City’s Edge project marks beginning of larger Bedford Dwellings redevelopment in Hill District

The first phase of work to redevelop the Bedford Dwellings section of Pittsburgh’s Hill District got underway Thursday with an event where community leaders said the project would be transformative in multiple ways.

The first phase includes construction of a seven-story building called City’s Edge, which will bring 110 new apartments to the area, with 92 of them designated as affordable for people making no more than 60% of the area median income.

The area median income ranges from $70,300 for an individual to $132,600 for a household of eight, according to the city’s Urban Redevelopment Authority.

Forty-three of the housing units will serve as replacement housing for existing Bedford Dwellings residents. City’s Edge is part of a larger project to replace all of the existing Bedford Dwellings units and revitalize the surrounding neighborhood, thanks in part to a $50 million federal grant that was announced in July.

The larger redevelopment project is expected to cost $62.5 million and bring a total of more than 800 housing units over about six years.

In addition to housing, City’s Edge also is slated to include a parking garage, community room, management office, fitness center, 13 units that are accessible for people with disabilities and 3,000 square feet of green space. The building will house nearly 40,000 square feet of commercial space and office space for minority- and women-owned businesses.

It also will include a health care facility and pharmacy, a business lounge and an ATM banking center, according to the Housing Authority of the City of Pittsburgh.

“It serves an important need and it’s designed in a very context-sensitive way,” URA Executive Director Susheela Nemani-Stanger said.

Marimba Milliones, president and CEO of the Hill Community Development Corporation, said the development is meeting the needs and wants of Hill District residents. The community organization she leads joined other community stakeholders in launching a community engagement process, which saw a 90% favorable ranking for the project.

“Affordable housing is badly needed in the city of Pittsburgh,” said P. Nathaniel Boe, president and CEO of Pittsburgh-based MidPoint Group of Companies and one of the leaders of the City’s Edge project.

Pittsburgh Mayor Ed Gainey said the project should serve as an example of how minority-led developments can succeed. He urged funders and other partners to help bolster diversity in development projects.

“There’s no reason we can’t have African American developers doing major developments,” he said. “There’s no reason at all.”

Julia Felton is a Tribune-Review staff writer. You can contact Julia by email at or via Twitter .

2016 study

Key Points

Question  What are the attitudes and awareness of Americans toward vision loss and public support for eye health and vision-related research?

Findings  In this online nationwide poll, respondents across all ethnic and racial groups described loss of eyesight as the worst ailment that could happen to them relative to losing memory, speech, hearing, or a limb. Most supported prevention and treatment of eye and vision disorders as a priority.

Meaning  These findings underscore the importance of focusing on preservation of eye health and the public support for vision research across all ethnic and racial groups in the United States.

Importance  Understanding the importance of eye health to the US population across ethnic and racial groups helps guide strategies to preserve vision in Americans and inform policy makers regarding priority of eye research to Americans.

Objective  To understand the importance and awareness of eye health in the US population across ethnic and racial groups.

Design, Setting, and Participants  Online nationwide poll created by experienced policy makers in August 2014 designed to understand the importance of eye health in the US population, although the poll was not subjected previously to formal construct-validity testing. The population survey comprised 2044 US adults including non-Hispanic white individuals and minority groups with minority oversampling to provide predicted margins of error no greater than 5%.

Main Outcomes and Measures  Respondent attitudes on the importance of eye health, concerns about losing vision, support for eye health research, and awareness of eye diseases and risk factors.

Results  Of the 2044 survey respondents, the weighten mean age was 46.2 years, 48% were male, and 11% were uninsured. Sixty three percent reported wearing glasses. Most individuals surveyed (87.5%; 95% CI, 84.5%-90%) believed that good vision is vital to overall health while 47.4% (95% CI, 43.7%-51.1%) rated losing vision as the worst possible health outcome. Respondents ranked losing vision as equal to or worse than losing hearing, memory, speech, or a limb. When asked about various possible consequences of vision loss, quality of life ranked as the top concern followed by loss of independence. Nearly two-thirds of respondents were aware of cataracts (65.8%) or glaucoma (63.4%); only half were aware of macular degeneration; 37.3% were aware of diabetic retinopathy; and 25% were not aware of any eye conditions. Approximately 75.8% and 58.3%, respectively, identified sunlight and family heritage as risk factors for losing vision; only half were aware of smoking risks on vision loss.

Conclusions and Relevance  In this well-characterized survey across all US ethnic and racial groups, vision health was a priority with high support for ongoing research for vision and eye health. Many Americans were unaware of important eye diseases and their behavioral or familial risk factors. The consistency of these findings among the varying ethnic/racial groups underscores the importance of educating the public on eye health and mobilizing public support for vision research.


As the world’s population and average life expectancy has increased, so has the prevalence of visual impairment (defined as best-corrected Snellen visual acuity equivalent between 20/40 to better than 20/400 in the better-seeing eye) and blindness (defined as 20/400 or worse in the better-seeing eye).1,2 As of 2010, the World Health Organization estimated that 39 million individuals were blind and 246 million experienced visual impairment.3 The financial impact of visual disability is also substantial. In 2013, the total economic burden of vision loss and blindness in the United States was estimated to be $139 billion,4 and treatment of eye-related disorders totaled more than $68.8 billion in annual direct medical costs.4,5 Owing to an aging population and medical cost growth, the total economic burden is projected to increase to $717 billion by 2050.4,5 The highest productivity losses from visual impairment are seen in high-income countries such as the United States.6

The negative impact of vision loss on quality of life has been well documented in the literature.720 This negative effect of vision loss on quality of life has been demonstrated in association with cataract,16,17 diabetic eye disease,18 and age-related macular degeneration.19 Consistently, a year of life with severe vision loss has been valued at a 50% to 70% decrement compared with a year of life in perfect health.20 However, previous studies of patient attitudes and values around vision loss have not drawn from a cross-sectional, multiethnic sample of Americans. Additionally, while the previous literature may inform policy makers regarding resource allocation for sight-saving interventions, the literature is largely silent on the attitudes of Americans regarding resource allocation for research into the prevention of vision loss. Research to Prevent Blindness performed an attitudinal survey on the public’s attitudes toward vision loss in 1965 and updated the poll in 1976 and 1988 (Gallup Organization Inc, unpublished material, 1976 and 1988); however, contemporary information regarding the public’s attitudes toward eye health and knowledge of eye diseases remains sparse.

While publications document that US ethnic minorities are affected disproportionately by chronic eye conditions, such as glaucoma, and have a greater chance of vision impairment or blindness from these,2132 little information exists regarding attitudes and awareness of these groups toward eye diseases. Furthermore, whereas vision loss from chronic age-related eye diseases are predicted to have a large impact on the US economy as life expectancy of Americans increases, federal funding for eye research is less than 0.5% of the $139 billion annual cost of vision disorders.33 To assess the importance of eye health in the current US population in this study, a comprehensive survey of US individuals, including non-Hispanic white individuals and minority groups, was undertaken to understand the attitudes of Americans regarding the importance of vision, vision loss, and vision research–related health care expenditures.

An online poll was conducted by Zogby Analytics, commissioned by Research!America in August 2014 with funding from Research to Prevent Blindness and the Alliance for Eye and Vision Research. Questions for the poll were suggested by a working group consisting of a panel of representatives from the vision community and Research!America that were designed to understand the importance of eye health in the US population. Source material included 1965, 1976, and 1988 Research to Prevent Blindness survey questions and results (Gallup Organization Inc, unpublished material, 1965, 1976, and 1988) that were updated to reflect 2014 as well as data that the vision community members were interested in obtaining based on studies on incidence and cost of vision impairment and eye disease. Survey questions also were developed based on perspectives from Research!America from extensive experience in conducting similar surveys in other diseases. The survey question wording and design was reviewed and edited by 2 Zogby Analytics senior public opinion researchers with expertise in survey design along with the Research!America team of researchers. Revisions to the question wording and design were made as needed. However, no formal construct-validity testing was performed for this survey. The Johns Hopkins Medicine institutional review board waived approval because it determined that this study did not constitute human participants research. Each participant responded to the invitation to participate in the poll, and by way of their response, agreed to participate in the poll.

The online survey was conducted using nationwide online panels of adults who had agreed to participate in public opinion research. The online panels were recruited through a diversified network rather than through a single source to avoid “professional” panelists. To ensure that the recruitment was broad, diversified, and exhaustive, a wide range of different methods and sources were used. These included online and offline advertisements, telephone recruitment, radio spots, postal invitation, and referral programs. The recruitment strategy was varied to try to ensure optimal diversity and quality and to try to minimize any distortions that could arise from only 1 or a few methods of recruitment. Both broadly targeted and more narrowly targeted campaigns were used to ensure the necessary diversity of participants and to ensure that specific hard-to-reach target groups were represented on the panel (eg, mothers with small children, high-income groups). Individuals of lower socioeconomic status or those with fewer years of education may not have access to computers or the internet; however, presurvey stratification of the sample respondents invited to participate in the survey was used to include lower-income and lower-education respondents in the final sample.

