Earth is exceeding its “safe operating space for humanity” in six of nine key measurements of its health, and two of the remaining three are headed in the wrong direction, a new study said.

Earth’s climate, biodiversity, land, freshwater, nutrient pollution and “novel” chemicals (human-made compounds like microplastics and nuclear waste) are all out of whack, a group of international scientists said in Wednesday’s journal Science Advances. Only the acidity of the oceans, the health of the air and the ozone layer are within the boundaries considered safe, and both ocean and air pollution are heading in the wrong direction, the study said.

“We are in very bad shape,” said study co-author Johan Rockstrom, director of the Potsdam Institute for Climate Impact Research in Germany. “We show in this analysis that the planet is losing resilience and the patient is sick.”

In 2009, Rockstrom and other researchers created nine different broad boundary areas and used scientific measurements to judge Earth’s health as a whole. Wednesday’s paper was an update from 2015 and it added a sixth factor to the unsafe category. Water went from barely safe to the out-of-bounds category because of worsening river run-off and better measurements and understanding of the problem, Rockstrom said.

These boundaries “determine the fate of the planet,” said Rockstrom, a climate scientist. The nine factors have been “scientifically well established” by numerous outside studies, he said.

If Earth can manage these nine factors, Earth could be relatively safe. But it’s not, he said.

In most of the cases, the team uses other peer-reviewed science to create measurable thresholds for a safety boundary. For example, they use 350 parts per million of carbon dioxide in the air, instead of the Paris climate agreement’s 1.5 degrees (2.7 degrees Fahrenheit) of warming since pre-industrial times. This year carbon in the air peaked at 424 parts per million.

The nine factors are intermingled. When the team used computer simulations, they found that making one factor worse, like the climate or biodiversity, made other Earth environmental issues degrade, while fixing one helped others. Rockstrom said this was like a simulated stress test for the planet.

The simulations showed “that one of the most powerful means that humanity has at its disposal to combat climate change” is cleaning up its land and saving forests, the study said. Returning forests to late 20th century levels would provide substantial natural sinks to store carbon dioxide instead of the air, where it traps heat, the study said.

Biodiversity – the amount and different types of species of life – is in some of the most troubling shape and it doesn’t get as much attention as other issues, like climate change, Rockstrom said.

“Biodiversity is fundamental to keeping the carbon cycle and the water cycle intact,” Rockstrom said. “The biggest headache we have today is the climate crisis and biodiversity crisis.”

University of Michigan environmental studies dean Jonathan Overpeck, who wasn’t part of the study, called the study “deeply troubling in its implications for the planet and people should be worried.”

“The analysis is balanced in that it clearly sounds a flashing red alarm, but it is not overly alarmist,” Overpeck said. “Importantly, there is hope.”

The fact that ozone layer is the sole improving factor shows that when the world and its leaders decide to recognize and act on a problem, it can be fixed and “for the most part there are things that we know how to do” to improve the remaining problems, said Carnegie Mellon chemistry and environment professor Neil Donahue.

Some biodiversity scientists, such as Duke’s Stuart Pimm, have long disputed Rockstrom’s methods and measurements, saying it makes the results not worth much.

But Carnegie Mellon environmental engineering professor Granger Morgan, who wasn’t part of the study, said, “Experts don’t agree on exactly where the limits are, or how much the planet’s different systems may interact, but we are getting dangerously close.”

“I’ve often said if we don’t quickly cut back on how we are stressing the Earth, we’re toast,” Morgan said in an email. “This paper says it’s more likely that we’re burnt toast.”

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A multidisciplinary research team composed of scientists from University of Miami and Columbia University Mailman School of Public Health will explore the links between oral and mental health in women with HIV. The collaborative study, supported by a $2.15 million five-year grant from the National Institutes of Health, is designed to provide insights that could improve overall health and quality of life for the estimated 300,000 women living with HIV in the United States.

“Interdisciplinary research will help us to understand the bidirectional relationship between mental and oral health, and the overall impact on women living with HIV,” said Carrigan Parish, DMD, PhD, assistant professor of sociomedical sciences at Columbia Mailman School of Public Health and a UM Miller School-trained epidemiologist.

