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Why Early Prostate Cancer Screening Matters for Black Men

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Wednesday, September 18, 2024

This episode is part of “Health Equity Heroes,” an editorially independent special project that was produced with financial support from Takeda Pharmaceuticals.Rachel Feltman: September is Prostate Cancer Awareness Month, so here’s something you should be aware of: earlier this year the Prostate Cancer Foundation issued new screening guidelines encouraging Black men to start getting baseline blood tests for prostate cancer as early as age 40. That’s because, according to the American Cancer Society, Black men are [about] 70 percent more likely than white men to develop prostate cancer in their lifetime and twice as likely to die from the disease.For Scientific American’s Science Quickly, I’m Rachel Feltman. Today I’m joined by Dr. Alfred Winkler, chief of urology at NewYork-Presbyterian Lower Manhattan Hospital. He’s here to tell us more about how folks can protect themselves from prostate cancer.On supporting science journalismIf you're enjoying this article, consider supporting our award-winning journalism by subscribing. By purchasing a subscription you are helping to ensure the future of impactful stories about the discoveries and ideas shaping our world today.Dr. Winkler, thanks so much for joining us. It’s great to have you on the show.Dr. Alfred Winkler: I welcome the opportunity. Thank you.Feltman: So why don’t we start by just talking a little bit about the prostate? You know, where is it, and what does it do?Winkler: Sure, happy to. So very, very important starting point because people really don’t know what—where the prostate is or what it does.So the prostate sits deep in the male pelvis—only men [meaning people assigned male at birth] have prostates—and it sits below the bladder. The urethra, the urine tube that drains the bladder, runs through the middle of the prostate.The prostate’s main job is to produce the fluid in which sperm are transported. It’s also thought to perhaps produce some antibacterial factors, but its main job is to produce transport fluid.Feltman: So earlier this year the Prostate Cancer Foundation updated its screening guidelines. Could you walk us through what changed and why?Winkler: I think there are two points of emphasis, and, and I’ll start with the one that really has made the biggest difference, and that is the fact that rectal exams, or physical exams, are no longer part of primary screening for prostate cancer. Frankly, that is really what deterred a lot of men from getting screened or even talking about it. So that’s a huge, huge victory in terms of getting more men to come in and be evaluated.Also, there’s a lot more emphasis on shared decision-making. We don’t want this to be a test that your primary care provider orders blindly. There needs to be at least some discussion of why it’s a possible test for you to be ordered. And really, is it a test that’s right for you? And that’s multifactorial.Feltman: Yeah, and so what’s replaced the rectal exam that deterred so many people?Winkler: So over many, many years we’ve just seen that the positive predictive value of doing a rectal exam just isn’t there. It really does not help us diagnose prostate cancer. And what’s more, as I mentioned just now, it’s actually a deterrent for men seeking evaluation.Feltman: And so I assume there are blood tests or other diagnostics that can help detect prostate cancer?Winkler: So primary screening really is only going to consist of the blood test: PSA, or prostatic-specific antigen.Feltman: Got it. And so I believe that the new guidelines also change some of the, the recommendations for the age of first screening. Is that correct?Winkler: Sure, they did, and again, there’s more emphasis on shared decision-making and really fitting whether or not a patient should be screened or even have a test to their particular medical circumstance. So that includes ethnicity or race, it includes family history, and it includes age.And some of those factors even affect the interval of screening. We’ve said, “Well, maybe in certain age groups, we don’t have to screen every year, maybe every two or four years within a certain age band, depending on the patient’s family history.”Feltman: So tell me more about groups that are higher risk. What do we know about those disparities?Winkler: So we look, really, at two primary groups: those folks who have a family history of prostate cancer in a primary male relative, so that’s a father, brother; and also people who have a family history of hereditary breast or ovarian cancer. So it’s very important not only to know the—your own medical history, but it’s important to know your family’s medical history. Not always a favorite topic at family reunions, but it’s an opportunity to just learn more about your family and thereby more about yourself.The other group that continues to be at very high risk are African Americans. African Americans have among the highest rates of prostate cancer in the world. And that’s thought to be multifactorial, so a lot of effort is made towards reaching out to those groups and talking to them about whether or not they should be screened.Feltman: Well, and, you know, you said that that’s thought to be multifactorial, but do we have any idea what those factors might be?Winkler: We do. So some of these factors we can control, and some of these factors are really beyond our control.So the one that’s really—is beyond our control, most obviously, is genetics. Your family history is your family history; your genetics are your genetics. That’s why it’s important to really understand your family history and are there certain diseases that it’s important for you to be screened for, prostate cancer among them.But for most cancers, or at least many cancers, there’s