Health

(LONDON) — A new report commissioned by the National Health Service England advocates for further research on gender-affirming care for transgender youth and young adults.

Dr. Hillary Cass, a former president of the Royal College of Paediatrics and Child Health, was appointed by NHS England and NHS Improvement to chair the Independent Review of Gender Identity Services in 2020 amid a rise in referrals to NHS’ gender services. Upon review, she advises “extreme caution” for the use of hormone therapies.

“It is absolutely right that children and young people, who may be dealing with a complex range of issues around their gender identity, get the best possible support and expertise throughout their care,” Cass states in the report.

Around 2022, about 5,000 adolescents and children were referred to the NHS’ gender services. The report estimated that roughly 20% of children and young people seen by the Gender Identity Development Service (GIDS) enter a hormone pathway — roughly 1,000 people under 18 in England.

Following four years of data analysis, Cass concluded that “while a considerable amount of research has been published in this field, systematic evidence reviews demonstrated the poor quality of the published studies, meaning there is not a reliable evidence base upon which to make clinical decisions, or for children and their families to make informed choices.”

Cass continued: “The strengths and weaknesses of the evidence base on the care of children and young people are often misrepresented and overstated, both in scientific publications and social debate,” read the report.

Among her recommendations, she urged the NHS to increase the available workforce in this field, to work on setting up more regional outlets for care, increase investment in research on this care, and improve the quality of care to meet international guidelines.

Cass’ review comes as the NHS continues to expand its children and young people’s gender identity services across the country. The NHS has recently opened new children and young people’s gender services based in London and the Northwest.

NHS England, the country’s universal healthcare system, said the report is expected to guide and shape its use of gender affirming care in children and potentially impact youth patients in England accessing gender-affirming care.

The debate over transgender youth care
In an interview with The Guardian, Cass stated that her findings are not intended to undermine the validity of trans identities or challenge young people’s right to transition but to improve the care they are receiving.

“We’ve let them down because the research isn’t good enough and we haven’t got good data,” Cass told the news outlet. “The toxicity of the debate is perpetuated by adults, and that itself is unfair to the children who are caught in the middle of it. The children are being used as a football and this is a group that we should be showing more compassion to.”

In the report, Cass argued that the knowledge and expertise of “experienced clinicians who have reached different conclusions about the best approach to care” has been “dismissed and invalidated” amid arguments concerning transgender care in youth.

Cass did not immediately respond to ABC News’ request for comment.

Recommendations for trans youth care
Cass is calling for more thorough research that looks at the “characteristics, interventions and outcomes” of NHS gender service patients concerning puberty blockers and hormone therapy, particularly among children and adolescents.

The report’s recommendations also urge caregivers to take an approach to care that considers young patients “holistically and not solely in terms of their gender-related distress.”

The report notes that identity exploration is “a completely natural process during childhood and adolescence.”

Cass recommends that pre-pubertal children and their families have early discussions about how parents can best support their child “in a balanced and non-judgemental way,” which may include “psychological and psychopharmacological treatments” to manage distress associated with gender incongruence and co-occurring conditions.

In past interviews, U.S. physicians told ABC News, that patients, their physicians and their families often engage in a lengthy process of building a customized and individualized approach to care, meaning not every patient will receive any or every type of gender-affirming medical care option.

Cass’ report states that evidence particularly for puberty blockers in children and adolescents is “weak” regarding the impact on “gender dysphoria, mental or psychosocial health. The effect on cognitive and psychosexual development remains unknown.”

The NHS has said it will halt routine use of puberty blockers as it prepares for a study into the practice later this year.

According to the Endocrine Society puberty blockers, as opposed to hormone therapy, temporarily pause puberty so patients have more time to explore their gender identity.

The report also recommends “extreme caution” for transgender youth from age 16 who take more permanent hormone therapies.

“There should be a clear clinical rationale for providing hormones at this stage rather than waiting until an individual reaches 18,” the report’s recommendations state.

Hormone therapy, according to the Endocrine Society, triggers physical changes like hair growth, muscle development, body fat and more, that can help better align the body with a person’s gender identity. It’s not unusual for patients to stop hormone therapy and decide that they have transitioned as far as they wish, physicians have told ABC News.

Cass’ report asserts that there are many unknowns about the use of both puberty blockers and hormones for minors, “despite their longstanding use in the adult transgender population.”

“The lack of long-term follow-up data on those commencing treatment at an earlier age means we have inadequate information about the range of outcomes for this group,” the report states.

Cass recommends that NHS England facilities have procedures in place to follow up with 17 to 25-year-old patients “to ensure continuity of care and support at a potentially vulnerable stage in their journey,” as well as allow for further data and research on transgender minors through the years.

Several British medical organizations, including British Psychological Society and the Royal College of Paediatrics and Child Health, commended the report’s recommendations to expand the workforce and invest in further research to allow young people to make better informed decisions.