As a special needs dentist, Parish specializes in access to oral health care for medically compromised and underserved individuals, including those who are HIV-positive. “By identifying critical factors in that interactive relationship, we can develop mental and oral health interventions that can benefit women over the lifespan, including during pregnancy and as they experience menopause,” she said.

Parish is one of four principal investigators in “The CROWN study: Comprehensive Research on Oral and Mental Health among WomeN,” conducted by Columbia Public Health and the Miller School of Medicine at Miami in collaboration with the University of North Carolina. The other principal investigators are Deborah Jones Weiss, PhD, professor of psychiatry and behavioral sciences and co-director of the Center for HIV and Research in Mental Health, both at Miami Miller School; Maria Alcaide, MD, professor of infectious diseases/medicine and director of clinical research at the Miami Center for AIDS Research (CFAR) clinical core; and Daniel Feaster, PhD, professor of biostatistics in the University of Miami Department of Public Health Sciences.

“This will be the first study to address the relationship between HIV, oral health and mental health over a woman’s lifespan,” said Weiss. “It is also important because poor oral health may be linked to higher risks of infections, heart disease and other problems. For example, the American Heart Association has reported that inflammation in the gums has been associated with poor heart health.”

Mental health challenges, such as depression and anxiety, are higher in women living with HIV, according to Dr. Parish and colleagues. Those issues, combined with the stresses of managing their chronic disease as well as their personal and work relationships, keep many women from seeking preventive dental treatments.

Oral health problems and unmet dental needs are common in women living with HIV, note the researchers. For instance, antiretroviral therapy (ART) can decrease salivary flow, which hinders chewing and swallowing and increases the risk of dental cavities.

“Many women also experience periodontal issues during times of change, such as pregnancy, menopause and aging,” Dr. Parish said. “By looking at women across the lifespan, we hope to gain a better understanding of the impact of those changes on mental health.”

The team of researchers will leverage data from two prior studies: STAR (Study of Treatment and Reproductive outcomes) in women of reproductive age, and MWCCS (MACS/WIHS Combined Cohort Study) in women living with HIV and at risk of HIV. These are the largest cohort studies of women living with HIV, and they address the effect of HIV on health outcomes among young (STAR) and older (MWCCS) women in the U.S.

After reviewing the data, the team will recruit 400 women (200 in Miami and 200 in North Carolina) from the Southern states in both rural and urban communities, a region home to a highly diverse population of women who face some of the greatest health disparities in the nation.

Once the women have been recruited for the study, they will be given dental assessments, including their periodontal health, plaque, cavities and other oral conditions, said Parish. As part of their initial assessment, participants will fill out questionnaires regarding dental utilization, and if their oral health is impacting their lives, such as causing difficulties in smiling, speaking or eating with others in social situations. The questionnaires will also cover mental and behavioral health issues, such as depression or anxiety.

Any women identified as having oral health issues will be referred to their dentist or to the Lindsey Hopkins Community Smiles dental clinic in Miami for care. 

Participants will return in a year for follow-up assessments and questionnaires to assess any changes in oral or mental health, as well as quality of life. “We expect the results of our research will not only provide a foundation for programs targeting oral and mental health care but shine a light on the many health disparities facing women living with HIV,” said Weiss.

“In essence, the study provides a unique opportunity to isolate the true relationships between HIV, oral health and mental health because of the existence of the comprehensive historical data on these women we now have at our fingertips,” said Feaster.

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Researchers have found long-term evidence that actively monitoring localized prostate cancer is a safe alternative to immediate surgery or radiation.

The results, released Saturday, are encouraging for men who want to avoid treatment-related sexual and incontinence problems, said Dr. Stacy Loeb, a prostate cancer specialist at NYU Langone Health who was not involved in the research.

The study directly compared the three approaches — surgery to remove tumors, radiation treatment and monitoring. Most prostate cancer grows slowly, so it takes many years to look at the disease’s outcomes.

“There was no difference in prostate cancer mortality at 15 years between the groups,” Loeb said. And prostate cancer survival for all three groups was high — 97% regardless of treatment approach. “That’s also very good news.”

The results were published Saturday in the New England Journal of Medicine and presented at a European Association of Urology conference in Milan, Italy. Britain’s National Institute for Health and Care Research paid for the research.

