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The One Key Piece Missing From NYC’s Congestion Car Toll

News Feed
Monday, March 18, 2024

A nurse boarded the Bx18A bus, whose route circles between the Morris Heights and Highbridge neighborhoods of the Bronx. Having an anxious moment most New Yorkers will find relatable, she began hunting through her purse to look for her MetroCard to pay for her ride. When the driver pointed to a sign indicating that this was a “fare free” bus—part of an experiment in free public transit created by the state legislature last year—the nurse started dancing.I’d like to have what she’s having, please. I think we all would. “She cha-cha’d down the bus,” said Assemblyman Zohran Mamdani Thursday, telling the story in a speech on the New York Assembly floor. Mamdani was introducing his “Get Congestion Pricing Right” bill, which he said would “expand that feeling—of joy, of relief” by making 15 more bus routes free, across the city, as well as increasing bus frequency. Over the next couple weeks, the bill will be part of the always-harrowing negotiations with Governor Kathy Hochul and among the state legislators. Mamdani called his bill “Get Congestion Pricing Right” in part because, right now, New York risks getting it wrong: Few good ideas have been resisted as loudly as New York’s plan to charge a toll to drivers entering Manhattan ($15 for most) and use the money to improve public transit. The policy, set to take effect June 15, has been mocked, attacked, and misrepresented for years. Now that it’s finally happening, it’s crucial that it work well for the majority of New Yorkers. Otherwise, backlash could quickly sink the policy and discourage similar efforts in the future—in New York and elsewhere. For congestion pricing to work, as Mamdani clearly understands, public transit needs to be good enough to present a viable alternative to the $15 toll. Having fewer cars on the roads is demonstrably fantastic for the environment, public health, and quality of life. In Stockholm, congestion pricing has reduced carbon emissions by 20 percent. In London, it has reduced the nitrogen oxides and particulates in the air by 12 percent. Cleaner air will in turn improve health of New Yorkers: In Stockholm, congestion pricing cut the number of asthma-related hospital visits in half. Reducing traffic—the MTA estimates the plan will cut traffic by 17 percent—will also ease the stress of driving for anyone who has to do so, and make much of the city more pleasant for pedestrians, especially crucial since New Yorkers walk more than any other group of Americans. Reducing traffic will also save lives: Since emergency vehicles are among the few exempted from the toll, they will presumably be able to move more quickly to put out fires and get people to the hospital.  Congestion pricing will also raise $1 billion a year for the public transit system, allowing the MTA to make the kinds of improvements that will save New Yorkers money, time, and irritation. These improvements will also boost ridership; this will make the subway safer, which will, in turn, boost ridership further.Yet congestion pricing has received a great deal of pseudo-populist mockery and resistance. The New York Post has run negative articles on the topic on an almost daily basis (“Congestion Pricing Will Leave NYC in a Jam” and “Time for Congestion Pricing to Hit the Road”  are just two recent headlines). The policy has faced lawsuits from city workers’ unions, the governor of New Jersey, the mayor of Fort Lee, New Jersey, the Staten Island borough president, and a range of other injured parties. The gist of all the criticism is that the policy will hurt ordinary hardworking New Yorkers. Although New York’s policy does still have flaws that must be fixed—insufficient exemptions for low-income drivers, for instance—the populist argument against congestion pricing is mostly disingenuous. Only 4 percent of outer-borough New Yorkers drive to Manhattan to work; 57 percent take public transit. And only 2 percent of low-income outer-borough New Yorkers, specifically, would be asked to pay a congestion fee as part of their commute; 61 percent take public transit. As we’ve seen in France with the “gilet jaune” movement, in which motorists wore yellow vests and blocked highways to protest an unpopular gas tax in 2018, and the more recent farmer protests against the European Union’s effort to limit harmful pesticides, this kind of populist anti-environmental argument resonates when large numbers of ordinary people don’t feel their material needs have been considered by the elites in charge. Congestion pricing carries precisely this kind of baggage, even though it will improve our lives in many ways. That means the big question politically, the one that will determine congestion pricing’s longevity as a policy, is whether the vast majority of New Yorkers will experience its benefits and how quickly. We must see the positive results of congestion pricing in our own lives to balance out the rage induced by what behavioral economists call “the pain of paying” (research shows that we are far more bothered about small expenses that we pay frequently and can see, like milk or gas, than about bigger expenses we don’t pay often or that are simply deducted from our paychecks, like our health insurance premiums). Unfortunately, we can’t see or feel reductions in carbon emissions. Clean air is more ambiguous. We do notice pollution. We freak out about bad air quality warnings in the summer. And last year when the smoke from the Canadian wildfires turned New York City’s skies red and smoky, I saw children running out of school buildings to gape at it in terror. Some of us will undoubtedly feel, over time, that our asthma or headaches have improved, or that we are breathing more easily. But it’s possible that for many people, the clean air might be an invisible benefit, the kind that is politically troublesome because it doesn’t reward its architects. By contrast, New Yorkers have in recent years been complaining about the subway a lot and will notice if it gets better. Public transit is one of the least abstract political issues for New Yorkers, affecting where we can work, whether we can get there in time, and whether we can pick up our kids on time at the end of the day. Ridership has suffered since the pandemic. Sensationally reported crimes on the subway have contributed to anxiety about the system, which New York’s governor has idiotically played into by sending in the National Guard. Less dramatic but perhaps far more frustrating to most people, the service has deteriorated recently, with more delays and disruptions, and even derailments, which are quite scary. The political reception of congestion pricing, then, will be mostly determined by how tangibly it improves our transit system. Of course, there’s no evading the biggest problem with congestion pricing, which is that people hate being forced to change cherished habits. New York City is a great place to implement this policy, since it’s already a terrible city for motorists, the transit system goes almost everywhere, and many New Yorkers already avoid driving. But those who are attached to their cars will be vocal in their objections. Such gripes will resonate and spread like a contagion if people don’t see the positive effects of congestion pricing right away.That’s why immediate measures like Assemblyman Mamdani’s “Get Congestion Pricing Right” proposal—making more bus routes free and more frequent, before the revenue from congestion pricing even kicks in—are so crucial. Good environmental policy prods us to change our behavior while making our lives better at the same time. Congestion pricing will do this: It will obligate driving less by forcing cost-benefit analysis of our car trips, while also rewarding us by transforming urban life for the better—not just with cleaner air and better health, but by ensuring that we all waste less of our lives sitting in traffic. But the biggest benefit for most people will be the investments in our transit system, making a safer, more convenient, and joyful experience. If more of us start feeling anything close to the happiness that nurse felt on the Bx18A that day, congestion pricing will be a lasting political success.

