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America’s newest soccer star, plus a bad night for Green Bay
The Pulse Newsletter 📣 | This is The Athletic’s daily sports newsletter. Sign up here to receive The Pulse directly in your inbox. Good morning! Don’t get fined today. Coming up: 😮 A Falcons blowout win? ✅ The latest MLB playoff clinches 👋 Say hello to Cavan Sullivan Geoff Stellfox / Getty Images It’s a busy day, so this will be short. Important stuff from last night: The Falcons routed the Packers on the road, 35-14, in one of the more surprising results of the early NFL season. A lesson learned: Having a competent quarterback to go with Atlanta’s...
MORNING BUSINESS REPORT: Mortgage rates soar, rising vacation costs, McDonald's vs GLP-1 users
Mortgage rates rise again, families navigate high vacation costs, and McDonald's looks to attract GLP-1 users. Here's the Morning Business Report for Sept. 25.
Surprising Short-Notice Welterweight Bout Added to UFC 332
A surprising short-notice welterweight bout has been added to UFC 332, which takes place next Saturday night.As first reported by MMAMania.com, welterweight prospect Jacobe Smith will return to the Octagon to face UFC newcomer Bruce Whitehead in a surprising booking that has MMA fans scratching their heads.Heavy’s Marcel Dorff further confirmed that Smith vs. Whitehead […] The post Surprising Short-Notice Welterweight Bout Added to UFC 332 appeared first on HEAVY.
Utah Jazz Could See Major Player Swings as Expectations Rise
As the franchise pivots from development to winning, shifting stakes will test locker room veterans and rising stars alike, forcing critical adjustments in performance and nightly availability.
Canada’s Tariffs Cost This Cheesemaker Nearly $1 Million in Sales. Now Its Costs Are Rising at Home
A Vermont business says the trade war between the two countries has damaged its biggest export market.
Michigan's economy feels rising diesel prices
Higher diesel fuel prices are being felt across Michigan’s economy
Microsoft Copilot+ Branding Disappears from Latest Surface PCs
Microsoft's recent Snapdragon-powered Surface Laptop and Surface Pro launch was surprisingly absent the usual Copilot+ branding, aside from as a callout to the inclusion of the actual AI assistant on the devices. Apparently, this was an intentional branding change, according to Surface Corporate...
George Kittle weighs in on 49ers’ surprising early success
San Francisco 49ers tight end George Kittle weighs in on the team's early success.It’s only been about three weeks into the NFL season, and no team might be hotter than...
Brewers Roll Out Expected Postseason Rotation vs. Cardinals
Rising Milwaukee Brewers southpaw Robert Gasser looks to stay hot while Dustin May fights for his role.
Rising health costs concern local governments
Budgets and healthcare costs were on the minds of local government and school officials who met at Minot’s Liaison Committee meeting on Thursday, Sept. 24. One of the shared budget concerns is the rising cost of health insurance. Ward County’s employee health insurance costs increased nearly 10% for 2027. Initially, the county was looking at […]
Montana State Employee Health Plan Costs Change Under New Union Agreement
The State of Montana Benefit Plan faces rising medical and prescription drug costs. The state says its self-funded plan is expected to see nearly double-digit h
Patrick Mahomes makes surprising admission after controversial Colts fumble reversal
Patrick Mahomes joked he was glad Laquon Treadwell’s overtime fumble was overturned because he did not want to see Twitter’s reaction.
Amid rising political violence, N.J. passes bill that would allow campaigns to use funds for security
The bill, which would campaign dollars to pay for politicians' alarm systems and other security measures, now heads to Gov. Mikie Sherrill's desk.
Rising prescription and supplement use poses health risks for seniors
Older Americans are increasingly taking multiple prescription medications and dietary supplements. Although the prevalence of potentially major drug-drug interactions has declined slightly, more than 1 in 5 older adults are potentially at risk, according to a USC-led study published September 24 in JAMA.
ESPN evaluates surprising early-season Lions trend
ESPN thinks Jameson Williams' early-season trend with the Lions is a mirage.