“Dr Cass and her team have produced a thought-provoking, detailed and wide-ranging list of recommendations, which will have implications for all professionals working with gender-questioning children and young people,” said Dr Roman Raczka, of the British Psychological Society. “It will take time to carefully review and respond to the whole report, but I am sure that psychology, as a profession, will reflect and learn lessons from the review, its findings and recommendations.”

Some groups expressed fears that the report will be misused by anti-transgender groups.

“All children have the right to access specialist effective care on time and must be afforded the privacy to make decisions that are appropriate for them in consultation with a specialist,” said human rights group Amnesty International. “This review is being weaponised by people who revel in spreading disinformation and myths about healthcare for trans young people.”

Transgender care for people under 18 has been a source of contention in both the United States and the United Kingdom. Legislation is being pushed across the U.S. by many Republican legislators focused on banning all medical care options like puberty blockers and hormone therapies for minors. Some argue that gender-affirming care is unsafe for youth, or that they should wait until they’re older.

Gender-affirming medical does come with risks, according to the Endocrine Society, including impacts to bone mineral density, cholesterol levels, and blood clot risks. However, physicians have told ABC News that all medications, surgeries or vaccines come with some kind of risk.

Major national medical associations in the U.S., including the American Academy of Pediatrics, the American Medical Association, the American Academy of Child and Adolescent Psychiatry, and more than 20 others have argued that gender-affirming care is safe, effective, beneficial, and medically necessary.

The first-of-its-kind gender care clinic at Johns Hopkins Hospital in Maryland opened in the 1960s, using similar procedures still used today.

Some studies have shown that some gender-affirming options can have positive impacts on the mental health of transgender patients, who may experience gender-related stress.

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(NEW YORK) — From Whole Foods to corner bodegas, fizzy juice drinks from fruity seltzers to reduced-sugar sodas that boast prebiotic and digestive support have exploded in popularity.

But what are the actual benefits of these juices and sodas?

Registered dietitian and nutritionist Maya Feller joined ABC News’ Good Morning America on Wednesday to weigh in on the canned beverage consumption trend.

“Flavored sparkling water like Spindrift is literally seltzer water and a splash of real fruit [juice, with] no sugar added or sugar substitutes,” Feller said. “[Juice sodas] can have cane sugar and other juice concentrates.”

Feller said that Spindrift and other similar sparkling water with real fruit is a great option for consumers looking to enjoy a zero-added-sugar soda alternative, and a good way to stay hydrated.

“Be mindful and intentional,” she continued. “Choose the things that have no added sugar.”

While juice sodas can be a better alternative to a sugary traditional soft drink, Feller encouraged people to “read the nutrition facts label, be an informed consumer and know what you’re drinking.”

According to the nutrition page for the popular prebiotic soda Poppi, the drink is a combination of sparking water, organic cane sugar and other juice concentrates, and each drink contains “5 grams of sugar or less.”

Similarly, Olipop, a self-proclaimed “healthy” soda that contains prebiotics, plant fiber and botanicals, states on its website that the drinks contain just 2 to 5 grams of sugar.

When it comes to regular fruit juice like orange or apple juice, Feller reminded people to “opt for 100% juice, because there’s no sugar added.”

Feller recommends drinking just 4 ounces with a meal to “help slow down the sugar absorption into your bloodstream” and avoid a glucose spike.

As for the drinks that boast health support — such as Olipop or Poppi — Feller said to “tread lightly.”

“I wouldn’t say there’s anything negative about it,” she said, reiterating that it’s “a good alternative to sugar sweetened beverages, [but] don’t think you’re doing yourself this health favor — because many scientists don’t actually agree with these health claims.”

“Do your homework — especially when these are claiming to be good for our health,” she added. “When you’re having a prebiotic soda, you are not actually adding any extreme nutrients to your overall day. If you want to have it, go for it.”

Feller said that she will enjoy a prebiotic soda “once in a while,” with the caveat that it’s “an intentional and mindful choice.”

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(NEW YORK) — Eight-year-old Hannah is winning over audiences and raising awareness for a rare but serious disorder one bite at a time.

Hannah, along with her mother Michelle, has gone viral with her Instagram videos where she tries out little bits of certain food for the first time. She samples everything from mac and cheese to different yogurts, and ranks them on a scale from 1 to 10.

Some days honeydew melon has her fighting back tears; some days a taste of a sweet apple pear is followed by a smile.

The videos have been a form of therapy for Hannah, who suffers from avoidant restrictive food intake disorder, or ARFID, a disorder where a person is afraid of food to the point where they don’t want to consume it.

Hannah told ABC News’ Nightline that talking about her struggles and finding the right food has helped her push through.

“That helps motivate me,” she said. “Whenever I’m trying food, I think about all the people that I’m helping.”

Between 0.5% to 5% of children and adults in the general population have ARFID, which was added as an official diagnosis in feeding and eating disorders in 2013, according to the National Eating Disorders Association.

Some research suggests a possible connection with ARFID and conditions like Autism, ADHD and Anxiety, according to the American Psychiatric Association.

The condition is often confused with more common eating disorders like anorexia or bulimia, but ARFID is not about a person’s self-image or drive to be thin, according to mental health experts.

