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What CDC's new teen health survey shows, and what it skips
Teen suicide risk hit a 10-year low in 2025. Guns, sexual violence, and self-harm. Where are the 2025 data on transgender teens? Missing data changes public health policy. Teen suicide risk hit a 10-year low in 2025. CDC asked more than 10,000 high school students over 100 questions in spring 2025. Yesterday, it published a report covering a fraction of them. The report focsed on five areas: diet, physical activity, sleep, digital behaviors, and mental health, reflecting the priorities of the Make America Healthy Again movement. There was good news. Fewer teens seriously considered suicide in 2025 than in any survey year since 2015: 14%, down from 20% in 2023. Sadness fell. Underlying Conditions is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber. Subscribe Sports participation, which dipped to 49% in 2021, is back to its 2015 level of 58%. Daily PE fell from 27% to 20% in two years, while fewer students eat breakfast daily than a decade ago. Guns, sexual violence, and self-harm. The questionnaire is public, and it goes well beyond those five areas. Students answered questions about sexual violence, self-harm, and whether they got help when they felt sad or anxious. They said how quickly they could get a loaded gun. They reported whether food ran out at home and whether they felt close to people at school. There were questions about sexual identity, including whether they were transgender. The report did not publish any of the answers students gave to those questions. CDC posts the raw survey data online, so anyone can see what the report left out. The report doesn’t cover the health of sexual minority students. Among students who identified as gay, lesbian, bisexual, questioning, or another non-straight identity, persistent sadness fell from 66% to 57% between 2023 and 2025. Serious thoughts of suicide fell from 41% to 30%. Those drops were bigger than the ones among straight students, although the gap remains wide: 28% of straight students reported persistent sadness, about half the rate of LGBQ+ students. About 1 in 7 girls reported sexual violence in the past year. One in 6 students hurt themselves on purpose. Among students who needed help for sadness or anxiety, half rarely or never got it. And among students who had seriously considered suicide, 43% said they could get a loaded gun without an adult’s permission. One protective factor rose sharply. In 2023, 55% of students said they felt close to people at their school; in 2025, 63% did. CDC’s earlier research ties that kind of connection to better mental health. Where are the 2025 data on transgender teens? In 2023, CDC's national survey asked high school students, for the first time, whether they were transgender. Their answers are the only nationally representative data on transgender teens, and their mental health is by far the worst of any demographic. That year, 71% of transgender students reported persistent sadness, 54% seriously considered suicide, and 26% attempted it, compared with 38%, 18%, and 8% of cisgender students. But we don’t have 2025 data. The timing matters because students took the survey in spring 2025, as federal policy toward transgender youth shifted. On January 28th, an executive order directed agencies to end federal support for gender-affirming care for people under 19, and several hospitals paused that care within days. In February, the CDC said it would no longer process transgender identity data. Later in 2025, the Supreme Court upheld Tennessee’s ban on gender-affirming care for minors, and HHS ended the 988 Lifeline’s dedicated line for LGBTQ+ youth. Researchers disagree about how much state policy shapes trans teens’ mental health. A 2024 Trevor Project study estimated that anti-trans laws increased suicide attempts among trans and nonbinary youth. Critics dispute its methods and its estimates. The 2025 survey could have added national evidence to that fight. CDC collected the data but hasn’t publicly released it. Missing data changes public health policy. Surveillance works as a feedback loop. It can show officials whether their policies help or hurt. The CDC didn’t provide data on the students most exposed to transgender policy shifts. The report kept measures that frame health as personal choice, like fruit, breakfast, and sports. It left out measures that track policy, like gun access, mental healthcare, food at home, and school climate, all of which respond to what legislators and agencies decide. HHS did not respond to questions that I sent on September 21st.
Find your inspiration at the 50th Annual Women & Business Conference and ATHENA Awards Luncheon
Whether you're an established executive, a rising professional or someone simply looking for a spark of motivation to move forward in your career, the conference offers opportunities to learn, connect and grow.
Epic's mortality model, and Omada's future products
In this edition of STAT Health Tech: What Epic's mortality prediction algorithm tells us about AI in geriatrics, Omada's expansion plans, and more.
