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Analysis | Trump’s playing his greatest hits. They don’t work as well as they used to.
With midterm elections a month away, the president is turning the audacity up to 11 as he labors to reverse his party’s decline in the polls.
This Photograph Might Not Look Like Much, But It Proved That "Island Universes" Really Do Exist
After months of searching with the Earth's most powerful telescope, a single star showed us the true scale of the universe.
Trump administration reverses stance on integration of people with disabilities
Disability rights advocates are angered by the latest reversal but are rallying behind proposed legislation and working with states to strengthen protections for community integration.
September Monthly Review: Health MCP Guy?
For all the time I spend talking about APIs and data exchange, this newsletter has had embarrassingly little interoperability of its own. It’s old-school SaaS, baby - UI or bust. Not all of that is my fault! Substack, for all its popularity, is (as mentioned before) really frustrating as my system of record. The primary user it optimizes towards is the reader, whose attention feeds the app, the Notes feed, and the recommendation network that Substack is actually selling. Health API Guy is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber. Subscribe They’re falling into the same trap that Medium once sprinted into, albeit at a much more glacial speed. Younger generations may not remember (or never knew) it, but Medium once lured publications like The Ringer and Signal v. Noise onto its platform, only to lose them as it rebuilt itself around a paywall and an algorithmic feed. Substack’s original pitch circa 2020 was the antidote (you own your list), but every new feed feature chips away at it. I get it: writers are generic supply in the eyes of the Substack product team. Generic supply follows demand, so the consistent pressure on the PMs is to generate demand, which leads to every product cycle going toward discovery (Notes, recommendations, the app, live video). The end result lackluster author tools (laggy and broken analytics are truly crippling) all despite the premium price point. The archive is where it crosses from authorial gripes to actual reader impact, though. Across Substack and LinkedIn, I’ve published 1,218 posts and nearly 900,000 words since 2018. Substack’s native search can see only the 464 posts that live on Substack, and even there it’s woefully inadequate at surfacing relevant content (even for the guy who wrote it)! Readers have the same problem, writ large. Ask the Archive Fixing search (for both my readers and my own use) turned out to be extremely non-trivial, unfortunately: There’s no public API for readers to access content RSS exists for new content notification, but it only carries the 20 most recent posts and cuts paid ones off at the preview The only Substack MCP is an admin tool for analytics The export exists for authors, but it’s painfully awkward and slow. So I built something to work around that: the Health API Guy MCP. It’s a private MCP server holding the full text of everything I’ve written across Substack and LinkedIn. Add it to Claude or ChatGPT as a connector and you can ask things like: It pairs keyword search (for acronyms and case names, of which we have many) with semantic search. Every post is also labeled by topic, form, and court case, so you can pull a lawsuit’s (or multiple cases’) entire docket across Substack and LinkedIn in one query: Hail, Healthapiguyhydra This is also a bit of me eating my own cooking. I’ve spent the year arguing that headless healthcare is arriving and that developers want primitives over abstractions. Last week in Hail, Benihydra, I watched Salesforce plug its platform into Claude and bet that the records underneath outlive whatever interface sits on top: Salesforce must believe that the Hydra’s immortal head is the records, permissions, and business logic (in that they will survive whatever happens to the interface). It felt a bit hypocritical to keep my own archive behind a Substack search bar. The archive is the body. Substack is one head, and now whatever tool you might use is another. Will the EHRs follow my lead? Probably not imminently, but one can hope! Why Founding Members Only The MCP is available to Founding Member subscribers. A few reasons: It costs money and time to run. Hosting, the database, Clerk usage and AI compute for search and labeling are significant operational costs (that increase with usage). Substack gives me no way to automate access. There’s no API to check whether someone is a paid subscriber, so every user is manual operations for now. It’s a beta. We’ll need to improve things and parts will break. I’d rather they break for a small group of dedicated readers who will tell me about it. The Founding tier deserved a real benefit. Until now it was mostly a generous tip. Now it comes with something. If you’re already a Founding Member, reply to this email with the address you’d like provisioned. If you’re not and want in, upgrade here. Larger teams (such as companies) can get access too: group subscriptions at the Founding tier come with the group discount. The admin for the subscription can reply with the list of addresses to provision. Get 20% off a group subscription Pricing Founding membership is now a flat $200 a year, replacing the old suggested $150 that readers could adjust. Existing Founding Members will have access grandfathered in at their previous rate. Month in Review Articles Published Make Networks Dumb Again (Sep 11): AI is making old analog networks cheaper to use and flooding them with machine traffic in the process. A plea for agent-native rails with the intelligence at the endpoints, and for Washington to drag them to ubiquity. Interoperability, Unbuttoned (Sep 29): Interoperability is a series of workflows in a trenchcoat, and this post finally takes the trenchcoat off. A color-coded map shows which provider workflows went digital, which are fragmented, and which still run on fax. Video Content Antitrust’s System of Record Problem (Sep 3): The FTC’s investigation into Epic prompted a ninety-minute webinar, now posted with chapters and a smoothed transcript. We get into why market definition, missing B2B share data, and the SSNIP test leave antitrust poorly suited to systems of record, plus why information blocking may be doing more than any pending lawsuit. The Information Exchange: Cerner Milking Edition (Sep 18): This was so fucking fun. Ryan Tucker, Ryan Brickner, Brad Thorson, and I try an Around the Horn format, complete with points, penalties, and a mute button. We debate whether Oracle Health is dead, who would actually buy Cerner (IBM enters the chat), p(Doom), and why the front desk still hands you a clipboard. Regulatory Ask Not What Your Network Can Do (Sep 23): CDC’s RFI on public health data intermediaries lists use cases already served, unevenly, by eCR, lab reporting, IZ Gateway, and syndromic surveillance. The real opportunity sits in one question about AI: a network that can handle the next emergency without another interface project. Court cases Particle v. Epic: The Naughty Schoolteacher (Sep 4): After a summer-long vigil, the answer on Epic’s early summary judgment bid is two paragraphs and a remedial assignment. Particle advances to the next grade, and market definition gets another year of discovery. The Epic Discovery Files (Sep 8): Texas’s motions to compel arrive with a 251-page appendix of requests, objections, and meet-and-confer letters with Cravath. Inside: Epic using generative AI for document review, denied interoperability requests in scope, and Noerr-Pennington raised