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What scientists have learned from 20 years of microplastics research

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Friday, September 20, 2024

Twenty years ago, a team of U.K. scientists sounded the alarm on a then-underappreciated problem: the breakdown of plastic litter into small, even microscopic, fragments. While many previous reports had documented the buildup of plastic bottles and bags in the natural environment, much less attention had been paid to what the scientists dubbed “microplastics.”  Due to “the rapid increase in plastic production, the longevity of plastic, and the disposable nature of plastic items,” the researchers concluded that there was “considerable potential” for microplastic pollution to become a major problem for the environment and human health. It turns out, they were right. Over the past two decades, the rate of plastic production has roughly doubled, to more than 400 million metric tons per year, about the weight of 1,200 Empire State Buildings. In the same time period, microplastics — defined as particles with a diameter less than 5 micrometers, about the width of a human hair — have exploded into the public consciousness, riding on a wave of research into the particles’ prevalence across ecosystems and in humans’ bodies. Since that 2004 paper, one of the first to use the term “microplastics,” microscopic plastic fragments have been found everywhere from deep sea sediments to the top of Mount Everest, as well as in human blood, breast milk, colons, kidneys, livers, lungs, placentas, and other body parts. Many of these findings are synthesized in a review paper published this week in the journal Science. The paper considers what we’ve learned from thousands of research articles about microplastics — including where they come from, where they end up, and how they affect organisms — and appraises regulatory options for dealing with the problem.  Research on the topic has “kind of taken off,” said Richard Thompson, a professor of marine biology at the University of Plymouth in the U.K. who was lead author on the paper from 20 years ago and the new one published on Thursday. “It’s now pretty clear that this stuff is everywhere,” he added, and that unless something changes, humanity will eventually reach a point of “wide-scale” and “irreversible” harm to the environment.  One thing that has become much clearer since the early 2000s is the sheer extent of microplastic pollution. While Thompson’s 2004 paper documented small fragments of acrylic, nylon, and polyester in coastal environments around the U.K., further investigation has shown that contamination is global. By now, microplastics have been found in virtually every ecosystem researchers have looked, including in soils, lakes, and rivers, and on remote mountains. One alarming study from 2020 found that microplastics are present in rainwater, while others have shown that the particles are ubiquitous in the indoor air we breathe. Earlier this year, the environmental consulting firm Earth Action estimated that nearly 13 million metric tons of microplastic enter the oceans and terrestrial environment annually. Tires are a major source of microplastics, which are released as they rub against the roadway. Nasir Kachroo / NurPhoto via Getty Images Where did all these microplastics come from? Early on, scientists intuited that they were generated by larger pieces of plastic debris breaking down — and this is indeed the most significant source of microplastics. But many more have been identified. Paint, for example, contains plastic polymers and may contribute as much as 1.9 million metric tons of microplastics to the marine environment annually. Some of the other most significant sources of microplastics include rubber tires, which shed microplastics as they rub against the road, and synthetic textiles, which release microfibers when worn and washed. An unknown amount of microplastic pollution comes from plastic-derived fishing nets and gear, which make up a huge fraction of plastic in the ocean more broadly. One reason scientists have found microplastics so far and wide is because there are more of them looking than ever before. But those scientists also have better technologies at their disposal. A kind of imaging called pyrolysis-gas chromatography-mass spectroscopy, for instance, has recently made it easier for researchers to identify small, dark microplastics released by the erosion of rubber tires. Other methods have made it possible to more precisely count the number of microplastics in a given sample, and to sort them by size and polymer — all of which can yield clues about their toxicity.  More researchers and better technology have also led to the detection of microplastics in living organisms. Over the past 20 years, scientists have documented microplastics in more than 1,300 aquatic and terrestrial species, and throughout the human body. Eye-catching headlines over the past few months have highlighted the particles’ presence in human testicles and penises, and this February, scientists at the University of New Mexico found microplastics in every placenta out of 62 that they tested. Scientists still don’t have a complete picture of how exactly this contamination is affecting human health, but lab studies have linked microplastics to cell inflammation and the spread of cancer. Some epidemiological evidence suggests they may be a risk factor for heart disease.  Synthetic textiles release plastic microfibers when washed and worn. Dieter Menne / Picture Alliance via Getty Images These findings help explain why microplastics have risen so quickly to the top of many average people’s priority lists. In Germany, for example, consumers in a 2023 survey said they were more concerned about microplastics in food than any other health topic, including antibiotic resistance and pesticides residues on food. Another recent survey showed that more than 90 percent of U.S. voters are also “somewhat” or “very” concerned about microplastics in the human body. Many jurisdictions are seeking to hold plastic makers responsible for the pollution they’ve caused, and at least two lawsuits against the plastics industry — one brought by the New York attorney general’s office and the other brought by the City of Baltimore — specifically call out the proliferation and health risks of microplastics. Industry groups acknowledge that humans are being exposed to microplastics, but deny that there is any evidence that they may harm human health or the environment. On its website, the Plastics Industry Association says the industry “supports more and better research on microplastics” and highlights its investments in pollution prevention and recycling infrastructure. “Everyone agrees on one thing,” the trade group says: “Plastics, large or small, don’t belong in our waterways.” On that narrow point, Thompson agrees. He thinks there’s already enough evidence of microplastics’ harms that scientists should concentrate on ways to stop microplastics from entering the environment in the first place. Several interventions have already been taken — a 2020 French law, for example, now requires new washing machines to come with microfiber filters, and the European Union is phasing glitter and other microplastics out of products like shampoo and lotion. But Thompson’s paper highlights the need for multidisciplinary approaches that take into account insights from a variety of fields, including economics and behavioral science. Initiatives to replace single-use plastics with reusable alternatives, for example, could play a major role in reducing the generation of microplastics — but they’ll only work if they’re inexpensive and convenient enough for consumers to accept them. “To get something to work, it’s not just about a chemistry experiment in a lab,” Thompson said. “It’s going to take changes in social norms, the economy, society, legal frameworks.” At the broadest level, Thompson, other scientists, and environmental advocates are supportive of measures to limit overall plastic production and ban the most problematic categories of plastic, both of which would indirectly reduce the generation of microplastics. These solutions are currently being discussed as part of  a high-profile United Nations treaty to end plastic pollution. Jen Fela, vice president of programs and communications for the nonprofit Plastic Pollution Coalition, described the treaty as “the best chance we have” to address the plastic pollution crisis. “Solutions exist,” she told Grist. “The only way to stop plastic pollution is to significantly reduce plastic production.” The fifth and final round of negotiations over the treaty is scheduled to take place this November and December in Busan, South Korea. This story was originally published by Grist with the headline What scientists have learned from 20 years of microplastics research on Sep 20, 2024.