How lip-syncing to AI let Forced Entertainment ‘play the game of theatre’
Today we have a fascinating piece by long-time Forced Entertainment fan Ben Kulvichit, speaking to Tim Etchells about their latest show Cold Sweat, how they are integrating lip-sync and AI voices into their work, the question of ‘authenticity’ on stage, and how lip-sync has even opened the door for them to make “something a little bit like drama”. This piece is a paid partnership with the Southbank Centre, where you can see Cold Sweat next month – we’re very grateful to the Southbank Centre for their ongoing support for Exeunt. Holly Williams ‘It was immediately interesting and uncanny’ **By Ben Kulvichit** “Is the microphone on?” So goes one of the opening lines of Signal to Noise, delivered by a human performer lip-syncing to an AI-generated voice. The voice is American, cheery but sluggish, slowed down into a gelatinous drawl. It repeats ad infinitum in a farce of stuckness; an answer never materialises. I find myself asking the same question as I hop on a Google Meet call with Tim Etchells, the artistic director of Forced Entertainment. We spend five or ten minutes frowning at each other, muting and unmuting, me gesticulating in semaphore into my webcam, checking if I am coming through now, restarting the laptop. To Etchells, I appear exaggeratedly mouthing words, my voice missing. In this gloopy purgatory of broken communication, life imitates art imitates life imitates art. We try a Zoom instead. Forced Entertainment, the pioneering British theatre company who have been at the avant-garde of performance since the 1980s, turned an interesting artistic corner with Signal to Noise, created on the occasion of their 40th anniversary. The whole performance employed this lip-sync technique to AI voices; on the face of it a left-field move from a company whose identity has long been grounded in the earthy, immediate presences of its performers and its unassuming, low-tech approach to theatricality. The technique, however, turned out to provide the company with a “rich new seam” of artistic enquiry, and has now spawned a trilogy of works. The second instalment, Cold Sweat, plays at Sheffield Theatres, Southbank Centre, and Lancaster Arts in October, while the third part, Everything Must Go, has been touring in Europe and is slated to come to the UK in 2027. As is often the case with Forced Entertainment shows, the main conceit for this work didn’t arrive until quite late. They were “four or five weeks into rehearsals for Signal to Noise,” Etchells recalls, and getting nowhere. Away from rehearsals, he had been playing around with feeding “weird texts” to AI voices to see how they would cope with them – “basically for my own amusement” – and was compelled by the uniformly “serviceable, benign, good-natured” tone they would read in, no matter how poetic, fractured or experimental the writing. On a hunch, he brought some examples into rehearsals and the performers gave lip-syncing a go. “It was immediately interesting and uncanny,” he recalls, with the performers having to deal in the moment with the problem of mapping themselves onto another artificial ‘performer,’ which itself was dealing with the problem of a very human text. “Almost all the writing for these projects would be useless to us unless it was done in this way,” says Etchells. “We wouldn’t know what to do with it. It’s too poetic. It’s too fictional. It’s too tangled.” But exploring lip-syncing along to the text has opened “an enormous reservoir of ways of thinking about writing and performing.” Subscribe to Exeunt, and get two in-depth pieces on theatre a week, direct to your inbox Subscribe Forced Entertainment have long been sifting through the detritus of popular culture, from daytime TV to end-of-the-pier vaudeville, magic acts and clown shows, to find frameworks for their own unusual entertainments. Lip-syncing, then, makes sense for them to experiment with. As a mode of performance, it’s wired into popular consciousness through pop stars trying to convince stadium audiences of their liveness, or those same voices as channeled through the made-up lips of contestants on RuPaul’s Drag Race, or movie dialogue spreading virally through the host bodies of TikTok users. For Etchells, lip-syncing is often about “approaching real voices and trying to take on their aura,” subsuming that original human presence into yours. “There’s a very basic, elemental sort of theatre magic to it, produced in this very easy way.” This broad approach resonates with instances of lip-syncing within contemporary performance, too. In works like Re-Member Me and Showmanism, performance artist Dickie Beau acts as a kind of spirit medium for archival recordings (this process of re-membering – as in, giving corporeal form to voices – relies on his masterfully precise actor’s technique), while Frankie Thompson is similarly possessed by a host of characters ranging from a nine-year-old Jacob Rees-Mogg to Cliff Richards, all of whom she finds compellingly nauseating, in the exorcism ritual that is her latest show, Horrible Things. What’s different about Forced Entertainment’s use of lip-syncing is that here, there is no original presence to be channeled. The performers are instead taking on what Etchells describes as “the voices of nobody,” or rather the “phantasmic, aggregated echoes” of the many many voices on whose data the AI has been trained, and which are now conjuring into existence words they never actually said. There is a sort of mournful, empty quality to these voices, having “washed up” far away from the people they originally belonged to, to find themselves in stranger’s mouths listing objects, wondering if anyone can hear them and glitching in interminable loops. There is a cold, sad anonymity to it all. Etchells remarks that occasionally the software company he used has notified him that particular people are withdrawing their voices from the platform, instructing him to cease use of those voices. Using these technologies in performance certainly brings up ethical questions around digital rights, consent, identity and ownership, although in the grand scheme of things, Etchells is fairly blasé about it: of all the purposes someone’s voice might be put to without their knowledge, “an avant-garde performance is probably the least of their worries.” [ ](https://exeuntmagazine.substack.com/p/frankie-thompson-horrible-things-essay-mental-health-compulsive-behaviours-pleasance-courtyard-soho-theatre) [ Frankie Thompson: How I manage my own ‘horrible things’ at the Edinburgh Fringe ](https://exeuntmagazine.substack.com/p/frankie-thompson-horrible-things-essay-mental-health-compulsive-behaviours-pleasance-courtyard-soho-theatre) Exeunt · Aug 25 [ Read full story ](https://exeuntmagazine.substack.com/p/frankie-thompson-horrible-things-essay-mental-health-compulsive-behaviours-pleasance-courtyard-soho-theatre) For the performers, though, lip-syncing to these strange, artificial voices is an odd task, requiring them to bend their live, human presence into the shapes produced by machines. Politically, it mirrors processes that are already at play in the continued computational automation of human life. Etchells brings up James Bridle’s writings on new technologies as a reference point: one example Bridle gives is of “chaotic storage”, a logistics technique employed by Amazon fulfilment centres whereby items are stored not according to traditional methods of categorisation or alphabetisation, but in a way that an algorithm determines