic overuse of some treatments,” said Trotzky-Sirr, who wasn’t involved in the study.

In addition to its federal classification as a controlled substance, buprenorphine is also subject to state regulations to prevent illegal use. Pharmacies that carry it know that wholesalers and distributors audit their orders, which dissuades some from stocking or dispensing it.

Dima Qato, associate professor of clinical pharmacy at the University of Southern California and an author of the Health Affairs study, said that without changes in policy, Black and Hispanic people will continue to have an especially hard time getting buprenorphine.

“If you don’t address these dispensing regulations, or regulate buprenorphine from the aspect of pharmacy regulations, people are still going to encounter barriers accessing it,” she said.

In neighborhoods where at least a fifth of the population is on Medicaid, just 35% of pharmacies dispensed buprenorphine, Qato and her team found. But in neighborhoods with fewer residents on Medicaid, about 42% of pharmacies carried the drug.

Medicaid covers nearly half— 47% — of nonelderly adults who suffer from opioid use disorder. In states that expanded Medicaid under the Affordable Care Act, another recent study found an increase in people getting prescriptions for buprenorphine.

“Medicaid is the backbone of care for people struggling with opioid use disorder,” said Cherlette McCullough, a Florida-based mental health therapist. “We’re going to see people in relapse. We’re going to see more overdoses. We’re going to see more people in the ER.”

Qato said the shortage of pharmacies in minority communities is likely to get worse, as many independent pharmacists are already struggling to stay open.

“We know they’re more likely to close in neighborhoods of color, so there’s going to be even fewer pharmacies that carry it in the neighborhoods that really need it,” she said.

‘There needs to be urgency’

Qato and her colleagues say states and local governments should mandate that pharmacies carry a minimum stock of buprenorphine and dispense it to anyone coming in with a legitimate prescription. As examples, they point to a Philadelphia ordinance mandating that pharmacies carry the opioid overdose-reversal drug naloxone and similar emergency contraception requirements in Massachusetts.

“We need to create expectations. We need to encourage our pharmacies to carry this to make it accessible, same day, and there needs to be urgency,” said Arianna Campbell, a physician assistant and co-founder of the Bridge Center, a California-based organization that aims to help increase addiction treatment in emergency rooms.

“In many of the conversations I have with pharmacies, when I’m getting some pushback, I have to say: ‘Hey, this person’s at the highest risk of dying right now. They need this medication right now.’”

She said patients frequently become discouraged due to barriers they face in getting prescriptions filled. The Bridge Center has been expanding its patient navigator program across the state, and helping other states start their own. The program helps patients identify pharmacies where they can fill their prescription fastest.

“There’s a medication that can help you, but at every turn it’s really hard to get it,” she said, calling the disparities in access to medication treatment “unacceptable.”

Trotzky-Sirr, the California doctor, fears the looming Medicaid cuts will cause many of her patients to discontinue treatment and relapse. Many of her patients are covered by Medi-Cal, the state’s Medicaid program.

“A lot of our patients are able to obtain medications for treatment of addiction like buprenorphine, because of the state covering the cost of the medication,” said Trotzky-Sirr, who also is a regional coordinator at the Bridge Center.

“They don’t have the resources to pay for it, cash, out of pocket.”

Some low-income patients switch between multiple providers or clinics as they try to find care and coverage, she added. These could be interpreted as red flags to a pharmacy.

Trotzky-Sirr argued buprenorphine does not need to be monitored as carefully as opioids and other drugs that are easier to misuse or overuse.

“Buprenorphine does not have those features and really needs to be in a class by itself,” she said. “Unfortunately, it’s hard to explain that to a pharmacist in 30 seconds over the phone.”

More is known about the medication now than when it was placed on the controlled substances list about two decades ago, said Brendan Saloner, a Bloomberg Professor of American Health in Addiction and Overdose at Johns Hopkins University.

Pharmacies are fearful of regulatory scrutiny and don’t have “countervailing pressure” to ensure patients get the treatments, he said.

On top of that fear, Medicaid managed care plans’ prior authorization processes may also be adding to the pharmacy bottleneck, he said.

“Black and Latino communities have higher rates of Medicaid enrollment, so to the extent that Medicaid prior authorization techniques are a hassle to pharmacies, that may also kind of discourage them [pharmacies] from stocking buprenorphine,” he said.

In some states, buprenorphine is much more readily available. In Maine, New Hampshire, Oregon, Rhode Island, Utah and Vermont, more than 70% of pharmacies carried the drug, according to the study. Buprenorphine availability was highest in states such as Oregon that have the least restrictive regulations for dispensing it.

In contrast, less than a quarter of pharmacies in Iowa, North Dakota, Texas, Virginia and Washington, D.C., carried the medication.

“We’re going to see more people becoming unhoused, because without treatment, they’re going to go back to those old habits,” McCullough, the Florida therapist, said. “When we talk about marginalized communities, these are the populations that are going to suffer the most because they already have challenges with access to care.”

Stateline reporter Nada Hassanein can be reached at nhassanein@stateline.org.

©2025 States Newsroom. Visit at stateline.org. Distributed by Tribune Content Agency, LLC.

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The University of Michigan is ending gender-affirming care for minors, leaving an untold number of families with fewer options and greater uncertainty.

Gender-affirming care for minors is legal in Michigan, and major medical and mental-health associations recognize it as best practice. Research links it to lower depression and suicide risk. 

But a Michigan Medicine spokesperson said in a prepared statement that the risks of offering this care are now too high. This comes after it received a federal subpoena as part of a criminal and civil investigation into gender-affirming care for minors.

“We recognize the gravity and impact of this decision for our patients and our community. We are working closely with all those impacted,” the statement reads.

The announcement represents a profound loss for families. For some young people, it means a place they felt safe and could trust is closing its doors. And the consequences are real: more anxiety, more depression, greater risk of suicide.

Equality Michigan’s Emme Zanotti joined Robyn Vincent to discuss the impacts on Michigan families. Zanotti, a trans woman, also took off her advocate hat to reflect on the personal reverberations she feels at this moment.

Michigan Medicine did not respond to an email request about the number of patients who will be affected and how the hospital plans to assist patients during this transition. 

Editor’s Note: After this conversation aired, Corewell Health, a major healthcare provider in Michigan, also announced the end of its gender-affirming care. 

Listen to The Metro weekdays from 10 a.m. to noon ET on 101.9 FM and streaming on demand.