Howard Youth Data Shows Declines in Substance Use, Growing Mental Health Concerns
New survey data spanning more than a decade shows significant declines in substance use among Howard County youth, while rising reports of sadness and
Meet Sienna Spiro, the rising star bringing ‘60s style to the MTV VMAs
Spiro will mark yet another milestone when she takes the main stage at the 2026 MTV VMAs for her debut performance.
Forced Eviction of 87-Year-Old Woman Spurs Outrage in Spain
Demonstrations broke out across the country over the woman’s eviction in Madrid, putting rising rents and affordability at the top of the political conversation.
Distant time crystals can somehow fall into the same rhythm
Researchers have shown that multiple time crystals inside a semiconductor can synchronize their oscillations, much like pendulum clocks gradually falling into the same rhythm. The coupling is carried by spin-polarized electrons, allowing time crystals separated by up to 40 micrometers to lock to a common frequency. The discovery reveals surprisingly long-range connections between these exotic spin systems and could help researchers develop future spin-based devices.
ADHD and autism diagnoses have surged. A massive study may help explain why
A large Danish study found that children diagnosed with ADHD or autism today more closely resemble their peers in the general population than those diagnosed 10 years ago. The shift suggests that rising diagnosis rates may partly reflect broader identification and changing diagnostic patterns, rather than only an increase in the underlying conditions.
How the fate of a rural hospital could help flip the House
In one Virginia race and others, Democrats are highlighting the rising costs of health care and possible closures of facilities, putting Republicans on defense.
HSBC plans India equity broking return after 13 years amid IPO boom, sources say
HSBC is re-entering India's equity broking business after an absence of more than a decade, seeking to capitalise on a robust pipeline of share sales and rising demand from wealthy clients for equity market products, two people with direct knowledge of the matter said.
Sacramento's Azul restaurant closing after 19 years in business
After nearly two decades, Azul Mexican Food and Tequila Bar announced this week that it will close its Midtown Sacramento location due to impacts from rising costs and declining business over the last two years.
Aaron Boone Gives Surprising Yankees Wild Card Rotation Update
The New York Yankees have a huge Wild Card series coming up against the Boston Red Sox for a chance to compete for the World Series. Aaron Boone has lucked out with a tremendous MLB pitching staff of superstars giving NY a viable chance in every series. However, a new quote from Boone claims that […] The post Aaron Boone Gives Surprising Yankees Wild Card Rotation Update appeared first on HEAVY.
Columbus City Schools teachers warn health insurance plan costs could double in 2027
Columbus City Schools teachers are warning that they could be in a financial crisis soon due to rising health insurance costs.They said their healthcare insura
Vikings Land Surprising New Weapon in 2027 Mock Draft
It’s never too early for a mock NFL draft, and a recent one from Sports Illustrated has the Minnesota Vikings selecting a running back. Gilberto Manzano has the Vikings selecting SEC star Kewan Lacy with the 29th overall selection. Age And Depth Hurting Vikings Running Back Room Depth at the position is important, and as […] The post Vikings Land Surprising New Weapon in 2027 Mock Draft appeared first on HEAVY.
Meta's New Holographic Avatars Are Here And They're Surprisingly Real
They're a notable improvement over the company's earlier attempts at digital likeness.
Wall Street ends down as oil prices, Treasury yields rise
Wall Street ended lower as oil prices surged nearly 4% and treasury yields hit multi-year highs amid escalating tensions with Iran and rising interest rate expectations.
Beacon Health System appears to have new round of layoffs, according to statement
Beacon Health said it is navigating significant financial pressures, lower reimbursement rates from insurance companies, and rising costs of providing care.
Giants' John Harbaugh shares surprisingly good Jaxson Dart injury news
Even though Jaxson Dart is out for the season, New York Giants head coach John Harbaugh has shared some positive news about Dart's future, and we're not even talking next season.