“The people that have this diagnosis have a fear of food, meaning a fear consuming food, [and] a fear of being around food. That can look like a fear of texture, [or] different aversions to smells. It can also present in a form of fear of choking, vomiting, or being allergic to the food,” Danielle Gordon, a therapist who specializes in eating disorders, told Nightline.

Gordon diagnosed Hannah with ARFID after her parents sought solutions to her extra picky eating. Michelle told Nightline that they were growing concerned about Hannah’s health.

“We noticed when she went to get her physicals at the doctors, and her growth was not increasing at the rate that it was supposed to. She ended up falling off of the growth chart eventually,” she said. “Often times she couldn’t even be in the same room with us when we were eating.”

Gordon recommends exposure therapy to her ARFID patients and Michelle said it has greatly helped her daughter.

“She is on cloud nine,” Michelle, who asked Nightline not to disclose her family’s last name, said of Hannah. “She’s very happy to, you know, prove to herself and prove to everybody else that’s watching her that she can do it, and that she can overcome these challenges.”

In January, Hannah and Michelle started Hannah’s Instagram page and began “My ARFID Life,” bringing in fans from around the world, including those who are also living with the condition.

They said they have received so many good comments from people who are also suffering from ARFID but didn’t have an outlet for their feelings.

Cassidy Arvidson, 27, of Brooklyn, told Nightline that after she was diagnosed with ARFID three years ago she couldn’t find anyone in the community who she could talk to about her struggle.

“ARFID affects my life every single day. It affects my life socially more than anything,” she said. “And it is very exhausting dating, specifically. I really do not enjoy. And then other social events like going out with friends, meeting new people, work events.”

Arvidson said she was touched and inspired by Hannah’s posts.

“She is so brave in doing all the exposures that she does,” she said.

Gordon and other advocates hope more can be done to shine a light on ARFID.

“I think that we need to do a better job as an eating disorder community to give ARFID as much of a spotlight as the other disorders,” she said. “And even research-wise, we need to do more work around this area to really help people and provide proper treatment for all.”

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(NEW YORK) — The Environmental Protection Agency on Wednesday announced a new rule mandating the first-ever national standard for the presence of so-called “forever chemicals” in drinking water.

The new standard limits six types of per- and polyfluoroalkyl substances, or PFAS, found in drinking water — a move the EPA says will protect around 100 million people from exposure.

“Today, I’m extremely excited to announce that we are finalizing the first ever nationwide, legally enforceable drinking water standard for PFAS — the most significant action on PFAS the EPA has ever taken,” EPA Administrator Michael Regan said during a call with reporters. “This standard will reduce PFAS exposure to approximately 100 million people.”

PFAS are a ubiquitous group of chemicals found in a host of industrial and personal products, including fire extinguishing foam, food packaging, dental floss and others, according to the EPA.

The chemicals break down very slowly, allowing them to build up in people, animals and the environment over time — hence the nickname, “forever chemicals.”

“This rule really is a breakout from where we’ve been for decades,” Erik Olson, senior strategic director for health at the Natural Resources Defense Council, told ABC News. “Finally, we’re seeing government start to take the PFAS crisis seriously.”

The EPA says it expects 6% to 10% of the 66,000 public drinking water systems in the U.S. may have to reduce PFAS from their water systems to meet the new standard.

Under this rule, water systems across the country will have three years to monitor for these chemicals and an additional two years to implement new technology to reduce their PFAS levels.

One billion in funding from the Bipartisan Infrastructure Law will be available to help states and territories with testing and treatment for PFAS as they work to come into compliance over the next few years.

By reducing PFAS exposure for millions of Americans, the Biden administration says this new standard will also prevent severe illness and death for many Americans.

“One hundred million people will be healthier and safer because of this action,” Regan said. “This action will prevent thousands of deaths and tens of thousands of serious illnesses.”

PFAS exposure has been linked to increases in cholesterol, changes in liver enzymes and pregnancy complications like preeclampsia, among other issues, according to the Centers for Disease Control and Prevention.

“Every single person in the United States is walking around with PFAS in their bodies,” Olson said. “The risks are very real. These EPA rules will start the process of controlling the risks from tap water.”

The chemicals targeted by the EPA in this rule include five individual PFAS: PFOA, PFOS, PFNA, PFHxS, and HFPO-DA. These five are also known as “GenX Chemicals.” The rule also targets mixtures of two or more of four PFAS: PFNA, PFHxS, PFBS, and “GenX chemicals.”

Olson noted that a large area in North Carolina famously became polluted with GenX Chemicals after a chemical plant spent decades dumping PFAS into the Cape Fear River.

“There’s still only six that EPA is regulating, which is a good step, but they are 14,000 of these PFAS,” Olson said. “So, we’re taking a bite out of the problem, but we really need to regulate this whole class of toxic chemicals together because if we keep regulating them a few at a time, we’re just never going to get off the toxic treadmill and never going to catch up with all the new chemicals the industry keeps producing and exposing us to.”

Some industry groups opposed the rule during its public comment period.