thought to be an environmental factor, and that you can control. So that is the environment in which you live and how you participate in that environment, and the biggest example of that is diet.Feltman: Yeah, that makes sense.So what are the age ranges where people should start thinking about screening, and, you know, how is that different if you are in one of these higher-risk categories?Winkler: Sure, so higher-risk patients should consider getting screened at age 45—and actually, in fact, some people we start screening at age 40. And that screening really consists of the PSA blood test. We essentially have never found value in screening people younger than age 40, regardless of their family history.We really, really try to screen people with the model of shared decision-making, in terms of speaking to your primary care provider and deciding the interval in the context with your family history.We typically do not screen people above the age of 75. The thought process of that is when we discover or diagnose prostate cancer beyond age 75, it tends to be a slower-growing cancer. But again, I think we still need to apply the rule that everyone’s an individual, and if you’re 76, and you’re in great health, and you have a family history, be an advocate for yourself and ask the question, “Is this a good test for me?”The key is early diagnosis. A really wonderful thing that we’re seeing in prostate cancer is that we’re diagnosing more and more people at an earlier stage, where, in fact, they undergo what we call active surveillance, which means that they require no treatment and they require a close follow-up. And that close follow-up is essentially periodic blood tests over the course of two years; some imaging with an MRI of the prostate, which has been a huge difference maker in terms of determining who does and doesn’t need a prostate biopsy. Even folks who are diagnosed with cancer that’s a little bit more aggressive, there are tons of options that include surgery, focal therapy, radiation therapy, and the cure rate of those are easily in the mid-90s.But again, the earlier you diagnose, the more choices you have and the higher your survival rate is. So again, all the more reason to ask about this test so that you can have more information about your risk.Feltman: So if someone is listening to this episode, and they’ve been avoiding getting screened for prostate cancer or talking to their doctor about it, what steps would you recommend that they take?Winkler: Well, I want them to realize that, really, the evaluation is first a discussion ...Feltman: Mm-hmm.Winkler: And then a blood test, and that’s it.Really everyone, to the best of, of their ability, should be seen by a primary care provider on a yearly basis. And for most of us that’s going to involve some questions and a questionnaire and some blood work. So this is just another disease that you are just trying to gauge your risk for.So I think it starts with asking about the test in the first place. I’m very sympathetic to my primary care colleagues. They’re overwhelmed. There’re not enough of them. They’re trying to squeeze a tremendous amount of information and detective work into a short visit, and we sort of have to be our own advocates in that realm.So I think it starts with simply asking your primary care provider, “Do I need this test?” And the conversation may surprise you. You may not actually need that test. Or maybe it’s been a test that you’ve gotten in recently enough that you can skip this year.I think the other thing that’s important for people to realize is when a problem is discovered early there tends to be many, many more choices you have to deal with that problem. And chances are, the more choices there are, the more likely you are to find one that you like. And I think prostate cancer is a great, great example of that.By asking the question you’re only being an advocate for yourself—you really, really have to be an advocate for yourself in all things that have to do with your health. I think there are many things in our lives that we do a better job of taking care of or keeping appointments for way over our health. And it really, really shouldn’t be that way.And to just remember your health is just not you; it’s the people who are around you, who love you, who depend on you and want you here. And they would want you to be an advocate.One idea I, I have that I wish people would do is almost have in your life a “bring a loved one to the doctors” day. When you make your appointment for yourself, maybe make an appointment for your significant other and bring them along. I think that way you’re taking care of two people instead of one, and maybe you’re breaking down some barriers for someone who is not seeking out care just because they’re afraid.Feltman: Yeah, that’s great advice. Thank you so much for joining us, Dr. Winkler. I think this is gonna be really helpful for a lot of our listeners.Winkler: Thank you for the opportunity.Feltman: That’s all for today’s episode. We’ll be back on Friday with part one of our latest Friday Fascination miniseries. This one is all about the beauty and mystery of math, and I promise it’s a surprisingly wild ride.In the meantime, do us a favor and leave a quick rating or a review wherever you listen to this podcast. You can also send us any questions or comments at ScienceQuickly@sciam.com.Science Quickly is produced by me, Rachel Feltman, along with Fonda Mwangi, Kelso Harper, Madison Goldberg and Jeff DelViscio. Shayna Posses and Aaron Shattuck fact-check our show. Our theme music was composed by Dominic Smith. Subscribe to Scientific American for more up-to-date and in-depth science news.For Scientific American, this is Rachel Feltman. See you next time!This episode is part of “Health Equity Heroes,” an editorially independent special project that was produced with financial support from Takeda Pharmaceuticals.