From the panels, a random selection of potential survey respondents was selected and invited to participate in the survey. No participant had prior knowledge that they would be selected for the survey. The random sampling was based on select demographic variables, and for the nationwide survey, the unique sample selection was based on a representative sample of the respondents that had been disaggregated by sex, age, and geography. When the required criteria for the survey had been established, a random sample was pulled for individuals to receive the email invitations to participate in the survey. When panel participants responded to the email invitation to participate in the poll, they were taken via a secure link to online survey software where they completed the survey. Because email is password protected and unique to the respondent, the response most likely came from the intended participant. The link expired after a single use so no respondent could take the survey more than once and to ensure that the link could not be forwarded and used by another individual. Respondents who completed the survey received points toward online gift certificates. The poll questions may be viewed in the eAppendix in the Supplement.34

Minority oversampling was used because a nationwide US survey that is representative of the adult population is likely to have a high margin of sampling error among minority groups. For example, according to the US Census, African American individuals make up 13.2% of the total US population.35 Therefore, a nationwide US survey of 1000 adults would include only about 136 African American individuals. The margin of sampling error for African American individuals then would be approximately 10.5% percentage points, meaning the results for a specific question could fall within a 21-point range. Therefore, the following 3 minority subgroups were oversampled: African American individuals: sample size, 417; margin of error, 4.9%; Asian individuals: sample size, 301; margin of error, 5.8%; and Hispanic individuals: sample size, 401; margin of error, 5%. These larger sample sizes ensured that enough members of the oversampled subgroups had more reliable estimates to be reported for that group. For the nationwide survey results, the members in the oversampled groups were weighted to their actual percentage in the population, allowing for the overall nationwide survey results to be representative on a national level as well as for the oversampled subgroups.

The final survey sample was compiled using information based on census data, voter registration figures and exit polls, and Central Intelligence Agency fact books. Zogby Analytics used weighting techniques to best represent the demographics of the population being surveyed. The entire US population in every state was part of the sample and was representative of the overall population distribution. The survey was not piloted prior to national distribution and data collection.

Survey questions were ordered by category, with the most general questions at the beginning and the most specific questions at the end in an attempt to reduce bias. Sample respondents remained anonymous. Data collection and subsequent analysis adhered to the tenets of the Declaration of Helsinki. Survey results were analyzed using Stata 12 (StataCorp) to control for the multistage sampling weights.

Polling data from 2044 US adults from the general population were obtained, and a press release issued by Research!America and AEVR revealing the results was published online on September 18, 2014.36Table 1 shows sample sizes and sociodemographic characteristics of the study population (Table 1), and attitudinal results (Table 2) include nationally representative responses as well as by race/ethnicity. Response rates are reported as percentages calculated by sampling weights, and information on uncertainty is provided by confidence intervals. Of all respondents, 87.5% (95% CI, 84.5%-90%) agreed that good eye health is important to overall health. Losing eyesight was described as potentially having the greatest effect on their day-to-day life by 47.4% (95% CI: 43.7%-51.1%) of respondents, greater than loss of limb, memory, hearing, and speech (Figure 1). When asked which disease or ailment is the worst that could happen to them, blindness was ranked highest nationally and either first or second within each racial/ethnic group. Asian and Hispanic respondents ranked blindness (15% and 15%, respectively) behind only cancer (18% and 22%, respectively). Among white respondents, 24% ranked Alzheimer disease as the worst condition followed by 20% for blindness. Blindness was ranked worse than AIDS/human immunodeficiency virus, loss of limb, heart disease, arthritis, and deafness by all racial/ethnic groups (Figure 2).

National support of research focusing on improving prevention and treatment of eye and vision disorders was considered a priority among 81.5% (95% CI, 78.2%-84.5%). When told that the federal government spends on average $2.10 per person each year on such research, 45.9% (95% CI, 42.2%-49.7%) said that was not enough. Almost half (47.9%; 95% CI, 44.2%-51.7%) believed that nongovernmental sectors including industry, patient groups, and philanthropic organizations should increase funding for eye and vision research. Respondents reported willingness to pay 24.8% (95% CI, 22.8%-26.8%) of their total financial resources to prevent visual impairment including 31.1% (95% CI, 28.8%-33.4%) to prevent legal blindness.

Results for awareness of major eye conditions and risk factors are presented in Table 3. While 81.5% (95% CI, 78.2%-84.5%) of Americans reported having an eye examination, knowledge about specific eye disorders was uneven among eye disorders and among racial/ethnic groups. Nationally, 65.8% (95% CI, 61.9%-69.5%) reported awareness of cataract or glaucoma (63.4%; 95% CI, 59.5%-67.2%). Awareness of these conditions was lower among Asian and Hispanic individuals; just more than half reported awareness of these. While nationally half of Americans reported awareness of age-related macular degeneration, white respondents were more likely to do so (59.1%; 95% CI, 54.5%-63.6% compared with 33.2% of Asian respondents, 32.1% of African American respondents, and 26.8% of Hispanic respondents). Awareness of diabetic retinopathy was lowest across all groups (37.3%; 95% CI, 33.8%-40.8%) nationally and particularly low among Hispanic respondents, among whom 26.8% (95% CI, 21.9%-32.4%) reported awareness. Of all Americans, 25% (95% CI, 21.7%-28.6%) reported they were not aware of any of these conditions; an additional 4.8% (95% CI, 3.1%-7.3%) said they were not sure. Lack of awareness was higher among Asian respondents (31.2%; 95% CI, 26.1%-36.8%) and Hispanic respondents (35.4%; 95% CI, 29.5%-41.9%).

Awareness of risk factors for vision loss exhibited high rates of disparity. Of all respondents, 75.8% (95% CI, 72.2%-79.1%) believed excessive sunlight or ultraviolet radiation was a risk factor for eye disease. Awareness of ethnic heritage as a risk factor was second highest (58.3%; 95% CI, 54.4%-62.0%). Smoking was identified as a risk factor by 53.5% (95% CI, 49.7%-57.3%) nationally and higher among Asian respondents (60.1%; 95% CI, 54.4%-65.6%) and Hispanic respondents (62.0%; 95% CI, 55.9%-67.7%).

Nationally, 59.1% (95% CI, 55.3%-62.8%) believed health care costs from eye disorders will increase by 2050, while 49.6% (95% CI, 45.9%-53.4%) said they likely would participate in a clinical trial for eye and vision research if recommended by a clinician. Of all respondents, 50.2% (95% CI, 46.4%-54.0%) said they had insurance coverage for routine eye examinations or glasses, while 33.0% (95% CI, 29.6%-36.5%) said they had eye examinations less frequently than they would like because of their insurance situation.


Across all ethnic and racial demographics, nearly 88% of Americans surveyed viewed eye health as critical to overall health. In a manner similar to previous non–cross-sectional studies, 47% viewed vision loss as the worst possible health condition that might befall them. This was true of 57% of African American individuals, a group known to have a several-fold increased prevalence of severe vision loss and potentially a greater personal experience with its effects than Americans of other ethnicities.24 A similar attitudinal study, the knowledge, attitudes, and practices (KAP) study,37 sponsored by the National Eye Institute and the Lions Clubs International Foundation, took place first in 1991 and again between October 2005 and January 2006.37 In the KAP study, 3180 telephone interviews were completed in which patients from varying demographic groups were queried as to their knowledge of and attitudes toward vision loss. In keeping with the results of our study, 71% of adults in the KAP study ranked loss of eyesight a 10 on a scale of 1 to 10, with 10 having the greatest impact on their daily living.37

These findings underscore the importance of good eyesight to most and that having good vision is key to one’s overall sense of well-being, irrespective of ethnic or racial demographic. A study by Brown and Barrett38 examined the relationship between visual impairment and quality of life in older people. These authors stated that to many individuals, loss of vision may signify loss of independence. Individuals with blindness or other visual impairment may be perceived as having to rely on others for basic life needs, including bathing, cooking meals, or housekeeping. Second, individuals with blindness may be more likely to have decreased income. Independently, visual impairment may cause or worsen financial hardship. Third, visual impairment, including blindness, is associated with social isolation, decreased social integration, and increased social avoidance. These authors proposed that individuals with visual impairment may feel as though they have less control over their life circumstance.38 Persons with greater visual impairments have been shown to have a decreased quality of life, linked to a perception of having less control over their environment,3840 supporting our findings that respondents across all ethnic and racial backgrounds listed blindness high among most-feared ailments.