to produce the most efficient routes for ‘picking’ based on customer purchase patterns. This appears completely random and incomprehensible to humans, with paddling pools sitting next to USB sticks sitting next to blowtorches, and so for the warehouse workers, the process of picking items becomes completely reliant on technology which tells them where to go. Our world is increasingly being designed not with humans in mind, but rather machines. As Etchells puts it, “technology malforms the space, and then you end up having to live in it.” Initially, Forced Entertainment tried their best to live in the world of machines: “I was in the it’s-got-to-be-perfect school of lip-sync,” says Etchells. But with their aesthetic being so tied to the failing act, the slipping mask, the shoddy costume, “it’s no surprise really that that didn’t last.” Instead, the performers got to enjoy being late for a line, or playing games with each other, “stealing” each other’s voices. Etchells compares it to the principles of ventriloquism, in which a free-floating voice unattached to a body is fundamentally discomforting and “sort of traumatic”. That discomfort is equally as alluring to Forced Entertainment as the satisfaction of precision, the pretence of authenticity only interesting if shown to be a pretence. Lip-sync has also opened up new avenues for the company. Having been allergic all their lives to Plays-with-a-capital-P, with Cold Sweat Forced Entertainment find themselves approaching something a little bit like drama. Rather than the presentational arena of Signal to Noise’s open white stage, Cold Sweat places us more decisively in a “fictional locale”: what appears to be “the aftermath of some disastrous party or backyard drinking binge” where three figures – family members, or neighbours, perhaps – are the last ones standing. “It’s all quite acrimonious and accusatory, everyone’s talking over each other.” For Etchells, this more fictional mode is “a door that we’ve never been able to open. We’ve just never really gone there.” Perhaps it is the technique of lip-syncing, an extra buffer of mediation, that allows them to venture away from the here-and-now without feeling that they have to commit to the “psychological claptrap” that comes along with acting; to be able to “play the game of theatre, without getting one’s hands too dirty.” As I wonder how else the impulses behind Forced Entertainment’s work have changed over time, it occurs to me that over the last ten years of new creations, with the exception of If All Else Fails, the company’s performers haven’t ever spoken on stage: there were two shows without any language at all, Out of Order and Under Bright Light, and then this trilogy of lip-sync works. Etchells agrees it’s a shift away from earlier productions, that were so often about “the actual voices of the performers and their actual presences. We had a lot of money, in some ways, on an authentic approach to what it might mean to speak on the stage.” But this sense of authentic presence itself had a fakeness to it; these days, Etchells can’t stand that mode of being onstage where performers “are here to be cheeky and witty versions of themselves. I don’t want to be charmed.” Pulling back into a more anonymous space has resulted in works that feel slightly sharper-edged, more brutal in a way. “All of these shows are post-Brexit, post-Trump, post-truth, post-everything,” Etchells notes. Speech, charisma, authenticity – these things feel politically loaded, and perhaps warmth and openness just don’t feel like the right tools to reflect the world we’re living in. “It feels like the space is closing down, and we’re trying to deal with the fact that the system, the structure that you’re in, is more oppressive and more powerful. It probably always was, but I think we’re just more tuned to it now.” Yet even without their voices, the performers’ distinctive presences – ones that many audiences have followed around for years, if not decades – still, inevitably, shine through as they physically navigate whatever unending task the system of the piece has set for them. They’re still trying to keep up with the onslaught of text, still running about, changing costumes, moving stuff around. The human is always stuck in the teeth of the machine, jamming the smooth, frictionless cheeriness of the not-real, gesticulating silently, trying desperately to communicate. Cold Sweat is at Sheffield Theatres, 2 to 3 October; Southbank Centre, London, 9 to 10 October; Lancaster Arts, 14 October [ ](https://exeuntmagazine.substack.com/p/exeunt-recommends-the-best-autumn-theatre-2026-lives-of-others-standard-of-living-our-friends-in-the-north-lanny-) [ Exeunt recommends... the best autumn theatre ](https://exeuntmagazine.substack.com/p/exeunt-recommends-the-best-autumn-theatre-2026-lives-of-others-standard-of-living-our-friends-in-the-north-lanny-) Exeunt · Sep 16 [ Read full story ](https://exeuntmagazine.substack.com/p/exeunt-recommends-the-best-autumn-theatre-2026-lives-of-others-standard-of-living-our-friends-in-the-north-lanny-) This piece was paid for by the Southbank Centre. Such support helps Exeunt to keep publishing the most interesting writing, about the most exciting theatre. Interested in partnering with Exeunt? Visit our Advertise with Exeunt page, where you can get more information, download an advertising pack, and find our contact details.
Egan's late career resurgence back to Premier League
BBC Sport NI looks at Republic of Ireland centre-back's John Egan's rise back to the Premier League with Hull City and the international set-up under Heimir Hallgrimsson.
Bipartisan bill aims to expand health protections for wildland firefighters
A bipartisan bill backed by Utah Sen. John Curtis promises to expand health and safety protections for wildland firefighters.
Surging diesel prices threaten North Country trucking businesses
With diesel prices inching closer to $7 a gallon, independent truckers say soaring fuel costs are threatening to put them out of business.
Covenant Health doctor providing tips to stay healthy ahead of flu season
Flu season usually starts in October, and with cases already starting to pop up across the United States, healthcare professionals are making sure everyone prepares ahead of time.
Could healthcare price transparency lower costs? Mike Rogers thinks so
As healthcare costs grow ever higher, Michigan GOP US Senate candidate Mike Rogers argues that better consumer awareness of how much the services they need cost will help bring prices down.
11 RB Leipzig Players Head Away On International Duty
From Maarten Vandevoordt’s Belgian call-up to Ezechiel Banzuzi’s allegiance switch for DR Congo, stars across Europe and Africa prepare for crucial qualifiers and Nations League clashes this week.
Opinion: When bigger businesses are reclassified as ‘small,’ small firms lose
Small-business policies should help small businesses grow. It should not redefine them out of opportunity, Dan Seals writes.
Cape Cod Chamber Orchestra Will Perform ‘Mostly Mozart’
The Cape Cod Chamber Orchestra will present “Mostly Mozart” on Sunday, October 4, at 3 PM at Pilgrim Congregational Church in Harwich Port.
Headley's 'Sweet Magnolias' canceled at Netflix
Northrop High School graduate Heather Headley’s Netflix series has "poured it out" for the last time.
LG Display starts mass production of 24.5-inch 720Hz OLED panel for ASUS ROG
LG Display has started mass production of its new 24.5-inch 720Hz OLED panel. ASUS is using it first in the ROG Swift OLED PG259QWS Ace.
