Wednesday, May 07, 2025

Significant gaps in NHS care for patients who are deaf or have hearing loss, study finds

University of Cambridge

A majority of individuals who are deaf or have hearing loss face significant communication barriers when accessing care through the National Health Service (NHS), with nearly two-thirds of patients missing half or more of vital information shared during appointments.

A team of patients, clinicians, researchers and charity representatives, led by the University of Cambridge and the British Society of Audiology, surveyed over 550 people who are deaf or have hearing loss about their experiences with the NHS – making it the largest study of its kind. Their findings, reported in the journal PLOS One, highlight systemic failures and suggest changes and recommendations for improving deaf-aware communication in the NHS.

“The real power of this study lies in the stories people shared,” said lead author Dr Bhavisha Parmar from Cambridge’s Department of Clinical Neurosciences (Sound Lab) and UCL Ear Institute. “Patients weren’t just rating their experiences – they were telling us how these barriers affect every part of their healthcare journey, and in many cases, why they avoid healthcare altogether.”

The study found that despite being a legal requirement under the Accessible Information Standards, NHS patients have inadequate and inconsistent access to British Sign Language (BSL) interpreters and other accessibility accommodations such as hearing loop systems.

Nearly two-thirds (64.4%) of respondents reported missing at least half of the important information during appointments, and only a third (32%) expressed satisfaction with NHS staff communication skills. Respondents said they had to rely on family members or advocates to communicate with healthcare workers, raising privacy and consent concerns.

The research found that communication barriers extend across the entire patient journey – from booking appointments to receiving results. Simple actions, like calling a patient’s name in a waiting room or giving instructions during a scan, become anxiety-inducing when basic accommodations are lacking. Respondents noted that hearing aids often must be removed for X-rays or MRI scans, leaving them struggling or unable to follow verbal instructions.

“We heard over and over that patients fear missing their name being called, or avoid making appointments altogether,” said Parmar. “These aren’t isolated experiences – this is a systemic issue.”

The idea for the study was sparked by real-life experiences shared online by NHS patients, particularly audiology patients– a field Parmar believes should lead by example. “We’re audiologists: we see more patients with hearing loss than anyone else in the NHS,” she said. “If we’re not deaf-aware, then how can we expect other parts of the NHS to be?”

The research team included NHS patients with deafness or hearing loss, who contributed to study design, data analysis, and report writing. As part of the study, they received training in research methods, ensuring the work was grounded in and reflective of lived experiences.

Co-author Zara Musker, current England Deaf Women’s futsal captain and winner of deaf sports personality of the year 2023 said her disappointing experiences with the NHS in part motivated her to qualify as an audiologist.

“The research is extremely important as I have faced my own experiences of inadequate access, and lack of deaf awareness in NHS healthcare not just in the appointment room but the whole process of booking appointments, being in the waiting room, interacting with clinicians and receiving important healthcare information,” said Musker. “I really hope that the results will really highlight that NHS services are still not meeting the needs of patients. Despite this, the study also highlights ways that the NHS can improve, and recommendations are suggested by those who face these barriers within healthcare.”

The researchers have also released a set of recommendations that could improve accessibility in the NHS, such as:

Mandatory deaf awareness and communication training for NHS staff
Consistent provision of interpreters and alert systems across all NHS sites
Infrastructure improvements, such as text-based appointment systems and visual waiting room alerts
The creation of walk-through assessments at hospitals to ensure accessibility across the full patient journey

“This is a legal obligation, not a luxury,” said Parmar. “No one should have to write down their symptoms in a GP appointment or worry they’ll miss their name being called in a waiting room. These are simple, solvable issues.”

A practice guidance resource – developed in consultation with patients and driven by this research – is currently open for feedback until 15 June and will be made publicly available as a free tool to help clinicians and NHS services improve deaf awareness. People can submit feedback at the British Society of Audiology website.

“Ultimately, better communication for deaf patients benefits everyone,” Parmar said. “We’re not just pointing out problems – we’re providing practical solutions.”

Journal

PLOS One

DOI

10.1371/journal.pone.0322850

Article Title

“I always feel like I’m the first deaf person they have ever met.” Deaf Awareness, Accessibility and Communication in the United Kingdom's National Health Service (NHS): How can we do better?

