New study links millions of diabetes and heart disease cases globally to sugary drinks

Research reveals the health impacts of consuming sugar-sweetened beverages

Tufts University

 

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Soda bottle on its side

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Credit: Alonso Nichols/Tufts University

A new study from researchers at the Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy at Tufts University, which published in Nature Medicine on January 6, estimates that 2.2 million new cases of type 2 diabetes and 1.2 million new cases of cardiovascular disease occur each year globally due to consumption of sugar-sweetened beverages.

In developing countries, the case count is particularly sobering. In Sub-Saharan Africa, the study found that sugar-sweetened beverages contributed to more than 21% of all new diabetes cases. In Latin America and the Caribbean, they contributed to nearly 24% of new diabetes cases and more than 11% of new cases of cardiovascular disease.

Colombia, Mexico, and South Africa are countries that have been particularly hard hit.  More than 48% of all new diabetes cases in Colombia were attributable to consumption of sugary drinks. Nearly one third of all new diabetes cases in Mexico were linked to sugary drink consumption. In South Africa, 27.6% of new diabetes cases and 14.6% of cardiovascular disease cases were attributable to sugary drink consumption.

Sugary beverages are rapidly digested, causing a spike in blood sugar levels with little nutritional value. Regular consumption over time leads to weight gain, insulin resistance, and a host of metabolic issues tied to type 2 diabetes and heart disease, two of the world’s leading causes of death.

“Sugar-sweetened beverages are heavily marketed and sold in low- and middle-income nations. Not only are these communities consuming harmful products, but they are also often less well equipped to deal with the long-term health consequences,” says Dariush Mozaffarian, senior author on the paper and director of the Food is Medicine Institute at the Friedman School.

As countries develop and incomes rise, sugary drinks become more accessible and desirable, the authors say. Men are more likely than women to suffer the consequences of sugary drink consumption, as are younger adults compared to their older counterparts, the researchers say.

“We need urgent, evidence-based interventions to curb consumption of sugar-sweetened beverages globally, before even more lives are shortened by their effects on diabetes and heart disease,” says Laura Lara-Castor, NG24, first author on the paper who earned her Ph.D. at the Friedman School and is now at the University of Washington.

The study’s authors call for a multi-pronged approach, including public health campaigns, regulation of sugary drink advertising, and taxes on sugar-sweetened beverages.  Some countries have already taken steps in this direction. Mexico, which has one of the highest per capita rates of sugary drink consumption in the world, introduced a tax on the beverages in 2014. Early evidence suggests that the tax has been effective in reducing consumption, particularly among lower-income individuals. 

“Much more needs to be done, especially in countries in Latin America and Africa where consumption is high and the health consequence severe,” says Mozaffarian, who is also Jean Mayer Professor of Nutrition at the Friedman School. “As a species, we need to address sugar-sweetened beverage consumption.”

 

Research reported in this article was supported by the Gates Foundation, the American Heart Association, and the National Council for Science and Technology in Mexico. Complete information on authors, methodology, limitations, and conflicts of interest is available in the published paper. The content is solely the responsibility of the authors and does not necessarily represent the official views of the funders. 

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Journal

Nature Medicine

DOI

10.1038/s41591-024-03345-4 

Article Publication Date

6-Jan-2025

Fluoride once again scrutinized for possible effect on children's brains

Erika Edwards
Mon, January 6, 2025


Fluoride once again scrutinized for possible effect on children's brains
Yahoo is using AI to generate takeaways from this article. This means the info may not always match what's in the article. Reporting mistakes helps us improve the experience.

A new report once again raises the question of whether there is a link between fluoride in drinking water and lower IQ levels in children.

The research, published in JAMA Pediatrics on Monday, is a review of 74 other studies exploring how the mineral may affect children’s IQ levels.

The analysis found a statistically significant association between higher fluoride exposure and lower children’s IQ scores. It showed that "the more fluoride a child is exposed to, the more likely that child’s IQ will be lower than if they were not exposed,” Kyla Taylor, author of the study and a health scientist at the National Institute of Environmental Health Studies at the National Institutes of Health, wrote in an email. Taylor was not available for an interview.

For every small increase of fluoride found in kids' urine, Taylor wrote, “there is a decrease of 1.63 IQ points in children.”

The researchers did not suggest that fluoride should be removed from drinking water. According to the study authors, most of the 74 studies they reviewed were low-quality ones. All were done in countries other than the United States, such as China, where researchers analyzed fluoride levels in water and in urine. Fluoride levels in China and other countries tend to be much higher than in the U.S., the researchers noted.

Fluoride has been added to public water supplies in the U.S. for decades. No studies in the U.S. have flagged any measurable decreases in children's cognitive development since fluoride was introduced.

There has been a growing pushback against fluoridated water in a number of communities across the country.

Some have already voted to remove fluoride from public water supplies.

Dentists worry the findings will be potentially damaging to public health.