Although all demographics in the US adult population surveyed ranked vision loss highly among most feared conditions, African American respondents ranked blindness as the worst possible ailment, more feared than AIDS/human immunodeficiency virus and cancer. Owsley and colleagues23 reported similar findings in a cohort of older African American individuals who were reported to prioritize eye care and placed a high value on good vision for overall well-being. Our survey result regarding African American individuals may be related to findings that African American individuals are more likely to experience visual impairment, including blindness, than white individuals, not only from conditions such as glaucoma and diabetic retinopathy, but also from potentially correctable conditions such as refractive error or cataract.2432 Specifically, prevalence of visual impairment from eye diseases among older African American individuals is 2 times higher than that of white individuals.2432

The 2006 KAP study reported that Asian, African American, and non-white Hispanic individuals were more knowledgeable about eye disease and more likely to have their eyes examined than Hispanic adults.37 Similarly, this study showed that Hispanic adults are the ethnic group least likely to have heard of common eye conditions such as age-related macular degeneration or diabetic eye disease. This finding is particularly concerning in that older Latino adults with diabetes or self-reported eye disease had a higher incidence of vision loss when followed over a 4-year period.41

This study has several limitations. While the survey was designed by individuals with expertise in these methods, no formal construct validity testing was performed. Further, a limitation inherent to polling data is the possibility of sampling error. In polling, it is possible that the data obtained are not reflective of the opinions of the entire population and therefore must be interpreted with caution in extrapolating the opinions of poll respondents as applicable to all individuals within the United States. However, this study, with its large number of respondents and minority oversampling, does seek to overcome this limitation. Surveys, including online surveys, such as the one used in this study, are subject to risk of sampling bias. A diversified sampling design was used to minimize any potential recruitment or participation bias. It is also possible that some questions may have been biased owing to phrasing or influenced by preceding questions. The survey design attempted to minimize this bias by asking the general health questions, such as the questions pertaining to the worst diseases of conditions, before participants were asked detailed questions about vision. However, certain questions could be perceived as “leading questions.” For instance, the question relating to national research expenditures informed respondents that “The federal government spends on average $2.10 per person each year on eye and vision research.” Providing this total on a per-person basis, rather than a national total, may have influenced respondents to view this as a lower amount. Thus, this question in particular should be considered when interpreting results. Also, the survey on insurance questions does not address whether individuals understood their insurance coverage, eg, whether their medical insurance covered ophthalmologic examinations. Additionally, this cross-sectional survey aimed to present data from Americans across multiethnic backgrounds but was conducted only in English, missing the opportunity to reflect attitudes of non–English-speaking Americans.


This contemporary and comprehensive survey suggests that most Americans across all ethnic and racial groups describe losing eyesight as having the greatest impact on their daily life when ranked against other conditions including loss of limb, memory, hearing, or speech. This study and its findings are consistent with the large body of previously published literature demonstrating the enormous value that humans place on their vision. For the first time, to our knowledge, these cross-sectional data are presented from a multiethnic sample of Americans and show that Americans support resource allocation dedicated to the research for prevention of vision loss.

Corresponding Author: Adrienne W. Scott, MD, Wilmer Eye Institute, Retina Division, Department of Ophthalmology, Johns Hopkins University School of Medicine and Hospital, 600 N Wolfe St, Maumenee 719, Baltimore, MD 21287 (

Accepted for Publication: April 1, 2016.

Published Online: August 4, 2016. doi:10.1001/jamaophthalmol.2016.2627

Author Contributions: Dr Scott and Ms Ffolkes had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Bressler, Wittenborn, Jorkasky.

Acquisition, analysis, or interpretation of data: Scott, Bressler, Ffolkes, Wittenborn.

Drafting of the manuscript: Scott, Wittenborn.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: Ffolkes, Wittenborn.

Obtaining funding: Jorkasky.

Administrative, technical, or material support: Scott.

Conflict of Interest Disclosures: All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported.

Funding/Support: Supported through a grant from Research to Prevent Blindness to the Alliance for Eye and Vision Research.

Role of the Funder/Sponsor: Although the funders participated in an Alliance for Eye and Vision Research Working Group of vision community representatives who suggested initial questions, reviewed the final results for communications purposes, and reviewed the manuscript, they had no role in the final design and conduct of the study; collection, management, analysis, and interpretation of the data or in writing the manuscript.

Disclaimer: Dr Bressler is the Editor of JAMA Ophthalmology. He was not involved in the editorial evaluation or decision to accept this article for publication.

Previous Presentations: Portions of these data were presented at the Association for Research in Vision and Ophthalmology; May 4, 2015; Denver, Colorado; and at the National Press Club; September 18, 2014.



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Yonekawa  Y, Varma  R, Choudhury  F, Torres  M, Azen  SP; Los Angeles Latino Eye Study Group.  Risk factors for four-year incident visual impairment and blindness: the Los Angeles Latino Eye Study.  Ophthalmology. 2011;118(9):1790-1797.PubMedGoogle ScholarCrossref

Writers Guild voting on deal with movie, stage, video, TV bosses

Writers Guild voting on deal with movie, stage, video, TV bosses

Hollywood and New York are not yet back in business because the actors have yet to sign with the entertainment bosses. SAG-AFTRA actors walk on a picket line outside Netflix studios on Tuesday, Sep. 26, 2023, in Los Angeles. Damian Dovarganes—AP

HOLLYWOOD and NEW YORK—Some 11,500 writers for movies, TV shows, streaming videos, Netflix, and Broadway stages, in New York, Los Angeles, and elsewhere, will vote from October 2-9 on a tentative three-year contract with their bosses, represented by the Alliance of Motion Picture and Television Producers.

Bargainers for the scribes’ union, the Writers Guild of America-West, for the Hollywood studios, and WGA-East, for the Broadway stages, sent their members back to work at 12:01 a.m. Pacific Time/3:01 a.m. Eastern Time on September 27. They were out for 146 days. The new tentative agreement runs from Sept. 25, 2023, through May 1, 2026.

“This allows writers to return to work during the ratification process, but does not affect the membership’s right to make a final determination on contract approval,” bargainers said.

The writers’ return does not mean Hollywood in particular is back open for business. That’s because the 160,000 members of SAG-AFTRA, which represents performers in those same shows, are still on strike against the AMPTP and over almost all the same issues. Both strikes have drawn wide and deep public support.

Issues include low pay, lack of residuals, a high floor before workers are eligible for company-paid health care, and AMPTP’s greed at taking workers’ jobs away through the use of computer-replicated artificial intelligence to copy a performer’s body, face, motions, and words in one-day sessions, and then use them, without pay, forever.

“We didn’t take any old deal that was on the table,” young African-American writer Kyra Jones told the Associated Press in a video it posted online. “The younger writers and minority writers were spearheading the strike this around and I feel really proud to be part of that group.

“We’re going to have to keep fighting. There’ll be new issues or issues that we didn’t address, three years from now. One of the reasons the studios were able to get away with some of the s— that they do is that the unions weren’t all speaking up and standing up for each other. Now they are and we can’t let this die. We got to keep showing up for SAG, too.”

Minimum pay for most writers will increase by 5% on ratification, and 4% and 3.5% on May 2 in each of the following two years. Some increases will be a straight 3%. The contract summary didn’t specify which ones. There will be larger health and pension contributions for writing teams—a staple of TV shows—and there will be strong limits on the bosses’ use of artificial intelligence. And shows will have writing teams of at least three writers.

The AI limits include: “AI can’t write or rewrite literary material, and AI-generated material will not be considered source material…meaning AI-generated material can’t be used to undermine a writer’s credit or rights.”

A writer can choose to use AI, but only if the film, stage, or video firm consents. “But the company can’t require the writer to use AI software (e.g., ChatGPT) when performing writing services,” the union’s contract summary says. And the company must tell the writer if AI produced any material it gives the writer.

“The WGA reserves the right to assert that exploitation of writers’ material to train AI is prohibited by” the contract or by law, it adds.

Payments for streaming videos and residuals—payments for reruns—will vastly increase, and, for the first time, the residuals will be based not just on U.S. viewership but foreign viewership, too.

“When a feature-length project is made for streaming with a budget of $30 million or more, the minimum initial compensation for a story and teleplay is $100,000, an 18% increase from the current rate and a 26% increase in the residual base,” the contract summary says.

“Combined with the foreign residual improvements, this results in a 3-year residual of $216,000 for projects on the largest services, a 49% increase from $144,993 under the 2020” contract.

SAG-AFTRA congratulated the Writers Guild on its tentative agreement but made clear its own strike against the studios, networks, streaming video producers and the like continues.

“SAG-AFTRA congratulates the WGA on reaching a tentative agreement with the AMPTP after 146 days of incredible strength, resiliency, and solidarity on the picket lines. While we look forward to reviewing the WGA and AMPTP’s tentative agreement, we remain committed to achieving the necessary terms for our members,” its statement said.

