In the first of many papers expected from the study, the researchers found that, a year after the ultra-low emissions zone took effect, 2 out of every 5 London students in the study had switched from “passive” to “active” ways of getting to school. So instead of being chauffeured to school by their parents, the students started walking, biking, scootering, or taking public transit. On the other hand, in Luton, which acted as a control group, 1 in 5 made the same switch to modes that got them up and active, but an equal proportion switched to passive travel. But in London’s ultra-low emissions zone, shifting to driving was rare.
The implications of getting kids active, even if it’s just for their pre-class commute, are intuitive but important.
“Walking and biking and scootering to school is better for the child, better for the family, and better for the environment,” said Alison Macpherson, an epidemiologist at York University in Toronto who researches ways to protect and promote the health and safety of children. (She was not involved in the London study.)
“It’s a great way for children to start their day,” she said. “You can imagine just being thrown in a car and thrown out of a car is not the most calming way.” Walking or biking to school, on the other hand, can be calming and conducive to concentration, Macpherson said, potentially even improving academic performance. But perhaps most importantly, at a time when an epidemic of childhood obesity is on the rise worldwide, walking or wheeling to and from school can get kids more active.
Health
What do housing, transit and lifestyle statistics have to do with loneliness and unhappiness, you might ask. Well, I don’t think it’s a reach to suggest that separating people physically also leads to emotional and psychological separation. Moreover, the implements that make sprawl-induced physical separation work on a societal level — cars to contract long distances and digital media to ameliorate the effects of social isolation — deepen loneliness and unhappiness on the personal level. These implements also make people sedentary, directly relating to the fact that 73% of the total American population is overweight and 42% is obese, per the CDC.
One of the biggest issues is population density. At the risk of oversimplifying, it’s a lot harder to socially isolate when there are people around you.
There is an increasing demand for trans and gender diverse (TGD) health services worldwide. Given the unique and diverse healthcare needs of the TGD community, best practice TGD health services should be community-led. We aimed to understand the healthcare needs of a broad group of TGD Australians, how health professionals could better support TGD people, and gain an understanding of TGD-related research priorities. An anonymous online survey received 928 eligible responses from TGD Australian adults. This paper focuses on three questions out of that survey that allowed for free-text responses. The data were qualitatively coded, and overarching themes were identified for each question. Better training for healthcare professionals and more accessible transgender healthcare were the most commonly reported healthcare needs of participants. Findings highlight a pressing need for better training for healthcare professionals in transgender healthcare. In order to meet the demand for TGD health services, more gender services are needed, and in time, mainstreaming health services in primary care will likely improve accessibility. Evaluation of training strategies and further research into optimal models of TGD care are needed; however, until further data is available, views of the TGD community should guide research priorities and the TGD health service delivery.
Informed consent means that a trans person could access gender-affirming care without any need for mental health treatment or a lengthy assessment process. This model is routine in the vast majority of all non-transgender medical care. Cisgender people routinely access similar hormonal medications as trans people without a mental health diagnosis for conditions like polycystic ovarian syndrome, precocious puberty, menopause, loss of virility with age, and birth control.
Many doctors worldwide use a gatekeeping approach to gender-affirming care, but the informed consent model for transgender hormone replacement therapy is also widespread in the United States—a map of IC providers created by activist and journalist Erin Reed lists nearly 1,000 such providers in this country. This has been the result of decades of advocacy by the trans community to have our healthcare approached similarly to other comparable treatments.
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How do we know that informed consent works better? Well, to start, granting trans people significant levels of autonomy over their medical care is in line with the ethics of the medical profession, which directs doctors to engage in shared decision-making and uphold client autonomy whenever possible. As Bryan Murray puts it in a piece for the American Medical Association Journal of Ethics, “Informed consent is at the heart of shared decision making—a recommended approach to medical treatment decision in which patients actively participate with their doctors.” Scholar Madeleine Lipshie-Williams points out that the gatekeeping mode for gender-affirming care is at odds with how the majority of medicine is practiced in the U.S.: “[the gatekeeping model], which requires medical professionals to provide official opinions on a trangender patient’s readiness to accept and undergo care, stands in contrast to the majority model of medical consent in the US.” Lipshie-Williams also argues that the informed consent framework is preferable because it is necessary for the normalization of trans identities: “there cannot be a depathologizing of transgender identity as long as transgender individuals are required to be seen by mental health specialists to confirm both the validity of their own self-proclaimed identity, as well as their mental fitness to consent to medical interventions that have been broadly accepted as necessary. There is an inherent contradiction in declaring medical care necessary whilst simultaneously maintaining that those for whom it is necessary continue to lack the capacity to consent to this care without assistance.”