According to the American Cancer Society, Black men are about 70 percent more likely than white men to develop prostate cancer in their lifetime and twice as likely to die from the disease.

This episode is part of “Health Equity Heroes,” an editorially independent special project that was produced with financial support from Takeda Pharmaceuticals.

Rachel Feltman: September is Prostate Cancer Awareness Month, so here’s something you should be aware of: earlier this year the Prostate Cancer Foundation issued new screening guidelines encouraging Black men to start getting baseline blood tests for prostate cancer as early as age 40. That’s because, according to the American Cancer Society, Black men are [about] 70 percent more likely than white men to develop prostate cancer in their lifetime and twice as likely to die from the disease.

For Scientific American’s Science Quickly, I’m Rachel Feltman. Today I’m joined by Dr. Alfred Winkler, chief of urology at NewYork-Presbyterian Lower Manhattan Hospital. He’s here to tell us more about how folks can protect themselves from prostate cancer.

On supporting science journalism

If you're enjoying this article, consider supporting our award-winning journalism by subscribing. By purchasing a subscription you are helping to ensure the future of impactful stories about the discoveries and ideas shaping our world today.

Dr. Winkler, thanks so much for joining us. It’s great to have you on the show.

Dr. Alfred Winkler: I welcome the opportunity. Thank you.

Feltman: So why don’t we start by just talking a little bit about the prostate? You know, where is it, and what does it do?

Winkler: Sure, happy to. So very, very important starting point because people really don’t know what—where the prostate is or what it does.

So the prostate sits deep in the male pelvis—only men [meaning people assigned male at birth] have prostates—and it sits below the bladder. The urethra, the urine tube that drains the bladder, runs through the middle of the prostate.

The prostate’s main job is to produce the fluid in which sperm are transported. It’s also thought to perhaps produce some antibacterial factors, but its main job is to produce transport fluid.

Feltman: So earlier this year the Prostate Cancer Foundation updated its screening guidelines. Could you walk us through what changed and why?

Winkler: I think there are two points of emphasis, and, and I’ll start with the one that really has made the biggest difference, and that is the fact that rectal exams, or physical exams, are no longer part of primary screening for prostate cancer. Frankly, that is really what deterred a lot of men from getting screened or even talking about it. So that’s a huge, huge victory in terms of getting more men to come in and be evaluated.

Also, there’s a lot more emphasis on shared decision-making. We don’t want this to be a test that your primary care provider orders blindly. There needs to be at least some discussion of why it’s a possible test for you to be ordered. And really, is it a test that’s right for you? And that’s multifactorial.

Feltman: Yeah, and so what’s replaced the rectal exam that deterred so many people?

Winkler: So over many, many years we’ve just seen that the positive predictive value of doing a rectal exam just isn’t there. It really does not help us diagnose prostate cancer. And what’s more, as I mentioned just now, it’s actually a deterrent for men seeking evaluation.

Feltman: And so I assume there are blood tests or other diagnostics that can help detect prostate cancer?

Winkler: So primary screening really is only going to consist of the blood test: PSA, or prostatic-specific antigen.

Feltman: Got it. And so I believe that the new guidelines also change some of the, the recommendations for the age of first screening. Is that correct?

Winkler: Sure, they did, and again, there’s more emphasis on shared decision-making and really fitting whether or not a patient should be screened or even have a test to their particular medical circumstance. So that includes ethnicity or race, it includes family history, and it includes age.

And some of those factors even affect the interval of screening. We’ve said, “Well, maybe in certain age groups, we don’t have to screen every year, maybe every two or four years within a certain age band, depending on the patient’s family history.”

Feltman: So tell me more about groups that are higher risk. What do we know about those disparities?

Winkler: So we look, really, at two primary groups: those folks who have a family history of prostate cancer in a primary male relative, so that’s a father, brother; and also people who have a family history of hereditary breast or ovarian cancer. So it’s very important not only to know the—your own medical history, but it’s important to know your family’s medical history. Not always a favorite topic at family reunions, but it’s an opportunity to just learn more about your family and thereby more about yourself.

The other group that continues to be at very high risk are African Americans. African Americans have among the highest rates of prostate cancer in the world. And that’s thought to be multifactorial, so a lot of effort is made towards reaching out to those groups and talking to them about whether or not they should be screened.

Feltman: Well, and, you know, you said that that’s thought to be multifactorial, but do we have any idea what those factors might be?

Winkler: We do. So some of these factors we can control, and some of these factors are really beyond our control.

So the one that’s really—is beyond our control, most obviously, is genetics. Your family history is your family history; your genetics are your genetics. That’s why it’s important to really understand your family history and are there certain diseases that it’s important for you to be screened for, prostate cancer among them.

But for most cancers, or at least many cancers, there’s thought to be an environmental factor, and that you can control. So that is the environment in which you live and how you participate in that environment, and the biggest example of that is diet.

Feltman: Yeah, that makes sense.

So what are the age ranges where people should start thinking about screening, and, you know, how is that different if you are in one of these higher-risk categories?

Winkler: Sure, so higher-risk patients should consider getting screened at age 45—and actually, in fact, some people we start screening at age 40. And that screening really consists of the PSA blood test. We essentially have never found value in screening people younger than age 40, regardless of their family history.

We really, really try to screen people with the model of shared decision-making, in terms of speaking to your primary care provider and deciding the interval in the context with your family history.

We typically do not screen people above the age of 75. The thought process of that is when we discover or diagnose prostate cancer beyond age 75, it tends to be a slower-growing cancer. But again, I think we still need to apply the rule that everyone’s an individual, and if you’re 76, and you’re in great health, and you have a family history, be an advocate for yourself and ask the question, “Is this a good test for me?”

The key is early diagnosis. A really wonderful thing that we’re seeing in prostate cancer is that we’re diagnosing more and more people at an earlier stage, where, in fact, they undergo what we call active surveillance, which means that they require no treatment and they require a close follow-up. And that close follow-up is essentially periodic blood tests over the course of two years; some imaging with an MRI of the prostate, which has been a huge difference maker in terms of determining who does and doesn’t need a prostate biopsy. 

Even folks who are diagnosed with cancer that’s a little bit more aggressive, there are tons of options that include surgery, focal therapy, radiation therapy, and the cure rate of those are easily in the mid-90s.

