Healthbeat

Michigan cyclospora outbreak reveals strains on U.S. public health system

2026-08-25T15:00:55+00:00

As the number of people stricken with cyclospora infections across the U.S. finally seems to be winding down, I recently spoke with Dr. Natasha Bagdasarian, the chief medical executive for the state of Michigan, about the challenges her state has faced investigating the outbreak.

Michigan — where the state health department has confirmed more than 14,000 cases of infected people across the state, including hundreds of hospitalizations and two rare deaths — seems to be the outbreak’s epicenter based on case counts.

At its height, Bagdasarian said:

About 400 cases a day were being reported.
Health systems couldn’t keep testing supplies stocked.
Labs were backlogged.
Some healthcare systems restricted testing to hospitalized and immunocompromised patients.

Yet those were only some of the challenges.

The cyclospora outbreak also revealed disconnects in how the U.S. public health system — operating with reduced funding, fewer people and strained federal-state coordination — currently responds when confronted with a massive outbreak, according to what Bagdasarian told Healthbeat.

Click here to continue reading.

Alison Young is Healthbeat’s senior national reporter. You can reach her at ayoung@healthbeat.org or through the messaging app Signal at alisonyoungreports.48

Second baby formula recall linked to botulism raises questions about safety, oversight

2026-06-15T20:57:35+00:00

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When ByHeart infant formula was linked to a nationwide outbreak of infant botulism last fall, the company encouraged its customers to switch to another premium whole milk formula made by Nara Organics.

Now Nara Organics, which has promoted the “thousands of tests” it runs on every formula batch, is recalling all of its whole milk organic powdered infant formula after the Centers for Disease Control and Prevention linked it to three babies being hospitalized with infant botulism.

The CDC and the U.S. Food and Drug Administration are urging parents and caregivers to immediately stop using Nara Organics Whole Milk Organic Infant formula, which is sold at Target and online. Parents should seek immediate care for their infant if they have symptoms such as poor feeding, loss of head control, difficult swallowing, or decreased facial expression.

Nara Organics organic infant formula. Lot code is found on the bottom of each can. Lot code is outlined in white in the above image

The Nara Organics recall, which follows ByHeart’s recall in November, marks the second time in seven months that a premium organic whole milk infant formula has been linked to an outbreak of infant botulism. The recalls have fueled concerns among parents about the safety of infant formula and the effectiveness of federal oversight.

“Two outbreaks in less than a year show that ByHeart was not a unique accident,” said Sarah Sorscher, director of regulatory affairs at the Center for Science in the Public Interest, a consumer advocacy group.

“Something is very wrong in the production of these formulas, and FDA is not moving fast enough to find the cause,” Sorscher said. “The agency is currently conducting testing of milk ingredients, but that process is creeping along at a snail’s pace and they still have no advice to offer on how to control these risks.”

Nara Organics says the recall, announced Saturday, is being done “out of an abundance of caution” because of the risk that its formula is contaminated with Clostridium botulinum bacteria spores, which cause infant botulism. It can take several weeks between when a child consumes the spores and when they start showing signs of illness. If not treated, infant botulism can lead to paralysis and death.

The company said its infant formula has not tested positive for C. botulinum. The CDC said testing is underway of opened cans of Nara Organics formula and unopened product samples from the company. Results are expected “in the coming weeks,” the CDC said.

Nara Organics did not answer Healthbeat’s questions about the decision last fall to promote Nara’s formula as the replacement for ByHeart’s recalled formula during its infant botulism outbreak. Nara also didn’t answer questions about whether the companies have any common suppliers or other relationships.

In an email Monday afternoon, a ByHeart spokesperson said: “ByHeart and Nara Organics are completely separate companies. There is no corporate, financial, contractual, manufacturing, operational, or ownership relationship between ByHeart and Nara.”

ByHeart said it shared a Nara discount code as a resource to help its customers find alternative options quickly.

A ByHeart post on Instagram from Nov. 11 that recommended Nara Organics products and offered a 20% off discount code was deleted Monday after Healthbeat shared the link with both companies. An archived image of the post is available here.

ByHeart told Healthbeat it removed the post “for safety considerations following the Nara news - while the offer is no longer valid, we did not want to take any chances.”

The source of the contamination of ByHeart’s formula is still under investigation. The FDA has focused on ingredients supplied to the company, including a powdered milk ingredient.

The agency said June 3 that while its inspections led to the identification of C. botulinum in a powdered milk ingredient, the agency “did not identify any additional factors within ByHeart’s facilities that could explain the cause of this outbreak. FDA’s root cause investigation is ongoing and will continue with a focus on ingredients.”

The FDA told Healthbeat it is working with experts around the world to understand the risks of C. botulinum in infant formula to inform future monitoring and control measures.

“Last year’s outbreak involving ByHeart powdered infant formula was the first botulism outbreak definitively tied to infant formula anywhere in the world since infant botulism was first described as a distinct clinical entity almost 50 years ago,” the FDA said in an email.

Health and Human Services Secretary Robert F. Kennedy Jr. last year launched an infant formula initiative called Operation Stork Speed, which initially focused on formula nutrients and testing for pesticides, heavy metals, and per- and polyfluoroalkyl substances, or PFAS. In February, in response to the ByHeart recall and infant botulism outbreak, the FDA said it was beginning a sampling project focused on dairy-based ingredients that includes looking for C. botulinum.

Nara Organics formula has been on the market less than a year

Nara Organics launched its infant formula last July, touting celebrity investors such as Serena Williams, Gina Rodriguez, and Nicky Hilton, and saying the company was “setting a new standard that exceeds both U.S. and European safety requirements.”

After initially being sold online, in January, the company announced its first retail launch, which put the product on the shelves of more than 1,800 Target stores nationwide, as well as on the retailer’s website.

The formula is manufactured in Germany from organic ingredients sourced from the United States and the European Union, according to the company.

“At Nara, we run testing three times. On raw ingredients, on our formula powder as it’s being made, and on our finished canned formula,” the company’s website says. “From our first batch, we’ve run voluntary screening for clostridia – a sign of bacteria that can cause botulism – and B. cereus, the organism that produces cereulide.” Cereulide is a toxin that can cause nausea, vomiting, and dehydration in infants.

Officials at Nara Organics did not answer questions from Healthbeat, including about its microbial safety testing and whether its testing methods and protocols are sufficient to ensure botulism bacteria spores are not present in formula sold to consumers. A Nara spokesperson told Healthbeat the company had no comment beyond what was in its recall announcement.

Over the years, some international food safety experts have expressed concerns about the difficulty of testing for and detecting botulism spores in infant formula.

Infants hospitalized in California, Pennsylvania, Washington

The FDA told Healthbeat that it first contacted Nara Organics on Wednesday, June 10, asking the company whether it had received any consumer complaints about infant botulism diagnoses.

Then on Friday, June 12, the FDA said it contacted Nara Organics and recommended the company conduct a recall “due to the severity of illness and the epidemiological signal.” The company, which said it was contacted “late Friday,” announced its recall on Saturday, June 13.

According to the FDA, the three infants – who all had been fed Nara Organics-brand powdered infant formula – fell ill between April and May. All required hospitalization. The last date of illness onset was May 31. The infants, who ranged in age from 2-months-old to 5-months-old, were in California, Pennsylvania, and Washington state.

Leftover formula has been collected for testing in two of the states, the FDA said.

The FDA told Healthbeat that before it was aware of the infant botulism cases, the agency inspected the two firms that manufacture Nara Organics Whole Milk Organic Infant Formula in Europe. “At the conclusion of both inspections, observations citing deficiencies were issued to both facilities. Both firms have submitted corrective action responses to FDA, which are currently under review,” the FDA said. No further details were provided.

The FDA is warning consumers to not use any Nara Organics Whole Milk Organic Powdered Infant Formula. But the agency is suggesting parents and caregivers consider holding onto any opened formula containers for a month – labeling them as “DO NOT USE” – so that they can be tested should their child become ill.

Because Nara Organics’ formula makes up less than 1% of the infant formula sold nationwide, there is not a risk of the recall and outbreak causing concerns about shortages.

Editor’s note: This story has been updated with responses from the FDA and ByHeart, which were sent after initial publication.

Alison Young is Healthbeat’s senior national reporter. You can reach her at ayoung@healthbeat.org or through the messaging app Signal at alisonyoungreports.48

NYC food aid groups take stock after rough winter for hungry seniors

2026-04-30T14:52:32+00:00

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As New York City emerges from one of the coldest winters in years, those who serve the growing population of seniors facing food insecurity are reflecting on what more can be done – before summer, when extreme heat could bring another barrier to aid distribution.

“They have to think: Do we want to be hungry or do we want to freeze?” said Tyler Efferon, executive director of EV Loves NYC, a food pantry in the East Village. He noticed seniors were missing from food distribution sites this winter.

“We usually do 384 meals, and this past week we only did 240 meals,” he said in February.

In 2023, 1 in 10 New Yorkers ages 65 and older experienced food insecurity – a 3% increase from 2021, according to Feeding America, a nationwide network of food banks, food pantries, and soup kitchens.

Since the pandemic, the city’s total population has declined – but the senior population has continued to grow, according to a 2025 report by the state comptroller’s office. The city’s 65-and-older population grew 53% from 2000 to 2023 – 17 times faster than the total population.

Many seniors in need don’t have the mobility to get to food distribution sites, especially when sidewalks are slippery with snow and ice, said Alexina Cather, former deputy director of the NYC Food Policy Center at Hunter College.

“When it’s 5 degrees outside, you cannot come,” Julie, 63, told Healthbeat as she braved a frigid evening in February to pick up free groceries from a City Harvest truck on Manhattan’s Upper East Side. She declined to give her last name. “One Monday I came, but it was too cold, so I went home.”

It can be hard during summer heatwaves, too.

City Council Member Elsie Encarnacion, whose district includes part of the Bronx and the Upper East Side, introduced a bill on April 10 at the Committee on Aging to require the city Department for the Aging to develop a protocol for conducting in-person and phone wellness checks during extreme hot or cold weather.

People line up to receive food distributions from City Harvest in New York City in February.

For older people, exposure to the cold poses a higher risk of hypothermia, as the human body’s ability to regulate temperature deteriorates with age.

Chris Jay, a 61-year-old unemployed man who lives in an apartment in Sunset Park, said he defied the cold every Monday this winter to get food at the Gotham Food Pantry, where he received a hot meal at 6 p.m.: chicken, rice, vegetables, and lemon cake.

Afterward, he spent an hour and a half in 23-degree weather on the steps of All Souls NYC Church, waiting for a truck from City Harvest, which redistributes surplus food that would otherwise go to waste.

“A lot of people just come for the meal, and then they leave,” Jay said. “They don’t want to wait around for the truck because we never know when the truck’s going to be here.”

Delivering food directly to seniors’ homes would require more resources, trucks, drivers, and other workers. Gotham Food Pantry operates with only four employees and 100 volunteers, making personalized home delivery out of reach, Executive Director Douglas Silver said.

“I would need to have all the addresses of all those people,” he said. “I don’t have this.”

Advocates say more funding for local food pantries, not just big food banks, could make a difference.

“Right now, a few core companies get all the funding for food access,” Efferon said.

Cather said the city mainly funds the Food Bank for NYC but should be investing in neighborhood food pantries. With more money, she said, local food pantries could schedule delivery to some senior centers, giving food to 100 people at the same location.

“The food pantries are at the front line,” Cather said. “They understand the nuance of their clientele and can meet people where they’re at.”

Meals on Wheels delivers a wellness check

The city Department for the Aging provides one meal every weekday through its Meals On Wheels program. It is dedicated to seniors who cannot cook, travel to food pantries, or stand waiting for hours. The program serves 24,000 of the city’s 1.43 million seniors, according to the comptroller’s report.

Meals on Wheels was created by the Older Americans Act of 1965, when the senior population was only 9% of the whole U.S. population. In 2025, the Census Bureau estimated this same population to be at 61.2 million, or 17% of the total population.

The meals are delivered door to door, providing human contact for older adults, said Susan Zhuang, chair of City Council’s Committee on Aging. ”Meals on Wheels is not only just a meal delivered to their home. It is also a check-in with them.”

Meals are not delivered on weekends. Zhuang said many nonprofits have told her that seniors often fall and cannot reach the phone. Deliverers from Meals on Wheels knock on the door and find them on the floor.

“If it happened Friday night and then the whole weekend passed and no one checked on them, the people are going to die,” Zhuang said. “It’s not only just a meal issue. It’s a meal issue plus isolation issue plus health health issue plus caregiver issue.”

New York City food pantries work to give immigrants a taste of home. Trump’s aid cuts are making it harder.

City Council Member Linda Lee, whose district in eastern Queens includes the Douglaston and Bayside neighborhoods, has introduced a bill to extend Meals On Wheels to seven days a week.

Meanwhile, Citymeals on Wheels, created in 1981, distributes weekend meals to 16,000 to 20,000 people every year. About 2,000 senior New Yorkers get a monthly breakfast box containing the equivalent of 30 breakfasts with perishable and non-perishable items, and the program delivers groceries to 700 seniors a year.

Fear of ICE keeps people from food distribution sites

Fear of being detained by Immigration and Customs Enforcement agents are also hindering seniors from going out for food, advocates say.

Council Member Alexa Aviles, whose district covers Red Hook and parts of Park Slope, Sunset Park, Borough Park, Dyker Heights, Bensonhurst, and Bath Beach where 46% of the residents were born in another country, said she has noticed this fear among her constituents.

“Now that ICE is in the community,” she said, “people are afraid and don’t want to stand in long lines where they feel vulnerable.”

Aviles, whose office participated in food distribution, said that fear of ICE “concerns everyone who does food distributions and any activity where now you have a mass of people.”

“The first question we are now asking is not ‘Do we have enough?’ Now it’s ‘What are we going to do if ICE shows up? How are we going to keep community members safe? Will people come out if we do this?’ ”

NYC Department for the Aging’s budget, which the Committee on Aging oversees, is less than 1% of the city’s budget. Zhuang is negotiating for more.

Rachel Sherrow, COO of Citymeals on Wheels, said society is too focused on youth and doesn’t take enough care of seniors.

“We are talking about universal pre-K, universal child care, universal all of that,” she said. “What about universal older adults, universal meals? An older adult should be getting at least three meals a day.”

Apolline Lamy is a freelance journalist in New York.

Many babies sickened in ByHeart formula botulism outbreak needed more treatment after hospitalization

2026-04-24T22:15:24+00:00

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Most of the babies hospitalized in a recent nationwide outbreak of infant botulism linked to ByHeart baby formula have needed additional physical therapy and other medical support after going home, according to new data shared Friday.

“Although many infants are now progressing in their recovery, evaluating their outcomes is essential to understanding the progression and severity of illness observed during this outbreak,” said Myra Brooks, a member of the Centers for Disease Control and Prevention’s Epidemic Intelligence Service, who presented the data at the service’s annual conference in Atlanta. The conference highlights the work of the agency’s disease detectives.

Brooks, a first-year EIS officer, works with the CDC’s National Botulism Consultation Service and was part of the response to the outbreak linked to ByHeart infant formula last year. It is the first documented outbreak of infant botulism linked to powdered formula, she noted.