"What we have seen in areas where fluoride has been removed, is that dental decay rates have increased dramatically," said Dr. Erica Caffrey, a pediatric dentist and chair of the American Academy of Pediatric Dentistry’s Council on Clinical Affairs.

Major public health groups, including the CDC, the American Academy of Pediatrics and the American Dental Association, support the use of fluoridated water.

An ADA spokesperson, Dr. Scott Tomar, said that if more robust studies prove a link between fluoride and brain development, public health leaders should take a closer look at the mineral's effects. That proof doesn't exist yet, he said.

Fluoride exposure and children’s IQ scores

 News Release 6-Jan-2025

JAMA Network

About The Study:

 This systematic review and meta-analysis found inverse associations and a dose-response association between fluoride measurements in urine and drinking water and children’s IQ across the large multi-country epidemiological literature. There were limited data and uncertainty in the dose-response association between fluoride exposure and children’s IQ when fluoride exposure was estimated by drinking water alone at concentrations less than 1.5 mg/L. These findings may inform future comprehensive public health risk-benefit assessments of fluoride exposures.

Corresponding Author: To contact the corresponding author, Kyla W. Taylor, PhD, email kyla.taylor@nih.gov.

To access the embargoed study: Visit our For The Media website at this link https://media.jamanetwork.com/

(doi:10.1001/jamapediatrics.2024.5542)

Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, conflict of interest and financial disclosures, and funding and support.

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Embed this link to provide your readers free access to the full-text article This link will be live at the embargo time https://jamanetwork.com/journals/jamapediatrics/fullarticle/10.1001/jamapediatrics.2024.5542?guestAccessKey=f61d2921-6a2b-436a-8710-c9623f148bdf&utm_source=for_the_media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=010625

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Journal

JAMA Pediatrics

TRUTH ABOUT U$ TRANS YOUTH

Gender-affirming medications rarely prescribed to US adolescents

Harvard T.H. Chan School of Public Health

Key points:

• Less than 0.1% of U.S. adolescents were transgender and gender diverse (TGD) and prescribed puberty blockers or gender-affirming hormones in a study of private insurance claims representing 5.1 million patients ages eight to 17.

• No TGD patients under age 12 received hormones.

• According to the researchers, the findings counter a growing concern among policymakers that gender-affirming care is frequently over-prescribed to children.

Boston, MA—Puberty blockers and gender-affirming hormones are rarely prescribed to U.S. transgender and gender diverse (TGD) adolescents, according to a new study from researchers at Harvard T.H. Chan School of Public Health, Harvard Pilgrim Health Care Institute, and FOLX Health.

The study will be published Jan. 6 in JAMA Pediatrics.

“The politicization of gender-affirming care for transgender youth has been driven by a narrative that millions of children are using hormones and that this type of care is too freely given. Our findings reveal that is not the case,” said lead author Landon Hughes, Yerby Fellow in Harvard Chan School’s Department of Epidemiology and postdoctoral fellow at Harvard Chan School and Harvard Pilgrim Health Care Institute’s LGBTQ Health Center of Excellence.

A 2024 study led by researchers at Harvard Chan School and Harvard Pilgrim Health Care Institute documented the rarity of gender-affirming surgeries among adolescents. But little is known about hormone use among transgender and gender diverse adolescents. The researchers analyzed private insurance claims data from 2018 to 2022, representing more than 5.1 million young patients ages eight to 17. They identified transgender or gender-diverse patients based on a gender-related diagnosis and then checked if they received puberty blockers or gender-affirming hormones. They then calculated the rate of adolescents who are TGD and receiving this care per 100,000 privately insured adolescents according to age and sex assigned at birth.

The study found that less than 0.1% of minors with private insurance are TGD and received puberty blockers or gender-affirming hormone treatment. No TGD patients under age 12 were prescribed gender-affirming hormones. Use of puberty blockers and gender-affirming hormones was more common among TGD adolescents assigned female sex at birth than those assigned male sex at birth.

The researchers noted that higher rates of puberty blocker and hormone prescriptions for TGD patients assigned female sex at birth aligned with an earlier onset of puberty for people who are female vs. male sex assigned at birth.

“Our study found that, overall, very few TGD youth access gender-affirming care, which was surprisingly low, given that over 3% of high school youth identify as transgender .” said senior author Jae Corman, head of analytics and research at FOLX Health. “Among those that do, the timing of care aligns with the standards outlined by the World Professional Association for Transgender Health, the Endocrine Society, and the American Academy of Pediatrics.”

The researchers also noted that the study likely reflects the highest rates of puberty blocker and hormone use by adolescents, given the study used private insurance data, likely reflecting greater access to gender-affirming care. Lower rates would be expected among the uninsured, Medicaid recipients, and those with less comprehensive private insurance.

Isa Berzansky, research analyst at Harvard Pilgrim Health Care Institute, and Brittany Charlton, associate professor in the Department of Epidemiology at Harvard Chan School and founding director of the LGBTQ Health Center of Excellence, were co-authors.