A nurse boarded the Bx18A bus, whose route circles between the Morris Heights and Highbridge neighborhoods of the Bronx. Having an anxious moment most New Yorkers will find relatable, she began hunting through her purse to look for her MetroCard to pay for her ride. When the driver pointed to a sign indicating that this was a “fare free” bus—part of an experiment in free public transit created by the state legislature last year—the nurse started dancing.I’d like to have what she’s having, please. I think we all would. “She cha-cha’d down the bus,” said Assemblyman Zohran Mamdani Thursday, telling the story in a speech on the New York Assembly floor. Mamdani was introducing his “Get Congestion Pricing Right” bill, which he said would “expand that feeling—of joy, of relief” by making 15 more bus routes free, across the city, as well as increasing bus frequency. Over the next couple weeks, the bill will be part of the always-harrowing negotiations with Governor Kathy Hochul and among the state legislators. Mamdani called his bill “Get Congestion Pricing Right” in part because, right now, New York risks getting it wrong: Few good ideas have been resisted as loudly as New York’s plan to charge a toll to drivers entering Manhattan ($15 for most) and use the money to improve public transit. The policy, set to take effect June 15, has been mocked, attacked, and misrepresented for years. Now that it’s finally happening, it’s crucial that it work well for the majority of New Yorkers. Otherwise, backlash could quickly sink the policy and discourage similar efforts in the future—in New York and elsewhere. For congestion pricing to work, as Mamdani clearly understands, public transit needs to be good enough to present a viable alternative to the $15 toll. Having fewer cars on the roads is demonstrably fantastic for the environment, public health, and quality of life. In Stockholm, congestion pricing has reduced carbon emissions by 20 percent. In London, it has reduced the nitrogen oxides and particulates in the air by 12 percent. Cleaner air will in turn improve health of New Yorkers: In Stockholm, congestion pricing cut the number of asthma-related hospital visits in half. Reducing traffic—the MTA estimates the plan will cut traffic by 17 percent—will also ease the stress of driving for anyone who has to do so, and make much of the city more pleasant for pedestrians, especially crucial since New Yorkers walk more than any other group of Americans. Reducing traffic will also save lives: Since emergency vehicles are among the few exempted from the toll, they will presumably be able to move more quickly to put out fires and get people to the hospital.  Congestion pricing will also raise $1 billion a year for the public transit system, allowing the MTA to make the kinds of improvements that will save New Yorkers money, time, and irritation. These improvements will also boost ridership; this will make the subway safer, which will, in turn, boost ridership further.Yet congestion pricing has received a great deal of pseudo-populist mockery and resistance. The New York Post has run negative articles on the topic on an almost daily basis (“Congestion Pricing Will Leave NYC in a Jam” and “Time for Congestion Pricing to Hit the Road”  are just two recent headlines). The policy has faced lawsuits from city workers’ unions, the governor of New Jersey, the mayor of Fort Lee, New Jersey, the Staten Island borough president, and a range of other injured parties. The gist of all the criticism is that the policy will hurt ordinary hardworking New Yorkers. Although New York’s policy does still have flaws that must be fixed—insufficient exemptions for low-income drivers, for instance—the populist argument against congestion pricing is mostly disingenuous. Only 4 percent of outer-borough New Yorkers drive to Manhattan to work; 57 percent take public transit. And only 2 percent of low-income outer-borough New Yorkers, specifically, would be asked to pay a congestion fee as part of their commute; 61 percent take public transit. As we’ve seen in France with the “gilet jaune” movement, in which motorists wore yellow vests and blocked highways to protest an unpopular gas tax in 2018, and the more recent farmer protests against the European Union’s effort to limit harmful pesticides, this kind of populist anti-environmental argument resonates when large numbers of ordinary people don’t feel their material needs have been considered by the elites in charge. Congestion pricing carries precisely this kind of baggage, even though it will improve our lives in many ways. That means the big question politically, the one that will determine congestion pricing’s longevity as a policy, is whether the vast majority of New Yorkers will experience its benefits and how quickly. We must see the positive results of congestion pricing in our own lives to balance out the rage induced by what behavioral economists call “the pain of paying” (research shows that we are far more bothered about small expenses that we pay frequently and can see, like milk or gas, than about bigger expenses we don’t pay often or that are simply deducted from our paychecks, like our health insurance premiums). Unfortunately, we can’t see or feel reductions in carbon emissions. Clean air is more ambiguous. We do notice pollution. We freak out about bad air quality warnings in the summer. And last year when the smoke from the Canadian wildfires turned New York City’s skies red and smoky, I saw children running out of school buildings to gape at it in terror. Some of us will undoubtedly feel, over time, that our asthma or headaches have improved, or that we are breathing more easily. But it’s possible that for many people, the clean air might be an invisible benefit, the kind that is politically troublesome because it doesn’t reward its architects. By contrast, New Yorkers have in recent years been complaining about the subway a lot and will notice if it gets better. Public transit is one of the least abstract political issues for New Yorkers, affecting where we can work, whether we can get there in time, and whether we can pick up our kids on time at the end of the day. Ridership has suffered since the pandemic. Sensationally reported crimes on the subway have contributed to anxiety about the system, which New York’s governor has idiotically played into by sending in the National Guard. Less dramatic but perhaps far more frustrating to most people, the service has deteriorated recently, with more delays and disruptions, and even derailments, which are quite scary. The political reception of congestion pricing, then, will be mostly determined by how tangibly it improves our transit system. Of course, there’s no evading the biggest problem with congestion pricing, which is that people hate being forced to change cherished habits. New York City is a great place to implement this policy, since it’s already a terrible city for motorists, the transit system goes almost everywhere, and many New Yorkers already avoid driving. But those who are attached to their cars will be vocal in their objections. Such gripes will resonate and spread like a contagion if people don’t see the positive effects of congestion pricing right away.That’s why immediate measures like Assemblyman Mamdani’s “Get Congestion Pricing Right” proposal—making more bus routes free and more frequent, before the revenue from congestion pricing even kicks in—are so crucial. Good environmental policy prods us to change our behavior while making our lives better at the same time. Congestion pricing will do this: It will obligate driving less by forcing cost-benefit analysis of our car trips, while also rewarding us by transforming urban life for the better—not just with cleaner air and better health, but by ensuring that we all waste less of our lives sitting in traffic. But the biggest benefit for most people will be the investments in our transit system, making a safer, more convenient, and joyful experience. If more of us start feeling anything close to the happiness that nurse felt on the Bx18A that day, congestion pricing will be a lasting political success.