“Since the day the WGA strike began, SAG-AFTRA members have stood alongside the writers on the picket lines. We remain on strike in our TV/Theatrical contract and continue to urge the studio and streamer CEOs and the AMPTP to return to the table and make the fair deal that our members deserve and demand.”

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Press Associates

At GOP debate, DeSantis stumbled on health care question and was criticized by his opponents

On the campaign trail and now in both Republican presidential debates, Gov. Ron DeSantis frequently boasts about his vast achievements as governor of Florida since he entered the office in 2019.

But DeSantis appeared absolutely flatfooted on Wednesday night in Simi Valley, California, when he was asked during the GOP debate by Fox News Business moderator Stuart Varney about the fact that currently 2.5 million people in Florida don’t have health insurance.

“That’s worse than the national average.  Can Americans trust you on this?” Varney asked.

DeSantis didn’t directly answer the question, and instead initially criticized high inflation rates in the country.

“Well, I think this is a symptom of our overall economic decline,” he began. “Everything has gotten more expensive.  You see insurance rates are going through the roof.”

DeSantis then went on to criticize “Bidenomics” and to discuss his energy plan before he finally came around to addressing health care, saying that “we have big pharma, big insurance and big government, and we need to tackle that, and have more power for the people, and the doctor-patient relationship.”

After the minute and nine second response, Varney fired right back.

“Governor. Why is your record in Florida on (health) insurance worse than the national average?”

DeSantis then went on to say that there has been a population boom in the state and that the state does not have “a lot of welfare benefits in Florida.”

“We basically say this is a field of dreams, you can do well in this state, but we’re not going to be like California and have massive numbers of people on government programs without work requirements,” he said. “We believe you work, and you gotta do that, and so that goes for all of the welfare benefits.”

Left unsaid was the fact that Florida is now one of just 10 states in the country that hasn’t expanded Medicaid, according to the Kaiser Family Foundation. As part of the Affordable Care Act, states currently receive a 90% federal matching rate for adults covered through the ACA expansion. It was a signature initiative of former Democratic President Barack Obama, which is why it has always received resistance from Republicans, though many GOP-led states have ultimately relented and gone ahead to get more of their citizens onto the program.

Also, then-governor Rick Scott (now a U.S. senator) also did not pursue a Medicaid expansion in Florida.

Also, DeSantis was asked by moderator Ilia Calderón about the controversy regarding a sentence in the state’s new standards for African American history that says that Black people benefitted from slavery because it taught them certain skills “which in some instances, could be applied for their personal benefit.”

DeSantis responded that it was actually “a hoax perpetrated by Kamala Harris.”

“That was written by descendants of slaves,” the governor continued. “These are great Black history scholars. So we need to stop playing these games.”

But that wasn’t the end of the conversation on the subject. Calderon then asked South Carolina Sen. Tim Scott, the only Black person on the stage, about the issue.

“There is not – there is not a redeeming quality in slavery,” Scott said. “He and Kamala should have just taken the one sentence out.”

Scott then went on to say that America “has suffered because of slavery, but we’ve overcome that.”

Later, former South Carolina Governor Nikki Haley, standing to DeSantis’ right, delivered the most direct criticism to the governor, when talking about energy independence. She said that “Ron DeSantis is against fracking. He’s against drilling.”

Haley was referencing that DeSantis in fact was against fracking and drilling, as he put into an executive order that he signed Florida in 2019.

However, DeSantis has been saying something different on the campaign trail in 2023.

Speaking in Rochester, New Hampshire on July 31, DeSantis was asked by a reporter about his call to expand American energy production, and how that compares with the fact that in Florida, offshore oil and gas drilling is banned in Florida’s state waters, due to a 2018 constitutional amendment passed the voters.

“I don’t support national – I think in Florida people have kind of misconstrued – we have a constitutional amendment that does not allow offshore drilling. And so that’s something that we honor,” he said.

“That is not saying that I think that should apply to Louisiana or Texas and all of that, so that will continue,” he added. “And we want them to be able to do it and we also want them to be able to use hydraulic fracturing. It’s been something that’s been very effective, and it’s really taken our country to be the world’s leading energy producer. But clearly states in Florida – we’re a coastal state – we’ve had oil spills, we’ve put that in our constitution, our voters did. And that’s something that as governor that I’ve followed and respected.”

Meanwhile, former President Donald Trump leads the entire GOP presidential field by approximately 40 points in national polls, but was again absent at the debate. That’s two absences since the debates began.

No candidate was fiercer in attacking Trump and his absence from the stage than former New Jersey Gov. Chris Christie, who was the first to mention the fact that under Trump’s tenure, the national debt increased to more than $7 trillion.

At one point, Christie spoke directly to the camera as he imagined Trump watching on television.

“You’re not here tonight because you’re afraid of being on the stage and defending your record,” he said. “You’re ducking these things. And let me tell you what’s going to happen. You keep doing that, no one up here is going to call you Donald Trump anymore. We’re gonna call you Donald Duck.”

DeSantis also responded to a question about the pending potential shutdown of the federal government this week by saying that President Joe Biden was “completely missing in action,” but then so was Trump.

“Donald Trump is missing in action. He should be on this stage tonight,” DeSantis said to applause from the audience.  “He owes it to you…… to defend his record, where they added $7.8 trillion to the debt. That set the stage for the inflation that we have.”

The Florida governor took another shot at Trump later in the debate on abortion.

On NBC’s Meet the Press earlier this month, Trump blasted DeSantis for signing a six-week abortion ban into law in Florida, saying, “I think what he did is a terrible thing and a terrible mistake.”

DeSantis has been hammering Trump for those comments ever since and did so again in Simi Valley.

“The former president, you know, he is missing tonight,” DeSantis said. “He’s had a lot to say about that. He should be here explaining his comments to try to say that pro-life protections are somehow a terrible thing.”

But DeSantis shrugged off a question by Fox News moderator Dana Perino about how he was going to win over independent pro-choice voters in a crucial swing state like Arizona. Perino referred to the fact that since Roe v. Wade was struck down by the U.S. Supreme Court last year, Republicans have lost ballot measures regarding abortion in six different states.

DeSantis said he would win in Arizona like he did in winning blue areas of Florida in his 2022 reelection victory, referring to how he won in places like Miami-Dade and Palm Beach counties.

Aaron Kall is the director of the University of Michigan Debate Program and Debate Institute. He said while he believed DeSantis performed well in the debate, that’s not going to be enough for the Florida governor to catch up to Trump.

“Nothing fundamentally changed in the race since the first debate and I don’t expect the needle to move after tonight,” Kall wrote to the Phoenix overnight. “This can only happen if Trump returns to the ring and (Chris) Christie did the best job trying to lure the frontrunner back to join the other candidates before the next debate in Miami. Maybe DeSantis will be the last candidate standing and eventually participate in head-to-head debates with Trump. I think Republican primary voters would like to see this matchup and the country would benefit from it. Time is running out for this to materialize though, as voting starts early next year.”

Speaking on Fox News with Sean Hannity immediately after the debate Wednesday night, DeSantis suggested that he’d like to debate Trump one-on-one.

But apparently that won’t be happening anytime soon. The Hill reports that a spokesperson for Trump said, “Sorry, Ron. We’re not as thirsty and desperate like you or your sleazeball partner Gavin Newsom.”

Fox News announced earlier this week that DeSantis will engage in a debate with Newsom in late November.

DeSantis criticizes Trump, ducks insurance issue at GOP presidential debate

Wednesday’s second Republican presidential primary debate had candidates talking over each other, moderators threatening to cut mics, and a “Survivor”-themed closing question that no one wanted to answer.

But for Gov. Ron DeSantis, there was one positive: He got the most airtime.

DeSantis spoke for 12 minutes and 27 seconds during the debate at the Ronald Reagan Presidential Library in Simi Valley, California, according to the New York Times. That outpaced entrepreneur Vivek Ramaswamy by more than 30 seconds, and South Carolina Sen. Tim Scott by a minute and a half.

Here are some takeaways from DeSantis’ debate performance.

Some shots at Trump

More than 15 minutes passed before moderators gave DeSantis his first question, on the economy. Instead, he jumped in before they could ask it.

And in his response, he criticized not only President Joe Biden but former President Donald Trump. Following the lead of former New Jersey Gov. Chris Christie, DeSantis said he believed it was time for Trump to show up for a debate.

“Donald Trump is missing in action,” DeSantis said. “He should be on this stage tonight. He owes it to you to defend his record where they added $7.8 trillion to the debt. That set the stage for the inflation that we have now.”

DeSantis again swiped at Trump while answering a question on abortion, saying he didn’t think that “pro-lifers are to blame for midterm defeats.”

“We are not getting a mulligan on the 2024 elections,” DeSantis said. “Republicans have lost three straight elections in a row. We were supposed to have a red wave with inflation at 9%. It crashed and burned. Not in Florida, it didn’t. We delivered in Florida.”

