Working Smarter < Working Brighter!
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When it comes to working smarter, not harder, there’s plenty of advice and honestly, it’s mostly quite sensible. For example:
(Nice to see they featured a method we talked about last week—great minds!)
But, as standards of productivity rise, the goalposts get moved too, and the treadmill just keeps on going…
- 49% of entrepreneurs say they’ve struggled with some kind of mental illness
- Millennial women are one of the workforce groups at the highest risk of anxiety
- About 7 in 10 millennials experience burnout at work
Not that these things are confined to Millennials, by any stretch, but Millennials make up a huge portion of working people. Ideally, this age group should be able to bring the best of both worlds to the workplace by combining years of experience with youthful energy.
So clearly something is going wrong; the question is: what can be done about it?
Workers of the World, Unwind
A knee-jerk response might be “work to rule”—a tactic long-used by disgruntled exploited workers to do no more than the absolute minimum required to not get fired. And it’s arguably better for them than breaking themselves at work, but that’s not exactly enriching, is it?
This is Brittany Berger, founder of “Work Brighter”.
She’s a content marketing consultant, mental health advocate, and (in her words) a highly ridiculous human who always has a pop culture reference at the ready.
What, besides pop culture references, is she bringing to the table? What is Working Brighter?
❝Working brighter means going beyond generic “work smarter” advice on the internet and personalizing it to work FOR YOU. It means creating your own routines for work, productivity, and self-care.❞
Brittany Berger
Examples of working brighter include…
Asking:
- What would your work involve, if it were more fun?
- How can you make your work more comfortable for you?
- What changes could you make that would make your work more sustainable (i.e., to avoid burnout)?
Remembering:
- Mental health is just health
- Self-care is a “soft skill”
- Rest is work when it’s needed
This is not one of those “what workers really want is not more pay, it’s beanbags” things, by the way (but if you want a beanbag, then by all means, get yourself a beanbag).
It’s about making time to rest, it’s about having the things that make you feel good while you’re working, and making sure you can enjoy working. You’re going to spend a lot of your life doing it; you might as well enjoy it.
❝Nobody goes to their deathbed wishing they’d spent more time at the office❞
Anon
On the contrary, having worked too hard is one of the top reported regrets of the dying!
Article: The Top Five Regrets Of The Dying
And no, they don’t wish they’d “worked smarter, not harder”. They wish (also in the above list, in fact) that they’d had the courage to live a life more true to themselves.
You can do that in your work. Whatever your work is. And if your work doesn’t permit that (be it the evil boss trope, or even that you are the boss and your line of work just doesn’t work that way), time to change that up. Stop focusing on what you can’t do, and look for what you can do.
Spoiler: you can have a blast just trying things out!
That doesn’t mean you should quit your job, or replace your PC with a Playstation, or whatever.
It just means that you deserve comfort and happiness while working, and around your work!
Need a helping hand getting started?
- Create your own self-care plan to avoid burnout
- ⏳ Complete your first “time audit”
- ❣️ Zip through to self-awareness with bullet-journalling
Like A Boss
And pssst, if you’re a business-owner who is thinking “but I have quotas to meet”, your customers are going to love your staff being happier, and will enjoy their interactions with your company much more. Or if your staff aren’t customer-facing, then still, they’ll work better when they enjoy doing it. This isn’t rocket science, but all too many companies give a cursory nod to it before proceeding to ignore it for the rest of the life of the company.
So where do you start, if you’re in those particular shoes?
Read on…
*straightens tie because this is the serious bit* —just kidding, I’m wearing my comfiest dress and fluffy-lined slipper-socks. But that makes this absolutely no less serious:
The Institute for Health and Productivity Management (IHPM) and WorkPlace Wellness Alliance (WPWA) might be a good place to get you on the right track!
❝IHPM/WPWA is a global nonprofit enterprise devoted to establishing the full economic value of employee health as a business asset—a neglected investment in the increased productivity of human capital.