A nurse boarded the Bx18A bus, whose route circles between the Morris Heights and Highbridge neighborhoods of the Bronx. Having an anxious moment most New Yorkers will find relatable, she began hunting through her purse to look for her MetroCard to pay for her ride. When the driver pointed to a sign indicating that this was a “fare free” bus—part of an experiment in free public transit created by the state legislature last year—the nurse started dancing.

I’d like to have what she’s having, please. I think we all would. “She cha-cha’d down the bus,” said Assemblyman Zohran Mamdani Thursday, telling the story in a speech on the New York Assembly floor. Mamdani was introducing his “Get Congestion Pricing Right” bill, which he said would “expand that feeling—of joy, of relief” by making 15 more bus routes free, across the city, as well as increasing bus frequency. Over the next couple weeks, the bill will be part of the always-harrowing negotiations with Governor Kathy Hochul and among the state legislators.

Mamdani called his bill “Get Congestion Pricing Right” in part because, right now, New York risks getting it wrong: Few good ideas have been resisted as loudly as New York’s plan to charge a toll to drivers entering Manhattan ($15 for most) and use the money to improve public transit. The policy, set to take effect June 15, has been mocked, attacked, and misrepresented for years. Now that it’s finally happening, it’s crucial that it work well for the majority of New Yorkers. Otherwise, backlash could quickly sink the policy and discourage similar efforts in the future—in New York and elsewhere. For congestion pricing to work, as Mamdani clearly understands, public transit needs to be good enough to present a viable alternative to the $15 toll.

