Study: Minorities bore brunt of 'excess deaths' due to killings, drugs during pandemic

Between March and December 2020, the first nine months of the COVID-19 pandemic, nearly 242,000 deaths from "external causes," including homicides, were reported in the United States, according to the Centers for Disease Control and Prevention.

 File Photo by Debbie Hill/UPI | License Photo

May 9 (UPI) -- Black Americans, as well as American Indians and Alaska Natives, were more likely to be slain or die as a result of drug overdoses or traffic accidents during the first year of the COVID-19 pandemic than White Americans and those of other racial and ethnic groups, an analysis published Monday found.

Of more than 17,000 "excess deaths," or more than expected fatalities, between March and December 2020, nearly 7,000, or 42%, involved Black Americans, the data published Monday by JAMA Internal Medicine showed.

Meanwhile, about 3% of these deaths involved American Indians or Alaska Natives, the researchers said.

Black Americans make up about 12% of the total population of the United States, while American Indians and Alaska Natives account for just over 1%, according to 2020 census figures.

RELATED Thousands of COVID-19 deaths in U.S. South were preventable, study suggests

"The pandemic has and continues to disproportionately impact some communities -- especially marginalized communities -- above and beyond just COVID-19 infection," study co-author Mathew V. Kiang told UPI in an email.

"It is clear that we need more structural ways of protecting these marginalized groups," said Kiang, a computational and social epidemiologist and an Instructor in epidemiology and population health at Stanford University in Palo Alto, Calif.

Between March and December 2020, the first nine months of the COVID-19 pandemic, nearly 242,000 deaths from "external causes" were reported in the United States, according to the Centers for Disease Control and Prevention.

External, or unnatural, causes of death include intentional and unintentional injury and poisoning, such as drug overdose, as well as complications of medical or surgical care, and homicide and suicide, the agency says.

The 242,000 figure is about 17,000 above what would normally be expected for the nine-month period, based on data from prior years, Kiang and his colleagues said.

The 17,000 excess deaths included 4,300 homicides,12,900 drug overdoses and 2,200 transportation fatalities, the data showed.

RELATED Minority groups bear brunt of COVID-19 death toll, study says

Black Americans accounted for two-thirds of all excess deaths attributed to homicide and 19% of those linked with drug overdoses, the researchers said.

They also made up 57% of excess deaths associated with transportation-related accidents, according to the researchers.

American Indians and Alaska Natives accounted for 2% of all drug overdose-related excess deaths and 2% of homicide fatalities, the data showed.

This group also had higher rates of suicide deaths during the first nine months of the COVID-19 pandemic while others experienced declines, the researchers said.

"Excess deaths are a way for us to think about what would have happened to these groups if COVID-19 never happened," Kiang said.

"In that way, it allows us to understand the full brunt of COVID-19, both directly in terms of infection but also indirectly," he said.

MAY BE CRIMINAL CAPITALI$M

Justice Department investigates mental health startup Cerebral for misleading ads

Cerebral, currently under investigation for possible Controlled Substances Act violations, offers prescriptions for some of the conditions it offers therapy and counseling services for, including attention-deficit/hyperactivity disorder, anxiety and insomnia. 

File Photo by Sponge/Wikimedia Commons


May 9 (UPI) -- The United States Department of Justice launched an investigation into Cerebral, a mental health startup facing scrutiny over its advertising and prescribing practices for controlled substances including Xanax and Adderall.

The DOJ is looking into Cerebral for "possible violations" of the Controlled Substances Act, which regulates distribution of medications that come with a high risk of addiction.

The online, San-Francisco-based company offers prescriptions for some of the conditions it offers therapy and counseling services for, including attention-deficit/hyperactivity disorder, anxiety and insomnia.

In recent months, medical professionals and social media platforms like TikTok and Meta have accused Cerebral of misleading advertisements linking ADHD to obesity.

Meta and TikTok have subsequently pulled such ads from its platforms.

After the U.S. Attorney for the Eastern District of New York issued a grand jury subpoena on Wednesday requesting documents, Cerebral halted issuing controlled substance prescriptions the same day.

The company's Adderall prescriptions could no longer be filled by certain pharmacies including CVS and Walmart as of April, and the pharmacy described by Cerebral as its preferred choice -- Truepill -- announced on April 29 it would no longer mail Schedule 2 controlled substances like Adderall to their customers.