The CDC declared the outbreak over on Feb. 26, with 48 confirmed and probable cases of infant botulism in 17 states that were linked to the baby formula. All of the infants required hospitalization; there were no deaths. All of ByHeart’s Whole Nutrition Infant Formula products were recalled.

Infant botulism is caused by babies ingesting spores of Clostridium botulinum bacteria, which can activate in their intestines and produce a dangerous toxin that can cause muscle weakness and paralysis. Initial symptoms can include difficulty sucking and swallowing, constipation, and loss of head control. Without treatment, breathing difficulties can develop.

Health investigators were able to obtain and review the medical records for 46 of the 48 infants, which showed that most of those who were sickened had moderate to severe disease.

Those with moderate disease, 61% of the infants in the outbreak, required assisted feeding or non-invasive respiratory support, Brooks said Friday. Another 11% of the infants had severe disease. “During hospitalization, these infants experienced respiratory difficulty, requiring intubation or received a surgically placed feeding tube,” she said.

The remaining 28% of infants in the outbreak were classified as having mild disease, although they still needed hospitalization.

While the outbreak cases stayed in the hospital for a median of eight days, some of those with severe disease were hospitalized for more than a month, according to her presentation slides.

For many of the infants sickened in the outbreak, their medical treatments needed to continue after leaving the hospital, Brooks said.

“A third of infants were discharged with nasogastric tubes to supplement feeding, and two-thirds of infants had follow-up orders for physical, speech or occupational therapy,” she said.

The infant botulism outbreak was first identified in early November by the California Department of Public Health, which runs the national infant botulism program that distributes the only FDA-approved drug to treat children sickened by the toxin. The department noticed an increase in medication requests among babies who had consumed ByHeart formula and alerted federal officials.

Outbreak cases continued to rise in the weeks that followed amid delays by retailers in removing recalled formula from store shelves that were compounded by delays by the Food and Drug Administration in sharing information with state food safety officials about where the product was being sold.

While health officials initially thought babies had started falling ill in August 2025, they later identified cases going back to December 2023.

Although ByHeart’s products made up only about 1% of the formula products sold in the United States, the premium organic brand had a loyal following and the outbreak shook some consumers’ confidence in formula safety generally.

The federal investigation of how ByHeart’s formula became contaminated has in recent months focused on the product’s ingredients. Earlier this year, the FDA announced that tests had detected contamination with Clostridium botulinum – the bacteria that cause infant botulism – in some samples of powdered whole milk used to make the formula.

The FDA has said its investigation into the root cause of the contamination is ongoing, but the agency has not provided any update since Feb. 26.

ByHeart’s media team, in an email to Healthbeat late Friday, said the company continues to work with the FDA on its investigation. “Our root cause investigation remains ongoing, and we’ll share updates as they become available,” the email said.

Alison Young is Healthbeat’s senior national reporter. You can reach her at ayoung@healthbeat.org or through the messaging app Signal at alisonyoungreports.48.

SNAP work requirements take effect: What New Yorkers need to know

2026-03-02T16:19:43+00:00

This story was originally published by THE CITY. Sign up to get the latest New York City news delivered to you each morning. Public health, explained: Sign up to receive Healthbeat’s free New York City newsletter here.

Some New Yorkers receiving food stamps must prove they are working, studying or volunteering for at least 80 hours per month or risk losing the benefit under new federal rules that began Sunday.

The changes immediately apply to approximately 123,000 able-bodied adults without dependents (ABAWD), according to the city’s Human Resources Administration. That number may rise as more people apply or recertify for benefits, the agency said.

New York, like many cities across the state and country, was left scrambling last year to adjust to the new requirements set by the Trump administration and to help those who will be affected by the changes to the Supplemental Nutrition Assistance Program or SNAP, also known as food stamps, keep their benefits.

No one will lose benefits immediately, said HRA administrator Scott French. Rather, March 1 is when the new work requirements are fully phased in, and recipients who fail to comply for any three months over the next three years would lose benefits.

The changes also apply to people previously exempt from work requirements, including homeless people and veterans.

In an interview with THE CITY, French urged people who believe they may be impacted by the changes to get in touch with the agency as soon as possible, either at an HRA office or through the agency’s online portal — and to respond to notices from the agency immediately.

“The most important thing that I think we can stress to folks is to reach out,” French said. “We don’t want people to not take action because they’re not sure what they’re supposed to do.”

The new work requirements apply to adults aged 18 to 64 who are able to work and do not live with a child under the age of 14. They can satisfy the work rules by doing paid work for at least 20 hours a week, with some exceptions; studying or learning job skills approved by HRA for at least 20 hours a week; or by volunteering.

Many ABAWD’s have already had to prove they are working long before the federal government enacted these changes, said Joel Berg, the CEO of Hunger Free America, a national nonprofit that helps people access SNAP benefits and provides other food assistance. He and other advocates fear that the additional paperwork will mean people who are entitled to their benefits may get kicked off based on simple human error.

“I call them work reporting requirements, because even people who are working have to actually report to the city that they’re working,” he said.

As the March 1 deadline neared, Berg described the emotions he’s heard from SNAP recipients and from community-based organizations that work with them as ranging “from focused determination to outright panic.”

“The bottom line is, this is a huge challenge,” he said. “We’re seeing that from the people we represent, from resignation, to reality, to true fear and worry and panic that some of the most vulnerable people are going to lose their main source of food.”

Rita Vega, who leads the housing and public benefits program at Legal Services NYC, said her group has also heard from older New Yorkers who have found themselves forced to return to work to keep their food stamps. The previous ABAWD rules applied to adults aged 18 to 54, but now adults up to age 64 will have to comply.

“Let’s say I’m 62, and I’m retired — do I still have to work in order to keep my SNAP?” said Vega. “I think people are grappling with these rules that are new to them, and facing these tough decisions themselves.”

Mamdani confident city will ‘meet the moment’

The changes stem from the “Big Beautiful Bill” that President Donald Trump signed into law last July, enacting more than $1 trillion in cuts to Medicaid and SNAP.

Though the federal government initially moved to enact those cuts — including the new work requirements — last fall, several states including New York successfully sued to extend waivers through February in order to give them more time to prepare for the changes.

Since last year, HRA and community-based organizations have been working around the clock to ensure SNAP recipients are aware of the changes, and have stepped up their efforts to help people enroll in workforce development programs. The agency and its partners have also encouraged SNAP recipients to check if they may qualify for medical waivers that exempt them from the work rules.

To date, HRA has held 14 training sessions with its community partners and trained more than 400 people on the new SNAP policy changes, according to the agency.

French, the HRA administrator, was unable to say how many of the 123,000 people the agency identified and reached out to had responded and updated their paperwork, or to say how many were placed in workforce development programs thanks to the agency’s efforts.

“We feel prepared right at this moment, but it’s obviously something that we’re going to track as implementation continues, and make sure that we’re tracking trends and looking where we may need to enhance outreach efforts,” he said.

At an unrelated press conference on Friday, Mayor Zohran Mamdani acknowledged the increased burden on HRA but said he is “confident” in the agency’s ability to “meet the moment, and in our city administration’s commitment to helping them do so.”

Vega, from Legal Services NYC, said that while she commended the city’s efforts to inform people about the changes, the coming months will show if those efforts have been sufficient.

“That may be where the turbulence is. If something is lost in the process, that’s where we know our clients may actually be at risk of losing their benefits,” she said.

Berg from Hunger Free America said the state and city can do more to help, from working with the private sector on jobs programs to partnering with more nonprofits on a comprehensive plan to ensure people keep the benefits they need.

The group has called on state lawmakers and Gov. Kathy Hochul to authorize funding to help anyone who is kicked out of SNAP because of the changes.

“We really need an all-hands, multi-agency state and city response,” he said. “And the truth is, we can’t rely on any help whatsoever from the federal government.”

Additional reporting by Samantha Maldonado.

Claudia Irizarry Aponte is a senior reporter covering labor and work for THE CITY.

Longevity has become big business. But it’s public health that’s driving gains.

2026-02-18T12:00:00+00:00

Public health, explained: Sign up to receive Dr. Jay K. Varma’s reports in your inbox a day early.

Hello and welcome to Healthbeat’s weekly report on the stories shaping public health in the United States.

I am Dr. Jay K. Varma, a physician, epidemiologist, and public health expert currently serving as chief medical officer at Fedcap, a national nonprofit focused on economic mobility and well-being for vulnerable communities. The views expressed here are my own.

This week, I’m focusing on one of the hottest topics in U.S. health care: longevity. Much of today’s longevity industry focuses on expensive medical interventions, even though the largest gains in life expectancy have come from public health and social conditions.

Longevity is now a big business

I am increasingly bombarded with advertisements for pills, scans, and tests that can help me live a longer and healthier life. The way these are marketed and the absence of high-quality evidence for their benefit indicate that these ventures are, fundamentally, about creating new lines of business, rather than helping people live longer.

Take a look at the news that the founder of Spotify, Daniel Ek, has founded a new company focused on full-body imaging and will be opening his first clinic for this near my home in New York City. While the price has not yet been announced for this “health check for your future self” (Ek’s words), this company will be competing against other start-ups that charge nearly $4,000 for similar scans.

In the food sector, it seems as if every grocery store, restaurant, or even coffee shop I visit sells items “packed with protein.” Cardiologist Eric Topol and ex-National Institutes of Health nutrition researcher Kevin Hall have written extensively about the lack of evidence for a high-protein diet, arguing that the average American already consumes all the protein that their body can safely use.

One of the people they both have pushed back against is Peter Attia, a physician and best-selling author of a book about longevity. Attia argues that Americans should consume roughly double the standard recommended daily allowance of protein, 1.6 grams per kilogram of body weight rather than 0.8. To help Americans up their protein intake, Attia has been serving as an investor in and chief science adviser to David Protein, a company that sells a popular high-protein, low-sugar supplement bar.

If you want more than just generic recommendations about protein intake, you can also pay for personalized advice. Attia says he is “neither a primary care physician nor a provider of concierge care,” yet charges between $100,000 and $500,000 per year for personalized longevity advice.

One of the people Attia appears to have been advising was human trafficker and convicted pedophile Jeffrey Epstein. Attia’s correspondence with Epstein provides a small window into the type of services wealthy clients pay for, such as blood tests for a wide range of analytes that no primary care physician would routinely order, as well as prescriptions for metformin, a first-line treatment for diabetes that some believe may have anti-aging properties.

Many other physicians and prominent practitioners in the longevity field appear to have the ear of the current federal government, despite extensive, inter-locking financial interests in companies that market supplements, tests, and other longevity and wellness products.

For example, according to a report from the consumer advocacy group Public Citizen, the nominee to be surgeon general, Dr. Casey Means, has extensive financial connections, many of which have not been fully disclosed by her. Means — who, like Attia, never completed residency training — is connected to companies that market basil seeds, algae, and a protein powder that has been found to have extensive lead contamination.

The real longevity experts work in public health

When I think about experts in longevity, I think first of my field: public health. In clinical medicine, we measure vital signs such as temperature, heart rate, respiratory rate, and blood pressure in an individual. In public health, we measure vital statistics: births, deaths, and causes of death in a community. Public health agencies count who lives and who dies, support analyses on why people die, and implement programs to avert those deaths.

Given all the public and commercial interest in longevity, I was dismayed that my news and social media feeds weren’t overflowing with the most important recent news about longevity: Americans are living longer than they’ve ever lived before. In the Centers for Disease Control and Prevention’s annual report on longevity, life expectancy for the U.S. population in 2024 rose 0.6 years to 79 years.

The top three causes of death remained the same as in previous years: heart disease, cancer, and unintentional injuries. There was a substantial decline in overdose deaths, and Covid-19 was no longer among the 10 leading causes of death.

From a public health perspective, the main reason humans live longer than they did a century ago have only partly to do with medical care. The biggest gains came from improvements in water, sanitation, and hygiene, which were then followed by medical interventions, such as vaccines and antibiotics.

Even today, the best estimates suggest that medical care accounts for only 5%-15% of improvements in life expectancy, with most of the rest driven by social, behavioral, and environmental factors.

My advice on longevity

So what does this mean for individuals? I don’t want to be too dismissive of the importance of health care. For people with underlying diseases, health care can be life-saving. Too many Americans still die from inadequate care for diabetes, high blood pressure, asthma, HIV, and many other conditions. I screen adults for breast, cervical, and colon cancer because strong evidence shows that early detection improves both length and quality of life.

That said, my advice to my friends and family about longevity is based on what we know from the public health and medical literature. Keep your BMI between 18.5-24.9. Exercise every day. Do not smoke cigarettes. Limit the amount of alcohol you drink.

And, if you have the means, get a good education, and find a career where you make a decent income and live in an area with lower air pollution and fewer traffic accidents.

Wishing you a long life,

Jay

Dr. Jay K. Varma, who is recognized globally for his leadership in the prevention and control of infectious disease, writes about public health for Healthbeat. He has guided epidemic responses, developed policies, and implemented programs that have saved lives across Asia, Africa, and the United States. He is based in New York. Contact Jay at jvarma@healthbeat.org.

Shutdown deal brought a reprieve for WIC. But NY braces for ripple effect of other looming aid cuts.

2026-01-12T10:00:00+00:00

Public health, explained: Sign up to receive Healthbeat’s free New York City newsletter here.

The WIC program, which has provided healthy food, health care referrals, and breastfeeding support for women, infants, and young children for more than 50 years – historically receiving strong bipartisan support – came out of the fall federal government shutdown intact for another year. But New York City public health experts fear that President Donald Trump’s looming transformation of public assistance will have ripple effects that will still hamper WIC access.

“We are headed toward a very uncertain future,” said Jack Newton, who directs the Public Benefits Unit in the Bronx office of Legal Services New York, helping people obtain and retain public benefits. “The next two years will be a sea change among low-income New Yorkers, who will find a dramatic change for nutrition assistance and health care.”

The U.S. Department of Agriculture reported that about 6.7 million people received monthly WIC benefits, including about 41% of all infants nationwide. That same year, 233,703 New Yorkers relied on WIC each month – over half of the state’s total beneficiaries, according to the New York State Comptroller.

On a typical day at a WIC agency in New York City, parents and their children come in for a health check, breastfeeding advice, or a nutrition consultation. They come to get referrals to prenatal or pediatric health care. They might also refill their eWIC benefit cards they can use to purchase healthy food and baby formula for a few months. Often they get help enrolling in other public assistance programs, such as the Supplemental Nutrition Assistance Program (formerly known as food stamps), the Head Start early education program, Healthy Start, or Medicaid.

Since the Covid-19 pandemic, WIC services have increasingly moved to remote access, allowing families to avoid taking time off work or organizing child care to keep their required appointments. Yet, throughout the country, and across New York City, local clinic offices, rooted in their communities, remain a key feature of the program.

When the federal government shut down on Oct. 1, unable to pass a budget for fiscal year 2026, WIC recipients and providers worried about how long the local agencies could remain open, and what changes might occur in the short term. Concern ran parallel to fears about SNAP benefits, which were disrupted in early November, delayed and debated in court, and finally distributed to New Yorkers on Nov. 9.

Cuts to food benefits stand in the way of RFK Jr.’s goals for a healthier national diet

Each new day of the shutdown brought new, often conflicting information. Several states, including New York, jumped in to cover a looming funding lapse with their own budgets. The USDA moved money around to cover WIC benefits. The White House injected emergency funds. Most WIC clinic managers in New York proceeded with a precarious “business as usual,” taking one day at a time and keeping a low profile.