“Gender-Affirming Medications Among Transgender Adolescents in the US, 2018-2022,” Landon D. Hughes, Brittany M. Charlton, Isa Berzansky, Jae D. Corman, JAMA Pediatrics, January 6, 2025, doi: 10.1001/jamapediatrics.2024.6081

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Harvard T.H. Chan School of Public Health is a community of innovative scientists, practitioners, educators, and students dedicated to improving health and advancing equity so all people can thrive. We research the many factors influencing health and collaborate widely to translate those insights into policies, programs, and practices that prevent disease and promote well-being for people around the world. We also educate thousands of public health leaders a year through our degree programs, postdoctoral training, fellowships, and continuing education courses. Founded in 1913 as America’s first professional training program in public health, the School continues to have an extraordinary impact in fields ranging from infectious disease to environmental justice to health systems and beyond.

The Harvard Pilgrim Health Care Institute's Department of Population Medicine is a unique collaboration between Harvard Pilgrim Health Care and Harvard Medical School. Created in 1992, it is the first appointing medical school department in the United States based in a health plan. The Institute focuses on improving health care delivery and population health through innovative research and education, in partnership with health plans, delivery systems, and public health agencies. Follow us on Bluesky, X, and LinkedIn.

The LGBTQ Health Center of Excellence was founded in 2024 through a first-of-its-kind partnership between the Harvard Chan School and the Harvard Pilgrim Health Care Institute. The Center aims to improve the health of a growing and diverse LGBTQ population, with a specific focus on reducing and preventing health inequities that impact LGBTQ communities. To do this, the Center embraces a multi-pronged approach, including training LGBTQ health leaders, catalyzing new research, and disseminating information about LGBTQ health to policy makers, healthcare providers, and the public.

Launched in December 2020, FOLX Health is an LGBTQIA+ healthcare service provider built to serve the community's specific needs. The company delivers a new standard of healthcare that's built to serve LGBTQIA+ people, rather than treat them as problems to be solved. FOLX Health provides end-to-end virtual primary care, HRT, PrEP, care navigation, content and community through a diverse network of queer and trans specialized providers. In January 2021, FOLX Health established the FOLX HRT Care Fund which redistributes financial resources from allies inside and outside of the LGBTQIA+ community to support trans, nonbinary, and intersex folks to access hormone replacement therapy care through FOLX.

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Journal

JAMA Pediatrics

DOI

10.1001/jamapediatrics.2024.6081 

Method of Research

Observational study

Subject of Research

Not applicable

Article Title

Gender-Affirming Medications Among Transgender Adolescents in the US, 2018-2022

Article Publication Date

6-Jan-2025

 

Economics research stumbled under Soviet regime, while mathematics thrived

Radboud University Nijmegen

Political and ideological barriers can shape the progress of academic disciplines, warns Ivan Boldyrev. In a new paper, the historian of economics at Radboud University explores the complex history of Soviet science and warns that a new Cold War might once again hinder academic progress. His findings have been published in the Journal of Economic Literature.

Starting in the 1930s and World War 2, the field of economics research changed greatly. ‘Prior to the 1930s, economic theory was much less formal’, explains Boldyrev. ‘Then, new publications led to the so-called mathematization of economics: more rigorous models were used to conceptualize the economy.’ 

This academic change encompassed almost all international economics research, except in the Soviet Union where most economists either emigrated or were repressed . As a result, there were few if any notable papers published by Soviet economists in this period.

Ideology over academics

In his paper, Boldyrev explores some of the factors that limited research by Soviet economists. ‘The Soviet government valued ideology over academic rigor, and there was a hostility to the direction of Western economics in the 1930s and 1940s. This, in turn, led to censorship on many levels. By the government, trying to keep out Western thought, but also by scholarly institutions careful to avoid pressure from the government. That led to self-censorship, too, as researchers did not feel able to freely write and contribute to the ‘new’ style of economics research. Academic exchange was severely restricted during this time between Soviet and non-Soviet economists.’ 

Remarkably, some of the Soviet work did contribute greatly to research in non-Soviet economics, Boldyrev explains. However, it wasn’t economists, but mathematicians who were mostly able to keep contributing, despite many Cold War obstacles. Soviet mathematics was under less pressure and remained internationally competitive in many fields.

Learning from the past

‘Throughout the Soviet regime, formal technical contributions in the fields of mathematics (optimization, games, probability) were applied to various fields of non-Soviet economic theory. And some of the Soviet mathematical work was actually directly inspired by economic applications. Unfortunately, the support and contributions of mathematicians were never enough to outweigh the lack of a free and internationally open research environment.’

