It’s possible that I shall make an ass of myself. But in that case one can always get out of it with a little dialectic. I have, of course, so worded my proposition as to be right either way (K.Marx, Letter to F.Engels on the Indian Mutiny)
Thursday, February 02, 2023
Mistaken fossil rewrites history of Indian subcontinent for second time
A fossil turned out to be just a beehive, and the correction puts the geologic and life history of India back into contention
IMAGE: WHAT AT FIRST LOOKED LIKE A DICKINSONIA FOSSIL (ON THE LEFT) HAD DECAYED AND STARTED PEELING OFF THE ROCK IN JUST A FEW SHORT YEARS (ON THE RIGHT), A SIGN IT WAS SOMETHING MUCH MORE MODERN.view more
CREDIT: GREGORY RETALLACK/JOE MEERT
In 2020, amid the first pandemic lockdowns, a scientific conference scheduled to take place in India never happened.
But a group of geologists who were already on site decided to make the most of their time and visited the Bhimbetka Rock Shelters, a series of caves with ancient cave art near Bhopal, India. There, they spotted the fossil of Dickinsonia¸ a flat, elongated and primitive animal from before complex animals evolved. It marked the first-ever discovery of Dickinsonia in India.
The animal lived 550 million years ago, and the find seemed to settle once and for all the surprisingly controversial age of the rocks making up much of the Indian subcontinent. The find attracted the attention of The New York Times, The Weather Channel and the scientific journal Nature as well as many Indian newspapers.
Only, it turns out, the “fossil” was a case of mistaken identity. The true culprit? Bees.
University of Florida researchers traveled to the site last year and discovered the object had seemingly decayed significantly – quite unusual for a fossil. What’s more, giant bee’s nests populate the site, and the mark spotted by the scientists in 2020 closely resembled the remains of these large hives.
“As soon as I looked at it, I thought something’s not right here,” said Joseph Meert, a UF professor of geology and expert on the geology of the area. “The fossil was peeling off the rock.”
The erstwhile fossil was also lying nearly vertical along the walls of the caves, which didn’t make sense. Instead, Meert says, fossils in this area should only be visible flat on the floor or ceiling of the cave structures.
Meert collaborated on the investigation with his graduate students Samuel Kwafo and Ananya Singha and University of Rajasthan professor Manoj Pandit. They documented the rapid decay of the object and photographed similar remains from nearby beehives. The team published their findings of the mistaken identity Jan. 19 in the journal Gondwana Research, which previously published the report of the serendipitous Dickinsonia fossil find.
Gregory Retallack, professor emeritus at the University of Oregon and lead author of the original paper, says he and his co-authors agree with Meert’s findings that the object is really just a beehive. They are submitting a comment in support of the new paper to the journal.
This kind of self-correction is a bedrock principle of the scientific method. But the reality is that admitting errors is hard for scientists to do, and it doesn’t happen often.
“It is rare but essential for scientists to confess mistakes when new evidence is discovered,” Retallack said in an email.
Correcting the fossil record puts the age of the rocks back into contention. Because the rock formation doesn’t have any fossils from a known time period, dating it can be difficult.
Meert says the evidence continues to point to the rocks being closer to one billion years old. His team has used the radioactive decay of tiny crystals called zircons to date the rocks to that time period. And the magnetic signature of the rocks, which captures information about the Earth’s magnetic field when the rocks formed, closely matches the signatures of formations confidently dated to a billion years ago.
Other scientists have reported findings supporting a younger age. The time period is essential to understand because of its implications for the evolution of life in the area and how the Indian subcontinent formed.
“You might say, ‘Okay, well what's the big deal if they are 550 million or a billion years old?’ Well, there are lots of implications,” Meert said. “One has to do with the paleogeography at the time, what was happening to continents, where the continents were located, how they were assembled. And it was a period when life was going through a major change, from very simple fossils to more complex fossils.”
“So trying to figure out the paleogeography at the time is very, very important. And in order to figure out the paleogeography, we have to know the age of the rocks,” he said.
The caves near Bhopal, India, host prehistoric cave art. Because they don't have any fossils, they are hard to date.
Large beehives dot the site. After they are abandonded and decay, they briefly resemble fossils of the primitive animal Dickinsonia.