NEA C-Suite: Jaime King
How would you describe your company? Body Indulgence Spa & Boutique is a wellness and beauty business focused on helping people look and feel their best. We offer a variety...
Groundbreaking held for $44M Murray Mill in Anderson
Charleston-based Southeast Partners broke ground on the $44 million Murray Mill in downtown Anderson on Sept. 17.
Wrangling for votes: Oregon governor’s candidates make political pilgrimage to Pendleton Round-Up
In a close race, both candidates say going to the rodeo is a must.
Why your smartwatch is so bad at telling you how many calories you burned
A new study found that smartwatches overestimated caloric burns by about 15 to 25 percent.
More than 12,000 power transformers could face flood risk as warming rises
SCE plans temperature monitors for underground circuits, while the report urges agencies, utilities and communities to use climate data in planning.
France Football turns its spotlight on Algeria's ‘Mazadona’
The Algerian wonderkid blends multi-cultural roots with midfield mastery, earning Ballon d’Or recognition and a legendary nickname as he anchors the future of Bayer Leverkusen’s ambitious project.
As Medicaid cuts near, one free Chicago clinic pushes expansion
Chicago-based Community Health doesn’t take Medicaid, Medicare or other payment, so it is doubling down on a growth strategy to meet the expected influx of newly uninsured patients.
Banqup and Post Business Solutions partner to revolutionize digital financial workflows for Austrian businesses
LA HULPE, BELGIUM – 21 September 2026, 7:00 a.m. CEST – Banqup Group SA (Euronext: BANQ) (Banqup, Company), a European fintech provider that simplifies financial flows through an innovative secured platform for e-invoicing, e-payment, e-reporting and e-trust solutions with built-in compliance at its core, announces a new meaningful collaboration with Post Business Solutions, an Austrian based leader in innovative digital and physical business process solutions. The new partnership marks a signif
Olympiacos Needs Time and Patience Under Imanol Alguacil
Olympiacos needs time and patience under Imanol Alguacil after a controversial coaching change left the team without a preseason or a clear playing system.
Health collaborative working to improve care, dignity for elderly Utahns
The dignity in dying initiative within the One Utah Health Collaborative is seeking to reduce costs and improve care by helping elderly Utahns get their care wishes recorded properly.
How to Navigate Social Media’s Data Evolution as a Small Business Owner
As the digital media landscape evolves rapidly, small business owners need to stay informed and learn how to leverage emerging platforms to reach their audience. Max McCoy, a paid Media Specialist for Circulus Digital Media, says Meta’s recent algorithm adjustments have changed how it gathers user data. He says Meta increasingly relies on first-party data, […]
Why politicians should pay more attention to the polls (reprise)
Welcome to the 231st edition of The Week in Polls (TWIP), a polling newsletter that always welcomes new readers. So please don’t keep TWIP a secret; share it with your friends and colleagues: Share The Week in Polls With all the stories swirling around Reform, JL Partners and political polling, I am finally tearing myself away from talking about the regulation of polling this week - and instead re-running a previous piece reminding us why the solution to problems with polls isn’t simply to ban or ignore them. Rather, we need them to play a vital role in making our politics - and politicians - better. This is followed by summaries of the latest national voting intention polls, seat projections from MRPs and the most recent party leader ratings. Subscribers who pay for the full edition can also read ten insights from the latest polls and analyses, including: A trio of organisations and a pair of professors have been casting their eyes over the Liberal Democrats ahead of the party’s autumn conference; What impact did the summer heatwave have on views on climate change? and Which wins out between chocolate and cheese? If you are not yet a paid subscriber, you can read all ten by starting a free trial now: Get FREE 7-day trial For more polling news as it comes in ahead of next week’s edition, you can also follow The Week in Polls on Bluesky. Picking up on my doubt last week about whether or not 35% of British train travellers have tried to order a takeaway for delivery to a railway station or carriage, thank you to reader Iain, who has been in touch to say he has done just that… in India. Another quick pair of updates, this time on the controversies around Reform and polling. Politico has a further scoop - “Farage aide caught in donor sting attended Egypt retreat with JL Partners” - and Ian Dunt has written about the problems with polling too: “Seeing the response of many polling experts in the last few weeks suggests that they are nervous about what is happening and keen to mitigate against it. Seeing the response of journalists, which has been basically non-existent, suggests the precise opposite.” My usual reminder as well: please do hit reply if you’ve spotted a poll, focus group or new piece of poll-based research that you think should be in contention for coverage in a future edition. Thank you! And with that, on with the show. How politicians get public opinion wrong I have written before about the benefits that come from widespread availability of high-quality political polling. We need more polls and more good coverage of polls. However, what I’ve not dug into before is the research into how accurately politicians estimate public opinion on issues. Thankfully we have academic research to tell us. First, the bad news: We present results from a study of 866 politicians in four countries.1 Politicians were asked to estimate the percentage of public support for various policy proposals. Comparing more than 10,000 estimations with actual levels of public support, we conclude that politicians are quite inaccurate estimators of people’s preferences. They make large errors and even regularly misperceive what a majority of the voters wants. Politicians are hardly better at estimating public preferences than ordinary citizens. Walgrave, S., Jansen, A., Sevenans, J., Soontjens, K., Pilet, J.B., Brack, N., Varone, F., Helfer, L., Vliegenthart, R., van der Meer, T., Breunig, C., Bailer, S., Sheffer, L. & Loewen, P.J. (2023a), “Inaccurate Politicians: Elected Representatives’ Estimations of Public Opinion in Four Countries”, The Journal of Politics, 85(1): 209-222. The bad news is not quite as bad as that makes it sound because, when asked whether the majority of public opinion was for