Having fewer cars on the roads is demonstrably fantastic for the environment, public health, and quality of life. In Stockholm, congestion pricing has reduced carbon emissions by 20 percent. In London, it has reduced the nitrogen oxides and particulates in the air by 12 percent. Cleaner air will in turn improve health of New Yorkers: In Stockholm, congestion pricing cut the number of asthma-related hospital visits in half. Reducing traffic—the MTA estimates the plan will cut traffic by 17 percent—will also ease the stress of driving for anyone who has to do so, and make much of the city more pleasant for pedestrians, especially crucial since New Yorkers walk more than any other group of Americans. Reducing traffic will also save lives: Since emergency vehicles are among the few exempted from the toll, they will presumably be able to move more quickly to put out fires and get people to the hospital. 

Congestion pricing will also raise $1 billion a year for the public transit system, allowing the MTA to make the kinds of improvements that will save New Yorkers money, time, and irritation. These improvements will also boost ridership; this will make the subway safer, which will, in turn, boost ridership further.

Yet congestion pricing has received a great deal of pseudo-populist mockery and resistance. The New York Post has run negative articles on the topic on an almost daily basis (“Congestion Pricing Will Leave NYC in a Jam” and “Time for Congestion Pricing to Hit the Road”  are just two recent headlines). The policy has faced lawsuits from city workers’ unions, the governor of New Jersey, the mayor of Fort Lee, New Jersey, the Staten Island borough president, and a range of other injured parties. The gist of all the criticism is that the policy will hurt ordinary hardworking New Yorkers.

Although New York’s policy does still have flaws that must be fixed—insufficient exemptions for low-income drivers, for instance—the populist argument against congestion pricing is mostly disingenuous. Only 4 percent of outer-borough New Yorkers drive to Manhattan to work; 57 percent take public transit. And only 2 percent of low-income outer-borough New Yorkers, specifically, would be asked to pay a congestion fee as part of their commute; 61 percent take public transit.

As we’ve seen in France with the “gilet jaune” movement, in which motorists wore yellow vests and blocked highways to protest an unpopular gas tax in 2018, and the more recent farmer protests against the European Union’s effort to limit harmful pesticides, this kind of populist anti-environmental argument resonates when large numbers of ordinary people don’t feel their material needs have been considered by the elites in charge.

Congestion pricing carries precisely this kind of baggage, even though it will improve our lives in many ways. That means the big question politically, the one that will determine congestion pricing’s longevity as a policy, is whether the vast majority of New Yorkers will experience its benefits and how quickly.

We must see the positive results of congestion pricing in our own lives to balance out the rage induced by what behavioral economists call “the pain of paying” (research shows that we are far more bothered about small expenses that we pay frequently and can see, like milk or gas, than about bigger expenses we don’t pay often or that are simply deducted from our paychecks, like our health insurance premiums). Unfortunately, we can’t see or feel reductions in carbon emissions. Clean air is more ambiguous. We do notice pollution. We freak out about bad air quality warnings in the summer. And last year when the smoke from the Canadian wildfires turned New York City’s skies red and smoky, I saw children running out of school buildings to gape at it in terror. Some of us will undoubtedly feel, over time, that our asthma or headaches have improved, or that we are breathing more easily. But it’s possible that for many people, the clean air might be an invisible benefit, the kind that is politically troublesome because it doesn’t reward its architects.

By contrast, New Yorkers have in recent years been complaining about the subway a lot and will notice if it gets better. Public transit is one of the least abstract political issues for New Yorkers, affecting where we can work, whether we can get there in time, and whether we can pick up our kids on time at the end of the day. Ridership has suffered since the pandemic. Sensationally reported crimes on the subway have contributed to anxiety about the system, which New York’s governor has idiotically played into by sending in the National Guard. Less dramatic but perhaps far more frustrating to most people, the service has deteriorated recently, with more delays and disruptions, and even derailments, which are quite scary. The political reception of congestion pricing, then, will be mostly determined by how tangibly it improves our transit system.

Of course, there’s no evading the biggest problem with congestion pricing, which is that people hate being forced to change cherished habits. New York City is a great place to implement this policy, since it’s already a terrible city for motorists, the transit system goes almost everywhere, and many New Yorkers already avoid driving. But those who are attached to their cars will be vocal in their objections. Such gripes will resonate and spread like a contagion if people don’t see the positive effects of congestion pricing right away.

That’s why immediate measures like Assemblyman Mamdani’s “Get Congestion Pricing Right” proposal—making more bus routes free and more frequent, before the revenue from congestion pricing even kicks in—are so crucial. Good environmental policy prods us to change our behavior while making our lives better at the same time. Congestion pricing will do this: It will obligate driving less by forcing cost-benefit analysis of our car trips, while also rewarding us by transforming urban life for the better—not just with cleaner air and better health, but by ensuring that we all waste less of our lives sitting in traffic. But the biggest benefit for most people will be the investments in our transit system, making a safer, more convenient, and joyful experience. If more of us start feeling anything close to the happiness that nurse felt on the Bx18A that day, congestion pricing will be a lasting political success.

Read the full story here.
Photos courtesy of

New Flu Variant Could Bring Another Severe U.S. Season

By I. Edwards HealthDay ReporterTHURSDAY, Nov. 20, 2025 (HealthDay News) — A new flu variant spreading overseas may set the stage for another tough...