Men diagnosed with localized prostate cancer shouldn’t panic or rush treatment decisions, said lead author Dr. Freddie Hamdy of the University of Oxford. Instead, they should “consider carefully the possible benefits and harms caused by the treatment options.”

A small number of men with high-risk or more advanced disease do need urgent treatments, he added.

Researchers followed more than 1,600 U.K. men who agreed to be randomly assigned to get surgery, radiation or active monitoring. The patients’ cancer was confined to the prostate, a walnut-sized gland that’s part of the reproductive system. Men in the monitoring group had regular blood tests and some went on to have surgery or radiation.

Death from prostate cancer occurred in 3.1% of the active-monitoring group, 2.2% in the surgery group, and 2.9% in the radiation group, differences considered statistically insignificant.

At 15 years, cancer had spread in 9.4% of the active-monitoring group, 4.7% of the surgery group and 5% of the radiation group. The study was started in 1999, and experts said today’s monitoring practices are better, with MRI imaging and gene tests guiding decisions.

“We have more ways now to help catch that the disease is progressing before it spreads,” Loeb said. In the U.S., about 60% of low-risk patients choose monitoring, now called active surveillance.

Hamdy said the researchers had seen the difference in cancer spread at 10 years and expected it to make a difference in survival at 15 years, “but it did not.” He said spread alone doesn’t predict prostate cancer death.

“This is a new and interesting finding, useful for men when they make decisions about treatments,” he said.

___

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

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The research findings appear in the peer-reviewed journal eClinicalMedicine, part of The Lancet Discovery Science suite of open-access journals.

Previous studies on individual pollutants have suggested adverse effects on bone mineral density, osteoporosis risk, and fractures in older individuals. The new study is the first to explore the connection between air pollution and bone mineral density specifically in postmenopausal women, and the first to explore the effects of air pollution mixtures on bone outcomes.

The researchers analyzed data collected through the Women’s Health Initiative study, an ethnically diverse cohort of 161,808 postmenopausal women. They estimated air pollution (PM10, NO, NO2, and SO2) exposures based on participants’ home addresses. They measured bone mineral density (BMD; whole-body, total hip, femoral neck, and lumbar spine) at enrollment at follow-up at year one, year three, and year six using dual-energy X-ray absorptiometry.

The magnitude of the effects of nitrogen oxides on lumbar spine BMD would amount to 1.22 percent annual reductions—nearly double the annual effects of age on any of the anatomical sites evaluated. These effects are believed to happen through bone cell death by way of oxidative damage and other mechanisms.

“Our findings confirm that poor air quality may be a risk factor for bone loss, independent of socioeconomic or demographic factors. For the first time, we have evidence that nitrogen oxides, in particular, are a major contributor to bone damage and that the lumbar spine is one of the most susceptible sites of this damage,” says study first author Diddier Prada, MD, PhD, associate research scientist in the Department of Environmental Health Sciences at Columbia Mailman School of Public Health.

“Improvements in air pollution exposure, particularly nitrogen oxides, will reduce bone damage in postmenopausal women, prevent bone fractures, and reduce the health cost burden associated with osteoporosis among postmenopausal women. Further efforts should focus on detecting those at higher risk of air pollution-related bone damage,” says lead author Andrea Baccarelli, MD, PhD, chair of the Department of Environmental Health Sciences at Columbia Mailman School of Public Health.

Car and truck exhaust is a major source of nitrous oxides, as are the emissions from electrical power generation plants.

Approximately 2.1 million osteoporosis-related bone fractures occur annually, resulting in up to $20.3 billion in annual direct health costs. Osteoporosis impacts women more than men, with 80 percent of the estimated 10 million Americans with osteoporosis being women. Postmenopausal women are at higher risk, with one in two women over 50 experiencing a bone fracture because of osteoporosis.

Previously, Columbia researchers showed that long-term air pollution exposure reduces BMD and increases bone fracture risk in later life. Subsequently, these findings have been confirmed in multiple human studies.

Study co-authors include Carolyn J. Crandall at UCLA; Allison Kupsco, Marianthi-Anna Kioumourtzoglou, Yike Shen, Gary Miller, Iuliana Ionita-Laza at Columbia Mailman; James D. Stewart, Eric A. Whitsel at UNC Chapel Hill; Duanping Liao and Jeff D. Yanosky at Public Health Sciences, Hershey, PA; Andrea Ramirez at National Autonomous University of Mexico; and Jean Wactawski-Wende at SUNY Buffalo.

