Tag Archives: disease

A bill in Congress could get to the bottom of how coronavirus links air pollution and racism

It’s becoming clear that black and Latino communities in the U.S. suffer disproportionately from the novel coronavirus. The COVID-19 mortality rate for black New York City residents, for example, is twice that of white residents, and a Centers for Disease Control and Prevention report has suggested that black Americans in general are hospitalized for COVID-19 at much higher rates. Research is also emerging showing that exposure to air pollution likely makes COVID-19 deadlier. In other words, when it comes to COVID-19 outcomes, it’s clear that race matters and that pollution matters. What is not yet clear is how, exactly, these two troubling trends are related.

In hopes of finding concrete connections between air pollution in communities of color and COVID-19 outcomes, last month Democrats in Congress introduced the Environmental Justice COVID-19 Act, which would allocate an additional $50 million to existing Environmental Protection Agency (EPA) grant programs and prioritize that funding for projects that “investigate or address the disproportionate impacts of the COVID–19 pandemic in environmental justice communities.”

The measure was included in the HEROES Act, the $3 trillion pandemic relief legislation that passed the House of Representatives last month with mostly Democratic support. The legislation’s future in a Republican-controlled Senate is shaky, but at a House Committee on Energy and Commerce hearing on Tuesday, lawmakers and advocates continued to push for the bill funding the study of the relationship between pollution and racial disparities in COVID-19 outcomes.

“COVID-19 has exacerbated what we have known all along,” said California Representative Raul Ruiz, one of the bill’s cosponsors, during the hearing. “[At-risk communities are] disproportionately breathing polluted air and drinking dirty water due to neglect or decisions by others.”

Jacqueline Patterson, director of the NAACP’s Environmental and Climate Justice Program, discussed how black and Latino communities in the U.S. face more extensive exposure to pollutants, making them more susceptible to lower respiratory illnesses like COVID-19. More than 70 percent of black Americans “are living in counties in violation of federal air pollution standards,” she told the panel of lawmakers.

Patterson also criticized the Trump administration’s approach to environmental policy.

“Instead of strengthening regulations to reinforce protections for communities made vulnerable by poor air quality, we have an administration that has rolled back over 100 regulations in the context of COVID-19,” she said, referring to the Trump administration’s broad relaxation of environmental enforcement during the pandemic.

Patterson said that the funding provided by the Environmental Justice COVID-19 Act would help existing organizations, like local chapters of the NAACP, study the way environmental factors affect public health for communities of color. However, she isn’t sure that the $50 million allocated is enough to accomplish the bill’s aims.

“[The bill] is going to make a difference, but I think ‘enough’ is gonna be a hard bar to reach at this point because the needs are so great,” she told Grist. “Air pollution standards aren’t even stringent enough in the first place.”

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A bill in Congress could get to the bottom of how coronavirus links air pollution and racism

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This Philadephia refinery is the country’s worst benzene polluter. Trump wants to keep it open.

Before it exploded last June, Philadelphia Energy Solutions (PES) — the largest crude oil refinery on the East Coast — was processing 335,000 barrels of oil each day. It was also producing some of the highest levels of benzene pollution of any refinery in the country, according to a new report by nonprofit watchdog group the Environmental Integrity Project.

The report, which follows a recent investigation of PES’s benzene pollution by NBC News, found that 10 refineries across the U.S. were releasing cancer-causing benzene into nearby communities at concentrations above the federal maximum in the year ending in September 2019. Under 2015 EPA rules, facilities are required to investigate where their toxic emissions are coming from, then take immediate action to reduce impacts — both of which PES failed to do. The refinery had an annual average net benzene concentration that was more than five times the EPA standard, beating a long line of refineries in the oil-friendly state of Texas. Out of the 114 refineries that the group examined across the country over the course of a year, PES emitted the highest levels of benzene.

Environmental Integrity Project

That includes the period after the refinery was shut down following the explosion.

Residents of South Philadelphia say they were awakened in the early hours of June 21, 2019 by a loud boom. Large pieces of debris poured down on the streets followed shortly by the smell of gas. Neighbors looked out their windows and saw clouds of dark smoke billowing from the nearby complex, which already had a history of safety issues.