THURSDAY, Nov. 20, 2025 (HealthDay News) — A new flu variant spreading overseas may set the stage for another tough winter in the United States, experts warn.The strain, called subclade K, has caused a rise in flu cases in the United Kingdom, Canada and Japan. And now signs suggest it is beginning to take hold across the United States as flu activity rises.According to the latest U.S. Centers for Disease Control and Prevention (CDC) FluView report, reported flu activity in the United States remains low but is climbing quickly.Last year’s flu season was the worst the United States had seen in nearly 15 years and led to at least 280 child deaths, according to the CDC.Most cases this year are from the H3N2 virus and about half of those belong to the subclade K variant, the same strain that fueled a difficult flu season in the Southern Hemisphere.Because it wasn’t circulating widely when strains were selected for the vaccine update, this year’s flu shot targets close strains of the virus."It’s not like we’re expecting to get complete loss of protection for the vaccine, but perhaps we might expect a little bit of a drop-off if this is the virus that sort of dominates the season, and early indications are that’s probably going to be the case," Richard Webby, a researcher at St. Jude Children’s Research Hospital in Memphis, Tennessee, told CNN.Early findings from the UK Health Security Agency suggest the variant carries seven genetic changes on a major part of the virus, making it a bit harder for the body's immune system to recognize.Even so, they found that the flu shot has reduced the risk of hospitalization or emergency care by about 75% in children and 30% to 40% in adults so far this season.What worries experts even more is that fewer Americans appear to be getting the flu shot.Data from IQVIA shows that pharmacies gave 26.5 million flu vaccinations from August through October, down from 28.7 million during the same period last year."I’m not surprised," Jennifer Nuzzo, professor of epidemiology and director of the Pandemic Center at Brown University in Providence, Rhode Island, said.She said recent debates about vaccine safety have "left people confused but possibly at the worst have left people worried about getting vaccinated."Australia’s flu shot rates also fell this year and the country went on to record more than 443,000 cases."What they saw in Australia is that they had a bad season. And so it’s concerning for you and us, what’s coming," Dr. Earl Rubin, division director of infectious disease at Montreal Children’s Hospital, told CNN.Several early indicators already show flu levels rising in the U.S.The WastewaterSCAN network found type A flu in 40% of samples in November, up from 18% in October, according to Marlene Wolfe, an assistant professor in the department of environmental health at Emory University in Atlanta.Only four U.S. monitoring sites in Maine, Vermont, Iowa and Hawaii have officially crossed the threshold for declaring flu activity high, but experts say the trend is clear.While it’s not yet clear whether subclade K could cause more severe illness, a rise in infections alone could cause hospitalizations to skyrocket, Rubin noted."It’s not too late. Go and get your flu shot," Dr. Adam Lauring, chief of the division of infectious diseases at the University of Michigan Medical School, in Ann Arbor, said.These results are preliminary and have not yet been peer-reviewed.The Texas Department of State Health Services (DSHS) has more on the flu vaccine.SOURCE: CNN, Nov. 18, 2025Copyright © 2025 HealthDay. All rights reserved.

Thousands of US Hazardous Sites Are at Risk of Flooding Because of Sea Level Rise, Study Finds

A new study finds that thousands of hazardous sites across the U.S. are at risk of flooding due to sea level rise that could pose public health threats to neighboring communities