Hoda Kotb shares surprising way she disciplined her daughter after she ran off on her own
The former “Today” host is mother to Haley, 9, and Hope, 7.
Miami Business Club: Inside Miami's Rising Business Community
Miami Business Club hosts its inaugural Gala on October 10 at the Miami Beach Convention Center, benefiting Miami Waterkeeper.
Health Care Partnership outlines workforce progress
More local nursing graduates are staying in the region, according to officials offering an update on the progress of the New Hanover Healthcare Career Partnership at a public forum last night. According to Jack Watson, dean of UNCW’s College of Health & Human Services, the number of UNCW nursing graduates choosing to remain in the area after graduation has climbed from 27% to the mid-40% range. The New Hanover Healthcare Career Partnership aims to address the region’s healthcare worker shortage, with a key focus on nursing through strategic partnerships between UNCW, Cape Fear Community College (CFCC), New Hanover County Schools and the Wilmington Chamber of Commerce Foundation. "Each of the partners had pathway programs,” said Watson, “but they were almost at times done in a silo." One of the New Hanover Community Endowment's largest commitments to date, the collaborative received a $22.3 million grant in 2023, to be disbursed over three years, beginning in 2024. At the public forum, leadership addressed the nursing bottleneck created by the pandemic, and Laurie Whalin, president of the Novant Health Coastal Region, acknowledged that Novant Health had relied heavily on travel nurses during that period, with travel nurses making up about 47% of staff and nursing turnover at 35% at the height of the pandemic. "I can say we are in a tremendously different place today,” Whalin said at the forum. The number of travel nurses employed by the Novant Health Coastal Region has dropped to around 100 today, which Whalin says accounts for less than 4% of the workforce. Roughly two years into the grant term, major stakeholders in the collaboration pointed to various accomplishments tied to the initiative. According to Stephen Hill, vice president of talent development with the Greater Wilmington Chamber of Commerce, 250 more nurses live in New Hanover County in 2026 than in 2023. Whalin added that between 2021 and 2025, the Novant Health Coastal Region has hired close to 1,200 registered nurses. Additionally, according to Whalin, over the past two years, hiring and retention of nursing graduates from UNCW increased by 103%, while hiring and retention of nursing graduates from CFCC increased by 70%. Mandy Mills, director of career & technical education at New Hanover County Schools, pointed to the launch of its first Health Sciences Academy program, established across the county's four traditional high schools (Hoggard High School, Laney High School, Ashley High School and New Hanover High School), which started with 38 students last year. Mills also pointed to growth in the district’s Nursing Fundamentals course, which grew from 10 seats in 2023 to 50 in 2025-2026 and is now offered at all four traditional high schools. Watson emphasized the growing nursing class sizes and offered an update on the school’s accelerated nursing degree, which launched last year. Eleven students graduated in the first class, and all passed their boards on the first try, Watson said. This year’s class has 24 students. When the endowment announced its $22.3 million grant for the collaborative in 2023, UNCW and CFCC were each slated to receive the bulk of the funds, at about $10 million each. UNCW’s plans for the grant money included expanding its simulation lab, Watson said. He added that construction is expected to begin on the simulation lab this year and will likely extend through next year. According to Mary Ellen Naylor, dean of Health & Human Services at CFCC, the college has experienced growth in its associate degree nursing retention, rising from 59% in 2023 to 76% for the May 2026 class. CFCC used part of its endowment funding to support wraparound services, including a housing stipend, tuition assistance, exam assistance, emergency assistance, drop-in daycare and clinical and educational supplies. "We have very strong … students, but once they get into the program, there are competing priorities,” Naylor said. “They are working multiple jobs. They have children. They're single parents." According to Naylor, in 2026, 94% of students who used support services are still enrolled or have graduated. Addressing a question from an audience member about an approaching “enrollment cliff,” driven largely by dropping birth rates, Watson and Naylor said demand remains strong at both schools. “Right now … we do have more applicants than we have spots in our nursing program, and it is still a competitive process to get into,” Watson said. “I do not foresee that changing.” "(We've) doubled enrollment in our nursing programs over the last few years, but just as Dean Watson said, we still have very robust applicant pools, so it is still very competitive to get in,” Naylor said. "We have the applicant pool to support that, but again, it's not as easy as just saying, 'Okay … we're going to take another 90 students.' It's making sure all the resources and infrastructure that we need to educate the students outside the classroom is there as well." In response to a question about applying the collaborative model to other healthcare positions besides nursing, Sophie Dagenais, CEO and president of the endowment, said she sees the potential for the model to expand to other healthcare jobs and even other industries, but that the endowment hopes to learn from this model first. “This is a grant that is in year two of three years, and first we wanted to learn what is this going to demonstrate, what will we learn and then how may we scale it possibly,” she said. According to endowment spokesperson Amber Rogerson, funds for the program are set to expire after June 2027. “It's too early to discuss what happens after that,” wrote Rogerson in an email, “though we know the partners are considering the future, and some of the work supported by the grants is now built into their regular operations.”