Subscribe to The Metro on Apple Podcasts, Spotify, NPR.org or wherever you get your podcasts.

Trusted, accurate, up-to-date.

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The Warren Police Department is refusing to release public records to Metro Times, including video footage that shows cops allegedly beating a man with a mental health emergency. Christopher Gibson, 26, was “brutally battered, tasered and threatened with a barking K-9” by Warren cops while detained in December 2022, according to a recent lawsuit filed […]

The post Warren police block release of records showing alleged brutality of man in crisis appeared first on Detroit Metro Times.

By Anne Snabes, MediaNews Group

Corewell Health leaders, doctors and other staff gathered on Monday to mark the groundbreaking of an estimated $75 million project to build a new ambulatory surgery center and medical office building across the street from William Beaumont University Hospital in Royal Oak.

Construction on the 89,000-square-foot facility will start in the next two weeks and is expected to take 18-24 months, ending in 2027, said Dr. Daniel Cary, president of William Beaumont University Hospital.

He said the facility at 3828 13 Mile Road, called the Corewell Health Care Center and located across the street from the main hospital, will include an ambulatory surgical center, which is a space for “less complicated surgeries” that can be safely done outside of the hospital. It will also include medical office space, including for primary care, behavioral health and digestive health.

“We’re really trying to create new access, because … the population is aging and we have more and more good therapies for conditions,” Cary said. “So we’re expanding access at this site.”

Lamont Yoder, president of Corewell Health East, said at a groundbreaking ceremony attended by more than several dozen people Monday morning that it’s “a momentous time for us.”

“We’re really trying to create new access, because … the population is aging and we have more and more good therapies for conditions,” Cary said. “So we’re expanding access at this site.”

Lamont Yoder, president of Corewell Health East, said at a groundbreaking ceremony attended by more than several dozen people Monday morning that it’s “a momentous time for us.”

Cary said the new ambulatory surgery center, also known as outpatient surgery, will be easy for patients to access ― there will be two entrances off of 13 Mile Road ― and they won’t have to enter the main William Beaumont University Hospital campus to have a surgery.

He said the surgeries that take place at the center will be “low complexity surgeries” that don’t require people to stay overnight, including orthopaedic, low-risk spine, gall bladder, appendix, and ear, nose and throat surgeries. The center will have four operating rooms and one procedure room.

Several residents expressed concerns about the project as it was going through the city of Royal Oak’s site plan approval process. Cary said neighbors on the north side of the development had concerns regarding the loss of trees during the project and a barrier between the facility and their homes.

“We really appreciate the neighbors and our own building team coming together to come with a design that everyone felt good about,” he said.

He said they came to a compromise about the number of trees that would be lost. Corewell Health will also be building a decorative wall, which will serve as a sound barrier between the facility and the neighbors.

Royal Oak Mayor Michael Fournier praised the project at the groundbreaking.

“I believe we stand here today because so many people truly care about making a difference in the lives of people they will never meet,” he said. “When this project is completed, we will awe at the technological, engineering and construction accomplishments. Let’s not forget the spirit of serving others that is responsible for taking an idea and making it a reality.”

By Paula Span, KFF Health News

It started with a high school typing course.

Wanda Woods enrolled because her father advised that typing proficiency would lead to jobs. Sure enough, the federal Environmental Protection Agency hired her as an after-school worker while she was still a junior.

Her supervisor “sat me down and put me on a machine called a word processor,” Woods, now 67, recalled. “It was big and bulky and used magnetic cards to store information. I thought, ‘I kinda like this.’”

Decades later, she was still liking it. In 2012 — the first year that more than half of Americans 65 and older were internet users — she started a computer training business.

Now she is an instructor with Senior Planet in Denver, an AARP-supported effort to help older people learn and stay abreast of technology. Woods has no plans to retire. Staying involved with tech “keeps me in the know, too,” she said.

Some neuroscientists researching the effects of technology on older adults are inclined to agree. The first cohort of seniors to have contended — not always enthusiastically — with a digital society has reached the age when cognitive impairment becomes more common.

Given decades of alarms about technology’s threats to our brains and well-being — sometimes called “digital dementia” — one might expect to start seeing negative effects.

The opposite appears true. “Among the digital pioneer generation, use of everyday digital technology has been associated with reduced risk of cognitive impairment and dementia,” said Michael Scullin, a cognitive neuroscientist at Baylor University.

It’s almost akin to hearing from a nutritionist that bacon is good for you.

“It flips the script that technology is always bad,” said Murali Doraiswamy, director of the Neurocognitive Disorders Program at Duke University, who was not involved with the study. “It’s refreshing and provocative and poses a hypothesis that deserves further research.”

Scullin and Jared Benge, a neuropsychologist at the University of Texas at Austin, were co-authors of a recent analysis investigating the effects of technology use on people over 50 (average age: 69).

They found that those who used computers, smartphones, the internet, or a mix did better on cognitive tests, with lower rates of cognitive impairment or dementia diagnoses, than those who avoided technology or used it less often.

“Normally, you see a lot of variability across studies,” Scullin said. But in this analysis of 57 studies involving more than 411,000 seniors, published in Nature Human Behavior, almost 90% of the studies found that technology had a protective cognitive effect.

Much of the apprehension about technology and cognition arose from research on children, sometimes focused on adolescents, whose brains are still developing.

“There’s pretty compelling data that difficulties can emerge with attention or mental health or behavioral problems” when young people are overexposed to screens and digital devices, Scullin said.

Older adults’ brains are also malleable, but less so. And those who began grappling with technology in midlife had already learned “foundational abilities and skills,” Scullin said.

Then, to participate in a swiftly evolving society, they had to learn a whole lot more.

Years of online brain-training experiments lasting a few weeks or months have produced varying results. Often, they improve a person’s ability to perform the task in question without enhancing other skills.

“I tend to be pretty skeptical” of their benefit, said Walter Boot, a psychologist at the Center on Aging and Behavioral Research at Weill Cornell Medicine. “Cognition is really hard to change.”

The new analysis, however, reflects “technology use in the wild,” he said, with adults “having to adapt to a rapidly changing technological environment” over several decades. He found the study’s conclusions “plausible.”

Analyses like this can’t determine causality. Does technology improve older people’s cognition, or do people with low cognitive ability avoid technology? Is tech adoption just a proxy for enough wealth to buy a laptop?