The particles are everywhere, and they may harm human health.

Twenty years ago, a team of U.K. scientists sounded the alarm on a then-underappreciated problem: the breakdown of plastic litter into small, even microscopic, fragments. While many previous reports had documented the buildup of plastic bottles and bags in the natural environment, much less attention had been paid to what the scientists dubbed “microplastics.” 

Due to “the rapid increase in plastic production, the longevity of plastic, and the disposable nature of plastic items,” the researchers concluded that there was “considerable potential” for microplastic pollution to become a major problem for the environment and human health.

It turns out, they were right.

Over the past two decades, the rate of plastic production has roughly doubled, to more than 400 million metric tons per year, about the weight of 1,200 Empire State Buildings. In the same time period, microplastics — defined as particles with a diameter less than 5 micrometers, about the width of a human hair — have exploded into the public consciousness, riding on a wave of research into the particles’ prevalence across ecosystems and in humans’ bodies. Since that 2004 paper, one of the first to use the term “microplastics,” microscopic plastic fragments have been found everywhere from deep sea sediments to the top of Mount Everest, as well as in human blood, breast milk, colons, kidneys, livers, lungs, placentas, and other body parts.

Many of these findings are synthesized in a review paper published this week in the journal Science. The paper considers what we’ve learned from thousands of research articles about microplastics — including where they come from, where they end up, and how they affect organisms — and appraises regulatory options for dealing with the problem. 