Non-answers on insurance

DeSantis was asked about one of the sore spots for Floridians: insurance. But he didn’t seem to want to talk about it.

Moderator Stuart Varney asked why 2.5 million Floridians didn’t have health insurance, “worse than the national average.”

“Can Americans trust you on this?” Varney asked.

DeSantis pivoted to blame “Bidenomics, “overspending,” and “rules and regulations” without directly addressing the topic.

“What we need to do with health care is recognize our health care is putting patients at the back of the bus,” DeSantis said. “We have big pharma, big insurance and big government and we need to tackle that and have more power for the people and the doctor-patient relationship.”

Varney then pressed him: “Why is your record in Florida on insurance worse than the national average?”

DeSantis again didn’t answer, saying the state has had a “population boom” and “we also don’t have a lot of welfare benefits in Florida.”

One of the reasons why so many Floridians lack health insurance is because he and lawmakers have refused to accept federal money to expand Medicaid coverage.

This year alone, more than 120,000 Florida children have lost Medicaid coverage since April, and families have struggled to get help through the state’s helplines.

DeSantis has also received bipartisan scorn for his handling of the state’s property insurance crisis. Floridians pay the highest homeowners insurance premiums in the nation, and the state ranks among the highest for automobile insurance.

DeSantis’ solution has been to make it much harder to sue insurance companies — prompting criticism by Trump earlier this year, who said homeowners were being “crushed” by their insurers.

A battle on Black history

DeSantis was asked about a Florida education controversy that he has had to explain over and over: a line in new standards for African American history that states that while performing jobs like blacksmithing and agricultural work, teachers should show students how “slaves developed skills which, in some instances, could be applied for their personal benefit.”

DeSantis said the idea Florida was teaching that slavery was good was a “hoax that was perpetuated by (Vice President) Kamala Harris,” adding that the standards were written by Black history scholars.

Scott, the only Black person on the stage, pounced. He has criticized the standards line on the campaign trail, and did so again, saying DeSantis should’ve just “taken the one sentence out.”

“There is not a redeeming quality in slavery,” he said. “Our nation continues to go in the right direction. It’s why I can say I have been discriminated against, but America is not a racist country. Never ever doubt who we are!”

Haley hits him on drilling

One of the most direct attacks on DeSantis came from former South Carolina Gov. Nikki Haley, a former United Nations ambassador. Speaking about energy, she called out DeSantis for opposing fracking and oil drilling.

“You did it,” she said. “He always talks about what happens on Day 1. You better watch out, because what happens on Day 2 is when you’re in trouble. Day 2 in Florida, you banned fracking, you banned offshore drilling, you did it on federal land, and you took green subsidies you didn’t have to take.”

It’s true that when DeSantis first ran for Florida governor in 2018, he opposed fracking.

Two days after his inauguration, he issued an executive order directing the Department of Environmental Protection to push to end all fracking and offshore “oil and gas activities” in Florida.

But a state law banning fracking, which is the process of injecting water and chemicals deep into the ground to extract fossil fuels, has not fully come to fruition.

Haley then doubled down, pressing DeSantis on fracking and drilling in Florida. DeSantis shifted responsibility to voters, who enacted a constitutional amendment banning offshore drilling, which is hugely unpopular in the state.

He talked about focusing on increasing drilling in Texas to increase U.S. oil production. On the campaign trail, he has supported offshore drilling in states that allow it.

White House briefs campuses across the country on affordability, affirmative action and more

Co-Managing News Editor

Co-Managing News Editor

During their first Campus Press Briefing of the academic year on Monday, White House officials spoke to invited university publications nationwide regarding actions the Biden Administration says to be taking to address persisting issues on college campuses.

The key talking points of affordability, climate change and mental health were determined to be “of particular importance to the president,” White House Communications Director, Ben LaBolt, said.

Discussion was opened to unrelated issues during a Q-and-A portion, where LaBolt called on pre-selected student reporters to ask their pre-submitted inquiries. Of the 12-minute Q-and-A session, the topic of affirmative action took up a majority of the time.

What was said about college affordability?

“We know that many young people are worried about student loans as a barrier to opportunity,” LaBolt said. “And the president’s hope is that all of these plans and all these actions reassure students, reassure alumni that the president has your back, and he won’t stop fighting to bring the promise of affordability to more students and families.”

LaBolt expressed that Biden is aware of the “broken student loan system” and is committed to making education affordable.

A government shutdown, as fueled by Republicans in the House of Representatives based on calls for deep federal spending cuts, would disrupt the progress of loan forgiveness as well as other government programs, according to LaBolt.

He stated that the House “really needs to get its act together” but assured that more actions of forgiveness would be announced in the coming weeks.

What was the discussion on climate change?

“The President sees this as really the one existential threat to humanity, an existential threat to the United States and something that he’s committed to taking the most substantial domestic and international action that has ever been taken by a president,” LaBolt said.

LaBolt pointed to the Inflation Reduction Act and the establishment of the American Climate Corps as evidence of this, though the specific relation to higher education remained unclear.

During the Q-and-A, Jackson Dembrosky from The Kennesaw State University Sentinel asked how Biden intends to implement “lasting policies to fight climate change” given the U.S. Supreme Court’s 6-3 decision to limit the power of the Environmental Protection Agency (EPA) in June 2022. 

In their ruling, the Supreme Court explained that for an agency to do something new – in this case, address climate change – the regulation is invalid unless Congress has specifically authorized regulating within that area.

“The Supreme Court may have limited some of the creativity with which the EPA can address pollution,” Maria Michalos, White House associate communications director, said. “But it did not restrict its ability overall to address emissions from the power sector.”

Michalos went on to say that the EPA still released a proposal in the spring which intends to eliminate the production of “more than 600 million metric tons of carbon dioxide through 2042.” That amount is equal to the yearly emissions of 137 million cars, according to Michalos.

“This President is laser-focused on tackling climate change, using every legal tool to do just that,” Michalos said.

How did they address mental health?

“Students across the country have been struggling with an array of mental health challenges,” LaBolt said. “The president hears you.”

Poor mental health rates have reached an all-time high among U.S. college students, according to an Inside Higher Ed survey published in March. 

After collecting responses from 96,000 students across 133 universities, researchers found that 44% of respondents shared symptoms of depression, 37% experienced anxiety and 15% reported considering suicide. Each of these findings marked a new record high in the survey’s 15-year history.

There are three main actions that the Biden Administration is taking to give mental health its deserved acknowledgment, LaBolt said.

First, he mentioned the Bipartisan Safer Communities Act, which was passed in June 2022 in the wake of the gun violence incident in Buffalo, New York, and an elementary school in Texas. The legislation attempts to restrict gun ownership and provide trauma resources for those who have been impacted. 

While references of “school-aged children and youth,” as well as their families, are made, there is no specific mention of assistance on a college level in the bill.

LaBolt added that there is recently-proposed legislation to assist with access to health care insurance outside of school, which awaits finalization and implementation.

Finally, the president is investing $200 million in the 988 Suicide & Crisis Lifeline, which “sees some millions of calls and texts a year, some from students in college and recent graduates,” according to LaBolt.

What about affirmative action?

“How does the President claim to support higher education institutions in light of the SCOTUS opinion on affirmative action?” Yana Mulani, co-editor-in-chief at the Johns Hopkins News-Letter, asked.

The decision to end affirmative action in college admissions on June 29 passed 6-3 on the grounds that students must be evaluated on their experiences “as an individual – not on the basis of race.”

LaBolt referenced a statement where Biden announced his disapproval of the decision.

“Reduced to its simplest terms, the Court’s conclusion is that an increase in the representation of racial minorities at institutions of higher learning that were historically reserved for white Americans is an unfair and repugnant outcome that offends the Equal Protection Clause,” Justice Sonia Sotomayor wrote in her dissenting opinion. 

Similar to Sotomayor, White House Press Secretary Karine Jean-Pierre expressed that it was a “very disappointing decision.”

“Diversity is a huge strength of the U.S.,” LaBolt said.

68.8% of the university’s undergraduate student body is white, 6.1% is Black or African American, 9.5% is Hispanic or Latino, 5.6% is Asian and 9.9% is other, according to the university’s Office of Institutional Research and Effectiveness in 2022.

“The Court didn’t deny the value of having diverse student experiences on campus,” LaBolt said. “So there are certain factors that colleges can still take into consideration in the wake of the decision that the president’s administration has pointed to.”

What was the final takeaway?

Though the 30-minute call did not leave enough time to cover more than a handful of college-related subjects, promises of long-term improvements were detailed in the briefing’s fact sheet released shortly after the meeting.

“President Biden understands the importance of higher education,” LaBolt said. “It’s got the power to unlock doors of opportunity for millions of students.”

Getting healthy should not ruin Americans’ credit | Editorial

This article represents the opinion of the Tampa Bay Times Editorial Board.

