Goat Milk Greek Yogurt vs Almond Milk Greek Yogurt – Which is Healthier?
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Our Verdict
When comparing goat milk yogurt to almond milk yogurt, we picked the almond milk yogurt.
Why?
Surprised? Honestly, we were too!
Much as we love almonds, we were fully expecting to write about how they’re very close in nutritional value, but the dairy yogurt has more probiotics, but no, as it turns out when we looked into them, they’re quite comparable in that regard.
It’s easy to assume “goat milk yogurt is more natural and therefore healthier”, but in both cases, it was a case of taking a fermentable milk, and fermenting it (an ancient process). “But almond milk is a newfangled thing”, well, new-ish…
So what was the deciding factor?
In this case, the almond milk yogurt has about twice the protein per (same size) serving, compared to the goat milk; all the other macros are about the same, and the micronutrients are similar. Like many plant-based milks and yogurts, this one is fortified with calcium and vitamin D, so that wasn’t an issue either.
In short: the only meaningful difference was the protein, and the almond came out on top.
However!
The almond came out on top only because it is strained; this can be done (or not) with any kind of yogurt, be it from an animal or a plant.
In other words: if it had been different brands, the goat milk yogurt could have come out on top!
The take-away idea here is: always read labels, because as you’ve just seen, even we can get surprised sometimes!
seriously if you only remember one thing from this today, make it the above
Other thing worth mentioning: yogurts, and dairy products in general, are often made with common allergens (e.g. dairy, nuts, soy, etc). So if you are allergic or intolerant, obviously don’t choose the one to which you are allergic or intolerant.
That said… If you are lactose-intolerant, but not allergic, goat’s milk does have less lactose than cow’s milk. But of course, you know your limits better than we can in this regard.
Want to try some?
Amazon is not coming up with the goods for this one (or anything even similar, at time of writing), so we recommend trying your local supermarket (and reading labels, because products vary widely!)
What you’re looking for (be it animal- or plant-based):
- Live culture probiotic bacteria
- No added sugar
- Minimal additives in general
- Lastly, check out the amounts for protein, calcium, vitamin D, etc.
Enjoy!
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What is a virtual emergency department? And when should you ‘visit’ one?
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For many Australians the emergency department (ED) is the physical and emblematic front door to accessing urgent health-care services.
But health-care services are evolving rapidly to meet the population’s changing needs. In recent years, we’ve seen growing use of telephone, video, and online health services, including the national healthdirect helpline, 13YARN (a crisis support service for First Nations people), state-funded lines like 13 HEALTH, and bulk-billed telehealth services, which have helped millions of Australians to access health care on demand and from home.
The ED is similarly expanding into new telehealth models to improve access to emergency medical care. Virtual EDs allow people to access the expertise of a hospital ED through their phone, computer or tablet.
All Australian states and the Northern Territory have some form of virtual ED at least in development, although not all of these services are available to the general public at this stage.
So what is a virtual ED, and when is it appropriate to consider using one?
Shutterstock/Nils Versemann How does a virtual ED work?
A virtual ED is set up to mirror the way you would enter the physical ED front door. First you provide some basic information to administration staff, then you are triaged by a nurse (this means they categorise the level of urgency of your case), then you see the ED doctor. Generally, this all takes place in a single video call.
In some instances, virtual ED clinicians may consult with other specialists such as neurologists, cardiologists or trauma experts to make clinical decisions.
A virtual ED is not suitable for managing medical emergencies which would require immediate resuscitation, or potentially serious chest pains, difficulty breathing or severe injuries.
A virtual ED is best suited to conditions that require immediate attention but are not life-threatening. These could include wounds, sprains, respiratory illnesses, allergic reactions, rashes, bites, pain, infections, minor burns, children with fevers, gastroenteritis, vertigo, high blood pressure, and many more.
People with these sorts of conditions and concerns may not be able to get in to see a GP straight away and may feel they need emergency advice, care or treatment.
When attending the ED, they can be subject to long wait times and delayed specialist attention because more serious cases are naturally prioritised. Attending a virtual ED may mean they’re seen by a doctor more quickly, and can begin any relevant treatment sooner.
From the perspective of the health-care system, virtual EDs are about redirecting unnecessary presentations away from physical EDs, helping them be ready to respond to emergencies. The virtual ED will not hesitate in directing callers to come into the physical ED if staff believe it is an emergency.