The American Chemistry Council released a statement last summer criticizing the EPA’s plan, saying the assessment of health impacts the agency relied on for its analysis was flawed and that it underestimated the cost of compliance for water systems.

Biden administration officials say they expect continued opposition under the finalized standards, but that they designed the rule to withstand potential challenges.

“We feel very confident that we have designed a very durable rule, well within our statutory authority, that begins to protect people from harmful pollutants that are showing up in their drinking water,” a senior administration official said. “This is something that we’ve done in concert with our sister agencies. It’s a government wide effort, and we’re very proud of the product that we are releasing today.”

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(NEW YORK) — Theo Huot de Saint-Albin was a 9-year-old elementary school student when he first contracted COVID-19 in July 2020, near the start of the coronavirus pandemic.

Four years later, as much of the world has moved on from the pandemic and resumed normal life, Theo, now nearly a teenager, is still battling the effects of long COVID.

“What happened directly after COVID-19 was worse than my actual COVID-19,” Theo, now in seventh grade, told ABC News’ Good Morning America. “For me, I have chronic migraines … it doesn’t mean the migraine is terrible every day. It’s very unpredictable. It goes in waves. But it’s always there. It never leaves.”

Over the past four years, Theo has contracted COVID-19 a total of three times, and each case has been mild. It’s what happens in the weeks and months after the COVID-19 diagnosis that he says has impacted his ability to learn, go to school and play with friends.

In addition to battling chronic migraines, Theo was also diagnosed with postural orthostatic tachycardia syndrome, or POTS, a blood circulation disorder that can cause dizziness, lightheadedness and a rapid heartbeat, according to the U.S. National Institute of Neurological Disorders and Stroke.

He said he also suffers from symptoms like muscle pain, extreme fatigue and brain fog, and takes around two dozen medications and supplements each day to help manage his symptoms.

“There’s no real way to tell how I’m going to feel,” Theo said, noting that some days he is able to go to school for only a half-day, while other days he feels closer to his pre-COVID-19 self, and still others he can’t move beyond the couch all day.

“It’s especially hard because it’s ‘invisible,'” Theo said of his long COVID diagnosis. “Sometimes it’s hard to get people to believe you as well because they can empathize with something they know is there. ‘Oh, you have a broken leg, I can see that. Wow, you can’t walk. That must be tough.’ But, your head hurts? ‘I don’t see a big bulge on your head. I don’t see bandages wrapped around it.'”

An ‘invisible’ condition impacting potentially millions of kids

While battling long COVID can seem lonely, Theo is far from alone, data shows.

An analysis published in February in the journal Pediatrics reported that as many as 5.8 million children in the United States have developed long COVID, or between 10% to 20% of children who have contracted COVID-19.

Figures from the Centers for Disease Control and Prevention show a smaller but still noteworthy estimate of 1.3% of children in the U.S. having had long COVID as of 2022.

Long COVID is diagnosed when patients still have symptoms at least four weeks after they have cleared the infection, according to the CDC. In some cases, like Theo’s, symptoms can be present for months or years.

It’s not clear if long COVID symptoms last a lifetime. Many people eventually recover, but scientists are still working to understand who is most affected, and why.

Symptoms vary and can include fatigue, difficulty breathing, headaches, dizziness brain fog, joint and muscle pain and continued loss of taste and smell, according to the CDC.

In kids, symptoms of long COVID can also include rashes, diarrhea, heart issues and diabetes, according to the research published in Pediatrics.

Part of the complication with long COVID is there is no single test or bloodwork to diagnose it. Instead, doctors have to rule out other conditions and rely on patients to describe and track their symptoms, which can be difficult with kids.

For Theo, it took nearly two years for him to be diagnosed with long COVID, according to his mom Meredith Eubanks.

Eubanks said she was told “no” by doctors when she would ask if her son might have long COVID, and faced misdiagnoses along the way, like Lyme disease. Both she and Theo struggled to answer when asked roughly how many doctors he had seen over the past four years.

In April 2022, Eubanks said Theo was diagnosed with long COVID by an infectious disease group at a local children’s hospital in Atlanta, where the family lives. But the hospital, according to Eubanks, had no answer to her question of “Now what?” in terms of treatments and rehabilitation.

For that, the family traveled over 600 miles to Baltimore, where Dr. Laura Malone, a pediatric neurologist, had established the Pediatric Post-COVID-19 Rehabilitation Clinic at the Kennedy Krieger Institute, a pediatric-focused nonprofit health organization affiliated with Johns Hopkins Medicine.

“They were the first place we got to where they were like, ‘Here’s a list of symptoms, and did you have any pre-COVID, and what did you have post-COVID?'” Eubanks said, recalling how Theo checked nearly all of the symptoms on the list. “I just remember that was such relief. It was just like, ‘Oh, you know, they’re recognizing this and it’s official, and Theo is not alone.'”

Malone said she and her team at the Kennedy Krieger Institute established the clinic in the summer of 2020 as they saw reports of adults developing long COVID. As the pandemic continued, demand began to grow.