For a while, that seemed to be the end for the refinery. Rather than make repairs and clean up the mess after the June incident, PES shut down the facility and filed for bankruptcy. The company put the 1,300-acre waterfront property up for sale, either to be maintained as a refinery or to be turned into housing or mixed-use development. And last month, after a closed-door auction in New York City, Hilco Redevelopment Partners, a Chicago-based real estate company, was the selected winner. But just when it seemed the PES refinery complex would shut down for good, the Trump administration got involved, offering its help last week to spurned bidders who are challenging Hilco’s victory because they want to keep the property processing crude oil.

The idea of keeping the refinery active doesn’t sit well with some environmental activists, especially in light of the new benzene report.

“Today’s report is just one more factor and data point on why this plot of land should not be put back into a use that puts local communities at risk,” said David Masur, executive director of PennEnvironment, a statewide environmental group working for clean air and water.. “Whether it’s an explosion or a constant threat of pollution from known carcinogens, the choice of putting a refinery there is just too dirty and dangerous.”

A community fuming

South Philadelphia has long been a diverse cultural hub for the city. It also faces multiple sources of pollution. In addition to the PES refinery complex, the largest source of particulate air pollution in Philadelphia and a repeat violator of the Clean Air and Water Acts, South Philly also has major arterial highways, the Philadelphia International Airport, large industrial factories, and other processing facilities.

More than 5,100 people live in the area within a one-mile radius of the PES refinery. Most of the residents are black, and 70 percent of the residents live below the poverty line. These residents also suffer from disproportionately high rates of asthma and cancer.

In a letter sent to the City of Philadelphia Refinery Advisory Group — a group the city created in wake of the June 21 explosion — at the end of October 2019, Drexel University researchers summarized the health impacts of living near the PES refinery based on data they’d gathered. They listed negative birth outcomes, cancer, liver malfunction, asthma, and other respiratory illnesses. They also included mental health impacts such as stress, anxiety, and depression that come with living near a large industrial site like PES.

“Because the PES refinery is immediately surrounded by several neighborhoods, communities near the refinery will be disproportionately affected by compounds released by it,” Kathleen Escoto, a graduate student at the Dornsife School of Public Health at Drexel who was one of the authors of the letter, told Grist. “If the refinery released the highest levels of benzene in the country, especially considering its proximity to densely-populated areas, then the burden of disease that the refinery has on the surrounding communities is even worse than we thought.”

Benzene, a colorless chemical with a somewhat sweet odor that evaporates from oil and gas, is used as an ingredient in plastics and pesticides. According to the U.S. Center for Disease Control, exposure to benzene can cause vomiting, headaches, anemia, cancer, and in high doses, death.

Philly Thrive, a grassroots environmental justice group that has been raising awareness about the public health costs of living near a fossil fuel facility since 2015, has been organizing community members from South Philadelphia to fight against PES and to ensure that they have a seat at the decision-making table.

“Part of what Philly Thrive has faced when residents tell their stories about the impact of the refinery on residents’ health is confrontation from politicians and leaders, who challenge our personal stories, lived experiences, and wisdom,” said Philly Thrive organizer Alexa Ross. “It’s always been offensive, perplexing and confusing to be challenged on the basis of facts.”

The refinery’s fate

Despite the Trump administration’s efforts to keep the refinery in operation, the fate of the land is still up in the air. On Thursday, Philly Thrive organized a call bank session for members to make phone calls to Philadelphia Mayor Jim Kenney and the Industrial Realty Group, an alternative bidder on the property that wants to keep it as a refinery. They cited the new report as part of their reasoning that the refinery should remain closed.

“This report just leaves us fuming, speechless, dumbfounded, and reeling about how residents have known for so long that the refinery has been killing generations of Philadelphians, but politicians still ask us to prove it,” Ross said.

“Imagine if we actually have the right kind of air monitoring system we need,” she added. “Imagine what else would come to light about what facilities like the refinery has been doing to human health.”

A hearing to finalize the details of PES’s 11 bankruptcy sale is now scheduled for February 12 in Wilmington, Delaware.

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This Philadephia refinery is the country’s worst benzene polluter. Trump wants to keep it open.