Health Care Partnership outlines workforce progress
More local nursing graduates are staying in the region, according to officials offering an update on the progress of the New Hanover Healthcare Career Partnership at a public forum last night. According to Jack Watson, dean of UNCW’s College of Health & Human Services, the number of UNCW nursing graduates choosing to remain in the area after graduation has climbed from 27% to the mid-40% range. The New Hanover Healthcare Career Partnership aims to address the region’s healthcare worker shortage, with a key focus on nursing through strategic partnerships between UNCW, Cape Fear Community College (CFCC), New Hanover County Schools and the Wilmington Chamber of Commerce Foundation. "Each of the partners had pathway programs,” said Watson, “but they were almost at times done in a silo." One of the New Hanover Community Endowment's largest commitments to date, the collaborative received a $22.3 million grant in 2023, to be disbursed over three years, beginning in 2024. At the public forum, leadership addressed the nursing bottleneck created by the pandemic, and Laurie Whalin, president of the Novant Health Coastal Region, acknowledged that Novant Health had relied heavily on travel nurses during that period, with travel nurses making up about 47% of staff and nursing turnover at 35% at the height of the pandemic. "I can say we are in a tremendously different place today,” Whalin said at the forum. The number of travel nurses employed by the Novant Health Coastal Region has dropped to around 100 today, which Whalin says accounts for less than 4% of the workforce. Roughly two years into the grant term, major stakeholders in the collaboration pointed to various accomplishments tied to the initiative. According to Stephen Hill, vice president of talent development with the Greater Wilmington Chamber of Commerce, 250 more nurses live in New Hanover County in 2026 than in 2023. Whalin added that between 2021 and 2025, the Novant Health Coastal Region has hired close to 1,200 registered nurses. Additionally, according to Whalin, over the past two years, hiring and retention of nursing graduates from UNCW increased by 103%, while hiring and retention of nursing graduates from CFCC increased by 70%. Mandy Mills, director of career & technical education at New Hanover County Schools, pointed to the launch of its first Health Sciences Academy program, established across the county's four traditional high schools (Hoggard High School, Laney High School, Ashley High School and New Hanover High School), which started with 38 students last year. Mills also pointed to growth in the district’s Nursing Fundamentals course, which grew from 10 seats in 2023 to 50 in 2025-2026 and is now offered at all four traditional high schools. Watson emphasized the growing nursing class sizes and offered an update on the school’s accelerated nursing degree, which launched last year. Eleven students graduated in the first class, and all passed their boards on the first try, Watson said. This year’s class has 24 students. When the endowment announced its $22.3 million grant for the collaborative in 2023, UNCW and CFCC were each slated to receive the bulk of the funds, at about $10 million each. UNCW’s plans for the grant money included expanding its simulation lab, Watson said. He added that construction is expected to begin on the simulation lab this year and will likely extend through next year. According to Mary Ellen Naylor, dean of Health & Human Services at CFCC, the college has experienced growth in its associate degree nursing retention, rising from 59% in 2023 to 76% for the May 2026 class. CFCC used part of its endowment funding to support wraparound services, including a housing stipend, tuition assistance, exam assistance, emergency assistance, drop-in daycare and clinical and educational supplies. "We have very strong … students, but once they get into the program, there are competing priorities,” Naylor said. “They are working multiple jobs. They have children. They're single parents." According to Naylor, in 2026, 94% of students who used support services are still enrolled or have graduated. Addressing a question