IHPM helps employers identify the full economic cost impact of employee health issues on business performance, design and implement the best programs to reduce this impact by improving functional health and productivity, and measure the success of their efforts in financial terms.❞
The Institute for Health and Productivity Management
They offer courses and consultations, but they also have free downloadables and videos, which are awesome and in many cases may already be enough to seriously improve things for your business already:
Check Out IHPM’s Resources Here!
What can you do to make your working life better for you? We’d love to hear about any changes you make inspired by Brittany’s work—you can always just hit reply, and we’re always glad to hear from you!
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The Brain Alarm Signs That Warn Of Dementia
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.
When it comes to predicting age-related cognitive impairment:
First there are genetic factors to take into account (such as the APOE4 gene for Alzheimer’s), as well as things such as age and sex.
When it comes to sex, by the way, what matters here is hormones, which is why [it seems; this as technically as yet unproven with full rigor, but the hypothesis is sound and there is a body of evidence gradually being accumulated to support it] postmenopausal women with untreated menopause get Alzheimer’s at a higher rate and deteriorate more quickly:
Alzheimer’s Sex Differences May Not Be What They Appear
Next, there are obviously modifiable lifestyle factors to take into account, things that will reduce your risk such as getting good sleep, good diet, good exercise, and abstaining from alcohol and smoking, as well as oft-forgotten things such as keeping cognitively active and, equally importantly, socially active:
How To Reduce Your Alzheimer’s Risk
(the article outlines what matters the most in each of the above areas, by the way, so that you can get the most bang-for-buck in terms of lifestyle adjustments)
Lastly (in the category of risk factors), there are things to watch out for in the blood such as hypertension and high cholesterol.
Nipping it in the blood
In new research (so new it is still ongoing, but being at year 2 of a 4-year prospective study, they have published a paper with their results so far), researchers have:
- started with the premise “dementia is preceded by mild cognitive impairment”
- then, asked the question “what are the biometric signs of mild cognitive impairment?”
Using such tools as functional near-infrared spectroscopy (fNIRS) while the participants performed cognitive tasks, they were able to record changes in plasma levels of extracellular vesicles, assessing them with small-particle flow cytometry.
Translating from sciencese: they gave the participants mental tasks, and while they completed them, the researchers scanned their brains and monitored blood flow and the brain’s ability to compensate for any lack of it.
What they found:
- in young adults, blood flow increased, facilitating neurovascular coupling (this is good)
- in older adults, blood flow did not increase as much, but they engaged other areas of the brain to compensate, by what’s called functional connectivity (this is next best)
- in those with mild cognitive impairment, blood flow was reduced, and they did not have the ability to compensate by functional connectivity (this is not good)
They also performed a liquid biopsy, which sounds alarming but it just means they took some blood, and tested this for density of cerebrovascular endothelial extracellular vesicles (CEEVs), which—in more prosaic words—are bits from the cells lining the blood vessels in the brain.
People with mild cognitive impairment had more of these brain bits in their blood than those without.
You can read the paper itself here:
What this means
The science here is obviously still young (being as it is still in progress), but this will likely contribute greatly to early warning signs of dementia, by catching mild cognitive impairment in its early stages, by means of a simple blood test, instead of years of wondering before getting a dementia diagnosis.
And of course, forewarned is forearmed, so if this is something that could be done as a matter of routine upon hitting the age of, say, 65 and then periodically thereafter, it would catch a lot of cases while there’s still more time to turn things around.
As for how to turn things around, well, we imagine you have now read our “How To Reduce Your Alzheimer’s Risk” article linked up top (if not, we recommend checking it out), and there is also…
Do Try This At Home: The 12-Week Brain Fitness Program To Measurably Boost Your Brain
Take care!
When it comes to predicting age-related cognitive impairment:
First there are genetic factors to take into account (such as the APOE4 gene for Alzheimer’s), as well as things such as age and sex.