The doctor in the virtual ED may also direct the patient to a GP or other health professional, for example if their condition can’t be assessed visually, or if they need physical treatment.
The results so far
Virtual EDs have developed significantly over the past three years, predominantly driven by the COVID pandemic. We are now starting to slowly see assessments of these services.
A recent evaluation my colleagues and I did of Queensland’s Metro North Virtual ED found roughly 30% of calls were directed to the physical ED. This suggests 70% of the time, cases could be managed effectively by the virtual ED.
Preliminary data from a Victorian virtual ED indicates it curbed a similar rate of avoidable ED presentations – 72% of patients were successfully managed by the virtual ED alone. A study on the cost-effectiveness of another Victorian virtual ED suggested it has the potential to generate savings in health-care costs if it prevents physical ED visits.
Only 1.2% of people assessed in Queensland’s Metro North Virtual ED required unexpected hospital admission within 48 hours of being “discharged” from the virtual ED. None of these cases were life-threatening. This indicates the virtual ED is very safe.
The service experienced an average growth rate of 65% each month over a two-year evaluation period, highlighting increasing demand and confidence in the service. Surveys suggested clinicians also view the virtual ED positively.
The right advice could tell you whether you need to visit hospital in person or not. 1st footage/Shutterstock What now?
We need further research into patient outcomes and satisfaction, as well as the demographics of those using virtual EDs, and how these measures compare to the physical ED across different triage categories.
There are also challenges associated with virtual EDs, including around technology (connection and skills among patients and health professionals), training (for health professionals) and the importance of maintaining security and privacy.
Nonetheless, these services have the potential to reduce congestion in physical EDs, and offer greater convenience for patients.
Eligibility differs between different programs, so if you want to use a virtual ED, you may need to check you are eligible in your jurisdiction. Most virtual EDs can be accessed online, and some have direct phone numbers.
Jaimon Kelly, Senior Research Fellow in Telehealth delivered health services, The University of Queensland
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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The Brain’s Way of Healing – by Dr. Norman Doidge
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First, what this book isn’t: any sort of wishy-washy “think yourself better” fluff, and nor is it a “tapping into your Universal Divine Essence” thing.
In contrast, Dr. Norman Doidge sticks with science, and the only “vibrational frequencies” involved are the sort that come from an MRI machine or similar.
The author makes bold claims of the potential for leveraging neuroplasticity to heal many chronic diseases. All of them are neurological in whole or in part, ranging from chronic pain to Parkinson’s.
How well are these claims backed up, you ask?
The book makes heavy use of case studies. In science, case studies rarely prove anything, so much as indicate a potential proof of principle. Clinical trials are what’s needed to become more certain, and for Dr. Doidge’s claims, these are so far sadly lacking, or as yet inconclusive.
Where the book’s strengths lie is in describing exactly what is done, and how, to effect each recovery. Specific exercises to do, and explanations of the mechanism of action. To that end, it makes them very repeatable for any would-be “citizen scientist” who wishes to try (in the cases that they don’t require special equipment).
Bottom line: this book would be more reassuring if its putative techniques had enjoyed more clinical studies… But in the meantime, it’s a fair collection of promising therapeutic approaches for a number of neurological disorders.
Click here to check out The Brain’s Way of Healing, and learn more!
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The Art and Science of Connection – by Kasley Killam, MPH
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We can eat well, exercise well, and even sleep well, and we’ll still have a +53% increased all-cause mortality if we lack social connection—even if we technically have support and access to social resources, just not the real human connection itself. And as we get older, it gets increasingly easy to find ourselves isolated.
The author is a social scientist by profession, and it shows. None of what she shares in the book is wishy-washy; it has abundant scientific references coming thick and fast, and a great deal of clarity with regard to terms, something often not found in books of this genre that lean more towards the art than the science.
On which note, for the reader who may be thinking “I am indeed quite alone”, she also offers proven techniques for remedying that; not in the way that many books use the word “proven” to mean “we got some testimonials”, but rather, proven in the sense of “we did science to it and based on these 17 large population-based retrospective cohort studies, we can say with 99% confidence that this is an effective tool to mediate improved social bonds and social health outcomes”.