from an audience member about an approaching “enrollment cliff,” driven largely by dropping birth rates, Watson and Naylor said demand remains strong at both schools. “Right now … we do have more applicants than we have spots in our nursing program, and it is still a competitive process to get into,” Watson said. “I do not foresee that changing.” "(We've) doubled enrollment in our nursing programs over the last few years, but just as Dean Watson said, we still have very robust applicant pools, so it is still very competitive to get in,” Naylor said. "We have the applicant pool to support that, but again, it's not as easy as just saying, 'Okay … we're going to take another 90 students.' It's making sure all the resources and infrastructure that we need to educate the students outside the classroom is there as well." In response to a question about applying the collaborative model to other healthcare positions besides nursing, Sophie Dagenais, CEO and president of the endowment, said she sees the potential for the model to expand to other healthcare jobs and even other industries, but that the endowment hopes to learn from this model first. “This is a grant that is in year two of three years, and first we wanted to learn what is this going to demonstrate, what will we learn and then how may we scale it possibly,” she said. According to endowment spokesperson Amber Rogerson, funds for the program are set to expire after June 2027. “It's too early to discuss what happens after that,” wrote Rogerson in an email, “though we know the partners are considering the future, and some of the work supported by the grants is now built into their regular operations.”
Ravens Insider Delivers Final Verdict on Surprising Lamar Jackson Trend
The Baltimore Ravens are off to a mixed start to the 2026 season, but their starting quarterback, Lamar Jackson, has done plenty of good.Jackson has been throwing the ball more than the Ravens have seen from him in the past, and it seems to be working. When the running game struggled in their Week 2 […] The post Ravens Insider Delivers Final Verdict on Surprising Lamar Jackson Trend appeared first on HEAVY.
Playoff Countdown: New England Revolution, St. Louis CITY mean business
Most teams have eight games left. The end is nigh. Until then… Each week, we’ll look at four teams rising or falling in the standings, three players making an impact, and three storylines to watch. An Audi 2026 MLS Cup Playoffs race 4-3-3, if you will. Four teams we're monitoring
Rising diesel prices squeeze Tallahassee small businesses and county services
A gallon of diesel currently tops $6 in Tallahassee, squeezing small businesses and driving up costs for county public works and EMS.
Last call: Bellingham’s Rock and Rye Oyster House announces last day of business
Owners told The Herald the closure is due to rising rent costs, high labor costs, increasing utilities.
Alien sunsets, stone spiderwebs and mysterious doors: Curiosity's top 10 photos after 5,000 days on Mars
Curiosity has been photographing Mars in its search for evidence of water and life for over 5,000 Martian days. Here are 10 of the most surprising and weird photos the rover has sent back to Earth.
KFF/AP Survey Probes Rural Voters’ Increasing Anxieties About the Rising Cost of Living, Including Health Costs, Heading into the Midterm Elections
Rural voters’ frustrations about the cost of living in their community are growing and appear to be chipping away at Republicans’ enthusiasm to vote as the midterm elections near, a new KFF/AP Survey of Rural Voters finds.
How extreme heat can affect your mental health
Extreme heat does more than cause physical harm. Experts explain how rising temperatures impact mental health.
Rising Star Named Breakout Candidate for the San Antonio Spurs
The San Antonio Spurs made it all the way to the NBA Finals last season. If they’re going to take the next step and win the sixth championship in franchise history, one particular player is going to need to take a major step forward in the upcoming campaign. Dylan Harper Named Breakout Candidate for the […] The post Rising Star Named Breakout Candidate for the San Antonio Spurs appeared first on HEAVY.