When it comes to sex, by the way, what matters here is hormones, which is why [it seems; this as technically as yet unproven with full rigor, but the hypothesis is sound and there is a body of evidence gradually being accumulated to support it] postmenopausal women with untreated menopause get Alzheimer’s at a higher rate and deteriorate more quickly:
Alzheimer’s Sex Differences May Not Be What They Appear
Next, there are obviously modifiable lifestyle factors to take into account, things that will reduce your risk such as getting good sleep, good diet, good exercise, and abstaining from alcohol and smoking, as well as oft-forgotten things such as keeping cognitively active and, equally importantly, socially active:
How To Reduce Your Alzheimer’s Risk
(the article outlines what matters the most in each of the above areas, by the way, so that you can get the most bang-for-buck in terms of lifestyle adjustments)
Lastly (in the category of risk factors), there are things to watch out for in the blood such as hypertension and high cholesterol.
Nipping it in the blood
In new research (so new it is still ongoing, but being at year 2 of a 4-year prospective study, they have published a paper with their results so far), researchers have:
- started with the premise “dementia is preceded by mild cognitive impairment”
- then, asked the question “what are the biometric signs of mild cognitive impairment?”
Using such tools as functional near-infrared spectroscopy (fNIRS) while the participants performed cognitive tasks, they were able to record changes in plasma levels of extracellular vesicles, assessing them with small-particle flow cytometry.
Translating from sciencese: they gave the participants mental tasks, and while they completed them, the researchers scanned their brains and monitored blood flow and the brain’s ability to compensate for any lack of it.
What they found:
- in young adults, blood flow increased, facilitating neurovascular coupling (this is good)
- in older adults, blood flow did not increase as much, but they engaged other areas of the brain to compensate, by what’s called functional connectivity (this is next best)
- in those with mild cognitive impairment, blood flow was reduced, and they did not have the ability to compensate by functional connectivity (this is not good)
They also performed a liquid biopsy, which sounds alarming but it just means they took some blood, and tested this for density of cerebrovascular endothelial extracellular vesicles (CEEVs), which—in more prosaic words—are bits from the cells lining the blood vessels in the brain.
People with mild cognitive impairment had more of these brain bits in their blood than those without.
You can read the paper itself here:
What this means
The science here is obviously still young (being as it is still in progress), but this will likely contribute greatly to early warning signs of dementia, by catching mild cognitive impairment in its early stages, by means of a simple blood test, instead of years of wondering before getting a dementia diagnosis.
And of course, forewarned is forearmed, so if this is something that could be done as a matter of routine upon hitting the age of, say, 65 and then periodically thereafter, it would catch a lot of cases while there’s still more time to turn things around.
As for how to turn things around, well, we imagine you have now read our “How To Reduce Your Alzheimer’s Risk” article linked up top (if not, we recommend checking it out), and there is also…
Do Try This At Home: The 12-Week Brain Fitness Program To Measurably Boost Your Brain
Take care!
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The Science of Self-Learning – by Peter Hollins
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Teaching oneself new things is often the most difficult kind of bootstrapping, especially when one is unsure of such critical things as:
- Where to begin? How, for that matter, do we find where to begin?
- What can/should a learning journey look like?
- What challenges should we expect, and how will we overcome them?
Hollins answers all of these questions and more. The greatest value of this book is perhaps in its clear presentation of concrete step-by-step instructions. Hollins gives illustrated examples too, but most importantly, he gives models that can be applied to any given type of learning.
The book also covers the most difficult problems most people face when trying to learn something by themselves, including:
- Keeping oneself on-task (maintaining discipline)
- Measuring progress (self-testing beyond memorization)
- Keeping a fair pace of progress (avoiding plateaus)
- How to know when one’s knowledge is sufficient or not (avoiding Dunning-Kruger Club)
All in all, if you’re looking to learn a new subject or skill, this could be a first step that saves you a lot of time later!
Get your copy of the Science of Self-Learning on Amazon today!
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Hope Not Nope – by Dr. Dillon Caswell
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The author a Doctor of Physical Therapy, writes from both professional expertise and personal experience, when it comes to the treatment of long term injury / disability / chronic illness.