As New York state’s largest WIC Vendor Management Program and WIC provider, Public Health Solutions, however, quickly took a vocal stance. On Oct. 8, leaders of the non-profit organization gathered for a press conference at their WIC office in the Bronx with Democratic U.S. Rep. Ritchie Torres. Speakers highlighted the urgency of the situation – and the consequences of a sudden lapse in or loss of WIC benefits for the 35,000 low-income women, infants, and children that PHS annually serves through their WIC program.

A chart presented at a news conference on Oct. 8, 2025, in the Bronx shows the impact of the WIC program.

For the Bronx, Torres said, WIC is essential.

“My congressional district is the largest recipient of WIC of any congressional district in New York state,” Torres said. On that day, he was speaking “not only as a United States congressman, but as the product of a strong single mother, who raised my twin brother and me on the strength of the WIC program.”

PHS was responding to the immediate crisis. But concern about the future of WIC had begun before the shutdown, and remains top of mind for many recipients and advocates, despite the funding deal’s reprieve.

The recurring, principal concern is that social benefits are not designed as isolated forms of support – they work together. Changes to one part of the system, the non-profit National WIC Association explains, will not be contained. Changes in other programs to eligibility criteria, new work requirements, enrollment procedures, cost-shifting onto the states, and, now, a potential expansion of the nation’s “public charge” determination means fewer people might access WIC.

Many recipients of public assistance have been anticipating those ripple effects, Newton said. Participants who visited Legal Services New York in mid-October were seeking clarity. Their shutdown anxiety, he said, was “greatly compounded” by the One Big Beautiful Bill Act and its looming cuts to SNAP and Medicaid, new eligibility and work requirements, and the long-term consequences of shifting the costs of the programs to states.

On the one hand, Newton said, it is the combination of different public benefits – SNAP plus WIC, for example – that helps low-income families access adequate nutrition.

“When you’re pregnant or have young children, your need for nutrition increases - so the already inadequate SNAP benefits plus WIC gets you closer to a place where you can provide adequate nutrition and healthy nutrition,” he said.

How connecting with nature helps Black women have healthier pregnancies

On the other hand, WIC is “extraordinary” among benefits, Newton explained, because it does not have immigration requirements like SNAP and Medicaid.

“For some families, that is the only benefit they have,” Newton said of WIC. But to get even just that, a pregnant or new parent would have to feel inclined, safe, and comfortable enrolling in the program. For public health experts, the “chilling effect” of the federal government’s immigration-related actions, and the sense of chaos and uncertainty many experience, is a considerable source of concern.

To the alarm of many, days after the shutdown came to an end, the government re-introduced possible changes to the public charge rule, which, if passed, could discourage people from enrolling in public assistance.

Here’s what else to know about WIC.

What is WIC?

“WIC is best thought of as a public health program,” Nell Menefee-Libey, senior public policy manager for the National WIC Association, told Healthbeat in a recent interview. “The goal of WIC is to support and improve pregnancy and birth outcomes, child development outcomes, with a very specific nutritionally tailored food package, with nutrition education, and breastfeeding support.”

Launched as a pilot program in 1972 to address a growing concern over malnutrition and poor health outcomes of mothers and children across the nation, WIC offers eligible families through pregnancy and early childhood direct nutritional assistance (vouchers and cash benefits) and other support.

It is managed at the state level, often through contracted local independent agencies – primarily public hospitals, community health centers, or non-profits. Embedding the program within institutions providing health care services typically helps promote WIC’s mission to improve health outcomes.

WIC’s purchasing guidelines are strict. The benefits can only be used for specific foods, in specific quantities, based on the recipient’s specific circumstances (fully breastfeeding, partially breastfeeding, or not). Covered items include dairy, cereal, canned fish, whole wheat bread, dry or canned legumes, baby food, peanut butter, and fruits and vegetables, through the popular Cash Value Benefits.

Eligibility is determined by income, nutritional risk, and/or enrollment in other public benefit programs, also known as “adjunctive eligibility.” The income limit is set at or below 185% of the U.S. Poverty Income Guidelines. In 2025, according to the U.S. Department of Health and Human Services, that represented $59,477.50 a year, for a family of four.

What has been the impact of the WIC program?

Over the past five decades, studies have shown WIC to be effective in improving diet quality (including consumption of important nutrients such as iron, protein, and vitamins); increasing access to early prenatal health care, as well as post-partum and pediatric health care, and reducing adverse maternal and birth outcomes, such as premature births, low and very low birth weight, or fetal and infant mortality.

“The consequences of a child not getting enough nutrition are multifaceted,” Dr. Adam Aponte, pediatrician and CEO of the East Harlem Council for Human Services, said in a recent interview. “It affects brain growth, it affects all sorts of organ systems within the body. If [children] do not have proper nutrition during those early years, that can have consequences for the remainder of their life.”

Aponte highlighted the considerable energy needs for growth of the baby in utero, those of the child in its first two years of life, and the changes to nutritional demands that occur in a pregnant person’s body. WIC, he said, directly helps ensure children and their mothers have access to good quality, nutritious foods and get connected with other forms of support and health care.

For over 40 years, Aponte said, EHCHS ran its own WIC program. Since the organization has a Federally Qualified Health Center component – the Boriken Neighborhood Health Center, which provides pediatric and OB-GYN care – managing a WIC program was “very convenient.” It embodied the embedded, streamlined, and comprehensive continuity of care that makes many WIC programs unique.

But the agency ceased operating its WIC program in 2022, Aponte said, due to a post-Covid provider consolidation effort across the city, and the increase in online and remote services. Other WIC providers serve the area, including the NYC Health + Hospital in Harlem and the Institute for Family Health.

How will cuts to SNAP and Medicaid affect WIC?

The funding deal struck to end the government shutdown includes the full year of appropriations for the USDA, where WIC’s budget resides, Menefee-Libey explained. So its funding is assured through October 2026.

The funding deal gave WIC two other wins, the NWA noted. Reductions to the program’s fruit and vegetable benefits, which had been proposed over the summer in Trump’s and in the House Agriculture Committee’s budgets, were dropped. And the federal government refilled WIC’s emergency contingency fund, which played a key role in holding the program over during the shutdown.

But other cuts to the ecosystem of public benefits are expected this year, and that could affect WIC access.

“Programs like WIC, Medicaid, and SNAP all work together to help to improve public health outcomes,” Menefee-Libey said. “Upheaval or uncertainty in any of these programs doesn’t stay isolated; it will have ripple effects.”

For many of the families Newton’s office helps access, retain, or increase public benefits, losing one, or both, he says, would have “very adverse consequences.”

The consequences are practical: They are about how much food a family will be able to have on the table if they have to manage without SNAP, or what health care will look like for them if they lose Medicaid.

But beside the immediate implications of losing other benefits for a family supported by WIC lies an important bureaucratic “domino effect.”

“If someone is participating in Medicaid and SNAP,” Menefee-Libey explained, “they are presumed to be eligible for WIC – their certification process is streamlined.” That process is called “adjunctive eligibility.” The point of this is to increase the reach of the public benefit programs, and simplify the bureaucratic process.

But the looming changes throw a wrench in the machine. If people lose access to one kind of public benefit, and then become pregnant and want to enroll in WIC, they would, at the very least, need to complete additional administrative steps. But, in the worst case, Menefee-Libey said, they could “lose their eligibility entirely.”

That concern is particularly relevant in the states like New York that expanded Medicaid under the 2014 Affordable Care Act, Menefee-Libey said. The ACA gave states the option to extend Medicaid coverage to address the “coverage gap” that left adults with incomes too high to qualify for traditional Medicaid, but too low to afford for private health insurance – and who often had no access to employment health benefits – with virtually no options.

Now, people who stand to lose access to Medicaid may lose WIC, too.

What would Trump’s proposed ‘public charge’ rule mean for WIC?

On Nov. 19, the federal government reopened the “public charge” rule dossier, as Trump had done in his first term.

The rule refers to a test under federal law that allows immigration officials to deny applications for lawful permanent residence, or a green card, and certain visas if they determine that the applicant could become a “public charge.” The current policy for the test does not consider participation in health care programs like Medicaid, nutrition programs, or housing programs, and focuses instead on cash assistance and long-term institutionalized care. It was established in 2022 and remains in effect.

Ripple effects of ICE raids create health challenges for New York City

But the Trump administration is seeking to considerably broaden the test. Effectively, the new proposed rule does not provide explicit guidance as to which benefits would or would not be considered.

WIC providers have said that such an expanded rule could further discourage immigrant and mixed-status families from seeking enrollment in WIC and other benefits.

“The fear is that many immigrant and mixed-status families will withdraw from public benefit programs entirely, including from WIC,” Menefee-Libey said. “We know that will have tremendous implications for public health impact generally – worse health and pregnancy outcomes, and real uncertainty and fear during a challenging period” of pregnancy and early parenting.

Multiple studies have documented the relationship between punitive immigration policies and decreased health care utilization among immigrants (known as the “chilling effect”).

Answering the public comment period for the rule, which is open through Jan. 26, many public health organizations and individuals have voiced opposition. The Protecting Immigrant Families Coalition issued a response, signed by 725 national, state, and local organizations, including PHS, the NWA, New York’s Legal Aid Society, and the Committee for Hispanic Children and Families.

“Unknown rules lead to chaos and bias,” the coalition wrote Dec. 19. “This proposal would remove essential guardrails that protect millions of immigrant families, in favor of an unknown immigration policy that invites arbitrary decisions and political bias. It will deter millions of U.S. citizens in immigrant families, as well as lawfully present immigrants, from seeking care and aid for which they qualify under law. It will undermine the nation’s health and weaken our country’s economy, while making every social problem we face worse.”

Julie Flandreau is a freelance reporter in New York.

ByHeart baby formula outbreak prompts global safety study as U.S. struggles to find botulism source

2026-01-08T16:06:51+00:00

Public health, explained: Sign up to receive Healthbeat’s free national newsletter here.

An international food standards committee of the United Nations and World Health Organization has called for a scientific risk assessment of botulism spores in powdered infant formulas as a result of the U.S. outbreak linked to ByHeart products.

The action by the Codex Committee on Food Hygiene, supported by attendees from 50 member countries, noted the “global implications” of contaminated baby formula. It was taken as U.S. health agencies have struggled since early November to determine how ByHeart’s formula became contaminated.

Investigations have been ongoing since early November.

At least 51 U.S. babies have been sickened with infant botulism in the outbreak, with no new cases identified in recent weeks; all required hospitalization. The U.S. Food and Drug Administration has said it was first alerted on Nov. 6 to an initial cluster of illnesses linked to ByHeart formula and that its investigation has been underway since then.

ByHeart has recalled all of its formula products. Federal officials have said they cannot rule out the possibility the company’s formula – which was marketed as a premium, organic formula “closest to breast milk” – has been contaminated with botulism bacteria since it was first put on the market in March 2022.

Food safety advocates said they supported the international risk assessment, but noted it will likely take years to result in any reforms to protect against future outbreaks.

A well-functioning food safety agency would have some answers by now about what caused the outbreak and would be committed to doing widespread product testing to ensure other formula brands are safe.”
Sarah Sorscher, director of regulatory affairs for the Center for Science in the Public Interest

“It’s a really bad sign for Americans when a slow-moving international scientific agency has now initiated public plans, and yet our own regulators responsible for preventing this outbreak haven’t taken any public action,” said Sarah Sorscher, director of regulatory affairs for the Center for Science in the Public Interest, a consumer advocacy group in Washington, D.C., that focuses on food issues.

“A well-functioning food safety agency would have some answers by now about what caused the outbreak and would be committed to doing widespread product testing to ensure other formula brands are safe,” Sorscher told Healthbeat. “Instead, we have utter silence. It’s a complete failure of leadership.”

Officials with the FDA, Centers for Disease Control and Prevention, and U.S. Department of Health and Human Services said their investigations are ongoing but they did not answer Healthbeat’s questions this week about what challenges may be contributing to delays in finding the cause.

They also didn’t respond to questions about whether it’s surprising that a source of ByHeart’s botulism bacteria contamination hasn’t yet been identified.

Federal regulators haven’t decided whether a U.S. risk assessment is needed

Infant botulism is caused by babies ingesting spores of Clostridium botulinum bacteria, which can take 30 days to start growing in their immature guts and produce a toxin that can cause symptoms ranging from constipation, loss of head control, difficulty swallowing and breathing, and respiratory arrest.

Recent tests by government investigators and ByHeart have detected botulism bacteria in some containers of the company’s formula. The company received a formal warning letter from the FDA in August 2023 about contamination issues with a different type of bacteria and its plants have been cited by FDA inspectors for manufacturing and sanitation issues.

A HHS spokesperson, in an email to Healthbeat, said the FDA advocated for the Codex committee’s request for the international risk assessment. Staff from the FDA and U.S. Department of Agriculture participated in the Codex meeting, the meeting’s report shows.

ByHeart baby formula recall exposes dangerous gaps in food safety

“We welcome any and all scientific evidence that can inform recommendations on this important public health matter,” HHS said.

When asked whether the FDA or CDC would be doing their own U.S. assessment of risks for infant formula contamination with Clostridium botulinum bacteria, which cause infant botulism, HHS said that has not yet been determined. The FDA will decide the need for any additional risk assessment after more information is gathered about the current outbreak, HHS said.

“Additional testing by ByHeart, FDA, CDC, and state partners is currently underway, and more results are expected in the coming weeks,” HHS said. No details were provided about the types of testing being done.

ByHeart said the ongoing investigation “includes a rigorous audit of every step of our supply chain” and that the company is working closely with regulators to identify the source of the contamination.

HHS Secretary Robert F. Kennedy Jr., in launching Operation Stork Speed last spring, said that “safe, reliable, and nutritious” infant formula is a priority of the administration.

During the Codex Committee on Food Hygiene, which held its multi-national meeting Dec. 15-19 in Nashville, Tenn., members discussed the need for scientific input to inform a potential revision in the international code of hygienic practice for powdered infant formula. The code has sections that need updating, including sections on cleaning and environmental monitoring when producing formula, participants said.

Global review seeks to identify safety gaps in powdered formula manufacturing

“While Members acknowledged that historical data had not always categorized Clostridium botulinum as a major risk in these products, the importance of investigating whether current gaps in [the powdered infant formula code] contributed to the risk was underlined,” according to the report of the meeting.

The committee’s request seeks a risk assessment of spore-forming pathogens in powdered infant formula, and specifically cites Clostridium botulinum, which causes infant botulism, and Bacillus cereus, which can produce a toxin that causes nausea, vomiting and diarrhea.

Nestle is undertaking a global recall of certain infant formulas because of possible contamination with the toxin produced by Bacillus cereus. The company said a potentially contaminated ingredient is the culprit. While the recall involves formula sold in dozens of countries, the company’s recall advisory as of Thursday morning did not list the United States.

The Codex committee also has asked for an update to the existing risk assessment and scientific advice on environmental pathogens, such as Cronobacter and Salmonella, and to provide additional scientific advice to inform recommendations for strengthened pathogen control measures in all stages of the formula manufacturing process.