or against various policies, politicians picked the wrong option ‘only’ 29% of the time. However, this included getting it wrong even when public opinion is far from evenly split on an issue: They do not only get it wrong when the public is divided and hard to read (e.g., when there is a 51%:49% distribution). Seventy percent of the misplacements occur for policies with a relatively clear distribution of at least 60% (dis)agreeing citizens. Moreover, the public scored only slightly worse than politicians, picking the wrong option 2.7 out of 8 times on average, compared with 2.3 times for politicians. Turning to the other measure of accuracy (not which side is in the lead but what the percentage support is for each side), politicians on average were 18 percentage points out in their guesses. Again, this was only slightly better than the public, whose error came in at 21 percentage points.2 Further research, using the same mix of countries, gives a little more comfort about how (in)accurate perceptions are: We show that politicians have a better understanding of public opinion when they think the issue matters to voters. Further, when an issue is personally important to politicians they more accurately estimate their party supporters’ opinions. The results confirm that politicians hold more accurate perceptions of voters’ preferences when they think it is important to do so but not necessarily when the issues actually are important to voters. Butler, C., Walgrave, S., Soontjens, K. & Loewen, P.J. (2024), “Politicians are better at estimating public opinion when they think it is more salient”, Party Politics: 1–13. Even so, it’s not a good picture. The remedy for this? Politicians should spend more time reading the polls. So forward this newsletter to someone you know… Share For a more general argument against banning polls, see my 2024 piece. Is “Let Bartlet Be Bartlet” good advice or not? The latest episode of my Political Fictions podcast heads across the Atlantic for a dip into one of the political TV classics: Mark and Cory talk about a giant of American political drama for the first time this week, as they tackle The West Wing. They talk about Let Bartlet Be Bartlet, the nineteenth episode of series one. In it, Mark wonders if The West Wing is actually the epitome of the “Boris Johnson school of politics”, Cory outmanoeuvres Mark into confirming we will record a Christmas Special about Love, Actually and they debate whether the central message of this episode has been misunderstood. Cory’s email newsletter is Paperback Rioter and Mark has a family of email newsletters. Subscribe to our newsletter for some additional bonus content and to get alerted whenever a new episode comes out. Our theme tune is “Monkeys Spinning Monkeys” by Kevin MacLeod/incompetech.com and licensed under the Creative Commons: By Attribution 4.0 License. You can also listen to our episode on Apple Podcasts, Spotify, the web or YouTube. Elsewhere from me… [ A Lord's Eye View How to fix the problem of money in our politics Welcome to my latest update on work in the House of Lords. This time I am taking a look at how our political system is regulated, and the protections we need to keep democracy safe from becoming simply a contest to see who has the biggest bank account… Read more 5 days ago · 3 likes · 2 comments · Mark Pack ](https://lordseyeview.substack.com/p/how-to-fix-the-problem-of-money-in?utm_source=substack&utm_campaign=post_embed&utm_medium=web&embedding_publication_id=1269283) If you spot a factual error… Borrowing an idea from Stuart Ritchie and others, if you spot a factual error in an edition of this newsletter, I will give you a free 12-month subscription to the paid-for version (or an extra 12 months on your existing one). Factual errors qualify, but grammatical errors or disagreements over interpretation do not, and my decision is final. Messages about both of those are always welcome, though. Voting intention and leadership ratings Here are the latest voting intention polls from different pollsters. It is all pretty static at the moment, with a small and consistent Labour lead in nearly all the polls. The table is also online here, along with explanations about what is included. It is updated regularly throughout the week as new polls are released. Next are the seat projections from MRPs, also sorted by fieldwork dates, listing those which are based on dedicated fieldwork (rather than models based on averages of other polls). Because such MRPs are published infrequently, some of the entries below are quite old. Finally, here is a summary of leadership ratings, with a graph from PollCheck: Detailed numbers from the latest polls are online here, and both that and the graph are updated regularly throughout the week as new data comes out. For historical figures on both voting intention and leader approval stretching back to the 1930s, including Parliamentary by-election polls, see PollBase. Catch up on the previous two editions [ ](https://theweekinpolls.substack.com/p/a-crisis-point-for-political-polling) [ A crisis point for political polling Sep 13 ](https://theweekinpolls.substack.com/p/a-crisis-point-for-political-polling) [ Read full story ](https://theweekinpolls.substack.com/p/a-crisis-point-for-political-polling) [ ](https://theweekinpolls.substack.com/p/extra-questions-about-the-polls-in) [ Extra questions about the polls in Reform’s funding scandal Sep 6 ](https://theweekinpolls.substack.com/p/extra-questions-about-the-polls-in) [ Read full story ](https://theweekinpolls.substack.com/p/extra-questions-about-the-polls-in) My privacy policy and other legal information are available here. Links to purchase books or other items are usually affiliate links which pay a commission for each sale. Quotes from social media messages are occasionally lightly edited for punctuation and clarity. If you are subscribed to other email lists of mine, please note that unsubscribing from this one will not automatically remove you from the others. If you wish to be removed from all my lists, simply reply to this email to let me know. A quintet of Lib Dem polling analyses, and 9 other polling insights you shouldn’t miss The following ten findings from the most recent polls and analyses are only for subscribers who pay for the full edition, but you can sign up for a free trial to read them straight away. Ahead of the start of Liberal Democrat conference, we have a trio of organisations and a pair of professors with pieces out about Ed Davey’s party:
Minecraft Takes Science to a New Level: A Fly’s Brain Was Transplanted Into the Video Game
The experiment demonstrated the potential of gaming as a tool for testing consciousness in a virtual environment.