Many Americans drowning in debt did not get there by spending irresponsibly on televisions, cars or pricey goodies. Medical bills have become the largest source of debt in collections — more than credit cards, utilities and auto loans combined — which is why the Biden administration’s plan to keep unpaid medical bills from affecting a person’s credit score would be a life-altering change for millions.

The administration announced a major initiative in September to craft new federal rules barring unpaid medical bills from affecting patients’ credit scores. If enacted, the changes would potentially help tens of millions of people by removing information on credit reports that can make it harder for Americans to get a job, rent an apartment or secure a loan.

One in 3 U.S. adults has medical debt, which between 2009 and 2020 became the largest source of debt Americans owed collections agencies, totaling at least $140 billion, according to research published in 2021 by the Journal of the American Medical Association. That $140 billion doesn’t include all medical bills owed to health care providers, only the outstanding debt held by collection agencies. Some 11 million Americans have medical debt above $2,000, according to a survey by health policy research group KFF of all outstanding medical debt, including medical bills put on credit cards. Three million people have debts above $10,000. For many, it’s a financial hole that only sinks further as they confront more complex medical problems.

Medical debt is unlike any other consumer spending. Unlike buying products from retailers, health care providers usually provide little if any upfront detail of what a procedure will cost. Patients seeking treatment are often bounced between physicians, specialists, clinics and labs, without any clear menu of prices along the way. And Americans seeking emergency treatment are hardly in a position to comparison shop. In other words, this type of debt doesn’t necessarily reflect reckless spending, but the opaqueness of America’s health care system, where prices are shaped through Byzantine formulas involving insurers, their networks, discounts, copays and deductibles.

Debt included on a credit score is meant to signal a person’s monetary fitness — and, by extension, their financial trustworthiness. Low scores can limit a person’s job and housing prospects, and medical debt in particular can discourage some from seeking further health care.

Yet research shows that owing medical debt is not a reliable predictor of a person’s overall financial steadiness. Indeed, many with medical debt are merely struggling to manage their health concerns within a system that makes price-shopping virtually impossible. Not surprisingly, women shoulder a disproportionate burden of medical debt — likely related to childbirth expenses — as do Black Americans, who report carrying nearly twice the debt of white or Hispanic adults. Americans are also more likely to have significant medical debt if they live in rural areas or in one of the 10 states (including Florida) that have not expanded Medicaid under the Affordable Care Act, also known as Obamacare.

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Removing these bills from credit reports won’t erase the debt; rather, it keeps collectors from weaponizing the information to further harm consumers who typically never sought to incur this expense in the first place. Of course, the details matter, and we’ll reserve judgment as the administration develops the rules over the coming year. But this measure is a well-intentioned response to a crisis facing millions and a welcome signal to the health care industry to make medical costs more transparent.

Editorials are the institutional voice of the Tampa Bay Times. The members of the Editorial Board are Editor of Editorials Graham Brink, Sherri Day, Sebastian Dortch, John Hill, Jim Verhulst and Chairman and CEO Conan Gallaty. Follow @TBTimes_Opinion on Twitter for more opinion news.

UB health forum honors 5/14 victim Pearl Young’s legacy, features trailblazing doctor

Dr. Barbara Ross-Lee thinks of two titles that exemplify her long career in medicine.

One is trailblazer, because Ross-Lee remembers what it was like when she became a doctor more than a five decades ago, in a field that had few minorities and was dominated by white men.

But she kept pushing forward, becoming the first African American woman to lead a U.S. medical school in 1993 as dean of Ohio University’s College of Osteopathic Medicine.

The other title is change agent because, at each of her stops along the way, she said she’s brought “a lot of different changes, particularly in osteopathic medicine.”

She’s the founding president of the Maryland Osteopathic College of Medicine at Morgan State University in Baltimore, a medical school she’s developing to boost diversity in medicine.

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Ross-Lee, a nationally recognized expert on health policy issues and the older sister of singer Diana Ross, will be the keynote speaker Friday at a University at Buffalo forum titled, “A Mother Pearl Young Legacy Forum on Hope and Healing: Advancing Key Maternal Health Policies.”

Dr. Barbara Ross-Lee

Dr. Barbara Ross-Lee is the keynote speaker at a maternal health forum at University at Buffalo on Friday, Sept. 29, 2023.

The event, from noon to 2 p.m. Friday in the M&T Auditorium at the Jacobs School of Medicine and Biomedical Sciences, is free and open to the public. Those interested in attending are asked to register online.

UB faculty and staff planned the forum in conjunction with relatives of Pearl Young, one of the 10 people killed in the racist mass shooting at the Tops supermarket on Jefferson Avenue on May 14, 2022. 

Young studied health and nutrition and received her degree from UB in gerontology studies. Young, a longtime volunteer at a Central Park food pantry affiliated with her home church, was a mother of three, a grandmother of 10 and a great-grandmother of seven, among the reasons why UB and the family felt an event focused on maternal health was a natural fit.

Young’s relative Allen Dewane, a 1993 UB alumnus and CEO of Acuity Productions, said Young was focused on health equity and the cause of food and health concerns for the Black community. She worked with older adults, Dewane said, as well as children as a substitute teacher in Buffalo Public Schools, knowing that not getting the proper food and nutrition could affect a student’s ability to learn.

“Her life’s mission was health equity and health and nutrition,” Dewane said.

‘Her efforts will not be forgotten’

Dewane said he became acquainted with the Ross family about 10 years ago through his connections in show business, when he met Rhonda Ross, whose mother is Diana Ross.

And in recent years, Dewane had hoped to organize a concert with Rhonda Ross to raise funds for Young’s food pantry, though the Covid-19 pandemic kept getting in the way of those plans.

After the tragedy at Tops, Dewane connected with UB, looking to do an event honoring Young to keep her work and her legacy alive. It was in those conversations that Dr. Roseanne Berger, a family medicine professor at UB, reminded Dewane that Rhonda Ross had an aunt who was very famous in the medical world.

Young’s family is hosting a food and soup giveaway April 29 at a vacant lot at 266 Leroy Ave., a spot which they hope will one day become a permanent site for a pantry and soup kitchen in Young’s honor.

That led Dewane to reach out to Ross-Lee.

“She’s not just another doctor,” he said. “She’s as big as Diana in the medical field. Dr. Barbara Ross-Lee is a history maker, and I want the city to come out, because we have an important person in Black history in the City of Buffalo. We should be honored that someone of such high status is coming to our town to recognize one of our Buffalo 10.”

For Ross-Lee, who travels the country to speak about health policy, primary care and women’s health, she said Friday’s event takes on an added importance because it’s honoring Young.

“We tend to focus on the event itself – 5/14 – and kind of forget the people, you know?” Ross-Lee said. “She was one of those people that I am really proud of her family for saying, ‘Hey, her efforts will not be forgotten. And in fact, we will continue to push in the areas in which she was so committed.'” 

‘It’s time for change’

When Ross-Lee thinks about U.S. health care, she said maternal health is one of the most glaring examples of this country’s health inequities.

Recent federal data shows, in fact, that Black women are two to three times more likely to die from pregnancy-related complications than white women, according to UB.

“Maternal Health is the perfect example of the health inequities in communities of color because, not only have they been present for decades – and I mean decades – but it’s not getting better,” Ross-Lee said. “It’s getting worse. And how can that be when you consider the sophistication of the health care system that we have. So it’s time for the broader community to get involved and say it’s time for change.”

Ross-Lee, who will speak about health policy opportunities related to maternal health, said she has seen positive momentum in other parts of medicine, particularly as it relates to women in medicine.

Much more work, she said, remains to increase racial diversity in medicine.

One of the missions of the new osteopathic medical school she’s developing in Baltimore, she said, is to increase the number of minorities in medicine – and not just in primary care but also in specialty areas such as orthopedics and radiology. 

“It’s still a mountain in front of us,” she said, “but we’re climbing it, and we’ll get there.”

If you go 

What: “A Mother Pearl Young Legacy Forum on Hope and Healing: Advancing Key Maternal Health Policies.”

When: Noon to 2 p.m. on Friday, Sept. 29.

Where: M&T Auditorium in the Jacobs School, 955 Main St.

How to sign up to attend: Register online.

In addition to this event, UB’s Jacobs School will host its sixth annual Igniting Hope conference the next day, from 8 a.m. to 3:40 p.m. on Saturday, Sept. 30. The conference, which focuses on discussing, addressing and trying to mitigate the social determinants of health, is free and open to the public, with registration available at this link.

Jon Harris can be reached at 716-849-3482 or Follow him on Twitter at @ByJonHarris.

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Is air pol­lu­tion dead­lier than we thought?

Ella Kissi-Debrah’s little body could take it no more. In 2013, the nine-year-old died after an acute asthma attack after living the whole of her short life 30 metres from London’s busy South Circular road, with repeated visits to the hospital following frequent seizures.