Research on the topic has “kind of taken off,” said Richard Thompson, a professor of marine biology at the University of Plymouth in the U.K. who was lead author on the paper from 20 years ago and the new one published on Thursday. “It’s now pretty clear that this stuff is everywhere,” he added, and that unless something changes, humanity will eventually reach a point of “wide-scale” and “irreversible” harm to the environment. 

One thing that has become much clearer since the early 2000s is the sheer extent of microplastic pollution. While Thompson’s 2004 paper documented small fragments of acrylic, nylon, and polyester in coastal environments around the U.K., further investigation has shown that contamination is global. By now, microplastics have been found in virtually every ecosystem researchers have looked, including in soils, lakes, and rivers, and on remote mountains. One alarming study from 2020 found that microplastics are present in rainwater, while others have shown that the particles are ubiquitous in the indoor air we breathe. Earlier this year, the environmental consulting firm Earth Action estimated that nearly 13 million metric tons of microplastic enter the oceans and terrestrial environment annually.

Closeup of a worn black tire, with the word "Bridgestone" written on it.
Tires are a major source of microplastics, which are released as they rub against the roadway.
Nasir Kachroo / NurPhoto via Getty Images

Where did all these microplastics come from? Early on, scientists intuited that they were generated by larger pieces of plastic debris breaking down — and this is indeed the most significant source of microplastics. But many more have been identified. Paint, for example, contains plastic polymers and may contribute as much as 1.9 million metric tons of microplastics to the marine environment annually. Some of the other most significant sources of microplastics include rubber tires, which shed microplastics as they rub against the road, and synthetic textiles, which release microfibers when worn and washed. An unknown amount of microplastic pollution comes from plastic-derived fishing nets and gear, which make up a huge fraction of plastic in the ocean more broadly.

One reason scientists have found microplastics so far and wide is because there are more of them looking than ever before. But those scientists also have better technologies at their disposal. A kind of imaging called pyrolysis-gas chromatography-mass spectroscopy, for instance, has recently made it easier for researchers to identify small, dark microplastics released by the erosion of rubber tires. Other methods have made it possible to more precisely count the number of microplastics in a given sample, and to sort them by size and polymer — all of which can yield clues about their toxicity. 

More researchers and better technology have also led to the detection of microplastics in living organisms. Over the past 20 years, scientists have documented microplastics in more than 1,300 aquatic and terrestrial species, and throughout the human body. Eye-catching headlines over the past few months have highlighted the particles’ presence in human testicles and penises, and this February, scientists at the University of New Mexico found microplastics in every placenta out of 62 that they tested. Scientists still don’t have a complete picture of how exactly this contamination is affecting human health, but lab studies have linked microplastics to cell inflammation and the spread of cancer. Some epidemiological evidence suggests they may be a risk factor for heart disease

White washing machines lined up on a row on a shopping room floor, with shoppers looking at them.
Synthetic textiles release plastic microfibers when washed and worn. Dieter Menne / Picture Alliance via Getty Images

These findings help explain why microplastics have risen so quickly to the top of many average people’s priority lists. In Germany, for example, consumers in a 2023 survey said they were more concerned about microplastics in food than any other health topic, including antibiotic resistance and pesticides residues on food. Another recent survey showed that more than 90 percent of U.S. voters are also “somewhat” or “very” concerned about microplastics in the human body. Many jurisdictions are seeking to hold plastic makers responsible for the pollution they’ve caused, and at least two lawsuits against the plastics industry — one brought by the New York attorney general’s office and the other brought by the City of Baltimore — specifically call out the proliferation and health risks of microplastics.

Industry groups acknowledge that humans are being exposed to microplastics, but deny that there is any evidence that they may harm human health or the environment. On its website, the Plastics Industry Association says the industry “supports more and better research on microplastics” and highlights its investments in pollution prevention and recycling infrastructure. “Everyone agrees on one thing,” the trade group says: “Plastics, large or small, don’t belong in our waterways.”

On that narrow point, Thompson agrees. He thinks there’s already enough evidence of microplastics’ harms that scientists should concentrate on ways to stop microplastics from entering the environment in the first place. Several interventions have already been taken — a 2020 French law, for example, now requires new washing machines to come with microfiber filters, and the European Union is phasing glitter and other microplastics out of products like shampoo and lotion. But Thompson’s paper highlights the need for multidisciplinary approaches that take into account insights from a variety of fields, including economics and behavioral science. Initiatives to replace single-use plastics with reusable alternatives, for example, could play a major role in reducing the generation of microplastics — but they’ll only work if they’re inexpensive and convenient enough for consumers to accept them.