His position here is that while suffering is unavoidable, we don’t have to suffer as much or as long as many might tell us. We can do things to crawl and claw our way to a better position, and we do not have to settle for any outcome we don’t want. That doesn’t mean there’s always a miracle cure—we don’t get to decide that—but we do get to decide whether we keep trying.
Dr. Caswell’s advice is based mostly in psychology—a lot of it in sports psychology, which is no surprise given his long history as an athlete as well as his medical career.
The style is very easy-reading, and a combination of explanation, illustrative (often funny) anecdotes, and a backbone of actual research to keep everything within the realms of science rather than mere wishful thinking—he strikes a good balance.
Bottom line: if your current health outlook is more of an uphill marathon, then this book can give you the tools to carry yourself through the healthcare system that’s been made for numbers, not people.
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Grains: Bread Of Life, Or Cereal Killer?
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Going Against The Grain?
In Wednesday’s newsletter, we asked you for your health-related opinion of grains (aside from any gluten-specific concerns), and got the above-depicted, below-described, set of responses:
- About 69% said “They are an important cornerstone of a healthy balanced diet”
- About 22% said “They can be enjoyed in moderation, but watch out”
- About 8% said “They are terrible health-drainers that will kill us”
So, what does the science say?
They are terrible health-drainers that will kill us: True or False?
True or False depending on the manner of their consumption!
There is a big difference between the average pizza base and a bowl of oats, for instance. Or rather, there are a lot of differences, but what’s most critical here?
The key is: refined and ultraprocessed grains are so inferior to whole grains as to be actively negative for health in most cases for most people most of the time.
But! It’s not because processing is ontologically evil (in reality: some processed foods are healthy, and some unprocessed foods are poisonous). although it is a very good general rule of thumb.
So, we need to understand the “why” behind the “key” that we just gave above, and that’s mostly about the resultant glycemic index and associated metrics (glycemic load, insulin index, etc).
In the case of refined and ultraprocessed grains, our body gains sugar faster than it can process it, and stores it wherever and however it can, like someone who has just realised that they will be entertaining a houseguest in 10 minutes and must tidy up super-rapidly by hiding things wherever they’ll fit.
And when the body tries to do this with sugar from refined grains, the result is very bad for multiple organs (most notably the liver, but the pancreas takes quite a hit too) which in turn causes damage elsewhere in the body, not to mention that we now have urgently-produced fat stored in unfortunate places like our liver and abdominal cavity when it should have gone to subcutaneous fat stores instead.
In contrast, whole grains come with fiber that slows down the absorption of the sugars, such that the body can deal with them in an ideal fashion, which usually means:
- using them immediately, or
- storing them as muscle glycogen, or
- storing them as subcutaneous fat
👆 that’s an oversimplification, but we only have so much room here.
For more on this, see:
Glycemic Index vs Glycemic Load vs Insulin Index
And for why this matters, see:
Which Sugars Are Healthier, And Which Are Just The Same?
And for fixing it, see:
They can be enjoyed in moderation, but watch out: True or False?
Technically True but functionally False:
- Technically true: “in moderation” is doing a lot of heavy lifting here. One person’s “moderation” may be another person’s “abstemiousness” or “gluttony”.
- Functionally false: while of course extreme consumption of pretty much anything is going to be bad, unless you are Cereals Georg eating 10,000 cereals each day and being a statistical outlier, the issue is not the quantity so much as the quality.
Quality, we discussed above—and that is, as we say, paramount. As for quantity however, you might want to know a baseline for “getting enough”, so…
They are an important cornerstone of a healthy balanced diet: True or False?
True! This one’s quite straightforward.
3 servings (each being 90g, or about ½ cup) of whole grains per day is associated with a 22% reduction in risk of heart disease, 5% reduction in all-cause mortality, and a lot of benefits across a lot of disease risks:
❝This meta-analysis provides further evidence that whole grain intake is associated with a reduced risk of coronary heart disease, cardiovascular disease, and total cancer, and mortality from all causes, respiratory diseases, infectious diseases, diabetes, and all non-cardiovascular, non-cancer causes.