But again, the earlier you diagnose, the more choices you have and the higher your survival rate is. So again, all the more reason to ask about this test so that you can have more information about your risk.

Feltman: So if someone is listening to this episode, and they’ve been avoiding getting screened for prostate cancer or talking to their doctor about it, what steps would you recommend that they take?

Winkler: Well, I want them to realize that, really, the evaluation is first a discussion ...

Feltman: Mm-hmm.

Winkler: And then a blood test, and that’s it.

Really everyone, to the best of, of their ability, should be seen by a primary care provider on a yearly basis. And for most of us that’s going to involve some questions and a questionnaire and some blood work. So this is just another disease that you are just trying to gauge your risk for.

So I think it starts with asking about the test in the first place. I’m very sympathetic to my primary care colleagues. They’re overwhelmed. There’re not enough of them. They’re trying to squeeze a tremendous amount of information and detective work into a short visit, and we sort of have to be our own advocates in that realm.

So I think it starts with simply asking your primary care provider, “Do I need this test?” And the conversation may surprise you. You may not actually need that test. Or maybe it’s been a test that you’ve gotten in recently enough that you can skip this year.

I think the other thing that’s important for people to realize is when a problem is discovered early there tends to be many, many more choices you have to deal with that problem. And chances are, the more choices there are, the more likely you are to find one that you like. And I think prostate cancer is a great, great example of that.

By asking the question you’re only being an advocate for yourself—you really, really have to be an advocate for yourself in all things that have to do with your health. I think there are many things in our lives that we do a better job of taking care of or keeping appointments for way over our health. And it really, really shouldn’t be that way.

And to just remember your health is just not you; it’s the people who are around you, who love you, who depend on you and want you here. And they would want you to be an advocate.

One idea I, I have that I wish people would do is almost have in your life a “bring a loved one to the doctors” day. When you make your appointment for yourself, maybe make an appointment for your significant other and bring them along. I think that way you’re taking care of two people instead of one, and maybe you’re breaking down some barriers for someone who is not seeking out care just because they’re afraid.

Feltman: Yeah, that’s great advice. Thank you so much for joining us, Dr. Winkler. I think this is gonna be really helpful for a lot of our listeners.

Winkler: Thank you for the opportunity.

Feltman: That’s all for today’s episode. We’ll be back on Friday with part one of our latest Friday Fascination miniseries. This one is all about the beauty and mystery of math, and I promise it’s a surprisingly wild ride.

In the meantime, do us a favor and leave a quick rating or a review wherever you listen to this podcast. You can also send us any questions or comments at ScienceQuickly@sciam.com.

Science Quickly is produced by me, Rachel Feltman, along with Fonda Mwangi, Kelso Harper, Madison Goldberg and Jeff DelViscio. Shayna Posses and Aaron Shattuck fact-check our show. Our theme music was composed by Dominic Smith. Subscribe to Scientific American for more up-to-date and in-depth science news.

For Scientific American, this is Rachel Feltman. See you next time!

This episode is part of “Health Equity Heroes,” an editorially independent special project that was produced with financial support from Takeda Pharmaceuticals.

