Monday, March 26, 2018

The New Rise of 'Black Lung'

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March 26, 2018

Hello, readers! This is Sy.

Environmental and workplace factors play a significant role in human health, as evidenced by the myriad studies establishing poor air quality, low access to nutrition, and other similar circumstances as important risk factors for earlier death and disease. And while global public health strategies like clean air policies and environmental regulations have helped mitigate the harms, certain workplace conditions may still present a big problem, as highlighted by a new report in West Virginia’s Register-Herald.

As my colleague Andrew Nusca reports, the Register-Herald says that local health centers in the state—which is a mainstay of the mining industry—have seen a swell in “black lung” (aka Pneumoconiosis) cases. It’s unclear exactly why this condition, associated heavily with poor air quality conditions in mines, is on the rise. But the numbers are striking, raising concerns about potential worker safety in the community—and questions about the cause of the reported black lung resurgence.

Read on for the day’s news.

Sy Mukherjee
@the_sy_guy
sayak.mukherjee@fortune.com
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DIGITAL HEALTH

A digital solution to 'contraception deserts'? NPR reports that women in so-called contraception deserts—places where it's hard to get into a clinic or a doctor's office, particularly in states that have cracked down on family planning centers—are turning to digital services for their medical needs. That includes companies like NURX, Maven, and Lemonaid Health, which offer hormonal contraceptives through apps that can deliver the products to their pharmacies and doorsteps. (NPR)

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INDICATIONS

Roche adds to impressive lung cancer data. Roche was a bit behind rivals like Merck and Bristol-Myers Squibb in the new-wave cancer immunotherapy space of "checkpoint inhibitors". But its marquee treatment in this lucrative new space, called Tecentriq, scored a new clinical trial win Monday when Roche announced the drug's combination with another cancer therapy helped lung cancer patients live longer. (Reuters)

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THE BIG PICTURE

What are America's 'healthiest' communities? U.S. News & World Report is out with a new ranking of America's "healthiest" communities (a list compiled in collaboration with the Aetna Foundation). According to the list's methodology, the healthiest county in the U.S. is... Falls Church, Virginia. (The list "scores nearly 3,000 communities across 80 metrics that extend beyond health coverage and doctors' visits to social determinants like income, housing and public safety, aiming to determine how location and circumstances affect the overall health of Americans across the country," as U.S. News explains). Check out the full list here. (U.S. News & World Report)

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REQUIRED READING

How Microsoft Could Hit $1 Trillionby Aaron Pressman

Facebook Stock Is in the Red This Year After FTC Confirms Investigationby Lucinda Shen

Police Say Mastermind of $1 Billion Cyber Robbery Has Been Caughtby David Meyer

Blame It On The Robots: FedEx Scraps Plans for a Giant Distribution Centerby Natasha Bach

Produced by Sy Mukherjee
@the_sy_guy
sayak.mukherjee@fortune.com

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raceAhead: Trump Re-Bans Transgender Troops

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March 26, 2018

Hundreds of thousands of students, parents, friends, and allies poured into the streets of Washington, D.C. and other cities around the U.S. to demand stronger gun laws during Saturday's March for Our Lives Rally.

If you haven't had the time to watch the extraordinary speeches from some of the young activists who took the stage, by all means, do.

But I want to draw your attention to some additional news that may have not hit your radar. It could use a little activism action.

Late Friday night, the Trump administration released a memo which confirmed a near total ban on transgender people serving in the military. It was a preceded by an earlier memo from Defense Secretary James Mattis recommending the change, reversing an Obama-era rule of inclusion.

From the president's memorandum:

Among other things, the policies set forth by the Secretary of Defense state that transgender persons with a history or diagnosis of gender dysphoria — individuals who the policies state may require substantial medical treatment, including medications and surgery — are disqualified from military service except under certain limited circumstances.

Transgender troops currently in the military may stay, but it appears as if the Pentagon could require them to serve according to their gender at birth.

The announcement sent shockwaves throughout the LGBTQ community. Katelyn Burns a freelance writer for Them, interviewed several transgender service members, many of whom called B.S. on the medical aspect of the ban. For one, service members are routinely deployed with twelve months worth of meds for things like malaria prevention or blood pressure management. As Navy Lt. Cmdr. Blake Dremann told Them , "There is no point in transition that a person is non-deployable for twelve consecutive months." Dremann is a trans man who also supervises transgender troops currently deployed in places like Jordan, Iraq, and Afghanistan. "Not a single person that is currently serving has been non-deployable for twelve consecutive months for any reason related to transition," he says.

A report commissioned by the Pentagon in 2016 on the possible effects of allowing transgender people to serve, showed that the costs would be negligible both in terms of medical requirements and unit cohesion. The study, conducted by the Rand Corporation, estimated that there are between 1,320 and 6,630 transgender individuals on active duty in a force of 1.3 million people. The cost of providing those individuals with specialized health care, including possible surgeries, would be between $2.4 million and $8.4 million a year. Total military health-care expenditures were $6.27 billion in 2014.

But in his memo, Mattis said that the Rand study "heavily caveated data to support its conclusions, glossed over the impacts of health care costs, readiness, and unit cohesion, and erroneously relied on the selective experiences of foreign militaries with different operational requirements than our own." Bottom line, "this policy issue has proven more complex than the prior administration or Rand assumed," he wrote.