"To be clear, at this time, no regulatory or law enforcement authority has accused Cerebral of violating any law," Cerebral said in a statement to Insider.

"Cerebral intends to fully cooperate with the investigation, which we already have conveyed to the U.S. Attorney's Office," the statement to Insider read.

Antibiotics may cause recurrent UTIs, study suggests

By Amy Norton, HealthDay News

The antibiotics used to treat UTIs might set the stage for repeat infections by depleting the gut microbiome of beneficial bacteria, a new study found. 

File Photo by John Angelillo/UPI | License Photo

Urinary tract infections (UTIs) are common and often easily managed, yet some women are plagued by one infection after another. Now, a new study hints at a culprit: the antibiotics used to treat them.

UTIs can affect anyone, but are particularly prevalent among women. Studies suggest that up to 80% of women develop a UTI at some point, and about one-quarter of them have frequent recurrences.

Exactly why those women suffer repeat bouts has been unclear.

The new study, published recently in the journal Nature Microbiology, offers early evidence of a potential reason: The antibiotics used to treat UTIs might set the stage for repeat infections by depleting the gut microbiome of beneficial bacteria.

The microbiome refers to the vast array of bacteria that naturally dwell in the body, largely the gut, and help keep vital functions running smoothly -- including the immune response.

The makeup of those bacteria is always in flux, being influenced by various factors, from diet to antibiotic use. Anyone who has ever had digestive issues after a course of antibiotics has felt those effects.

The gut is also known to be a "reservoir" for certain bacteria that cause most UTIs -- so-called uropathogenic E. coli. In fact, UTIs often arise from the "ascension" of those bacteria from the gut to the urinary tract, explained Scott Hultgren, one of the senior researchers on the new study.

In theory, throwing off the delicate balance between "good" and "bad" gut bacteria could predispose some women to recurrent UTIs.

But until now, studies have not delved into the question, said Hultgren, a professor of molecular microbiology at Washington University School of Medicine in St. Louis.

So he and his colleagues recruited 31 women ages 18 to 45. Fifteen of them had recurrent UTIs -- three or more in the past year. Over the next year, the researchers collected blood and urine samples, plus monthly stool samples, from the women. During that time, there were 24 more UTIs in the study group, all among women who'd been suffering recurrent bouts, and they were usually treated with antibiotics.

Overall, the researchers found, women with recurrent UTIs had a gut microbiome that looked different from other women's. They had much less diversity in their good bacteria, and fewer microbes that produce butyrate -- a fatty acid that helps control inflammation.

Meanwhile, women in the comparison group were just as likely to show UTI-causing E. coli in their guts, and those bugs sometimes traveled to their bladders. The difference was, those women did not develop UTIs.

According to the researchers, it all suggests that those UTI-free women were able to control the bad bugs, while women with recurrent UTIs were not -- possibly due to the disturbances in their gut bacteria.

One big unknown is how everything is thrown off in the first place, said Ashlee Earl, co-senior researcher on the study. Was it the antibiotic treatment for the first UTI? Or was there a gut microbiome disturbance, for whatever reason, which set women up for the first UTI and the antibiotic worsened the situation?

"To be determined," said Earl, of the Broad Institute of MIT and Harvard in Cambridge, Mass.

A bigger point, she noted, is that this study throws cold water on the traditional notion that recurrent UTIs are a matter of "hygiene."

"There can be a stigma around recurrent UTIs," Earl said. "But this doesn't have to do with hygiene. There is something else going on inside the body."

Dr. Karyn Eilber, a urologist who was not involved in the study, said the findings make sense, and fit with the longstanding concern that antibiotics are probably overused for UTIs.

There are certainly times when an antibiotic is needed, including when a UTI involves fever, said Eilber, who is based at Cedars-Sinai Medical Center in Los Angeles.

"But if your doctor recommends an antibiotic," she said, "you can feel free to ask whether it's necessary."

Sometimes it's possible to simply treat symptoms, like using common painkillers to manage abdominal discomfort. Another alternative for recurrent UTIs, Eilber said, is a medication called methenamine. It works by making the urine more acidic and stopping bacterial growth, and studies have shown that it can prevent recurrent UTIs.

Yet another option for some women, Eilber said, is vaginal estrogen: After menopause, the vaginal lining thins, which can foster the growth of bad bacteria there, and sometimes lead to UTIs. Vaginal estrogen counters that, and may prevent recurrent UTIs in some women.