against lobbying discovery. Epic v. Health Gorilla: “Working as Designed” (Sep 9): Epic wants nothing to do with the data breach MDL, and explaining why puts fresh discovery on the public docket. The spiciest allegation: Health Gorilla told GuardDog to scrub its law firm business from its website instead of cutting off access. Veeva v. Epic: Legal Bypass Surgery (Sep 15): Veeva asks the Wisconsin Supreme Court to skip the Court of Appeals, while law professors and three policy groups line up as amici. Meanwhile, Epic’s lawyers apologize for another round of citation errors, including a quote that never existed. Texas v. Epic: Behind the Black Bars (Sep 17): The court portal served up Epic’s unredacted filings, revealing a $5 million document review budget and the AI workflow behind it. Also inside: the 200-plus company names Texas wants searched, and one very expensive Zoom invitation. OpenEvidence v. Doximity: Consequences Will Follow (Sep 25): OpenEvidence tells the court it will not comply with a discovery order, and its own lawyers at Quinn Emanuel say they won’t defend the choice. Add years of Slack reported unrecoverable, and Rule 37 sanctions come into view. Health Tech Keeps Choosing Violence (Sep 28): Doximity moves to end OpenEvidence’s case, Epic asks Texas to show its work, and a sleepy Audacious Inquiry patent fight sprouts antitrust and information blocking counterclaims. The main event is a long-sealed Cognizant v. Infosys ruling that hints where system of record antitrust claims can survive. EHRs One Verb for Oracle Health (Sep 14): Oracle’s earnings call quantifies every data center to the decimal point, while Oracle Health gets a single verb: “accelerate.” Panning the few healthcare mentions turns up an agentic care management system, a research-to-care ledger play, and the question of whether healthcare gets Larry’s patience. Epic’s Forretress Under Siege (Sep 30): Judy Faulkner tells a panel Epic paused hundreds of projects to harden its software and calls it a “shame,” while a spokesperson insists the roadmap hasn’t changed. Project Glasswing, a Pokémon-branded QAN sprint, and a trove of Jodel grievances reconcile the two Epics and preview the Jevons paradox coming for all software. Industry Analysis Scanning for a Network (Sep 1): Scan.com raises $220M to build the imaging network labs never got, speedrunning Zocdoc’s consumer-to-B2B pivot. Its wedge to network density may be the most American one available: personal injury litigation. The Front Desk Wants the Damn Whole Building (Sep 16): Hello Patient buys Converse Health, pushing its AI front desk into referrals, chart work, and prior auth. The copilot categories keep blurring, and your distribution partner is still your final boss. Cross-industry Comparisons A Different Patchwork Quilt (Sep 10): Healthcare loves to envy open banking, but the US version has no mandate, a toll booth at Chase, and data quality problems of its own. The grass isn’t greener; it’s another American patchwork quilt, and perhaps a worse one. Hail, Benihydra (Sep 21): Salesforce brings its platform into Claude, Slack, and its own agent, inviting the interfaces that might replace it. Cut off one head and more grow back, so long as the records underneath stay put. Living on A Trade Secret Prayer (Sep 22): Six credit unions are suing Fiserv, the Epic of core banking, by claiming their own member records as trade secrets. Banking has no Cures Act, so its lawyers reach for legal alchemy that healthcare has already tried. Other News None this month External Media Nabla Accelerate NYC: I kicked off fall conference season at Nabla’s Accelerate event in New York, where Delphine Groll opened by asking the room to picture the company it wants to become and the one it doesn’t. I liked her framework of bureaucracy, fear, and ego as the blockers. I also love vendor conferences/events in general - different vibe than industry biggies. Healthcare 101 with Nikhil Krishnan: I briefly guest lectured Out-Of-Pocket’s Healthcare 101 class. Appreciated Nikhil’s takeaways cover whether AI doctors can query HIEs, why healthcare’s data-liberation rules beat most industries’, and the hi-res graphic is in the comments. HCN: Epic Probed by the FTC: I joined the HCN guys to talk through the FTC’s investigation into Epic. Cedric’s new hairdo was an unexpected plot twist. The episode also covers MFN drug pricing, healthcare M&A and Eli Lilly’s acquisition streak. Fall Conferences: At eHealth Exchange’s Annual Meeting in Austin on Oct 27, I’ll moderate a panel on the tensions between AI, HIEs, and timely patient access with Jean Ross (Primary Record), Therasa Bell (Kno2), Byron Crowe (Doctronic), and Michael Marchant (Freenome). Here’s the rest of my schedule if you want to meet up: CommonWell (Redwood Shores, CA): Oct 13-14 Will be participating in a fun Jeopardy event Open@Epic (Madison, WI): Oct 20-23 Will be enjoying Verona, Willy Street, and other local adventures eHealth Exchange and Sequoia Project (Austin, TX): Oct 27-29 Yeehaw HLTH (Vegas): Nov 15-18 Groundhog Day, Venetian Edition RSNA (Chicago): Nov 30-Dec 2 See me at “Governing AI in Breast Imaging: What Health Systems Are Actually Doing” Digital Health Counsel 2026 AI Summit (Seattle): December 2-3 Will likely be speaking to a bunch of lawyers about information blocking Posts I Liked ChatGPT’s Epic integration: game changer or nothing burger?: Joshua Liu, MD offers five thoughts on OpenAI’s Epic launch, starting from the point that it rides the same open APIs available to anyone. He argues read-only access leaves ordering to Art and the ambient startups, and asks why HCA is piloting it alongside Commure. He’s sorta a must-follow at this point - consistently excellent, thought-provoking takes. Epic, Lilly, and the Discovery pass: Seth Chaney reads Epic’s first major Discovery deal (with Eli Lilly), as well as its revised developer terms on commercial displays, as the pipe finally opening between EHRs and pharma. Life sciences and health continue to collide. Scott Rossignol on EHR payer platforms and ePA fees: Scott argues the top ambulatory EHR vendors are turning the prior auth mandate into a per-member-per-year toll on payers, for an API whose operating cost has nothing to do with covered lives. His fix is two lines of regulatory text: put the CRD/DTR/PAS certification criteria in the Base EHR definition, and bring payer-facing ePA connectivity under § 170.404’s cost-based fee rules. It’s a good solution. Health API Guy is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber. Subscribe
Liverpool's ahead-of-the-curve approach to youth recruitment
Liverpool's global talent department - led by Matt Newberry - is responsible for deciding which young talents from overseas should be targeted for a transfer move. Using their wealth of contacts across the world, including dedicated regional scouts, Liverpool are becoming increasingly aggressive in the space - and it helps that new sporting director Julian Ward is well known for his global network. After the Under-17s World Cup, Liverpool made a £1m move for Senegalese Mor Talla Ndiaye and a £2.6m move for fellow centre-back half Ifeanyi Ndukwe, who was representing Austria.
Ancient hydrogen spotted in the early universe could open a new way to study space's baffling expansion
After seven years of work, Canada's CHIME telescope has a measurement of dark energy from 2019. More detailed studies are planned to expand the research.
Coralville sues University of Iowa Health Care, alleging breach of contract
The City of Coralville is suing Iowa’s Board of Regents, which oversees the University of Iowa, claiming the university’s health care system promised to build medical offices that never materialized.