To this end, it’s a very practical book also, and should bestow upon any isolated reader a sense of confidence that in fact, things can be better. A particular strength is that it also looks at many different scenarios, so for the “what if I…” people with clear reasons why social connection is not abundantly available, yes, she has such cases covered too.
Bottom line: if you’d like to live more healthily for longer, social health is an underrated and oft-forgotten way of greatly increasing those things, by science.
Click here to check out The Art And Science Of Social Connection, and get connected!
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What Does “Balance Your Hormones” Even Mean?
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Hormonal Health: Is It Really A Balancing Act?
Have you ever wondered what “balancing your hormones” actually means?
The popular view is that men’s hormones look like this:
Testosterone (less) ⟷ Testosterone (more)
…And that women’s hormones look more like this:
♀︎ Estrogen ↭ Progesterone ⤵︎
⇣⤷ FSH ⤦ ↴ ☾ ⤹⤷ Luteinizing Hormone ⤦
DHEA ↪︎ Gonadotrophin ⤾
↪︎ Testosterone? ⥅⛢
Clear as mud, right?
But, don’t worry, Supplements McHerbal Inc will sell you something guaranteed to balance your hormones!
How can a supplement (or dietary adjustment) “balance” all that hotly dynamic chaos, and make everything “balanced”?
The truth is, “balanced” in such a nebulous term, and this is why you will not hear endocrinologists using it. It’s used in advertising to mean “in good order”, and “not causing problems”, and “healthy”.
In reality, our hormone levels depend on everything from our diet to our age to our anatomy to our mood to the time of the day to the phase of the moon.
Not that the moon has an influence on our physiology at all—that’s a myth—but you know, 28 day cycle and all. And, yes, half the hormones affect the levels of the others, either directly or indirectly.
Trying to “balance” them would be quite a game of whack-a-mole, and not something that a “cure-all” single “hormone-balancing” supplement could do.
So why aren’t we running this piece on Friday, for our “mythbusting” section? Well, we could have, but the more useful information is yet to come and will take up more of today’s newsletter than the myth-busting!
What, then, can we do to untangle the confusion of these hormones?
Well first, let’s understand what they do, in the most simple terms possible:
- Estrogen—the most general feminizing hormone from puberty onwards, busiest in the beginning of the menstrual cycle, and starts getting things ready for ovulation.
- Progesterone—secondary feminizing hormone, fluffs the pillows for the oncoming fertilized egg to be implanted, increases sex drive, and adjusts metabolism accordingly. Busiest in the second half of the menstrual cycle.
- Testosterone—is also present, contributes to sex drive, is often higher in individuals with PCOS. If menopause is untreated, testosterone will also rise, because there will be less estrogen
- (testosterone and estrogen “antagonize” each other, which is the colorfully scientific way of saying they work against each other)
- DHEA—Dehydroepiandrosterone, supports production of testosterone (and estrogen!). Sounds self-balancing, but in practice, too much DHEA can thus cause elevated testosterone levels, and thus hirsutism.
- Gonadotrophin—or more specifically human chorionic gonadotrophin, HcG, is “the pregnancy hormone“, present only during pregnancy, and has specific duties relating to such. This is what’s detected in (most) pregnancy test kits.
- FSH—follicle stimulating hormone, is critical to ovulation, and is thus essential to female fertility. On the other hand, when the ovaries stop working, FSH levels will rise in a vain attempt to encourage the ovulation that isn’t going to happen anymore.
- Luteinizing hormone—says “go” to the new egg and sends it on its merry way to go get fertilized. This is what’s detected by ovulation prediction kits.
Sooooooo…
What, for most women, most often is meant by a “hormonal imbalance” is:
- Low levels of E and/or P
- High levels of DHEA and/or T
- Low or High levels of FSH
In the case of low levels of E and/or P, the most reliable way to increase these is, drumroll please… To take E and/or P. That’s it, that’s the magic bullet.
Bonus Tip: take your E in the morning (this is when your body will normally make more and use more) take your P in the evening (it won’t make you sleepy, but it will improve your sleep quality when you do sleep)
In the case of high levels of DHEA and/or T, then that’s a bit more complex:
- Taking E will antagonize (counteract) the unwanted T.
- Taking T-blockers (such as spironolactone or bicalutamide) will do what it says on the tin, and block T from doing the jobs it’s trying to do, but the side-effects are considered sufficient to not prescribe them to most people.
