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When a 1-in-100 year flood washed through the Coorong, it made the vital microbiome of this lagoon healthier

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Thursday, March 27, 2025

Darcy Whittaker, CC BYYou might know South Australia’s iconic Coorong from the famous Australian children’s book, Storm Boy, set around this coastal lagoon. This internationally important wetland is sacred to the Ngarrindjeri people and a haven for migratory birds. The lagoon is the final stop for the Murray River’s waters before they reach the sea. Tens of thousands of migratory waterbirds visit annually. Pelicans, plovers, terns and ibises nest, while orange-bellied parrots visit and Murray Cod swim. But there are other important inhabitants – trillions of microscopic organisms. You might not give much thought to the sedimentary microbes of a lagoon. But these tiny microbes in the mud are vital to river ecosystems, quietly cycling nutrients and supporting the food web. Healthy microbes make for a healthy Coorong – and this unassuming lagoon is a key indicator for the health of the entire Murray-Darling Basin. For decades, the Coorong has been in poor health. Low water flows have concentrated salt and an excess of nutrients. But in 2022, torrential rains on the east coast turned into a once-in-a-century flood, which swept down the Murray into the Coorong. In our new research, we took the pulse of the Coorong’s microbiome after this huge flood and found the surging fresh water corrected microbial imbalances. The numbers of methane producing microbes fell while beneficial nutrient-eating bacteria grew. Populations of plants, animals and invertebrates boomed. We can’t just wait for irregular floods – we have to find ways to ensure enough water is left in the river to cleanse the Coorong naturally. Under a scanning electron micrograph, the mixed community of microbes in water is visible. This image shows a seawater sample. Sophie Leterme/Flinders University, CC BY Rivers have microbiomes, just like us Our gut microbes can change after a heavy meal or in response to dietary changes. In humans, a sudden shift in diet can encourage either helpful or harmful microbes. In the same way, aquatic microbes respond to changes in salinity and freshwater flows. Depending on what changes are happening, some species boom and others bust. As water gets saltier in brackish lagoons, communities of microbes have to adapt or die. High salinity often favours microbes with anaerobic metabolisms, meaning they don’t need oxygen. But these tiny lifeforms often produce the highly potent greenhouse gas methane. The microbes in wetlands are a large natural source of the gas. While we know pulses of freshwater are vital for river health, they don’t happen often enough. The waters of the Murray-Darling Basin support most of Australia’s irrigated farming. Negotiations over how to ensure adequate environmental flows have been fraught – and long-running. Water buybacks have improved matters somewhat, but researchers have found the river basin’s ecosystems are not in good condition. Wetlands such as the Coorong are a natural source of methane. The saltier the water gets, the more environmentally harmful microbes flourish – potentially producing more methane. Vincent_Nguyen The Coorong is out of balance A century ago, regular pulses of fresh water from the Murray flushed nutrients and sediment out of the Coorong, helping maintain habitat for fish, waterbirds and the plants and invertebrates they eat. While other catchments discharge into the Coorong, the Murray is by far the major water source. Over the next decades, growth in water use for farming meant less water in the river. In the 1930s, barrages were built near the river’s mouth to control nearby lake levels and prevent high salinity moving upstream in the face of reduced river flows. Major droughts have added further stress. Under these low-flow conditions, salt and nutrients get more and more concentrated, reaching extreme levels due to South Australia’s high rate of evaporation. In response, microbial communities can trigger harmful algae blooms or create low-oxygen “dead zones”, suffocating river life. The big flush of 2022 In 2022, torrential rain fell in many parts of eastern Australia. Rainfall on the inland side of the Great Dividing Range filled rivers in the Murray-Darling Basin. That year became the largest flood since 1956. We set about recording the changes. As the salinity fell in ultra-salty areas, local microbial communities in the sediment were reshuffled. The numbers of methane-producing microbes fell sharply. This means the floods would have temporarily reduced the Coorong’s greenhouse footprint. Christopher Keneally sampling for microbes in the Coorong in 2022. Tyler Dornan, CC BY When we talk about harmful bacteria, we’re referring to microbes that emit greenhouse gases such as methane, drive the accumulation of toxic sulfide (such as Desulfobacteraceae), or cause algae blooms (Cyanobacteria) that can sicken people, fish and wildlife. During the flood, beneficial microbes from groups such as Halanaerobiaceae and Beggiatoaceae grew rapidly, consuming nutrients such as nitrogen, which is extremely high in the Coorong. This is very useful to prevent algae blooms. Beggiatoaceae bacteria also remove toxic sulfide compounds. The floods also let plants and invertebrates bounce back, flushed out salt and supported a healthier food web. On balance, we found the 2022 flood was positive for the Coorong. It’s as if the Coorong switched packets of chips for carrot sticks – the flood pulse reduced harmful bacteria and encouraged beneficial ones. While the variety of microbes shrank in some areas, those remaining performed key functions helping keep the ecosystem in balance. From 2022 to 2023, consistent high flows let native fish and aquatic plants bounce back, in turn improving feeding grounds for birds and allowing black swans to thrive. A group of black swans cruise the Coorong’s waters. Darcy Whittaker, CC BY Floods aren’t enough When enough water is allowed to flow down the Murray to the Coorong, ecosystems get healthier. But the Coorong has been in poor health for decades. It can’t just rely on rare flood events. Next year, policymakers will review the Murray-Darling Basin Plan, which sets the rules for sharing water in Australia’s largest and most economically important river system. Balancing our needs with those of other species is tricky. But if we neglect the environment, we risk more degradation and biodiversity loss in the Coorong. As the climate changes and rising water demands squeeze the basin, decision-makers must keep the water flowing for wildlife. Christopher Keneally receives funding from the Australian Government Department of Climate Change, Energy, the Environment and Water. His research is affiliated with The University of Adelaide and the Goyder Institute for Water Research. Chris is also a committee member and former president of the Biology Society of South Australia, and a member of the Australian Freshwater Sciences Society.Matt Gibbs receives funding from the Australian Government Department of Climate Change, Energy, the Environment and Water. Sophie Leterme receives funding from the Australian Research Council (ARC). Her research is affiliated with Flinders University, with the ARC Training Centre for Biofilm Research & Innovation, and with the Goyder Institute for Water Research.Justin Brookes does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