Since the launch of the Cass Review in 2020, the situation for trans children in the UK has continued to decline (Madrigal-Borloz, Citation2023). In 2022 the UK Minister for Health called for clinicians to look for evidence of “what has caused children to be trans,” citing the Cass Review to claim that “identifying as trans” is likely to be a response to “child sex abuse” (Milton, Citation2022). The Cass Review was cited by the British government to justify plans to exclude trans people from legislation to ban conversion therapy (British Psychological Society, Citation2022). The Cass Review was also cited to justify the closure of existing children’s gender services for England and Wales, with services ceasing to see any new referrals 18 months before replacement services are expected to be operational (Ali, Citation2023). Trans healthcare professionals outside of the UK have critiqued the Cass review (Pang et al., Citation2022) as well as critiquing healthcare policies inspired by the Cass Review such as the NHS’ 2023 draft service specification (WPATH et al., Citation2023).
On Friday, numerous conservative accounts and news sources promoted headlines that the "American College of Pediatricians" had issued a statement against transgender care. A video accompanied the announcement featuring Dr. Jill Simons, who, wearing a white lab coat, states that there must be an end to "social affirmation, puberty blockers, and cross-sex hormones" for transgender youth. Despite the official-looking attire and name, the organization's name serves to mislead observers into thinking they are the much larger American Academy of Pediatrics, which represents tens of thousands of pediatricians. In reality, the ACP is a hyper-conservative Christian group of doctors created in 2002 to oppose gay parenting.
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The American College of Pediatricians has been hugely influential in the promotion of anti-trans policy in the United States, relying in part to its misleading name. Members of the organization testify in state houses and courtrooms across the United States, misleading legislators into thinking they are the much larger American Academy of Pediatrics, the professional society that represents 67,000 pediatricians in the United States.
When a heat dome shattered temperature records across the Western U.S. and Canada in June 2021, the resulting fatalities exposed a pattern. In Portland, Oregon, and surrounding Multnomah County, 56 of the 72 people who died were age 60 and up. In British Columbia, people 60 or older accounted for 555 of the 619 fatalities.
Just over a year later, a sizzling June, July and August in England caused roughly 2,800 excess deaths among people 65 and older. More than 1,000 of them occurred over four days in late July.
Intense heat waves in recent years offer a stark warning of what’s at stake for humanity. The planet just endured its 12 hottest consecutive months on record, and this summer threatens to be hotter than ever. But those stakes are not experienced equally across age groups. Older adults are more at risk of experiencing dangerous health impacts during periods of intense heat.
When used to generate power or move vehicles, fossil fuels kill people. Particulates and ozone resulting from fossil fuel burning cause direct health impacts, while climate change will act indirectly. Regardless of the immediacy, premature deaths and illness prior to death are felt through lost productivity and the cost of treatments.
Typically, you see the financial impacts quantified when the EPA issues new regulations, as the health benefits of limiting pollution typically dwarf the costs of meeting new standards. But some researchers from Lawrence Berkeley National Lab have now done similar calculations—but focusing on the impact of renewable energy. Wind and solar, by displacing fossil fuel use, are acting as a form of pollution control and so should produce similar economic benefits.
Do they ever. The researchers find that, in the US, wind and solar have health and climate benefits of over $100 for every Megawatt-hour produced, for a total of a quarter-trillion dollars in just the last four years. This dwarfs the cost of the electricity they generate and the total of the subsidies they received.
Rapid diffusion of solutions to a changing climate is paramount if the US is to mitigate carbon emissions. A timely response depends on how people perceive and understand innovations such as new practices, programs, policies, and technologies that promise to reduce emissions. This article explores multisolving innovations in the context of interventions that can be targeted to community leaders and decision makers. We focus on examples led by policy staff; directors of municipal offices and departments of transportation, housing, sustainability, urban planning, and public health; and elected county and city officials where there may be mixed support for efforts to reduce carbon emissions, to show that some innovations can be accurately framed solely in terms of community health benefits. When communicating with stakeholders who are dismissive or skeptical of climate change, we suggest using messages that describe the benefits of mitigation innovations in terms of human health, rather than climate, to achieve broader acceptability.
Being able to afford health care is a pressing issue for many Australians. And encouraging GPs to bulk bill is one measure the government is taking to ease the strain.
So what would it take for GPs to bulk bill everyone? In our recent paper, we calculated this is possible and affordable, given the current health budget.
But we show recent incentives for GPs to bulk bill aren’t enough to get us there.
Instead, we need to adjust health policies to increase bulk-billing rates and to make our health system more sustainable.