During last month’s meeting, a representative of the Food and Agriculture Organization of the United Nations, also referred to as the FAO, said that the scientific advice requested by the committee would be provided by an international scientific expert group called JEMRA – the Joint FAO/WHO Expert Meetings on Microbial Risk Assessment. The FAO did not respond to questions from Healthbeat about how long the risk assessment process will take or what it will involve.

Elisabeth Sterken, a nutritionist with the International Baby Food Action Network Global Council, said actions to address infant botulism and other microbial risks in powdered infant formula need to be taken sooner than will occur through this process. IBFAN is an international coalition that advocates for public policies that favor breastfeeding and investigates the marketing of infant formula.

“From JEMRA, which will likely take years, its recommendation will then go back to the Codex Committee on Food Hygiene, and any changes in the Code of Hygienic Practice will take at least another two years,” Sterken told Healthbeat.

Moms say ByHeart recall has shaken their trust in baby formula safety

“From there the final recommendations go to national regulatory bodies,” she said. “In the meantime, infants will continue to be at risk from the serious health consequences of potentially contaminated powdered infant formula.”

HHS, the FDA, and CDC have not responded to a Dec. 8 letter from the Safe Food Coalition, a group of major food safety organizations, that has called for actions to address “dangerous deficiencies” in the nation’s food inspection and regulatory systems that they say have been highlighted by the ByHeart recall and infant botulism outbreak.

Sorscher, whose organization – the Center for Science in the Public Interest – is a member of the coalition, called the lack of any response to the five-page letter “unacceptable.”

“These agencies owe answers to the public, and the silence at this point speaks volumes about their current ability to protect our food,” she said.

The letter, among many recommendations, has called for the FDA to declare contamination with Clostridium botulinum to be a hazard that requires prevention and must be addressed in manufacturers’ food safety plans. And it urges the FDA to conduct a nationwide sampling program to test infant formula for this type of bacteria, which causes infant botulism.

Other coalition members that signed the letter include the Center for Food Safety, Consumer Federation of America, Consumer Reports, Government Accountability Project, the Institute for Food Safety and Nutrition Security at George Washington University, and Stop Foodborne Illness.

The HHS last month told Healthbeat it has received the letter and will be responding to it.

Alison Young is Healthbeat’s senior national reporter. You can reach her at ayoung@healthbeat.org or through the messaging app Signal at alisonyoungreports.48

Screwworm threat returns to U.S.: Why it matters

2026-01-05T14:29:14+00:00

Dr. Jay K. Varma is a special contributor to Healthbeat. Public health, explained: Sign up to receive Healthbeat’s free national newsletter here.

In 2025, the United States faced a series of reminders that the security of our food supply depends on public health systems that are largely invisible to the general population. Poultry and dairy production were disrupted by H5N1 avian influenza and infant formula by botulism contamination. Less visible was a parasite that once terrified American ranchers: the New World screwworm.

The resurgence of screwworm highlights the fragility of infectious disease control and the importance of sustained government cooperation across different sectors and across international borders.

What screwworm is and why it matters

The New World screwworm is caused by the larvae of a blowfly called Cochliomyia hominivorax. The adult fly targets warm-blooded animals, most often cattle, and lays its eggs in open wounds. These wounds can be large, such as those caused by branding or dehorning, or barely visible, such as a tick bite or an abrasion.

Within hours, the eggs hatch, and the larvae burrow into the flesh and feed aggressively on living tissue. (This is what distinguishes screwworm from other maggots, which eat decaying or dead tissue.) As the larvae grow, the wound expands, attracting more flies, which deposit even more eggs. The larvae cause severe pain, tissue destruction, secondary infections, and often death of the animal.

After several days, mature larvae drop to the ground, pupate in the soil, and emerge as adult flies ready to repeat the cycle on another cow. Under warm conditions, the entire process can take only a few weeks. In a herd setting, infestations can spread rapidly, devastating entire herds of cattle.

Before eradication, screwworm caused hundreds of millions of dollars in financial losses each year in the United States. Ranchers spent enormous time and money on treatment and prevention. The parasite also occasionally infected wildlife, pets, and some humans.

How screwworm was controlled in the 20th century

Beginning in the mid 20th century, U.S. scientists developed a special technique to stop screwworm reproduction. The “sterile insect technique” involved breeding millions of male screwworm flies in specialized facilities, sterilizing them with radiation, and releasing them into the wild. Because female screwworm flies mate only once, they produce no offspring after they mate with a sterile male fly. Over time, the screwworm population dies off.

Using this approach, screwworm was eliminated from the United States by the mid 1960s. The program then moved south, in collaboration with Mexico and Central American countries. By the early 2000s, screwworm had been pushed as far south of the United States as Panama. Every week, sterile flies were released to prevent northward spread from endemic regions in South America, creating a biological barrier to screwworm making its way into the United States.

This screwworm control program remains one of the most successful examples of international disease control in the Americas. To maintain it, however, requires constant effort to produce sterile flies and conduct surveillance for breakthrough infections.

Why the screwworm threat has returned

For decades, screwworm was largely absent from the United States and Mexico. That changed in 2023, when outbreaks began spreading northward through Central America and into southern Mexico. The reasons are still being investigated, but likely include interruptions in sterile fly production during the Covid pandemic, increased movement of cattle and people, and the sheer difficulty of maintaining surveillance across remote terrain.

In August, the United States confirmed its first human screwworm case in decades. The patient, a Maryland resident, had recently traveled to El Salvador and returned with larvae embedded in living tissue. The infection was treated successfully, and there was no evidence that infection was either acquired locally or transmitted onward.

While the risk to Americans of this case was low, it was considered an important warning sign. Because they are so rare, even one human screwworm infection suggests widespread prevalence in animals.

The economic stakes are particularly worrisome. Cattle herd sizes in the United States are near historic lows due to drought and rising costs. In response to the screwworm threat, the United States halted cattle imports from Mexico in 2025. Prolonged disruption could drive prices higher, an important problem because the average American consumes 60 pounds of beef each year.

What is being done to stop the New World Screwworm outbreak?

The United States and Mexico have begun to rebuild the capacity that previously stopped screwworm transmission in both countries. Sterile insect production in Panama has been expanded to release roughly 100 million flies per week. Facilities in southern Mexico are being renovated to produce tens of millions more, and the U.S. Department of Agriculture is working on additional dispersal capacity in Texas.

These efforts are expensive and slow. Experts estimate that several hundred million sterile flies per week may be needed to re-establish the barrier that once existed. At the same time, workforce reductions and loss of institutional memory are making it harder for the U.S. government to respond quickly.

New tools are also emerging. Last month, the Food and Drug Administration conditionally approved a topical antiparasitic drug for cattle that can help prevent or treat screwworm infestations. While this drug gives cattle farmers another option, there are challenges with using it; it is prescription only, has withdrawal periods, and cannot be used in all cattle.

Why this matters beyond screwworm

The return of screwworm illustrates broader lessons about public health and food security. When they work, public health protections are invisible, and, when they fail, the consequences are difficult and expensive.

Particularly with food security, these protections must embrace a One Health model, in which human, animal, and environmental sectors work in partnership. And, finally, at a time when the United States has dramatically cut its global health workforce, screwworm offers an important example about why such work remains essential.

Dr. Jay K. Varma is a physician and epidemiologist. An expert in the prevention and control of infectious diseases, he has led epidemic responses, developed global and national policies, and implemented large-scale programs that saved hundreds of thousands of lives in Asia, Africa, and the United States.

ByHeart baby formula recall: What to know about 4 new developments

2025-12-19T23:30:03+00:00

Public health, explained: Sign up to receive Healthbeat’s free national newsletter here.

It’s been six weeks since ByHeart Inc. began recalling its popular organic baby formula amid a nationwide outbreak of infant botulism – and nearly two years since children started becoming infected across the country.

Here are four things to know about the latest developments in the outbreak investigation and formula recall.

Some good news: No new cases of sick infants discovered in the past week

The U.S. Food and Drug Administration announced this week that the identification of new infant botulism cases linked to ByHeart infant formula has slowed, with none identified during the past week.

The number of infants known to have been sickened in the outbreak remains at 51 – and all of them required hospitalization. The infants live in 19 states. There have been no deaths.

The most recent date a child started showing signs of illness was Dec. 1, according to the FDA.

The lack of new cases is an encouraging sign. ByHeart did an initial, limited recall of its formula products on Nov. 8, followed by a recall of all of its products on Nov. 11.

But it can take up to 30 days after an infant ingests botulism spores for the bacteria to start growing in the child’s immature gut and produce a toxin that causes symptoms, such as constipation, poor eating, loss of head control, difficulty swallowing and breathing, and potentially respiratory arrest. And ByHeart formula remained on the shelves of some stores for weeks after the recall. (More on this below.)

Some bad news: The discovery that babies started being sickened two years ago

Until recently, federal health officials had said the earliest outbreak illnesses began in August. But they’ve now identified children who were fed ByHeart formula who were hospitalized with infant botulism as far back as December 2023.

The Centers for Disease Control and Prevention has expanded its outbreak case definition to include any infant with botulism who was exposed to ByHeart baby formula at any time since the product first went on the market in March 2022.

Initially, investigators were focused only on infants sickened since Aug. 1, 2025. When they looked at earlier infant botulism cases, they identified 10 additional children who consumed ByHeart products and fell ill from December 2023 through July 2025. Those cases are included in the 51 total outbreak cases.

While no cases have been identified before December 2023, the investigation is ongoing, and the FDA said it “cannot rule out the possibility that contamination might have affected all ByHeart formula products.”

Federal officials and ByHeart say they are still investigating how botulism bacteria spores got into ByHeart formula.

FDA issues warning letters to retailers that kept selling recalled ByHeart formula

Retailers across the country continued to sell ByHeart infant formula for weeks after the recall began on Nov. 8 and was expanded to include all products on Nov. 11.

State and local food safety officials along with FDA inspectors performed more than 4,000 spot-checks of retail stores across the country to ensure recalled ByHeart’s formula was no longer being sold. Yet they continued to find ByHeart products on store shelves at more than 175 locations in 36 states, the FDA said.

However, those checks of retail stores, Healthbeat reported last month, were slowed by FDA delays in sharing ByHeart product distribution lists with state and local officials.

The FDA says it hasn’t received any reports of recalled ByHeart formula still being on store shelves since Nov. 26.

At a Target store in Arkansas, state inspectors on Nov. 20 discovered ByHeart single-serve “anywhere pack” sticks on a shelf with a promotional “Sale!” sign offering a $2 discount more than a week after all of the company’s products were recalled because of botulism risks.

This week the FDA called on food industry officials across the country to improve their compliance with protecting the public from recalled products.

The FDA also announced it sent formal warning letters on Dec. 12 to corporate officials at Target, Walmart, Kroger, and Albertsons Companies for failing to remove ByHeart products from their store shelves.

At a Target store in Arkansas, state inspectors on Nov. 20 discovered a promotional “Sale!” sign offering a $2 discount off recalled ByHeart single-serve “anywhere pack” sticks from Nov. 16 to Nov. 22, according to the FDA’s warning letter to the company.

Investigators found recalled ByHeart formula on Target store shelves across 20 states from Nov. 12 to Nov. 20, the FDA’s letter said.

Workers at Target stores – as well as those at Walmart stores in 21 states, Kroger stores in 10 states, Albertsons Companies’ stores operated under various names in 11 states – gave state and local inspectors a variety of explanations for the presence of ByHeart formula in stores after the recalls were launched, the letters say.

Explanations included that store associates weren’t aware of the recall and that there was confusion over which specific lots were recalled. Workers also told investigators that there were failures to remove all of the recalled products from shelves and that stocking of shelves occurred when recalled products arrived after the recall notification, the warning letters say.

The four companies have 15 days to respond to the FDA warning letters with steps they are taking to address violations or provide information supporting why they believe they haven’t violated the law.

In a statement to Healthbeat, Walmart said: “We take all reports of inaction seriously and will respond to the letter.” The company said it “moved swiftly” to issue a sales restriction and remove the product from its stores and online platform.

Albertsons Companies said they have procedures to address product recalls and that ByHeart products have been removed from their stores. Target and Kroger did not immediately respond to Healthbeat’s requests for comment on their warning letters.

Food safety groups call for botulism testing, investigation of recall delays

The ByHeart formula recall and outbreak has “exposed dangerous deficiencies” in the nation’s food inspection and regulatory systems, according to a letter sent to the heads of the FDA, CDC and Department of Health and Human Services by the Safe Food Coalition, whose members are national food safety advocacy groups.

The five-page letter calls for a range of reforms to strengthen food safety inspections and regulations and improve the speed of recalls. It also urges fully funding food safety work and illness surveillance systems at the CDC’s National Center for Emerging and Zoonotic Infectious Diseases.

Citing Healthbeat’s reporting, the coalition is calling for the FDA to investigate bureaucratic delays in releasing to state food safety regulators the names of retailers that received ByHeart’s recalled products. It’s a lengthy process “that can and must be streamlined not just with respect to recall communication, but for all communication with state regulators,” the Dec. 8 letter said.

The Safe Food Coalition letter, among its many recommendations, also calls for the FDA to declare contamination with Clostridium botulinum to be a hazard that requires prevention and must be addressed in manufacturers’ food safety plans. And it urges the FDA to conduct a nationwide sampling program to test infant formula for this type of bacteria, which causes infant botulism.

“I think it’s critically important that the agency go out there in the field and do a survey of all the infant formula out there to reassure consumers and to understand whether this is a broader problem,” Sarah Sorscher, director of regulatory affairs at the Center for Science in the Public Interest, told Healthbeat.

Other groups in the Safe Food Coalition that signed the letter include the Center for Food Safety, Consumer Federation of America, Consumer Reports, Government Accountability Project, the Institute for Food Safety and Nutrition Security at George Washington University, and Stop Foodborne Illness.

Federal officials have not yet replied to the coalition’s letter. “HHS is in receipt of the letter and will respond directly to the requestors,” HHS said Friday in an email to Healthbeat.

“FDA acted quickly to protect the public, issuing multiple warnings alongside the firm’s initial and expanded recall,” HHS said in its email.

The FDA has previously not responded to Healthbeat’s questions about delays in sharing ByHeart’s product distribution lists with local and state food safety regulators.

HHS said Friday that the FDA began conducting its own recall effectiveness checks “at the corporate level of large retailers” on Nov. 10 – two days after ByHeart announced its initial recall of two batches of formula.

The FDA didn’t receive ByHeart’s product distribution lists from the company until Nov. 12, the day after the company expanded the recall to all products, HHS said. The list was shared the same day with a subset of state food safety regulators who had information-sharing agreements on file with the FDA, the HHS said.

HHS acknowledged that the FDA had to go through a process to obtain exceptions for local and state regulators that lacked information agreements and “where such sharing of commercial confidential information would be otherwise prohibited under the Trade Secrets Act.”

Healthbeat reported last month that according to the Association of Food and Drug Officials – whose members are state and local regulators – the FDA didn’t start fully sharing ByHeart’s product distribution lists with all state and local officials until a teleconference held at 6 p.m. on Nov. 14 – nearly a week after the formula was linked to the outbreak and the company had launched its initial recall on Nov. 8.

HHS did not say how many states had information sharing agreements with FDA that allowed them to receive the distribution lists on Nov. 12. The department only said a “majority” of the 50 states and the District of Columbia have the agreements.