“To get something to work, it’s not just about a chemistry experiment in a lab,” Thompson said. “It’s going to take changes in social norms, the economy, society, legal frameworks.”

At the broadest level, Thompson, other scientists, and environmental advocates are supportive of measures to limit overall plastic production and ban the most problematic categories of plastic, both of which would indirectly reduce the generation of microplastics. These solutions are currently being discussed as part of  a high-profile United Nations treaty to end plastic pollution. Jen Fela, vice president of programs and communications for the nonprofit Plastic Pollution Coalition, described the treaty as “the best chance we have” to address the plastic pollution crisis.

“Solutions exist,” she told Grist. “The only way to stop plastic pollution is to significantly reduce plastic production.” The fifth and final round of negotiations over the treaty is scheduled to take place this November and December in Busan, South Korea.

This story was originally published by Grist with the headline What scientists have learned from 20 years of microplastics research on Sep 20, 2024.

Read the full story here.
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Nearly Half of Americans Still Live With High Levels of Air Pollution, Posing Serious Health Risks, Report Finds

The most recent State of the Air report by the American Lung Association found that more than 150 million Americans breathe air with unhealthy levels of ozone or particle pollution

Nearly Half of Americans Still Live With High Levels of Air Pollution, Posing Serious Health Risks, Report Finds The most recent State of the Air report by the American Lung Association found that more than 150 million Americans breathe air with unhealthy levels of ozone or particle pollution Lillian Ali - Staff Contributor April 25, 2025 12:50 p.m. For 25 of the 26 years the American Lung Association has reported State of the Air, Los Angeles—pictured here in smog—has been declared the city with the worst ozone pollution in the United States. David Iliff via Wikimedia Commons under CC BY-SA 3.0 Since 2000, the American Lung Association has released an annual State of the Air report analyzing air quality data across the United States. This year’s report, released on Wednesday, found the highest number of people exposed to unhealthy levels of air pollution in a decade. According to the findings, 156 million Americans—or 46 percent of the U.S. population—live with levels of particle or ozone pollution that received a failing grade. “Both these types of pollution cause people to die,” Mary Rice, a pulmonologist at Harvard University, tells NPR’s Alejandra Borunda. “They shorten life expectancy and drive increases in asthma rates.” Particle pollution, also called soot pollution, is made up of minuscule solid and liquid particles that hang in the air. They’re often emitted by fuel combustion, like diesel- and gasoline-powered cars or the burning of wood. Ozone pollution occurs when polluting gases are hit by sunlight, leading to a reaction that forms ozone smog. Breathing in ozone can irritate your lungs, causing shortness of breath, coughing or asthma attacks. The 2025 State of the Air report, which analyzed air quality data from 2021 to 2023, found 25 million more people breathing polluted air compared to the 2024 report. The authors link this rise to climate change. “There’s definitely a worsening trend that’s driven largely by climate change,” Katherine Pruitt, the lead author of the report and national senior director for policy at the American Lung Association, tells USA Today’s Ignacio Calderon. “Every year seems to be a bit hotter globally, resulting in more extreme weather events, more droughts, more extreme heat and more wildfires.” Those wildfires produce the sooty particles that contribute to particulate pollution, while extreme heat creates more favorable conditions for ozone formation, producing smog. While climate change is contributing to heavy air pollution, it used to be much worse. Smog has covered cities like Los Angeles since the early 20th century. At one point, these “hellish clouds” of smog were so thick that, in the middle of World War II, residents thought the city was under attack. The Optimist Club of Highland Park, a neighborhood in northeast Los Angleles, wore gas masks at a 1954 banquet to highlight air pollution in the city. Los Angeles Daily News via Wikimedia Commons under CC-BY 4.0 The passage of the Clean Air Act and the creation of the federal Environmental Protection Agency (EPA) in 1970 marked a turning point in air quality, empowering the government to regulate pollution and promote public health. Now, six key air pollutants have dropped by about 80 percent since the law’s passage, according to this year’s report. But some researchers see climate change as halting—or even reversing—this improvement. “Since the act passed, the air pollution has gone down overall,” Laura Kate Bender, an assistant vice president at the American Lung Association, tells CBS News’ Kiki Intarasuwan. “The challenge is that over the last few years, we’re starting to see it tick back up again, and that’s because of climate change, in part.” At the same time, federal action against climate change appears to be slowing. On March 12, EPA administrator Lee Zeldin announced significant rollbacks and re-evaluations, declaring it “the greatest day of deregulation our nation has seen.” Zeldin argued that his deregulation will drive “a dagger straight into the heart of the climate change religion.” Included in Zeldin’s push for deregulation is a re-evaluation of Biden-era air quality standards, including those for particulate pollution and greenhouse gases. The EPA provided a list of 31 regulations it plans to scale back or eliminate, including limits on air pollution, mercury emissions and vehicles. This week, the EPA sent termination notices to nearly 200 employees at the Office of Environmental Justice and External Civil Rights. “Unfortunately, we see that everything that makes our air quality better is at risk,” Kate Bender tells CBS News, citing the regulation rollbacks and cuts to staff and funding at the EPA. “If we see all those cuts become reality, it’s gonna have a real impact on people’s health by making the air they breathe dirtier.” Get the latest stories in your inbox every weekday.