IMAGE: LARVAL INLAND SILVERSIDES WITH COTTON MICROFIBERS IN THEIR DIGESTIVE TRACTS.view more
CREDIT: OREGON STATE UNIVERSITY
CORVALLIS, Ore. – While microplastics have received significant attention in recent years for their negative environmental impacts, a new study from Oregon State University scientists found microfibers from synthetic materials as well as cotton impacted the behavior and growth of water organisms.
“We’re trying to shift the narrative a little bit because so much of the focus has been just on the plastics, but really we need to focus more generally on microfibers of all types,” said Susanne Brander, an associate professor and ecotoxicologist at Oregon State. “What we are seeing is that even the cotton, while it has less of an impact than the synthetic materials, still has an impact on the growth and behavior of the organisms we studied.”
The study, published this week in the journal Frontiers in Marine Science, is being released at a time of increased attention on regulating microfibers. Like microplastics, microfibers are of concern because scientists are increasingly identifying them in water samples and finding they are causing adverse impacts in organisms and ecosystems.
A bill was recently introduced in Oregon that would require new clothes washers sold in the state be equipped with a microfiber filtration system. France recently approved a similar measure and several other countries, states and provinces are considering bills. Related, a study from Canada in 2021 found that washing machine filters reduce microfiber emissions.
Brander, who studies the responses of aquatic organisms to environmental stressors, believes other measures could be taken to reduce the release of microfibers, including increasing the sustainability of clothing so that it sheds less and passing laws that would require filters on both clothes washers and dryers. Previous studies have found dryers are an underestimated source of microfibers being released into the environment.
“The answer isn’t to stop using cotton but to have a better awareness and better control over the release of fibers,” Brander said.
For the new study, Brander’s lab, with support from the lab of Stacey Harper, a professor of toxicology and environmental engineering at Oregon State, created microfiber samples of different sizes from ropes made of cotton, polyester and polypropylene, all of which are commonly found in coastal waters, including in wild organisms such as rockfish and zooplankton that Brander’s students study.
The researchers then exposed larval and juvenile inland silverside and mysid shrimp, both model organisms for estuaries and coastal ecosystems, to the three microfiber types at three concentrations and different levels of salinity meant to mimic conditions in an estuary and measured behavioral responses, growth and ingestion levels in the two organisms.
Among their findings:
Cotton had no effect on growth in silversides but did reduce growth in the mysids at the two lower salinities. This finding surprised Brander, who thought the researchers would find growth impacts on both organisms or neither, not just one. She speculated that the finding may be a result of the silversides being better at breaking down the cotton than the shrimp.
Synthetic fibers reduced growth in both organisms over just a few days of exposure.
Polyester and polypropylene had more of an effect on behavior than cotton did in both organisms. Brander believes this could be due to residual chemicals on the polyester and polypropylene, which could remain despite the researchers rinsing the microfibers.
Cotton was not detected in the digestive tracts of silversides, however polyester and polypropylene were detected in the silversides’ stomach and gut lining. None of the fiber types were detected in mysid shrimps.
Cotton impacted both organisms’ behavior more at higher salinities, whereas polyester and polypropylene had more behavioral impacts at lower salinities. This could be due to differences in the densities of the different materials, which influences how long they stay in suspension.
“Increasing amounts of microfibers are being detected in environmental samples and we really need to identify the risk associated with them, especially at sensitive early life stages of organisms,” Harper said. “This study and others begin to do that, but more research is needed.”
Harper and Brander are based in the Oregon State College of Agricultural Sciences. Harper also has an appointment in the College of Engineering. This research was led by Samreen Siddiqui, a former postdoctoral fellow in Brander’s lab. Graduate students Sarah Hutton and John Dickens and technician Emily Pedersen also contributed.