Bear Up, Bear Down: Who helped, hurt stock vs. Vikings
Following their Week 2 loss to the Vikings, here are the Bears players whose stock is rising and falling.
Rising costs top concern at Ohio Farm Science Review
LONDON, Ohio — The high costs of diesel fuel, fertilizer, and health care are among the top concerns of farmers as the November election approaches, Ohio ...
Country star overthrows Mariah Carey’s record for longest-running No. 1 song in U.S. history
Carey previously held the title with her perennial Christmas smash “All I Want for Christmas Is You,” though a rising country act has now shattered the record.
PFF Report Cards: LSU vs Ole Miss
PFF grades are out for LSU vs Ole Miss and some of the grades are pretty surprising
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.
RSM US Middle Market Business Index Holds Near Recent Highs as Rising Profits and Business Investment Sustain Optimism
/PRNewswire/ -- The RSM US Middle Market Business Index (MMBI) remained near recent highs, registering at 111.8 for the third quarter, which is a statistically...
Homebuilding permits plunge in Charlotte metro as builders face infrastructure issues, rising land prices
Building permits in Charlotte dropped 17.7% through July as zoning and infrastructure challenges constrain homebuilder supply.
Workers should brace for biggest health insurance cost jump in decades
Small businesses warn rising healthcare costs could lead to higher premiums, reduced benefits, stalled wages and tougher choices for workers.
Everything You Know About Political Violence Is Probably Wrong
Public disagreement about whether political violence is rising and who is responsible for it stems not from ideology alone but from competing definitions about what should be counted.
Look up 100 top-paid employees at nonprofit health systems in the Philadelphia region in 2024
Employee pay and benefits typically account for more than half of health system expenses and have contributed to rising healthcare costs for employers and governments.
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
Letters: Disney isn’t only corporate offender | Donalds’ hollow tax claim | Data centers will harm society
Disney is making donations to political candidates who support Disney interests. Why is that surprising? This is what all corporations do.
GOP Money vs. $5 Gas: What Will Matter More in the Midterms?
GOP groups are spending big as rising gas prices fuel Republicans’ panic ahead of the midterms.
Jiang Feng: The Unravelling of German & European Politics
A state election in eastern Germany has become a revealing test of the changing political landscapes of Germany and Europe, writes Jiang Feng, Professor and Chairman of the Council of the Shanghai Academy of Global Governance and Area Studies (SAGGAS) at Shanghai International Studies University. His analysis follows the decisive victory of the Alternative for Germany (AfD) (which has been classified as right-wing extremist by German authorities)in the state of Saxony-Anhalt on 6 September, in which it finished far ahead of its mainstream rivals. Jiang previously served as Minister-Counsellor at the Chinese Embassy in Berlin. The following article was published on 8 September 2026 on huanqiu.com, the online platform of the Global Times. On 6 September, the results of the state election in Saxony-Anhalt, Germany, were announced. The Alternative for Germany (AfD), classified as far-right by German authorities, made history by becoming the largest party in the state parliament, winning 43.8 per cent of the vote — twice its share in the previous election. The Christian Democratic Union (CDU), which had governed the state continuously for 24 years, won just 17.2 per cent, its worst result ever in Saxony-Anhalt. On the night the results were announced, the atmosphere at the CDU gathering was unusually calm. There was neither shock nor argument, as if the defeat had long been expected. Several veteran party members who had spent years working in the state government said: “Defeat is not a bad thing. It is time to make changes.” This state election has not only upended Saxony-Anhalt’s political landscape, but also laid bare the deep tensions between Germany’s traditional party structure and model of governance, on the one hand, and an increasingly polarised society on the other. Its repercussions are already being felt at the federal level, making Saxony-Anhalt a useful case study of the broader trend towards political polarisation and realignment in Europe. Governing Difficulties after Electoral Victory The most immediate consequence of the election is a historic setback for the mainstream party order that took shape in post-war Germany. In Saxony-Anhalt, the AfD has leapt from a peripheral party to the largest political force in the state. Its electoral base has expanded beyond the traditional category of “marginal protest voters” to take on the characteristics of a cross-class coalition. The party has not only consolidated its support in rural areas, but also attracted many middle-class