Scientists hope deeper-rooted soybeans can withstand climate extremes and store more carbon
Scientists have explored ways to remove carbon from the atmosphere, including through air capture, changes to ocean chemistry and reforestation. Now, researchers are testing deeper-rooted soybeans.
How will California's new law restricting social media for kids work?
California will implement a new law in January that bans social media platforms from offering addictive features, such as infinite scroll, autoplay, and algorithm-driven "For You" feeds, to kids under the age of 16.
As tailors disappear, this Upper Bucks shop looks to a fifth generation
With tailors disappearing, an Upper Bucks shop is set to pass to a fifth generation. That's "extraordinarily uncommon," the head of a trade association said.
Trump and sons invest heavily in AI economy as he resists calls for slowdown
Trump’s decisions as president on one of the most consequential policy debates of his administration could affect the value of his personal investments.
Column: SC arts board targets LGBTQ art and creates political test for art
The board of the South Carolina Arts Commission made four dangerous political decisions at their Aug. 20 meeting.
What’s Your Hottest Business Take?
Let us know your hottest business takes in the comments.Subscribe to The Hustle:🔗 https://clickhubspot.com/vu3lGet the 5-minute newsletter keeping 2M+ innovators in the loop🔗 https://clickhubspot.com/3klnAbout HubSpot: HubSpot is a customer platform that provides education, software, and support to help businesses grow better. The platform includes marketing, sales, service, commerce, operations, and website management products that start free and scale to meet our customers’ needs at any stage of growth. Today, thousands of customers around the world use HubSpot’s powerful and easy-to-use tools and apps to attract, engage, and delight customers.#TheHustle #HubSpot
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The Big Holes in Wearable Heart Rate Variability And Readiness Scores
On September 9th, Apple announced it was revamping its Apple Watch Health Sensing System, rolling out a Readiness score (0 to 10), and increasing the frequency of heart rate variability (HRV) outputs 24-fold. This can be viewed as upping its competition with various other consumer wearable sensors. These “readiness scores” as a composite of multiple metrics, with heart rate variability (HRV) being front and center for most. The majority of Americans are now using wearable sensors, which equates to well over 100 million adults. HRV and Readiness scores are increasingly being marketed as a measurement of autonomic nervous system health, a digital marker for future disease, a clock for biological age, and a holistic metric to promote healthspan and even longevity. (Apple also introduced a new longevity tab and “Health Age”.) None of this has been proven. In this edition of Ground Truths I am going to review what we know about heart rate variability and readiness scores. Heart Rate Variability HRV is the variation in normal heart cycle timing. The variability of the heart rate, the barely perceptible millisecond changes in time between consecutive heart beats (see R-R intervals in the Figure below, left panel), is due to interplay between the sympathetic and parasympathetic (vagal nerve) inputs. Distinct from heart rate, individuals with the same heart rate can have very different HRVs. It is a rough reflection of the autonomic nervous system (ANS) activity, inadequate to say whether a person’s ANS function is abnormal. For more than three decades, heart rate variability (HRV) has been measured and several studies have found an association of low HRV and clinical outcomes, particularly a link with higher all-cause and cardiovascular mortality. There have also been less well established links of low HRV to risk of early cognitive impairment, dementia, mental illness, Type 2 diabetes and substance abuse. An important reminder is that HRV is a surrogate marker without any established cause-and-effect relationship. If you increase your HRV, that doesn’t mean it will improve health outcomes. In fact, there is no hard evidence for that. All that work linking to health outcomes was done with electrocardiogram (ECG) derived HRV. Now, in the era of consumer wearables, this is getting assessed differently, by optical pulse (yes, the lights you see) plethysmography (PPG) or what is called pulse rate variability (PRV). They are not the same, as shown below (right panel) and only concordant when the delay between the ECG and pulse is kept constant, which basically means at rest. I should mention there’s also what I will call MPV, a mattress mechanical movement sensor, a derived heart rate variability, that companies like Eight Sleep use, even further away from directly measuring HRV. HRV has not one uniform measurement but many different types of quantification, such as RMSSD, the magnitude of difference between successive R-R intervals of normal sinus beats (N-N) or SDNN, the standard deviation of NN intervals, both in milliseconds. SDNN is one of the so-called frequency domain HRVs (others are LF, HF, LF/HF). Different wearable sensors use different metics; Apple has relied on SDNN and nearly all of the others use RMSSD, which is generally considered the more accurate metric. There’s also the different length of time measured, such as for a matter of minutes, all day, or an overnight’s sleep. Short measurements are especially problematic since they don’t capture enough of respiratory modulation and other factors that influence HRV. Share Ground Truths How well does HRV correlate with PRV? There are very limited studies, especially independently done. One that is commonly cited was conducted by Air Force researchers in only 13 healthy adults assessing Oura ring 3 and 4, Whoop 4.0, and Garmin Fenix 6 and showed a correlation coefficient of 0.88 to 0.97 and a mean absolute percentage error from 6 to 10%. The correlation is not a perfect 1.0, but there’s at least a fairly high level of correlation. HRV is supposed to increase during the night due to takeover of the parasympathetic nervous system, and higher during deep sleep. A recent example of my 1 week, all day “HRV,” and one during sleep is shown below. As you can see, the N of 1 data are inconsistent for the same days from different sensors (Oura, AppleWatch, Fitbit Air, and Eight Sleep) by patterns, absolute numbers, and comparison with prior days and weeks. The largest study in over 8 million Fitbit users (the old version, not Google Fitbit Air, introduced in May 2026) gives you a sense of the effect of age, sex, and the 2 different main HRV (here PRV) metrics, with RMSSD on the left and SDRR (=SDNN) on the right below. That study, from data collected in 2018, is a major outlier, since all the more recent ones are tiny with respect to sample size. Many of the companies have not had independent evaluation of their HRV, such as Eight Sleep, but have published a low standard error on their website. There are some other published studies on the correlation between HRV and PRV, but they