IMAGE: MATTHEW JORDAN, ASSOCIATE PROFESSOR AND HEAD OF THE DEPARTMENT OF FILM PRODUCTION AND MEDIA STUDIES IN THE DONALD P. BELLISARIO COLLEGE OF COMMUNICATIONS, WILL DISCUSS HIS LATEST BOOK DETAILING THE RISE AND FALL OF THE KLAXON AUTOMOBILE HORN AT A BOOK LAUNCH EVENT ON FEBRUARY 21.view more
CREDIT: PENN STATE
UNIVERSITY PARK, Pa. — A new book by Penn State faculty member Matt Jordan chronicles the rise and fall of the Klaxon automobile horn, one of the first great electrical consumer technologies of the 20th century. Jordan, associate professor and head of the Department of Film Production and Media Studies in the Donald P. Bellisario College of Communications, will discuss his research into the iconic horn’s history at a book launch event at 5:30 p.m. Feb. 21 in the Foster Auditorium of Paterno Library.
Matt McAllister, professor of media studies, will moderate the event and a question-and-answer session with the author following Jordan’s talk.
Jordan’s book, “Danger Sound Klaxon! The Horn That Changed History,” shares how the metallic shriek of the horn first shocked pedestrians, improving safety, and how savvy advertising strategies convinced consumers across the United States and western Europe to adopt the horn as the safest signaling technology available in the 1910s.
While the shrill-sounding horn improved early automobile safety and provided a positive impact for a communications technology, the book chronicles how the technology went awry because of world events.
The widespread use of Klaxons in the trenches of World War I transformed how the public heard the car horn, according to Jordan, and its traumatic association with gas attacks ultimately doomed this once ubiquitous consumer technology.
By charting the meteoric rise and eventual fall of the Klaxon, "Danger Sound Klaxon!" highlights how perceptions of sound-producing technologies are guided by, manipulated and transformed through advertising strategies, public debate, consumer reactions and governmental regulations. Jordan’s book demonstrates how consumers are led toward technological solutions for problems themselves created by technology.
Jordan is a critical media scholar who works on the role of media in everyday culture and its impact on society. He teaches courses in film studies and media studies. His writing engages with how different popular media forms and technologies change the way that people see themselves and the world. Along with various academic publications on sound, technology and the impact of media on democracy, he writes essays for the popular press on his research topics as they relate to news of the day.
Jordan is the executive producer of the Penn State Humanities Institute’s Emmy-nominated documentary series “Humin Focus,” which is broadcast on WPSU and on the web. He also leads Penn State’s news Literacy Initiative, which includes hosting the “News Over Noise” radio/show podcast that is available on all podcast platforms and in most public radio markets across Pennsylvania.
Experts urge kids’ comic the Beano to stop promoting junk food brands
Many of the comic’s online quizzes revolve around food high in fat, salt and sugar. Experts call it “incredibly irresponsible” and want the company to change its policy
The website of the UK children’s comic the Beano describes itself as “100% safe for children” - but is its junk food-related content doing more harm than good?
An investigation by The BMJ shows how the Beano’s website - promoted as a digital hub for 6- to 12-year-olds - showcases products from well-known brands that are harmful to children, including fast food, confectionery, soft drinks and ultra-processed food.
Since its launch in 2016, 47.9 million children have visited beano.com, which includes frequent references to well known high fat, salt and sugar (HFSS) brands, explain Claire Mulrenan and Mark Petticrew at the London School of Hygiene and Tropical Medicine and freelance journalist Harry Wallop.
For example, there is a ‘Ultimate McDonald’s Quiz,’ ‘How Well do you know the Nando’s Menu’ quiz, and a ‘Skittles jokes’ page. There is also an ‘Ultimate Food Logo’ quiz, whose ten answers are: Greggs, Heinz, Pizza Hut, Nando’s, Subway, Domino’s, Quorn, KFC, Pizza Express and Burger King.
There is even a quiz that features alcohol, with the question ‘how long have humans been making beer for?’ accompanied by an image of a pint being poured.
There is no suggestion that any of these quizzes have been paid for by the brands themselves, which could be deemed as a form of advertising known as “advergames” under the self-regulating UK Code of Non-broadcast Advertising and Direct & Promotional Marketing (CAP).
Health campaigners, however, are disappointed with Beano’s willingness to showcase so many junk food brands – and to put these brands right at the front of children’s minds, suggesting that a chocolate, fizzy drink or burger brand is “cool” – even if it’s not taking money from the companies themselves.
With estimates that 22% of reception aged schoolchildren are overweight or obese, rising to 37% of children by year 6, health experts are also deeply concerned.