Alison Young is Healthbeat’s senior national reporter. You can reach her at ayoung@healthbeat.org or through the messaging app Signal at alisonyoungreports.48

New York health update: Nuts recalled, measles nearby, medspa red flags, flu rising

2025-12-19T15:56:47+00:00

This article originally appeared at Your Local Epidemiologist New York. Sign up for the YLE NY newsletter here. Public health, explained: Sign up to receive Healthbeat’s free New York City newsletter here.

How beautiful was New York this weekend with the snow?! I hope you all enjoyed it, stayed warm, and didn’t have any slips (I had to catch myself a couple times on ice.)

As we head into the holidays and many of us travel to be with loved ones, there’s some health news to keep in mind. This week, I’m covering a recall of mixed nuts, measles in Connecticut, health violations at medspas, and circulating respiratory viruses before YLE slows down for a holiday break. As always, drop us any comments on what you’re interested in hearing more about.

Let’s jump in.

Salmonella and Wegmans mixed nuts recall

Time for a pantry check: Wegmans grocery store is recalling two mixed nuts products for potential Salmonella contamination, sold in New York and eight other states and Washington, D.C. Products were sold between Nov. 3 and Dec. 1. No illnesses have been reported so far.

Products recalled:

Wegmans Deluxe Unsalted Mixed Nuts 34-oz. tub, Family Pack
- UPC 077890421314
- Lot 58041
- Best by Jul. 28, 2026
Wegmans Deluxe Unsalted Mixed Nuts 11.5-oz. bag
- UPC 077890421352
- Lot 58171
- Best by Aug. 10, 2026

Recalled mixed nuts from Wegmans.

Routine testing by the supplier found one lot of raw pistachios to be positive for salmonella. The company then initiated a recall after determining these pistachios had been further used in the production of the Deluxe Mixed Nuts products.

What to do:

Don’t eat them. Return for a refund or discard them.
If you ate them and get fever, diarrhea, vomiting, or belly pain, most people can recover at home. But call your clinician sooner if you’re pregnant, over age 65, immunocompromised, or if your symptoms are severe/dehydrating.

Medspas are everywhere. Here’s how to check if yours is legit

Medical spas (or “medspas”) — those day spa-like clinics offering beauty services — are popping up everywhere. While they might feel like day spas, offering services like manicures or facials, many of their other procedures — Botox, fillers, IV drips, etc. — require providers to have a medical license. So before you visit one for a holiday season facial or a new treatment, it’s a good idea to make sure you know what you’re getting into.

A recent investigation into 15 New York City medpas (all of which had been flagged by consumers or agency staff as potentially problematic) found several health and safety violations, many of which could put customers and employees at risk.

Percentage of medspas receiving violations by type.

If you plan to visit a medspa, there are a couple of steps you can take to make sure standards are being met:

If you are getting something that qualifies as a medical procedure (a rule of thumb is anything that breaks the skin or goes inside your body), check that your provider has a valid license. You can verify it through New York’s official database. Medical procedures must be performed by a licensed medical professional — like an MD, DO, PA, or RN — and in a licensed medical setting. It’s the law. All 15 of the investigated medspas were offering medical procedures without proper licensing.
Check the business’s license. An “Appearance Enhancement Business” license covers cosmetology-type services (like facials, manicures, and hair salon services), but it does not cover injectables or other more invasive medical services, such as Botox, IV drips, or liposuction.
Look for medical “green flags”:

A real medical intake (history, meds, allergies), informed consent, and a plan for complications.
Clear labeling and unopened product (especially for injectables).
Clean room setup (hand hygiene, sharps container, sterile supplies).

Over half of the investigated medspas had serious sanitation and hygiene issues; some offered foreign or unregulated medications, and others used expired or potentially fraudulent products.

Report concerns. To file a complaint against a medical practitioner in New York, you can contact the New York State Department of Health’s Office of Professional Medical Conduct for doctors/PAs or the New York State Education Department’s Office of Professional Discipline for other professionals (licensed or unlicensed).

Measles in Connecticut (and what it means for New York)

Connecticut just confirmed its first measles case in more than four years in an unvaccinated child under 10 in Fairfield County. The child had recently traveled internationally with family. Contact tracing by the health department is underway, and people who may have been exposed are being notified. The health department said unvaccinated or under-vaccinated (with fewer than two doses of MMR) children and adults, including those with vaccination exemptions, will need to be out of school for 21 days.

Measles is one of the most contagious viruses — it can linger in the air for up to two hours after an infected person leaves a room, and 9 out of 10 unvaccinated people exposed will get infected. It also isn’t “just a rash” and can cause severe illness: In children under 5 years old, 1 in 5 cases are hospitalized. In severe cases, measles can cause pneumonia and brain swelling.

What to do (in Connecticut, New York, and anywhere else):

Check MMR status for everyone in your household. Two doses are about 97% effective at preventing measles.
If you think you or your child were exposed and develop symptoms, call your doctor/urgent care. Make sure to call before showing up in person so that proper precautions can be taken to avoid exposing others.
Watch for symptoms: fever/cough/runny nose/red eyes, then rash that often starts at the hairline and moves downward.

It’s not too late to get vaccinated, especially if you will be traveling internationally or to any U.S. region with a measles outbreak.

The recommendation is:

Being fully vaccinated with the MMR vaccine at least two weeks before departure.
If the trip is less than two weeks away and the traveler is not immunized, getting one dose of MMR is advised.

As always, consult with your medical provider to discuss what’s right for you and your family.

Infectious disease ‘weather report’

Flu: Increasing sharply. The most recent data show that cases and hospitalizations in the state have increased by 29% and 75%, respectively. Emergency department visits and hospitalizations for the flu in New York City are also rising, with the largest increases among kids under 18.

Hospitalizations for respiratory viruses in New York.

RSV: Also increasing across the state, mostly in kids under age 4. Statewide, hospitalizations increased by 18%.

Covid: Slowly increasing in New York.

As we head into the holidays, when many of us will be traveling to see loved ones, flu is top of mind. To reduce the spread of illness, consider masking in indoor crowded spaces — I’ve been wearing mine on the train, in the airport, and at grocery stores — and reducing contact with others if you’re feeling sick.

Bottom line

You’re all caught up on New York public health news! I hope the holidays bring you peace, joy, rest, and all the cookies.

Love,

Your NY Epi

Dr. Marisa Donnelly, PhD, is an epidemiologist, science communicator, and public health advocate. She specializes in infectious diseases, outbreak response, and emerging health threats. She has led multiple outbreak investigations at the California Department of Public Health and served as an Epidemic Intelligence Service Officer at the Centers for Disease Control and Prevention. Donnelly is also an epidemiologist at Biobot Analytics, where she works at the forefront of wastewater-based disease surveillance.

Moms say ByHeart recall has shaken their trust in baby formula safety

2025-12-03T19:45:03+00:00

Public health, explained: Sign up to receive Healthbeat’s free national newsletter here.

For moms like Elisabeth Bates and Ashlee Johnson, the decision to feed their babies ByHeart infant formula was driven by necessity and influenced heavily by words like these on the products’ labels:

“Closest to Breast Milk”

“Made with Organic Grass-Fed Whole Milk”

“Certified Clean Ingredients”

“Purity Award”

Bates, a pediatric nurse practitioner in New York City, said she wanted something better for her son than your average baby formula.

Instead – like parents across the country – Bates has been on “high alert” scrutinizing 7-month-old Beau for signs of infant botulism and counting down the 30 days until he is safely beyond the period when any botulism bacteria spores he may have consumed before ByHeart’s recall could still germinate inside his body.

“Seeing that label, you as a parent, you just kind of automatically trust that some higher body gave them this kind of certification,” said Bates, who regrets stopping breastfeeding and giving her trust to the product. “There is a big feeling of guilt.”

So far, Beau remains healthy.

ByHeart’s recall of all of its formula products last month amid a growing nationwide outbreak of infant botulism has shaken the trust of moms and caregivers – not just in ByHeart’s formula, but also in formula made by other brands, moms from across the country told Healthbeat.

Nearly a month has passed since regulators and state health officials issued the first public warnings on Nov. 8 that ByHeart’s baby formula was suspected of fueling an increase in infant botulism hospitalizations across the country. Yet as the weeks have gone by, they’ve released little information about how botulism spores could have gotten into ByHeart’s formula – such as whether the source is likely inside a ByHeart manufacturing facility or in an ingredient used to make the companies’ formula.

This lack of information, the moms said, is not reassuring for families already on edge after making a hasty switch to different companies’ formulas in the wake of the ByHeart recall.

Johnson, who lives in Bremerton, Wash., said she worries about the potential for botulism contamination in the new formula she’s feeding her 5-month-old son, Elio.

“Even with the formula we’re using now, if he has an off day, I’m like: Is there something wrong with this one?” Johnson said. “It’s supposed to be top of the line, good stuff from a reputable company. And you are still worried about it. What if there’s another recall for this one?”

Bates said even her friends who never fed ByHeart formula are worried: “If this can happen to one formula, they’re also wondering: Could my formula be next?”

Few details released about how ByHeart formula became contaminated

At least 39 infants who were fed ByHeart formula have been hospitalized in 18 states with suspected or confirmed infant botulism, according to the Food and Drug Administration’s outbreak update on Wednesday. The dates these infants first started showing signs of illness ranged from Aug. 9 to Nov. 19.

ByHeart announced a small, initial recall of two batches of its formula on Nov. 8, then recalled all of its products on Nov. 11 after more babies were hospitalized.

ByHeart has all of its infant formula products amid a botulism outbreak affecting babies across the country.

Infant botulism is caused by babies ingesting spores of the bacterium Clostridium botulinum, which can colonize their large intestine. Once inside the body, it can take up to 30 days for the spores to activate and produce a paralyzing toxin in the child’s intestine, then start causing symptoms, such as constipation, difficulty feeding, and signs of muscle weakness, such as a floppy head.

The FDA and the Centers for Disease Control and Prevention have said little about their investigation into how botulism bacteria got into unopened containers of ByHeart infant formula. They have previously said they have not identified any other infant formula brands that pose a risk.

While ByHeart officials initially had emphasized “there is no historical precedent of infant formula causing infant botulism,” the company has since said that its own recent testing has detected botulism bacteria in five of 36 samples of unopened formula packages.

“Based on these results, we cannot rule out the risk that all ByHeart formula across all product lots may have been contaminated,” the company said late last month. “We continue to be focused on finding the root cause, through a rigorous audit of every step of our product development chain, from suppliers and raw ingredients, through to packaging and transportation.”

ByHeart did not answer questions from Healthbeat about what has been done to investigate each of those manufacturing steps and examine the component ingredients that were used to make the contaminated products.

Officials at the FDA and the CDC also did not answer questions from Healthbeat about what their investigation has found in the search for where and how botulism spores got into the product.

“FDA’s investigation, including onsite inspections, is ongoing to determine the point of contamination,” the agency said in an outbreak update last week that provided no details about what those recent inspections have found at ByHeart’s manufacturing plants or at any other companies that supplied the individual ingredients used to make ByHeart’s formula.

The FDA released redacted copies of inspection reports for three ByHeart manufacturing facilities from February and March 2025, and January 2024. The reports show manufacturing and contamination problems, some of which have been previously reported by Healthbeat and other news organizations.

But the FDA has released nothing about what its inspectors and investigators have found during the past month – in the wake of the infant botulism outbreak – as they have examined ByHeart’s manufacturing facilities, and potentially also the facilities of other companies supplying ingredients to ByHeart.

ByHeart told Healthbeat this week that “no observable links” have been found between the FDA’s facility inspection findings and the botulism bacteria that tests have detected in the company’s formula.

‘No signals’ other brands of infant formula are at risk, California officials say

The outbreak was initially identified by the California Department of Public Health, which noticed an increase in requests for a drug it makes to treat infant botulism. The drug, called BabyBIG, is the only FDA-approved treatment for infant botulism. California’s health department also serves as the nation’s infant botulism program.

The FDA has said it was alerted on Nov. 6 that California officials had identified a cluster of infant botulism cases linked to ByHeart’s formula.

CDPH told Healthbeat Tuesday evening that among the 118 infants nationwide treated for infant botulism with BabyBIG between Aug. 1 and Nov. 30, the only cases with a common source of exposure are those that have been linked to ByHeart’s formula.

FDA delays left recalled baby formula on store shelves, food safety expert says

“To date, there have been no signals that other infant formulas have been affected,” the department said in an email.

“It is usually difficult to pinpoint a root cause of any infant botulism case,” the department said. “Infant botulism is a very rare disease, and cases typically occur sporadically.”

CDPH noted that investigations and testing over many years indicate that most infant botulism patients become infected by simply swallowing microscopic dust particles containing spores. Honey is also a known and avoidable source of botulism bacteria spores.

The FDA and CDC did not respond to questions from Healthbeat about the potential for other products to be contributing to the recent rise in infant botulism cases.

Could contaminated milk or another ingredient be the source of botulism spores?

While ByHeart has said botulism bacteria has not been among the pathogens routinely tested for across the formula industry, formula maker Mead Johnson – whose brands include Enfamil – told Healthbeat it has tested its products for botulism contamination for years.

“Every lot of ingredients containing dairy undergoes testing for possible infant botulism contamination during the raw material phase because these bacteria can occur naturally in soil and farm environments, and we aim to mitigate risk right from the start,” Mead Johnson said in an email on Tuesday. “We also conduct routine clostridium and spore testing to ensure the quality and safety of our finished powdered products.”

The testing has not showed any evidence of infant botulism contamination, according to the company’s review of readily available testing records.

“To the best of our knowledge, there had never before been a confirmed case of botulism linked to infant formula. We are closely monitoring the recent competitor recall and look forward to understanding the circumstances behind it,” Mead Johnson said in its statement.

Formula maker Bobbie, which like ByHeart markets itself as a premium organic, whole milk formula, recently announced it is increasing testing of its facilities and products.

Recalled baby formula went to groups serving homeless and at-risk families

As of November, in the wake of ByHeart’s recall, Bobbie has added to its existing testing protocols a type of test that can identify potential spore-forming bacteria, including botulism bacteria. This kind of sulfite-reducing clostridia testing is a screening tool that can serve as an “early-warning system” that further testing is necessary if a positive result comes back, the company said.

It’s unclear what actions other formula makers are taking as a result of the ongoing ByHeart investigation.

Officials with the Infant Nutrition Council of America, an association of infant formula and toddler milk manufacturers, did not respond to repeated requests for comment since Nov. 20 about the potential implications of ByHeart’s botulism contamination for the wider formula industry. The council’s members include Abbott Nutrition, which makes Similac brand formula, and Perrigo Nutrition, which makes store-brand formulas and owns the rights to Nestlé’s Good Start brand.

Bill Marler, an attorney who has specialized in representing victims of foodborne illnesses for more than 30 years and who has filed four lawsuits against ByHeart on behalf of the families of sickened infants, told Healthbeat that manufacturing sanitation and ingredients are the primary suspects.

Marler said that ByHeart’s use of whole milk, not used by many formula makers, is a potential suspect ingredient. But the sanitation issues described in the FDA’s past inspections of ByHeart’s manufacturing plants are also concerning, he said.