The research was supported by grants from the National Institutes of Health (ES030163, TR00187, ES020836, ES025225, ES009089, AG069120, ES032242, ES027747, ES031688, AG058704, ES028805, ES030616, ES029943).

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A 2010 federal law that boosted nutrition standards for school meals may have begun to help slow the rise in obesity among America’s children — even teenagers who can buy their own snacks, a new study showed.

The national study found a small but significant decline in the average body mass index of more than 14,000 schoolkids ages 5 to 18 whose heights and weights were tracked before and after implementation of the Healthy, Hunger-Free Kids Act of 2010.

The study is new evidence that improving the quality of school meals through legislation might be one way to help shift the trajectory of childhood obesity, which has been rising for decades and now affects about 1 in 5 U.S. kids. Whether the program has begun to turn the tide for the whole country, and not just the groups of kids studied, is still unclear. About 30 million children in the U.S. receive school lunches each day.

“You have the potential to really impact their excess weight gain over the course of their entire childhood,” said Dr. Aruna Chandran, a social epidemiologist with the Johns Hopkins Bloomberg School of Public Health. She led the study published Monday in the journal JAMA Pediatrics.

The Healthy, Hunger-Free Kids Act of 2010, championed by former first lady Michelle Obama, was the first national legislation to improve school meals in more than 20 years. It increased the quantity of fruits, vegetables and whole grains required in school meals.

The new study analyzed nationwide data from 50 cohorts of schoolchildren from January 2005 to August 2016, before the law took effect, and data from September 2016 to March 2020, after it was fully implemented. Researchers calculated kids’ body-mass index, a weight-to-height ratio.

It found that a body mass index for children, adjusted for age and gender, fell by 0.041 units per year, compared to before the law took effect. That amounts to about a quarter of one BMI unit per year, Chandran said. There was a slight decline in kids who were overweight or obese, too, the study showed.

One way to think of the change is that for a 10-year-old boy with an elevated body-mass index, the decline would amount to a 1-pound weight loss, noted Dr. Lauren Fiechtner, director of nutrition at MassGeneral Hospital for Children in Boston, who wrote an editorial accompanying the study.

“This is important as even BMI flattening over time is likely important,” she said. Holding kids’ weight steady as they grow can help keep obesity in check.

Previous studies have shown weight-related effects of the federal law among children from low-income families. The new study is the first to find lower BMI in kids across all income levels.

At the same time, significant decreases in BMI measures were seen not only in kids ages 5 to 11, but also in those age 12 to 18.

“That’s an incredible shift,” Chandran said. “These are kids who potentially have their own autonomy to buy their own snacks.”

The new results come within days of the release of updated standards for school meals, including the first limits on added sugars, decreased sodium and increased flexibility for whole grains. Agriculture Secretary Tom Vilsack said the study shows that healthy school meals are “critical for tackling diet-related conditions like obesity.”

But some researchers cautioned against interpreting the study’s findings too broadly. Some of the children included in the study might not have been enrolled in school meals programs, or their district may not have fully implemented the nutrition requirements, said Kendrin Sonneville, associate professor of nutritional sciences at the University of Michigan School of Public Health.

Significantly, measures like BMI, even when adjusted for children, “should not be used as a proxy for health,” she added.

A slight reduction in those measures, she said, “doesn’t tell us whether the health, well-being, concerns related to food security of children participating in the school breakfast or lunch program improved.”

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A new analysis led by researchers with the University of California has found the 2020 wildfires in the state, the most disastrous wildfire year on record, put twice as much greenhouse gas emissions into the Earth’s atmosphere as the total reduction in such pollutants in California between 2003–2019. “Wildfires in California have become a major and growing source of GHG emissions,” said Dr. Michael Jerrett, UCLA Fielding School of Public Health professor of environmental health sciences and a lead author of the research. “Wildfire emissions in 2020 essentially negate 18 years of reductions in greenhouse gas emission.” The research—”Up in smoke: California’s greenhouse gas reductions could be wiped out by 2020 wildfires”—is published in the October edition of the journal Environmental Pollution.