Article Publication Date

7-May-2025

Eating disorders: The hidden health crisis on college campuses

Washington University in St. Louis

What does a person with an eating disorder look like? The picture may not be as clear-cut as many people think. Researchers at Washington University in St. Louis led a groundbreaking study with an important lesson: Eating disorders don’t discriminate.

“There’s been a perception that eating disorders mostly affect thin, white women,” said Ellen Fitzsimmons-Craft, an associate professor of psychological and brain sciences. “Our study of college students dispels that myth.”

The study, funded by a National Institute of Mental Health grant, surveyed 29,951 students from 26 colleges and universities, including WashU. Two-thirds of respondents were female. The students were asked to answer a series of questions about their health, including their mental health and their attitudes toward food and body image.

Thirteen percent of respondents showed signs of eating disorders, including anorexia nervosa, bulimia nervosa, and binge eating disorder — an unprecedented insight into the magnitude of the crisis on campus.

Importantly, the risk of eating disorders was relatively similar for white, Black, Asian, and Latino students.

“No matter their racial or ethnic background, these students all live in a culture that encourages or expects individuals to conform to certain body ideals,” said Fitzsimmons-Craft, also an associate professor of psychiatry at the Medical School. “These findings show that eating disorders can happen to anyone.”

The study was published in The International Journal of Eating Disorders. Co-authors include Carli Howe, a research coordinator with the Center for Healthy Weight and Wellness; Mia Kouveliotes, an undergraduate studying global health and environment; Zhaoyi Pan, Lawrence Monocello, and Marie-Laure Firebaugh from the Department of Psychiatry in the School of Medicine; and Denise Wilfley, a professor of psychological and brain sciences and of medicine, pediatrics, and psychiatry in the School of Medicine.

The most common eating disorders found in the study were bulimia nervosa, a condition marked by regular bouts of binge eating followed by self-induced vomiting or purging, and binge eating disorder, in which a person engages in regular binge eating (but without the accompanying behaviors seen in bulimia nervosa), often in response to negative emotions, like feeling upset or stressed. Combined, those disorders were seen in 13% to 18% of women (depending on race) and 10% to 12% of men. Anorexia nervosa, a condition that causes people to severely limit food intake out of an intense fear of gaining weight, was much less common, affecting 2% to 4% of women and less than 1% of men.

There were some minor differences between racial groups. Asian women, for example, were more likely than other women to show signs of anorexia nervosa, while Hispanic women were most likely to show signs of bulimia nervosa or binge eating disorder. Importantly, while the big picture looked similar for everyone, where differences did emerge, students from historically underrepresented racial and ethnic groups often had a higher prevalence, dismantling the stereotype that eating disorders mostly affect white women.

Anorexia nervosa can have noticeable symptoms, but other, more common types of eating disorders can be completely hidden from others, even close friends and family, Fitzsimmons-Craft said. “You would never know if someone had bulimia nervosa or a binge eating disorder based just on how they looked,” she said. “Even doctors can miss these problems, especially if the person doesn’t fit the stereotype.”

The study found that eating disorders often go hand in hand with other psychological problems. For example, up to 78% of women and 68% of men with eating disorders also showed signs of major depressive disorder. “In the past, health professionals would often put eating disorders and other psychological problems in completely different silos,” Fitzsimmons-Craft said. “That approach caused a lot of damage.”

The new findings underscore the need for counselors, doctors, and others to ask about eating habits when treating someone for depression, anxiety, alcohol use disorder, or another mental health concern, Fitzsimmons-Craft said. “These are treatable problems, but early identification is really the key.”

Fitzsimmons-Craft and Wilfley are working to provide resources for people with eating disorders through Body U, an online program funded by the Missouri Eating Disorders Council, part of the Missouri Department of Mental Health. The program, available to all adults in Missouri, provides individuals with access to online screening for disordered eating and then offers individuals access to free, tailored online programs to meet their needs. When appropriate, users will receive referrals to health providers.