“We still don’t know if it’s chicken or egg,” Doraiswamy said.

Yet when Scullin and Benge accounted for health, education, socioeconomic status, and other demographic variables, they still found significantly higher cognitive ability among older digital technology users.

What might explain the apparent connection?

“These devices represent complex new challenges,” Scullin said. “If you don’t give up on them, if you push through the frustration, you’re engaging in the same challenges that studies have shown to be cognitively beneficial.”

Even handling the constant updates, the troubleshooting, and the sometimes maddening new operating systems might prove advantageous. “Having to relearn something is another positive mental challenge,” he said.

Still, digital technology may also protect brain health by fostering social connections, known to help stave off cognitive decline. Or its reminders and prompts could partially compensate for memory loss, as Scullin and Benge found in a smartphone study, while apps help preserve functional abilities like shopping and banking.

Numerous studies have shown that while the number of people with dementia is increasing as the population ages, the proportion of older adults who develop dementia has been falling in the United States and several European countries.

Researchers have attributed the decline to a variety of factors, including reduced smoking, higher education levels, and better blood pressure treatments. Possibly, Doraiswamy said, engaging with technology has been part of the pattern.

Of course, digital technologies present risks, too. Online fraud and scams often target older adults, and while they are less apt to report fraud losses than younger people, the amounts they lose are much higher, according to the Federal Trade Commission. Disinformation poses its own hazards.

And as with users of any age, more is not necessarily better.

“If you’re bingeing Netflix 10 hours a day, you may lose social connections,” Doraiswamy pointed out. Technology, he noted, cannot “substitute for other brain-healthy activities” like exercising and eating sensibly.

An unanswered question: Will this supposed benefit extend to subsequent generations, digital natives more comfortable with the technology their grandparents often labored over? “The technology is not static — it still changes,” Boot said. “So maybe it’s not a one-time effect.”

Still, the change tech has wrought “follows a pattern,” he added. “A new technology gets introduced, and there’s a kind of panic.”

From television and video games to the latest and perhaps scariest development, artificial intelligence, “a lot of it is an overblown initial reaction,” he said. “Then, over time, we see it’s not so bad and may actually have benefits.”

Like most people her age, Woods grew up in an analog world of paper checks and paper maps. But as she moved from one employer to another through the ’80s and ’90s, she progressed to IBM desktops and mastered Lotus 1-2-3 and Windows 3.1.

Along the way, her personal life turned digital, too: a home desktop when her sons needed one for school, a cellphone after she and her husband couldn’t summon help for a roadside flat, a smartwatch to track her steps.

These days, Woods pays bills and shops online, uses a digital calendar, and group-texts her relatives. And she seems unafraid of AI, the most earthshaking new tech.

Last year, Woods turned to AI chatbots like Google Gemini and OpenAI’s ChatGPT to plan an RV excursion to South Carolina. Now, she’s using them to arrange a family cruise celebrating her 50th wedding anniversary.

The New Old Age is produced through a partnership with The New York Times.

©2025 KFF Health News. Distributed by Tribune Content Agency, LLC.

Detroit is undergoing changes. You can see it as you drive around. From the murals to the development and redevelopment of particular areas, Detroit can be the model for what it looks like to create a more inclusive city for all. 

And with Detroit being the only U.S. city with a UNESCO Design City designation, it’s natural for Detroit to be at the forefront of major changes that include a creative flair.

UNESCO or The United Nations Educational, Scientific and Cultural Organization promotes international cooperation in various fields to build peace and sustainable development worldwide.

Over the next month, Detroit Month of Design will celebrate 10 years as a UNESCO city of design, with more than 95 events featuring more than 500 creatives in the city.

SustainACity is one of those events. It’s curated by Asia Hamilton, the founder and director of Norwest Gallery of Art. Hamilton is also the Climate Resilience Program Manager for the City of Detroit. 

She spoke on The Metro about what a reimagined Detroit could look like with environmental health at the forefront.

 

Listen to The Metro weekdays from 10 a.m. to noon ET on 101.9 FM and streaming on demand.

Subscribe to The Metro on Apple Podcasts, Spotify, NPR.org or wherever you get your podcasts.

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By JESSICA DAMIANO, Associated Press

If you spend any time gardening, you probably understand what I mean when I say it feels good — despite the lifting, sweating and straining involved. Yes, exercise is good for our bodies, but there’s something about digging in the dirt while listening to a bird soundtrack that lifts my spirits. Even the scent of the soil and mulch makes me happy.

As it turns out, there are scientific reasons for this.

In fact, there’s an entire field called horticultural therapy that’s dedicated to using “plant-based and garden-based activities to support people who have identified treatment needs,” according to Karen Haney, a horticultural therapy instructor at UCLA Extension in Long Beach, California.

“Research suggests 20-30 minutes (of gardening) a few times a week can reduce stress and lift mood, with benefits increasing the more regularly one gardens,” says Sarah Thompson, a professionally registered horticultural therapist in Boise, Idaho.

It’s not just about being outdoors

Yes, the simple act of being in nature can improve mood and restore focus, she said, but “the active engagement of nurturing plants, making decisions and seeing results over time adds a unique layer of meaning and satisfaction that passive time outdoors does not.”

In addition, Thompson said gardening has been shown to ease symptoms of anxiety and depression, and fosters a sense of calm, purpose and accomplishment.

A recent study at the University of Colorado-Boulder backs this up.

The researchers there provided one group of participants with an instructional gardening class, seeds, starter plants and a community gardening plot. They had a second group refrain from gardening for two years.

The gardening cohorts reported stronger social connections, lower stress levels and about a 7% increase in fiber intake, which have been shown to reduce risk factors for some physical and mental illnesses, including depression, high blood pressure, type 2 diabetes and cancer. They also reported a 42-minute weekly increase in physical activity, which the non-gardeners did not.

A mindful, rewarding and versatile activity

Previous studies have arrived at similar findings. In 2020, for instance, researchers at the University of Exeter and the Royal Horticultural Society in the U.K. found the health and well-being of gardeners over non-gardeners to be similar to that of residents of wealthy communities over those who live in poorer areas.

In addition to encouraging mindfulness, grounding people in the present moment and providing a sense of achievement, Thompson said, “research has also shown that exposure to sunlight can boost serotonin levels, while contact with soil introduces beneficial microbes linked to mood enhancement.”

So, it seems you just can’t go wrong with gardening.