The hope is that additional treatment options will be available in the near future.

"We're trying to develop new compounds to selectively deplete uropathogenic E. coli, while keeping the gut microbiome intact," Hultgren said.

One such compound, based on the sugar mannoside, is currently being tested in a clinical trial.

For now, the researchers said, it's unknown whether any diet changes or probiotics can aid in preventing recurrent UTIs.

More information

The U.S. Office on Women's Health has more on urinary tract infections.

Copyright © 2022 HealthDay. All rights reserved.

Exclusive-U.S. asked Brazil's Petrobras if it could raise oil output; it said no -sources


By Gabriel Stargardter, Gram Slattery and Rodrigo Viga Gaier

RIO DE JANEIRO (Reuters) - U.S. government officials in March asked Brazil's state-run oil company Petrobras whether it could increase crude output after Russia's invasion of Ukraine sent global prices soaring, three people with knowledge of the matter told Reuters.

They came away empty-handed, the sources said.

Officials at Petrobras, formally Petroleo Brasileiro SA, said output levels were a function of business strategy rather than diplomacy and also that a significant short-term production boost would not be logistically possible, the sources said.

"We are ... doing everything possible with our allies and partners to mitigate the economic impacts of Russian actions on other economies like Brazil," a U.S. State Department spokesperson said in a statement to Reuters. "We are working with energy companies to surge their capacity to supply energy to the market, particularly as prices increase."

The spokesperson did not elaborate or comment specifically on the March meeting with Petrobras officials.

Petrobras denied in a statement that any meeting had occurred with "representatives of the U.S. State Department." It did not respond to a request for comment when asked if it had been contacted by any other U.S. government agency.

Washington has been making a sweeping diplomatic push to secure global oil supplies and keep a lid on prices after Moscow's invasion of Ukraine. U.S. officials also have been trying to improve relations with the right-wing government of President Jair Bolsonaro, despite disagreements over the Ukraine war and environmental policy.

Brazil is the world's ninth-largest oil producer.

U.S. officials have also called on domestic producers to boost output. In March, U.S. Energy Secretary Jennifer Granholm said the country was on "war footing."

Also in March, U.S. officials traveled to Venezuela for their first high-level bilateral talks in years. The sides discussed the easing of some oil sanctions on Venezuela.

Brazil Mines and Energy Minister Bento Albuquerque told Reuters in April that he had met with Granholm twice to discuss the South American nation's role in keeping a lid on global crude prices. Few details of the government-to-government talks have emerged previously.

During a March meeting, U.S. officials asked Petrobras if the company had the capacity to increase short-term production, according to U.S. government and Petrobras sources, who requested anonymity to discuss private talks.

One of the sources said that initial contacts were made between the U.S. and Brazilian governments, and Petrobras officials were consulted in an "informal" follow-up meeting.

The Petrobras officials responded that such a move was not on the table due to strategic goals and logistical obstacles, all three sources said.

Those officials added, however, that Petrobras was ramping up medium-term production as part of an announced plan to add 500,000 barrels per day of crude production by 2026.

Petrobras executives insist it operates independently of the government, but the state is by far its biggest shareholder.

($1 = 5.08 reais)

(Reporting by Gabriel Stargardter, Gram Slattery and Rodrigo Viga Gaier; Editing by Brad Haynes and David Gregorio)

North Carolina Zoo announces birth of three red wolf pups

May 10 (UPI) -- North Carolina Zoo has announced the birth of three red wolf pups -- who are one of the most endangered animals on the planet.

The zoo uploaded to Twitter on Monday photos of the pups being held by the veterinary team. The small newborn's can fit inside one hand.

"Introducing the newest addition to the North Carolina Zoo: a trio of red wolf pups! Three brothers were born on April 20th to mom Ayita, and dad, Denali.

There is an estimated 15 to 17 red wolves living int he wild and another 241 existing in captivity.

In April, a littler of six red wolf pups were born for the first time since 2018 at the Alligator River National Wildlife Refuge in North Carolina. The litter included four females an two males.

CDC looks to rebuild trust after sweeping review
By Serena McNiff, HealthDay News

Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention, testifies before a Senate Health, Education, Labor, and Pensions Committee hearing to examine the federal response to COVID-19 and new emerging variants on Capitol Hill in Washington, D.C. on January 11. 