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Ocean Outbreak – Drew Harvell

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Ocean Outbreak

Confronting the Rising Tide of Marine Disease

Drew Harvell

Genre: Environment

Price: $18.99

Publish Date: April 16, 2019

Publisher: University of California Press

Seller: University of California Press


There is a growing crisis in our oceans as rates of infectious disease outbreaks are on the rise. Marine epidemics have the potential to cause a mass die-off of wildlife from the bottom to the top of the food chain, impacting the health of ocean ecosystems as well as lives on land. Fueled by sewage dumping, unregulated aquaculture, and drifting plastic in warming seas, ocean outbreaks are sentinels of impending global environmental disaster.   Ocean Outbreak follows renowned scientist Drew Harvell and her colleagues as they investigate how four iconic marine animals—corals, abalone, salmon, and starfish—have been devastated by disease. Based on over twenty years of research, this firsthand account of the sometimes creeping, sometimes exploding impact of disease on our ocean’s biodiversity ends with a hopeful message. Through policy changes and the implementation of innovative solutions from nature, we can reduce major outbreaks, save some ocean ecosystems, and protect our fragile environment.      

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Ocean Outbreak – Drew Harvell

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The Story of the Human Body – Daniel Lieberman

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The Story of the Human Body

Evolution, Health, and Disease

Daniel Lieberman

Genre: Life Sciences

Price: $1.99

Publish Date: October 1, 2013

Publisher: Knopf Doubleday Publishing Group

Seller: Penguin Random House LLC


In this landmark book of popular science, Daniel E. Lieberman—chair of the department of human evolutionary biology at Harvard University and a leader in the field—gives us a lucid and engaging account of how the human body evolved over millions of years, even as it shows how the increasing disparity between the jumble of adaptations in our Stone Age bodies and advancements in the modern world is occasioning this paradox: greater longevity but increased chronic disease.   The Story of the Human Body brilliantly illuminates as never before the major transformations that contributed key adaptations to the body: the rise of bipedalism; the shift to a non-fruit-based diet; the advent of hunting and gathering, leading to our superlative endurance athleticism; the development of a very large brain; and the incipience of cultural proficiencies. Lieberman also elucidates how cultural evolution differs from biological evolution, and how our bodies were further transformed during the Agricultural and Industrial Revolutions.   While these ongoing changes have brought about many benefits, they have also created conditions to which our bodies are not entirely adapted, Lieberman argues, resulting in the growing incidence of obesity and new but avoidable diseases, such as type 2 diabetes. Lieberman proposes that many of these chronic illnesses persist and in some cases are intensifying because of “dysevolution,” a pernicious dynamic whereby only the symptoms rather than the causes of these maladies are treated. And finally—provocatively—he advocates the use of evolutionary information to help nudge, push, and sometimes even compel us to create a more salubrious environment. (With charts and line drawings throughout.)

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The Story of the Human Body – Daniel Lieberman

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The Ghost Map – Steven Johnson

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The Ghost Map

The Story of London’s Most Terrifying Epidemic–and How It Changed Science, Cities, and the Modern World

Steven Johnson

Genre: History

Price: $1.99

Publish Date: October 19, 2006

Publisher: Penguin Publishing Group

Seller: PENGUIN GROUP USA, INC.


A National Bestseller, a New York Times Notable Book, and an Entertainment Weekly Best Book of the Year From Steven Johnson, the dynamic thinker routinely compared to James Gleick, Dava Sobel, and Malcolm Gladwell, The Ghost Map is a riveting page-turner about a real-life historical hero, Dr. John Snow. It's the summer of 1854, and London is just emerging as one of the first modern cities in the world. But lacking the infrastructure — garbage removal, clean water, sewers — necessary to support its rapidly expanding population, the city has become the perfect breeding ground for a terrifying disease no one knows how to cure. As the cholera outbreak takes hold, a physician and a local curate are spurred to action-and ultimately solve the most pressing medical riddle of their time. In a triumph of multidisciplinary thinking, Johnson illuminates the intertwined histories and interconnectedness of the spread of disease, contagion theory, the rise of cities, and the nature of scientific inquiry, offering both a riveting history and a powerful explanation of how it has shaped the world we live in.

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The Ghost Map – Steven Johnson

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Indica vs Sativa: Are These Useful Titles or Just Smoke and Mirrors?