“Physically, gardening improves strength, flexibility and balance. Socially, it can foster connection. Cognitively, it engages problem solving and creativity,” Thompson said, adding that it’s a highly adaptable activity.

“Gardening can be scaled to any space, ability or age, and its benefits are accessible to everyone,” she said.

Deep down, we gardeners have always believed this. Now, we have the science to prove it.

Jessica Damiano writes weekly gardening columns for the AP and publishes the award-winning Weekly Dirt Newsletter. You can sign up here for weekly gardening tips and advice.

The Shifa Institute hosts Islamic psychoeducation workshops across community centers and college campuses as students return to school.

At a recent Institute for Muslim Mental Health networking event, Shifa founder Salman Pervez shared how this initiative is creating mental health safe spaces across the state. 

“It’s it started at MSU as a school chapter, and then now we’ve branched out into the community… we have chapters starting at Wayne State University and the University of Michigan and University of Detroit Mercy this fall,” he says. 

Shifa means healing in Arabic. 

Pervez says the group uses creative outlets to introduce students to wellness, “like Golden Age ideas of Islam, like astronomy or art or, or like, engagement with nature and sort of like being in awe of it.”

The workshops usually consist of professional speakers engaging people about mental health related topics in third spaces by “informing people, translating mental health research, and sharing it with college students in a way that’s relatable, applicable to them,” he says. 

“We found that that’s very effective in getting students to engage with this sort of work and into the field as well education,” says Pervez.

The group also works with campus Counseling and Psychological Services (CAPS), which provides free therapy to full-time students. 

Pervez says he works with college students to help them become aware of resources and even potentially go into psychology as a field. He says Gen Z is a lot more open to talk about mental health.

“I think it’s overall, it’s really nice that they’re they’re more casual about it, and that they want to do something about it,” he says. 

 

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August is the best time of the year to take a dip in Lake Michigan, when its waters hover in the balmy upper 60s. Experts say so, and Chicago’s crowded beaches offer proof. But an invisible hazard can quickly turn a sunny day out into a sick night in.

In 2024, over 300 beaches across the Great Lakes closed to visitors or issued swim bans or advisories due to the presence of bacteria in the water — mostly E. coli, from nearby surface runoff or sewer system overflows, especially during heavy rain — according to state and federal data.

Bacteria levels triggered 83 advisories or closures in Illinois last summer, making it the second worst in the Midwest, with 71 in Lake County’s 13 lakefront beaches and 12 across nine beaches in Cook County. As of Thursday, Lake County beaches have had 49 advisories this summer, according to data from the state’s Department of Public Health. There has been at least one beach advisory in Cook County so far, according to Evanston officials.

“What we want, really want, to see is not that people say, ‘Well, that’s just the way it is.’ It shouldn’t have to be this way,” said Nancy Stoner, senior attorney at the Environmental Law and Policy Center, who focuses on clean water issues. “It’s pollution that can be controlled and should be controlled, because people deserve to be able to know that they can swim safely in the Great Lakes.”

In Wisconsin, 90 beaches closed or had advisories between May and September 2024 — representing the most lakefront locations affected — followed by Illinois, Ohio with 67, Michigan with 62, Indiana with 20 and Minnesota with 17, according to data from the U.S. Environmental Protection Agency’s Beach Advisory and Closing Online Notification system, which ELPC analyzed.

Even these numbers are just a starting point. In addition to different frequencies in testing among municipalities, there can also be a lag time by states in filing this information to the U.S. EPA. For instance, the federal agency’s system lists no advisories or closures for Illinois in 2024, data that currently can only be found on the state website. According to a spokesperson, the IDPH attempted a submission, which was rejected because of formatting compatibility issues. The state agency said it continues to work to rectify the situation with the U.S. EPA.

“Beachgoers should be able to rely upon the information provided by U.S. EPA to find out whether the beach they want to go to is safe for swimming,” Stoner said. “They can’t do that right now, and the fact that wrong information is being provided by U.S. EPA makes the situation even worse. U.S. EPA needs to fix this problem right away so that beachgoers don’t unknowingly swim in contaminated water and risk getting sick.”

Known as the BEACON system, it is supported by federal grant funding that allows officials to monitor water quality and bacteria levels. Symptoms in humans exposed to this and similar pathogens can include nausea, diarrhea, ear infections and rashes. According to scientists, each year, there are 57 million cases of people getting sick in the United States from swimming in contaminated waters.

When a certain safety threshold set by the U.S. EPA is exceeded, local officials can decide to issue a swim ban or advisory. Three locations, all north of Chicago, exceeded the EPA’s threshold on at least 25% of days tested last year: North Point Marina Beach, Waukegan North Beach and Winnetka Lloyd Park Beach, according to data from BEACON analyzed in a July report by advocacy nonprofit Environment America.

Chicago tests the water in all its public lakefront beaches every day of the summer, unlike communities in Lake County, which only test four days a week. The report also found that, on the city’s 26 miles of public lakefront during the 2024 season, at least four beaches had potentially unsafe levels between 14% and 21% of the days that the water was tested, including 31st Street Beach, Calumet South Beach, 63rd Street Beach and Montrose Beach.

Most of the funding for testing and monitoring comes from the BEACH Act, or the Beaches Environmental Assessment and Coastal Health Act, which has protected public health in recreational waters across the country since its unanimous passing 25 years ago. Since then, the U.S. EPA has awarded over $226 million in grants for these programs.

“(It) is a small program for a federal program, but a lot in funding” impact, Stoner said.

However, in its 2026 proposed budget, the administration of President Donald Trump suggested slashing the EPA’s budget and clean water programs. In July, the House Appropriations Committee approved a 25% cut in the agency’s Clean Water State Revolving Fund, which helps states manage wastewater infrastructure to ensure the cleanliness of waterways.

The proposed cuts come at a time when humid weather and heavier storms, intensified by human-made climate change, are overwhelming outdated sewer systems and releasing human waste into waterways. Stormwater can carry runoff pollution and manure from industrial livestock operations into beaches. E. coli also grows faster in warmer water, so increasing lake temperatures pose a growing risk to swimmers.

Advocates say that — for the sake of public health and recreation — the federal government must continue to ensure funding for these programs and support the staff and institutions that uphold environmental protections.

“The BEACH Act is a piece of it. That’s about monitoring and public notification. That’s important,” Stoner said, “but really, funding the underlying work that needs to be done is essential. So, funding the EPA, funding the staff at the EPA, funding these labs throughout the Great Lakes, funding NOAA … There’s a whole system.”