As Boldyrev explains, understanding the history of economics research and international communication of ideas is crucial to advancing the field. ‘Science can only succeed in the right context, by understanding what happened before and learning from that. That’s why our students of economics all study the history of the field. It’s also important to not repeat the mistakes of the past. The global situation now is not so different from that of the Cold War, and this paper shows in more detail how limiting that can be for academic research.’ 

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Journal

Journal of Economic Literature

DOI

10.1257/jel.20241699 

Article Title

Soviet Mathematics and Economic Theory in the Past Century: A Historical Reappraisal

Prime apple growing areas in US face increasing climate risks

Washington State University

 

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Sun damage is one risk apple growers face from a changing climate, particularly from more extreme heat days, when the maximum temperature is greater than 34 degrees C (93 F).

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Credit: Bob Hubner, Washington State University

VANCOUVER, Wash. – Some of the most productive apple regions in America are facing big challenges from a changing climate, according to a Washington State University study.

Researchers analyzed over 40 years of climate conditions that impact the growth cycle of apple trees from bud break and flowering through fruit development, maturation and color development.

While many growing areas are facing increased climate risks, the top three largest apple producing counties in the U.S. were among the most impacted: Yakima in Washington, Kent in Michigan and Wayne in New York. In particular, Yakima County, the largest of the three with more than 48,800 acres of apple orchards, has seen harmful trends in five of the six metrics the researchers analyzed.

“We shouldn’t take the delicious apples we love to consume for granted,” said Deepti Singh, a WSU climate scientist and the study’s corresponding author. “Changing climate conditions over multiple parts of the growth cycle pose potentially compounding threats to the production and quality of apples. Moving forward, it would be helpful to think about adaptations at different stages of apple growth that can minimize overall harmful impacts.”

The team’s immediate next step is to look at projections, Singh added, to inform planning and management in the tree fruit industry.

For this study, published in the journal Environmental Research Letters, the researchers analyzed climate data from 1979-2022. They specifically looked at six metrics that impact the apple growth, including two metrics of extremes—extreme heat days, defined as days with a maximum temperature greater than 34 degrees C (93 F) that can cause sunburn as well as other problems, and warm nights when the minimum temperatures were greater than 15 C (59 F) that can adversely affect coloration.

The researchers also looked at the number of cold days; “chill portions” or the number of colder hours an apple tree needs to be dormant; the last day of spring frost; and growing degree days, meaning the number of days above a certain temperature that are conducive for apples to grow.

Changes in these metrics can impact apple production, changing the time when apple flowers bloom, increasing the risk of sunburn on apples as well as affecting apple appearance and quality. The western U.S. has experienced the strongest trends in multiple metrics that are detrimental to apples.

The challenges are complex partly because apple trees are perennials, said co-author Lee Kalcsits, a WSU tree physiologist who leads programming at the Wenatchee Tree Fruit Research and Extension Center.

“What goes on in different seasons can affect long-term health as well as the performance and productivity of the apple tree during that specific season,” he said. “So what goes on in the winter affects what happens in the spring, which affects the summer, and it just keeps going around in a cycle.”

Growers are already adapting, he added, noting that in Washington state, producers are employing measures such as netting and evaporative cooling to fend off sunburn during the more frequent extreme heat.

With more climate risks likely, researchers are also taking steps to help the industry adapt. Kalcsits is leading a project funded by a $6.75 million grant from the U.S. Department of Agriculture to help mitigate the impact of extreme climate events on apple and pear crops. It is a multi-institution grant with work planned across the nation as well as in the apple growing regions of Washington state.

“Washington is a great place to start to talk about adaptation,” said Kirti Rajagopalan, a WSU biological systems engineer and study co-author, who is also working on the grant project. “A lot of the commercial apple production happens in the northern U.S. There are also parts of Washington where the summers can get pretty hot, so this is a good place for a case study – and if we can manage it here, then it's likely manageable elsewhere too.”

Additional researchers on the current study include first author Shawn Preston and Matthew Yourek of WSU. This research was supported by the National Science Foundation and WSU’s Emerging Research Initiative.

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Journal

Environmental Research Letters

DOI

10.1088/1748-9326/ad90f4 

Article Title

Changing climate risks for high-value tree fruit production across the United States

 

Climate extremes in 2024 ‘wreaking havoc’ on the global water cycle

Australian National University

2024 was another year of record-breaking temperatures, driving the global water cycle to new climate extremes and contributing to ferocious floods and crippling droughts, a new report led by The Australian National University (ANU) shows. 

The 2024 Global Water Monitor Report, involving an international team of researchers and led by ANU Professor Albert van Dijk, found rising temperatures are changing the way water moves around the planet, “wreaking havoc” on the water cycle. 

“Rising sea surface temperatures intensified tropical cyclones and droughts in the Amazon Basin and southern Africa. Global warming also contributed to heavier downpours and slower-moving storms, as evidenced by deadly flash floods in Europe, Asia and Brazil,” Professor van Dijk said. 