Pool photo by Shawn Thew/UPI | License Photo

In April, the U.S. Centers for Disease Control and Prevention launched a new center to better forecast infectious disease outbreaks. It also underwent a monthlong review to examine their current systems and inform future strategies.

Together, these announcements paint a picture of an agency at a crossroads, in the wake of enormous public scrutiny during the COVID-19 pandemic.

Most recently, the CDC came under fire for paying a controversial data storage company for location data from the phones of tens of millions of Americans to study their adherence to public health measures, according to documents obtained by Vice. More broadly, the criticisms have centered around inconsistent messaging and the unsophisticated data collection systems that inform the agency's guidance.

CDC leadership has suggested that the agency's overhaul is partly in response to these criticisms. In a statement announcing that the CDC would be undergoing a comprehensive review, CDC Director Dr. Rochelle Walensky said, "Never in its 75-year history has [the] CDC had to make decisions so quickly, based on often limited, real-time and evolving science... As we've challenged our state and local partners, we know that now is the time for CDC to integrate the lessons learned into a strategy for the future."

According to Kyle McGowan, a former chief of staff at the CDC, many of the agency's difficulties have been exacerbated by political interference.

"This is what it looks like when you run a public health response or any type of emergency response out of the White House," McGowan said during a HealthDay Now interview. "It takes a very complicated process and response and makes it 10 times or 100 times more complicated than it needs to be. And every time that a guidance document is put out, or every time an interview is requested, there are 10 or 15 different people from [the Department of Health and Human Services] on up to the White House that has to confirm or sign off on those documents."

McGowan was tapped to join the CDC by the Trump administration in 2018, where he served for two years before resigning. He shared his experiences in a 2021 interview with The New York Times, citing political meddling from the White House and the U.S. Department of Health and Human Services as one of the reasons for his departure. The Trump administration's efforts to downplay the pandemic and control the CDC's messaging have been widely reported.

But despite promises to the contrary, the Biden administration hasn't seemed to loosen the political grip. In fact, there were far fewer CDC briefings on COVID-19 in 2021 than there were in 2020, when Trump was in office. "We're asking the CDC to be nimble and flexible and communicate faster. Yet we put all of these burdens in their way of being able to do that," McGowan said.

The fallout over messaging has cost the agency some public trust: In an NBC poll from January, only 44% of Americans said they trust the CDC's information about COVID-19. According to Dr. Natasha Bagdasarian, Michigan's chief medical executive, dwindling public trust in the CDC has a trickle-down effect, jeopardizing the authority of public health messaging across the board.

"When the public doesn't trust what the CDC is saying, that also affects the public trust that we have at the state level and that our local health departments have with their communities," Bagdasarian told HealthDay News. "And I'm also hearing from medical providers, from my colleagues who are practicing clinically, that it's affected their clinical relationships with patients. It becomes just a lack of public trust in healthcare recommendations."

As the evaluation of the CDC wraps up and the agency looks to improve its communication strategy in the future, Bagdasarian emphasized the importance of finding better ways to communicate uncertainty. She said public health authorities should clarify that recommendations will evolve with the science and change over time. "So far, I think that hasn't been done. Guidance has been issued as 'this is the new guidance,' when instead it should be, 'this is the guidance for where we are right now, but we expect things to change,'" she added.

The systems for collecting and analyzing data are another weak point for the agency. "The CDC is only as good as the entities that provide the information to them," McGowan said. "And I think it's important to understand that the CDC really owns no data of its own."

Managing infectious disease outbreaks properly requires massive amounts of data. On the most basic level, data allows the CDC to track the number of infections, infection severity, where infections are occurring, and who is affected. There is no comprehensive or standardized system for collecting this information. Instead, the CDC gathers data from a patchwork of sources, including private sector companies, academic institutions, and state health departments. States relay regional case numbers to the CDC on their own timetable and with varying levels of precision as part of a voluntary reporting system.

With more extensive data, the CDC can run better analyses to help predict future trends or outbreaks. "We now need to be preemptive, proactive, and look ahead and provide this type of information very much like a weather forecast, and then also provide instructions for how we want people to prepare," Bagdasarian said.