While it doesn’t often do so, Chicago is one of 158 communities authorized to discharge sewage into the Great Lakes.

Besides Chicago, cities like Milwaukee, Grand Rapids, Michigan, and Toledo, Ohio, have also updated their sewer systems and reduced the raw sewage they send flowing into the Great Lakes, thanks in no small part to federal infrastructure funding. These systems, advocates say, might offer a blueprint for the safety of beachgoers across the basin.

“There are solutions. We just have to invest for them to happen,” Stoner said. “So, it’s not a technological problem. It’s a … failure to decide that we want to solve this problem with solutions that exist.”

Emily Kowalski, outreach and engagement manager at the research and education center of Environment America in Illinois, said investments should go beyond upgrading sewage systems and focus on green infrastructure or natural, permeable surfaces like green roofs, parks and wetlands, which can help absorb rainwater and reduce flooding.

“A lot of these problems are things that we know how to fix and mitigate, but they do take money,” she said.

A report released by the U.S. EPA last year found the country needs at least $630 billion to address wastewater, stormwater and clean water infrastructure needs over the next 20 years.

“We need Congress to fully fund the Clean Water State Revolving Fund so that we can enjoy Chicago’s beaches, but also so (that) when we are on vacation on other shorelines or coastlines, we can enjoy beaches that are safe for swimming,” Kowalski said.

Sewage and animal waste

Every morning between Memorial Day and Labor Day, a handful of University of Illinois Chicago students head out to the city’s public beaches. As the sun rises and the day starts, they wade into the lake at each location and collect water in two plastic bottles.

The samples are then tested in a laboratory to detect the presence of genetic material from Enterococci — bacteria that, like E. coli, live in the intestines of warm-blooded animals such as humans. While Enterococci are not considered harmful to humans, scientists test for their presence in water as an indicator that other disease-causing microbes like E. Coli might be present from possible fecal contamination. In a few hours, the results allow the Chicago Park District to issue the necessary water quality advisories for any of its beaches.

If the concentration of Enterococci in water samples from a beach registers an estimated illness rate of 36 per 1,000 swimmers, following U.S. EPA criteria, the Park District will issue a swim advisory. But the agency rarely issues full-on swim bans based on water quality; for that to happen, test results need to correspond with an event when sewage flows into the lake, said Cathy Breitenbach, natural resources director at the Chicago Park District.

“Our river flows backwards. Sewer overflows are pretty rare these days, and even when they do occur, they don’t go into the lake,” Breitenbach said.

That is, unless intense precipitation levels overwhelm sewers already overflowing within the city, and officials open the locks between the river and the lake and reverse that flow.

“Then we’d issue a systemwide ban until we test below the threshold,” she said.

The last time this occurred and a ban was issued in Chicago was in July 2023. The locks near Navy Pier were opened to relieve the pressure on the sewer system during heavy rainfall, allowing more than 1.1 billion gallons of murky, bacteria-laden waste to flow into Lake Michigan.

While sewage contamination from heavy storms attracts the most attention, waste from animals, such as seagulls and even dogs, can be washed by rain into the lake and is often the biggest source of bacterial concentrations across Chicago beaches.

“We have so many beautiful buildings, but when water falls on our city, that water runs off of our roads into our waterways, picking up pollutants along the way,” Kowalski said.

Runoff can contaminate Lake County beaches, too, when waste from waterfowl makes its way into the lake.

“Some of it is very localized,” said Alana Bartolai, ecological services program coordinator at the Lake County Health Department. North Point Marina Beach, she said, is well-known in the community because “the seagulls and the gulls love it.”

It’s a recurring observation among department staff when they conduct monitoring at the county’s lakefront beaches. Waukegan Beach has the same issue.

“When we take samples … we routinely are recording 300-plus gulls on the beach,” at those two locations, Bartolai said.

North Point Marina and Waukegan beaches accounted for almost half of all bacteria-related advisories and closures issued in Lake County last summer and so far this summer.

Bartolai said most of the advisories and swim bans in 2024 were weather-related. “Even though we were in drought conditions, we did still have heavy rain events,” she said.

Because swimmers at a lakefront beach are engaging in an activity in a natural body of water, “there’s no such thing as no risk,” Breitenbach said.

Earlier this month, at a beach in Portugal, over 100 people had to be treated for nausea and vomiting after swimming.

“When you see reports like this, you’re really thankful that Chicago is so ahead and has been doing (testing) for over a decade now,” said Abhilasha Shrestha, a University of Illinois Chicago research assistant professor of environmental and occupational health sciences who leads the laboratory testing for the city’s public beaches.

The rapid test the Chicago Park District is now using cuts the wait time down to only three to four hours, providing the most up-to-date information to ensure the safety of beachgoers. Before the city’s partnership with UIC began with a pilot program in 2015, testing relied solely on culturing E. coli, a laboratory process that incubates live cells in an artificial, controlled environment — with results available in 18 to 24 hours.

“It didn’t really make sense, because you were telling people what the water was like yesterday and doing the closure or advisory the day after,” Shrestha said.

But some municipalities say they can’t afford the more expensive rapid test.

“Not every community has the funding or has the setup where their beaches get tested every single day,” said Kowalski of Environment America in Illinois.

The Lake County Health Department uses the more time-consuming culture method to test water samples for E. coli — largely due to resources and funding constraints to adopting the faster methodology, officials said.

“The cost of it is almost like 10 times the cost of running an E. coli sample in our lab,” Bartolai said. “But we are looking at it, because there is that need to have that quicker turnaround.”

She said many Lake County suburbs take precautions such as raking the sand at their beaches to clear droppings from geese and seagulls “so that when it rains, it’s not getting washed in.”

In Chicago, Park District staff clean the public beaches daily, starting before dawn. Operations include tractors pulling raking machines, supporting crews of laborers who pick up litter and empty trash cans by hand and beach sweepers who clear paths for pedestrians and bike trail users. Kowalski said beachgoers can also help by picking up after dogs and ensuring babies wear swim diapers.

“(We) ask people to help, to do their part, to keep the water quality good and the beaches clean,” Breitenbach said. “Put your garbage away, don’t feed the birds, listen to the lifeguards.”