Kat Jenner, director of nutrition, research, campaigns, and policy at the Obesity Health Alliance, says, “It is an incredibly irresponsible way of promoting unhealthy food,” while Boyd Swinburn, professor of population nutrition and global health at the University of Auckland and honorary professor at the Global Obesity Centre in Melbourne, believes that the company is being “naive” in giving “free advertising” to HFSS brands and products.
Through these quizzes and games, beano.com also collectsdata on children’s consumption preferences, which is then sold, on an anonymised basis, to companieslooking to find out more about what children like and don’t like.
Beano insists that its surveys meet all legal and data protection obligations, and say “any suggestion that Beano is somehow contributing to increased consumption of HFSS products in children is false, misleading and damaging.”
Nevertheless, campaigners say that there’s a question around whether the company has an ethical duty to safeguard child health, write the authors.
Henry Dimbleby, lead author of the National Food Strategy, which called for a salt and sugar tax on processed food, says: “People at Beano might be thinking: ‘Oh, well, you know, it's just a little bit of fun, that's what the kids like.’ But I just think it is all pervasive in society. This stuff invades every element of their lives.”
Former health minister James Bethell agrees. Pointing to UK government plans to delay a ban on junk food adverts before 9pm on TV and online, he says: “What annoys me about this is just the relentlessness of it in young people's lives. There's no escape.”
Because Beano says that it hasn’t taken money from any of the HFSS brands that so often feature in its quizzes, the stricter (and now delayed) rules about marketing junk food to children would not stop the company from continuing to showcase so many burgers, pizzas, crisps, and fizzy drinks or from suggesting that these brands were “cool” write the authors.
Nor would it stop the comic running Forknite, a game fronted by one of its characters Minnie the Minx who has “been served up a plate of vile veg and she needs your help to eat them and defeat them!”.
J. Bernadette Moore, associate professor of obesity at the University of Leeds, says, “This idea that children won’t like healthy food pervades all aspects of our society. Yet companies with such extensive young audiences must acknowledge that they are not merely reflecting child preferences but shaping them."
Beano responded, “We take enormous care in what we present to children particularly around health and wellbeing,” adding that its website also runs some positive content about fruit, vegetables, and healthy eating, including the “Ultimate Vegetarian Quiz.”
But Swinburn argues that Beano must do better, and he called on the company to change its policy and to no longer showcase products that are harmful to children - including alcohol, fast food, confectionery, soft drinks, and ultra-processed food.
He concludes, “Corporations which are clever enough to capture and hold children’s attention need to have very high ethical standards to ensure that they are not exploiting those same children by promoting unhealthy products to them.”
IMAGE: SINOLOGIST LENA HENNINGSEN RECEIVES ERC CONSOLIDATOR GRANT.view more
CREDIT: PHOTO: PROVIDED. UNIVERSITY OF FREIBURG
Sinologist PD Dr. Lena Henningsen from the University of Freiburg has been awarded a Consolidator Grant from the European Research Council (ERC) to fund her research project on comic culture in the People’s Republic of China. The European Union grant is one of the most prestigious awards for researchers in the EU. It is worth two million euros over a period of five years.
Independent Genre and Research Field
Henningsen’s project “Comics Culture in the People’s Republic of China (ChinaComx)” is devoted to Chinese comics as an independent cultural form: “‘Lianhuanhua’ – translated literally, linked images – are still largely unexplored,” says Henningsen. “Our project explores the intellectual, political, social, historical, and transcultural dimensions of this exciting medium.” Henningsen and her team will analyze comics from the People’s Republic of China with regard to Chinese and global comic culture – as well as the specific conditions of their production, circulation, and consumption. In the process, they will also address the question of whether and to what extent comics further the goals of state propaganda, such as the legitimization of the Communist Party of China, the creation of the “new socialist man,” and nation building – or whether they counteract these goals.
Lena Henningsen served from 2012 to 2022 as a junior professor at the University of Freiburg’s Institute of Sinology and is currently Principal Investigator of the research project “The Politics of Reading in the People’s Republic of China (READCHINA)”. In it, she and her team are studying intellectual, literary, and social change in China since the 1940s from the perspective of reading practices. She has already received an ERC Starting Grant for this project. Her research foci also include modern Chinese literature and culture, contemporary Chinese society, intellectual property and plagiarism, and pop culture and music in China. Henningsen was an elected member of the “Young Academy” from 2013 to 2018 and received the Leopoldina Early Career Award in 2016.