Nearly Half of Americans Breathe Unhealthy Air, New Report Finds

By I. Edwards HealthDay ReporterFRIDAY, April 25, 2025 (HealthDay News) —Breathing the air in nearly half of the United States could be putting...

FRIDAY, April 25, 2025 (HealthDay News) —Breathing the air in nearly half of the United States could be putting your health at risk.A new American Lung Association report shows that 156 million people live in areas with unhealthy air.The group’s annual "State of the Air" report found that smog and soot pollution are getting worse, not better. The report looked at air quality data from 2021 to 2023. It found that 25 million more people than in the group's last report were breathing "unhealthy levels of air pollution." That's more than in any other "State of the Air" report in the last decade, the association said.Since the Clean Air Act became law in 1970, air pollution has gone down overall, said Laura Kate Bender, an assistant vice president at the lung association, told CBS News."The challenge is that over the last few years, we're starting to see it tick back up again and that's because of climate change, in part," she said. "Climate change is making some of those conditions for wildfires and extreme heat that drive ozone pollution worse for a lot of the country."The city with the worst year-round and short-term particle pollution? Bakersfield, California, for the sixth year in a row.What's more, it was ranked third worst for high ozone days. In contrast, Casper, Wyoming, was listed as the cleanest city for year-round particle pollution, CBS News said.Here are the top 10 cities with the worst year-round particle pollution, according to the association:Bakersfield-Delano, Calif. Visalia, Calif. Fresno-Hanford-Corcoran, Calif. Eugene-Springfield, Ore. Los Angeles-Long Beach, Calif. Detroit-Warren-Ann Arbor, Mich. San Jose-San Francisco-Oakland, Calif. Houston-Pasadena, Texas Cleveland-Akron-Canton, Ohio Fairbanks-College, Ark. The report warned that pollution isn't just an issue in the west. Extreme heat and wildfires are spreading pollution across the country.In fact, smoke from Canada's wildfires in 2023 caused unhealthy air quality even in the eastern parts of the U.S., the report pointed out.Some of the findings came as a surprise, according to Kevin Stewart, the association’s environmental health director."I think we knew that the wildfire smoke would have an impact on air quality in the United States," he told CBS News. "I think we were surprised at the Lung Association by how strong the effect was, especially in the northeastern quadrant of the continental United States." Last month, the U.S. Environmental Protection Agency (EPA) announced it will roll back 31 environmental rules, including ones pertaining to vehicle emissions, CBS News reported.Bender said that puts decades of progress at risk."Unfortunately, we see that everything that makes our air quality better is at risk," she said. "The EPA is at risk — the agency that is protecting our health — through staff cuts, funding cuts. The regulations that have cleaned up our air over time are at risk of being cut. If we see all those cuts become reality, it's gonna have a real impact on people's health by making the air they breathe dirtier."Lee Zeldin, the EPA administrator, argued that, instead, the deregulation will drive "a dagger straight into the heart of the climate change religion to drive down cost of living for American families, unleash American energy, bring auto jobs back to the U.S. and more," according to CBS News."This air pollution is causing kids to have asthma attacks, making people who work outdoors sick and unable to work, and leading to low birth weight in babies," Kezia Ofosu Atta, the Lung Association’s advocacy director, told CBS News.The report also found that Black Americans are more likely to suffer serious health problems from air pollution.SOURCE: CBS News, April 23, 2025Copyright © 2025 HealthDay. All rights reserved.