“Everybody was, early in the pandemic, very focused on hospitalized cases, and the sequela after people get care in the ICU or are very critically ill with the acute infection, and that’s not generally what we see in pediatrics,” Malone said. “Most children can have a relatively mild infection and then go on to develop long-term sequela. So, that took a little bit of time to recognize and for patients to seek care, both from their primary care doctors and then also from clinics like us.”

As long COVID became more recognized, Malone said the clinic has seen steady demand from pediatric patients across the country, while she said other patients may go undiagnosed.

“You have to look at a lot of behavioral changes, especially in younger children, to say, ‘Something seems off’.’ So I do think that [long COVID] is probably a little bit under-recognized still,” Malone said. “We do see that there can be a lot of resiliency in children, and so despite them sometimes maybe having the symptoms, they may not always bring it up to family members or doctors but rather just try and manage the symptoms, and it’s only when it gets to be intolerable that sometimes it will present to more medical care.”

Helping kids return to ‘normal’ life

Along with there being no diagnostic test for long COVID, there is also no cure for the condition. Much of what can be done for patients is symptom management, according to Malone.

For kids, she said that means helping them manage their symptoms so they can, at least to some degree, return to school and social activities.

“Participation in life and all the activities, including education, that kids are designed to be participating in is really important,” Malone said. “One of our big focuses is to try to provide accommodations to get kids back into school, but meet them where they are, because they may not be able to do a full course load, or they may not be able to make it through the full day of school, but there is still benefit if they can go for an hour, and gradually increase that over time to getting them back into that sort of routine, and getting them back into the social aspects of school and the educational aspects.”

Patients at the clinic see not only medical doctors like Malone, but a team of experts including behavioral and neuropsychologists, social workers, pain specialists and physical therapists.

Ellen Henning, Ph.D., a pediatric psychologist at the Kennedy Krieger Institute, said patients often struggle with anxiety and depression due to long COVID. She said new research is also suggesting that long COVID itself could be influencing mental health symptoms due to factors like inflammation in the brain and lower levels of serotonin.

“We learn new things constantly and we adjust as we as we go,” Henning said. “We try to provide the best supports that we can and then we all are always integrating new knowledge and adjusting things as we need to.”

In October, the clinic received a $5 million grant from the Department of Health and Human Services that it is using to help train school nurses and other community health care providers to identify long COVID in students and provide accommodations for students already diagnosed with the condition.

“We have a lot of families and children that say that they have to educate, sometimes, their providers and tell their doctors at home about what’s going on and about long COVID,” Malone said. “That can just be really exhausting for kid, so that’s a big thing that we’ve been working on, and we’re really proud of that.”

Theo said while his long COVID symptoms continue, he has felt more at ease since receiving his diagnosis and as the condition becomes more recognized.

With the help of Malone and the team at the Kennedy Krieger Institute, Theo is back in school for periods of time and working on catching up with his classmates.

“We have a lot of hope,” he said. “I know I’m going to finish school at some point. Maybe a little later than most people, but who knows. And I think I’m going to get better. With all the research that’s going to come out, hopefully, something will help me more than anything else.”

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(NEW YORK) — Aruba Aloe Balm N.V. has issued a voluntary recall of some of its hand sanitizer products due to the presence of alcohol denatured with methanol, which poses significant health risks to consumers.

Forty lots of Aruba Aloe Hand Sanitizer Gel Alcohol 80% and Aruba Aloe Alcoholada Gel were found to have contained methanol, the company said Friday in a press release in conjunction with the U.S. Food and Drug Administration.

“Although all persons using these products on their hands are at risk, young children who accidentally ingest these products and adolescents and adults who drink these products as an alcohol (ethanol) substitute are most at risk for methanol poisoning,” the company said in a statement.

The company said there have been no reported adverse events related to these products thus far, but methanol exposure can lead to severe consequences, including nausea, vomiting, headache, blurred vision, coma, seizures, permanent blindness, and even death.

Aruba Aloe Hand Sanitizer Gel comes in 12 fl oz (355 mL) dark green plastic bottles with a white label. The label reads in part, “ARUBA ALOE Hand Sanitizer GEL 80% Alcohol Made in Aruba World’s Finest Aloe” with the barcode 0 82252 03300 5. The recall affects specific lot numbers distributed between May 1, 2021, and Oct. 27, 2023.

Aruba Aloe Alcoholada Gel, used for pain relief and itching associated with minor burns, sunburn, insect bites, or minor skin irritations, comes in two sizes: 2.2 fl oz (65 mL) and 8.5 fl oz (251 mL) plastic bottles. The bottles have barcodes 0 82252 34030 1 and 0 82252 03120 9, respectively. Lot numbers for this product are also included in the recall, covering the same distribution period.

These products were sold exclusively online via the Aruba Aloe Balm N.V. website during the specified distribution timeframe.

ABC News’ Good Morning America has reached out to Aruba Aloe Balm N.V. for further comment.