Mapping Mexico’s dengue fever hotspots
Rutgers researcher co-creates tool to help identify outbreaks and prioritize virus control efforts
As many as one in five dengue fever deaths in the Americas occur in Mexico, and the rate of the disease’s severity has been increasing for decades, according to the World Health Organization. Now, a Rutgers researcher has generated data that could help curb the mosquito-borne illness in the country.
Ubydul Haque, an assistant professor of global health at the Rutgers Global Health Institute, has analyzed data from Mexico’s Ministry of Health to identify dengue fever hotspots. Working with epidemiologists at the University of North Texas and Universidad Autónoma de Nuevo León, the team calculated environmental and socioeconomic risk factors and mapped areas where severe outbreaks occur.
The findings are published in the journal Ecological Informatics.
“These maps can aid health officials in targeting fogging activities or enhancing surveillance,” Haque said. “By knowing where severe dengue fever frequently occurs, we can significantly reduce the number of cases.”
Dengue fever has been reported in 28 of 32 states in Mexico, and researchers have long known that socioeconomic status and weather affect dengue fever case counts in those states. But the factors contributing to disease severity hasn’t been studied.
Past work also has failed to account for geographic distribution of variants, or serotypes. There are four dengue virus serotypes – DENV-1, DENV-2, DENV-3 and DENV-4 – and transmissibility and lethality differ by each.
To fill these research gaps, Haque analyzed laboratory-confirmed dengue fever infections from 71,059 individuals in 2,469 Mexican municipalities collected between 2012 and 2020. Samples included serotype classification.
This data was overlaid with localized weather and socioeconomic statistics, such as literacy, access to health services, electricity and sanitation.
As expected, each degree Celsius increase in temperature was associated with lower rates of occurrence of the virus – mosquito eggs don’t hatch well in high heat – while increasing humidity was associated with an increase in the rate of each virus serotype.
Moreover, the researchers determined that lower socioeconomic status increases risk of dengue fever, and indicators such as access to education, information and infrastructure are better predictive factors of dengue fever distribution.
From this data, the researchers produced heatmaps highlighting dengue virus distribution and severity. Hotspots were generally observed in humid coastal regions at lower altitude. Throughout the country, the most prevalent serotype was DENV-2 and the least prevalent was DENV-4, Haque said.
While efforts are underway to develop DENV-specific vaccines, mosquito control programs such as fogging, and drone surveillance remain the most effective means of slowing the disease’s spread. Haque said data visualization can help health officials plan where to target their activities.
“From our data we know that DENV-2 is deadlier compared to other serotypes,” Haque said. “If regional health officials had limited resources for their control program, they could focus most of their resources in places where DENV-2 was prevalent.”
The WHO estimates dengue fever infects as many as 400 million people every year, killing thousands. With climate change predicted to increase dengue fever cases in Mexico over the coming decades, continuous surveillance of serotype patterns will be essential to preventing or slowing the rate of increase, Haque said.
The ecological determinants of severe dengue: A Bayesian inferential model
https://www.who.int/news-room/fact-sheets/detail/dengue-and-severe-dengue Dengue and severe dengue - World Health Organization (WHO) Jan 10, 2022 ... Dengue is a mosquito-borne viral disease that has rapidly spread to all regions of WHO in recent years. Dengue virus is transmitted by female ...
https://en.wikipedia.org/wiki/Dengue_fever Dengue fever - Wikipedia Dengue fever virus (DENV) is an RNA virus ; The dengue virus genome ; Dengue virus is primarily transmitted by Aedes mosquitos, particularly A. aegypti. · These ... Dengue fever, a man-made disease
Apr 30th 1998 | JAKARTA
THE ECONOMIST
EXCERPT
SUPERSTITIOUS South-East Asians might suspect a supernatural curse. Reeling from economic turmoil, and bracing themselves for a return of the smog that forest fires last year belched over much of the region, they are also now battling the Aedes aegypti mosquito, and the disease it carries: dengue fever. In most of the tropical world, dengue is ever-present, and spreading. Last year saw the highest-ever recorded number of infected people in the Americas, with Brazil and Cuba especially badly hit. This year dengue has reached pandemic proportions in Indonesia and Thailand, and Malaysia, Cambodia and Vietnam are all experiencing serious outbreaks. Most sufferers are children. As with the smog, it is tempting, but unfair, to blame mother nature. The weather patterns brought by the El Niño effect have mucked about with the mosquito's life-cycle, just as they have delayed the rains to douse the burning trees. But dengue is a disease of urbanisation and human travel. In the words of Suchitra Nimmannitya, a Thai specialist on the disease, the infected Aedes aegypti is “a man-made mosquito”.