- Taking spearmint or saw palmetto will lower testosterone’s effects
- Scientists aren’t sure how or why spearmint works for this
- Saw palmetto blocks testosterone’s conversion into a more potent form, DHT, and so “detoothes” it a bit. It works similarly to drugs such as finasteride, often prescribed for androgenic alopecia, called “male pattern baldness”, but it affects plenty of women too.
In the case of low levels of FSH, eating leafy greens will help.
In the case of high levels of FSH, see a doctor. HRT (Hormone Replacement Therapy) may help. If you’re not of menopausal age, it could be a sign something else is amiss, so it could be worth getting that checked out too.
What can I eat to boost my estrogen levels naturally?
A common question. The simple answer is:
- Flaxseeds and soy contain plant estrogens that the body can’t actually use as such (too incompatible). They’ve lots of high-quality nutrients though, and the polyphenols and isoflavones can help with some of the same jobs when it comes to sexual health.
- Fruit, especially peaches, apricots, blueberries, and strawberries, contain a lot of lignans and also won’t increase your E levels as such, but will support the same functions and reduce your breast cancer risk.
- Nuts, especially almonds (yay!), cashews, and pistachios, contain plant estrogens that again can’t be used as bioidentical estrogen (like you’d get from your ovaries or the pharmacy) but do support heart health.
- Leafy greens and cruciferous vegetables support a lot of bodily functions including good hormonal health generally, in ways that are beyond the scope of this article, but in short: do eat your greens!
Note: because none of these plant-estrogens or otherwise estrogenic nutrients can actually do the job of estradiol (the main form of estrogen in your body), this is why they’re still perfectly healthy for men to eat too, and—contrary to popular “soy boy” social myths—won’t have any feminizing effects whatsoever.
On the contrary, most of the same foods support good testosterone-related health in men.
The bottom line:
- Our hormones are very special, and cannot be replaced with any amount of herbs or foods.
- We can support our body’s natural hormonal functions with good diet, though.
- Our hormones naturally fluctuate, and are broadly self-correcting.
- If something gets seriously out of whack, you need an endocrinologist, not a homeopath or even a dietician.
In case you missed it…
We gave a more general overview of supporting hormonal health (including some hormones that aren’t sex hormones but are really important too), back in February.
Check it out here: Healthy Hormones And How To Hack Them
Want to read more?
Anthea Levi, RD, takes much the same view:
❝For some ‘hormone-balancing’ products, the greatest risk might simply be lost dollars. Others could come at a higher cost.❞
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The Powerful Constraints on Medical Care in Catholic Hospitals Across America
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Nurse midwife Beverly Maldonado recalls a pregnant woman arriving at Ascension Saint Agnes Hospital in Maryland after her water broke. It was weeks before the baby would have any chance of survival, and the patient’s wishes were clear, she recalled: “Why am I staying pregnant then? What’s the point?” the patient pleaded.
But the doctors couldn’t intervene, she said. The fetus still had a heartbeat and it was a Catholic hospital, subject to the “Ethical and Religious Directives for Catholic Health Care Services” that prohibit or limit procedures like abortion that the church deems “immoral” or “intrinsically evil,” according to its interpretation of the Bible.
“I remember asking the doctors. And they were like, ‘Well, the baby still has a heartbeat. We can’t do anything,’” said Maldonado, now working as a nurse midwife in California, who asked them: “What do you mean we can’t do anything? This baby’s not going to survive.”
The woman was hospitalized for days before going into labor, Maldonado said, and the baby died.
Ascension declined to comment for this article.
The Catholic Church’s directives are often at odds with accepted medical standards, especially in areas of reproductive health, according to physicians and other medical practitioners.
The American College of Obstetricians and Gynecologists’ clinical guidelines for managing pre-labor rupture of membranes, in which a patient’s water breaks before labor begins, state that women should be offered options, including ending the pregnancy.
Maldonado felt her patient made her wishes clear.
“Under the ideal medical practice, that patient should be helped to obtain an appropriate method of terminating the pregnancy,” said Christian Pettker, a professor of obstetrics, gynecology, and reproductive sciences at the Yale School of Medicine, who helped author the guidelines.
He said, “It would be perfectly medically appropriate to do a termination of pregnancy before the cessation of cardiac activity, to avoid the health risks to the pregnant person.”