The CDC is trying to do that with the new forecasting center, which will focus on modeling the path of outbreaks to inform more timely recommendations. These forecasts will allow public health authorities to "start messaging when we know that there are surges expected," according to Bagdasarian. "So, now is the time to get ready. Make sure you've got over-the-counter tests at home. Make sure that if you are eligible for a booster, that you have a plan to get a booster."

However, the CDC is limited in the data it can collect. In an interview with "60 Minutes," Walensky explained that the agency is the "compiler of the data, but we do not have the authority to collect it," according to CBS. With a public health emergency in effect due to COVID-19, the CDC has benefited from looser restrictions, allowing the agency to receive more direct reports from laboratories and hospitals. The CDC could lose access to this data when the COVID-19 emergency declaration expires, which, barring another renewal, is scheduled to occur in July.

How the agency will go about enacting the goals they've signaled in recent months remains uncertain. Obstacles include limitations on data collection and a lack of flexible funding.

"The CDC needs to have congressional funding that is sustainable and flexible. It also needs the data authorities to truly do its job," McGowan said. "And if we wait until Congress temporarily gives funding or temporarily gives authorities during the next public health emergency, we've already failed as a country because the people are already sick, and we need the CDC to have those authorities and that funding now and during peacetime so that we can better prepare so that we never have to live through something like COVID again."

More information

Find out more about the CDC's disease forecasting center.

Copyright © 2022 HealthDay. All rights reserved.

Cancer nutrition misinformation is common on Pinterest

By HealthDay News


The brand logo for Pinterest hangs outside of the 

New York Stock Exchange on Wall Street in New York City on July 23, 2018. 

File Photo by John Angelillo/UPI | License Photo

About one-third of cancer nutrition information on the social media site Pinterest is misleading and posted by businesses trying to sell products, according to a new study.

"Our results revealed a significant amount of misinformation about cancer and nutrition," said study co-author Tracy Crane, an associate professor at the University of Miami Miller School of Medicine.

"There's a pervasiveness of health claims that are not necessarily valid or coming from reliable sources," Crane said in a university news release.

Crane and colleagues searched Pinterest using terms like "cancer recipe" or "cancer nutrition," to replicate the kinds of queries made by cancer patients.

RELATED Cancer patients may be more susceptible to COVID-19 misinformation

Nearly half the responses to their searches were on "for-profit" sites. Also, numerous health claims featured terms such as anti-cancer, cancer-fighting or cancer-busting.

Many posts exaggerated the ability of food and/or supplements to cure cancer. One even claimed a "terminal cancer patient reverses disease with anti-angiogenic foods," which is almost certainly false, according to the authors.

"Around 33% of the times we went to Pinterest, someone tried to sell us something that claimed to be anti-cancer or cancer cell killing," Crane said. "These health claims may or may not be true. But put yourself in the shoes of a cancer patient. They see buzzwords around these products and may automatically be inclined to purchase them."

RELATED Bogus information on cancer common online, study shows

Posts targeted both patients and caregivers, and many focused on breast cancer. Only about 18% of posters listed any health-related qualifications.

The study findings were published online recently in the journal Cancer.

"The key takeaway is for patients and providers to be aware that there is quite a bit of misinformation online, and that online misinformation should be part of the conversation between providers and patients," Crane said.

RELATED Misinformation lowers vaccinations, raises risks

"Patients want to find out all they can about their disease, but we need to be concerned for their internet hygiene and guide them to reliable places to find information, like the American Cancer Society, the American Society of Clinical Oncology and the American Association for Cancer Research," Crane added.

She said healthcare providers need to identify the best ways to help patients determine if online information is reliable. They might also create handouts and other materials to help patients and caregivers find reputable sources.

"We live in a digital world now, and that fundamentally changes how people get their information. Providers need to be aware of this and respond," Crane said. "We need to be asking more questions about where people are getting their information and how that may be affecting their health."

More information

To learn more about nutrition for cancer patients, go to the American Cancer Society.

Copyright © 2022 HealthDay. All rights reserved.

Exposure to chemicals rising among pregnant women

By HealthDay News

Researches checked urine samples of pregnant women for 103 chemicals, mostly from pesticides, plastics and replacement chemicals for BPA and phthalates. More than 80% of the chemicals were found in at least one of the women in the study and more than one-third were found in a majority of the women. 

Photo courtesy of Max Pixel.

Exposure to potentially harmful chemicals is on the rise among pregnant women in the United States, a new study warns.