More information

Beachgoers across the Great Lakes can find water quality monitoring results on state government websites such as the Illinois Department of Public Health’s BeachGuard page or from volunteer-led efforts in nonprofits such as SwimGuide.

Beach advisories in Chicago are updated on the Park District’s website and with an on-site color-coded flag system that indicates whether conditions are safe for people to swim. These can change throughout the day due to bacteria levels in the water, as well as weather like lightning or high winds, and surf conditions like high waves.

In Chicago public beaches, three colored flags indicate three different things: red for a swim ban, yellow for a swim advisory, which means that swimming is allowed with caution, and green for permitted swimming. On any given day, the flag color between noon and 1:30 p.m. likely indicates the most recent information from water quality test results.

adperez@chicagotribune.com

By Amanda Hernández, Stateline.org

For years, state lawmakers have taken the lead on regulating kratom — the controversial herbal supplement used for pain relief, anxiety and opioid withdrawal symptoms. Some states have banned it entirely. Others have passed laws requiring age limits, labeling and lab testing.

At least half of the states and the District of Columbia have enacted some form of regulation on kratom or its components — building a patchwork of policies around a product largely unaddressed by the federal government.

But that may soon change. The U.S. Food and Drug Administration is pushing to ban 7-hydroxymitragynine, or 7-OH — a powerful compound found in small amounts in kratom and sometimes concentrated or synthesized in products sold online, at smoke shops or behind gas station counters.

Federal health officials announced last month that the compound poses serious public health risks and should be classified as a Schedule I controlled substance, alongside heroin and LSD.

The move marks a significant shift in how federal regulators are approaching kratom, which they attempted to ban in 2016. It also has sparked debate about how the change could impact the growing 7-OH industry and its consumers.

This year, at least seven states have considered bills to tighten kratom regulations, including proposals for bans, age restrictions and labeling requirements.

Kratom, which originates from the leaves of a tree native to Southeast Asia, can have a wide range of mental and bodily effects, according to federal officials, addiction medicine specialists and kratom researchers. Reports of fatal kratom overdoses have surfaced in recent years, though kratom is often taken in combination with other substances.

Kratom and 7-OH are distinct products with separate markets, but they are closely connected. 7-OH is a semi-synthetic compound derived from kratom and only emerged on the market in late 2023, while kratom itself has been available for decades.

Leading kratom researchers also say more research is needed to fully understand the long-term effects of using both substances.

“There’s much we don’t know, unfortunately, on all sides,” said Christopher R. McCurdy, a professor of medicinal chemistry at the University of Florida. McCurdy is a trained pharmacist and has studied kratom for more than 20 years.

Research suggests kratom may help with opioid withdrawal and doesn’t seem to cause severe withdrawal on its own. Smaller amounts seem to act as a stimulant, while larger doses may have sedative, opioidlike effects. Very little is known about the risks of long-term use in humans, according to McCurdy.

As for 7-OH, it shows potential for treating pain, but it hasn’t been studied in humans, and it may carry a high risk of addiction. Researchers don’t yet understand how much is safe to take or how often it should be used, McCurdy told Stateline.

While some leading kratom experts agree that kratom and 7-OH should be regulated, they caution that placing 7-OH under a strict Schedule I classification would make it much harder to study — and argue it should instead be classified as Schedule II like some other opioids.

A federal survey from 2023 estimated that about 1.6 million Americans age 12 and older used kratom in the year before the study. The American Kratom Association, a national industry lobbying group, estimated in 2021 that between 11 million and 16 million Americans safely consume kratom products each year.

Since gaining popularity in recent years, 7-OH has appeared in a growing number of products. Some researchers and addiction medicine specialists say many consumers, especially those new to kratom, sometimes don’t understand the difference between products.

“It’s a pure opioid that’s available without a prescription, so it’s akin to having morphine or oxycodone for sale at a smoke shop or a gas station,” McCurdy said. “This is a public health crisis waiting to happen.”

Federal crackdown targets 7-OH, not kratom

In late July, the U.S. Department of Health and Human Services recommended that the federal Drug Enforcement Administration place 7-OH in Schedule I, citing a high potential for abuse. The classification would not apply to kratom leaves or powders with naturally occurring 7-OH.

“We’re not targeting the kratom leaf or ground-up kratom,” FDA Commissioner Marty Makary said at a news conference. “We are targeting a concentrated synthetic byproduct that is an opioid.”

Makary acknowledged that there isn’t enough research or data to fully understand how widespread 7-OH’s use or impact may be. Still, he said the Trump administration wants to be “aggressive and proactive” in addressing the issue before it grows into a larger public health problem.

While only small amounts of 7-OH occur naturally in the kratom plant, federal officials have raised concerns about U.S. products containing synthetic or concentrated forms of the compound because it’s more potent than morphine and primarily responsible for kratom’s opioidlike effects.

The FDA’s recommendation to schedule 7-OH will now go to the DEA, which oversees the final steps of the process — including issuing a formal proposal and opening a public comment period.

If finalized, the rule could affect both companies selling enhanced kratom products and consumers in states where those products are currently legal.

The DEA backed off scheduling kratom compounds in 2016 after widespread public opposition.

Kirsten Smith, an assistant professor of psychiatry and behavioral sciences at Johns Hopkins University who is studying kratom’s effects in humans, said she was surprised by the FDA’s push to schedule 7-OH.

“We don’t really have a public health signal of a lot of adverse events for either kratom or for 7-OH at this time,” she told Stateline. “I was, frankly, always surprised that kratom was pushed toward scheduling at an earlier time point. … I don’t know that we have data to support scheduling even now.”

Still, some advocacy groups, including the Holistic Alternative Recovery Trust, argue the push to schedule 7-OH is driven more by corporate interests than public health, suggesting the kratom industry is trying to sideline competition from 7-OH products.

“We think that this is just happening because of the legacy kratom manufacturers losing market share and wanting to gin up a crisis with this,” said Jeff Smith, the national policy director for the group, who said he has used 7-OH for sleep and pain management.

While his organization supports regulation and safe consumption, members worry the federal government’s move could drive people to riskier substances or push the market underground.

“It’s made a profound difference in my life,” Smith said. “We think it would be tragic to cut it off based on such a paucity of data when there’s so much potential for this product to help people.”

Public health concerns

Federal health officials say a key concern is the growing use of kratom and 7-OH products among teens and young adults.