Jerrett’s co-authors, who include researchers from UCLA and the University of Chicago, found California’s wildfire carbon dioxide equivalent, or CO2e, emissions from the 2020 blazes are approximately two times higher than California’s total greenhouse gas (GHG) emission reductions since 2003. “To the great credit of California’s policy-makers and residents, from 2003 to 2019, California’s GHG emissions declined by 65 million metric tons of pollutants, a 13% drop that was largely driven by reductions from the electric power generation sector,” said Jerrett, who also serves as co-director of the UCLA Center for Healthy Climate Solutions (C-Solutions), a research center focused on protecting people and communities from the effects of climate change.

“Essentially, the positive impact of all that hard work over almost two decades is at risk of being swept aside by the smoke produced in a single year of record-breaking wildfires.” Over the long to very long term, regrowth of vegetation in burned areas could alleviate some of the emissions, but will not occur quickly enough to avert highly dangerous levels of increased pollutions, temperatures, and climate change, the researchers said. “To put this into perspective, without considering future vegetation regrowth, emissions from the 2020 wildfires could be the second most important source of GHG emissions in the state of California; above either industry or electrical power generation,” said Dr. Miriam Marlier, a UCLA Fielding School professor and co-author. “It’s worth noting that many of the worst fire years in California’s history have occurred in the past 20 years, with eighteen of the top 20 most destructive fires—in terms of loss of life and property—since 2000, and five in 2020 alone.”

The researchers also examined the financial costs of the wildfire-derived air pollution; based on different criteria, the carbon emissions-only damages for California alone are approximately $98.7 million; for the United States, some $986.9 million; and globally, as much as $7 billion. “These are estimates, of course, but they represent a currently unquantified aspect of damages due to fires that are incurred globally, in the U.S., and in California itself,” said Dr. Amir Jina, an assistant professor at the University of Chicago’s Harris School of Public Policy and a co-author of the research. “These damages should be counted in addition to fire control costs, damages to health from air pollution, and direct loss of life and property.” Historically, California’s summer wildfire burned area increased eightfold from 1972 to 2018, and statewide climate change projections suggest increased wildfire risk due to higher temperatures and drier conditions.

Climate change exacerbates fire risks already stoked by increasing development near the wildland-urban interface (WUI), as well as decades of fire suppression and underinvestment in preventive measures, including mechanical clearing or prescribed burns. Wildfires, in turn, release GHG emissions that can contribute to climate change. “Although wildfires are a natural feature of many ecosystems in California, the increase in severe and frequent wildfire events has raised the possibility of transformed post-fire ecosystems,” Marlier said.

“Even if long-term regrowth occurs, however, the carbon emissions occurring in the next 15–20 years will make it difficult to reach emission reduction targets needed to avert the increases in mean global temperature advocated by the Intergovernmental Panel on Climate Change, or IPCC.” The challenges of understanding these very complex system, and finding policy options that can help find solutions, is at the core of the research, Jerrett said. “Wildfire emissions have not received nearly the same level of investment or attention as GHG emissions from other sectors,” he said. “Although wildfires are to some extent natural occurrences, human activity contributes to making wildfires ‘unnatural disasters’ through man-made climate change and development at the WUI in fire prone areas—and every Californian can understand the potential costs.”

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Shares of Biogen and other drugmakers researching Alzheimer’s disease soared Wednesday after Japan’s Eisai Co. said its potential treatment appeared to slow the fatal disease in a late-stage study.

The drugmaker said early results showed that its treatment, lecanemab, reduced patient clinical decline by 27% when compared to a placebo or fake drug after 18 months of the infused treatment.

Eisai announced results late Tuesday from a global study of nearly 1,800 people with early-stage Alzheimer’s.

Patients were monitored using a scale that measures mental decline and their ability to do daily activities like getting dressed or feeding oneself.

Eisai Co. Ltd. said it would discuss full results from the research at a conference in late November. It also plans to publish findings in a peer-reviewed medical journal.

The company is already seeking an accelerated approval from the U.S. Food and Drug Administration, and the agency is expected to decide by early next year. Eisai and Biogen will co-promote the drug.

Researchers typically urge caution in evaluating a study until the full results are released. But the initial findings appear to be “quite robust” and will likely support regulatory approval, Mizuho Securities analyst Graig Suvannavejh said in a research note.