voters and even members of the social elite with stable jobs, their own homes, and substantial incomes. It has thus evolved from a “protest party” into one with the potential to govern. Despite its commanding lead in the vote, however, the AfD faces an institutional obstacle to governing the state: the mainstream parties’ long-standing “firewall” against it. Neither of the two potential routes to forming a government appears likely to break the current political deadlock. The first would be a coalition of establishment parties, led by the CDU and bringing together the Social Democratic Party (SPD), the Greens, the Left Party (Die Linke) and the Sahra Wagenknecht Alliance (BSW) in a cross-camp government. In terms of parliamentary arithmetic, such a coalition could prevent the AfD from forming a government and preserve the outward stability of the traditional political order. Yet these parties are fundamentally divided over key issues including immigration, the energy transition, economic management, and cultural and education policy. Coalition negotiations would therefore be extremely difficult, and even if a government could be formed, it would most likely prove short-lived. More importantly, an alliance of establishment parties aimed at keeping the largest party out of government would play directly into the AfD’s narrative that “political elites are suppressing public opinion”. It could deepen perceptions of political unfairness, further strengthening the AfD’s political capital, and creating a dynamic in which “the more it is suppressed, the more people vote for it”. Ulrich Siegmund, the AfD’s candidate for state premier, has said that if efforts to form a government fail because other parties refuse to cooperate, the AfD will push for a fresh election, which he believes could deliver the party an absolute majority of seats. This points to more intense political battles ahead. The second option would be a coalition between the AfD and the BSW. Together, the two parties would command a simple majority in parliament, making this, on paper, the quickest route to forming a government. The BSW is the only elected party that has not ruled out cooperation with the AfD, and the two parties share some common ground, including on policy towards Russia. There is therefore a degree of political basis for cooperation. Were such a coalition to materialise, Germany would see its first state government jointly formed by a party defined as far-right and one with a far-left background, creating what might be called a “bipolar anti-establishment alliance”. Such an outcome would fundamentally break with the ideological boundaries of post-war German party politics. It is worth noting that even if the AfD ultimately fails to enter the state government, its roughly 47 per cent share of parliamentary seats would give it a powerful blocking minority. Without its consent, major decisions requiring a two-thirds majority — including constitutional amendments, significant budgetary adjustments, and state-level institutional reforms — would be extremely difficult to pass. Therefore, whoever ultimately forms the government, the AfD will be an unavoidable force in Saxony-Anhalt politics, with a direct influence on the state’s legislative process. Systemic Failures in Germany’s Governance Model The Saxony-Anhalt election result reflects a systemic failure of Germany’s post-war mainstream-party model of governance to adapt to rapidly changing socioeconomic conditions. It stems from multiple, mutually reinforcing structural tensions and highlights the existing political system’s difficulty in adapting to “an increasingly polarised society First, collective anxiety has replaced individual material hardship as a central driver of political mobilisation. The rise of the AfD can no longer be explained simply by poverty or social marginalisation. Its increasingly cross-class electoral base suggests that what is driving voters towards the party is, above all, concern about the broader direction of society. This anxiety about the future of the political community goes beyond individual gains and losses. In political discourse, economic anxiety has become closely intertwined with immigration, while immigration and refugee issues are, in essence, questions of social fairness. This perception turns conflicts over the distribution of social resources into negative assessments of governing parties, providing a broad social basis for far-right political narratives. Second, regional disparities and East German identity have undermined the strategy of addressing eastern Germany’s structural challenges at the regional level. More than three decades after German reunification, eastern states such as Saxony-Anhalt have experienced periods of economic growth, but their underlying economic structures remain weak, and household incomes and wealth remain significantly below those in western Germany. At the same time, they continue to face population outflow, an ageing population, labour shortages, and other structural challenges. At