In 2024, about four billion people across 111 countries – half of the world’s population − experienced their warmest year yet. Professor van Dijk said air temperatures over land in 2024 were 1.2 degrees Celsius warmer than at the start of the century, and about 2.2 degrees Celsius higher than at the start of the Industrial Revolution. 

“In 2024, Earth experienced its hottest year on record, for the fourth year in a row. Water systems across the globe bore the brunt,” he said. 

“2024 was a year of extremes but was not an isolated occurrence. It is part of a worsening trend of more intense floods, prolonged droughts, and record-breaking extremes.” 

The most damaging water-related disasters in 2024 included flash floods, river floods, droughts, tropical cyclones and landslides. Water-related disasters killed more than 8,700 people, displaced 40 million people and caused economic losses exceeding US $550 billion. 

“From historic droughts to catastrophic floods, these extreme events impact lives, livelihoods, and entire ecosystems. Separate, heavy rainfall events caused widespread flash flooding in Afghanistan and Pakistan, killing more than 1,000 people,” Professor van Dijk said. 

“Catastrophic flooding in Brazil caused more than 80 deaths, with the region recording more than 300 millimetres of rainfall. 

“We found rainfall records are being broken with increasing regularity. For example, record-high monthly rainfall totals were achieved 27 per cent more frequently in 2024 than at the start of this century, whereas daily rainfall records were achieved 52 per cent more frequently. Record-lows were 38 per cent more frequent, so we are seeing worse extremes on both sides. 

“In southern China, the Yangtze and Pearl Rivers flooded cities and towns, displacing tens of thousands of people and causing hundreds of millions of dollars in crop damages. 

“In Bangladesh in August, heavy monsoon rains and dam releases in August caused widespread river flooding. More than 5.8 million people were affected and at least one million tonnes of rice was destroyed. In Spain, more than 500 millimetres of rain fell within eight hours in late October, causing deadly flash floods.” 

While some parts of the world experienced major flooding in 2024, others endured crippling drought. 

“In the Amazon Basin, one of the Earth’s most important ecosystems, record low river levels cut off transport routes and disrupted hydropower generation. Wildfires driven by the hot and dry weather burned through more than 52,000 square kilometres in September alone, releasing vast amounts of greenhouse gases,” Professor van Dijk said. 

“In southern Africa, a severe drought reduced maize production by more than 50 per cent, leaving 30 million people facing food shortages. Farmers were forced to cull livestock as pastures dried up. The drought also reduced hydropower output, leading to widespread blackouts. 

“We need to prepare and adapt to inevitably more severe extreme events. That can mean stronger flood defences, developing more drought-resilient food production and water supplies, and better early warning systems. 

“Water is our most critical resource, and its extremes—both floods and droughts—are among the greatest threats we face.” 

The research team used data from thousands of ground stations and satellites orbiting the Earth to deliver near real-time insights into critical water variables such as rainfall, soil moisture, river flows, and flooding. 

The Global Water Monitor is a collaboration between institutions across the world and involves various public and private organisations. 

The 2024 report is available on the Global Water Monitor website.  

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Method of Research

Observational study

Floods linked to rise in US deaths from several major causes

Study in Nature Medicine reveals potential deadly effect of large floods on injuries, infectious diseases, and other causes

Columbia University's Mailman School of Public Health

Over the last 20 years, large floods were associated with up to 24.9 percent higher death rates from major mortality causes in the U.S. compared to normal conditions. A new study in the journal Nature Medicine demonstrates the sweeping and hidden effects of floods—including floods unrelated to hurricanes, such as those due to heavy rain, snowmelt, or ice jams.

Scientists at Columbia University Mailman School of Public Health led the study in partnership with researchers at Arizona State University, Harvard University, and the University of Arizona. 

Until now, there had been a critical knowledge gap about cause-specific flood mortality risks in the U.S. over time, and how risks may vary among groups within the population. The study’s findings provide information that could help public health agencies allocate resources.

In the U.S., population growth alone is projected to result in an estimated 72 percent increase in the population exposed to floods annually by 2050, before accounting for the effect of climate change in leading to more frequent river, coastal, and flash floods.

“Flooding is an urgent public health concern as sea level rise, rapid snowpack melting, and increased storm severity will lead to more destructive and frequent events,” says first author Victoria Lynch, PhD, post-doctoral research fellow at Columbia Mailman School. “Our results show that floods were associated with higher death rates for most major causes of death, even for rain- and snow-related floods that are less likely to generate rapid emergency responses.”

“In the U.S., floods have a devastating effect on society, yet a comprehensive assessment of their continuing health impacts had been lacking,” says Robbie M. Parks, assistant professor in Environmental Health Sciences at Columbia Mailman School and senior author. “Our study is a first major step in better understanding how floods may affect deaths, which provides an essential foundation for improving resilience to climate-related disasters across the days, weeks, months, and years after they wreak destruction.”