Sandhills Community College Small Business Center expands to Moore and Hoke Counties
Small Business Center Director, Laura Kinsman. Photo provided by: SCCSandhills Community College (SCC) is launching a redesigned Small Business Center model that expands no-cost entrepreneurial support across Moore and Hoke Counties. Rooted in the College’s commitment to strengthening small businesses and entrepreneurship as drivers of economic growth, the enhanced model is led by recently appointed Small Business Center Director, Laura Kinsman. The model also includes two new Senior Business Advisors who will provide trusted expertise, stronger community connections, and individualized guidance to entrepreneurs and business owners throughout the region.Kinsman brings a unique perspective to the director’s role as both a local business owner, operating in downtown Southern Pines, and a former Moore County educator. “Her combination of education, business ownership, leadership, and community involvement make her a great fit for the Small Business Center and the work we are continuing to build across Moore and Hoke counties,” said Taylor L. McCaskill, senior director of Workforce Development & Corporate Partnerships in a press release.Kinsman is an active member of the Southern Pines Business Association and has been connected to the Sandhills Small Business Center since the beginning of her entrepreneurial journey. She looks forward to building on that experience by strengthening the Center’s partnerships and expanding its connections throughout the community.She will lead the Center's efforts to support entrepreneurs and business owners throughout Moore and Hoke County and be the connector to the North Carolina Community College System Small Business Center Network operations. The Center offers no-cost, confidential one-on-one counseling, practical workshops, and connections to the resources and partners that help local businesses start, grow, and create jobs.A key part of this new approach, only offered at SCC, is a network of Senior Business Advisors, experienced professionals who will provide individualized guidance in areas such as business planning, finance, marketing, operations, growth strategy, and problem-solving. These advisors will serve as trusted partners to entrepreneurs and business owners, helping them turn ideas into action, overcome barriers, strengthen existing businesses, and pursue new opportunities. This one-on-one counseling is available at no cost, ensuring that high-quality business support is accessible to entrepreneurs at every stage.Senior Business Advisor for Hoke County, Kenna Parks. Photo provided by: SCCKenna Parks has been named the senior business advisor for Hoke County. She is a business professional, entrepreneur, and educator who brings a unique combination of academic training and real-world business experience. She earned her Master of Business Administration (MBA) in 2017 and has built her career around entrepreneurship, marketing, business development, and helping others turn ideas into sustainable opportunities.Senior Business Advisor for Moore County, Katrin Henderson. Photo provided by: SCCAs a military spouse, she has successfully launched and operated businesses across five states, giving her firsthand experience in adapting to diverse markets, building new customer bases and understanding the importance of global reach in today’s business environment. Over the last decade, her areas of focus include business planning, marketing strategy, branding, customer development, financial preparedness, operational planning and connecting entrepreneurs with educational programs and community resources.Parks brings an especially valuable perspective to business advising because she is an entrepreneur herself. She is the owner of Glamo Society Bridal & Formal Wear in Raeford, N.C., giving her firsthand experience with the realities of launching, operating, marketing and growing a small business. She understands that entrepreneurship extends far beyond developing a great idea; it requires strategy, financial awareness, adaptability, strong customer relationships, and consistent execution.Katrin Henderson will serve as the senior business advisor for Moore County. Thriving in hospitality and retail, Henderson has enjoyed positions in Food & Beverage Management and Retail Management in various fine dining and retail establishments in the area, before opening her own children's shop in 2015, in the Village of Pinehurst. She is a native of Moore County.Quickly immersing herself in this new world of small business ownership, Henderson joined various boards and committees, including President Elect of Pinehurst Business Partners and Event Chair for the Holly Arts & Crafts Festival. She also partnered with local organizations such as Moore County Economic Development and Moore County Chamber of Commerce and Sandhills Community College Small Business Center in events and educational opportunities. In 2026, Henderson sold her shop and now offers full-time support to both new and seasoned entrepreneurs through freelance consulting mentorship and the SCC Small Business Center program.The Small Business Center team is passionate about making business resources more accessible, and ensuring entrepreneurs know they do not have to navigate business ownership alone. Through their work with SCC, they are committed to building meaningful relationships with local businesses, community organizations, and industry partners while helping entrepreneurs move from idea to strategy, strategy to action, and action to sustainable growth.“Sandhills Community College believes deeply in the power of small business and entrepreneurship because strong local businesses create jobs, spark innovation, generate investment, and strengthen the communities we serve,” said McCaskill in press release. “Through this new Small Business Center model, Sandhills is building a stronger ecosystem where entrepreneurs can connect, grow, and thrive, while helping drive long-term economic vitality throughout our region.”To learn more about the Center's services or to schedule a consultation, please contact Kinsman directly at kinsmanl@sandhills.edu or 910-695-3938.
The Indiana secretary of state oversees elections. Should they eschew partisan politics?
Indiana's secretary of state is the state's top election official. One candidate for the office is asking: should they engage in supporting a political party themselves?
Zane Collings Joins Jacksonville Jaguars As SVP, Live Entertainment
Industry veteran Zane Collings has joined the Jacksonville Jaguars as senior vice president, live entertainment where he will manage a team overseeing
Fall entertainment overview: Fall theater looks bright and diverse
The fall theater season is upon us. One sign is that Capital Repertory Theater in Albany is opening its season. It’s a world premiere: “The Last American Newspaper.”
If Your Whisky Tastes Like Mango, There's A Science-Backed Explanation
The diverse flavor profiles are what makes whisky so interesting. A study looks into where the tropical fruit flavor in some whiskies comes from.
Multiple businesses hit by burglars on Chicago's North, Northwest sides
Burglars hit multiple businesses on Chicago's North and Northwest sides early Wednesday, including a corner shop in the Logan Square neighborhood.
Can death be reversed? New science is testing where life really ends
Death sounds absolute. Once the heart stops, blood stops circulating and oxygen no longer reaches the brain, most people assume there is a clear point beyond which nothing can be recovered. Modern res...
Universe Entertainment And Culture Group (SEHK:1046) Stock Confronts Revenue Collapse And Rich P S Multiple
The market has been treating Universe Entertainment and Culture Group like a high‑beta punt, with the stock almost doubling over the past month. However, today’s full year release tells a tougher story. The business delivered only HK$120.096 million in trailing twelve month revenue while still posting a loss of HK$10.938 million from ongoing operations. Set that against a P/S ratio of 10.1x, well above the Hong Kong entertainment pack, and the headline is clear: rich sales multiples now meet...
When “DEI” research is cut, what happens to community health?
“I’m just going to run to the grocery store!” How many times have we said this without thinking about it? For most of us, it's usually an easy walk or a short drive to get the cheese we forgot. In reality, though, 13% of the U.S. population (about 39 million people) live in “food deserts,” which means living more than a mile from a grocery store in urban areas and more than 10 miles in rural areas. This was the case for people in Pittsburgh’s Hill District, where a quick run to buy food wasn’t an option. In the 1930s, federal maps marked the Hill as "hazardous" for lending, a practice known as redlining that steered investment away from Black neighborhoods. Decades of disinvestment followed, and residents went about 30 years without a nearby grocery store. This made it hard to keep healthy eating habits and contributed to chronic disease. When a grocery store finally opened in the area in 2013, researchers saw the opportunity and launched the PHRESH study, which initially compared the health of participants from the Hill district to those in the Homewood district. Over time, the study expanded to other factors such as brain health and Alzheimer's risk. Residents like Roderick Blair overcame initial hesitation to share their health data, trusting it would benefit their neighborhood. Then, in August 2026, the NIH abruptly canceled the study’s grant, citing that it was “subjective” and fell outside their scientific scope—an effect of the administration’s interpretation of diversity, equity and inclusion (DEI). Research like PHRESH can help determine what changes in a neighborhood actually improve health, so cutting it has left that question unanswered. Other canceled studies have examined health issues like maternal health, preterm birth rates, or sickle cell disease. Courts