The coroner pronounced in 2020 that the toxic fumes she had breathed because of the traffic on the roadway were partly to blame. It was the first known instance of the law recognising air pollution as a cause of death.

Yet public health experts believe that Kissi-Debrah was a victim of a far more widespread, global emergency. The World Health Organization (WHO) estimates that air pollution is responsible for more than seven million premature deaths every year around the world, contributing to pulmonary and heart diseases, lung cancer and respiratory infections. Almost all of the world’s population – 99 percent – breathes air that is dirtier than levels recommended by the WHO.

In August, research published in The Lancet journal by a team of Chinese scientists showed that air pollution increases antibiotic resistance, which – their calculations suggest – in turn led to 480,000 premature deaths and 18 million years lost globally in 2018.

The same month, Harvard scientists showed an association between pollutants in emissions from carbon combustion and an increased risk of some cancers.

So, just how dangerous is the air we breathe?

The short answer: Very. In fact, air pollution, by some estimates, is a leading cause of death internationally. Carbon emissions are down, but wildfires are up, and the global hunger for energy continues to mount, posing new threats that do not affect everyone equally. Like with many other public health challenges, where people live and how much they earn determines the risks they face from toxic air.

People attend a protest against pollution and for a cleaner air in Belgrade, Serbia, Sunday, Nov. 13, 2022. Protesters urge the Serbian government to change its attitude towards environmental issues. (AP Photo/Darko Vojinovic)
People attend a protest against pollution and for cleaner air in Belgrade, Serbia, on Sunday, November 13, 2022. Protesters urge the Serbian government to change its attitude towards environmental issues [File: Darko Vojinovic/AP Photo]

Gas and particles

Airborne pollutants principally fall into two categories, said Sophie Gumy, a technical lead for the WHO’s Department of Environment, Climate Change and Health: gases and particulate matter that are either produced directly from carbon combustion or through secondary mechanisms.

Nitrous oxides – a group of gases commonly produced by vehicles, fossil fuel-based power production, industrial refineries and chemical plants – are an example.

As a primary pollutant, nitrogen dioxide has been shown to exacerbate asthma and respiratory conditions. However, nitrogen dioxide, along with other nitrogen oxides, can also interact with the sun’s ultraviolet light and a category of gases known as volatile organic compounds to produce secondary pollutants like ground-level ozone, which can pose health problems such as inflammation and damage to the airways. This evolution of pollutants also complicates the problem of understanding where to stem the tide.

These same nitrogen oxides can also contribute to the formation of airborne particulates. And though both the ozone and the particle originated from the same sources, such as tailpipe nitrogen dioxide – their effects and magnitude are markedly different.

“The particulate pollutants are the ones that are particularly important for public health,” said Scott Budinger, chief of pulmonary and critical care at Northwestern University Feinberg School of Medicine. In fact, he notes, research has found that following just days after upswings in particulate exposure, there is often an increase in deaths from a wide range of health complications.

“What epidemiologists have noted,” said Budinger, “is that if you look at daily particle exposure in any large, urban city, you’ll see about a two- to three-day lag, then an increase in all-cause mortality.”

The biggest burden is on the heart.

“People think ‘air pollutant’,” said Gumy, “and they think ‘respiratory problems’.” However, she said, particulates, taken up by the lungs and transported through the bloodstream, cause inflammation in cells. This strains the heart, contributing to cardiovascular issues, such as heart attacks and strokes.

The worst offenders are particles smaller than 2.5 microns, approximately 20-28 times smaller than the diameter of a human hair. At that size, the particulates can even get into the placenta, and thus, the brains of foetuses, said Maria Neira, director of the WHO’s Department of Environment, Climate Change, and Health.

Several studies have even found high exposure to these fine particles, known as PM2.5, to be a significant risk factor for premature birth. Long-term PM2.5 exposure has also been associated with an increased risk of developing neurodegenerative diseases such as dementia, Parkinson’s and Alzheimer’s.

And often, the worst sufferers are already disadvantaged communities.

In this photo taken Friday, Oct. 28, 2016, a layer of smog envelops the city skyline before Diwali festival in New Delhi, India. As north Indian cities enter the season of high air pollution, a new report is warning about the dangers to children. (AP Photo/Altaf Qadri)
A layer of smog envelops the city skyline of New Delhi, India, on October 28, 2016, before the Diwali festival [File: Altaf Qadri/AP Photo]

Deadly exposure

According to the Institute for Health Metrics and Evaluation at the University of Washington in Seattle, air pollution is the fourth-leading cause of mortality among all metabolic and behavioural risk factors, after high systolic blood pressure, tobacco use and dietary risks.

But that toll is not distributed equally.

According to WHO, Indoor air pollution is associated with 3.2 million deaths a year. Most of that is in regions such as Sub-Saharan Africa, the Indian subcontinent, several Southeast Asian countries and Russia, where many households still use dirtier-burning fuels such as kerosene, wood or coal for primary heating or cooking.

The associated increase in stroke, ischaemic heart disease, chronic obstructive pulmonary disease (COPD), and lung cancer tend to hit women and children, who traditionally tend to do more household chores, the hardest.

Outdoor, or ambient, air pollution is associated with 4.2 million premature deaths worldwide, according to the WHO. Last year, the World Bank estimated the global toll of the health damages associated with ambient air pollution to be $8.1 trillion – roughly 6.1 percent of the global gross domestic product.

However, again, much of that burden falls on low and middle-income populations. One analysis estimated that, if air pollution could have been kept to theoretical minimum levels across the Middle East and North Africa in 2019, the average life expectancy would have been higher by anywhere between one and six years.

Air pollution’s effects are felt most by susceptible and vulnerable populations, said Gumy. A susceptible population is a group likely to be hardest hit by the effects of air pollution: Those with preexisting conditions, or genetic predispositions to respiratory or cardiovascular issues, for instance. The vulnerable, on the other hand, are those most likely to be exposed in the first place. Often, those who live in poorer areas fit both criteria. They may live or work jobs that expose them more, while also having less access to health care and less time to stay active and fit.

Picture a police officer in India’s capital New Delhi, said Gumy. Every winter, farmers from neighbouring states burn their fields, triggering a months-long season of toxic air pollution. An officer patrolling their beat outside has no choice but to be exposed throughout the day.

Even in high-income countries, groups in lower socioeconomic brackets tend to be disproportionately affected. In the United States, Budinger pointed out, such communities often live closer to roadways. This saddles many minority groups, especially Black Americans, with a higher incidence of premature death from associated medical conditions.

Socioeconomics aside, geography influences who gets most affected by air pollution. Generally, said Budinger, the cities most affected are ones in valleys, where air can often get trapped.

Likewise, with the progression of climate change, areas most at risk for forest fires face significant challenges to air quality.

According to US Environmental Protection Agency data, the country has seen a 42 percent decline in PM2.5 nationally over the last two decades. However, in that time, the incidence of wildfires has tripled. The average fire size has quadrupled. And so despite the national decline, Pacific Northwest communities face rising particulate levels, with incidents of heavy exposure. One Stanford University analysis found that from 2007 to 2019,  wildfires accounted for 20 percent of PM2.5 emissions in the US, racked up $92bn in annual welfare tolls, cost between $8bn and $31bn in premature mortality-related expenditures, and reduced labour earnings by nearly 2 percent.

“Every day,” said the WHO’s Neira, “we are getting more evidence about how air pollution is affecting [us].”

A recent analysis of 12 research studies conducted across 116 countries found that every 10 percent increase in PM2.5 was associated with a roughly 1 percent increase in antibiotic resistance, equating to 43,654 deaths, with the highest levels of resistance seen in North Africa and West Asia.

“We need to make sure that everyone understands that air pollution is representing probably one of the biggest public health challenges that we are confronting today,” said Neira.

To be sure, the health effects of air pollution are still a relatively new area of research – with many questions unanswered. What is clear, though, is that the road ahead is bumpy.

The shut down coal-fired power plant Westfalen of RWE Generation SE is seen behind a fence in Hamm, Germany, Thursday, Aug. 10, 2023. The power plant was taken off the grid two years ago before the energy crisis as part of the nationwide decommissioning auction for hard coal-fired power plants. Germany focus on decarbonization and renewable energy to fight climate change. (AP Photo/Martin Meissner)
The shut down coal-fired power plant Westfalen in Hamm, Germany, Thursday, August 10, 2023. Many coal plants are being decommissioned around the world, but as the demand for energy grows, experts anticipate a dangerous mix of old and new pollutants [File: Martin Meissner/AP Photo]

Good news and bad

There have been victories in the battle against air pollution.

The EPA in the US estimates that the Clean Air Act has saved hundreds of thousands of lives across the country in the 50 years since it was passed.