Aruba Aloe Balm N.V. has taken steps to notify customers who purchased these product lots via email and is offering a discount coupon for a future purchase as compensation. However, consumers with these recalled products are strongly advised to discontinue use immediately and dispose of them properly by taking them to your nearest Household Hazardous Waste Recycling & Disposal center.

Aruba Aloe Balm N.V. said in their release that those with concerns or questions regarding this recall and announcement can contact the company via email at recall@arubaaloe.com.

Additionally, consumers who have experienced any adverse reactions or quality problems associated with these products are encouraged to report them to the FDA’s MedWatch Adverse Event Reporting program.

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(NEW YORK) — Thousands of women between ages 50 and 74 are not receiving life-saving mammograms, according to new federal data.

Researchers from the Centers for Disease Control and Prevention looked at the prevalence of mammography use over a two-year period, in a report published Tuesday.

Mammography use varied by state and sociodemographics, but the study found the more health-related social needs (HRSNs) a woman had, the less likely she was to get a mammogram.

HRSNs are barriers that impact a person’s health or health care access with examples, including food insecurity and lack of access to reliable transportation. These are sometimes referred to as social determinants of health (SDOHs).

For women between ages 50 and 74, mammography prevalence was 83.2% for women with no adverse SDOHs or HRSNs. However, among women in that age bracket with three or more SDOHs or HRSNs, the prevalence was 65.7%.

Social isolation, life dissatisfaction, lost or reduced hours of employment, being on food stamps, lack of reliable public transportation and cost barriers were all associated with not having had a mammogram within the previous two years.

The authors said this was consistent with findings from previous studies showing associations between lower mammography use and HRSNs, including lower educational attainment and income, not having a usual source of health care and being uninsured.

“We have to address these health-related social needs to help women get the mammograms they need,” CDC Chief Medical Officer Dr. Debra Houry said in a statement. “Identifying these challenges and coordinating efforts between health care, social services, community organizations, and public health to help address these needs could improve efforts to increase breast cancer screening and ultimately save these tragic losses to families.”

Breast cancer causes more than 40,000 deaths among women in the U.S. each year, according to the CDC. Breast cancer death rates have been decreasing, but the report noted this has not been equitable across all groups. For example, Black women and women with low incomes are more likely to die from breast cancer.

However, evidence has shown that mammograms reduce breast cancer deaths. A multi-national study published in 2020, led by Queen Mary University in London, found that women who participated in mammography screenings had a 41% reduced risk of dying of breast cancer within 10 years and a 25% reduction in the rate of advanced breast cancers.

The U.S. Preventive Services Task Force, the group of specialists that set national guidelines for preventive care in the US, currently had recommended women between ages 50 and 74 receive a mammogram every two years during the dates that were studied. The Task Force now recommends all women should get screened for breast cancer every other year, starting at age 40 with final guidelines expected shortly.

“If we are to achieve higher breast cancer screening for all women, we have to look at all the possible challenges women face in getting mammograms,” said Lisa Richardson, director of the CDC’s Division of Cancer Prevention and Control, in a statement. “Health care providers can now assess whether women have health-related social needs and help women get the services they need. Every woman should be able to get screened for breast cancer without barriers.”

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(NEW YORK) — A new study evaluating older adults with a high risk of heart attacks or strokes has found that salt substitutions may be linked to a lower risk of death, specifically from heart disease and stroke.

The study was a meta-analysis of several studies primarily based in Asia, where experts say cuisine and food culture likely make it easier to use salt substitutes. Here in the U.S., people get roughly 70% of their sodium intake from packaged and prepared foods — not from table salt that’s added to food when cooking, according to the American Heart Association.

Still, experts say the findings, published Tuesday in the journal Annals of Internal Medicine, could act as a helpful reminder about excess sodium content, and help people explore possible alternatives.

“The average American eats 3,400 milligrams of salt [per day]. The recommended amount is about 2,300 milligrams [per day],” ABC News medical correspondent Dr. Darien Sutton explained, citing the American Heart Association, which also encourages “an ideal limit of no more than 1,500 mg per day for most adults, especially for those with high blood pressure.”

“More than 97% of people don’t know how much — or underestimate how much — sodium is in their diet,” Sutton said.

Diets high in sodium result in more than 2 million deaths around the world each year, according to the World Heath Organization.

Not all adults have an urgent medical need to replace salt in their diet. The new study was specific to people who have a higher risk of heart attacks and strokes. People with an elevated risk should talk to their doctor about ways to reduce salt in their diets. And the first step is often looking at the label on any packaged food.

For example, Sutton pointed to a bowl of Doritos tortilla chips, saying that just 12 contain “about 200 milligrams” of sodium.

“If you look at the actual bag, there’s 15 servings in one of those regular bags,” he said. “That equates to more than 3,000 milligrams of sodium. You have to make sure that you’re mindful of your sodium, and the majority of it comes from processed food.”

One recommendation Sutton shared is to “eat regular today, categorize or quantify how much sodium you are having and then, at the end of the day, figure out how to do better.”

Additionally, he suggested being smart with nutritious ways to add flavor in lieu of salt.