?Is it an Indica or Sativa strain??

Whether you?re a moderate or proficient user of cannabis, you?ve most likely heard this question in numerous cannabis conversations ? but what does it really mean? More importantly, does it really even matter if a cannabis product is determined to be an ?Indica? or ?Sativa? strain?

Where do the terms ?Indica? and ?Sativa? come from?

A quick history lesson: In 1753, Carl Linneaus classified two subspecies of cannabis: Cannabis sativa L (hemp, non-intoxicating) and Cannabis Sativa (psychoactive and intoxicating). A second subspecies discovery was made by Jean-Baptiste Lamarck in 1785: Cannabis Indica.

Cannabis Sativa and Cannabis Indica are responsible for the Indica/Sativa classifications we know today. These taxonomic classifications are somewhat controversial, but the important distinctions have to do with geographic origins, variances in morphologies (shape of leaves, plant height, growing conditions), and slight differences in genetics.

A quick cultivation lesson: This Sativa and Indica taxonomy helps cultivators indicate the physical qualities of a particular strain (technically known as a cultivar) and its growing conditions. Sativa plants typically grow tall with bright, narrow leaves. Indicas typically grow into short, dense plants with wide leaves with deep green colors. Sativas have longer flowering cycles and are better suited for warm climates with long seasons, while Indicas have shorter flowering cycles and are capable of growing in cold climates with shorter seasons.

Due to extensive crossbreeding over the past fifty plus years, cultivators have effectively eliminated pure Sativa and Indica cultivars, leaving behind only hybrids that may lean more heavily toward one or the other initial subspecies, further confusing matters for the end user.

Are the effects of Indica and Sativa different?

You?ve heard it before: Sativas are invigorating, Indicas are relaxing. Sativas get you high. Indicas get you stoned.

Your local budtender may be quick to use words like ?cerebral,? ?heady,? ?uplifting,? ?energizing? and ?like a cup of coffee? when describing Sativas, and words like ?relaxing,? ?sedating,? ?full-bodied,? ?stoney? and ?like a cup of nighttime tea? when describing Indicas. Although all marijuana strains are now technically hybrids, a third categorization, Hybrid, is reserved for strains that have a balance of effects inherited from the genetic crossing of Indica and Sativa strains.

What does science have to say?

Let?s cut to the chase ? is it scientifically accurate to label cannabis as ?Indica? and ?Sativa? based on genetic ancestry? The answer: not likely.

Or, as famed cannabis researcher Dr. Ethan Russo puts it: ?The sativa/indica distinction as commonly applied in the lay literature is total nonsense and an exercise in futility.?

Science is increasingly backing this up. Bedrocan, one of the largest producers of legal medicinal cannabis, teamed up with Canadian Dalhousie University to study the genetic differences between cannabis labelled Sativa and Indica. The study analyzed 149 different cannabis samples to determine if the genotype and chemotype accurately correlated to their reported ?ancestry.? ?The results indicated that there is ?no clear evidence of ancestry differences between Sativa- and Indica-labelled cannabis.?

In short, the reported genetic lineages of strains are somewhat dubious and less distinct than cannabis cultivators and breeders would have consumers believe.

However, Bedrocan?s study did find a strong relationship between chemical and genetic profiles. This suggests that the Indica/Sativa classification has much more to do with a strain?s terpene profile and less to do with its cannabinoid profile, as previously believed.

This finding makes sense and is supported in other studies. When indicating the effect a particular strain will produce, consider the cannabinoid and terpene profiles, as the concentration of terpenes will not only indicate the aroma and flavor of a particular strain, but also shed light on the associated effects. Research is confirming that aroma profiles of a plant, coupled with the ratio of the two major cannabinoids (THC and CBD), are the most important factors when attempting to determine the possible effects of a strain.

The main Indica and Sativa takeaway

While an Indica and Sativa label may accurately indicate its genetic lineage, it doesn?t necessarily predict what effects that strain or product will produce. Not all Indicas produce Indica-like effects and not all Sativas produce Sativa-like effect. It is common to find strains with an Indica lineage that have Sativa-like effects. If you take Indica/Sativa categorization with a grain of salt and pay attention to cannabinoid and terpene contents, you?ll have a clearer picture of what each cannabis product has to offer.