“Hopefully they’re going to be able to figure out the number of kids that are sick and what likely lot they consumed from, and then start working their way back upstream,” said Marler, whose firm is based in Washington state.

David Clark, a dairy product industry consultant who specializes in infant formulas, said contaminated milking equipment is one of many potential sources of the contamination in ByHeart’s products.

Botulism bacteria can be found in the environment, stalls, and bedding on dairy farms, he said. The spores, he notes, are not killed by pasteurization. That’s why there are strict requirements for cleaning the cows’ udders and milking equipment, said Clark, whose firm Bovina Mountain Consulting is based in Englewood, Fla.

Officials with the U.S. Department of Agriculture, the federal agency responsible for animal health, did not respond to questions from Healthbeat about whether there have been any botulism outbreaks on dairy farms in the past year, whether there are any requirements for such outbreaks to be reported, and whether there are any regulations that require milk from infected cattle to be withheld from the food supply.

“Please direct these questions to the U.S. Food & Drug Administration,” the USDA press office replied in an email. The FDA also did not respond to the questions.

ByHeart formula carried ‘Purity Award’ certification from Clean Label Project

In addition to ByHeart’s manufacturing plants undergoing FDA inspections, the company’s cans and pouches were emblazoned with a certification that the formula had received a Clean Label Project “Purity Award.”

But the certification never involved any testing for pathogens like those that cause infant botulism, said Kate Stuard, a spokesperson for the Clean Label Project, a nonprofit group based in Colorado.

The project’s voluntary certification program, which manufacturers can apply to, tests a wide range of consumer products for industrial and environmental contaminants such as heavy metals, pesticides, and phthalates, Stuard said. The certification’s rules also require products be produced in facilities that maintain compliance with Good Manufacturing Practices.

The Clean Label Project recently removed ByHeart’s formulas from its list of certified products, a review of archived images of its website shows. The organization did not answer Healthbeat’s questions about when and why ByHeart’s listing was removed recently. The group also didn’t answer whether it took any actions against ByHeart’s purity certification in the wake of a previous recall in December 2022 for a different kind of bacterial contamination that prompted the FDA to issue a formal warning letter to ByHeart in August 2023.

The organization issued a general statement that “if a brand is subject to a recall, we suspend their certification pending the outcome of the investigation.” But it’s unclear what is done to alert consumers to any suspension.

ByHeart, which acknowledged the project’s practice of suspension during a recall investigation, told Healthbeat that the Clean Label Project “did not take action against ByHeart’s certification after a regulatory inspection or report. FDA inspections are a routine regulatory practice, and a core part of ByHeart’s continuous improvement program.”

Baby formula maker linked to botulism outbreak was warned previously about contamination issues

The Clean Label Project last month announced it has been selected to assist with Amazon’s Compliance Fast Track Program that will allow certified brands to have automatic compliance verification with the online retailer.

Health and Human Services Secretary Robert F. Kennedy Jr. last spring announced an initiative to improve the safety and nutrition of infant formulas. But so far the program, called Operation Stork Speed, has indicated a focus on nutrition reviews and testing for heavy metals and other contaminants.

Lack of answers about source of ByHeart contamination fuels concerns among moms

For now, the biggest question for many parents and caregivers remains: How did ByHeart’s botulism contamination happen – especially in a premium product that emphasized its purity to consumers.

“What if it happens at another facility?” asked Dezirae Davies, a medical assistant and mom in Canton, Ohio. “These are our prides and joys that we’re talking about. And some people don’t have the option of breastfeeding babies. So, it’s a really important thing to find out: How did this happen and why did this occur?”

Dezirae Davies holds her son, Koa, in June 2025. “I just wanted the best for my baby,” she said of her decision to feed him ByHeart formula, was recalled in November.

Davies said she chose ByHeart after a lot of research because she wasn’t producing enough milk after six months of breastfeeding her son, Koa. “We wanted something that was organic and more naturally made,” she said. “We wanted something that was comparable to my own breast milk.”

Koa did well on ByHeart’s formula for months until Davies got an alert on her phone last month about the recall. She remembers the horrible wave of panic as she realized that the recalled cans included one that Koa – who was by then 11 months old – had just finished.

“We talked to poison control for like an hour,” Davies said. As the family watched for infant botulism symptoms, Koa developed diarrhea from switching formulas. So they switched him to whole milk, based on his age and his doctor’s advice, and he’s now doing well, she said.

But dozens of families across the country have not been so fortunate.

Hanna Everett of Richmond, Kentucky, said her 4-month-old daughter, Piper, is among the dozens of infants who have been sickened with infant botulism after being fed ByHeart formula.

Piper, who Everett said had recently started drooling her formula out the sides of her mouth, became constipated the same weekend ByHeart announced its first recall. What hadn’t seemed anything serious, became terrifying warning signs in the wake of the recall announcement, prompting the family to rush Piper to the emergency room.

“They had to start numerous IVs, and they had to put a feeding tube in because of the muscle paralysis. They were worried she was going to aspirate,” Everett said.

“Watching them do the feeding tube and the IVs was just awful,” Everett said. “It’s hurting her. She’s screaming and crying.”

Once she started receiving the BabyBIG botulism treatment, which had to be shipped to the hospital, Piper clearly started feeling better, and she was able to return home within a few days, her mother said.

Doctors expect Piper to recover, Everett said, though she will need to receive feeding therapy to help improve her sucking and eating. “We caught hers very early,” Everett said. “We’re very thankful for that.”

Everett said picking out a new formula to feed Piper after ByHeart’s recall was incredibly stressful, but necessary because she has had difficulty producing enough breast milk.

“That was already a big decision the first time around, and I thought I made the right choice. Then it came back to hurt my daughter,” she said.

Everett’s message for the FDA and ByHeart: “They need to do better.”

“They were in trouble multiple times. I feel like the government agencies really let the ball slip on this,” said Everett, who has sued ByHeart in federal court. “It’s not something you should ever have to worry about when feeding your children.”

This article has been updated to include an update Wednesday from the FDA on the number of cases.

Alison Young is Healthbeat’s senior national reporter. You can reach her at ayoung@healthbeat.org or through the messaging app Signal at alisonyoungreports.48

FDA delays left recalled baby formula on store shelves, food safety expert says

2025-11-22T00:47:57+00:00

Public health, explained: Sign up to receive Healthbeat’s free national newsletter here.

Efforts to ensure recalled ByHeart infant formula is removed from store shelves have been hampered across the country because of bureaucratic delays by the U.S. Food and Drug Administration in sharing product distribution lists with state and local officials, according to the head of the Association of Food and Drug Officials.

“I’m not sure they recognize the sense of urgency,” Steven Mandernach, the association’s executive director, told Healthbeat on Friday, amid the nationwide outbreak of infant botulism cases linked to ByHeart’s baby formula. “You expect all hands on deck. This is infants.”

Mandernach said the FDA didn’t start fully sharing ByHeart’s product distribution lists with all state and local food safety officials until a teleconference held 6 p.m. Nov. 14 – nearly a week after the formula was linked to the outbreak and the company announced its initial recall on Nov. 8.

“We wasted almost a week,” Mandernach said. He said recall effectiveness inspections have been finding recalled ByHeart formula offered for sale at about 10% of stores that had been checked as of earlier this week.

On Wednesday and Thursday, the FDA warned the public that recalled ByHeart formula is still being found on the shelves of major retailers, including Walmart, Target and Kroger stores. The FDA did not immediately respond to Healthbeat’s questions Friday about why it took so long for the agency to share distribution lists with local food safety officials.

At least 31 infants who have been fed ByHeart Whole Nutrition infant formula have been hospitalized in 15 states with suspected or confirmed infant botulism as of this week. ByHeart has announced that its independent testing has found the bacteria that causes infant botulism in some of its formula.

Federal health officials have warned consumers worldwide to not feed any ByHeart infant formula to babies because of the potential for it to be contaminated with botulism bacteria spores. It can take up to 30 days between when a baby ingests botulism spores until they start showing signs of illness.

Disjointed sharing of ByHeart sales locations delays removal

Mandernach, in an interview with Healthbeat, described what he said were the FDA’s delayed, limited and disjointed sharing of critical information needed by local food safety officials about what stores and distributors received ByHeart’s formula.

Part of the issue has been bureaucratic, he said.

In recent years, he said, the FDA’s legal team has reinterpreted the agency’s authority. The FDA now considers a food manufacturer’s list of where it sent its recalled products to be confidential business information that cannot be shared with local food safety officials unless they have signed a privacy agreement.

The FDA can also go through an internal process to allow it to justify sharing the information with local departments, Mandernach said, which the agency ultimately completed on Nov. 14.

“No one expects the law to prohibit the agency from trying to share information in this type of event,” he said. “For it to take four days for them to figure out how to use that exemption, that’s just not normal.”

Mandernach said there has been a bipartisan effort in Congress for some time to address the bureaucratic hurdles to sharing distribution lists for recalled products with local officials, but the fix hasn’t happened.

While some states that had federal data-sharing agreements with the FDA received ByHeart distribution lists on Nov. 11 and 12, Mandernach said they were not allowed to share the lists with others. And not all of the departments who had agreements with the FDA were given the information at that time, he said.

“Finally, Friday night [Nov. 14] at 6 p.m., FDA holds a call with all the state partners and some of the large health department partners and says we’re officially able to share the list with you,” Mandernach said.

By that late hour, it meant that many local and state food safety programs were not able to start visiting stores and other locations on the lists until Monday. “Wow. We waited from Tuesday to Friday night at 6,” he said.

In its outbreak updates to the public this week, the FDA emphasized that all ByHeart infant formula products, including cans and single-serve “anywhere pack” sticks have been recalled, and they should not be available for sale in stores or online.

“FDA has received reports that recalled formula is still being found on store shelves in multiple states, including at multiple Walmart, Target, and Kroger locations, and at one or more Sprouts Organic Market, Safeway, Jewel-Osco, Shaw’s, and Star Market locations,” the agency said in an announcement on Thursday. “FDA is working with state partners and retailers to ensure an effective recall and immediate removal of these products from store shelves across the country.”

Walmart said in a statement on Friday it has removed ByHeart formula from its stores and clubs as well as online sites. The retailer also said it has a “sales restriction” in place on ByHeart products, which electronically stops the products’ barcode from being scanned and sold to a customer when they check out.

Sprouts, which said it took “immediate action” to remove ByHeart products from its shelves, told Healthbeat the stores have also taken “additional measures” with vendors to ensure no remaining product is available for sale.

Recalled products have been left on store shelves during previous outbreaks

Food safety advocates said Friday it’s not surprising that ByHeart infant formula continues to be found on store shelves in multiple states, nearly two weeks into a recall and amid a nationwide nationwide outbreak of infant botulism

“This is part of a pattern we’ve seen in recalls, where products are often left on store shelves well after the recall announcement,” said Sarah Sorscher, director of regulatory affairs for the Center for Science in the Public Interest, a food and health watchdog organization based in Washington, D.C.

“It’s just a lot of dysfunction in how recalls are managed in this country,” she said.

The delays in FDA sharing ByHeart’s distribution lists with state officials is an example of this, Sorscher said.

“That slows the recall check because states can’t go out and check on the effectiveness of the recall unless they have that list,” she said. “FDA has repeatedly asked Congress to give it the authority to share more freely with states.”

During 2023 and 2024, after nationwide recalls of certain brands of cinnamon applesauce pouches that were linked to elevated lead levels in children, the FDA continued to find the product being sold on the shelves of Dollar Tree stores.

The FDA issued a formal warning letter to Dollar Tree in June 2024.

“In the weeks and months that followed the manufacturer’s voluntary recall of apple cinnamon fruit puree pouches, public health officials across many states reported continuing to see recalled WanaBana apple cinnamon fruit puree pouches on Dollar Tree store shelves,” the FDA said at the time it issued the warning letter.

“When a food is recalled, retailers play a crucial role in carrying out the recall by ensuring that recalled products are not available to consumers at their stores,” the FDA said at the end of the recall.

Still, it’s not uncommon for products to remain on store shelves, said Barbara Kowalcyk, director of the Institute for Food Safety and Nutrition Security at George Washington University.

The current issues with ByHeart formula remaining on store shelves deserves further scrutiny, she said.

“It’s not surprising to me, but it’s saddening. We know recall effectiveness is not as good as it should be,” Kowalcyk said. But this particular product involved such a vulnerable population – infants who often rely on formula as their only source of nutrition. “I think there needs to be an assessment of why that happened,” she said.

ByHeart officials on Friday said they have been working “with urgency” to recall their formula. The company told Healthbeat it has notified all of its retail customers to remove all ByHeart formula from shelves.

“Since November 9, ByHeart has notified retailer partners four times, and they have confirmed communication has been sent to stores. The FDA has also shared notifications with retailers,” the company said.

ByHeart also said it has taken action to notify members of its OpenHearted formula donation program of the recall. “All OpenHearted partner organizations have been notified, and ByHeart has helped aid recall implementation with them. We have shared all necessary information on our donation programs with the FDA and other regulatory bodies, as needed,” the company said.

Alison Young is Healthbeat’s senior national reporter. You can reach her at ayoung@healthbeat.org or through the messaging app Signal at alisonyoungreports.48

As botulism outbreak grows, major stores still selling recalled ByHeart baby formula

2025-11-20T22:43:47+00:00

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As the nationwide outbreak of infant botulism continues to grow, and new test results show botulism bacteria in some samples of ByHeart infant formula, the source of the potentially deadly contamination remains unknown.

ByHeart Inc., in an announcement on its website Wednesday night, said that testing the company commissioned has identified Clostridium botulinum, the bacteria that cause botulism, in some samples of its baby formula.

“We do not yet know the root cause, but we are committed to finding the answers,” the company said.

At least 31 infants in 15 states who have been fed ByHeart Whole Nutrition infant formula have been hospitalized with suspected or confirmed infant botulism as of Wednesday, according to the U.S. Food and Drug Administration.

That’s eight more infants since Friday’s outbreak update. It can take up to 30 days between when a baby ingests botulism spores until they start showing signs of illness.

Meanwhile, despite the outbreak and nationwide recall of all ByHeart products, FDA officials on Thursday warned that the company’s products are still being sold in multiple states. The FDA said the formula has been reported at “multiple Walmart, Target, and Kroger locations, and at one or more Sprouts Organic Market, Safeway, Jewel-Osco, Shaw’s, and Star Market locations.”

Here’s what to know about the latest developments in the outbreak investigation,

How did ByHeart formula become contaminated with botulism spores?

Federal investigators have said little about how they suspect ByHeart’s infant formula became contaminated, and they have released few details about what their investigation of ingredients and manufacturing processes have found.

“The contaminant is the spores, Clostridium botulinum spores,” said David Clark, a dairy product industry consultant whose practice specializes in infant formulas. “It’s very important to find out where the spores are coming from, because it’s difficult to eliminate them, to kill them, to prevent them from germinating into active bacteria.”

Pasteurization of milk does not occur at a high enough temperature to kill botulinum spores, which is why it’s important to prevent them from getting into milk, he said.

Infant botulism is caused by babies ingesting these inactive spores. But once the spores are in the body, they germinate and colonize the infant’s intestine, where they produce a neurotoxin. The infant may not have any symptoms until weeks after exposure, then begin to show signs of constipation, loss of head control, and difficulty sucking and feeding.