Read the full story here.
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Indorama Ventures in Port Neches is one of the main drivers of risk — it makes the potent carcinogen ethylene oxide and releases more of the gas into the air than any other facility in the U.S., federal data show. Peter DeCarlo, an atmospheric chemist and a professor at the Johns Hopkins Whiting School of Engineering, and a team of fellow scientists recently drove an air-monitoring van through neighborhoods bordering Indorama. They measured levels of ethylene oxide “greatly exceeding what is acceptable for long-term exposure,” DeCarlo told Public Health Watch. The county’s level of particulate matter already exceeds national air-quality standards. Jefferson County spent 18 years in violation of the standard for ground-level ozone, but improved after 2009. Now, the county’s ozone levels are creeping upward again. DeCarlo said that the new sources of pollution slated for the region could push the county over the limit again — subjecting it to tougher oversight — and worsen its fine-particle problem.  In a statement to Public Health Watch, Woodside said its ammonia plant is 97 percent complete and represents “a $2.35 billion investment in American energy, supporting approximately 2,000 construction jobs and hundreds of permanent ongoing jobs . . . Once operational [it] is expected to increase US ammonia production by more than 7 percent, strengthening domestic agriculture, food production and manufacturing, while potentially doubling US ammonia exports.”  The company said it met with four residents who filed comments with the TCEQ and appreciated “the strong community support for the project.” Energy Transfer and Indorama Ventures did not respond to requests for comment. Andy Morris-Ruiz Historic Black neighborhood threatened with extinction: Beaumont, Jefferson County The Charlton-Pollard neighborhood, on Beaumont’s south side, was established in 1869 by freed slave and school founder Charles Pole Charlton. In the mid-20th century it was a cultural hub — home to Beaumont’s “Black Main Street” and some of the oldest Black churches and schools in the city. It was part of the Chitlin’ Circuit, a group of performance venues during the Jim Crow era, which hosted James Brown, Ray Charles and other luminaries. Segregation, disinvestment and expanding industrial operations — railways, an international seaport and a petrochemical complex — gradually eroded Charlton-Pollard’s rich culture and institutions. Stores, schools and a hospital have closed, and now the buffer between the north end of the neighborhood and advancing industrial development is thinning.   The Port of Beaumont has acquired 78 parcels in Charlton-Pollard’s sparsely populated northeastern corner since 2016, property records show. This year it paved a lot the size of 18 football fields in their place, where it plans to store cargo, including building materials for new and expanding petrochemical plants. The lot lies across the street from the 97-year-old Starlight Missionary Baptist Church and two blocks from Charlton-Pollard Elementary School.  “The port recognizes the deep history of Charlton-Pollard and remains committed to operating responsibly and respectfully within that framework,” said Chris Fisher, the port’s director and CEO. He said he and his team have been transparent with the Charlton-Pollard Neighborhood Association, only developing in a specially zoned “transitional area” in the northeastern corner. In the 1990s and early 2000s, some residents asked the port to buy their properties, Fisher said. Later, after plans for the paved lot were solidified, the port began offering property owners 50 percent to 100 percent above appraised value and, in some cases, $15,000 relocation allowances, he said. “We kind of made sure that everybody that we dealt with was better off than before we did anything,” Fisher said. The port condemned properties when owners couldn’t be located or had unpaid taxes, he said. The neighborhood association’s president, Chris Jones, a 45-year-old former Beaumont mayoral candidate, said the port’s acquisitions are “the continuation of a long pattern. One  where Black neighborhoods were first under-documented, then under-invested, and ultimately treated as expendable in the path of industry.” When residents sold their properties, they “were navigating declining property values, loss of services, and the clear signal that the area was being prioritized for industrial use,” Jones said. “In that context, selling is often less about choice and more about survival.” He worries that the removal of trees and the addition of pavement will intensify heat and worsen noise pollution for those left in the neighborhood. Rail traffic supporting local industry has already increased, he said, and his status as an Army veteran makes him “vexed at the sound of a horn.” Jones and some allies hope to win historical designations for several churches in Charlton-Pollard to stave off further industrial encroachment. Environmental hazards are not new to Charlton-Pollard. A refinery now owned by Exxon Mobil was built less than a mile away in 1903. Almost a century later, residents filed a complaint with the EPA’s Office of Civil Rights, accusing the TCEQ of allowing the company to pollute above safe levels, increase emissions without public input and exceed permitted limits without penalty. The case was settled in 2017 after the TCEQ agreed to install an air monitor near the site and hold two public meetings. Charlton-Pollard still lies within the 99th percentile nationwide for cancer risk from air pollution, according to the Environmental Defense Fund.  In addition to the refinery, Exxon Mobil now operates a chemical plant, a polyethylene plant and a lubricant plant within the complex; last year the company said it plans to build a chemical-recycling facility there as well. Six more petrochemical projects are planned by other companies within five miles of Charlton-Pollard. In short, anyone who hasn’t been bought out by the port may breathe increasingly dirty air. Jefferson County is already violating the EPA’s standard for particulate matter, and diesel-burning trains and maritime vessels accommodating the industry expansion are large emitters of fine particles, as well as smog-forming nitrogen oxides.  Most infuriating, Jones said, is the idea that industrial development in Jefferson County is being underwritten in part by tax breaks even as Beaumont’s basic infrastructure — roads, sewage treatment — crumbles. Not long ago, he said, he saw “fecal waste” collecting in the Irving Avenue underpass. “The shit just rolled onto the street.” (Voters approved a $264 million bond package in November to improve streets and drainage) Andy Morris-Ruiz Fine particles, ozone and the body In addition to spewing carcinogens like benzene and 1,3-butadiene, petrochemical plants release large amounts of “criteria pollutants” —  the six common airborne substances the EPA regulates most closely. Regions across the country struggle to meet federal air-quality standards for two of these in particular: ground-level ozone and particulate matter. Dr. John Balmes, a professor emeritus at the University of California Berkeley School of Public Health, is a physician advisor to both the EPA and the California Air Resources Board, which regulates air quality in a state that’s had serious ozone and particulate-matter problems for years. He’s researched the effects of both pollutants on the body and helped craft EPA standards for them. Balmes said plant emissions will represent only a portion of particulate and ozone pollution from the petrochemical expansion in Texas. Transportation — diesel trucks, trains and ships — will add to the burden, he said. (Railyards and ports are often located in low-income and minority neighborhoods, like Charlton-Pollard.) Particulate matter and ozone can wreak havoc on the body, Balmes said. Fine particles, known as PM2.5, are about 20 times smaller than a human hair. When they’re inhaled, they don’t break down, and the body’s immune cells remain in a heightened state of response. Their ability to fight off infection is weakened. Fine particles often make their way into the bloodstream and trigger cardiovascular problems, such as heart attacks and congestive heart failure. They can also accumulate in the brain, contributing to cognitive decline and strokes. A 2023 analysis conducted for Public Health Watch by two researchers estimated that 8,405 Texans died from fine-particle pollution in 2016. Exposure to the particles also led to thousands of new cases of Alzheimer’s, asthma and strokes, the researchers found. Last year, an EPA advisory board, on which Balmes served, recommended tightening the National Ambient Air Quality Standard for PM2.5. The EPA said the new standard would prevent 4,500 premature deaths and yield $46 billion in net health benefits over more than a decade. According to federal data, 16 Texas counties, including Jefferson, violate the new standard, which the Trump administration has vowed to abandon. Environmental groups and regulators have been fighting ozone pollution for more than 70 years. Ozone gas is formed when two pollutants — VOCs and nitrogen oxides — are released from stacks and tailpipes and react in the presence of sunlight. When ozone enters the body, it chemically burns the respiratory system, leading to inflammation. It’s so caustic that it can break down synthetic rubber. Acute exposure can worsen asthma; chronic, high-level exposure can cause permanent lung damage. The eight-county Houston-Galveston-Brazoria area, with roughly 7.2 million people, has been under continual threat from ozone for two decades. It spent over half of that time classified as being in “serious” or “severe” violation of the EPA’s eight-hour standards. Still, 35   petrochemical projects in the region have been announced or permitted by the TCEQ.   “Adding 35 petrochemical plants to a region that is already in serious ozone [violation] is the wrong way to go in terms of public health,” Balmes said. Explore all 13 scenes from Texas’s petrochemical expansion at publichealthwatch.org. This story was originally published by Grist with the headline Texas clears the way for petrochemical expansion as experts warn of health risks on Jan 7, 2026.