Thanks in large part to the 1979 Convention on Long-Range Transboundary Air Pollution (LRTAP), which created a regional framework to address air pollution across Europe, North America, the former Soviet Union and its Warsaw Pact allies, a number of European countries have seen a dramatic decline in air pollution, especially for sulphurous emissions.

“For a very long time,  air pollution was considered an urban problem,” said the WHO’s Gumy. “But the science really allows us to analyse where the pollution comes from.”

For example, global emissions of nitrous oxides, sulphur dioxide, carbon monoxide, black carbon and atmospheric organic carbon have all been on the decline since 2012 or earlier, driven by reductions from China, North America and Europe.

Progress is not restricted to wealthier countries either. Emissions reductions in the transport sector in India and Africa, as well as a drop in pollutants from India’s energy sector, account for 60 percent of the global fall in emissions of nitrous oxide and 14 percent of sulphur dioxide.

However, it isn’t all good news. Year after year, global energy consumption continues to increase. Ammonia emissions steadily rise due to farming. Many volatile organic compounds are becoming increasingly common due to solvent use, energy production and traffic.

Moreover, Gumy pointed out, as many low or middle-income countries go through different development patterns than wealthier countries, they will likely see a mixture of both old and new sources of air pollution – with soot released from burned residential waste rising alongside nitrous oxide from growing car ownership.

The reality is that the road ahead is not one road – it is a multitude of different paths for different regions that crisscross in unpredictable ways.

A region could be a leader in improving its air quality through new standards for industrial emissions, while others could be lagging. A country doing well could also see its efforts poleaxed by soot if its neighbouring nation decides to clear forests. That is true for different neighbourhoods, cities and states within a country too.

And while the patchwork of monitoring services available in different regions makes it possible for people to monitor their air quality with some degree of accuracy, that is not good enough for the WHO, said Neira – especially in the face of the new health risks of air pollution emerging every day.

People need to understand what the pollution data means, “but not only by putting the responsibility on them to say, ‘Okay, I have an app that tells me the street is polluted’”, she said. “This is not the way to fight pollution.”

“You need to have the right to breathe air that is not killing you on a daily basis.”

2024 GOP PRESIDENTIAL DEBATE: Live Updates As 7 Republicans Face Off At Reagan Library

The tech entrepreneur said that workers should “go picket in front of the White House in Washington, D.C. That’s really where the protest needs to be.” Ramaswamy added that the Biden administration’s policies have been a disaster and that federal regulations are hampering the economy.

Chris Christie calls out Trump for adding to the national debt

Former Trump ally and Governor of New Jersey Chris Christie criticized the Trump administration for adding trillions of dollars to the national debt during the former president’s four years in office and called on him to defend his record on the debate stage.

“We don’t get any answers because Joe Biden hides in his basement and won’t answer as to why he’s raising the debt the way he’s done, and Donald Trump hides behind the walls of his golf clubs and won’t show up … he put $7 trillion on the debt. He should be here in this room to answer those questions.”

DeSantis calls out Trump for not being at the debate, criticizes the former president for signing large spending bills

“You know who else is missing in action? Donald Trump is missing in action,” the Florida governor said. “He should be on this stage tonight. He owes it to you to defend his record where they added $7.8 trillion to the debt that set the stage for the inflation that we have.” DeSantis said he will veto bloated spending bills.

Christie says that America wants more immigrants to come legally

“If you come here illegally, we will apprehend you and send you back across the border from whence you came.”

DeSantis tries to steer debate back to issues after Scott and Ramaswamy trade barbs

After Sen. Tim Scott called out Vivek Ramaswamy for criticizing his GOP opponents in the last debate and calling them “bought and paid for,” Gov. DeSantis tried to get the participants to “get back to the issues that matter.”

“Let’s focus on holding Joe Biden accountable,” DeSantis said. “That’s who we need to be focusing on.”

Pence asked about supporting a pathway for illegal immigrants allowed to stay in America under Obama and Biden’s DACA program, which was recently ruled illegal

The former vice president pointed to the Trump administration’s actions to secure the border and said he has negotiated change in Congress before.

DeSantis says that crime is a sign of “decaying” American culture, lays out his plan to go after Soros-backed DAs

The Florida governor pointed to his removal of two woke prosecutors in Florida and said that he will authorize the Department of Justice to bring civil rights cases against George Soros-backed prosecutors who are weak on prosecuting crime.

Pence calls for “expedited death penalty” for mass shooters

“I’m someone that believes that justice delayed is justice denied, and as a father of three, as a grandfather of three beautiful little girls, I am sick and tired of these mass shootings happening in the United States of America, and if I’m president of the United States, I will go to the Congress of the United States, and we’re going to pass a federal expedited death penalty for anyone involved in a mass shooting so they will meet their fate in months, not years.”

Ramaswamy says that part of dealing with the fentanyl crisis is cracking down on demand in the country

Ramaswamy said that the country needs to turn to faith-based mental health solutions and crack down on addictive social media platforms.

Haley addresses the broken health care system

Nikki Haley said that, as president, she will break down the American healthcare system as it currently stands and will bring competition and transparency to the industry.

Burgum blames the federal government for rising medical costs

When asked about how he would address the rising costs of health care, Doug Burgum pinned the blame on the federal government. He said that whenever the government gets involved, it picks winners and losers, which doesn’t work out well.

Haley says parents have to get involved with kids’ education, calls for transparency and an end to spending on DEI, CRT

Nikki Haley said parents need to get involved and public schools need to be more transparent with them. “We’ve got to make sure we catch our kids up … we need complete transparency in the classroom … we need school choice.”

“We’ve got to quit spending time on DEI and CRT,” Haley added.

Scott takes aim at Democrat welfare programs

Tim Scott said that black Americans survived all of the hardships of slavery, but were devastated by welfare programs in the 1960s. “What was hard to survive was Johnson’s Great Society where they decided to take the black father out of the household to get a check in the mail and you can now measure that in unemployment, crime, and devastation. If you want to restore hope, you need to restore the family,” he said.

Ramaswamy: Transgenderism is a mental health disorder

After being asked about parental notification laws for public schools, Vivek Ramaswamy said, “Transgenderism, especially in kids, is a mental health disorder,” adding that “it is not compassionate to confirm a child’s delusion.”

DeSantis says the U.S. must defend the American people before worrying about Ukraine

When asked if it was in America’s best interest to fund Ukraine’s defense, Gov. Ron DeSantis said it is in America’s interest “to end” the war in Ukraine. “We are not going to have a blank check. We will not have U.S. troops [in Ukraine].”

“We have to defend the American people,” DeSantis added, saying the U.S. needs to focus on the southern border.

Tim Scott: Opposing Russia in Ukraine is in America’s best interest

When asked about continued assistance to Ukraine, which Scott has consistently voted in favor of, the senator said, “Our national interest is in degrading the Russian military.”

Haley and Ramaswamy squabble over TikTok

Ramaswamy said that he would ban TikTok for those under 16 before Haley jumped in to attack him over downloading the app himself. Haley said that TikTok was a security liability and would allow China access to American voting. Ramaswamy said that having TikTok was necessary to reach out to the next generation.

Burgum: “We’re in a Cold War with China”

Burgum called out Biden’s foreign policy approach, saying that Biden invited more kidnappings of Americans with recent negotiations that gave billions to Iran in exchange for imprisoned Americans. He added that Ukraine should not fall to Russia and Taiwan should not fall to China.

Haley goes after DeSantis on energy

Nikki Haley attacked Gov. Ron DeSantis for his record on fracking, accusing DeSantis of issuing executive orders after taking office banning fracking and offshore drilling in the state.

DeSantis responded to Haley, saying her claims are “not true” and pointed to a Florida constitutional amendment that bans offshore drilling.

“That’s just wrong,” the governor said of Haley’s attack. “And let’s just get real here: my plan will get the job done. We are going to be energy dominant.”

DeSantis says being pro-life is not a liability for elections

“I reject this idea that pro-lifers are to blame for midterm defeats,” DeSantis said, adding that Trump should be at the debate to explain why he has been critical of pro-life activists. “We’re better off when everyone counts,” he added, saying Republicans should go after Democrats pushing extreme late-term abortion policies.

Candidates asked who they would vote “off the island”

Fox News host Dana Perino asked candidates to write down what candidate they would want to “vote off the island” but candidates refused with DeSantis calling the question disrespectful. Other candidates agreed and Perino moved on before Christie explained that he would want Trump “off the island.”

Ramaswamy: “America First agenda does not belong to one man”

With the final comment of the debate, Vivek Ramaswamy said he “respects” former President Trump’s “legacy,” but added that the America First agenda that Trump governed by “does not belong to one man.”

“It does not belong to Donald Trump. It doesn’t belong to me. It belongs to you, the people of this country. And the question is who is going to unite this country and take the America First agenda to the next level.”