If heat-trapping pollution from burning coal, oil and gas continues unchecked, thousands of hazardous sites across the United States risk being flooded from sea level rise by the turn of the century, posing serious health risks to nearby communities, according to a new study.Researchers identified 5,500 sites that store, emit or handle sewage, trash, oil, gas and other hazards that could face coastal flooding by 2100, with much of the risk already locked in due to past emissions. But more than half the sites are projected to face flood risk much sooner — as soon as 2050. Low-income, communities of color and other marginalized groups are the most at risk.With even moderate reductions to planet-warming emissions, researchers also determined that roughly 300 fewer sites would be at risk by the end of the century. “Our goal with this analysis was to try to get ahead of the problem by looking far out into the future," said Lara J. Cushing, associate professor in the Department of Environmental Health Sciences at the University of California, Los Angeles who co-authored the paper published in the science journal Nature Communications.“We do have time to respond and try to mitigate the risks and also increase resilience," she added, speaking at a media briefing Wednesday ahead of the study's release. The study was funded by the Environmental Protection Agency and builds on previous research from California. Climate change is driving and accelerating sea level rise. Glaciers and ice sheets are melting, and the sea's waters are expanding as they warm. In many places along the coastal U.S., sea level rise is accelerating faster than the global average because of things like erosion and land sinking from groundwater pumping, according to the National Oceanic and Atmospheric Administration. Thomas Chandler, managing director at the National Center for Disaster Preparedness at Columbia University who was not involved in the research, said it’s “a really important study” that the public, policy makers and government agencies “need to make note of.” Derek Van Berkel, an associate professor in the school for environment and sustainability at University of Michigan who was also not involved in the study, wasn't surprised to learn about the disproportionate risks. What was “alarming” was considering the magnitude of “feedback effects” from flooding, he said. How researchers approached the data The study's researchers started by identifying and classifying tens of thousands of hazardous sites near the coasts of Puerto Rico and the 23 states with coastline. Next, they wanted to know each site's projected future flood risk. They did this by calculating how likely each year coastal flooding could inundate a site using historical sea level measurements and projected sea level rise in 2050 and 2100 under low and high emissions scenarios. Lastly, they identified and classified communities as being at-risk if homes are located within 1 kilometer (0.62 miles) of a hazardous site with a high threat of future flooding, and compared those communities' characteristics with other coastal neighborhoods with no at-risk sites nearby. But researchers did not include all types of hazardous facilities, such as oil and gas pipelines, nor did they account for groundwater upwelling or more intense and frequent storms in the future, which could lead to underestimates. On the other end, the flood-risk model they used could have overestimated the number of threatened sites. “It is important to note that previous disasters, such as hurricanes Katrina, Rita and Harvey, did result in a lot of toxic contamination from oil and gas pipelines,” Chandler said. The 5,500 at-risk sites includes 44% that are fossil fuel ports and terminals, 30% power plants, 24% refineries and 22% coastal sewage treatment facilities. Most of the sites — nearly 80% — are in Louisiana, Florida, New Jersey, Texas, California, New York and Massachusetts. Potential health impacts from exposure to hazards People exposed to flood waters near industrial animal farms or sewage treatment plants could be exposed to bacteria like E. coli, said Sacoby Wilson, professor of global, environmental and occupational health at the University of Maryland during the briefing. Symptoms can include bloody or watery diarrhea, severe stomach cramps or vomiting and fever. Those living near industrial sites like refineries could be exposed to heavy metals and chemicals that can cause rashes, burning of the eyes, nose and throat, headaches or fatigue, added Wilson, who was not involved in the study. “For folks who are vulnerable, maybe have an underlying health condition, those health conditions could be exacerbated during those flood events.” Longer term, some of these exposures could contribute to cancer, liver, kidney or other organ damage, or have reproductive effects, he said. For Chandler, the Columbia University director, the study highlights the need to heavily invest in hazard mitigation. “It's really important for federal, state and local governments in the United States to address these factors through multi-stakeholder resilience planning and encouraging local governments to integrate climate risk assessments into their mitigation strategies.”The Associated Press receives support from the Walton Family Foundation for coverage of water and environmental policy. The AP is solely responsible for all content. For all of AP’s environmental coverage, visit https://apnews.com/hub/climate-and-environment.Copyright 2025 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.Photos You Should See – Nov. 2025

RFK Jr.’s Miasma Theory of Health Is Spreading

The agency is picking up Robert F. Kennedy Jr.’s argument that a healthy immune system can keep even pandemic germs at bay.