Health
Chemicals
Pollution

Airline Water Safety Raises Red Flags in New Study

By I. Edwards HealthDay ReporterMONDAY, Jan. 5, 2026 (HealthDay News) — If you order coffee or tea on a flight, you may want to think twice.A 2026...

MONDAY, Jan. 5, 2026 (HealthDay News) — If you order coffee or tea on a flight, you may want to think twice.A 2026 airline water study found that drinking water quality can vary sharply from one airline to another, and that many carriers still fail to meet federal safety standards meant to protect passengers and crew.Researchers evaluated 10 major airlines and 11 regional carriers, giving each a Water Safety Score ranging from a low of 0.00 to a high of 5.00. A score of 3.5 or higher earned a Grade A or B, meaning relatively safe onboard water."Delta Air Lines and Frontier Airlines win the top spots with the safest water in the sky, and Alaska Airlines finishes No. 3," the center’s director, Charles Platkin, said in a news release.By contrast, the lowest-scoring major airlines were American Airlines and JetBlue, the study found. "Nearly all regional airlines need to improve their onboard water safety, with the exception of GoJet Airlines," Platkin added.The federal Aircraft Drinking Water Rule (ADWR), in place since 2011, requires airlines to provide safe drinking water onboard. Airlines must regularly test water tanks for coliform bacteria and possible E. coli, and they must disinfect and flush each aircraft’s water system multiple times per year.To score airlines, researchers looked at five weighted factors, including:Violations per aircraft Maximum Contaminant Level violations for E. coli Rates of coliform-positive tests Public notices How often water systems were disinfected and flushed Across all airlines studied, 35,674 water sample locations were tested for coliform bacteria. Of those, 949 samples (2.7%) tested positive.The study also identified 32 E. coli violations across the 21 airlines analyzed, the single biggest factor dragging scores down.Delta Air Lines earned a perfect 5.00 (Grade A). Frontier Airlines scored 4.80 (Grade A). Alaska Airlines followed with 3.85 (Grade B). GoJet Airlines was the highest-rated regional carrier at 3.85 (Grade B). American Airlines ranked lowest among major airlines at 1.75 (Grade D). Mesa Airlines scored 1.35 (Grade F), the lowest among regional carriers. CommuteAir had a 33.33% coliform-positive rate, one of the highest in the study. The report’s "Shame on You" award went to the U.S. Environmental Protection Agency (EPA), which shares responsibility for enforcing aircraft water safety standards. Civil penalties for airline water violations remain extremely rare, the study noted.Testing for coliform bacteria matters because its presence can signal that disease-causing organisms may also be in the water system. When samples test positive, airlines are required to quickly retest, disinfect, flush or shut down affected systems, depending on results.Because aircraft refill water tanks from many locations, including international airports, onboard water quality can also be affected by hoses, trucks and other transfer equipment, researchers noted.Until airline water systems improve, the Center for Food as Medicine & Longevity offers clear guidance for travelers who want to reduce risk.“NEVER drink any water onboard that isn’t in a sealed bottle,” the group advises.They also recommend skipping onboard coffee and tea and using alcohol-based hand sanitizer with at least 60% alcohol instead of washing hands with airplane sink water.SOURCE: Center for Food As Medicine and Longevity, news release, Jan. 2, 2026 Copyright © 2026 HealthDay. All rights reserved.