A statement from the Alzheimer’s Association called the findings the most encouraging to date for potential treatments of the underlying disease causes.

Some 6 million people in the U.S. and many more worldwide have Alzheimer’s, which gradually attacks areas of the brain needed for memory, reasoning, communication and basic daily tasks.

Alzheimer’s has no known cure. Long-standing treatments on the market just manage symptoms, and researchers don’t fully understand what causes the disease.

Last year, Biogen’s Aduhelm became the first new Alzheimer’s drug introduced in nearly two decades. But it has largely flopped after debuting with a price tag of $56,000 annually, which Biogen later slashed.

Doctors have been hesitant to prescribe it, given weak evidence that the drug slows the progression of Alzheimer’s. Insurers have blocked or restricted coverage due to concerns over the drug’s high price tag and uncertain benefit.

Earlier this year, the federal Medicare program imposed strict limits on who can get the drug, wiping out most of its potential U.S. market. Biogen announced afterward that it would stop most of its spending on the treatment.

Like Aduhelm, lecanemab, which Eisai developed, aims to clear a protein called beta-amyloid from the brain.

The protein forms a plaque that researchers believe is a contributor to Alzheimer’s. They also point to other potential factors like family history and chronic conditions such as diabetes.

Eisai executives say lecanemab focuses more on floating clumps of the protein before it forms the plaque, which is what Aduhelm targets.

Eli Lilly and Co. also is developing a potential treatment, donanemab, that targets the protein.

Shares of Cambridge, Massachusetts-based Biogen Inc. jumped 40% to close Wednesday at $276.61. The stock had largely tumbled since Aduhelm’s debut last year.

Shares of Indianapolis-based Eli Lilly and Co. rose 7.5%.

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DETROIT (AP) — Nearly 43,000 people were killed on U.S. roads last year, the highest number in 16 years as Americans returned to the roads after the coronavirus pandemic forced many to stay at home.

The 10.5% jump over 2020 numbers was the largest percentage increase since the National Highway Traffic Safety Administration began its fatality data collection system in 1975. Exacerbating the problem was a persistence of risky driving behaviors during the pandemic, such as speeding and less frequent use of seat belts, as people began to venture out more in 2021 for out-of-state and other road trips, analysts said.

Transportation Secretary Pete Buttigieg said America faces a crisis on its roads. The safety administration urged state and local governments, drivers and safety advocates to join in an effort to reverse the rising death trend.

“Our nation has taken a dangerous and deadly step backwards in traffic safety and impaired driving,” said MADD National President Alex Otte, who urged strong public-private efforts akin to the seat belt and air bag public safety campaigns of the 1990s to stem reckless driving. “More families and more communities are feeling the crushing magnitude of this crisis on our roads.”

Preliminary figures released Tuesday by the agency show that 42,915 people died in traffic crashes last year, up from 38,824 in 2020. Final figures will be released in the fall.

Forty-four states as well as the District of Columbia and Puerto Rico had increases in traffic deaths in 2021 compared to the previous year, led by Texas, California and Florida. Posting declines were Wyoming, Nebraska, Wisconsin, Maryland and Maine. Rhode Island’s figures were unchanged.

Americans drove about 325 billion more miles last year, 11.2% higher than in 2020, which contributed to the increase.

Nearly 118 people died in U.S. traffic crashes every day last year, according to the agency’s figures. The Governors Highway Safety Association, a group of state traffic safety officials, blamed the increase on dangerous behavior such as speeding, driving while impaired by alcohol and drugs, and distracted driving, as well as “roads designed for speed instead of safety.”

The combination, the group said, “has wiped out a decade and a half of progress in reducing traffic crashes, injuries and deaths.”

Deaths last year increased in almost all types of crashes, NHTSA reported. Crashes occurring during out of state travel jumped 15%, compared to 2020, many of them on rural interstate roads or access roads off city highways. Fatalities in urban areas and deaths in multi-vehicle crashes each rose 16%. Pedestrian deaths were up 13%.

By age, fatalities among drivers 65 and older rose 14%, reversing a declining trend seen among them in 2020. Deaths also surged among middle-aged drivers, led by those 35-to-44, which rose 15%. Kids under age 16 saw traffic fatalities increase 6%.