These findings support dietary guidelines that recommend increased intake of whole grain to reduce the risk of chronic diseases and premature mortality.❞
~ Dr. Dagfinn Aune et al.
We’d like to give a lot more sources for the same findings, as well as papers for all the individual claims, but frankly, there are so many that there isn’t room. Suffice it to say, this is neither controversial nor uncertain; these benefits are well-established.
Here’s a very informative pop-science article, that also covers some of the things we discussed earlier (it shows what happens during refinement of grains) before getting on to recommendations and more citations for claims than we can fit here:
Harvard School Of Public Health | Whole Grains
“That’s all great, but what if I am concerned about gluten?”
There certainly are reasons you might be, be it because of a sensitivity, allergy, or just because perhaps you’d like to know more.
Let’s first mention: not all grains contain gluten, so it’s perfectly possible to enjoy naturally gluten-free grains (such as oats and rice) as well as gluten-free pseudocereals, which are not actually grains but do the same job in culinary and nutritional terms (such as quinoa and buckwheat, despite the latter’s name).
Finally, if you’d like to know more about gluten’s health considerations, then check out our previous mythbusting special:
Enjoy!
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Breathe; Don’t Vent (At Least In The Moment)
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Zen And The Art Of Breaking Things
We’ve talked before about identifying emotions and the importance of being able to express them:
Answering The Most Difficult Question: How Are You?
However, there can be a difference between “expressing how we feel” and “being possessed by how we feel and bulldozing everything in our path”
…which is, of course, primarily a problem in the case of anger—and by extension, emotions that are often contemporaneous with anger, such as jealousy, shame, fear, etc.
How much feeling is too much?
While this is in large part a subjective matter, clinically speaking the key question is generally: is it adversely affecting daily life to the point of being a problem?
For example, if you have to spend half an hour every day actively managing a certain emotion, that’s probably indicative of something unusual, but “unusual” is not inherently bad. If you’re managing it safely and in a way that doesn’t negatively affect the rest of your life, then that is generally considered fine, unless you feel otherwise about it.
A good example of this is complicated grief and/or prolonged grief.
But what about when it comes to anger? How much is ok?
When it comes to those around you, any amount of anger can seem like too much. Anger often makes us short-tempered even with people who are not the object of our anger, and it rarely brings out the best in us.
We can express our feelings in non-aggressive ways, for example:
and
Seriously Useful Communication Skills!
Sometimes, there’s another way though…
Breathe; don’t vent
That’s a great headline, but we can’t take the credit for it, because it came from:
Breathe, don’t vent: turning down the heat is key to managing anger
…in which it was found that, by all available metrics, the popular wisdom of “getting it off your chest” doesn’t necessarily stand up to scrutiny, at least in the short term:
❝The work was inspired in part by the rising popularity of rage rooms that promote smashing things (such as glass, plates and electronics) to work through angry feelings.
I wanted to debunk the whole theory of expressing anger as a way of coping with it,” she said. “We wanted to show that reducing arousal, and actually the physiological aspect of it, is really important.❞
And indeed, he and his team did find that various arousal-increasing activities (such as hitting a punchbag, breaking things, doing vigorous exercise) did not help as much as arousal-decreasing activities, such as mindfulness-based relaxation techniques.
If you’d like to read the full paper, then so would we, but we couldn’t get full access to this one yet. However, the abstract includes representative statistics, so that’s worth a once-over:
Caveat!
Did you notice the small gap between their results and their conclusion?
In a lab or similar short-term observational setting, their recommendation is clearly correct.
However, if the source of your anger is something chronic and persistent, it could well be that calming down without addressing the actual cause is just “kicking the can down the road”, and will still have to actually be dealt with eventually.