"This is the first time we've been able to measure the amounts of chemicals in such a large and diverse group of pregnant women -- not just identify chemicals," senior study author Tracey Woodruff, director of the University of California, San Francisco Program on Reproductive Health and the Environment, said in a university news release.

For the study, Woodruff's team analyzed 12 years of urine samples from 171 women in California, Georgia, Illinois, New Hampshire, New York and Puerto Rico enrolled in the U.S. National Institutes of Health Environmental Influences on Child Health Outcomes program.

About one-third (34%) were White, 40% were Hispanic, 20% were Black, and the remaining 6% were from other or multiple groups.

The study authors checked the urine samples for 103 chemicals, mostly from pesticides, plastics and replacement chemicals for BPA and phthalates.

More than 80% of the chemicals were found in at least one of the women in the study and more than one-third were found in a majority of the women. Some of these chemicals were present in higher amounts than seen in earlier studies, the researchers reported.

Many of the chemicals that the women had been exposed to were new forms of chemicals that have been banned or phased out, but that may be just as harmful as the ones they replaced.

The researchers also found many of the women had been exposed to neonicotinoids, a kind of pesticide that is toxic to bees, according to the study published online Tuesday in the journal Environmental Science & Technology.

Non-white women, those with lower levels of education, those who were single and those who had been exposed to tobacco had higher levels of overall chemical exposure, the findings showed.

Hispanics had especially high levels of parabens, which are used as preservatives, as well as phthalates and bisphenols, which are used in plastics.

"While pesticides and replacement chemicals were prevalent in all women, we were surprised to find that Latinas had substantially higher levels of parabens, phthalates and bisphenols," said study first author Jessie Buckley. She is an associate professor of environmental health and engineering and epidemiology at Johns Hopkins Bloomberg School of Public Health, in Baltimore.

"This could be the result of higher exposures to products with chemicals, such as processed foods or personal care products," Buckley suggested.


Exposure to chemicals can come from air, food, water, plastics and other industrial and consumer products. Although these chemicals can pose risks to pregnancy and child development, few are routinely monitored in people, the study authors noted.

More information

The U.S. Office on Women's Health offers pregnancy health and safety tips.

Copyright © 2022 HealthDay. All rights reserved.




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Yoga teacher holds scorpion pose for 29 minutes, breaks world record

Yash Moradiya broke a Guinness World Record by holding the scorpion yoga pose 

for 29 minutes and 4 seconds. Photo courtesy of Guinness World Records

May 10 (UPI) -- A yoga instructor in India broke a Guinness World Record by holding the difficult scorpion pose for 29 minutes and 4 seconds.

Yash Moradiya, 22, a Dubai native living in India, said he took on the record for longest time to hold the scorpion position as a means of raising awareness of the benefits of yoga.

"The scorpion position, particularly, is all about stability. The longer we hold the pose, the better we learn to establish the mental resilience to survive any critical situation we face in life with grace," Moradiya told the Khaleej Times. "Yoga has the ability to transform our physical and mental well-being, driving us to unlock our hidden potential of our bodies away from limiting thoughts."

Moradiya, who has been practicing yoga since he was 8 years old, said he has been working on his endurance in the scorpion position for five years.

He successfully held the position for 29 minutes and 4 seconds, handily defeating the previous record of 4 minutes and 47 seconds.

PATRIARCHY IS RAPE

'Sins of the Amish' docu-series explores rape in Amish communities

"Sins of the Amish" follows survivors in the Amish community.

 Photo courtesy of Peacock


May 10 (UPI) -- Peacock released the trailer for its true crime docu-series Sins of the Amish on Tuesday. The two part series premieres May 24.

Sins of the Amish follows Amish women who are pursuing justice against men in the community who raped them. One survivor alleges her biological father raped her when she was five.


"The odds of an Amish woman getting raped by a guy within their own community, it's 1 out of every 6, on a good day," one survivor says.

Another survivor discusses the Amish community bussing in people to support her attacker. One young woman calls her attacker a pedophile.

"Amish communities view going to the police as a greater sin than the rape itself," another survivor says.

Sins of the Amish explores the Amish and Mennonite communities and the roles of women in them. While many see the Amish as a peaceful community, as portrayed in films like Witness, the docu-series delves into abuse and mind-control that keeps women subservient to men.