Last week, the two top officials at the National Institutes of Health—the world’s largest public funder of biomedical research—debuted a new plan to help Americans weather the next pandemic: getting everyone to eat better and exercise.The standard pandemic-preparedness playbook “has failed catastrophically,” NIH Director Jay Bhattacharya and NIH Principal Deputy Director Matthew J. Memoli wrote in City Journal, a magazine and website published by the Manhattan Institute for Policy Research, a conservative think tank. The pair argue that finding and studying pathogens that could cause outbreaks, then stockpiling vaccines against them, is a waste of money. Instead, they say, the United States should encourage people to improve their baseline health—“whether simply by stopping smoking, controlling hypertension or diabetes, or getting up and walking more.”On its own, Bhattacharya and Memoli’s apparently serious suggestion that just being in better shape will carry the U.S. through an infectious crisis is reckless, experts told me—especially if it’s executed at the expense of other public-health responses. In an email, Andrew Nixon, the director of communications at the Department of Health and Human Services—which oversees the NIH—wrote that the agency “supports a comprehensive approach to pandemic preparedness that recognizes the importance of both biomedical tools and the factors individuals can control.” But more broadly, Bhattacharya and Memoli’s proposal reflects the spread of a dangerous philosophy that Robert F. Kennedy Jr., the secretary of HHS, has been pushing for years: a dismissal of germ theory, or the notion that infectious microbes are responsible for many of the diseases that plague humankind.In his 2021 book, The Real Anthony Fauci: Bill Gates, Big Pharma, and the Global War on Democracy and Public Health, Kennedy, a longtime anti-vaccine activist, argues that modern scientists have blamed too much of infectious disease on pathogens, which he suggests are rarely problematic, unless the immune system has been compromised by poor nutrition, toxins, and other environmental stressors. He credits sanitation and nutrition for driving declines in infectious-disease deaths during the 20th century; vaccination, he has baselessly claimed, was largely ineffective and unnecessary. In his view, germs don’t pose a substantial threat to people who have done the work of “fortifying the immune system”—essentially, those who have taken their health into their own hands.In terms of general health, most Americans would benefit from improvements in diet and exercise. A strong emphasis on both has been core to the Make America Healthy Again movement, and in one important aspect, Kennedy and his allies are correct: The immune system, like other bodily systems, is sensitive to nutritional status, and when people are dealing with chronic health issues, they often fare less well against infectious threats, Melinda Beck, a nutrition and infectious-disease researcher who recently retired from the University of North Carolina, told me. Conditions such as obesity and diabetes, for instance, raise the risk of severe COVID and flu; malnutrition exacerbates the course of diseases such as tuberculosis and measles.But applied to widespread infectious outbreaks, the MAHA prescription is still deeply flawed. Being generally healthy doesn’t guarantee survival, or even better outcomes against infectious diseases—especially when an entire population encounters a pathogen against which it has no immunity. Although some evidence suggests that the 1918 flu pandemic strongly affected certain groups of people who were less healthy at baseline—including undernourished World War I soldiers—“relatively healthy people, as far as we could understand, were the main victims,” Naomi Rogers, a historian of medicine at Yale, told me. Smallpox, too, infected and killed indiscriminately. HIV has devastated many communities of young, healthy people.In his book, Kennedy relies heavily on the term miasma theory as a shorthand for preventing disease “through nutrition and by reducing exposures to environmental toxins and stresses.” He’s employing that phrase incorrectly: Historically, at least, miasma theory referred to the notion that epidemics are caused by bad air—such as toxic emanations from corpses and trash—and was the predominant way of describing disease transmission until scientists found definitive proof of infectious microbes in the late 19th century. But his choice of words is also revealing. In pitting his ideas against germ theory, he plays on a centuries-old tension between lifestyle and microbes as roots of illness.In its early days, germ theory struggled to gain traction even among physicians, many of whom dismissed the idea as simplistic, Nancy Tomes, a historian at Stony Brook University, told me. After the idea became foundational to medicine, scientists still had to work to convince some members of the public that microbes could fell healthy people, too. In the early days of polio vaccination, when the virus still ran rampant in the U.S., some vaccine-skeptical Americans insisted that children were falling seriously ill primarily because their parents weren’t managing their kids’ nutrition well and “had disrupted the child’s internal health,” Rogers told me.Over time, as pharmaceutical companies made global businesses out of selling antibiotics, vaccines, and antivirals, the products became a symbol, for some people, of how germ theory had taken over medicine. Accepting vaccines came to represent trust in scientific expertise, Rogers said; misgivings about the industry, in contrast, might translate into rejecting those offerings. In that skeptical slice of the American public and amid the rise of alternative-wellness practitioners, Kennedy has found purchase for his ideas about nutrition as a cure-all.Since taking over as health secretary, he has on occasion made that distrust in germ theory national policy. In his book, he wrote that “when a starving African child succumbs to measles, the miasmist attributes the death to malnutrition; germ theory proponents (a.k.a. virologists) blame the virus.” Earlier this year, when measles raged through undervaccinated regions of West Texas, the secretary acted out his own miasmist theory of the outbreak, urging Americans to rely on vitamin-A supplementation as a first-line defense, even though deficiency of that vitamin is rare here.But germ theory is key to understanding why outbreaks become pandemics—not because people’s general health is wanting, but because a pathogen is so unfamiliar to so many people’s immune systems at once that it is able to spread unchecked. Pandemics then end because enough people acquire sufficient immunity to that pathogen. Vaccination, when available, remains the safest way to gain that immunity—and, unlike lifestyle choices, it can represent a near-universal strategy to shore up defenses against disease. Not all of the risk factors that worsen disease severity are tunable by simply eating better or working out more. For COVID and many other respiratory diseases, for instance, old age and pregnancy remain some of the biggest risk factors. Genetic predispositions to certain medical conditions, or structural barriers to changing health habits—not just lack of willpower—can make people vulnerable to disease, too.In their article, Bhattacharya and Memoli purport to be arguing against specific strategies of pandemic preparedness, most prominently the controversial type of gain-of-function research that can involve altering the disease-causing traits of pathogens, and has been restricted by the Trump administration. But the pair also mischaracterize the country’s current approach to pandemics, which, in addition to calling for virus research and vaccine development, prioritizes measures such as surveillance, international partnerships, and improved health-care capacity, Nahid Bhadelia, the director of the Center on Emerging Infectious Diseases at Boston University, told me. And Bhattacharya and Memoli’s alternative approach cuts against the most basic logic of public health—that the clearest way to help keep a whole population healthy is to offer protections that work on a societal level and that will reach as many people as possible. Fixating on personal nutrition and exercise regimens as pandemic preparedness would leave many people entirely unprotected. At the same time, “we’re basically setting up society to blame someone” in the event that they fall ill, Jennifer Nuzzo, the director of the pandemic center at the Brown University School of Public Health, told me.Kennedy’s book bemoans that the “warring philosophies” of miasma and germ theory have become a zero-sum game. And yet, at HHS, he and his officials are presenting outbreak preparedness—and the rest of public health—as exactly that: The country should worry about environment or pathogens; it should be either pushing people to eat better or stockpiling vaccines. Over email, Nixon told me that “encouraging healthier habits is one way to strengthen resilience alongside vaccines, treatments, and diagnostics developed through NIH-funded research.” But this year, under pressure from the Trump administration, the NIH has cut funding to hundreds of vaccine- and infectious-disease focused research projects; elsewhere at HHS, officials canceled nearly half a billion dollars’ worth of contracts geared toward developing mRNA vaccines.The reality is that both environment and pathogens often influence the outcome of disease, and both should be addressed. Today’s public-health establishment might not subscribe to the 19th-century version of miasma theory, but the idea that environmental and social factors shape people’s health is still core to the field. “They’re saying you can only do one thing at a time,” Bhadelia told me. “I don’t think we have to.”