have reversed some of these grant cancellations, but not all of them. If we really want America to be healthier, research into why some communities get sicker than others is absolutely critical. The law that created the federal minority health research institute passed with bipartisan support in 2000. But these days, as evidenced by grant cancellations, the political shift in attitudes toward DEI means we often lose access to the health information we need to help all communities thrive. DEI vs. health equity vs. equality and the overlap (or lack thereof) The letters “DEI” evoke very different reactions depending on who you are in the U.S. DEI programs can address gender, disability, age, and other factors, but the fiercest debate centers on race. For some people, hearing DEI brings to mind policies that may have cost them a job or a college seat because they are white. Others see DEI as a matter of justice: a way to expand representation and opportunity for groups that have been historically marginalized. Both perspectives are rooted in lived experience, and both center on the same question: whether hiring and admissions practices are fair. Hiring and admission practices, though related, are not the same as health equity. Health equity is “the attainment of the highest level of health for all people.” It’s the recognition that some groups of people consistently experience worse health outcomes than others. For instance, black mothers die from pregnancy-related complications at three times the rate of white mothers, and rural Americans are more likely to die from issues such as heart disease and cancer. Equity is also often conflated with “equality,” which leads to misunderstanding of how to actually best support communities. Equality ignores the fact that we aren’t all starting life with the same resources or circumstances, whereas equity is about helping people get what they specifically need based on their situation so they have the chance to achieve the same outcome as anyone else. For example, if every household in Pittsburgh got a $30 grocery gift card, that would be equal. But during the decades the Hill District went without a grocery store, that card wouldn’t have helped much. Equity means making sure everyone can actually access a store in the first place. DEI policies can overlap with health equity in many ways. For example, they may help expand access to quality education and stable, well-paying jobs, which in turn can provide health insurance, safer housing, and improved finances—all of which can reduce health disparities. But to make that happen, we first need data to identify disparities in communities and to develop solutions that effectively address them. What we lose when the research stops Community data is important to health equity because: You can’t fix what you don’t see: Data show which communities are most affected by health factors such as infection, heart disease, and cancer. If we don’t know what is happening and where, then we can’t develop interventions to help. Poor health costs everyone: Chronic disease is expensive—both to the individual person and to the overall economy. Understanding what groups of people are most at risk allows us to develop interventions that can save everyone money. Disparities exist for many communities: Health equity includes disparities that exist due to a whole host of factors, such as family background, race and ethnicity, rural vs. suburban residence, gender and sexual orientation, veteran status, disability, and lower income. This means many Americans can benefit from research into differences in health outcomes and how to improve them. Trust is easy to lose: Some participants in the PHRESH study were initially vocal about their concerns about participating. But that trust was earned because the researchers kept their promises and centered their work on the community. When projects are canceled mid-cycle, researchers have no choice but to leave behind communities they had promised to help. This hurts trust in the long run. It’s also a very inefficient use of resources, and it will take significant time and effort to redo the work when the government realizes this work is important again. How should we talk about health equity? This is hard because the words “equity” and “DEI” are currently very politically charged. So whether you’re a public health professional, teacher, or friend, how we talk about this topic matters. The right framing can help people who might otherwise be skeptical see why health equity research is important and deserves funding. Here are some suggestions to help your conversations: Choose your words strategically: Who are you trying to reach with your message? Are they likely to be resistant to terms like “diversity” and “equity”? If so, find alternative words to use to still get the message across. It is frustrating to be in that position, but the goal of improving health is too important not to try to make inroads. Sometimes simply reframing can help the message reach those who need to hear it. Focus on the problem: The terms “health equity” and “DEI” are abstract. Make it more specific. For example, discuss differences in maternal death or ways to improve health outcomes in rural communities. These still have equity at their core but will likely be better understood by those you’re talking with. Focus on systems: Disparities exist, but if they are communicated poorly, people can mistakenly think the issue is the individual’s fault. Disparities are largely driven by failures of the system—such as lack of access to health care and a long legacy of racism. When discussing the disparities, frame them around these systemic issues to ensure blame isn’t placed on the individuals impacted. Tell stories: Personalize these policies by using stories from those impacted that connect to the data you’re trying to convey. This helps make the policies and outcomes more concrete and meaningful. Bottom line Some communities end up sicker than others. That’s just the facts. We can argue about the best way to do that research, but canceling it simply because it may be linked to DEI doesn’t make anyone healthier. It just leaves communities like the Hill district behind. And in the end, it causes us all to move backward in our efforts to improve health in this country. Love, EM Big thanks to MacKenzie Isaac & Legairre Radden, who reviewed this piece and generously shared their expertise and lived experience to help improve it. Dr. Liz Marnik, PhD, is Executive Director of The Evidence Collective and a science communicator and immunologist working at the intersection of public trust, science, and public health. To discuss communication training on topics like health equity and storytelling, email Liz at liz@yle.health or learn more on our website. Your Local Epidemiologist (YLE) comprises a team of experts, ranging from physicians to immunologists to epidemiologists to nutritionists, working together with one goal: to “translate” ever-evolving public health science so that people are well-equipped to make evidence-based decisions. The YLE suite of newsletters reaches over 475,000 people across more than 132 countries. This newsletter is free to everyone, thanks to the generous support of fellow YLE community members. To support the effort, subscribe or upgrade below: Your Local Epidemiologist is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber. Subscribe
Xbox’s Millennial C.E.O., Asha Sharma, Isn’t Playing Around
“I think the industry will require disruption,” said Asha Sharma, who has overseen layoffs and divested studios since inheriting Microsoft’s flailing video game division.
Rep. Mike Kennedy questions federal role in health policy
Rep. Mike Kennedy questioned the federal government's role in overseeing Americans' health while speaking at the University of Utah on Tuesday.
Is It Really Dandruff? The Science Behind Seborrheic Dermatitis
Dandruff and seborrheic dermatitis are closely related, but the actual flakes can tell you the difference — making all the difference in how you treat it.
More than 1 million Florida mail ballots were sent out. Votes are trickling in
Supervisors of elections reported that more than 2,200 ballots have already been returned, mostly from voters in the military and overseas.
Kustom Entertainment executes 1-for-10 reverse stock split
Kustom Entertainment executes 1-for-10 reverse stock split
Kustom Entertainment, Inc. Announces Reverse Stock Split
Olathe, KS, Sept. 29, 2026 (GLOBE NEWSWIRE) -- Kustom Entertainment, Inc. (NASDAQ: KUST) (the “Company”), a leader in live event production and ticketing...
Kustom Entertainment, Inc. Announces Reverse Stock Split
Olathe, KS, Sept. 29, 2026 (GLOBE NEWSWIRE) -- Kustom Entertainment, Inc. (NASDAQ: KUST) (the “Company”), a leader in live event production and ticketing technology, today announced a 1-for-10 reverse split (the "Reverse Stock Split") of the Company’s common stock (the "Common Stock") and proportional reduction of the number of shares of Common Stock authorized (the “Capital Stock Reduction”). The Company anticipates that the Common Stock will begin trading on the Nasdaq Capital Market (“Nasdaq”
Bad Saints Jazz Festival to bring to Lancaster diverse jazz music \'that doesn\'t quite behave\'
With the inaugural Bad Saints Jazz Festival, Josh Gibbel hopes to create a Lancaster tradition that celebrates jazz music in all its glory for years to come.
Pa. Health Department reverses course on new disease-tracking guidance, for now
Pennsylvania’s Department of Health has rescinded a 502-page proposal that could’ve given the agency more control over how it tracks and investigates the spread of diseases — and that spelled out the measures officials can take in response.
Samsung Galaxy S27 Ultra camera leak points to warmer photos and cleaner night shots
Leaker Ice Universe says the Samsung Galaxy S27 Ultra moves from the Galaxy S26 Ultra's cool color profile to warmer tones, holds back small bright light sources on both its main camera and 50MP 5x telephoto, and shows less shadow noise at night.