The 2022 floods triggered shifts in the Coorong’s microbiome—similar to our gut bacteria on new diets—revealing why freshwater flows are vital to wetland health.

Darcy Whittaker, CC BY

You might know South Australia’s iconic Coorong from the famous Australian children’s book, Storm Boy, set around this coastal lagoon.

This internationally important wetland is sacred to the Ngarrindjeri people and a haven for migratory birds. The lagoon is the final stop for the Murray River’s waters before they reach the sea. Tens of thousands of migratory waterbirds visit annually. Pelicans, plovers, terns and ibises nest, while orange-bellied parrots visit and Murray Cod swim. But there are other important inhabitants – trillions of microscopic organisms.

You might not give much thought to the sedimentary microbes of a lagoon. But these tiny microbes in the mud are vital to river ecosystems, quietly cycling nutrients and supporting the food web. Healthy microbes make for a healthy Coorong – and this unassuming lagoon is a key indicator for the health of the entire Murray-Darling Basin.

For decades, the Coorong has been in poor health. Low water flows have concentrated salt and an excess of nutrients. But in 2022, torrential rains on the east coast turned into a once-in-a-century flood, which swept down the Murray into the Coorong.

In our new research, we took the pulse of the Coorong’s microbiome after this huge flood and found the surging fresh water corrected microbial imbalances. The numbers of methane producing microbes fell while beneficial nutrient-eating bacteria grew. Populations of plants, animals and invertebrates boomed.

We can’t just wait for irregular floods – we have to find ways to ensure enough water is left in the river to cleanse the Coorong naturally.

microbes under microscope
Under a scanning electron micrograph, the mixed community of microbes in water is visible. This image shows a seawater sample. Sophie Leterme/Flinders University, CC BY

Rivers have microbiomes, just like us

Our gut microbes can change after a heavy meal or in response to dietary changes.

In humans, a sudden shift in diet can encourage either helpful or harmful microbes.

In the same way, aquatic microbes respond to changes in salinity and freshwater flows. Depending on what changes are happening, some species boom and others bust.

As water gets saltier in brackish lagoons, communities of microbes have to adapt or die. High salinity often favours microbes with anaerobic metabolisms, meaning they don’t need oxygen. But these tiny lifeforms often produce the highly potent greenhouse gas methane. The microbes in wetlands are a large natural source of the gas.