Nicolas Gonzalez-Podesta is the Director of Science and Education at Weedmaps. He directs Weedmaps? educational initiatives and works with a range of professionals including scientists, government officials and educators. Weedmaps is the world?s largest marijuana technology company working with enterprises, governments, and consumers to provide the leading cloud platform to power the marijuana industry.

Related Stories:

Is Cannabis Actually Addictive?
4 Groundbreaking Studies on Cannabis and Disease
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Disclaimer: The views expressed above are solely those of the author and may not reflect those of Care2, Inc., its employees or advertisers.

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Indica vs Sativa: Are These Useful Titles or Just Smoke and Mirrors?

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After the lead crisis started, Flint’s fertility crisis began

This story was originally published by Mother Jones and is reproduced here as part of the Climate Desk collaboration.

In the year following the start of its water crisis, Flint, Michigan, saw fewer pregnancies among its residents and higher fetal deaths, according to a working paper published last month.

Kansas University economics professor David Slusky and West Virginia University economics professor Daniel Grossman examined health statistics in Flint between May 2007 and March 2015 and compared them to 15 other cities in Michigan. What they uncovered was alarming: After April 2014 — when, in an effort to cut costs, Flint officials switched its water supply from Detroit to the Flint River, leading to elevated lead levels — fertility rates among women in Flint dropped 12 percent. Fetal deaths spiked by 58 percent.

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“This represents a couple hundred fewer children born that otherwise would have been,” Slusky said in a university press release this week. The researchers project that between 198 and 276 more children would have been born from November 2013, when the child was first conceived, to March 2015 had the city not switched its water supply.

The researchers also conclude that the water change and the corresponding increased exposure to lead prompted a decline in the overall health of children born. Children exposed to high levels of lead can suffer from irreversible neurological and behavioral consequences. Moreover, children born in Flint since the start of its water crisis saw a 5 percent drop in average birth weight compared to those in other parts of Michigan during the same time period.

Shortly after the move in April 2014, residents complained about the water’s stench as it became inflicted with lead from old pipes in residential homes. Even after doctors and experts alerted state and federal officials to the elevated lead levels in Flint’s children and in houses’ water, Governor Rick Snyder and other state officials didn’t concede to the public health emergency in Flint until September 2015. The Michigan Department of Environmental Quality eventually acknowledged that it erred in not requiring the city to add anti-corrosive chemicals into its water.

Health officials found that between June 2014 and November 2015, 91 residents in Genesee County, which includes Flint, contracted Legionnaires’ Disease, a bacterial illness that can arise out of contaminated water, though not all were conclusively linked to Flint’s water crisis. At least 12 people from the disease died after 2014.

As of September 2017, 15 officials have been charged for their involvement in Flint’s water crisis, with five charged with involuntary manslaughter in connection to the Legionnaires’ outbreak. Earlier this year, a federal judge approved a $87 million settlement for the city of Flint that would pay to replace 18,000 water lines by 2020. The state still faces a number of lawsuits. One calls for the state to provide more special education services for children exposed to lead as a result of the water crisis.

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After the lead crisis started, Flint’s fertility crisis began

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The Species Seekers: Heroes, Fools, and the Mad Pursuit of Life on Earth – Richard Conniff

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The Species Seekers: Heroes, Fools, and the Mad Pursuit of Life on Earth
Richard Conniff

Genre: Science & Nature

Price: $1.99

Publish Date: November 1, 2010

Publisher: W. W. Norton & Company

Seller: W. W. Norton


The story of bold adventurers who risked death to discover strange life forms in the farthest corners of planet Earth. Beginning with Linnaeus, a colorful band of explorers made it their mission to travel to the most perilous corners of the planet and bring back astonishing new life forms. They attracted followers ranging from Thomas Jefferson, who laid out mastodon bones on the White House floor, to twentieth-century doctors who used their knowledge of new species to conquer epidemic diseases. Acclaimed science writer Richard Conniff brings these daredevil “species seekers” to vivid life. Alongside their globe-spanning tales of adventure, he recounts some of the most dramatic shifts in the history of human thought. At the start, everyone accepted that the Earth had been created for our benefit. We weren’t sure where vegetable ended and animal began, we couldn’t classify species, and we didn’t understand the causes of disease. But all that changed as the species seekers introduced us to the pantheon of life on Earth—and our place within it.