I faced a serious ethical dilemma while attending a couple of cases of dengue fever at a ward in the Kolkata Municipal Corporation (KMC) area during September 2013. Two patients had tested positive for dengue IgM antibody by MAC ELISA. Adjacent to their house was a vacant plot of around 1500 sq feet and this was heaped with domestic waste from the neighbouring houses. The waste comprised plastic cups, thermocol plates, plastic bags and boxes of biscuits, cakes, chips and other foodstuff, coconut shells, bicycle tyres and earthen pots. These served as a permanent breeding ground for Aedes mosquitoes, the vector for the dengue virus. The owner of the land lived elsewhere and the local people had been dumping their domestic waste here indiscriminately, without the owner’s permission. They had converted the area into an unauthorised garbage dump, despite the fact that the conservancy workers of the KMC visited the place for house collection of wastes every day.
Later, I came to know that two more NS1-reactive dengue cases had been reported from the same locality the following week. I informed the KMC health department about the matter, as dengue is a notifiable disease here. Health workers from the KMC visited the area and discovered several plastic cups, earthen pots, coconut shells and the like, which contained stagnant water. Larval and pupal stages of the Aedes species were found on the rooftops of most houses in the locality. Van-fogging of the area with adulticides was performed, as well as source reduction, followed by chemical (Temephos 50% EC) spraying in the moist areas and other possible breeding sites that could not be destroyed. Last year, there had been a dengue outbreak in the area and three deaths due to dengue shock syndrome were reported. The KMC authorities have been sending surveillance workers with information, education and communication (IEC) materials, such as handbills, to this area on a weekly basis for the past six months. They have even hired an auto-rickshaw and fitted it with a microphone to conduct IEC activities in the area twice a week. Their field workers and surveillance workers have been carrying out anti-larval activities, such as source destruction and chemical spraying, and conducting active surveillance for new cases of fever throughout the year. Further, IEC activities are being carried out through television, FM radio, newspapers, electricity bills, handbills, and so on.
Despite the above measures, people continue to dispose of waste indiscriminately, resulting in the accumulation of stagnant water. Therefore, it was evident that mere IEC and chemical spraying would not suffice; the civic authorities would need to take decisive action to improve the environment.
Despite the outbreak of dengue in the area the previous year, the residents failed to reduce the sources conducive to the breeding of mosquitoes in their own premises. Even after the enormous efforts of the KMC health department, they failed to realise how they themselves had promoted the breeding of Aedes mosquitoes. Should people have the liberty not to keep their premises clean when this can make others ill and even result in their deaths? Should the authorities, in the interest of beneficence and justice for the larger community, have the right to forcibly take action to clean up people’s premises? Should people have the right to convert others’ premises into an unauthorised dumping ground, endangering the life of others in the community? Should the authorities, in the interest of non-maleficence and justice for the owner, as well as beneficence for the community, have the right to take legal action against such transgressions? The dilemma remains unanswered.
About the Authors Subhasis Bhandari (subhasisbhandari@gmail.com) General Physician and Health Research Scholar Bhandari House, 151, Diamond Harbour Road, Behala, Kolkata 700034
Financial coaching for parents in clinic leads to higher attendance at well-child health care visits for their young children
UNIVERSITY OF CALIFORNIA - LOS ANGELES HEALTH SCIENCES
Implementing financial coaching for parents of infants in a pediatric primary care setting reduced missed well-child care visit rates by half and significantly improved receipt of vaccinations at a timely age, according to a new community-partnered pilot study led by UCLA researchers.
The study, published in Pediatrics, is the first to examine the effectiveness of delivering financial coaching and its impact on preventive care visits and vaccination in infants’ first six months of life, among families with low income who often face economic stress.