After collecting 35.6 million U.S. death records from 2001 to 2018, the researchers used a statistical model to calculate how death rates changed in three-month periods following large floods when compared to equivalent periods in normal conditions.

Residents of 2,711 counties, covering over 75 percent of the U.S. population, experienced at least one large flood during the study period. Heavy rain was the most common cause of large flood events with the next most common cause due to snowmelt in the Midwest and tropical cyclones in the southeast.

The researchers found the largest overall increases in injury death rates among older people (24.9 percent) and females (21.2 percent) during the month of tropical storm/hurricane-related flooding, with increases in death rates associated with heavy rain-related flooding for infectious diseases (3.2 percent) and cardiovascular diseases (2.1 percent). Snowmelt-related floods were associated with higher death rates for respiratory diseases (22.3 percent), neuropsychiatric conditions (15.9 percent), and cardiovascular diseases (8.9 percent).

The rise in infectious diseases is likely related to disruptions to drinking water and sewage infrastructure that can lead to waterborne disease transmission. Chronic and neuropsychiatric conditions may relate to stress from persistent flood-related disruptions. Socioeconomic factors that drive health outcomes in communities vulnerable to floods, as well as residents’ ability to evacuate during emergencies and respond to their aftermath, may also play important roles.

“The majority of our understanding of flood-related health impacts comes from major events like Hurricane Katrina or Harvey that, despite their devastation, are a sample of a larger phenomenon,” says Jonathan Sullivan, assistant professor in Geography, Development, and Environment at University of Arizona and co-author. “Our study shows that even floods caused by snowmelt or heavy rain, each uniquely driven by changes to climate and development, elevate mortality months after the fact providing critical knowledge of how to manage and adapt to floods.”

Previous research on climate and health by the authors of this paper has found elevated death rates after tropical cyclones in the U.S., including disproportionate increases in excess deaths in socially vulnerable communities of color, and that tropical cyclones are associated with the spread of waterborne infectious diseases.

Additional co-authors are Aaron Flores, Arizona State University; Sarika Aggarwal and Rachel C. Nethery, Harvard Chan School of Public Health; and Marianthi-Anna Kioumourtzoglou, Anne E Nigra, and Xicheng Xie, Columbia Mailman School of Public Health. 

The study was supported by the National Institute of Environmental Health Sciences (grants ES007322, ES033742, ES009089, AG093975, ES007142).

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Journal

Nature Medicine

DOI

10.1038/s41591-024-03358-z 

Method of Research

Data/statistical analysis

Subject of Research

People

Article Title

Large floods drive changes in cause-specific mortality in the United States

Article Publication Date

3-Jan-202

Teach Yourself Marxism

What did Marx mean by historical materialism?

What forces underpin the development of human society?

Egyptian workers built the gates of Thebes


Thursday 02 January 2025  

SOCIALIST WORKER Issue

Some of the most popular approaches to understanding history are the least convincing. Most people still learn that history is about the wars, laws and loves of powerful kings, a few queens, religious leaders and politicians.

We are taught that history is a journey from an oppressive past to a “glorious present” and the triumph of liberal democracy. Slavery, colonialism and tyranny were just creases ironed out by enlightened leaders.

But fantasies of endless progress have always been rudely interrupted by war, economic crisis, climate disaster and political upheavals.

Marxists have a distinct understanding of historical change—one that puts human activity, and specifically workers’ activity, at the heart of events.

Karl Marx’s great insight was that human beings “make their own history, but they do not make it as they please, they do not make it under self-selected circumstances, but under circumstances existing already, given and transmitted from the past”.

It is working people who have a key role in initiating change. The communist poet Bertolt Brecht shone a light on the hidden role of enslaved people and labourers in history when he asked:

“Who built the seven gates of Thebes?
“The books are filled with names of kings.
“Was it the kings who hauled the craggy blocks of stone?
“And Babylon, so many times destroyed.
“Who built the city up each time?”

As Marx wrote, “History does nothing, it ‘possesses no immense wealth,’ it ‘wages no battles’.” It is humans who do those things.

The Marxist approach to history focuses on the hidden forces that underpin the development of human society.

All human development depends on the development of productive forces—the technology, machinery and labour power used in production.

In the past, those productive forces developed enough to create a surplus in addition to what people needed to survive. Society divided into classes, with a minority controlling the surplus and a majority excluded from enjoying a share. Classes had different interests and fought for access to that surplus.

Today, societies produce more than enough food to feed everyone. But the imperative for the ruling class to create profit means some go hungry.

History is shaped by the struggles of successive social classes to mould society in their own interests.

Marx’s view of history, known as historical materialism, helps us to understand that there is nothing inevitable about progress.

Marx did discuss how technology influenced society. New technology opens up new possibilities for changes in society. The invention of the steam engine allowed for industrial capitalists to dominate.

But technology does not do this alone, and it is not automatic that society will progress forwards. It is all too easy to imagine capitalism collapsing into climate catastrophe rather than giving way to socialist freedom.