While we know pulses of freshwater are vital for river health, they don’t happen often enough. The waters of the Murray-Darling Basin support most of Australia’s irrigated farming. Negotiations over how to ensure adequate environmental flows have been fraught – and long-running. Water buybacks have improved matters somewhat, but researchers have found the river basin’s ecosystems are not in good condition.

coorong saltwater lagoon
Wetlands such as the Coorong are a natural source of methane. The saltier the water gets, the more environmentally harmful microbes flourish – potentially producing more methane. Vincent_Nguyen

The Coorong is out of balance

A century ago, regular pulses of fresh water from the Murray flushed nutrients and sediment out of the Coorong, helping maintain habitat for fish, waterbirds and the plants and invertebrates they eat. While other catchments discharge into the Coorong, the Murray is by far the major water source.

Over the next decades, growth in water use for farming meant less water in the river. In the 1930s, barrages were built near the river’s mouth to control nearby lake levels and prevent high salinity moving upstream in the face of reduced river flows.

Major droughts have added further stress. Under these low-flow conditions, salt and nutrients get more and more concentrated, reaching extreme levels due to South Australia’s high rate of evaporation.

In response, microbial communities can trigger harmful algae blooms or create low-oxygen “dead zones”, suffocating river life.

The big flush of 2022

In 2022, torrential rain fell in many parts of eastern Australia. Rainfall on the inland side of the Great Dividing Range filled rivers in the Murray-Darling Basin. That year became the largest flood since 1956.

We set about recording the changes. As the salinity fell in ultra-salty areas, local microbial communities in the sediment were reshuffled.

The numbers of methane-producing microbes fell sharply. This means the floods would have temporarily reduced the Coorong’s greenhouse footprint.

scientist taking microbe samples in Coorong.
Christopher Keneally sampling for microbes in the Coorong in 2022. Tyler Dornan, CC BY

When we talk about harmful bacteria, we’re referring to microbes that emit greenhouse gases such as methane, drive the accumulation of toxic sulfide (such as Desulfobacteraceae), or cause algae blooms (Cyanobacteria) that can sicken people, fish and wildlife.

During the flood, beneficial microbes from groups such as Halanaerobiaceae and Beggiatoaceae grew rapidly, consuming nutrients such as nitrogen, which is extremely high in the Coorong. This is very useful to prevent algae blooms. Beggiatoaceae bacteria also remove toxic sulfide compounds.

The floods also let plants and invertebrates bounce back, flushed out salt and supported a healthier food web.

On balance, we found the 2022 flood was positive for the Coorong. It’s as if the Coorong switched packets of chips for carrot sticks – the flood pulse reduced harmful bacteria and encouraged beneficial ones.

While the variety of microbes shrank in some areas, those remaining performed key functions helping keep the ecosystem in balance.

From 2022 to 2023, consistent high flows let native fish and aquatic plants bounce back, in turn improving feeding grounds for birds and allowing black swans to thrive.

black swans on coorong lagoon
A group of black swans cruise the Coorong’s waters. Darcy Whittaker, CC BY

Floods aren’t enough

When enough water is allowed to flow down the Murray to the Coorong, ecosystems get healthier.

But the Coorong has been in poor health for decades. It can’t just rely on rare flood events.

Next year, policymakers will review the Murray-Darling Basin Plan, which sets the rules for sharing water in Australia’s largest and most economically important river system.

Balancing our needs with those of other species is tricky. But if we neglect the environment, we risk more degradation and biodiversity loss in the Coorong.

As the climate changes and rising water demands squeeze the basin, decision-makers must keep the water flowing for wildlife.

The Conversation

Christopher Keneally receives funding from the Australian Government Department of Climate Change, Energy, the Environment and Water. His research is affiliated with The University of Adelaide and the Goyder Institute for Water Research. Chris is also a committee member and former president of the Biology Society of South Australia, and a member of the Australian Freshwater Sciences Society.

Matt Gibbs receives funding from the Australian Government Department of Climate Change, Energy, the Environment and Water.

Sophie Leterme receives funding from the Australian Research Council (ARC). Her research is affiliated with Flinders University, with the ARC Training Centre for Biofilm Research & Innovation, and with the Goyder Institute for Water Research.

Justin Brookes does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

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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