Clinicians can help address environmental toxics in reproductive health, international experts say

In a recent opinion paper published in the International Journal of Gynecology & Obstetrics, the International Federation of Obstetrics and Gynecology (FIGO) addresses how exposures to environmental toxics — including endocrine disrupting chemicals — have a wide range of impacts on reproductive health, and how clinicians can play a role in addressing this issue.In short: Extensive research has linked exposure to environmental toxics with an increased risk of polycystic ovary syndrome (PCOS), endometriosis, uterine fibroids, hormonally mediated cancers, menopause, and both female and male infertility. The key mechanisms behind these impacts include hormone disruption, oxidative stress, inflammation, and epigenetic changes that can affect multiple generations.FIGO emphasizes that harm from environmental toxics can be addressed, and that clinicians play a crucial role in ensuring environmental factors are meaningfully considered as a part of patient care. Key quote: “As trusted health advisors, obstetricians and gynecologists (OBGYNs) have an essential role in integrating environmental health into routine gynecologic and fertility care.” Why this matters: In this opinion paper, FIGO argues that clinicians should incorporate environmental health into routine care, and provides practical strategies to do so. Some of these strategies include taking environmental histories, counseling patients on risk reduction and healthy lifestyles, recognizing high-risk settings (e.g., occupational exposures), and advising patients on simple steps to reduce exposure — particularly during sensitive windows like preconception, pregnancy, puberty, and menopause. Clinicians should be aware of regional environmental health alerts, such as air quality advisories or contamination events. In addition, clinicians can advocate for policy change.Related EHN coverage: Chemical mixtures may impact fertility and IVF success, new study findsUnderstanding how the environment affects pregnant people’s healthMore resources: Additional International Federation of Obstetrics and Gynecology (FIGO) statements and opinions relating to the environment:FIGO opinion on reproductive health impacts of exposure to toxic environmental chemicalsFIGO calls for removal of PFAS from global useRemoval of glyphosate from global usageClimate Crisis and HealthStatement on Draft Strategy on health, environment and climate changeToxic chemicals and environmental contaminants in prenatal vitaminsDeNicola, Nathaniel et al. for International Journal of Gynecology & Obstetrics. Sept. 26, 2025

In a recent opinion paper published in the International Journal of Gynecology & Obstetrics, the International Federation of Obstetrics and Gynecology (FIGO) addresses how exposures to environmental toxics — including endocrine disrupting chemicals — have a wide range of impacts on reproductive health, and how clinicians can play a role in addressing this issue.In short: Extensive research has linked exposure to environmental toxics with an increased risk of polycystic ovary syndrome (PCOS), endometriosis, uterine fibroids, hormonally mediated cancers, menopause, and both female and male infertility. The key mechanisms behind these impacts include hormone disruption, oxidative stress, inflammation, and epigenetic changes that can affect multiple generations.FIGO emphasizes that harm from environmental toxics can be addressed, and that clinicians play a crucial role in ensuring environmental factors are meaningfully considered as a part of patient care. Key quote: “As trusted health advisors, obstetricians and gynecologists (OBGYNs) have an essential role in integrating environmental health into routine gynecologic and fertility care.” Why this matters: In this opinion paper, FIGO argues that clinicians should incorporate environmental health into routine care, and provides practical strategies to do so. Some of these strategies include taking environmental histories, counseling patients on risk reduction and healthy lifestyles, recognizing high-risk settings (e.g., occupational exposures), and advising patients on simple steps to reduce exposure — particularly during sensitive windows like preconception, pregnancy, puberty, and menopause. Clinicians should be aware of regional environmental health alerts, such as air quality advisories or contamination events. In addition, clinicians can advocate for policy change.Related EHN coverage: Chemical mixtures may impact fertility and IVF success, new study findsUnderstanding how the environment affects pregnant people’s healthMore resources: Additional International Federation of Obstetrics and Gynecology (FIGO) statements and opinions relating to the environment:FIGO opinion on reproductive health impacts of exposure to toxic environmental chemicalsFIGO calls for removal of PFAS from global useRemoval of glyphosate from global usageClimate Crisis and HealthStatement on Draft Strategy on health, environment and climate changeToxic chemicals and environmental contaminants in prenatal vitaminsDeNicola, Nathaniel et al. for International Journal of Gynecology & Obstetrics. Sept. 26, 2025

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