As federal investigators and ByHeart continue to look for how bacteria spores got into the formula, Clark said there are a wide range of ingredients and manufacturing processes that are likely being scrutinized.

Clark, whose firm Bovina Mountain Consulting is based in Englewood, Fla., told Healthbeat it’s important to keep an open mind about where the spores might be coming from, because the bacteria that causes botulism is found widely in the environment.

“As dairy ingredients are key in formula, they must look through those and how those ingredients are handled,” he said.

Dairy cows have the potential to become infected with botulism through contaminated feed and other sources in the environment. Scientists in Germany have reported detecting Clostridium botulinum bacteria and toxin in milk from dairy cattle that appeared to be infected with the bacteria. But other researchers have not found bacteria in the milk produced by a small number of experimentally infected dairy cattle.

“The most likely source of contamination is not actually in the milk coming out of the teat in the [cow’s] udder, it’s more likely to be contamination on the milking equipment,” Clark said.

Botulinum bacteria have the potential to grow in the environment where dairy cattle are kept, including in their bedding, where there is fecal material.

“That’s why there are very thorough requirements, operating procedures about cleansing the udder and the equipment” before milking cows, he said.

But Clark said there are many other potential sources of how the infant formula could have become contaminated. He noted there are other ingredients in formula beyond dairy, including oils, fiber, and minerals.

“It could come from any of the ingredients,” he said. It also could come from contamination of manufacturing or packing equipment or products. “So it’s going to be difficult to track it down,” he said.

Recalled ByHeart infant formula continues to be sold

The FDA this week raised concerns that the recall of all ByHeart infant formula products, which was announced on Nov. 11, has not been effective in protecting consumers.

“FDA has received reports that recalled formula is still being found on store shelves in multiple states,” the agency said. “All ByHeart infant formula products have been recalled, and these products should not be available for sale in stores or online. This includes all formula cans and single-serve ‘anywhere pack’ sticks.”

The FDA said it is working with state agencies and retailers “to ensure an effective recall.”

The agency also warned on Wednesday and Thursday that customers worldwide should not use ByHeart products, which were sold through online marketplaces and shipped to customers. Customer information provided to the FDA by Amazon shows ByHeart formula was distributed to about 20 countries, including Argentina, Canada, Egypt, Israel, Peru, South Africa, and Thailand.

Healthbeat reported last week that in addition to commercial sales, ByHeart had a formula donation program that gave away its product to food banks and organizations helping homeless and in-need families.

It remains unclear what actions are being taken to notify families who received donated formula. The FDA’s outbreak update Wednesday did not mention that ByHeart products have been supplied to food banks and social service agencies. The agency did not respond to questions about this sent by Healthbeat on Wednesday.

“I’m getting very concerned,” Donald Whitehead, executive director of the National Coalition for the Homeless, said Thursday. Whitehead said he’s tried to reach officials at the Centers for Disease Control and Prevention, an agency that has been helpful to his organization in the past.

“I’ve not heard anything back,” he said.

ByHeart’s statements evolve from skepticism to finding bacteria

News of potential issues with ByHeart’s infant formula first became public on Nov. 8. That’s when the company announced it was voluntarily recalling just two batches of its formula.

ByHeart’s announcement emphasized “there is no historical precedent of infant formula causing infant botulism,” that the FDA had not found a “direct link” to the company’s product, and said the recall was being done “out of an abundance of caution.”

At that time, health officials had identified 13 infants hospitalized with infant botulism who had consumed ByHeart formula.

Three days later, on Nov. 11, the company announced it was recalling all of its products after two more hospitalized infants that consumed ByHeart formula were identified the previous day.

The 31 infants whose illnesses are so far linked to the outbreak range in age from 16 days to about 6 months old. And they have fallen ill on different dates over the past three months. The dates that each of their illnesses started range from Aug. 9 to Nov. 13, the FDA said.

But most of these infants have fallen ill in recent weeks, according to the CDC’s timeline of infants’ illnesses. Of the 27 outbreak cases in the CDC’s data, 21 had a first date of illness on or after Oct. 19.

There can be a significant delay between when a child ingests botulism bacteria spores and when they start experiencing any symptoms of illness. Health officials say babies that drank ByHeart formula should be watched closely for 30 days after they last had any of the product.

While the California Department of Public Health announced on Nov. 8 that preliminary tests on an open can of ByHeart formula suggested the presence of Clostridium botulinum bacteria, ByHeart officials emphasized the need to test unopened cans.

“Opened product can be exposed to environmental factors – soil, dust, vegetables – that can contain C. botulinum, which is why it is important to test unopened samples to establish causation,” the company told Healthbeat on Nov. 10.

Now, the company’s own testing has identified the bacteria in “some samples” of its formula. ByHeart said the tests were done by IEH Laboratories & Consulting Group.

“We have been working in cooperation with the FDA, and we are investigating every facet of our process – from ingredient-sourcing to our manufacturing process and facilities, packaging, transportation, everything,” the company’s announcement of the test results said.

ByHeart did not answer questions from Healthbeat on Thursday about how many samples were tested by its lab contractor or how many tested positive for contamination. It’s unclear what regulators have found in their testing of ByHeart’s formula. The FDA said that its investigators have collected and are analyzing unopened ByHeart products.

“Additional testing is underway, and results are expected in the coming weeks,” the FDA said this week. “Detection of Clostridium botulinum in infant formula is difficult, and a negative test result does not rule out the presence of the bacteria in the product.”

Alison Young is Healthbeat’s senior national reporter. You can reach her at ayoung@healthbeat.org or through the messaging app Signal at alisonyoungreports.48

Recalled baby formula went to groups serving homeless and at-risk families

2025-11-14T20:17:49+00:00

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Baby formula linked to a nationwide outbreak of infant botulism was distributed to programs serving homeless mothers and other struggling families in multiple states, but it’s unclear what actions are being taken to alert those families to the recall.

Formula maker ByHeart Inc., operates a formula donation program in partnership with Baby2Baby, a Los Angeles-based nonprofit that counts high-profile celebrities among its supporters. ByHeart’s Open Hearted Initiative has donated nearly 24,000 cans of formula to at-risk families since June 2022, according to ByHeart’s website.

Neither ByHeart nor Baby2Baby answered questions sent by Healthbeat on Wednesday and Thursday about what actions are being taken to ensure people who received donated formula are aware they shouldn’t feed it to their babies.

Donald Whitehead Jr., executive director of the National Coalition for the Homeless, said Thursday he was unaware ByHeart’s recall involved formula that included cans that were donated to groups that help feed homeless people. Special outreach efforts are needed to ensure they are aware of the danger, he said.

“We have no clear indication that people have access to news stories or if they’re listening at a given time to the radio,” Whitehead said, emphasizing press releases are not enough.

Whitehead said his organization has not received any alert from the Centers for Disease Control and Prevention about the recall impacting homeless people. He said the CDC typically alerts the coalition of such health risks.

“Until you just alerted me, I did not know this issue existed,” Whitehead told Healthbeat. “I personally will reach out to the CDC.” He also said he will be sending an alert to his organization’s network.

The CDC did not immediately respond to questions from Healthbeat.

Bobby Watts, CEO of the National Health Care for the Homeless Council, also said he was not aware that the recalled formula was part of a distribution program to homeless people and food banks. “I’m glad you raised this to our attention,” he said.

Watts said the infant formula recall is occurring at a time when families are relying even more on donated products because of recent cuts to food aid under the federal Supplemental Nutrition Assistance Program.

The FDA announced Friday that the number of confirmed or suspected infant botulism cases in the outbreak has risen from 15 infants to 23 infants. All of these infants have needed to be hospitalized and all had confirmed exposures to various lots of ByHeart Whole Nutrition infant formula. The cases are spread across 13 states.

Symptoms of the dangerous infection – which include constipation, difficulty suckling or swallowing, loss of head control and progressive paralysis – are caused by infants ingesting bacteria spores.

ByHeart on Saturday announced a limited recall of its powdered formula, which it expanded to include all of its products on Tuesday as the number of infant botulism cases identified by federal and state health officials continued to grow.

According to ByHeart’s website, the company has been donating its infant formula as part of a goal of ending food insecurity for babies by 2028. “Whenever you purchase ByHeart, you’re supporting our OpenHearted Initiative, which helps provide infant formula, nutrition education, and essential support to families who need it most,” the company’s website says.

ByHeart said it partners with Baby2Baby to distribute formula to families. The program lists 23 organizations across the country as participants in the ByHeart formula donation program. They include WIN (Women In Need) in New York City, which provides services to homeless women and children and describes itself on its website as the city’s “largest provider of family shelter and supportive housing.”

In the metro Atlanta area, Helping Mamas in Norcross, Ga., is listed as another participant in the formula donation program.

Nobody from WIN or Helping Mamas responded to questions from Healthbeat about how much recalled formula they received and what is being done to ensure the people who were given the formula are aware it shouldn’t be used.

In Portland, Oregon, PDX Diaper Bank received 400 cans of the recalled ByHeart infant formula, of which 312 cans were recently distributed, said Rachel Alston, the group’s executive director.

But PDX Diaper bank wasn’t able to say what’s being done to alert the individual families who received the formula cans.

“PDX Diaper Bank does not provide direct services to families, so [we] are calling on our partner agencies to provide recall information to families directly impacted,” Alston said in an email to Healthbeat. Her organization disposed of the 88 formula cans remaining in its warehouse.

“We are prepared to support our partner agencies in regard to communications to families, if needed.”

Alston said PDX Diaper Bank, which was notified about the recall by Baby2Baby, has followed up by email and phone with the six organizations where it sent the formula to make sure they are aware of the recall. She did not name the six organizations.

Some of the other groups listed on ByHeart’s website as participating in the formula donation program include: El Nido Family Centers on Manchester Avenue in Los Angeles; Miami Diaper Bank in Hialeah, Florida.; Detroit Diaper Bank in Detroit; The Baby Bureau in Westminster, Pennsylvania; Mary’s Shelter in Reading, Pennsylvania; Family Network in Springdale, Arkansas; Power in Changing in Columbia, South Carolina; Northern Kentucky Community Action Commission in Covington, Kentucky; SheRises in Bowie, Maryland; and the Center for Children and Families in Norman, Oklahoma.

Healthbeat received no reply to messages left with these organizations asking how they are alerting people who received recalled formula.

A complete list of organizations that ByHeart’s website says are participating in the formula donation program is available at this link.

This story has been updated to reflect an increase in reported cases from the FDA.

Alison Young is Healthbeat’s senior national reporter. You can reach her at ayoung@healthbeat.org or through the messaging app Signal at alisonyoungreports.48

Baby formula maker linked to botulism outbreak was warned previously about contamination issues

2025-11-11T17:35:29+00:00

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The baby formula company linked to an infant botulism outbreak that has hospitalized children in at least 12 states, was previously cited by federal regulators for contamination issues involving a different type of dangerous bacteria.

ByHeart Inc. on Tuesday morning expanded its infant formula recall to all batches of ByHeart Whole Nutrition Infant Formula cans and Anywhere Pack amid new warnings from federal health officials that parents and caregivers should immediately stop using any of the company’s products.

“The decision to broaden our recall to all ByHeart products comes after a call with the FDA late last night, informing us that they found two more cases of infant botulism in babies that had also consumed ByHeart at some point,” the company said in a note to customers posted on its website.

ByHeart was involved in another formula recall in December 2022. The company received a formal warning letter in August 2023 from the Food and Drug Administration for failing to have manufacturing processes that ensured its products didn’t become contaminated with microorganisms.

In these earlier safety issues, records show FDA investigators found that ByHeart had failed for months to adequately look into warning signs that infant formula made at its Pennsylvania facility was at risk of contamination with Cronobacter sakazakii, bacteria that can cause life-threatening infections in infants. No illnesses were noted in the 2022 recall.

The current recall of ByHeart Whole Nutrition Infant Formula that began over the weekend involves a different type of bacterium – Clostridium botulinum – that causes infant botulism. And this time the recalled formula was made at ByHeart manufacturing facilities in Portland, Ore., and Allerton, Iowa, the company said in an email to Healthbeat.

The FDA most recently inspected ByHeart’s Oregon facility in March and classified it as “No Action Indicated.” The Iowa facility, however, was cited for issues related to good manufacturing practices on its February inspection, and it was classified as “Voluntary Action Indicated,” the FDA said.

No additional information about these inspections was available Monday. ByHeart officials did not answer Healthbeat’s questions about what the FDA found during the facilities’ inspections. The company said that no products other than infant formula are made at the facilities.

“We adhere to rigorous safety and quality standards and have the utmost confidence in our product, our safety systems, and the people behind them,” Dr. Devon Kuehn, ByHeart’s chief medical officer and chief scientific officer, said in emailed responses to Healthbeat’s questions on Monday night.

Preliminary tests indicate botulism bacteria in one opened formula can

Infant botulism is caused by a baby swallowing spores of Clostridium botulinum bacteria. Once inside the body, the spores activate, then infect the child’s large intestine and produce botulinum toxin. The toxin blocks nerve signals and causes weakness and loss of muscle tone.

Symptoms can take weeks to develop and may include constipation, difficulty suckling or swallowing, loss of head control and decreased facial expression. Without treatment, symptoms will worsen and can lead to breathing difficulties.

The California Department of Public Health, which runs the national infant botulism monitoring program that distributes the only FDA-approved drug to treat children who are sickened by the toxin, noticed an increase in medication requests, then alerted federal officials to the cases involving infants who drank ByHeart powdered infant formula.

“At this time, CDPH is urging families to stop using ByHeart formula immediately, and to report any signs or symptoms of infant botulism to their health care provider or local health department immediately,” the department said in an email to Healthbeat on Monday evening.

ByHeart infant formula is sold online by the company and through major retail stores including Amazon, Kroger, Walmart, Whole Foods, and Target.

As of Tuesday morning, the FDA said the infant botulism outbreak linked to ByHeart’s products involved 15 infants hospitalized in 12 states: Arizona, California, Illinois, Kentucky, Minnesota, North Carolina, New Jersey, Oregon, Pennsylvania, Rhode Island, Texas and Washington state.

The earliest known case linked to ByHeart formula became ill in August, and the most recent case became ill Monday, the FDA said.

The FDA said that among 84 infants treated nationwide for infant botulism since August, those who were fed powdered baby formula disproportionately consumed ByHeart formula. ”Investigations remain ongoing but have not identified any other infant formula brands or shared exposures that pose a risk to infants,” the FDA said.

Nine of the cases linked to ByHeart formula have been confirmed as toxin type A botulism; the others’ tests are still pending, CDPH has previously said.

California health officials on Saturday announced that their preliminary tests on a can of ByHeart powdered infant formula that was fed to one of the hospitalized infants “suggest the presence of the bacteria that produce botulinum toxin.”

ByHeart officials said the company is working with state and federal investigators.

“We are conducting a comprehensive investigation and have offered the FDA and CDC and CA Dept of Public Health full access to our facilities and unopened cans, without restriction,” Kuehn said.

He said that the bacteria that cause infant botulism are found naturally in soil, dust, and some vegetables. “International food safety authorities have concluded that C. botulinum is not a risk in powdered infant formula, and no U.S. or imported formula is currently required to be tested for C. botulinum.”