Body U is now available in every public university in Missouri through close partnerships with all 13 public universities in the state, a level of outreach and programming to address eating disorders unmatched by any other state in the country. With a grant from the U.S. Department of Health and Human Services, Fitzsimmons-Craft and Wilfley have also brought Body U to six public school districts and two private schools serving middle and high school students in Missouri, providing an important resource for young people at a time when eating disorders often first take hold.

“We’re going to stay committed to these efforts,” Fitsimmons-Craft said. “We want awareness about eating disorders to become part of the culture, and we want widespread access to screening, prevention, and treatment to become the norm, not the exception.”

Journal

International Journal of Eating Disorders

New study reveals striking differences in life expectancy across U.S. states

Yale University

New Haven, Conn. — A sweeping new study led by researchers at the Yale School of Public Health (YSPH) reveals stark disparities in life expectancy across U.S. states and Washington, D.C. over the past century – offering new insights into how a region’s public health policies, social conditions, and environmental factors can shape people’s lifespans.

Analyzing more than 179 million deaths between 1969 and 2020, the multi-institutional research team traced life expectancy trends by birth cohort — a more precise measure for following the life experiences of a population than traditional year-by-year summaries of mortality, which represent a mix of many generations.

The study, which appears in JAMA Network Open, found that some states saw dramatic gains in life expectancy, while others, particularly in the U.S. South, experienced little or no improvement over an entire century.

“For females born in some Southern states, life expectancy increased by less than three years from 1900 to 2000,” said Theodore R. Holford, the Susan Dwight Bliss Professor Emeritus of Biostatistics at YSPH and lead author of the study. “That’s a staggering contrast when you consider that in states like New York and California, life expectancy rose by more than 20 years over the same period.”

States in the Northeast and West, along with the District of Columbia, recorded the greatest gains. Notably, the nation’s capital had the lowest life expectancy for the 1900 birth cohort but improved by 30 years for females and 38 years for males by 2000.

By contrast, states like Mississippi, Alabama, and Kentucky saw minimal gains, particularly among women, suggesting that systemic factors — like socioeconomic disadvantages, limited access to health care, and weaker public health initiatives — have lasting impacts on mortality, researchers say.

“These trends in mortality and life expectancy reflect not only each state’s policy environment but also their underlying demographics as well,” said Jamie Tam, an assistant professor of health policy and management at YSPH and co-author of the study. “It’s not surprising that states with fewer improvements to life expectancy also have higher rates of poverty for example.”

The researchers used an age-period-cohort model, allowing them to disentangle the effects of aging, historical events, and generational influences on mortality. This method captured how early-life exposures — such as access to sanitation, vaccinations, or tobacco — shaped health trajectories later in life.

“Looking at mortality trends by cohort gives us a more accurate reflection of the lived experiences of populations,” Holford said. “It shows the long-term impact of policies and social conditions affecting the life course of populations that might otherwise be invisible in year-by-year comparisons of mortality rates from different generations.”

The team also examined the rate at which mortality increased after age 35, which is summarized by the number of years it takes for an individual’s risk of death to double. Longer doubling times indicate healthier aging. Again, researchers observed stark differences between states: New York and Florida showed slower mortality increases, while Oklahoma and Iowa saw faster mortality escalations.

Holford emphasized that these patterns aren’t just a reflection of the past. “The disparities we see today are the result of decades of cumulative effects — on smoking rates, health care access, environmental exposures, and public health investments,” he said. “Without conscious policy changes, these gaps will likely persist or even widen.”

The researchers pointed to California and Kentucky as examples of how local health policies can influence mortality rates. California was an early adopter of smoke-free workplace policies in 1995, which led to entire generations of young people growing up in smoke-free environments, as well as generations of working-age adults who were prompted to quit, the research said.

In contrast, Kentucky essentially made no effort to control cigarette smoking, resulting in higher cigarette use and, therefore, higher mortality compared with California. Similar patterns for smoking and higher mortality were observed in West Virginia, Oklahoma, Arkansas, Tennessee, Louisiana, Mississippi, and Alabama, the study said. Lower socioeconomic status is also associated with higher mortality risk; states that are socioeconomically advantaged appeared to have improved mortality rates more quickly than other states, according to the study.