Marx and Engels are often accused of reducing everything to economics. But as Frederick Engels wrote in 1890, “According to the materialist conception of history, the ultimately determining element in history is the production and reproduction of real life. More than this neither Marx nor I have ever asserted.”

Visions of fully automated, luxury communism may sound fantastic, but realising the potential of new technology requires a struggle.

Technology can always be appropriated by those who are hostile to progress. In the Communist Manifesto, Marx and Engels argued that class struggle is key to understanding history.

In that struggle, the organisation, confidence and understanding of the working class will be crucial in whether society moves forward or collapses backwards into barbarism.

In Depth

Can Marxism make sense of fashion?

Capitalism both bombards us with the ideal of clothes as individual expression, and denies us the means to attain anything truly distinctive. Sarah Bates looks at how Karl Marx can help us make sense of the contradiction

Hip hop street styles in the 1980s borrowed from designer chic—in the form of a Gucci T-shirt. Gucci then grabbed the style for itself

Friday 03 January 2025

SOCIALIST WORKER Issue

At this time of year, the high streets—what is left of them anyway—are filled with red and white banners declaring it’s our “last chance to buy”. We are bombarded with urgent demands to grab a bargain that will give us some longed-for confidence and social success.

Cheap “fast” fashion rightly gets a lot of stick for being environmentally damaging and made by workers in extremely poor conditions.

Socialists want clothes that don’t cost the earth and decent workplace practices for garment workers. But that only takes us so far. Thanks to the writings of Karl Marx, we can investigate the fashion industry from the perspective of both producer and consumer and explore how they relate to each other.

Marx wrote about the ­contradiction between the glamour of luxury goods and the terrible conditions that workers experienced when producing them. “It is a curious fact that the production of precisely those articles which serve the personal adornment of the ladies of the bourgeoisie involves the saddest consequences for the health of the workers,” he said.

But it’s not just the fact that workers can’t afford the objects they produce or services they deliver. The capitalist ­workplace is organised around the needs of accumulation of profit, not to respond to our wants and needs.

Clothes are more than simple objects to keep us warm or cover our naked bodies. Choosing clothes can be part of the way we express our personality and our individuality. What we wear is tied up with our gender expression, sexual orientation, cultural identity and class position.

Clothes are a way to both set yourself apart from the crowd and to place yourself in a social and cultural context.

This expression of identity can feel particularly important when many of us wear uniforms for much of our lives. We get our very first pair of polished black school shoes in early childhood.

Uniforms at work and school reflect ­hierarchies. Often the boss wears a suit while the ­workforce is forced to wear gaudy polyester. Sometimes, bosses will implement “casual Fridays” as a little treat or to impose a ­contrived sense of informality.

Most of us buy cheap, mass produced fashion from s­upermarkets, online retailers or clothes shops. But whether you shop in H&M, Shein or Sainsbury’s, the clothes look largely the same because they’re produced by similar designers using the same fabrics made in the same factories.

Despite the reality of being sold the same clothes as most other people, we’re also sold the myth of “individuality”. We’re told if we just buy the right clothes and wear them the right way, it will fulfil our desire for individual expression.

The concept of the self and individual identity are part of how we are encouraged to see ourselves under capitalism.

The capitalist fashion ­industry wants consumers to seek out individuality while stamping on their ability to achieve it.

But there’s more to the ­relationship between the fashions of the rich and the clothes the rest of us wear. Under capitalism, the fashions of the rich and poor interact with each other.

Designers regularly lift ideas straight from youth subcultures—think of the safety pin studded denim and leather of the punks, or dramatic black stylings of goths.

As young people figure out their own sense of identity, clothes operate as a way for us to tell the world who we are, and to develop unique styles.

But these organic street styles—often pioneered by the young people from oppressed groups and from the working class—are quickly snapped up by luxury designers. The way that sportswear companies, such as Nike with its “just do it” catchphrase, market trainers is a good example.

The firm pitches its­ ­products as essential for athletic ­brilliance and as symbols of vibrant street youth culture. Nike uses the music, imagery, language and wider cultural references of its intended customers to situate its products within their world.

Only a tiny minority of the rich can wear the finest exclusive fashions that are made to order and produced from the most luxurious materials. These garments display designers’ creativity, which is bought by celebrities for display at the gala dinner or red carpet event.

The cost of designer clothes vastly outstrips either the raw materials or the wages paid to the workers who make it. It is a hugely exploitative industry whether clothes are made in Bangladesh or Paris.

But the real point of one‑off designer clothing is to show that the wearer has a distinct and individual personality—­something few of us get the opportunity to express.

Some working class people save up to splash their hard‑earned cash on designer clothes that sell at greatly inflated prices. Partly, that is about status, but it also an attempt to grab a slice of that “individuality” seen on the red carpet.

The Marxist concept of ­alienation helps to explain why fashion plays such an important role in our lives. The fashion industry, like other industries, is both a source of exploitation and an opportunity for creativity.