are all small and only in healthy adults. A scoping review emphasized the lack of study in underrepresented individuals, including the aged, people of color (which affects the PPG signal), and individuals who are underweight or obese. Add the typical adult age 60 plus with one or more chronic diseases. For example, one study in over 900 adults found poor correlation of HRV and PRV, non-uniformly underestimated across many chronic diseases (cardiovascular, endocrine, neurological, respiratory, and others), concluding PRV is “an invalid surrogate for HRV.” A recent systematic review of 43 studies comparing HRV and PRV found reasonable pooled absolute standardized error (HRV as gold standard) but only 10 of the studies provided quantitative synthesis in ideal conditions. Their main conclusion was similarly cautious: “PPG-derived HRV [PRV] should not be regarded as universally interchangeable with ECG-derived HRV across all devices, populations, and recording contexts.” Factors Affecting HRV and PRV That gets me to the long list of factors that affect HRV (and PRV) besides the device, the type of measurement (RMSSD, SDNN or others), the person’s signal, the sensor site, the duration of data capture, if weighting by sleep stage is used, how artifact is processed and corrected. And this list is not complete!: Oura puts out data from their community of users (who input data) on what affects their overnight HRV. The factors currently provided are: no alcohol (increase 8%), melatonin (increase 2%, float tank (increase 2%), wine (decrease 4%), and party (decrease 14%) in overnight HRV. Must be some big parties! Subscribe What is a PRV measurement good for? It has been falsely characterized as an index of “autonomic balance” and a specific indicator of stress. A 2018 review of the studies available for HRV and its relationship to stress, not using any of the current wearables, found that stress can lower HRV. But so can many other factors. The non-specificity of the signal, indexed to the table above, is striking. Evidence from a UK Biobank study of over 46,000 participants with actual HRV looked at genetically predicted HRV, a genetic risk score, that failed to show the expected HRV-mortality link, indicating that _HRV is likely not causa_l, but rather a reflection of person’s physiologic state. A review of consumer wearable HRV data from 5 longitudinal studies showed that nighttime PRV was not associated with perceived stress, and surprisingly higher HRV, in the largest cohort (N=717 participants), was correlated with higher stress. An Oura ring cohort of 525 first-year college students found a link between overnight PRV and perceived stress, but that was also seen with resting heart rate, sleep, and respiratory rate. Several very small studies have examined the relationship of HRV and athletic injuries or guiding training with mixed, and predominantly negative results. HRV biofeedback training with paced breathing had no significant effect on reducing stress or raising HRV, as demonstrated with sham controlled trials. When HRV for multiple days showed a decline in conjunction with body temperature, the Oura ring published data for prediction of Covid. The WHOOP company sponsored an observational study, published in 2026, of 30,000 users for 72 weeks, without a control group, that reported reduced alcohol intake (5.8 % points) by self-report. That doesn’t tell us much, and particularly about the merits of HRV for behavioral change. If you use the same device and conditions as longitudinal trends for multiple (at least 2-3) weeks that may be the one way to get something useful from the measurements. Data for overnight sleep with minimal motion and using RMSSD is the best proxy for real HRV. The reason to look at trends rather than any given night is that it more likely represents something, even though you won’t know with certainty what the “it” is. Keep in mind there are no data, no peer-reviewed evidence, to show that HRV fluctuation in-person has any correlation with health outcomes. Share Readiness Scores These are proprietary scores that integrate different metrics for each of the wearables: no algorithms have been disclosed. They are unvalidated against health outcomes. In a review of 14 composite health scores of readiness and recovery, HRV contributed 86% to the scores, followed by reading heart rate (79%), physical activity and sleep duration (both at 71%). That review noted the substantial variability in measurement protools and lack of standardization. Sleep staging is notoriously inconsistent and inaccurate by these sensors, which adds further to the HRV uncertainties for what the scores, which use sleep stage data, mean. Only resting heart rate has been shown consistently across devices to be extremely accurate. I’ve made a Table to summarize what we know about which metrics are included, the scores, any peer-reviewed studies that compared the readiness score with health outcomes, and the corresponding (if any, NA-not available) citation. You will note that some companies do not use the term “readiness," such as WHOOP for recovery, and Garmin, which has 2 different scores, one of which is Body Battery. Eight Sleep uses the term “Fitness Score.” They all include HRV; Apple includes a new metric they call “Recovery HRV” which among other components uses 7-days of sleep, but it is unclear what this means or how it is differentiated from other scores (there are clearly no data for outcomes). We have no knowledge of how the different components are weighted or whether any of these scores are better than resting heart rate, HRV alone, physical activity, or any other single metric. Since none of these are standardized, they are not interchangeable, so if you get a 90 for Oura that has no relationship to a 90 on a Google Fitbit Air. Notably, the company can update its algorithm for readiness score at any point without notification to device users. Without any useful evidence of actionability for these scores or established relationship with health outcomes, it is hard to make a case for their value. At the Apple recent announcement they showed their Readiness score (0-10) on the watch (Figure below) but there are no published data on this score, not even on their website. It’s available only on their new Watch Series 12 or Ultra 4 [of course, ;-)]. That exemplifies the problems with these scores, lack of data and evidence for being meaningful to promote health. Perhaps the best study (which isn’t saying much) is the WHOOP Recovery for golfer performance, because it did correlate with an objective outcome, even though there was no control group and the authors were all from the company. Among the 389 pro golfers, an absolute 10-per cent point increase in Recovery score was associated with about 0.5 fewer strokes per round. But that’s hardly a health outcome! WHOOP is also conducting a study in over 2,700 runners to see if their recovery score will be linked to less injuries and improved performance, but that is not yet published and has no control group or randomization. Putting This in Context For two decades I’ve been enthusiastic about