It’s entirely possible that the new ban will not survive. In many ways, it's little different from the administration's previous attempt, which inspired a slew of lawsuits on constitutional grounds. Four federal courts have issued injunctions in cases filed by civil rights groups. "This policy is not based on an evaluation of new evidence," said Joshua Block, a Senior Staff Attorney for the ACLU in a statement. "It is reverse-engineered for the sole purpose of carrying out President Trump's reckless and unconstitutional ban, undermining the ability of transgender service members to serve openly and military readiness as a whole."

While corporations have laudably led on transgender inclusion in often remarkable ways, this issue remains an open wound for a community that has not only been fighting for the right to die for our country but to walk down the street safely.

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On Point

Love in the time of chicken nuggets
Well, not exactly. My colleague Michal Lev-Ram has the definitive take on why human editors won't eliminate the toxic, violent, harassing or fake posts on social media anytime soon: You can't hire enough of them to make it work at scale. Besides, the work itself is utterly draining. In some important instances, AI is helping quite a bit, though algorithms can't always make fine distinctions — like "tell the difference between a clip of someone eating a chicken sandwich and a video of someone performing inappropriate acts on one." Yes, that's a real example. Either way, Facebook needs a solution - marketers have serious questions about Cambridge Analytica.
HBR
The workplace is killing people
A new book by Stanford Graduate School professor Jeffrey Pfeffer sets out to explain how stress, long hours, economic uncertainty, eroding health insurance protections and work/life conflict are causing an epidemic of chronic disease that is not only driving up health care costs but killing people. "I see a workplace that is shockingly inhumane," says Pfeffer. With 75% of the health care burden in the U.S. coming from often preventable diseases like cardiovascular disease and diabetes, "I want this to be the Silent Spring of workplace health."
Stanford
There's an all-woman-of-color ticket in the Maryland governor's race
And they don't appear to be messing around. Krish Vignarajah was a former policy director for Michelle Obama, and has brought a refreshing candor to her campaign. She's all about the issues, but she really gets it about messaging: One video ad shows her breastfeeding her baby daughter - while talking directly to the camera about, among other things, the lack of women in statewide or federal office in her state. (Baltimore Teachers Union president Sharon Blake is her running mate, and both women are the products of the Baltimore public school system.) Click through for an extraordinary Q&A, in which she tackles Trump, Parkland, and a positive vision for Maryland. "We have to have more diverse representation, and I mean that across the board. I mean gender, ethnicity, socio-economic status, geographical location," she says.
Salon
On the shoulders of young giants: Other student-led social movements
National Geographic has put together a handy reminder that youth has long lead the way on vital social issues, taking on all the risks that come with it. While the Civil Rights era and the Vietnam War are most often cited, it's worth remembering that both Arab Spring and the movement for indigenous water rights (as exemplified by the most recent DAPL protests) have a place in the conversation. "Youth are tired of thinking that they don't have a future," says Micaela Iron Shell-Dominguez, a youth organizer who worked during the occupation of the Standing Rock reservation.
National Geographic
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The Woke Leader

I'm not normal and neither are you
I've long questioned the myth of optimality in humans and animals, but for the longest time, I thought I was alone. Turns out, the good people at Yale had the same question. There really isn't one way to be normal after all. In the "The Myth of Optimality in Clinical Neuroscience ," two members of Yale's psych department use evolution to show that all brains are different, and to expect uniformity is well, abnormal. "We propose that, instead of examining behaviors in isolation, psychiatric illnesses can be best understood through the study of domains of functioning and associated [complex] patterns of variation across distributed brain systems," they write. Put another way, limiting people to linear definitions of disease prevents them from enjoying a wide variety of behaviors and from being able to inhabit their full selves.
Quartz
Ida and Louise: A love story
Ida and Louise Cook were sisters, actually; sweet and plain and very British, and in the parlance of the day, spinsters. But they were also among the boldest and most efficient transporters of Jews out of Germany from 1937 until the war began. Their story is almost too fantastic to be believed, but it involves some unusual elements, their obsession with opera and their belief that they'd been contacted by people murdered in concentration camps via seance, chiefly among them. But the best tidbit of all is this: They paid for their numerous rescue trips abroad with the proceeds from Ida's work as a writer of very saucy romance novels. They may have personally transported more than 60 people. Pour a cup of tea, put on your auto-responder and read all about it.
Alternet
He's bringing civics back. So all the citizens will know how to act
Despite the object lesson in citizen engagement we all enjoyed this weekend, educator Eric Lieu says that Americans are illiterate in power - what it is, how it works and why some people have it and others don't. His idea? Make civics "sexy," meaning compelling as a personal concept, like it was during the Civil Rights Movement. This TED talk was filmed in the aftermath of Occupy Wall Street (but before the Movement for Black Lives) but he hits all the right notes for what can happen when we use fresh thinking to inspire all people to participate in shaping society.
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Quote

I represent the African-American women who are victims of gun violence, who are simply statistics, instead of vibrant, beautiful girls, full of potential. For far too long, these names, these black girls and women, have been just numbers. I'm here to say 'Never again,' for those girls too. I'm here to say that everyone should value those girls too. People have said that I am too young to have these thoughts on my own. People have said that I am a tool of some nameless adult. It's not true.
Naomi Wadler, 11
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