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The Species Seekers: Heroes, Fools, and the Mad Pursuit of Life on Earth – Richard Conniff

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The Dynamics of Disaster – Susan W. Kieffer

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The Dynamics of Disaster

Susan W. Kieffer

Genre: Earth Sciences

Price: $1.99

Publish Date: October 21, 2013

Publisher: W. W. Norton & Company

Seller: W. W. Norton


"If you are an amateur weather geek, disaster wonk, or budding student of earth sciences, you will want to read this book." —Seattle Times In 2011, there were fourteen natural calamities that each destroyed over a billion dollars’ worth of property in the United States alone. In 2012, Hurricane Sandy ravaged the East Coast and major earthquakes struck in Italy, the Philippines, Iran, and Afghanistan. In the first half of 2013, the awful drumbeat continued—a monster supertornado struck Moore, Oklahoma; a powerful earthquake shook Sichuan, China; a cyclone ravaged Queensland, Australia; massive floods inundated Jakarta, Indonesia; and the largest wildfire ever engulfed a large part of Colorado. Despite these events, we still behave as if natural disasters are outliers. Why else would we continue to build new communities near active volcanoes, on tectonically active faults, on flood plains, and in areas routinely lashed by vicious storms? A famous historian once observed that "civilization exists by geologic consent, subject to change without notice." In the pages of this unique book, leading geologist Susan W. Kieffer provides a primer on most types of natural disasters: earthquakes, tsunamis, volcanoes, landslides, hurricanes, cyclones, and tornadoes. By taking us behind the scenes of the underlying geology that causes them, she shows why natural disasters are more common than we realize, and that their impact on us will increase as our growing population crowds us into ever more vulnerable areas. Kieffer describes how natural disasters result from "changes in state" in a geologic system, much as when water turns to steam. By understanding what causes these changes of state, we can begin to understand the dynamics of natural disasters. In the book’s concluding chapter, Kieffer outlines how we might better prepare for, and in some cases prevent, future disasters. She also calls for the creation of an organization, something akin to the Centers for Disease Control and Prevention but focused on pending natural disasters.

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The Dynamics of Disaster – Susan W. Kieffer

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8 People Who Owe Their Lives to Obamacare

Mother Jones

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President Donald Trump has vowed to dismantle the Affordable Care Act (ACA)â&#128;&#138;—â&#128;&#138;a move that could leave some 30 million Americans without health insurance. ACA literally sustains millions of livesâ&#128;&#138;. Without the health insurance it provides, many people wouldn’t have access to medicine and procedures that they need to survive. When we asked people on Twitter and through healthcare advocacy organizations to share their stories of how ACA keeps them alive, we were overwhelmed with responses. We heard from people waiting for organ transplants, from cancer survivors, from people with debilitating mental illness, and more. They told us about the toll that disease has taken on their lives: Before the ACA, some were forced to skip treatments because of the price; others couldn’t get insurance at all because they were already sick. Here are a few of their stories.

Claudette Williams

Claudette Williams, 58, Orlando, Florida: I lost my job in 2005. After that I decided to purchase a policy. I found them online. They had a gentleman come to my house, and we talked about my blood pressure medications. The insurance was almost twice what they had quoted me because of the medication, and also because of my condition. I eventually couldn’t afford it any more. I was uninsured, except for one year when I qualified for Medicaid. I ended up in the emergency room on a few occasions for heart trouble. I also developed diabetes. I couldn’t afford to have regular mammograms. In 2014 I signed up for Obamacare. I was diagnosed with breast cancer in September of last year. The lumpectomy alone was billed at $40,000. I have four more chemo sessions to go, and after that, I have to do radiation. Luckily my cancer is only a stage one, so my prognosis is pretty good. But it is really scary thinking about my insurance being taken away. This is a fight for my life.

Charis Hill

Charis Hill, 30, California: When I was 25, in 2012, I had a series of unexplained and undiagnosable respiratory challenges that felt like the flu or bronchitis or pneumonia. Doctors just couldn’t figure out what was wrong with me. My condition got worse and worse. I visited urgent care a few times. I thought I was having a heart attack once. They tried to blame it on anxiety.