Bobby Kotick’s lawyers sent me a bad email (and later apologized)
The message I had received was unsettling—for a moment. Then it was just really confusing. Back on January 20 of this year, at 5:15pm ET, I received an email with the subject line “Legal Correspondence re Bobby Kotick.” It was from the law firm Clare Locke, a firm I’d heard had been emailing reporters in recent years about their coverage of Kotick, the former, longtime CEO of Activision Blizzard. The letter was threatening. A lawyer from the firm introduced themselves as “defamation counsel to Bobby Kotick.” They issued a “demand” that I “correct” a Game File article I’d published a week prior. The article that had irked them had been a scoop of sorts. I’d written about a a 2022 lawsuit brought by a Swedish pension fund, AP7, over Microsoft’s purchase of Activision Blizzard. The suit wasn’t news, but I was first to review and report about Kotick’s extensive pushback to the fund’s claims. The pension fund’s core contention was that the sale had been rushed by Kotick to avoid the consequences of sexual misconduct scandals swirling around the company in 2021. (He’d not been accused of misconduct himself in those suits, to be clear.) As I wrote at the time, Kotick had denied the allegations of the rushed sale. Beyond that, Kotick used a December 2025 reply to the Swedish fund’s lawsuit to assign blame for those workplace scandals, the bad press and even for the AP7 lawsuit. I’d found Kotick’s arguments novel and newsworthy. Across nearly 3,000 words, I explained Kotick’s take: that a Swedish gaming company was behind the Swedish fund’s lawsuit (the Embracer group; they denied it); that the Microsoft-Activision deal was not rushed and was secured at what Kotick felt history had proven to be an optimal price for shareholders; that he believed a conspiracy of people at unions government agencies, PR firms and the media had spun up claims of widespread workplace misconduct at Activision Blizzard in 2021. The article gave context for all of this, letting readers assess the claims and weigh their credibility. As I’d later write to Kotick’s lawyers: I would be surprised if you could point to any news article about Bobby Kotick in the last five years that has spent more of its wordcount articulating his point of view. He is welcome to do an interview with Game File any time. Nonetheless, there they were in my inbox that Tuesday evening: Clare Locke, the law firm that secured a $787.5 million settlement from Fox News over false statements about voting machines. They were emailing me, threatening that failure to comply with their demand could support a claim of “actual malice,” a legal standard for libel. Unless… Unless, they said, I added a key paragraph to my article. This was a paragraph that I already knew Kotick’s lawyers had been emailing reporters about for at least a year, and it was a paragraph that was already in my article. The paragraph they wanted is from a 2023 settlement that California’s Civil Rights Department struck with Activision Blizzard. The settlement had closed a two-year-old lawsuit over alleged sexual discrimination at the game maker. The paragraph basically said that claims of systemic or widespread sexual harassment—or of execs like Kotick tolerating such behavior—had never been proven. I’d already seen proof that Kotick’s lawyers had pushed for the settlement’s language to be added to reports about 2021 sexual discrimination and misconduct lawsuits brought against Activision Blizzard by California and, separately, by the U.S. federal government (both suits were since settled). I knew that Kotick and his lawyers felt that the California settlement language should be mentioned in the same breath as references to an article he hated and denied, a November 2021 Wall Street Journal article claiming Kotick knew “for years” of sexual misconduct at Activision Blizzard. So, in the Game File article that Clare Locke emailed me about, in the interest of ensuring I was being fair and balanced regarding the person I was covering, I had already included the following excerpt from the California settlement [emphasis added in bold]: (Kotick has repeatedly pushed back against that November article in the Wall Street Journal, citing among other things, language from a court-approved consent decree as part of Activision’s 2023 $54 million settlement over the California suit. It states: “no court or any independent investigation has substantiated any allegations that: there has been systemic or widespread sexual harassment at Activision Blizzard [or] that Activision Blizzard senior executives ignored, condoned, or tolerated a culture of systemic harassment, retaliation, or discrimination.”) On the evening of January 20, I was incredulous. How do you write a four page legal threat about a week-old article and miss this? While scrambling to also make my kids dinner, I wrote a lengthy reply to Clare Locke’s lawyers, basically asking them to cool it with the threats and to start making sense. In part, I wrote: I hope you can understand why I am having trouble understanding what you’re asking for, when the statement you’re demanding to see in Game File’s article already appears in Game File’s article. Actual malice, as you know, refers to a reckless disregard for the truth. I’m not sure what your argument is when my article already states your client’s position. Here is where I should remind you, the reader, that I am an independent journalist. I publish on Substack, and have availed myself of the Substack Defender program that provides writers on the platform with legal support. But I’m no Wall Street Journal or New York Times, nor even IGN or GameSpot when it comes to such things as, well, having a legal department. There are more fun things for me to do as an independent journalist than writing back to a powerful law firm representing a very rich person. On the evening of January 20th, I was just trying to cook some pasta, broccoli and chicken nuggets for hungry twins. Nevertheless, I wrote back to them. Two hours later, I got a reply. Summarizing: A lawyer for Clare Locke said they’d “reviewed an incomplete version” of my article and they “apologize for the confusion.” (My guess: Someone didn’t read past the piece’s paywall, even though they’d had a full week to scrounge up the funds to do so. What I’d published above the paywall was balanced, as was what came after.)1 That was almost that, but something about the situation bothered me. The letter had been marked “confidential.” I hadn’t agreed to that, and I disliked the idea that powerful people on the beat that I cover would act like they could unilaterally control what I might tell my readers about. On the morning of the 21st, having already gotten the powerful law firm to back off, I oh-so-wisely re-approached them with just one more thing. I thanked them for clearing things up the night before but noted that I’d never agreed to keep their letter confidential. I’m all for agreeing with a source to keep things off the record, but that’s the thing. We have to agree. You can’t just declare it. I’m not bound by that. I wrote to Clare Locke’s lawyer and said, in part: I trust the matter is resolved. It was disappointing to have to spend less time with my kids last night in order to address your legal letter. Family time’s precious. I will add, for clarity’s sake, that, while your letter stipulated that it was confidential, I did not agree to those terms. In the future, should you wish to communicate with me confidentially, I am happy to agree to classifying our communication as “off the record” prior to the actual communication—as is standard with any professional journalist. The firm’s lawyer replied, not directly addressing the confidentiality issue but asserting that the matter was resolved. Why I didn’t write about this until now In May, I told this story on an episode of Simon Parkin’s podcast My Perfect Console, but I held off on sharing it directly with Game File readers. I held off to avoid stepping on the toes of another reporter, the journalist Mikhail Klimentov. He’d interviewed me in the spring of 2025 about an investigation he was working on regarding Bobby Kotick lawyers pressing the media to add the California settlement language to stories referencing the 2021 lawsuits. And about how some outlets had changed their stories and how some simply deleted them. Initially, I was a third-party source for Klimentov’s reporting, providing on-the-record context about the state of the games media. I’d heard about the letters but hadn’t put the time into pursuing the story. I thought it was interesting, and I was glad he was covering it. When the outlet that Klimentov was going to run his reporting in dropped the story, I began talking to him about potentially publishing his reporting on Game File. This was tentative. Then, in January, when I got my own Clare Locke letter, I told Klimentov that I didn’t think it would make sense for me to publish him, not with me now being part of the story. I had my own version of this situation to tell. But I wished him well and said I’d refrain from telling my tale until he could get his reporting out there. Last Friday, Klimentov finally ran his investigation, in a nearly 48-minute video report for People Make Games. It covers various Clare Locke letters, how media outlets reacted to them and what to make of all this. His video weighs the merits of Kotick’s request and looks at some of the articles that were changed (one of which had a glaring error). I highly recommend watching it: (Note, I did some editorial consulting for a People Make Games video last year but nothing to do with this report.) While many outlets haven’t left any public evidence that they updated their Kotick coverage at Kotick’s counsel’s request, at least one has. Back in October 2025, the mainstream outlet Reuters applied the most transparent article update I’ve seen. On the 3rd of the month, they published an article about the state of the Swedish pension fund’s lawsuit. Days later, they added this: In an October 7 letter sent after publication of this article, Kotick’s defamation counsel disputed claims of widespread harassment at Activision. “Not a single investigation, court finding, verdict, or ruling ever concluded that there was any merit” to the allegations of widespread harassment at Activision, Tom Clare and Nick Brechbill of Clare Locke wrote. I’ve never added a statement to my article on Game File, because none was needed. Not for fairness’ sake, nor to meet any demands of Kotick’s lawyers. I’ve nevertheless wanted to be transparent with Game File readers. If someone powerful is questioning my reporting, is threatening a lawsuit over it… if that threat is part of a pattern involving other games media outlets and if, in my case, the whole thing ran into a ridiculous ditch, I want you to know about it. I also share this as a real example of how I handle threats to Game File. I stand up for my own reporting, even when it’s not comfortable to do so. (In that same category of standing up for the work I do, I’ll point to an incident in late August. Asocial media post I published to X/Twitter regarding reporting I did about Take Two and GTA VI was hit by bogus copyright claim by a firm working for the publisher. I pushed back and got it reversed; even while a bigger games media outlet let themselves be censored. This is the other reason I’m sharing this story: To emphasize that dealing with threats from powerful people is one of the costs of covering the video game industry independently and as fearlessly as possible. This is where you come in. Your support, through free and paid subscriptions (sign up here!), can help me keep doing that. It can ensure that I’ve got the back-up I need. And it can help make fiascoes like this even less of a worry, so I can spend my evenings dealing with more important things, such as making sure I steam the kids’ broccoli just right. 1 That pension fund lawsuit I wrote about in January has all but gone away. In May, the fund and Activision Blizzard owner Microsoft agreed to settle. Lawyers for the fund brokered a $250 million settlement for former Activision Blizzard shareholders. In the settlement, the fund’s lawyers changed their rhetoric. Where once they’d questioned the meaning of the California settlement language, they adopted a version of it for themselves. Several weeks ago, while seeking to get a court to sign off on the terms of the settlement, they proposed their fee for their work in the case: $60 million.