Umbilical Cord Could Contain Clues For Child's Future Health

By Dennis Thompson HealthDay ReporterFRIDAY, April 25, 2025 (HealthDay News) -- Doctors might be able to predict a newborn's long-term health...

By Dennis Thompson HealthDay ReporterFRIDAY, April 25, 2025 (HealthDay News) -- Doctors might be able to predict a newborn's long-term health outlook, by analyzing their umbilical cord blood, a new study says.Genetic clues found in cord blood can offer early insight into which infants are at higher risk for health problems like diabetes, stroke and liver disease later in life, researchers will report at the upcoming Digestive Disease Week meeting in San Diego.“We’re seeing kids develop metabolic problems earlier and earlier, which puts them at higher risk for serious complications as adults,” lead researcher Dr. Ashley Jowell, a resident physician in internal medicine at Duke University Health System in Durham, N.C., said in a news release. “If we can identify that risk at birth, we may be able to prevent it.”For the study, researchers performed genetic analysis on the umbilical cord blood of 38 children enrolled in a long-term study based in North Carolina.The analysis looked for chemical patterns in infants’ DNA that switch genes on or off. When these switches occur in critical parts of DNA, their health effects can persist through fetal development and into later life.The research team compared these DNA changes to the kids’ health at ages 7 to 12, and identified multiple areas where genes in cord blood predicted health problems in childhood.For example, changes in a gene called TNS3 were linked to fatty liver, liver inflammation or damage, and excess belly fat as measured by waist-to-hip ratio, results show.Changes in other genes were connected to blood pressure, waist-to-hip ratio, and liver inflammation or damage, researchers said.“These epigenetic signals are laid down during embryonic development, potentially influenced by environmental factors such as nutrition or maternal health during pregnancy,” co-researcher Dr. Cynthia Moylan, an associate professor in the division of gastroenterology at Duke University Health System, said in a news release.Researchers noted that the sample size was small, but the links so powerful that these findings warrant further investigation. A larger follow-up study funded by the National Institutes of Health is underway.“If validated in larger studies, this could open the door to new screening tools and early interventions for at-risk children,” Moylan added.Jowell said disease may be preventable even with these markers."Just because you're born with these markers doesn't mean disease is inevitable," she said. "But knowing your risk earlier in life could help families and clinicians take proactive steps to support a child’s long-term health."Researchers are scheduled to present their findings May 4. Findings presented at medical meetings are considered preliminary until published in a peer-reviewed journal.SOURCE: American Gastroenterological Association, news release, April 25, 2025Copyright © 2025 HealthDay. All rights reserved.

Biden let California get creative with Medicaid spending. Trump is signaling that may end

California uses Medicaid to pay for a range of nontraditional health care services, including housing. The Trump administration wants to scale back those programs.