Most people have no choice but to work for majority of their lives. But they’re denied any control over how they work and what the end results look like. Marx described this lack of control over how and what we produce as alienation.

Working together with others has the potential to be ­creative and fulfilling. But in ­capitalist society it is more likely to be frustrating, tedious and ­exhausting. Work robs us of our creativity and makes us sick.

For Marx, the untapped ­creativity of workers was one of the key distinctions between humans and other animals. He described how “spiders conduct operations which resemble weavers” and bees produce honeycombs.

These structures can appear as miracles of nature and are certainly the products of effort—but they do not contain the same constituent elements as human labour.

Marx argued that while other animals led narrow lives defined by instinct and survival, humans had the capacity to think beyond immediate need and behave creatively. Alienated labour under capitalism, wrote Marx, created “marvels and beauty beyond necessity” but at the same time it produced “suffering” for the worker.

It is this potential that is wasted in the ­capitalist workplace. Bosses want us to be spiders, endlessly creating the same web over and over again—but we could build so much more.

We have a capacity for ­imaginative labour that is untapped by the lives we lead. At every stage of fashion production, the workers who create, who do the sewing, ­cutting, trimming, the ­marketing and selling, know more about their jobs than the bosses.

Take sewing machinists as an example. Machinists are forced to work on a production line, which is boring and can be dangerous.

Or consider people who spend long hours picking cotton in fields. They are forced to repeat the same physical labour all day, even though some of it could be shared or automated. The cotton picker and the machinist have ideas and experiences that would make their work better.

But they are denied that chance because the current system needs to maximise profits. The bosses need workers to be obedient, to accept harsh discipline and the authority of those who exploit them.

The fact that most people working in the garment industry are poor women from the Global South makes it easier for corporations to ignore them, their abilities and their ideas.

We live in a deeply ­disheartening world. And we are told that it is primarily through the acquisition of commodities that we will find the fulfilment and the social connections that we need. Fashion and consumption choices are one way in which people constantly seek ways to fulfil themselves and buy into an illusion of choice.

The fashion industry ­reinforces the feeling that ­something is missing in our lives and then profits from our insecurities. This is possible because alienation shapes our need to clothe ourselves within a wider context of capitalist society.

Think about how Cuban heels make men appear taller and “Spanx” promise to smooth out any lumps and bumps our bodies have the audacity to possess.

Marx’s theory of alienation is not simply an exploration of how capitalism is responsible for human misery.

The theory of alienation is a deeply optimistic analysis. Marx argues that working class people have the potential to produce what they need collaboratively and creatively—and to become masters of their own destiny.

He did not think we had to spend our days weaving the bosses’ webs—and he was right.

In Depth

How the arms industry corrupts political parties—interview with Andrew Feinstein

Andrew Feinstein is joint editor of The Monstrous Anger of the Guns: How the Global Arms Trade Is Ruining the World and What We Can Do About It. He spoke to Judy Cox about the new book

Andrew Feinstein

Thursday 02 January 2025 

SOCIALIST WORKER  Issue

Why did you publish this book?

Put very simply, war and militarism—and the arms trade that feeds them—have never been more relevant than it is today.

There is the devastating impact of weapons in the conflicts in Gaza, in Sudan, in Congo. But there is also the impact the arms industry has on the entire world.

In the case of Britain, the one area that there never seems to be a lack of money for is the weapons industry and “defence”.

So, the money which should be going in the NHS and should be going into scrapping the two-child benefit cap and keeping the winter fuel allowance is going into the military and wars like that in Ukraine.

The book sets out how this happens and why it happens.

And it shows that those who benefit from this trade primarily are the ruling elite. The arms trade benefits those who control political and economic power in this country.

How does the link between arms corporations and governments encourage corruption?

The arms trade is very corrupt—and its corruption oils the wheels of the political establishment.

It funds political parties and politicians make extremely large amounts of money out of the business of war.

There are lots of examples of how this happens in the book. But the book also gives voice to campaigners and activists from around the world who fight against the arms trade and militarism.

It includes all sorts of different approaches and campaigns, from litigation against companies, to direct action against arms companies.

It gives a lot of food for thought about what we can do practically to change the situation.

What do you think the best tactics to use against the arms trade?

Currently this is so important because our government is using anti-terror legislation to stop criticism of its support for Israel.

Journalists and activists are being accused of terrorism for opposing a genocide. In a good society, it would be those perpetrating genocide who would be seen as the terrorists.

Will Donald Trump’s return to the White House this month make things worse?

Trump’s election will mean that some things important will change, like abortion rights.

But militarism would not have changed because both Republicans and Democrats support US imperialism and Israel’s genocide.

When it comes to the role of militarism, both the Republicans and the Democrats have uncritically supported Israel’s genocide.

Both parties rely on defence companies for their funding and both parties are both parties of war and militarism.

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