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Pioneer of China NewCo model sued in US over trade secret misuse, double-dealing
A legal feud unfolding in New York is putting a spotlight on the work of a business development veteran who is credited for pioneering one of biopharma’s hottest dealmaking mechanism: the China “NewCo” model. In a lawsuit originally filed in New York state court and recently moved to federal court, China’s Lepu Medical Technology has alleged that biopharma business development consultant Su Zhang, who was hired to help shop its GLP-1 weight-loss candidates to Western partners, engaged in corporate double-dealing and trade secret leaks. According to the complaint, while acting as Lepu’s primary dealmaking liaison for a group of obesity and metabolic disease drug candidates, Zhang was secretly double-dipping as the acting chief business officer for a direct competitor, BrightGene Pharmaceutical. “She never adequately disclosed the role, never sought Lepu’s consent, and never proposed any safeguard,” Lepu alleged in its complaint, which was filed in July after Zhang’s consulting firm, CoDevCo, sought certain transaction-based success fees from its angry customer through an arbitration process in Singapore. Lepu, the parent company of Lepu Biopharma, has asked Zhang to pay back its $500,000 retainer and disgorge all benefits she received during the alleged breaches of fiduciary duty, plus other damages and relief. The company has also requested the court grant injunctions to protect Lepu’s trade secrets. The ill-fated partnership officially kicked off in December 2024, when Lepu tapped CoDevCo as its “exclusive business development mechanism” to identify collaborators for the company’s drug candidates. According to Lepu’s complaint, Zhang personally negotiated and signed the agreement as managing director for CoDevCo, which used her home address. Before the Lepu deal, Zhang made a name following a short stint as the global head of business development for Hengrui Pharmaceuticals. It was during her tenure that Hengrui signed a landmark deal granting exclusive rights for a portfolio of GLP-1 assets to Hercules, which was at that time newly established by a group of private equity and venture capital firms. In addition to the regular upfront and milestone payments, Hengrui also gained an equity stake in Hercules, which later became Kailera Therapeutics. The Hengrui-Hercules deal opened a new paradigm, where a Chinese biopharma company spins off certain early-stage assets to investors for further development through the creation of a new company abroad. The “NewCo” model quickly came into vogue as it allows Western investors to access high-potential assets originating from China at an early stage while giving the Chinese licensors an opportunity to reap long-term benefits through equity stakes in the new firms. The NewCo model proved its value when Kailera staged a record-breaking $625 million IPO on Nasdaq this April, merely two years into the Hengrui deal. Related Kailera CEO 'knew we were in a good spot' before obesity biotech's record-breaking $625M IPO On her LinkedIn page, Zhang described her work at Hengrui as “[b]uilding team and capability from the ground up,” forming NewCo and major pharma partnerships worth billions of dollars. Lepu clearly wanted that kind of track record to help boost its own cardiometabolic portfolio, which includes a range of assets for obesity, Type 2 diabetes, fatty liver disease and muscle preservation during weight loss treatment. “Lepu’s pipeline is very valuable, but only if Lepu could secure the right international partner to expand into the overseas market during the available commercial window,” the company argued in its complaint. The Chinese biotech said it had little knowledge of U.S. laws, customs or business practices in the business development field, and therefore “needed to rely entirely” on the expertise of Zhang and her team as the firm’s first engagement of a U.S.-based BD consultant. “Zhang’s dominating influence on the business development strategy is further evidenced by the fact that she personally controlled the business-development communications on behalf of Lepu with potential partners,” Lepu said in its complaint. After entering the deal, Zhang introduced Lepu to her four associates. According to Lepu’s version of events, all of them were allegedly employed at different time points to perform similar jobs at other Chinese companies that Lepu described as its competitors, while having access to Lepu’s confidential information. As such, Lepu described Zhang’s team as “a roster of individuals whose primary professional loyalty, by virtue of their concurrent full-time employment, ran to Lepu’s competitors.” As well as the specific examples set out in the case, a look at Lepu’s deals over the period suggests Zhang may have been involved in at least one transaction. During their partnership, Lepu, through its subsidiary Shanghai Minwei Biotechnology, also out-licensed its GLP-1/GIP/FGF21 agonist MWN105 to a NewCo called Sidera Bio in the fall of 2025. The deal included an upfront and near-term payment of $35 million, up to $1.01 billion in milestones, and a 9.99% stake in the Danish startup. It seems likely that Zhang facilitated the Minwei deal given that Lepu is on record as having used CoDevCo as its “exclusive business development mechanism.” The big shock for Lepu came in the form of a news article on June 25, 2025. The article, reporting on phase 2 data for BrightGene’s GLP-1/GIP receptor agonist BGM0504, identified Zhang as acting chief business officer of the Lepu rival. Blindsided by her association with BrightGene, Lepu confronted Zhang in July 2025. “Lepu was given assurances that there was nothing to be concerned about and told that Zhang would explain the matter to Lepu,” Lepu alleged in its complaint. “Zhang never did.” Lepu claimed that Zhang had the motive and opportunity to steer potential prospective partners toward BrightGene or other competitors. Later, in February 2026, one of Zhang’s associates joined BrightGene as the vice president for global business development, according to the complaint. Around the same time, Lepu sent written demand letters asking Zhang to account for her BrightGene role, identify what confidential data were shared with the rival firm, and provide any conflict-of-interest or firewall policies during the engagement. According to Lepu, neither CoDevCo nor Zhang answered the questions in their responses. Related Novo vs. KBP: How a $1.3B deal turned into a fraud accusation and an international legal fight In a motion to dismiss filed with the U.S. District Court in the Eastern District of New York on Sept. 4, Zhang’s legal team argued that Lepu’s agreement was signed with CoDevCo, and that an employee of the contractor does not owe fiduciary duties to the client. In its complaint, Lepu said: “That CoDevCo was the contracting entity does not insulate Zhang from personal liability for duties she personally undertook and personally breached.” Taking the argument one step further, the defending party argued that the consulting agreement “does not create a fiduciary relationship even between CoDevCo and Lepu; instead, it identifies CoDevCo as an independent contractor retained to market Lepu’s business to potential western partners.” Although CoDevCo was Lepu’s exclusive business-development contractor, there were no terms stipulating that the consulting firm should serve only Lepu, Zhang’s lawyer noted. As to Lepu’s claims that Zhang misappropriated trade secrets, the defendant argued that Lepu authorized the use of the information so Zhang’s team could perform their service per the agreement. In a rebuttal filed on Sept. 11, Lepu’s lawyer set out why they believe the Chinese biotech satisfied New York law’s misappropriation definition by alleging that the defendant used a trade secret “in breach of a duty or through improper means.” As an alternative to dismissing the suit, the defendant suggested the action should be stayed pending outcomes from the arbitration of a separate case in Singapore. While NewCo pioneer Zhang is defending her business arrangements, momentum behind the NewCo trend has continued unabated into 2026. Through August, Chinese biotech assets have spurred 15 NewCo deals this year, according to local trade publication PharmaDJ.
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Can the Left Make America Fun Again?
Hi friends, I’ve got a piece in The New York Times today about how collective joy — participatory, youthful, anti-corporate — can defeat Trumpism and transform our lives. The basic argument is that politics used to be embedded in communal life: dances, sports leagues, union halls. As that infrastructure disappeared — and more of everyday life was atomized and privatized — politics became something broadcast at people rather than something they did together. NYC-DSA and Zohran provide another model, where socials and face-to-face organizing are tied to a fight vs the corporations that fenced off so much of the good life. Rebuilding that kind of collective fun, I argue, could help bring young people back into politics and, by redistributing America’s wealth, make everyday life more joyful. I would super appreciate it if you’d read the piece, share it, or post comments on it. Thank you! p.s. FYI, Opinion writers don’t get any say over their headlines! More Take action to support the fight of licensed deck officers at Alaska Tanker Company and Overseas Shipholding Group to win a first union contract. This is one of the most important, and underreported, unionization campaigns in America: these workers have a huge amount of power over domestic energy distribution and maritime supply chains, and they’re still without a contract two years after having voted overwhelmingly to unionize. Please sign the public petition here, and if you’re an academic you can sign this support letter.