By vehicle, fatalities involving at least one big truck were up 13%, while motorcycle deaths were up 9% and deaths of bicyclists rose 5%. Fatalities involving speeding drivers and deaths in alcohol-related crashes each were up 5%.

Government estimates show the rate of road deaths declined slightly from 2020. Last year there were 1.33 deaths per 100 million vehicle miles traveled, compared with 1.34 in 2020. The fatality rate rose in the first quarter of last year, but declined the rest of the year, NHTSA said.

Traffic deaths began to spike in 2020. NHTSA has blamed reckless driving behavior for increases during the pandemic, citing behavioral research showing that speeding and traveling without a seat belt have been higher. Before 2020, the number of fatalities had fallen for three straight years.

Deputy NHTSA Administrator Steven Cliff, the Biden administration’s nominee to run the agency, said the roadway crisis is urgent and preventable. “We will redouble our safety efforts, and we need everyone — state and local governments, safety advocates, automakers and drivers, to join us,” Cliff said in a statement. “All of our lives depend on it.”

Buttigieg pointed to a national strategy unveiled earlier this year aimed at reversing the trend. He said earlier that over the next two years his department will provide federal guidance as well as billions in grants under President Joe Biden’s new infrastructure law to spur states and localities to lower speed limits and embrace safer road design such as dedicated bike and bus lanes, better lighting and crosswalks. The strategy also urges the use of speed cameras, which the department says could provide more equitable enforcement than police traffic stops.

In Tuesday’s statement, the department said it opened up its first round of applications for the program, which will spend up to $6 billion over five years on local efforts to cut crashes and deaths.

The Transportation Department is moving in the right direction to stem the increase in deaths, but it will take years for many of the steps to work, said Michael Brooks, acting executive director of the nonprofit Center for Auto Safety.

NHTSA, for instance, has regulations pending to require electronic automatic emergency braking and pedestrian detection systems on all new light vehicles, and to require automatic emergency braking on heavy trucks, he said. Automatic emergency braking can slow or stop a vehicle if there’s an object in its path.

The agency also is requiring automakers to install systems that alert rear-seat passengers if their safety belts aren’t buckled.

“Responding to this is difficult,” Brooks said. “It takes a lot of work on a lot of different strategies to address these issues. They’ve got a lot of work on their hands.”

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The study was led by researchers at Columbia University Mailman School of Public Health. The findings are published in the Journal of Migration and Health.

The researchers conducted confidential interviews with 46 immigrant adolescent youth who had migrated overland from Latin America to the U.S through the U.S. Southern border as unaccompanied minors and had resettled in New York City,  where they were living in a variety of living arrangements: with parents,  with other family members (but not parents), or without any family members. They were recruited to the CAMINANDO study through three NYC community-based organizations offering services to migrant teens. All youth had been exposed to violence and came to the U.S. from households with limited financial resources.

Across the three resettlement household types, youth expressed desire to find better opportunities in the U.S. and highlighted the importance of finding support from adults—and for the group of youth who attend school—having supportive teachers and counselors. All groups experienced similar levels of life satisfaction.

Youth living with parents said they could rely on their parents to cover their basic needs and provide advice that empowered them to focus on their goals and to cope with daily hassles, possibly enhancing their outlook on life. On the other hand, these youth were more likely to experience a problematic level of perceived stress—potentially due to the challenges of readjusting to new family dynamics after separation. This group expressed greater interest in pursuing higher education, potentially influenced by a younger age of entry into the U.S. education system, their parents’ having migrated before them, and the higher prevalence of females in the group (generally, females express more interest in higher education than males).

Youth living with siblings or other relatives saw them as parental figures and seemed to benefit from these relationships through material support and in navigating the challenges of a new country, establishing friendships through their siblings and other relatives, and coping with the loss of what they left behind. Compared to other groups, this group was more likely to have good friends and lower perceived stress.

Youth living without family were less likely to express positive affect, had less resilience, and needed to expend greater efforts to mobilize social supports compared to those living with family members. Youth who left their family behind and did not live with relatives in the U.S. were more likely to express feeling lonely, in part because they lacked a caretaker. They relied on support from other youth like them and sometimes from older immigrant co-workers. Youth living in shelters or communal living found support from staff and counselors.