“Most of the time if you remove the sodium from our food, most people won’t recognize it, especially if you add other [ingredients],” he said suggesting substitutes such as paprika, ground pepper, onion powder, cinnamon, ginger or garlic.

This week’s analysis laid out what many already know, Sutton said, which is that salt can harm our health.

“This was a meta analysis which involved a lot of different studies at once, looking at older populations in Asia, specifically who were at higher risk. And it found that reducing sodium for six months significantly reduced risk of heart disease, stroke and kidney disease,” Sutton said. “You have to make sure you watch your sodium to help reduce your risk and improve your quality of life when you get older.”

When it comes to adjusting one’s salt intake, Sutton advised tracking how much you’ve had by writing it down and adding in more nutritional options.

“Potassium can help blunt the effect of sodium in our body, helping us manage our blood pressure,” he said. “So, leafy greens, bananas, sweet potatoes, you want to add these products, have less processed foods and be mindful of your sodium.”

ABC News’ Sony Salzman contributed to this report.

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(CAMBRIDGE, Mass.) — As many turn their eyes to the skies to watch the solar eclipse, some with vision impairment are turning their ears to a new gadget.

The LightSound is a 3D-printed device, about the size of a cell phone, which can register the changing brightness of light. It then turns that information into a variety of sounds using a process known as “sonification.”

“Sonification is just taking data and converting it into sound,” says Allyson Bieryla, an astronomer at Harvard University. Bieryla came up with the idea for the LightSound ahead of the 2017 solar eclipse, alongside Wanda Díaz-Merced, an astronomer and sonification researcher who is blind. Bieryla says the LightSound represents an effort to use sonification to make astronomy more accessible to those with physical impairments.

To do this, the LightSound emits a range of sounds based on the amount of light it receives, Bieryla tells ABC Audio.

“We have this Midi synthesizer board on the device that basically allows us to map different instruments to the data values.”

A flute, for example, represents bright light. When it gets darker, Bieryla says “the midrange goes to a clarinet, and then in totality, or like a dark room or something, you might hear a clicking.”

The LightSound’s clicking slows down the darker its environment becomes.

“For totality, we really didn’t want to distract with a lot of sound, so we chose, like, the absence of light, the absence of sound,” says Bieryla. She says that’s because totality – the brief moment when the moon completely obscures the sun – brings with it other environmental changes.

“A lot happens during totality,” says Bieryla. “Temperature changes, people react, you know, insects and animals react.”

Since 2017, Bieryla and her team have distributed hundreds of LightSound devices around the world. They say they’ve donated more than 200 devices in the lead-up to the 2024 eclipse, and feature instructions on their website that detail how to build a LightSound device at home.

“We don’t want people to make a profit off of it,” says Bieryla. “We want to give it to the community.”

As for what’s next, Bieryla says they’re looking into ways to add haptics to the Lightsound, which would vibrate the device based on the amount of light it receives. It’s intended, she says, to bring the eclipse experience to those who are both sight and hearing impaired.

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(NEW YORK) — Despite abortion being on the November ballot in Florida, pro-abortion groups say a six-week ban going into effect next month will have devastating consequences for women in the Southeast.

The Florida Supreme Court issued two decisions earlier this week, allowing a question on the November ballot that would enshrine abortion rights in the state’s constitution and upholding the state’s 15-week abortion ban. A trigger ban will now go into effect on May 1, prohibiting abortions at six-weeks gestation, before most women know they are pregnant.

Florida, despite its 15-week limit, has been a key point of access to women across the southeastern U.S. living in states that have ceased nearly all abortion services due to bans. At least 14 states have ceased nearly all abortions since the U.S. Supreme Court overturned Roe v. Wade, ending federal protections for abortion rights.

In Florida, the proportion of abortions provided to patients traveling from out of state increased from 5% in 2020 to 11% in 2023, according to the Guttmacher Institute.

In 2023, there were 8,940 more abortions in Florida compared to 2020 — a 12% increase — according to Guttmacher. Increased travel from out of state accounted for 58% of the state’s overall increase in abortions between 2020 and 2023.

A Woman’s Choice, an abortion clinic with a location in Jacksonville, Florida, told ABC News that about half of the patients it sees every month are from out of state. The clinic would not disclose how many patients it treats at the Jacksonville location, but said it had a large increase in patients after neighboring states began enforcing abortion bans.

With Florida bordering Alabama and Georgia — where there are severe restrictions — the closest point of access for Floridians to get care past 12 weeks gestation is now Virginia or New Mexico, pro-abortion activists told ABC News.

Abortion care is allowed in North Carolina up to 12 weeks. However, one maternal fetal medicine specialist, who left the state due to the ban, told ABC News that providing care after 20 weeks was “fundamental to her practice” as she often diagnoses fetal anomalies sometime between 18 and 20 weeks gestation.

A Woman’s Choice clinics, which has a facility in Danville, Virginia, says that location is over 500 miles from their Jacksonville clinic — an over 8-hour drive each way.