“Patients are being turned away from necessary care,” said Jennifer Chin, an OB-GYN at UW Medicine in Seattle, because of the “emphasis on these ethical and religious directives.”
They can be a powerful constraint on the care that patients receive at Catholic hospitals, whether emergency treatment when a woman’s health is at risk, or access to birth control and abortions.
More and more women are running into barriers to obtaining care as Catholic health systems have aggressively acquired secular hospitals in much of the country. Four of the 10 largest U.S. hospital chains by number of beds are Catholic, according to federal data from the Agency for Healthcare Research and Quality. There are just over 600 Catholic general hospitals nationally and roughly 100 more managed by Catholic chains that place some religious limits on care, a KFF Health News investigation reveals.
Maldonado’s experience in Maryland came just months before the Supreme Court’s ruling in 2022 to overturn Roe v. Wade, a decision that compounded the impact of Catholic health care restrictions. In its wake, roughly a third of states have banned or severely limited access to abortion, creating a one-two punch for women seeking to prevent pregnancy or to end one. Ironically, some states where Catholic hospitals dominate — such as Washington, Oregon, and Colorado — are now considered medical havens for women in nearby states that have banned abortion.
KFF Health News analyzed state-level birth data to discover that more than half a million babies are born each year in the U.S. in Catholic-run hospitals, including those owned by CommonSpirit Health, Ascension, Trinity Health, and Providence St. Joseph Health. That’s 16% of all hospital births each year, with rates in 10 states exceeding 30%. In Washington, half of all babies are born at such hospitals, the highest share in the country.
“We had many instances where people would have to get in their car to drive to us while they were bleeding, or patients who had had their water bags broken for up to five days or even up to a week,” said Chin, who has treated patients turned away by Catholic hospitals.
Physicians who turned away patients like that “were going against evidence-based care and going against what they had been taught in medical school and residency,” she said, “but felt that they had to provide a certain type of care — or lack of care — just because of the strength of the ethical and religious directives.”
Following religious mandates can be dangerous, Chin and other clinicians said.
When a patient has chosen to end a pregnancy after the amniotic sac — or water — has broken, Pettker said, “any delay that might be added to a procedure that is inevitably going to happen places that person at risk of serious, life-threatening complications,” including sepsis and organ infection.
Reporters analyzed American Hospital Association data as of August and used Catholic Health Association directories, news reports, government documents, and hospital websites and other materials to determine which hospitals are Catholic or part of Catholic systems, and gathered birth data from state health departments and hospital associations. They interviewed patients, medical providers, academic experts, advocacy organizations, and attorneys, and reviewed hundreds of pages of court and government records and guidance from Catholic health institutions and authorities to understand how the directives affect patient care.
Nationally, nearly 800,000 people have only Catholic or Catholic-affiliated birth hospitals within an hour’s drive, according to KFF Health News’ analysis. For example, that’s true of 1 in 10 North Dakotans. In South Dakota, it’s 1 in 20. When care is more than an hour away, academic researchers often define the area as a hospital desert. Pregnant women who must drive farther to a delivery facility are at higher risk of harm to themselves or their fetus, research shows.
Many Americans don’t have a choice — non-Catholic hospitals are too far to reach in an emergency or aren’t in their insurance networks. Ambulances may take patients to a Catholic facility without giving them a say. Women often don’t know that hospitals are affiliated with the Catholic Church or that they restrict reproductive care, academic research suggests.
And, in most of the country, state laws shield at least some hospitals from lawsuits for not performing procedures they object to on religious grounds, leaving little recourse for patients who were harmed because care was withheld. Thirty-five states prevent patients from suing hospitals for not providing abortions, including 25 states where abortion remains broadly legal. About half of those laws don’t include exceptions for emergencies, ectopic pregnancies, or miscarriages. Sixteen states prohibit lawsuits against hospitals for refusing to perform sterilization procedures.
“It’s hard for the ordinary citizen to understand, ‘Well, what difference does it make if my hospital is bought by this other big health system, as long as it stays open? That’s all I care about,’” said Erin Fuse Brown, who is the director of the Center for Law, Health & Society at Georgia State University and an expert in health care consolidation. Catholic directives also ban medical aid in dying for terminally ill patients.
People “may not realize that they’re losing access to important services, like reproductive health [and] end-of-life care,” she said.