So, while “here be science”, it’s not a mandate for necessarily suffering in silence. It’s more about being mindful about how we go about tackling our anger.
As for a primer on mindfulness, feel free to check out:
No-Frills, Evidence-Based Mindfulness
Take care!
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Learn to Age Gracefully
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Their First Baby Came With Medical Debt. These Illinois Parents Won’t Have Another.
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JACKSONVILLE, Ill. — Heather Crivilare was a month from her due date when she was rushed to an operating room for an emergency cesarean section.
The first-time mother, a high school teacher in rural Illinois, had developed high blood pressure, a sometimes life-threatening condition in pregnancy that prompted doctors to hospitalize her. Then Crivilare’s blood pressure spiked, and the baby’s heart rate dropped. “It was terrifying,” Crivilare said.
She gave birth to a healthy daughter. What followed, though, was another ordeal: thousands of dollars in medical debt that sent Crivilare and her husband scrambling for nearly a year to keep collectors at bay.
The Crivilares would eventually get on nine payment plans as they juggled close to $5,000 in bills.
“It really felt like a full-time job some days,” Crivilare recalled. “Getting the baby down to sleep and then getting on the phone. I’d set up one payment plan, and then a new bill would come that afternoon. And I’d have to set up another one.”
Crivilare’s pregnancy may have been more dramatic than most. But for millions of new parents, medical debt is now as much a hallmark of having children as long nights and dirty diapers.
About 12% of the 100 million U.S. adults with health care debt attribute at least some of it to pregnancy or childbirth, according to a KFF poll.
These people are more likely to report they’ve had to take on extra work, change their living situation, or make other sacrifices.
Overall, women between 18 and 35 who have had a baby in the past year and a half are twice as likely to have medical debt as women of the same age who haven’t given birth recently, other KFF research conducted for this project found.
“You feel bad for the patient because you know that they want the best for their pregnancy,” said Eilean Attwood, a Rhode Island OB-GYN who said she routinely sees pregnant women anxious about going into debt.
“So often, they may be coming to the office or the hospital with preexisting debt from school, from other financial pressures of starting adult life,” Attwood said. “They are having to make real choices, and what those real choices may entail can include the choice to not get certain services or medications or what may be needed for the care of themselves or their fetus.”
Best-Laid Plans
Crivilare and her husband, Andrew, also a teacher, anticipated some of the costs.
The young couple settled in Jacksonville, in part because the farming community less than two hours north of St. Louis was the kind of place two public school teachers could afford a house. They saved aggressively. They bought life insurance.
And before Crivilare got pregnant in 2021, they enrolled in the most robust health insurance plan they could, paying higher premiums to minimize their deductible and out-of-pocket costs.
Then, two months before their baby was due, Crivilare learned she had developed preeclampsia. Her pregnancy would no longer be routine. Crivilare was put on blood pressure medication, and doctors at the local hospital recommended bed rest at a larger medical center in Springfield, about 35 miles away.
“I remember thinking when they insisted that I ride an ambulance from Jacksonville to Springfield … ‘I’m never going to financially recover from this,’” she said. “‘But I want my baby to be OK.’”
For weeks, Crivilare remained in the hospital alone as covid protocols limited visitors. Meanwhile, doctors steadily upped her medications while monitoring the fetus. It was, she said, “the scariest month of my life.”
Fear turned to relief after her daughter, Rita, was born. The baby was small and had to spend nearly two weeks in the neonatal intensive care unit. But there were no complications. “We were incredibly lucky,” Crivilare said.
When she and Rita finally came home, a stack of medical bills awaited. One was already past due.
Crivilare rushed to set up payment plans with the hospitals in Jacksonville and Springfield, as well as the anesthesiologist, the surgeon, and the labs. Some providers demanded hundreds of dollars a month. Some settled for monthly payments of $20 or $25. Some pushed Crivilare to apply for new credit cards to pay the bills.
“It was a blur of just being on the phone constantly with all the different people collecting money,” she recalled. “That was a nightmare.”