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Is 50 the new 60?
Subscribe TL;DR: Younger generations are showing signs of worse health compared to earlier-born cohorts at the same age This backward “drift” is showing up both in mortality risk and chronic disease Worsening trends in obesity and diabetes are the most consistent signals Taking the long view, we’ve made astonishing gains in health and life expectancy in the last century. Global average life expectancy has more than doubled from 32 years in 1900 to 73 years in 2024. (But don’t forget, there were still old people when life expectancy was 32). As people lived longer, they also generally lived healthier along the way. It turns out that avoiding things that can kill you early, like malnutrition and lots of childhood infections, also keeps you healthier later in life. In a classic 2004 paper, Finch and Crimmins proposed that cohorts of children who benefited from fewer early life infections had less lifetime exposure to inflammation and cardiovascular disease later in life, accelerating mortality improvements at older ages. Poor nutrition in the womb has also been linked to a higher risk of later chronic disease. The upshot is that improvements in childhood health can pay dividends many decades later. The combination of better living conditions (nutrition, sanitation) and medical advances (antibiotics, vaccines, blood pressure meds, etc) meant that people’s healthy lifespan generally expanded, even as they lived longer. Aging researchers call this best-case scenario “compression of morbidity”—meaning we delay the onset of disease and disability even faster than the years of life we are adding. During my 20+ year research career, we could generally bank on the idea that younger generations would not only live longer but also keep getting healthier along the way. “60 is the new 50” as they say… Enter “Generational Health Drift” Sadly, this expectation of steady progress may be changing. You’ve probably heard that US life expectancy gains have slowed to a crawl in the past couple of decades. Mortality improvements are also slowing (though less dramatically) in many other high-income countries (you can read more about that in a review paper I wrote here). Mortality is a very blunt health measure, but it is often a good barometer for the broader population health trends happening underneath. And we are now seeing that younger generations may be in worse health at similar ages compared to earlier born cohorts. My collaborator Prof. George Ploubidis at University College London coined this worsening health in more recently born cohorts “generational health drift.” “Generational health drift” is bad news on multiple fronts. Most obviously, we don’t want our health progress to go backward. But the timing is also bad, since our populations are aging. In demographic terms, “population aging” means that the proportion of the population at older ages (i.e >65 years) is increasing. Fun demography fact: Current population aging is not due to the recent declines in the birth rates making the news, but declines in fertility decades ago, after the “baby boom.” As baby boomers reach older ages, the smaller cohorts behind them mean the percentage of older adults will increase. For example, the share of the population age 65 and older in the US increased from 12.4% in 2004 to 18.0% in 2024. This story of population aging was written long ago. Many worry that population aging will put pressure on health care and pension systems. But if people reach older ages in better health than in years past, those fiscal pressures would be less dire than projected. Healthy older people can also continue to contribute to society in many valuable ways, including paid work, caregiving, community service….even high political office 🤷. On the flip side, if younger generations reach retirement age in worse health and with more disabling conditions, this could magnify the societal challenge of population aging. Evidence for worsening generational health A recent paper that I LOVED in the Proceedings of the National Academy of Sciences by Dr. Leah Abrams and colleagues examined which birth cohorts (aka generations) were behind worsening US mortality. Behold the Lexis diagram (cue swooning demographers). Calendar time is on the x-axis, age on the y-axis. Birth cohorts can be followed over time as they age on the diagonal lines moving up and to the right. This figure plots the year-on-year % change in all-cause mortality at a given age. Green shading indicates mortality improvements over time, white is stagnation, and gray shading indicates worsening mortality. Following the diagonal line for those born in 1950, you can see a noticeable shift from green to gray that follows this cohort for most of their lives. This gray shading shows generally worsening mortality for the 1950 to 1959 birth cohorts compared to their predecessors across all ages. Concerningly for my GenX and elder millennial peeps, there was also a deterioration in mortality for birth cohorts born in the 1970s and 1980s, visible as dark gray areas at ages 30 to 45 during the 2010s. While some of these mortality changes reflect specific shocks such as the opioid epidemic, most deaths still occur from major causes of death such as cardiovascular disease and cancer. For cancer, the gray in the top left corner of the figure below reflects the legacies of smoking for older cohorts, followed by a period of green with improvements in cancer mortality as smoking rates declined. But the white/gray shading in the bottom right corner highlights a stagnation and reversal of the cancer trends, with cohorts born around 1970 to 1985 experiencing worsening cancer mortality. This deterioration was most noticeable for colon cancer mortality, possibly linked to obesity or dietary factors. Not just dying more, but less healthy along the way. A recent paper by Dr. Laura Gimeno of University College London (of which I am a co-author), found evidence that more recently born cohorts in Great Britain have stagnating or worsening health. A stylized picture of what“generational health drift” might look like: The review paper found: Rates of childhood overweight and obesity were highest among Gen Z. Rates of diabetes in the 40s almost doubled from 3.1% among the Baby Boomers to 5.9% in Generation X. Gen Z reported higher rates of poor mental health in adolescence compared to earlier-born groups. These UK results are consistent with studies showing worsening health across generations in the US as well. A 2021 US study found that more recently born cohorts had worse biological markers (like blood pressure and blood sugar) than earlier generations at the same age. A separate 2022 study of Americans aged 50 and over found that more recently born generations had a higher number of chronic diseases, with younger age of disease onset. A 2024 Lancet paper found that in the US, women born in 1945 had 33% obesity prevalence at age 50, rising to 48.2% for women born in 1970 turning 50. So what’s going on, and can we turn it around? We don’t have a definitive answer for what’s causing the deteriorating health of younger cohorts, but circumstantial evidence points to worsening trends in obesity and diabetes in both the US and UK. Remember that cohort trends reflect lagged effects of early environments, and younger generations have faced both earlier onset and more severe obesity across their lifetimes. Despite these very concerning trends, the future is not set in stone. We’ve reversed poor generational health trends before: drops in smoking are a major reason cancer and heart disease deaths fell so dramatically in recent decades. GLP-1 drugs may finally turn the tide against rising rates of obesity and diabetes, though it is still early days. But things could also get worse…for example from a return to higher levels of childhood infectious diseases that can have a lasting impact on health. See for example: [ ](https://jenndowd.substack.com/p/dont-you-forget-about-measles-the) [ Don’t You Forget About Me(asles): The Virus That Erases Immune Memory ](https://jenndowd.substack.com/p/dont-you-forget-about-measles-the) Jenn Dowd, PhD · March 24, 2025 [ Read full story ](https://jenndowd.substack.com/p/dont-you-forget-about-measles-the) Even as an optimist, emerging data on the “generational health drift” has my full attention. For most of my research career, we took it for granted that each generation would be healthier than the last. But if present trends continue, **50 could be the new 60….**and Gen Z celebrities will soon look older than Paul Rudd :). Stay well, Jenn Share the Health! If you found this post useful, please share it with a friend. Share
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Travel health insurance