‘Our Faith-Based Health Care Ministry’
After the Supreme Court ended the constitutional right to abortion in June 2022, Michigan resident Kalaina Sullivan wanted surgery to permanently prevent pregnancy.
Michigan voters in November that year enshrined the right to abortion under the state constitution, but the state’s concentration of Catholic hospitals means people like Sullivan sometimes still struggle to obtain reproductive health care.
Because her doctor worked for the Catholic chain Trinity Health, the nation’s fourth-largest hospital system, she had the surgery with a different doctor at North Ottawa Community Health System, an independent hospital near the shores of Lake Michigan.
Less than two months later, that, too, became a Catholic hospital, newly acquired by Trinity.
To mark the transition, Cory Mitchell, who at the time was the mission leader of Trinity Health Muskegon, stood before his new colleagues and offered a blessing.
“The work of your hands is what makes our faith-based health care ministry possible,” he said, according to a video of the ceremony Trinity Health provided to KFF Health News. “May these hands continue to bring compassion, compassion and healing, to all those they touch.”
Trinity Health declined to answer detailed questions about its merger with North Ottawa Community Health System and the ethical and religious directives. “Our commitment to high-quality, compassionate care means informing our patients of all appropriate care options, and trusting and supporting our physicians to make difficult and medically necessary decisions in the best interest of their patients’ health and safety,” spokesperson Jennifer Amundson said in an emailed statement. “High-quality, safe care is critical for the women in our communities and in cases where a non-critical service is not available at our facility, the physician will transfer care as appropriate.”
Leaders in Catholic-based health systems have hammered home the importance of the church’s directives, which are issued by the U.S. Conference of Catholic Bishops, all men, and were first drafted in 1948. The essential view on abortion is as it was in 1948. The last revision, in 2018, added several directives addressing Catholic health institution acquisitions or mergers with non-Catholic ones, including that “whatever comes under control of the Catholic institution — whether by acquisition, governance, or management — must be operated in full accord with the moral teaching of the Catholic Church.”
“While many of the faithful in the local church may not be aware of these requirements for Catholic health care, the local bishop certainly is,” wrote Sister Doris Gottemoeller, a former board member of the Bon Secours Mercy Health system, in a 2023 Catholic Health Association journal article. “In fact, the bishop should be briefed on a regular basis about the hospital’s activities and strategies.”
Now, for care at a non-Catholic hospital, Sullivan would need to travel nearly 30 miles.
“I don’t see why there’s any reason for me to have to follow the rules of their religion and have that be a part of what’s going on with my body,” she said.
Risks Come With Religion
Nathaniel Hibner, senior director of ethics at the Catholic Health Association, said the ethical and religious directives allow clinicians to provide medically necessary treatments in emergencies. In a pregnancy crisis when a person’s life is at risk, “I do not believe that the ERDs should restrict the physician in acting in the way that they see medically indicated.”
“Catholic health care is committed to the health of all women and mothers who enter into our facilities,” Hibner said.
The directives permit care to cure “a proportionately serious pathological condition of a pregnant woman” even if it would “result in the death of the unborn child.” Hibner demurred when asked who defines what that means and when such care is provided, saying, “for the most part, the physician and the patients are the ones that are having a conversation and dialogue with what is supposed to be medically appropriate.”
It is common for practitioners at any hospital to consult an ethics board about difficult cases — such as whether a teenager with cancer can decline treatment. At Catholic hospitals, providers must ask a board for permission to perform procedures restricted by the religious directives, clinicians and researchers say. For example, could an abortion be performed if a pregnancy threatened the mother’s life?
How and when an ethics consultation occurs depends on the hospital, Hibner said. “That ethics consultation can be initiated by anyone involved in the direct care of that situation — the patient, the surrogate of that patient, the physician, the nurse, the social worker all have the ability to request a consultation,” he said. When asked whether a consultation with an ethics board can occur without a request, he said “sometimes it could.”
How strictly directives are followed can depend on the hospital and the views of the local bishop.
“If the hospital has made a difficult decision about a critical pregnancy or an end-of-life care situation, the bishop should be the first to know about it,” Gottemoeller wrote.
In an interview, Gottemoeller said that even when pregnancy termination decisions are made on sound ethical grounds, not informing the bishop puts him in a bad position and hurts the church. “If there’s a possibility of it being misunderstood, or misinterpreted, or criticized,” Gottemoeller said, the bishop should understand what happened and why “before the newspapers call him and ask him for an opinion.”