Health
Water

Why Home Maintenance Deserves a Spot in the Annual Health and Budget Plans

Experts say home care can affect your health and finances

Many people start the new year thinking about ways to improve their health, be more organized and manage their finances. Experts say there is one area that touches on each of those resolutions — home care.Early and routine home maintenance goes beyond fixing visible damage. It helps ensure a healthy living environment, extends the life of a home and can protect its long-term value, according to real estate professionals. Planning ahead for regular upkeep and for unexpected emergencies can reduce the risk of costly repairs later and help spread expenses more evenly throughout the year.According to research by the U.S. Department of Energy and the Environmental Protection Agency, about three-quarters of existing homes are expected to still be in use in 2050.“Maintaining the homes that we have is really essential to protecting our health and our well-being,” said Amanda Reddy, executive director of the National Center for Healthy Housing, an organization that researches and advocates for reducing housing-related health disparities.Despite who owns the property, Reddy says, keeping residences dry, clean, pest-free, well-ventilated and safe is the goal, which can mean different types of maintenance depending on the type of home, where someone lives and the time of year. Here's what experts say about home care and what tasks to put on the checklist this year: Home care includes the big projects and the everyday decisions On average, Americans spend about 90% of their time indoors, 70% of that time inside of a residence, according to the National Human Activity Pattern Survey.“It's not just that we spend time indoors, but at home. If you are older, very young, have health concerns, or work from home, it is likely more than that,” Reddy said, emphasizing the reason why home care is a valuable investment.What many people think of maintenance includes addressing water and gas leaks, pest infestations, cracks and other major repairs, but home builders say not everything needs a professional and can include actions as simple as wiping counters and sweeping floors of food debris, opening windows for better ventilation or clearing out clogged filters and drains.Residents should also consider the needs of those living in the home, commonly used spaces such as kitchens, bathrooms and bedrooms, and typically neglected areas like attics and basements. Reddy says “anywhere we’re spending time” or often ignoring and possibly missing necessary repairs should be prioritized.“At the end of the day, doing any preventative maintenance at all matters more than doing it perfectly or at exactly the right time,” Reddy said. “But timing can make a big difference. A lot of these tasks are seasonal or annual, and you’re not just going to do it one time. Homes are stressed differently by different times of the year, so seasonal maintenance helps us catch problems before they’re made worse by environmental stressors.” Seasonal maintenance to plan for throughout the year When it comes to maintenance, planning and preparing for anticipated and routine changes in the environment can help mitigate natural wear and tear on the exterior of homes and also create healthy conditions inside — where most people shelter from extreme weather events.“What happens outside the house rarely stays outside the house. What’s outside gets inside, what’s inside builds up," Reddy said, adding that fluctuating outdoor conditions put stress on appliances and systems at different times of the year. “For most people, the seasonal rhythm not only makes sense because of those stressors, it also just is more realistic and effective than trying to tackle a long, overwhelming checklist all at once."For example, experts say the best time to prepare for cold and wet climate, storms and other natural disasters is to address concerns before temperatures drop. Similarly, it is recommended that residents address systems in homes that work to reduce the effects of extreme high temperatures, dry and drought conditions and associated risks like wildfires and air quality in the offseason.Professional guidance from home inspectors, builders and real estate agents says spring and summer tasks should focus on preparing for warmer weather. Experts recommend checking air conditioning systems, cleaning dryer vents to prevent fire hazards, testing sprinkler systems, tending to gardens and plants around homes' exterior and inspecting appliances, electrical equipment and plumbing fixtures. Experts also say spring is a good time to clean and do any house projects that involve painting or remodeling since rain is unlikely to cause delays during that time.In the fall and winter months, experts suggest focusing on temperature control and air quality measures as people tend to shelter indoors during incoming colder weather. American Home Inspectors Training guidance says check heating systems, clean air filters, make sure carbon monoxide detectors are working, seal air leaks, prioritize pest control, clean and repair roofs and chimneys, and inspecting drainage options in and around homes.Copyright 2026 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.Photos You Should See – December 2025

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Climate
Food

Understanding Childhood Obesity: Causes, Treatments and How to Reduce Stigma

By Shagun Bindlish, MD, FACP, FOMA, DABOM, DACLM HealthDay ReporterTUESDAY, Dec. 30, 2025 (HealthDay News) — While childhood obesity has become...