In summary California uses Medicaid to pay for a range of nontraditional health care services, including housing. The Trump administration wants to scale back those programs. In 2022, California made sweeping changes to its Medi-Cal program that reimagined what health care could look like for some of the state’s poorest and sickest residents by covering services from housing to healthy food. But the future of that program, known as CalAIM, could be at risk under the Trump administration.  In recent weeks, federal officials have signaled that support for creative uses of Medi-Cal funding is waning, particularly uses that California has invested in such as rent assistance and medically tailored meals. Medi-Cal is California’s name for Medicaid. The moves align with a narrower vision of Medicaid espoused by newly confirmed Centers for Medicare and Medicaid Services head Dr. Mehmet Oz, who said during his swearing-in ceremony that Medicaid spending was crowding out spending on education and other services in states with the federal government “paying most of the bill.” “This one really bothers me. There are states who are using Medicaid — Medicaid dollars for people who are vulnerable — for services that are not medical,” Oz said. It also fits with broader GOP calls to slim down the federal government. Medicaid is under scrutiny as part of a GOP-led budget process in the House of Representatives that calls for $880 billion in cuts over 10 years to programs including Medicaid. “The messaging that we want to go back to the basics of Medicaid puts all of these waiver programs in jeopardy,” said John Baackes, former chief executive of L.A. Care, the state’s largest Medi-Cal health insurer. CalAIM is authorized under a federal waiver that allows states to experiment with their Medicaid programs to try to save money and improve health outcomes. Under the waiver, California added extra benefits for high-cost users to help with food insecurity, housing instability,  substance use and behavioral health challenges. Roughly half of all Medi-Cal spending can be attributed to 5% of high-cost users, according to state documents. But in March, the federal government rescinded guidelines supporting Medi-Cal spending for social services. It also sent states a letter in April indicating that the Centers for Medicare and Medicaid Services would no longer approve a funding mechanism that helps support CalAIM, although that money will continue until 2026. Together, these moves should worry states that operate programs like CalAIM, said Kathy Hempstead, senior policy officer at the Robert Wood Johnson Foundation. “Under the Biden administration states were encouraged to experiment with things like that: To prescribe people prescriptions to get healthy food, to refer people to community-based services,” Hempstead said. “This administration is not receptive at all to … that vision of the Medicaid program.” In a press release, CMS said it is putting an end to spending that isn’t “directly tied to health care services.” “Mounting expenditures, such as covering housekeeping for individuals who are not eligible for Medicaid or high-speed internet for rural healthcare providers, distracts from the core mission of Medicaid, and in some instances, serves as an overly-creative financing mechanism to skirt state budget responsibilities,” the press release states. These signals from the federal government apply to future applications for Medicaid changes, and do not change California’s current programs or funding. The state’s CalAIM waiver expires at the end of 2026, and another similar waiver that supports California’s efforts to improve behavioral health care expires in 2029. According to a statement from the Department of Health Care Services, the agency that oversees Medi-Cal, all programs “remain federally approved and operational.” “We appreciate our Medi-Cal providers and community partners, and together we will push full steam ahead to transform our health system and improve health outcomes,” the department said. Physician assistant Brett Feldman checks his patient, Carla Bolen’s, blood pressure while in her encampment at the Figueroa St. Viaduct above Highway 110 in Elysian Valley Park in Los Angeles on Nov. 18, 2022. Photo by Larry Valenzuela, CalMatters/CatchLight Local Paul Shafer, co-director of the Boston University Medicaid Policy Lab, said decades of public health research show that people have worse health outcomes that require more expensive treatment when their social needs aren’t met. “We’ve spent the last few decades in public health and health policy, arguing that so much of health and medical costs is driven by environmental factors — people’s living conditions, income, etc.” Shafer said. But, Shafer said, programs like CalAIM are relatively recent and the research hasn’t had enough time to show whether paying for non-traditional services saves money. For example, California’s street medicine doctors who take care of people who are homeless say that their patients often cycle in and out of the emergency room — the most expensive point of service in the health care system. They have no place to recover from medical procedures, no address to deliver medications, and the constant exposure to the elements takes years off of their lives, doctors say.  CalAIM gives them options to help their clients find housing.  The federal government’s decision not to fund programs like this in the future is a “step backward,” Shafer said.  “I think we can all read the tea leaves and say that that means they’re sort of unlikely to be renewed,” he said. Supported by the California Health Care Foundation (CHCF), which works to ensure that people have access to the care they need, when they need it, at a price they can afford. Visit www.chcf.org to learn more. more on california health care They live in California’s Republican districts. They feel betrayed by looming health care cuts March 11, 2025March 12, 2025 California has big plans for improving mental health. Medicaid cuts could upend them April 7, 2025April 7, 2025

Chattanooga Just Became North America's First National Park City. Here's What That Means

The designation was awarded by a London-based charity that aims to make cities more like national parks: "greener, healthier and wilder"