Some officials and addiction medicine specialists have pointed out that these products often come in flavors and packaging designed to appeal to younger buyers, with few controls over where or how they’re sold. In some states without clear regulations, kratom and 7-OH products are available at gas stations or online, sometimes without any age verification.

“Whenever you go into a gas station and even though it’s behind the glass, it’s kind of eye level, and it has all of these bright colors — it has all of these things that really attract the visual of a kiddo,” said Socorro Green, a prevention specialist with Youth180, a nonprofit focused on youth substance use prevention in Dallas.

Green added that kratom and 7-OH products may be even more accessible to young people in rural communities, where gas stations and convenience stores are often among the few available retailers.

Some researchers and experts say that certain products may not clearly or accurately disclose their 7-OH content and are sometimes marketed or mistaken for traditional kratom.

Some cities, counties and states have responded by banning kratom or raising the minimum purchase age to 18 or 21. But in many areas, enforcement remains inconsistent, and some addiction specialists say clearer federal and state guidance is needed — especially as more people are using kratom and 7-OH to manage pain, anxiety or withdrawal symptoms on their own.

“There needs to be some kind of oversight, including some way of maybe helping to ensure that people know what they’re getting,” said Terrence Walton, the executive director and chief executive officer of NAADAC, the Association for Addiction Professionals.

State regulations

At least seven states have considered or enacted legislation this year related to kratom — ranging from age restrictions and labeling requirements to outright bans.

In New York, lawmakers passed two bills: one requiring warning labels and prohibiting kratom products from being labeled as “all natural,” and another raising the minimum purchase age to 21. Neither has been sent to the governor.

In Colorado, a new measure, which was signed into law in May, prohibits kratom from being sold in forms that resemble candy or appeal to children, increases labeling requirements, limits concentrations of 7-OH, and bans the manufacture and distribution of synthetic or semi-synthetic kratom.

In Mississippi, a new law that took effect in July raised the minimum purchase age for kratom to 21. It also bans synthetic kratom extracts and products with high concentrations of 7-OH. Lawmakers in Montana and Texas introduced similar legislation this year, but neither proposal advanced.

Louisiana is the latest state to enact a kratom ban, which took effect Aug. 1. Meanwhile, in July, Rhode Island became the first state to reverse its ban. The new law establishes a regulatory framework for the manufacturing, sale and distribution of kratom products, set to take effect in April 2026.

As of this year, Washington, D.C., and seven states — Alabama, Arkansas, Indiana, Louisiana, Rhode Island (until April 2026), Vermont and Wisconsin — have banned kratom. At least half of U.S. states now regulate kratom or its components in some way.

©2025 States Newsroom. Visit at stateline.org. Distributed by Tribune Content Agency, LLC.

By Madison Czopek, KFF Health News

For parents of school-aged children, the fall to-do list can seem ever-growing. Buy school supplies. Fill out endless school forms. Block off parent-teacher nights. Do the kids’ tennis shoes still fit?

Somewhere, at some point, you might remember flu shots. Get your flu shot. Get their flu shots. Or should you? Can you? Is that still a thing?

Amid political chatter about vaccines and the government entities that oversee them, it’s understandable to wonder where all this leaves the 2025-26 flu vaccine.

In short: Yes, the flu shot is still a thing. And doctors we spoke to said they recommend you get your flu shot this year.

Here are some answers to common questions:

Q: I heard the Trump administration could be changing vaccine recommendations. Does that apply to the flu vaccine?

There have been no substantial changes to the federal government’s flu vaccine recommendation: The Centers for Disease Control and Prevention still says that people 6 months old and up should get an annual flu vaccine.

That means most insurers will cover it, and it should soon be widely available.

Health and Human Services Secretary Robert F. Kennedy Jr., who has opposed vaccines, agreed that most people should get the flu vaccine. He followed a recommendation from the board that advises the federal government on vaccine policy; Kennedy replaced the members with his own.

The panel voted against recommending multidose flu shots that contained the preservative thimerosal, but the preservative had already been removed from most vaccines, including most flu shots.

Q: Who should not get the flu shot?

Doctors acknowledged there are always exceptions to broad guidance. For example, people with severe allergies to flu vaccine components should not get vaccines that contain those components.

You should discuss your health situation with your physician for personalized guidance.

Q: Is this season’s flu shot different from last season’s?

Yes. The flu shot was updated for the upcoming flu season, but the changes weren’t drastic. Like last year’s flu shot, this year’s vaccine is known as a three-component or trivalent vaccine that protects against three influenza viruses — two influenza A viruses and one influenza B virus.

This season’s vaccine was altered to target a specific strain of the influenza A/H3N2 virus expected to circulate this season, said Ryan Maves, a professor of medicine at Wake Forest University and a member of the Infectious Diseases Society of America. Those changes align with what the World Health Organization has recommended.

Q: When is the best time to get vaccinated?

September, October, or early November. This allows your body time to build up its protective antibodies as flu season begins and ensures your protection doesn’t wane before it ends.

In the U.S., influenza infection typically peaks in February, so you want to make sure you’re vaccinated and your protection is still strong through February and into March, said William Schaffner, a professor of infectious diseases at Vanderbilt University Medical Center.

Q: Is this season’s flu vaccine guaranteed to protect against the influenza strain that’s circulating?

Guarantee all protection? No.

Reduce risk of death? Yes.

Similar to the COVID-19 vaccine, flu vaccines are best at “protecting us from the most severe consequences of influenza,” Schaffner said. That means the flu vaccine is most effective at keeping people out of the hospital or the intensive care unit and keeping people from dying.

“A flu vaccine may not guarantee perfect protection against the flu, but skipping your flu shot simply guarantees you’ll have no protection at all,” said Benjamin Lee, a pediatric infectious diseases physician at the University of Vermont Children’s Hospital and an associate professor at the University of Vermont Larner College of Medicine.

Q: Will the flu shot be readily available this year?

All signs point to yes.

The FDA passed its formula recommendations to vaccine manufacturers March 13 — early enough that the agency expected there would be “ an adequate and diverse supply.” The people and places that administer flu shots should have them soon, typically beginning in September, said Flor Muñoz, a Baylor College of Medicine associate professor of pediatrics and infectious diseases.

Q: I heard Kennedy canceled $500 million in funding for vaccine development. Could this affect future flu vaccines?

Kennedy announced the cancellation of funding for mRNA vaccine development. Some companies have been researching combined mRNA flu and COVID shots, but there are currently no approved mRNA flu vaccines.