Manuela Orjuela-Grimm, MD, study first author and assistant professor of epidemiology (and pediatrics) at Columbia Mailman School: “The lives of unaccompanied minor migrants living in the U.S. doesn’t fit a single mold. Their emotional health and resilience are shaped by their US living arrangements, especially by the presence of parents and other family members who provide social support. Our study is unique in its ability to interview youth not living with parents, and especially to be able to include the voices of youth who are not in school, as these groups have been excluded from prior studies on migrant youth. Understanding the impact of living arrangements can guide the development of programs and resources to better meet their needs and support their healthy development.” 

Study co-authors include Silvia Bhatt-Carreño, Maria Castro, Hector Pinilla, Daniela Rodriguez, Ambar Ruiz, Michelle Valentin, Arielle Richey Levine, Rossmary Gonzaleza, Marisa Zuleta, Marisa Pharel, and Paola Medina, in the Migration and Nutrition Epidemiology (MaNE) group at Columbia Mailman; Alexandra Restrepo Henao at Columbia Mailman and the Universidad de Antioquia in Colombia;  Maria Marti Castaner at the Danish Research Center for Migration, Ethnicity, and Health, University of Copenhagen; and Roberto Lewis-Fernández at New York State Psychiatric Institute.

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Funding for the study was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (grant P2CHD058486), awarded to the Columbia Population Research Center, Columbia University Global Mental Health Council Grant 2019-02, the Institute of Latin American Studies (ILAS) at Columbia University, and the Oak Foundation. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or other funders.

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NEW YORK (AP) — Most U.S. gun owners say they own firearms to protect themselves and their loved ones, surveys show. But a study published Monday suggests people who live with handgun owners are shot to death at a higher rate than those who don’t have such weapons at home.

“We found zero evidence of any kind of protective effects” from living in a home with a handgun, said David Studdert, a Stanford University researcher who was the lead author of the Annals of Internal Medicine study.

The study has several shortcomings. For example, the researchers said they could not determine which victims were killed by the handgun owners or with the in-home weapons. They couldn’t account for illegal guns and looked only at handguns, not rifles or other firearms.

The dataset also was limited to registered voters in California who were 21 and older. It’s not clear that the findings are generalizable to the whole state, let alone to the rest of the country, the authors acknowledged.

But some outside experts said the work was well done, important and the largest research of its kind.

“I would call this a landmark study,” said Cassandra Crifasi, a gun violence policy researcher at Johns Hopkins University. “This contributes to our understanding of the potential causal relationship between guns in the home and homicides,” she said.

California is unusual in that it offers gun ownership data and other information not obtainable in almost any other state. That allowed the researchers to follow millions of people over many years to try to better establish what happens when a person begins living in a home with handgun, they said.

The study focused on nearly 600,000 Californians who did not own handguns but began living in homes with handguns between October 2004 and December 2016 — either because they started living with someone who owned one or because someone in their household bought one.

The researchers calculated that for every 100,000 people in that situation, 12 will be shot to death by someone else over five years. In comparison, eight out of 100,000 who live in gun-free homes will be killed that way over the same time span.

“The rates are low” and the absolute risk is small, but it’s important to consider the increase in a person’s risk of being killed, Studdert said.

Those numbers suggest the risk rises 50%, but Studdert said it’s actually higher: In a separate calculation designed to better account for where people live and other factors, the researchers estimated the risk was actually more than twice as high.

Separately, the researchers found that those who lived with handgun owners had a much higher rate of being fatally shot by a spouse or intimate partner. The vast majority of such victims — 84% — were women, they said.

The study was confined to California, but the risk is likely even greater in states with less stringent gun laws and where gun ownership is more common, Crifasi said.

Previous research estimated that nearly 3% of U.S. adults became new gun owners between January 2019 and April 2021, which translates to about 7.5 million Americans. Of those, about 5.4 million previously lived in a home with no guns.

For decades, studies have shown guns in the home raise the risk of a violent death. Much of that work, including an earlier study by Studdert and his colleagues, focused on suicide.

The new study goes further in addressing the perception that handguns are still worthwhile because of the safety they provide against being murdered, some experts said.

“The reason people have guns in their home is for protection from strangers,” said David Hemenway, director of the Harvard University’s Injury Control Research Center. “But what this is showing that having a gun in the home is bad for people in the home.”

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