Big Bills, Big Consequences
The Crivilares’ bills weren’t unusual. Parents with private health coverage now face on average more than $3,000 in medical bills related to a pregnancy and childbirth that aren’t covered by insurance, researchers at the University of Michigan found.
Out-of-pocket costs are even higher for families with a newborn who needs to stay in a neonatal ICU, averaging $5,000. And for 1 in 11 of these families, medical bills related to pregnancy and childbirth exceed $10,000, the researchers found.
“This forces very difficult trade-offs for families,” said Michelle Moniz, a University of Michigan OB-GYN who worked on the study. “Even though they have insurance, they still have these very high bills.”
Nationwide polls suggest millions of these families end up in debt, with sometimes devastating consequences.
About three-quarters of U.S. adults with debt related to pregnancy or childbirth have cut spending on food, clothing, or other essentials, KFF polling found.
About half have put off buying a home or delayed their own or their children’s education.
These burdens have spurred calls to limit what families must pay out-of-pocket for medical care related to pregnancy and childbirth.
In Massachusetts, state Sen. Cindy Friedman has proposed legislation to exempt all these bills from copays, deductibles, and other cost sharing. This would parallel federal rules that require health plans to cover recommended preventive services like annual physicals without cost sharing for patients. “We want … healthy children, and that starts with healthy mothers,” Friedman said. Massachusetts health insurers have warned the proposal will raise costs, but an independent state analysis estimated the bill would add only $1.24 to monthly insurance premiums.
Tough Lessons
For her part, Crivilare said she wishes new parents could catch their breath before paying down medical debt.
“No one is in the right frame of mind to deal with that when they have a new baby,” she said, noting that college graduates get such a break. “When I graduated with my college degree, it was like: ‘Hey, new adult, it’s going to take you six months to kind of figure out your life, so we’ll give you this six-month grace period before your student loans kick in and you can get a job.’”
Rita is now 2. The family scraped by on their payment plans, retiring the medical debt within a year, with help from Crivilare’s side job selling resources for teachers online.
But they are now back in debt, after Rita’s recurrent ear infections required surgery last year, leaving the family with thousands of dollars in new medical bills.
Crivilare said the stress has made her think twice about seeing a doctor, even for Rita. And, she added, she and her husband have decided their family is complete.
“It’s not for us to have another child,” she said. “I just hope that we can put some of these big bills behind us and give [Rita] the life that we want to give her.”
About This Project
“Diagnosis: Debt” is a reporting partnership between KFF Health News and NPR exploring the scale, impact, and causes of medical debt in America.
The series draws on original polling by KFF, court records, federal data on hospital finances, contracts obtained through public records requests, data on international health systems, and a yearlong investigation into the financial assistance and collection policies of more than 500 hospitals across the country.
Additional research was conducted by the Urban Institute, which analyzed credit bureau and other demographic data on poverty, race, and health status for KFF Health News to explore where medical debt is concentrated in the U.S. and what factors are associated with high debt levels.
The JPMorgan Chase Institute analyzed records from a sampling of Chase credit card holders to look at how customers’ balances may be affected by major medical expenses. And the CED Project, a Denver nonprofit, worked with KFF Health News on a survey of its clients to explore links between medical debt and housing instability.
KFF Health News journalists worked with KFF public opinion researchers to design and analyze the “KFF Health Care Debt Survey.” The survey was conducted Feb. 25 through March 20, 2022, online and via telephone, in English and Spanish, among a nationally representative sample of 2,375 U.S. adults, including 1,292 adults with current health care debt and 382 adults who had health care debt in the past five years. The margin of sampling error is plus or minus 3 percentage points for the full sample and 3 percentage points for those with current debt. For results based on subgroups, the margin of sampling error may be higher.
Reporters from KFF Health News and NPR also conducted hundreds of interviews with patients across the country; spoke with physicians, health industry leaders, consumer advocates, debt lawyers, and researchers; and reviewed scores of studies and surveys about medical debt.
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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