Eventually reached out to my dad, who was estranged from me. I knew that he had a severe health condition. The first words out of his mouth were, it sounds like you have what I have, which is ankylosing spondylitis (AS). I knew that I would need health insurance to be treated. But if I were to get a diagnosis before getting health insurance, I would have the preexisting condition working against me. So I got the cheapest plan that existed. I wasn’t getting all the tests done or getting all the treatments. Then, ten months later, the ACA was implemented, and because of my income, I was eligible for a subsidy to purchase health insurance on the exchange in California. I got a better plan for less than I was paying before, which meant that I could access more treatment and not skip medication.

I have infusions of a drug every eight weeks. I have to go to an infusion center for 2.5 hours. There’s no generic. There’s no way to get those treatments unless I have insurance. They slow down the progression of my disease. I also take anti-inflammatory medications orally. AS is a severe inflammatory condition. It primarily affects the spine. It causes a lot of pain and fatigue from the body trying to fight that inflammation. I’m permanently disabled. I was a college athlete, and now I’m not even able to run. I use a wheelchair sometimes. As hard as I fight to be healthy, I’m never going to be healthy, and I’m always going to have to rely on the medical system to keep me alive.

John Weiler, 27, Oakland, California: I got HIV when I was 19. When I was in college, I was on my parents health insurance, so when I started meds when I was 21, I took it for granted that I was going to have insurance that would cover it, because it was so easy. When I went to grad school, I naively accepted a position without asking any questions about how the insurance was structured. When you do a science PhD, it’s typical for the school to pay your tuition, pay your health insurance premium, and give you a stipend. In my program, the stipend is about $30,000 a year. So when I enrolled and started to look at my insurance situation, I realized the policy offered to students provided up to $10,000 worth of prescription coverage per academic year, and that was it. But in 2013, the student government got together and petitioned the university to change across the UC system. The students basically said, ‘We don’t care if our insurance premiums are higher, we don’t want these things that the ACA offers to not be part of the insurance plan for the school.’

I was on a med cocktail called Complera, and that one was $22,000 a year. HIV meds are super expensive. I switched to a different medication since then, called Stribild, and I don’t know exactly what it is this year, but if I remember correctly, that one was closer to $27,000 a year.

I’m about to graduate and find a job, and, let’s say worst case scenario, first Congressional session they manage to totally gut the ACA and revert to how things were before. If that were to happen and I were to get a job, it would be totally legal for an employer to be like, ‘Hey, yeah, we’re not covering this.’ I’d be looking at close to $35,000 a year in medical expenses just for maintenance, let alone if I got sick.

Ruth Linehan

Ruth Linehan, 26, Portland, Oregon: I graduated college in May 2012. I was 22. About a month later, I started an internship as a software developer at a Portland startup. Thanks to ACA I was on my parents’ insurance. After four months I was offered a full time job, but the insurance didn’t start until 6 weeks after my first day as an employee. On my first day I was diagnosed with Burkitt’s Lymphoma. I looked like I was 7 months pregnant. I started chemo the day after I was hospitalized. This is an incredibly fast-growing cancer. I was in the hospital for seven weeks. I received about four rounds of chemo. After four months I was declared in remission. I continue to be in remission. The hospital bills were about half a million dollars. I only had to pay about $10,000 because I was on my parents’ insurance.

If I lose my job and the cancer comes back, what am I going to do? I worry about illness down the road. I’ve had cancer at a very young age and a lot of very harsh chemo. I worry that I won’t be able to get affordable insurance, or get insurance at all.

Larry Sterlingshires, 35, Tennessee: I have a condition called hidradenitis surruptiva—look it up, do not look at pictures, because it’s not a good time—it’s a chronic skin condition that’s ultimately debilitating. As it progresses, it causes tissue degradation on the skin layer that doesn’t heal, like normal wounds do. Sometimes it creates lesions that don’t heal for a year and half. It’s debilitating because it’s painful—the tissue underneath is exposed without that protective layer, so it bleeds regularly. You have to keep everything patched and bandaged, and it easily gets infected. But because of the ACA, I can have medication that can’t completely undo the symptoms, but it seems to have halted its progression, and even promoted some healing. Complications related to the tissue damage and infections can be fatal.