Chattanooga Just Became North America’s First National Park City. Here’s What That Means The designation was awarded by a London-based charity that aims to make cities more like national parks: “greener, healthier and wilder” Sarah Kuta - Daily Correspondent April 23, 2025 4:20 p.m. Chattanooga was once one of the most polluted cities in the country. Now, it's North America's first National Park City. larrybraunphotography.com via Getty Images Chattanooga has been named North America’s first National Park City, a designation that acknowledges the city’s abundant green spaces and commitment to environmental stewardship. The city in southeast Tennessee, home to roughly 190,000 residents, is now the third National Park City in the world, following behind London and Adelaide, Australia. The title comes from the National Park City Foundation, a London-based charity that envisions a better future by thinking of cities more like national parks. The movement is not connected to the National Park Service, the federal agency that manages America’s national parks, monuments, historic sites and other protected lands. “[National parks] are special places where we have a better relationship with nature, culture and heritage and can enjoy and develop ourselves,” according to the foundation. “Combining the long-term and large-scale vision of national parks with cities has the potential to shift our collective understanding of what and who a city is for.” In Chattanooga, city leaders have used the initiative to encourage residents to “think about Chattanooga as a city in a park, rather than a city with some parks in it,” says Tim Kelly, the mayor of Chattanooga, in a video announcing the designation. “The outdoors is our competitive advantage,” he adds. “It’s at the heart of our story of revitalization, and it’s at the core of our identity as Chattanoogans. We’ve always known how special Chattanooga’s connection to the outdoors is, and now it’s going to be recognized around the world.” Chattanooga has been working toward the designation for nearly two years, per a statement from the city. In late 2023, officials collected more than 5,600 signatures of support and created a National Park City charter. Then, they filed an application describing how Chattanooga met the nonprofit’s criteria—such as being “a place, vision and community that aims to be greener, healthier and wilder.” Last month, delegates from the foundation visited Chattanooga to experience it first-hand. They toured an urban farm, explored several parks and met with various community leaders, per NOOGAtoday’s Haley Bartlett. The foundation’s experts were impressed by Chattanooga’s “culture of outdoor activity,” its “unrivaled access to nature,” its commitment to “inclusive and sustainable development” and its food and agriculture scene, among other factors. “We saw first-hand the extraordinary breadth and depth of engagement with the Chattanooga National Park City vision informed by outstanding experts in design, ecology, culture and arts,” says Alison Barnes, a trustee of the foundation, in a statement. “National Park City status introduces a new chapter for a city with a long history of revitalization and renewal through connecting its unique landscape and the history of its people.” Chattanooga has come a long way since 1969, when the federal government declared it the worst city in the nation for particulate air pollution. Hazy skies were the norm back then, as factories and railroads spewed unregulated emissions into the air, according to the Chattanooga/Hamilton County Air Pollution Control Bureau. Air pollution was so bad that residents sometimes had to drive with their headlights on in the middle of the day. But the pollution was more than just an eyesore. It was also causing the city’s residents to become sick—and sometimes die—from diseases like tuberculosis. Eventually, voters approved aggressive new rules to reduce emissions. By 1989, Chattanooga’s air quality had improved so much that it met all federal health standards. Today, it’s a vibrant, outdoorsy city with more than 100 parks and more than 35 miles of trails—plus many more within a short drive. The once-neglected riverfront downtown has been revitalized, and Chattanooga has experienced steady population growth in recent years. What does the National Park City designation mean for the city’s future? That remains to be seen. But officials hope it will help guide policy decisions and “help city government and community partners prioritize connecting more people to the outdoors that have long defined our identity,” according to a statement from the Chattanooga Area Chamber. It will also encourage citizens and leaders to embrace “all aspects of outdoor life,” from forests and lakes to native plants, according to the chamber. Mark McKnight, who serves as the president and CEO of Chattanooga’s Reflection Riding Arboretum and Nature Center, hopes that the new status will “yield some really cool stuff that we can’t even imagine today.” “Hopefully, we’re having this conversation in ten years, and it’s like, ‘Oh, wow, we never knew we would get to there,’” he tells the Chattanooga Times Free Press’ Sam Still. Get the latest stories in your inbox every weekday.

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