The researchers hope their findings encourage greater focus on interventions — like tobacco control, health care access, and environmental protections — that can transform life expectancy outcomes for future generations.

“This research highlights the importance of viewing health through a generational lens,” Tam said. “The benefits of health interventions ripple across lifetimes.”

As Holford put it, “Where you are born shouldn’t determine how long you live. But in America, it still does.”

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Journal

JAMA Network Open

Disclaimer: AAAS and EurekAle

New study reveals striking differences in life expectancy across U.S. states

Yale University

“This research highlights the importance of viewing health through a generational lens,” Tam said. “The benefits of health interventions ripple across lifetimes.”

As Holford put it, “Where you are born shouldn’t determine how long you live. But in America, it still does.”

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Journal

JAMA Network Open

Global study finds political left more trusting of climate scientists than right

Columbia University's Mailman School of Public Health

A sweeping 26-country study reveals a consistent gap in trust toward climate scientists based on political ideology, with right-leaning individuals reporting lower trust than their left-leaning counterparts. The divide is especially stark in wealthier democracies and English-speaking nations, according to the research, published in the Journal of Environmental Psychology (link is external and opens in a new window). The findings expand on past studies focused primarily on Western, English-speaking contexts.

“While climate scientists currently maintain fairly high levels of public trust—ranging from 58 percent in North America to 84 percent in South Asia—that trust is not held evenly across all groups,” says senior author Kai Ruggeri, PhD, professor in the Department of Health Policy and Management at Columbia University Mailman School of Public Health. “The political divide in trust isn’t inevitable. In fact, the popularity of most climate policies is dramatically underrated, even across that divide. To have a better balance, we must engage all political perspectives and foster trust that transcends ideology.”

Trust in climate scientists is central to effective policies being implemented successfully because public support for climate policies is known to be linked to the level of trust in climate scientists. Furthermore, the links between fossil fuel emissions, warming temperatures, and how they are changing our climate, through frequent extreme weather events, as one example, often cannot be understood through direct experience.

Analyzing survey data from 10,641 participants across 26 nations, researchers found political ideology significantly influences trust in climate scientists—with a few exceptions. While right-leaning individuals showed lower trust in 22 countries, the pattern reversed in China and Indonesia, where left-leaning respondents were more skeptical. In Egypt and Georgia, political views made no difference, suggesting climate change remains less politicized in these regions. On average, participants identified as politically centrist.

Development, Democracy, and Emissions

The link between political views and distrust of climate scientists was strongest in wealthier, more democratic countries with high levels of greenhouse gas emissions. Researchers call this the “post-industrial paradox”—as nations develop, some people may see science as less essential to progress, making them more skeptical. In democracies, political divides can deepen this distrust. High-emitting countries also face well-funded misinformation campaigns, often from fossil fuel interests, that undermine trust in climate science.

Does Education Breed Distrust?

The researchers report some preliminary evidence that the link between political ideology and distrust of climate scientists may be slightly stronger among more educated individuals versus those with less education. While the difference is small, higher education may enable people to selectively interpret scientific information through an ideological lens—potentially deepening partisan divides on climate issues.

A Few Limitations
Participants were mostly young, and there was an over-representation of educated women compared to the general population, so the researchers say their findings might not apply to everyone. They also used simple yes/no-style questions about trust and political views, which can't capture all the complexities of these topics. They note that it is important to distinguish between trusting climate science and trusting climate scientists, as people may feel differently about each. Future research could explore these nuances in more depth.

Implications for Communications

The study highlights the need for climate communication strategies that address ideological divides. To increase trust among right-leaning audiences, researchers recommend emphasizing climate change’s immediate impacts rather than distant future consequences and partnering with trusted local figures—from community leaders to political representatives—who can authentically convey scientific consensus. These approaches must be carefully adapted to national contexts, given how the politics of climate trust vary across borders.

“Failing to consider the perspectives of entire populations will inevitably create roadblocks for evidence-based policies. Closing this gap requires meeting people where they are, through messengers and messages that resonate across ideological lines,” says Ruggeri. “What is especially unique about this study is that it was led entirely by students and early career researchers, who took the initiative to make creative use of data on an extremely important topic.”