the potential for digital health and particularly wearable biosensors. Over the years, we’ve seen some great progress for their ability to promote physical activity and accurately detect atrial fibrillation (the first FDA cleared deep learning AI for consumers). That work was the subject of rigorous research. But there are holes in the data and evidence for other metrics. One notable one is the “VO2 max” story that I wrote about earlier this year. At that time many subscribers asked me to cover heart rate variability, which I finally got to here. When I dived into the research and publication for HRV and readiness scores, I expected to find at least some that were of high quality and demonstrated their utility by linkage to health outcomes. To my surprise, I found none. The wearable sensor measurements for HRV (PRV) are, for the most part, accurate, but that validation work has only been done in small studies of healthy adults and does not take into account the long list of factors, from the device, software side, and the user side, that affect HRV measurements. Moreover, this metric chiefly relies on optical sensing and, as we have learned for heart rate PPG sensing, may be less accurate in people of color. Keep in mind that all of the health outcome association evidence comes from ECG-derived HRV; none are from wearable sensor data. I will repeat the key point: there's no peer-reviewed evidence to show that in-person HRV fluctuation—or efforts to raise your HRV— has any correlation with health outcomes. For those of you who look at your HRV on awakening, or even 2+ week trends of it being low, I hope this context helps to relieve any anxiety. Yes, low HRV (not PRV) has been shown to increase risk of some diseases as summarized above. But efforts to raise your HRV—a surrogate metric— has not been established for improving any health outcomes. HRV does not have any evidence of causality (the genetic evidence actually goes against this possibility). In this summary, I have not included data for other wearable sensors such as Polar, Samsung, Withings, Suunto, Amazfit, Coros, Ultrahuman, or additional mattress sensors. These are beyond my first-hand experience, and as far as I know from my in-depth review none have any peer-reviewed published data that differ from the 6 sensors I’ve reviewed here. From the points I’ve gone over above, we’re not ready for readiness scores. Besides being proprietary, they are predominantly based on metrics that have their own issues. It’s compounding the problem, like building a house without a solid foundation that has never undergone a rigorous inspection, and then selling it. Like I mentioned for PRV, you can look at trends over weeks rather than any single day, to get a handle, but even that may not be helpful. There’s simply no evidence that these scores meaningfully relate to health outcomes. I’d emphasize they might, but that requires doing prospective or randomized studies to prove it. None exist. There’s great promise for HRV/PRV utility_. For example**,**_ Prof Maiken Nedergaard, who discovered the brain glymphatics that are essential in eliminating metabolic waste products from the brain during sleep, has posited that HRV could be a non-invasive marker for neuromodulator oscillations, brain-body regulatory circuits, and brain clearance. That would be extremely useful, but like everything else on HRV and readiness scores it requires solid research and validation. The lay media isn’t helping much to get the story straight. Earlier this year The Economist published a piece entitled “The most useful indicator of your overall health” which ordained HRV as an “accumulated stress score.” That’s akin to the false assertion about VO2max: “V02 max is the singular most powerful marker for longevity.” As I’ve summarized here, that is not established. The fact is that so many things can lower HRV, including physical exercise (especially an intense workout), reduced sleep quality, stress, the list above, no less the device, signal, and software. Whatever fluctuations observed have not been correlated with any health outcome. Sadly, “datamaxxers” are widely using HRV and readiness scores that have never been validated to mean anything. We already know that for some people using the sensors for sleep metrics, it can induce “orthosomnia,” an obsession to get high sleep quality, with associated high levels of anxiety. In an experiment done by a company to promote sleep quality for its employees, “For those employees who did use the trackers, many reported feeling perfectly rested until their tracker told them they had had a terrible night. Others were told that they had slept like a baby when they had actually been lying awake worrying about the quality of their sleep. “ The same problem can result from preoccupation with HRV or readiness scores, with anxiety that would lead to further reduction in both. It you are using a wearable like >100 million American adults, it’s OK to look at these data, but contextualized with the major caveats reviewed here. If you are one to require evidence that HRV or readiness scores are linked to health outcomes, you may not even want to look. The companies make it hard to turn them off! Let me end with the companies that make and sell wearables. Apple’s doubling down on HRV (24-fold more reporting and heart rate very 5 seconds) and introduction of a Readiness score tells us that consumers have bought into these metrics and they are joining the club. However, all of this is occurring with a backdrop of tens millions of users, claims about the data that are not backed up by adequate evidence, marketing way out in front of whatever limited data exists, and not being transparent about their readiness score algorithms. The companies can well afford to do the research that is needed to connect these metrics with health outcomes show, once and for all, that increasing HRV or using readiness scores promotes our health. If they believed and invested in the products they are selling, we’d not be in this position of not knowing. That’s essentially where we are with HRV and readiness scores. Perhaps someday this will change and we’ll have good reason to embrace them. NB: I wrote this post. No AI. I have no conflicts of interest with any of its content. Loading... Ground Truths has 215,000 subscribers from every US state and 214 countries. There are over 300,000 followers of Ground Truths so more than 90,000 folks who can easily convert to be free subscribers. Your subscription to these free essays and podcasts makes my work in putting them together worthwhile. If you’re not a subscriber, please join! If you found this interesting PLEASE share it! Share Ground Truths The proceeds from all voluntary paid subscriptions go to support our summer internship program. It enabled us to accept and support a record number of 62 summer interns that joined us in 2026! These are high school, college and medical students selected from thousands of applicants. We couldn’t do this expanded program without the funds coming in through Ground Truths. Thank you!
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