“Improving the continuity and quality of pediatric care has been a focus for pediatric care nationally, and the medical-financial partnership approach offers a novel strategy,” said the study’s lead author, Dr. Adam Schickedanz, an assistant professor of pediatrics at the David Geffen School of Medicine at UCLA. “Early childhood financial hardship has a significant impact on health. Infancy is full of new expenses and financial challenges that families grapple with. Having a new baby in the family can increase eligibility for a number of anti-poverty public benefits programs, and young children and their parents have relatively frequent visits to their physician, so the health care system has more contact with children and families in the preschool years than any other family-facing system. This makes health care a great setting for delivering financial guidance and supports to young families. What our study shows is that this in-clinic financial coaching leads to improvements in clinical care continuity and quality too.”
Poverty-related social needs and other measures of patient financial hardship are among the most consistent predictors of missed health care visits, yet interventions to increase patient visit attendance have tended not to focus on underlying financial needs of children and families. In this new study, conducted at the Harbor-UCLA pediatric primary care clinic, parents received financial coaching in exam rooms during their infants’ well-child visits while waiting for their pediatrician and other health care team members. The financial coaches, who have backgrounds in social work, were trained in the foundations of financial coaching by LIFT Inc., a national nonprofit that works to break intergenerational cycles of poverty. Through ongoing supervision and education from clinician supervisors, as well as LIFT’s financial coaching training, financial coaches were equipped to help parents identify their financial goals, plan action steps and ultimately achieve greater financial stability. The coaches also connected parents to public benefits and cost-saving services such as low-cost childcare, nutrition assistance programs, free tax preparation and other public resources. Coaches also followed up remotely with parents at least monthly to track progress toward goals.
The researchers enrolled 81 parents recruited from clinic waiting areas or exam rooms who were randomized to either receive clinic-based financial coaching plus usual care (the intervention group of 35) or usual care (the control group of 46). The parents were primarily mothers and over half were Latina.
Over the first months of their infants’ lives, parents and children in the intervention group had half the rate of missed primary care pediatric visits compared to those in the control group. They were also 26% more likely to be up-to-date with immunizations each visit and had fewer missed vaccinations overall by the end of the six-month visit period. Parents who received financial coaching also reported increased monthly household income relative to when they enrolled in the program.
“When we approached the parents in clinic to offer this service and support them with their financial goals, many already recognized that their finances and the health of their child were intertwined. It made sense, from their perspective, to receive financial coaching services in combination with their child’s health care,” Schickedanz said. “Once they began receiving the intervention service, many parents shared that they felt supported by their coach. This supportive relationship with that coach as a key new member of their health care team may have given parents more motivation to stick with the clinic for their pediatric visits over time.”
“We have found that the strong social connection between parent and coach is an integral part of the success of the service,” added co-author Michelle Rhone-Collins. “Coaching breaks down the goals of parents into concrete action steps alongside a partner to cheer them on, hold them accountable and offer them hope.”
The authors note the study has some limitations, including its small size at a single site and the inability to do a blinded study. A concurrent study of the influence of financial coaching on participating parents’ health outcomes remains ongoing.
Still, the results “suggest that addressing financial goals and needs can improve preventive visit care adherence and vaccinations,” the authors write. “This may partially offset costs to clinics of implementing medical-financial partnership programs, in addition to optimizing the host of health, developmental and psychosocial benefits of preventive pediatric care.”
Other study authors are Lorraine Perales and Dr. Peter G. Szilagyi of UCLA, Dr. Monique Holguin of UCLA and USC, Michelle Rhone-Collins and Helah Robinson of LIFT-Los Angeles, Dr. Niloufar Tehrani and Dr. Lynne Smith of Harbor-UCLA Medical Center, and Dr. Paul J. Chung of UCLA and the Kaiser Permanente Bernard J. Tyson School of Medicine.
The study was funded by the UCLA National Research Service Award Primary Care and Health Services Fellowship, the National Center for Advancing Translational Science (NCATS, KL2TR001882), a grant from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (K23HD099308) and NCATS at the National Institutes of Health through the Clinical and Translational Science Awards (CTSA) Program (UL1TR001881).