A list of study authors is available in the journal article linked above. All team members were connected through the Junior Researcher Programme, which also partners with Columbia’s Global Behavioral Science Initiative.

Journal

Journal of Environmental Psychology

DOI

10.1016/j.jenvp.2025.102609

Method of Research

Content analysis

Subject of Research

People

Article Title

Trust in Climate Scientists is Associated with Political Ideology: A 26-Country Analysis

National Jewish Health researchers coin new term ‘silicosarcoidosis’ to define distinct occupational lung disease

National Jewish Health

DENVER - In a groundbreaking study led by a multinational team of experts, researchers at National Jewish Health and their collaborators in Colorado, Illinois, Taiwan and Israel have introduced a new term to the medical lexicon: silicosarcoidosis. This novel designation describes cases where patients’ lung tissue exhibits overlapping features of both silicosis and sarcoidosis, two serious pulmonary diseases linked to occupational exposure to respirable crystalline silica (RCS) commonly found in construction, mining, and engineered stone fabrication.

Just published in the American Journal of Industrial Medicine (Opens in a new window), the study represents the first large case series to definitively characterize silicosarcoidosis through lung biopsy. The findings carry major implications for disease recognition, clinical treatment and occupational health policy.

“By coining the term silicosarcoidosis, we hope to improve identification and diagnosis of this under-recognized condition,” said Jeremy Hua, MD, lead author of the study and occupational pulmonologist at National Jewish Health. “Our work underscores the need for clinicians to consider occupational exposures when evaluating patients with sarcoidosis-like lung disease, especially those in high-risk professions.”

The research analyzed 35 patients from the United States, Israel and Taiwan with confirmed sarcoidosis and long-term occupational exposure to RCS.

Lung tissue analysis revealed that the majority of these patients exhibited classic features of both silicosis and sarcoidosis.

Sarcoidosis, a systemic inflammatory condition of unknown origin, is increasingly being linked to environmental and occupational exposures. However, exposure histories are rarely sought during clinical evaluation. The study’s authors argue that the term silicosarcoidosis can help bridge this gap by acknowledging silica exposure as a significant and modifiable risk factor in some patients with sarcoidosis.

A quantitative microscopy technique developed by Dr. Hua’s research team measured significantly elevated dust particle densities in lung tissue, confirming the overabundance of silica compared to healthy controls.

The findings revealed a higher diagnostic yield in larger biopsy samples, suggesting that standard small lung tissue samples may miss key evidence of silica exposure.

“This study brings much-needed clarity to the overlap between two complex lung diseases and reaffirms the critical role of an exposure history in pulmonary diagnosis,” said Cecile Rose, MD, senior author of the study and occupational pulmonologist at National Jewish Health. “The introduction of silicosarcoidosis marks a pivotal step in considering both treatment approaches and preventive strategies, especially in pulmonary clinical practice.”

Multiple National Jewish Health faculty contributed to the study, highlighting the institution’s leadership in pulmonary research and commitment to advancing care for patients with occupational and environmentally induced lung disease.

National Jewish Health is the leading respiratory hospital in the nation. Founded in 1899 as a nonprofit hospital, National Jewish Health today is the only facility in the world dedicated exclusively to groundbreaking medical research and treatment of children and adults with respiratory, cardiac, immune, and related disorders. Patients and families come to National Jewish Health from around the world to receive cutting-edge, comprehensive, coordinated care. To learn more, visit the media resources page.

Journal

American Journal of Industrial Medicine

DOI

10.1002/ajim.23724

Article Title

Silicosarcoidosis: Histologic and Clinical Features of an Occupational Granulomatous Disease

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Wednesday, May 07, 2025

Significant gaps in NHS care for patients who are deaf or have hearing loss, study finds

Journal

DOI

Article Title

Article Publication Date

Eating disorders: The hidden health crisis on college campuses

Journal

New study reveals striking differences in life expectancy across U.S. states

Journal

New study reveals striking differences in life expectancy across U.S. states

Journal

Global study finds political left more trusting of climate scientists than right

Journal

DOI

Method of Research

Subject of Research

Article Title

National Jewish Health researchers coin new term ‘silicosarcoidosis’ to define distinct occupational lung disease

Journal

DOI

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