The medications I’m on right now, in addition to just my normal medications for diabetes and hypertension, will help me survive longer. This lets me afford something called Claravis, and another medication called Humira. Humira runs approximately $7300 a month, and the Claravis is about $4000 a month. Those basically keep me functional without being completely disabled. That’s no exaggeration. If you check the disability schedule, it’s so painful and considered debilitating enough that you can qualify for full disability with it. The Affordable Care Act covers all of that medication in full. I come from poverty, I’m just now getting used to having insurance for the first time in my adult life, and now that seems like it might evaporate.

Debbie Lynn Smith, 59, Las Vegas, Nevada: I was a TV writer and producer. In 2000 I was diagnosed with bronchiolitis obliterans. It’s also called popcorn lung. I got it from buttered popcorn. When you work in TV, you work 15 hour days. They provide snacks and things. Microwave popcorn is one of the things they give you. I ate a lot of it. It just so happened that I was susceptible to this disease.

I was in remission for 16 years, but I was living with 50 percent of my lung capacity. I couldn’t do TV anymore, couldn’t put in those long hours. I really had a hard time working and being reliable because I would get sick. So I couldn’t get insurance through work. I had insurance through the high-risk California program and I was paying $2,000 a month for that. My husband was on it, too, he had prostate cancer. We moved to Nevada. When the ACA came around we were ecstatic. We were both out of work at the time, so we went on ACA.

This year, in April, my disease came out of remission. I am now down to 30 percent of my lung capacity and waiting for a lung transplant. So you can imagine the fear I have—being so close to getting a transplantthat they might repeal the ACA right away, and I will no longer have access to insurance, and I won’t be able to get my transplant. I am extremely stressed. I was so stressed before the election that I could not take anything else. I was working for Hillary and I ended up in the hospital.

Michele Munro

Michele Munro, 64, Southern California: I was first diagnosed with breast cancer in 1997. I was 44. I was a single mom with two boys. I had Kaiser insurance. It wasn’t a bad cancer, and we caught it early. Then seven years later I was diagnosed with a different type of breast cancer. That was 2004. I also had a hip replacement. The Kaiser premium doubled, so I went without insurance for the first time in years. I was working as a freelancer, and insurers told me I was uninsurable. In 2011, ACA started to kick in. It was not allowing insurance companies to consider preexisting conditions. I applied and was accepted into Aetna. The first thing I did was go for a mammogram, and, sure enough, I had a triplenegative tumor. Very aggressive. It was small and early, so we caught it just in time. I had a double mastectomy and chemotherapy and breast reconstruction, all covered through ACA. I went into the hospital seven times total for infections. The billing was $900,000. Aetna settled and paid out $180,000.

I’m feeling really good right now because December was the fifth anniversary of being cancer-free. I exercise a lot. I’m doing everything I can on my end. But there is only so much you can do. I’m scared for myself, and also for my children. My parents had to claim bankruptcy for health insurance reasons. They were not covered for a medical emergency.

Suzanna Moore, 29, Fairfield, Iowa: When I was a baby, I had a stroke. I recovered well, but I would always have issues afterward. Throughout my childhood, it always a concern if I would have proper health care. I grew up in a pretty poor family in New England. With Obamacare, I went to an orthopedist for the first time in forever and got a prescription for orthotics to alleviate chronic pain in my knees and ankles on one side, because my right side was affected more from the stroke than my left side. The pain built up for a while, but basically throughout my twenties, I was never able to get it addressed, because I was living on my own in Tennessee and was unable to focus any money toward my personal health care.

I also had a meniscus tear during that time. Had I had surgery on that on my own, it would have been like $15,000 or more. With Obamacare, we still had to prioritize, but we didn’t go in debt over it.

My husband has a rare condition called achalasia, which means the muscles in his throat stopped working the way they were supposed to, so he had trouble swallowing and eating. He had to force food down his esophagus with air and water. After a while, it got so painful that he was eating less and he was losing weight rapidly. It was hindering his quality of life, and, left untreated, it could contribute to throat cancer. So he had to have surgery about eight months after I had my knee surgery. We were able to afford all of it. We wouldn’t have been able to do that without Obamacare.

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8 People Who Owe Their Lives to Obamacare

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