TUESDAY, Dec. 30, 2025 (HealthDay News) — While childhood obesity has become more common in recent years, this is a condition that is about more than just weight.Childhood obesity reflects our modern environment of ultra-processed foods, digital devices and psychological stressors.To address childhood obesity, clinicians and families must work together to create a more nuanced, compassionate and evidence-based approach to prevention and care.What is childhood obesity?Today’s pediatric obesity epidemic involves both a child’s genetics and their environment. While genetics does play a significant role in the development of obesity in children, environments full of ultra-processed foods, screen-focused forms of recreation, poor sleep and mental stress are powerful contributors.Recent research shows that a mother’s health, how a baby is fed, and even exposure to certain chemicals during pregnancy can affect a child’s future metabolism.Combined with aggressive food marketing and environmental and social barriers to regular physical activity across diverse communities, these factors create a “perfect storm” for early metabolic risk.The power of early screeningThe American Academy of Pediatrics (AAP) and Obesity Medicine Association (OMA) recommend that screening for obesity begin as early as age 2. In diagnosing obesity in children, clinicians look for the following:Assessing all of these factors can help clinicians intervene before weight-related issues develop.  The goal is not to put labels on children. It’s to help them build habits early, fostering healthy eating patterns, physical activity and self-esteem during their early years. Tailoring treatment based on age For children who have not entered puberty, the main goal is to normalize growth: maintain a healthy weight so height can catch up. Success depends on parents modeling healthy habits, setting routines and encouraging activity through play. Teenagers need more independence and support for emotional and social issues. Effective care should assess their sleep, stress and emotional eating, and should also check for bullying, depression, disordered eating and the effects of social media.The importance of guidance from caregiversThe most important factor in treating pediatric obesity is family and/or caregivers.Families and caregivers need guidance on nutrition, physical activity, understanding behavior and providing emotional support. Sustainable change is possible when a family works together. Parent-led steps like cooking meals together, being active as a family and limiting certain foods can make a big difference.Behavioral therapy reframes obesity as a chronic, relapsing condition, not a personal failure. It empowers both children and caregivers to replace shame with skills.Both the Obesity Medicine Association and the American Academy of Pediatrics recommend intensive health behavior and lifestyle treatment (IHBLT), defined as at least 26 hours of structured, family-based counseling delivered over 6-12 months.Higher total contact time is associated with greater and more sustained improvements in BMI and cardiometabolic risk.Possibly one of the most important things clinicians can do is speak to children with obesity (and their parents) without putting the focus on weight. Using terms like “health habits” and “growth pattern” and emphasizing body positivity instead of focusing on “weight talk” can help patients feel more comfortable and committed to their treatment.It is also crucial to train staff to use person-first language (“child with obesity,” not “obese child”) to create a welcoming and weight-inclusive environment. This includes having appropriate seating, using a nonjudgmental tone and building trust with patients.For severe obesity, new options approved by the U.S. Food and Drug Administration have emerged, like liraglutide and semaglutide (GLP-1 receptor agonists).These medications must accompany the changes in lifestyle (nutrition, physical activity and behavioral therapy). They should be prescribed by clinicians trained in pediatric obesity medicine.For teenagers with severe obesity and other related health issues, metabolic bariatric surgery offers a durable solution but requires long-term nutritional and emotional support.Building a healthier future for childrenChildren cannot overcome obesity on their own. Effective prevention requires collaboration from their family, health care providers, schools, policymakers and communities.Policies like healthy school meals, walkable neighborhoods, early nutrition education and restrictions on junk food marketing can reduce pediatric obesity better than clinical care alone.Shagun Bindlish, MD, FACP, FOMA, DABOM, DACLM, is an internist and diabetologist with advanced expertise in obesity and lifestyle medicine. She serves as medical and scientific chair for the American Diabetes Association in Northern California and is the founder of the Golden State Obesity Society. An educator at Touro University California and University at Sea CME, she has trained providers worldwide in metabolic health. She is also a recipient of the prestigious Compassionate Physician of the Year Award by the California Medical Association. Her work focuses on advancing diabetes and obesity care through innovation, education and advocacy.Copyright © 2025 HealthDay. All rights reserved.

Health
Chemicals
Food

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Ground Operations: Battlefields to Farmfields

Combat veterans from the wars in Iraq & Afghanistan find a new mission and personal healing with new careers as organic farmers and ranchers.

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The Connection Between Bats and Coronavirus: Wildlife is not to blame

What exactly is the connection between bats and coronavirus? And how has sheltering-in-place disrupted field research in California and beyond? State and local governments have set restrictions on bat research and rescue in an effort to curtail the spread of the coronavirus. Dr. Winifred Frick, chief scientist of Bat Conservation International, describes how the new restrictions have affected conservation efforts.

Animals
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In His Own Home

Heavily armed officers of the University of Florida police department in Gainesville, FL, responding to a 911 call from a neighbor who heard screams, break into the campus apartment of Ghanaian graduate student, Kofi Adu-Brempong. Clad in SWAT gear and ready to attack, they see the disabled doctoral student, sitting with a metal table leg in his hand and within a minute of entry, shoot the unarmed man in the face. Adu-Brempong, who because of childhood polio, needed a cane to walk, and had been suffering from mental illness, now has severe facial injuries, and is charged with resisting arrest. He is guarded outside his hospital door, his legs shackled together when going to the bathroom. The officer who shoots Kofi, and who had previously been caught cruising through town throwing eggs at residents of a Black neighborhood, is not suspended or fired. Student protests lead the administration to drop charges but calls for revoking SWAT-like teams on campus go unheard. Kofi’s shooting is not an isolated incident but part of an ongoing pattern of police brutality against Blacks and a stark reminder of the dangers of increasingly militarized campuses nationwide. In His Own Home came out of outrage by a small group of concerned community members committed to seeing social justice happen on a local level. This documentary is an educational and organizing tool, especially calling for our communities to be safe from violence by racist and over-armed police.

Social Justice
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Again, Together - The Cumulative Impact of Environmental Racism in Houston

"Again, Together" is a film created in partnership with Ronald L. Jones, bringing stories from communities across Houston that have been impacted by environmental racism — namely redlining, segregation, underinvestment, exposure to pollution, gentrification, inequitable disaster recovery resources and freeway development.

Social Justice
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Allergy Alert: Paranoia in Our Immune System

From peanuts and pollen to cats and dust mites, allergy rates are soaring dramatically all over the globe, with inoffensive substances triggering life-threatening physical responses. Experts are predicting that by 2050, one in two will suffer from an allergy. Why are our immune systems overreacting in this way? To stem the tide of the epidemic, scientists are investigating the interface between genetics, environmental factors and our modern lifestyle, and developing revolutionary new approaches to prevention and treatment.

Science
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