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(Feature Impact) Driven by rising rates of obesity, diabetes, high blood pressure and other risk factors, cardiovascular disease has surpassed cancer as the leading cause of death among Hispanic adults in the United States. googletag.cmd.push(function() { googletag.display('fixed-big-ad-top-asset'); }); Hispanic people represent nearly 1 in 5 of the U.S. population and are the nation’s largest ethnic minority group, yet many continue to face barriers to achieving heart health and accessing high-quality healthcare. A new scientific statement published in the American Heart Association’s flagship journal, “Circulation,” revealed how social, economic, cultural and environmental factors contribute to persistent disparities in cardiovascular health, calling for culturally tailored prevention strategies, equitable access to care and greater representation of Hispanic populations in cardiovascular research.“Hispanic populations in the U.S. are incredibly diverse even within their own communities with differences in genetic ancestry, language, cultural traditions and social experiences that can significantly influence cardiovascular health,” said Johanna Contreras, M.D., M.Sc., FAHA, director of the Division of Heart Failure and medical director of the Hispanic Heart Center within the Mount Sinai Health System. “Yet Hispanic people remain underrepresented overall in the research that guides prevention and treatment strategies… Without better representation and more detailed data, we risk overlooking important differences that can help us improve care and save lives.”Hispanic Cardiovascular Health by the NumbersCardiovascular risk factors – obesity (nearly 46%), type 2 diabetes (15.5%) and high blood pressure (approximately 44%) – are prevalent among Hispanic adults and often emerge at younger ages and occur more frequently among Hispanic adults compared with white adults.According to the report, only about 1 in 5 Hispanic adults achieves ideal cardiovascular health as defined by the American Heart Association’s original Life’s Simple 7 metrics. Updated analyses using the Life’s Essential 8 framework demonstrated persistent disparities for heart and brain health, as well as suboptimal dietary quality, sleep patterns and levels of physical activity.Social and Economic Barriers MatterBiology alone does not explain cardiovascular health disparities. The environments where people live, work and age, along with social and economic challenges, impact heart health. In fact, approximately 17% of Hispanics live below the federal poverty threshold, compared with 8.2% of white adults. googletag.cmd.push(function() { googletag.display('fixed-big-ad-middle-asset'); }); “Many Hispanic adults face obstacles that extend far beyond the doctor’s office,” Contreras said. “Limited health insurance coverage, language differences, food insecurity, environmental exposures and concerns related to immigration status can make it more difficult to prevent disease, manage chronic conditions and receive timely treatment.”Contreras emphasized the cultural values and practices of Hispanic people also influence how they perceive their health and healthcare options.“Family plays a central role in many Hispanic communities and can be an extraordinary source of strength, support and resilience,” Contreras said. “At the same time, family members are often called upon to translate medical information, navigate health systems and help make healthcare decisions for loved ones. Those responsibilities can shape how health information is understood and acted upon.”An Action Plan for Improving Hispanic HealthThere are practical opportunities to achieve equitable cardiovascular health and reduce disparities through community engagement, culturally responsive care, inclusive research and policies that address the underlying drivers of health.“Reducing cardiovascular disease among Hispanic populations demands action at every level,” Contreras said, “from improving access to culturally responsive care and expanding research participation to addressing the social and environmental conditions that shape health.”By addressing both medical risk factors and the social conditions that shape health, experts believe there is an important opportunity to reduce disparities and help more people live longer, healthier lives. Learn more at Heart.org.Photo courtesy of Shutterstock googletag.cmd.push(function() { googletag.display('fixed-big-ad-bottom-asset'); });
Culturally Relevant Cardiovascular Disease Prevention and Care Strategies
(Feature Impact) Driven by rising rates of obesity, diabetes, high blood pressure and other risk factors, cardiovascular disease has surpassed cancer as the leading cause of death among Hispanic adults in the United States.Hispanic people represent nearly 1 in 5 of the U.S. population and are the nation’s largest ethnic minority group, yet many continue to face barriers to achieving heart health and accessing high-quality healthcare. A new scientific statement published in the American Heart Association’s flagship journal, “Circulation,” revealed how social, economic, cultural and environmental factors contribute to persistent disparities in cardiovascular health, calling for culturally tailored prevention strategies, equitable access to care and greater representation of Hispanic populations in cardiovascular research.“Hispanic populations in the U.S. are incredibly diverse even within their own communities with differences in genetic ancestry, language, cultural traditions and social experiences that can significantly influence cardiovascular health,” said Johanna Contreras, M.D., M.Sc., FAHA, director of the Division of Heart Failure and medical director of the Hispanic Heart Center within the Mount Sinai Health System. “Yet Hispanic people remain underrepresented overall in the research that guides prevention and treatment strategies… Without better representation and more detailed data, we risk overlooking important differences that can help us improve care and save lives.”Hispanic Cardiovascular Health by the NumbersCardiovascular risk factors – obesity (nearly 46%), type 2 diabetes (15.5%) and high blood pressure (approximately 44%) – are prevalent among Hispanic adults and often emerge at younger ages and occur more frequently among Hispanic adults compared with white adults.According to the report, only about 1 in 5 Hispanic adults achieves ideal cardiovascular health as defined by the American Heart Association’s original Life’s Simple 7 metrics. Updated analyses using the Life’s Essential 8 framework demonstrated persistent disparities for heart and brain health, as well as suboptimal dietary quality, sleep patterns and levels of physical activity.Social and Economic Barriers MatterBiology alone does not explain cardiovascular health disparities. The environments where people live, work and age, along with social and economic challenges, impact heart health. In fact, approximately 17% of Hispanics live below the federal poverty threshold, compared with 8.2% of white adults.#placement_976606_0_i{width:100%;max-width:550px;margin:0 auto;}var rnd = window.rnd || Math.floor(Math.random()*10e6);var pid976606 = window.pid976606 || rnd;var plc976606 = window.plc976606 || 0;var abkw = window.abkw || '';var absrc = 'https://ads.empowerlocal.co/adserve/;ID=181918;size=0x0;setID=976606;type=js;sw='+screen.width+';sh='+screen.height+';spr='+window.devicePixelRatio+';kw='+abkw+';pid='+pid976606+';place='+(plc976606++)+';rnd='+rnd+';click=CLICK_MACRO_PLACEHOLDER';var _absrc = absrc.split("type=js"); absrc = _absrc[0] + 'type=js;referrer=' + encodeURIComponent(document.location.href) + _absrc[1];document.write('');“Many Hispanic adults face obstacles that extend far beyond the doctor’s office,” Contreras said. “Limited health insurance coverage, language differences, food insecurity, environmental exposures and concerns related to immigration status can make it more difficult to prevent disease, manage chronic conditions and receive timely treatment.”Contreras emphasized the cultural values and practices of Hispanic people also influence how they perceive their health and healthcare options.“Family plays a central role in many Hispanic communities and can be an extraordinary source of strength, support and resilience,” Contreras said. “At the same time, family members are often called upon to translate medical information, navigate health systems and help make healthcare decisions for loved ones. Those responsibilities can shape how health information is understood and acted upon.”An Action Plan for Improving Hispanic HealthThere are practical opportunities to achieve equitable cardiovascular health and reduce disparities through community engagement, culturally responsive care, inclusive research and policies that address the underlying drivers of health.“Reducing cardiovascular disease among Hispanic populations demands action at every level,” Contreras said, “from improving access to culturally responsive care and expanding research participation to addressing the social and environmental conditions that shape health.”By addressing both medical risk factors and the social conditions that shape health, experts believe there is an important opportunity to reduce disparities and help more people live longer, healthier lives. Learn more at Heart.org.Photo courtesy of Shutterstock
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Sustained Youthful Energy: Science-Backed Strategies for Active Lifespan The Hype Magazine: Unveiling the Pulse of Urban Culture - From Hip Hop to Hollywood! Explore a Diverse Tapestry of Stories, Interviews, and Impactful Editorials Spanning Fashion, Gaming, Movies, MMA, EDM, Rock, and Beyond! www.thehypemagazine.com - The Hype Magazine The Hype Magazine - News From Hip Hop To Hollywood!
Discover the heartbeat of urban culture with The Hype Magazine! From Hip Hop to Hollywood, delve into a rich tapestry of diverse stories, interviews, and impactful editorials. We go beyond music, catering to fashion enthusiasts, gamers, movie buffs, MMA followers, EDM and rock fans, and more. If it's newsworthy, we cover it passionately. Join us for a journey through the pulse of entertainment and lifestyle!