“And if he has to say, ‘Well, I think you made a mistake,’ well, all right,” she said. “But don’t let him be blindsided. I mean, we’re one church and the bishop has pastoral concern over everything in his diocese.”
Katherine Parker Bryden, a nurse midwife in Iowa who works for MercyOne, said she regularly tells pregnant patients that the hospital cannot perform tubal sterilization surgery, to prevent future pregnancies, or refer patients to other hospitals that do. MercyOne is one of the largest health systems in Iowa. Nearly half of general hospitals in the state are Catholic or Catholic-affiliated — the highest share among all states.
The National Catholic Bioethics Center, an ethics authority for Catholic health institutions, has said that referrals for care that go against church teaching would be “immoral.”
“As providers, you’re put in this kind of moral dilemma,” Parker Bryden said. “Am I serving my patients or am I serving the archbishop and the pope?”
In response to questions, MercyOne spokesperson Eve Lederhouse said in an email that its providers “offer care and services that are consistent with the guidelines of a Catholic health system.”
Maria Rodriguez, an OB-GYN professor at Oregon Health & Science University, said that as a resident in the early 2000s at a Catholic hospital she was able to secure permission — what she calls a “pope note” — to sterilize some patients with conditions such as gestational diabetes.
Annie Iriye, a retired OB-GYN in Washington state, said that more than a decade ago she sought permission to administer medication to hasten labor for a patient experiencing a second-trimester miscarriage at a Catholic hospital. She said she was told no because the fetus had a heartbeat. The patient took 10 hours to deliver — time that would have been cut by half, Iriye said, had she been able to follow her own medical training and expertise. During that time, she said, the patient developed an infection.
Iriye and Chin were part of an effort by reproductive rights groups and medical organizations that pushed for a state law to protect physicians if they act against Catholic hospital restrictions. The bill, which Washington enacted in 2021, was opposed by the Washington State Hospital Association, whose membership includes multiple large Catholic health systems.
State lawmakers in Oregon in 2021 enacted legislation that beefed up powers to reject health care mergers if they would reduce access to the types of care constrained by Catholic directives. The hospital lobby has sued to block the statute. Washington state lawmakers introduced similar legislation last year, which the hospital association opposes.
Hibner said Catholic hospitals are committed to instituting systemic changes that improve maternal and child health, including access to primary, prenatal, and postpartum care. “Those are the things that I think rural communities really need support and advocacy for,” he said.
Maldonado, the nurse midwife, still thinks of her patient who was forced to stay pregnant with a baby who could not survive. “To feel like she was going to have to fight to have an abortion of a baby that she wanted?” Maldonado said. “It was just horrible.”
KFF Health News data editor Holly K. Hacker contributed to this report.
Click to open the methodology Methodology
By Hannah Recht
KFF Health News identified areas of the country where patients have only Catholic hospital options nearby. The “Ethical and Religious Directives for Catholic Health Care Services” — which are issued by the U.S. Conference of Catholic Bishops, all men — dictate how patients receive reproductive care at Catholic health facilities. In our analysis, we focused on hospitals where babies are born.
We constructed a national database of hospital locations, identified which ones are Catholic or Catholic-affiliated, found how many babies are born at each, and calculated how many people live near those hospitals.
Hospital Universe
We identified hospitals in the 50 states and the District of Columbia using the American Hospital Association database from August 2023. We removed hospitals that had closed or were listed more than once, added hospitals that were not included, and corrected inaccurate or out-of-date information about ownership, primary service type, and location. We excluded federal hospitals, such as military and Indian Health Service facilities, because they are not open to everyone.
Catholic Affiliation
To identify Catholic hospitals, we used the Catholic Health Association’s member directory. We also counted as Catholic a handful of hospitals that are not part of this voluntary membership group but explicitly follow the Ethical and Religious Directives, according to their mission statements, websites, or promotional materials.
We also tracked Catholic-affiliated hospitals: those that are owned or managed by a Catholic health system, such as CommonSpirit Health or Trinity Health, and are influenced by the religious directives but do not necessarily adhere to them in full. To identify Catholic-affiliated hospitals, we consulted health system and hospital websites, government documents, and news reports.