And, there could still be more barriers for patients able to travel that far for care in Virginia.

“I’m not sure if the infrastructure [in Virginia] can accommodate all the influx of patients. It’s something that I’m really concerned about and I know providers have been working incredibly hard to see as many patients as [they can] safely and compassionately,” Amber Gavin, the vice president of advocacy and operations at A Woman’s Choice, told ABC News.

“But I do think that folks fall through the cracks especially folks who are already marginalized in our healthcare system,” Gavin said.

Impact of six-week bans

The six-week ban going into effect is “devastating” and “catastrophic for the region,” Mini Timmaraju, the president and CEO of Reproductive Freedom for All, told ABC News.

“There is really no distinction between a six-week ban and a total ban on abortion,” Timmaraju said.

According to Guttmacher, six-week bans have “massive impacts on abortion provision.”

In South Carolina, the number of abortions provided in the formal health care system decreased by 71% after the state started enforcing the six-week ban on Aug. 23, 2023. The state provided 250 abortions in September 2023 compared to 870 in August 2023, according to Guttmacher.

After six-week bans took effect in Georgia and Texas, there was about a 50% decline in abortion caseloads, according to Guttmacher.

Despite exceptions that allow abortions in some cases — which differs depending on the state — and federal law which requires physicians to provide life-saving care to patients, many patients are unsure what kind of care they can receive.

Bans “create a lot of confusion and chaos for people seeking care” making it “a bit harder for people to access care, but it’s also gonna be harder for people to navigate when they can access care,” Candice Gibson, the director of state policy at Guttmacher, told ABC News.

“I think that there’s going to be a great need to educate individuals on what their rights are and also how they can access care,” Gibson said.

Americans United for Life, an anti-abortion group, said the court’s decision was “reasonable” in walking back the notion that a privacy clause in the state’s constitution provided protections for a right to abortion.

Asked about reports of patients unable to get care in line with exceptions to bans in Florida and other states, Americans United for Life said it is up to the legislature to “take a look at that issue.”

“If it decides that the right to treatment for truly medically necessary abortions isn’t sufficiently clear, it could legislate to protect that right,” Steven Aden, the chief legal officer and general counsel at Americans United for Life told ABC News.

Aden said the group does not support exceptions in cases of fatal fetal anomalies, proposing “perinatal hospice” instead.

“We cannot license or permit any human being to end the life of a human being. Even if it’s for purposes of compassion. That’s also why we oppose assisted suicide,” Aden said.

Care in Florida under the ban

A Woman’s Choice told ABC News the abortion clinic has already had to turn away patients under the 15-week ban, calling a six-week ban “devastating.”

“One of the reasons that this ban makes it one of the worst in the country is because Florida already has a state-mandatory delay law, forcing folks to wait 24 hours and it mandates two in-person trips to a clinic,” Gavin said.

“If in a few weeks a patient comes to us — let’s say they come to us in June — and they come in for their consult appointment and they measure at six-weeks pregnancy, we literally wouldn’t be able to see them the next day for their actual abortion appointment because they’d be past the gestational limit,” Gavin said.

For patients past the gestational limit, the clinic will have options: help from patient navigators who provide financial assistance for abortion costs, help finding care in another state or a referral to a pro-abortion adoption agency.

Gavin said it is also likely some Floridians will choose to take matters into their own hands and self manage their abortions, or they may be forced to carry their pregnancies to term. The clinic will remain open and offer a range of OB-GYN care including ultrasounds, HIV testing and STI testing.

Ballot Initiative

Pro-abortion groups and A Woman’s Choice told ABC News they were optimistic about abortion access being restored through the November election.

In all six states where there have been abortion questions posed to voters — including conservative state like Kansas — they have chosen to protect abortion rights.

Voters also overwhelmingly support abortion access, according to Gibson, who called the ballot initiative a “critical fight.”

A Woman’s Choice, which actively participated in collecting signatures for the initiative, said it will be raising awareness about the ballot question, telling patients at their clinic to vote to protect and restore abortion in Florida. It will also be holding a rally.

The National Latina Institute for Reproductive Justice told ABC News that bans disproportionately impact their community, which are more likely to be uninsured. The group, part of the campaign for the ballot initiative, said it will work to ensure that information is available in Spanish, to help overcome language barriers.

Americans United for Life told ABC News the group does not support the issue being left up to “popular majority vote.”

“We believe that the rights of minorities [in this case fetuses] shouldn’t be subjected to the popular vote of the majority,” Aden said.

“We hope that the people of the state of Florida will recognize that the proposed initiative is really an all-out regime of abortion on demand,” Aden said.

Timmaraju called the ballot initiative the state’s “best option at restoring access in the South,” but warned that a question on the November ballot is not an option in all states.

“There’s not that many states left where we can pursue a similar path,” Timmaraju said.

“Not every state has a pathway to get on the ballot because it requires you to go through the legislature and a lot of these southern states need a supermajority of Republicans and are several [election] cycles away from being able to pull something like this off. But in Florida you can go directly to the people and get on the ballot,” Timmaraju said.

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