Still, experts said the federal government’s changes — funding cuts, vaccine committee purges, deviations from existing procedures — are increasing uncertainty.

©2025 KFF Health News. Distributed by Tribune Content Agency, LLC.

By Julie Appleby, KFF Health News

People thinking about starting a business or retiring early — before they’re old enough for Medicare — may want to wait until November, when they can see just how much their Affordable Care Act health insurance will cost next year. Sharp increases are expected.

Premiums for ACA health plans, also known as Obamacare, which many early retirees and small-business owners rely on for coverage, are going up, partly due to policy changes advanced by the Trump administration and Congress. At the same time, more generous tax subsidies that have helped most policyholders pay for coverage are set to expire at the end of December.

After that, subsidies would return to what they were before the covid-19 pandemic. Also being reinstated would be an income cap barring people who earn more than four times the federal poverty level from getting any tax credits to help them purchase coverage. Although Congress potentially could act to extend the credits, people weighing optional life changes should factor in the potential cost if lawmakers fail to do so.

“I would hate for people to make a big decision now and then, in a few months, realize, ‘I’m not even going to qualify for a tax credit next year,’” said Lauren Jenkins, an insurance agent whose brokerage helps people sign up for coverage in Oklahoma. “Coupled with the rate increases, that could be significant, especially for someone at or near retirement, when it could easily cost over $1,000 a month.”

Still, how things play out in the real world will vary.

The key factor is income, as the subsidy amount people receive is primarily based on household income and local insurance costs.

People experiencing the biggest dollar increase in out-of-pocket premiums next year will be those who lose subsidies altogether because they earn more than 400% of the federal poverty level. This year, that’s $62,600 for a single person and $84,600 for a couple.

This “subsidy cliff” was removed in the legislation first enacted during the covid pandemic to create enhanced subsidies, but it will be back next year if they expire. About 1.6 million people who earn more than 400% of the poverty threshold bought ACA plans this year, many of them getting some tax credits to help with the premiums, according to KFF data. KFF is a health information nonprofit that includes KFF Health News.

“A lot of small-biz owners fall around that level of income,” said David Chase, vice president of policy and advocacy for the Small Business Majority, a Washington, D.C.-based advocacy group, which is urging Congress to extend the credits.

And a good chunk of ACA enrollment consists of small-business owners or their employees because, unlike larger firms, most small businesses don’t offer group health plans.

In the Washington metropolitan area, “seven out of 10 people who qualify for lower premiums [because of the tax credits] are small-business owners,” said Mila Kofman, executive director of the DC Health Benefit Exchange Authority.

Congress must decide by the end of December whether to extend the subsidies a second time. Permanently doing so could cost taxpayers $335 billion over the next decade, but not acting could cause financial pain for policyholders and pose political repercussions for lawmakers.

Because new premiums and smaller subsidies would take effect in January, the potential fallout has some Republican lawmakers worried about the midterm elections, according to news reports.

Republican pollsters Tony Fabrizio and Bob Ward warned the GOP in a memo that extending the enhanced credits could mean the difference between success and failure in some midterm races, because support for the premium help “comes from more than two-thirds of Trump voters and three-quarters of Swing voters.”

While supporters credit the enhanced subsidies for a record 24 million sign-ups for this year’s ACA plans, critics have blamed them for instances in which sales brokers or consumers engaged in improper enrollment.

“The expanded subsidies were a temporary covid pandemic policy enacted by congressional Democrats on a party-line vote and scheduled to end after 2025,” said Brian Blase, president of the Paragon Health Institute, a conservative think tank. “They have led to tremendous fraud and waste, they reduce employer coverage, and they should be permitted to expire.”

Ed Haislmaier, a senior research fellow at the conservative Heritage Foundation, acknowledged that people earning more than 400% of the poverty level would not be happy with losing access to subsidies, but he expects most to stay enrolled because they want to avoid huge medical bills that could threaten their businesses or savings.

“They are middle-class or upper-income people who are self-employed, or early retirees with significant income, which means they have a lot of assets behind that income,” he said. “These are people who view insurance as financial protection.”

He thinks lawmakers would win political support from voters in this category by addressing two of their other major ACA concerns: that annual deductibles are too high and insurers’ networks of doctors and hospitals are too small.

“If you just give these people money by extending subsidies, it’s only addressing one of their problems, and it’s the one they are least upset about,” Haislmaier said. “That is the political dynamics of this.”

Here’s how the expiration of subsidies could play out for some hypothetical consumers.

People in households earning less than four times the poverty rate would still get subsidies — just not as generous as the current ones.

For example, those whose earnings are at the lower end of the income scale — say, just over 150% of the poverty threshold, or about $23,000 — will go from paying a national average of about $2 a month, or $24 toward coverage for the year, to $72 a month, or $864 a year, according to a KFF online calculator.

On the other end of the income spectrum, a 55-year-old Portland, Oregon, couple with a household income of $85,000 would also take a big hit on the cost of their benchmark plan. They currently pay about $600 a month in premiums — about 8.5% of their household income — with subsidies kicking in about $1,000 to cover the remainder.

Next year, if the tax credits expire, the same couple would not get any federal help because they earn over four times the poverty limit. They would pay the full monthly premium, with no subsidies, which would be about $1,800, based on initial 2026 premium rates filed with state regulators, said Jared Ortaliza, a policy analyst at KFF.

People should begin to see insurance rates late this fall, and certainly by Nov. 1, when the ACA’s open enrollment season begins, said Jenkins, the Oklahoma insurance agent. That gives them time to mull over whether they want to make changes in their plan — or in their lives, such as quitting a job that has health insurance or retiring early. This year, open enrollment extends to Jan. 15. Under new legislation, that open period will shorten by about a month, starting with the 2027 sign-up period.

Those who do enroll for 2026, especially the self-employed and people retiring early, should closely track their incomes during the year, she said.

It would be easy to bust through that income cap, she said.

If they do, they’ll have to pay back any tax credits they initially qualified for. Their income might rise unexpectedly during the year, for example, pushing them over the limit. An income bump could come from drawing down more money from retirement accounts than planned, landing a new customer account, or even from winning big at the casino.

“Maybe they win $5,000 at the casino, but that puts them $500 over the limit for the year,” Jenkins said. “They might have to pay back $12,000 in tax credits for winning a few thousand at the casino.”

©2025 KFF Health News. Distributed by Tribune Content Agency, LLC.