We combined both Catholic and Catholic-affiliated hospitals for analysis, in line with previous research about the influence of Catholic directives on health care.
Births
To determine the share of births that occur at Catholic or Catholic-affiliated hospitals, we gathered the latest annual number of births by hospital from state health departments. Where recent data was not publicly available, we submitted records requests for the most recent complete year available.
The resulting data covered births in 2022 for nine states and D.C., births in 2021 for 23 states, births in 2020 for nine states, and births in 2019 for one state. We used data from the 2021 American Hospital Association survey, the latest available at the time of analysis, for the eight remaining states that did not provide birth data in response to our requests. A small number of hospitals have recently opened or closed labor and delivery units. The vast majority of the rest record about the same number of births each year. This means that the results would not be substantially different if data from 2023 were available.
We used this data to calculate the number of babies born in Catholic and Catholic-affiliated hospitals, as well as non-Catholic hospitals by state and nationally.
We used hospitals’ Catholic status as of August 2023 in this analysis. In 10 cases where the hospital had already closed, we used Catholic status at the time of the closure.
Because our analysis focuses on hospital care, we excluded births that occurred in non-hospital settings, such as homes and stand-alone birth centers, as well as federal hospitals.
Several states suppressed data from hospitals with fewer than 10 births due to privacy restrictions. Because those numbers were so low, this suppression had a negligible effect on state-level totals.
Drive-Time Analysis
We obtained hospitals’ geographic coordinates based on addresses in the AHA dataset using HERE’s geocoder. For addresses that could not be automatically geocoded with a high degree of certainty, we verified coordinates manually using hospital websites and Google Maps.
We calculated the areas within 30, 60, and 90 minutes of travel time from each birth hospital that was open in August 2023 using tools from HERE. We included only hospitals that had 10 or more births as a proxy for hospitals that have labor and delivery units, or where births regularly occur.
The analysis focused on the areas with hospitals within an hour’s drive. Researchers often define hospital deserts as places where one would have to drive an hour or more for hospital care. (For example: [1] “Disparities in Access to Trauma Care in the United States: A Population-Based Analysis,” [2] “Injury-Based Geographic Access to Trauma Centers,” [3] “Trends in the Geospatial Distribution of Inpatient Adult Surgical Services Across the United States,” [4] “Access to Trauma Centers in the United States.”)
We combined the drive-time areas to see which areas of the United States have only Catholic or Catholic-affiliated birth hospitals nearby, both Catholic and non-Catholic, non-Catholic only, or none. We then joined these areas to the 2021 census block group shapefile from IPUMS NHGIS and removed water bodies using the U.S. Geological Survey’s National Hydrography Dataset to calculate the percentage of each census block group that falls within each hospital access category. We calculated the number of people in each area using the 2021 “American Community Survey” block group population totals. For example, if half of a block group’s land area had access to only Catholic or Catholic-affiliated hospitals, then half of the population was counted in that category.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
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Treat Your Own Knee – by Robin McKenzie
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
First, a note about the author: he’s a physiotherapist and not a doctor, but with 40 years of practice to his name and 33 letters after his name (CNZM OBE FCSP (Hon) FNZSP (Hon) Dip MDT Dip MT), he seems to know his stuff.
The book covers recognizing the difference between arthritis, degeneration, or normal wear and tear, before narrowing down what your actual problem is and what can be done about it.
While there are many possible causes of knee pain (and by causes, we mean the first-level cause, such as “bad posture” or “old sports injury” or “inflammatory diet” or “repetitive strain” etc, not second-level causes that are also symptoms, like inflammation), McKenzie’s approach involves customizing his system to your body’s specific problems and needs. That’s what most of the book is about.
The style is direct and to-the-point; there’s no sensationalization here nor a feel of being sold anything. There’s lots of science scattered throughout, but all with the intent of enabling the reader to understand what’s going on with the problems, processes, and solutions, and why/how the things that work, work. Where there are exercises offered they are clearly-described and well-illustrated.
Bottom line: this is not a fancy book but it is an effective one. If you have knee pain, this is a very worthwhile one to read.
Click here to check out Treat Your Own Knee, and treat your own knee!
PS: if you have musculoskeletal problems elsewhere in your body, you might want to check out the rest of his body parts series (back, hip, neck, wrist, ankle, etc) for the one that’s tailored to your specific problem.
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