a deeper level, historical experiences — including the collapse of the former East German economic system, mass unemployment during the transition, and the westward shift of decision-making power over major issues — have left some residents with a sense of being “second-class citizens” and of being excluded. For years, the German government treated the “syndrome” of reunification as a regional problem to be gradually addressed at the local level. That approach is becoming increasingly unsustainable, as regional development disparities emerge as a core structural factor shaping national politics. Third, the erosion of institutional trust is perhaps the most decisive factor. AfD supporters tend to distrust establishment institutions, including parliament, government, and the mainstream media. Their concerns about economic security, pensions, and social fairness are significantly greater than the social average. Increasingly, their support for the AfD reflects not an expectation that the existing system can be improved, but a search for an alternative to the current political order. Such a systemic deficit of trust will be extremely difficult for the traditional parties to repair in the short term. Fourth, a generational shift in political mobilisation has amplified political polarisation. Unlike traditional parties, which rely heavily on offline rallies and mainstream media coverage, the AfD has developed a social-media mobilisation strategy built around “raising an issue — identifying who is responsible — offering a simplified solution — building a shared identity”. It turns complex social tensions into concise political narratives, rapidly channelling public sentiment into political support. The contrast on the eve of the election was particularly telling. The establishment parties, together with trade unions and churches, organised an offline march attended by more than 10,000 people, but its reach was largely confined to those present and to traditional media coverage. The AfD held a much smaller indoor event, yet livestreaming on TikTok, YouTube, and other platforms, combined with the involvement of online influencers, gave it a reach and mobilising capacity far beyond that of the march. The contrast illustrates how the traditional parties’ methods of political mobilisation are increasingly struggling to keep pace with a political environment transformed by changes in media technology. A Microcosm of Structural Political Change in Europe The shockwaves from the Saxony-Anhalt election quickly travelled beyond the state to the federal level. Calls for political accountability followed immediately after the results were announced. The governing CDU and SPD are now under enormous pressure, while Chancellor Friedrich Merz and Vice Chancellor Lars Klingbeil face an unprecedented test. Political polarisation in Germany is no longer simply a regional phenomenon. The post-war model of multiparty government by establishment parties is breaking down and being reshaped. Viewed in a broader European context, the Saxony-Anhalt election is part of a continent-wide wave of party polarisation, mainstream-party decline, and rising right-wing forces. Far from an isolated phenomenon, it is a microcosm of the structural political changes unfolding across Europe. Weak economic growth, cultural tensions over immigration, and declining trust in institutions are fuelling the rise of right-wing forces in several countries, challenging the liberal internationalist order established in post-war Europe. As a core member state of the European Union, Germany’s ability to adapt its political system and the direction of its politics will have profound implications for both European integration and the evolution of the international order. Subscribe [ Pekingnology China’s Germany watchers take stock of Berlin’s uneasy turn On 7 December 2025, nearly 50 Chinese scholars and policy researchers gathered in Beijing for the 2025年德国形势年终研讨会 “2025 Year-End Seminar on the Situation in Germany… Read more 9 months ago · 31 likes · 1 comment · YIRUI LI and Yuxuan JIA ](https://www.pekingnology.com/p/chinas-germany-watchers-take-stock?utm_source=substack&utm_campaign=post_embed&utm_medium=web&embedding_publication_id=1151841) [ Jiang Feng on Germany's 2025 and beyond: no easy exit ](https://www.eastisread.com/p/jiang-feng-on-germanys-2025-and-beyond) Yirui LI and Yuxuan JIA · Jan 24 The following is an op-ed by Jiang Feng, published on 29 December 2025 at Shanghai Observer 上观新闻, the digital platform of Jiefang Daily, the official newspaper of the Shanghai Municipal Committee of the Communist Party of China (CPC). [ Read full story ](https://www.eastisread.com/p/jiang-feng-on-germanys-2025-and-beyond)
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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. 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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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. 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