ByHeart says it launched recall within 24 hours of notification

The FDA was first made aware of a cluster of illnesses on Thursday afternoon. ByHeart officials say they were notified of concerns about their formula on Friday. Then on Saturday, the company announced its voluntary recall and public warnings were put out by state and federal health officials.

ByHeart officials say they were told by the FDA that the infant botulism cases linked to their formula are part of a larger spike in infant botulism cases involving about 83 infant botulism cases since August.

ByHeart’s recall announcement posted on the FDA website Saturday said, “No ByHeart product has tested positive for any contaminants,” even though California health officials in their same-day announcement noted their preliminary tests of ByHeart formula in one opened can indicated the presence of the bacteria that causes botulism.

When asked about the conflicting information, Kuehn told Healthbeat: “We became aware of the CDPH test result on Sunday, November 9 and are treating it with the utmost seriousness.”

But because opened cans could have become contaminated from the environment while they are being used, Kuehn emphasized the importance of testing unopened cans of formula.

“We are working closely with the FDA, as well as a third-party independent testing facility, to test unopened product from the voluntarily recalled lots to conclusively determine causation,” he said.

The Centers for Disease Control and Prevention on its outbreak web page said that officials in several states have collected leftover infant formula for testing. Results “are expected in the coming weeks,” it says. The CDC did not respond to questions on Monday about the outbreak and its role in investigating its source.

The company told Healthbeat on Monday night that there had been no government recommendation to recall any product lots beyond two batches of formula made on April 23 and May 6, which were recommended by the FDA. These batches were distributed primarily in July and August, the company said.

Then Tuesday morning, the company announced it was voluntarily expanding its recall to include all batches of ByHeart Whole Nutrition Infant Formula cans and Anywhere Pack “despite the fact that no unopened ByHeart product has tested positive for Clostridium botulinum spores or toxin.”

The recalled cans have UPC code 85004496800, and Anywhere Packs are marked with UPC code 85004496802.

“The safety and well‑being of every infant who uses our formula is, and always will be, our highest priority,” Mia Funt, ByHeart co‑founder and president, said in the company’s announcement.

The FDA on Tuesday warned parents and caregivers to immediately stop using ByHeart formula and to seek immediate medical attention if their child has consumed the company’s products and is experiencing any symptoms.

Children who are not showing any symptoms should be monitored for signs of infant botulism, the FDA said, which can take weeks to appear. The FDA advises that people who have any leftover ByHeart formula take a photo or record the information on the bottom of the package, then store the product in a safe place after marking it as “DO NOT USE.”

“If your child develops symptoms, your state health department might want to collect your formula container for testing,” the FDA said. “If your child does not develop symptoms after 30 days, throw your containers out.”

This story has been updated with ByHeart voluntarily expanding the recall.

Alison Young is Healthbeat’s senior national reporter. You can reach her at ayoung@healthbeat.org or through the messaging app Signal at alisonyoungreports.48

With SNAP caught in legal limbo, Georgia implements expanded work requirements for food aid

2025-11-10T16:14:04+00:00

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In the midst of a national legal battle over the Supplemental Nutrition Assistance Program, Georgia has started the process of implementing expanded work requirements for people getting the food aid.

The new requirements were enacted as part of the “One Big Beautiful Bill Act” signed by President Donald Trump in July, and the Georgia Department of Human Services announced it would implement them beginning Nov. 1.

The new requirements will result in about 96,000 Georgia SNAP recipients out of a total of 1.4 million eventually losing their benefits, according to an estimate from the Center on Budget and Policy Priorities.

For those already enrolled in the program, the requirements kick in when they recertify their eligibility, typically every four months for able-bodied adults in Georgia. New participants will have three months to meet the work requirements, said Gina Plata-Nino, the SNAP director for the Food Research and Action Center.

SNAP, formerly known as food stamps, was created in the 1960s to provide food aid to low-income people, typically those who are living at or around the federal poverty level, which amounts to a $3,483 monthly gross income for a family of four, or $1,696 for a single person.

About 1 in 8 Georgians are enrolled in the program, which allows them to purchase food at 9,800 retailers across the state, according to the Center on Budget and Policy Priorities.

While the program has for many years required participants to work, the regulations that took effect Nov. 1 add requirements for three groups that have since 2023 been exempt: the homeless, veterans, and youth aging out of foster care.

Whereas previously the requirements applied to those up to age 54, the new requirements in Georgia will apply to those up to age 60, according to the Georgia Department of Human Services. And while previously caretakers of children under age 18 were exempt, now the exemption only applies to those who take care of children 14 and under.

People will have to work or participate in an employment and training program for an average of 20 hours each week to maintain eligibility. If people fail to meet the work requirements for three months in a 36-month-period, they lose benefits.

Certain groups are still exempt, including those who are pregnant or mentally and physically unfit for work, as determined by the caseworker and, in some cases, medical professionals, or the receipt of disability benefits.

“It’s going to increase hunger,” Plata-Nino said. “There are people who are not going to get benefits in the future, even though they’re still hungry, even though they still have no other income, just because there are insufficient jobs, and they’re doing the best they can working 19.5 hours” instead of 20 a week.

“You’ll start seeing it really around the winter time, around February, March, when whole buckets of populations as a whole will start losing benefits,” as people undergo the recertification process for the first time under the new requirements, she said.

The One Big Beautiful Bill Act also ended SNAP benefits for refugees, asylum seekers, trafficking and domestic violence victims, and some other groups who are living in the United States lawfully. The rules will be applied to new applicants at the time of their application and to people already receiving SNAP when they seek recertification.

A post from Trump on Truth Social earlier this week said that under President Joe Biden, the benefits were “haphazardly ‘handed’ to anyone for the asking, as opposed to just those in need, which is the purpose of SNAP!”

SNAP benefits for November stalled again

The systemic changes come as the program has been thrown into crisis due to the federal government shutdown. The U.S. Department of Agriculture last month announced that the program would run out of funds beginning in November.

That prompted two legal challenges, one filed by a group of Democratic-led states and one filed by a coalition of municipalities, nonprofit groups, businesses, and unions.

That’s led to confusion at the Georgia DHS as the agency tries to navigate rapidly changing federal guidance and court orders.

The Georgia DHS on Sunday said it would issue partial SNAP benefits to beneficiaries “based on new federal directives.” The funds will be distributed to enrollees whose payment date has already passed by Tuesday. Benefits will then be issued on a normal schedule for the rest of the month.

People will receive up to 65% of their normal benefit amount depending on their household income.

WIC funding expected to last into December

Meanwhile, the release of an additional $450 million in emergency funds last week has given a separate nutrition program – the Women, Infants and Children program – a few more weeks of breathing room.

WIC, administered by the Georgia Department of Public Health, focuses on low-income pregnant and breastfeeding mothers and children under 5.

“At this time, DPH is projecting Georgia WIC will have sufficient funding to provide WIC benefits through approximately the first week of December,” spokesperson Nancy Nydam Shirek said. The funds will allow the agency to continue to operate WIC clinics at local public health departments through the end of the year.

Georgia has 248,506 people enrolled in WIC.

The program, unlike SNAP, is limited to certain foods, including baby formula. WIC also provides additional services like breastfeeding support.

“WIC is serving individuals at such a critical time of growth and development. Forty percent of all infants born in this country are participating in WIC,” said Kate Scully, deputy director of WIC at the Food Research and Advocacy Center. “It’s providing them the formula they need if they’re not being breastfed. And these are things that babies can’t go without. You can’t just substitute something else.”

This story has been updated to reflect court action on SNAP dispersal through the weekend.

Is the federal shutdown affecting you? Reach out to Rebecca Grapevine at rgrapevine@healthbeat.org with your story.

NY youth tobacco use hits historic low. State of emergency for food aid.

2025-11-07T15:52:19+00:00

To each and every runner, volunteer, spectator, and crew member who participated in the NYC Marathon this past weekend, you are incredible. The sheer scale of coordination and determination to pull off this event shows us what New York is all about — grit, community, and dreams.

And it’s not just the runners. The marathon couldn’t exist without public investment — in parks, clean air, and safe roadways, as well as the labor it takes to keep the city moving. I want to give a special shoutout to the city sanitation department as well, as they did some heavy lifting to get the streets back in good shape for Monday.

Thank you to everyone who made this possible, and to those who lined the streets to cheer on Sunday. I’ll never forget the roar of the crowds. And how sore I was after. 😅

Now let’s get into this week’s Dose. We’ll cover updates to SNAP funding in New York, new data on declining tobacco use among teens, and respiratory viruses.

SNAP state of emergency in New York

Due to the ongoing federal government shutdown, a timeline for food aid for nearly 3 million New Yorkers is still unclear. Last week, Gov. Kathy Hochul declared a state of emergency to free up an additional $65 million in state funding for food pantries and hunger relief — enough to cover 40 million meals. The state also began mobilizing SUNY and Empire Corps teams to help food banks and expand the Supplemental Nutrition Assistance Program outreach on college campuses.

Then came a wave of legal pressure. On Oct. 31, two federal judges ruled that the SNAP freeze was unlawful. In response, the U.S. Department of Agriculture announced it would issue half of November’s SNAP benefits using contingency funds. But then, on Tuesday, President Donald Trump, in defiance of the two court orders, threatened to deny the assistance for the 42 million low-income Americans until the end of the shutdown.

Hours after that, White House press secretary Karoline Leavitt told reporters the administration would fully comply with the court and provide the partial food stamp payments. The back and forth on this continues - and has been exhausting, and only compounds the uncertainty many families are experiencing as they think about food for the next month.

Hochul’s emergency funds — $40 million for the Hunger Prevention and Nutrition Assistance Program and $25 million for Nourish NY — are filling some gaps. And these new emergency funds are on top of the $41 million in state funds for food assistance issued earlier last week, bringing the total state emergency funds to $106 million. But as Hochul emphasized, “No state can replace SNAP.” The federal program provides $650 million per month to New York residents. If half gets paid out with USDA contingency funds (~$325 million), and the state has committed $106 million, New York will have ~$431 million for SNAP in November — $219 million short of the need.

This isn’t only an economic issue. Nutrition insecurity worsens chronic disease, disrupts childhood development, and places enormous stress on mental health. Ensuring consistent food access is foundational to public health.

What you can do

If you’re a SNAP recipient: Monitor your EBT card closely and check otda.ny.gov for updates.
If you’re not: Volunteer or donate to your local food pantry. They need it now more than ever.
If you want to make your voice heard: Call your reps. Tell them hunger shouldn’t be a political tactic.

I’ll keep watching this story.

Tobacco use in New York hits a record low

Great news: Last month, a New York State Department of Health report revealed that youth tobacco use in the state has declined to its lowest level since the agency started measuring it 25 years ago. The agency found that fewer high school students reported using cigarettes, e‑cigarettes, or other tobacco products last year.

Tobacco use among high school students in New York state is the lowest it’s been.

Why it matters

If fewer young people pick up tobacco, fewer will carry nicotine dependence, lung disease, or cardiovascular risk into adulthood.
Lower youth uptake often predicts lower adult usage in the years ahead.
It shows that there is potential to move the dial.

The key here, though, is understanding what actually caused the reduction. I think the decline is likely due to a combination of new policies, outreach efforts, and educational initiatives. Over the past six years, several state policies have been implemented, including bans on flavored e-cigarettes, an increase in the minimum purchasing age, and restrictions on tobacco price discounts. The New York State Quitline also developed a program to help teens quit smoking called “Drop the Vape.”

While we won’t be able to determine the exact impact each of these changes had on reducing tobacco use among teens, gathering more data would help us better direct resources in the future.

Infectious disease ‘weather report’

New York state and New York City have rolled out updated, more user-friendly reports and dashboards to track viruses this season. The standout feature for both is the summary boxes at the top of each report showing which viruses are ramping up and causing the most disease.

Covid-19: Decreasing in both New York City and across the state. We are in a Covid lull, but likely not for long. Wastewater data (via Biobot and WastewaterSCAN) are showing early signs of a small uptick in the Midwest, a sign Covid might begin increasing elsewhere, too.

Influenza: Rising steadily across the state and city.

RSV: Also increasing across many counties statewide and in New York City, mostly in the youngest children.

Who’s most affected?

Infants and toddlers (ages 0-4) are seeing the highest rates of flu and RSV.
Covid is hitting both the youngest children and adults over 75 the hardest.

Respiratory virus cases by age group across New York state.

What you can do right now

Get vaccinated. It’s not too late. Flu, updated Covid, and RSV vaccines (for eligible groups — see this YLE National post) are all available. I’m getting my flu shot this week.
Layer protections. If you’ll be around young kids, older adults, or those who are immunocompromised, consider masking in crowded indoor spaces like the grocery store, airports, or on the train/subway.

Bottom line

From marathons to sanitation crews and food banks to virus tracking, there’s a web of systems and people keeping New York running. It’s a reminder that public health is public infrastructure. And we need to keep investing in it and ensuring it has what it needs to keep serving New Yorkers.

Love,

Your NY Epi

‘A shutout for parents’: Looming SNAP, WIC, and Head Start cutoffs threaten children’s health, advocates say

2025-10-30T21:22:22+00:00

Public health, explained: Sign up to receive Healthbeat’s free Atlanta newsletter here.

Georgians who rely on state programs for food assistance and child care – and the public health benefits that come with them – will likely lose access to those services on Saturday due to the government shutdown.

SNAP – the Supplemental Nutrition Assistance Program – helps about 1.4 million people in Georgia with monthly funding to purchase food. SNAP will run out of funds on Saturday. About 45% of those enrolled are 17 and under, said Ife Floyd Finch, director of economic justice at the Georgia Budget and Policy Institute.

She and other advocates say the state should draw on its $14.6 billion budget surplus, about $9 million of which is undesignated, to extend food assistance, Floyd said. That could easily cover the estimated $265 million monthly cost for Georgians on SNAP. Floyd said Gov. Brian Kemp could either declare a state of emergency to address the issue or call a special session of the legislature to appropriate the funds.

Kemp’s office blamed Democrats for the shutdown and said Thursday in a statement that the federal Office of Management and Budget has said states will not be reimbursed for covering SNAP costs.

“While they waste time playing the blame game, my office is in contact with food banks, nonprofit organizations, and community partners across the state to hear feedback on how the shutdown is affecting them and to assess current demand,” Kemp said in the statement.

“But the only way to quickly and effectively resolve this issue is for Democrats to vote to reopen the federal government immediately.”

The statement urged Georgians to call Sens. Jon Ossoff and Raphael Warnock and tell them to reopen the government.

A group of Democratic-led states has challenged the Trump administration’s refusal to use federal funds to continue the November payments for SNAP in federal court.

In Georgia, SNAP enrollees can use funds that are already on their cards to continue to purchase food, but November funds will not be added to the cards.

WIC funds may last a couple more weeks

WIC, the Special Supplemental Nutrition Program for Women Infants and Children that helps families pay for healthy food for children under 5, as well as pregnant, recently pregnant, and breastfeeding mothers, is also on the brink of losing funds.

There are 248,506 enrollees in the program, which is administered through the Georgia Department of Public Health.

DPH spokesperson Nancy Nydam Shirek said the agency projects the program has enough funds to continue through mid-November.

“A break in WIC benefits could occur due to an extended federal government shutdown,” she said. The agency is looking at options for extending WIC benefits for as long as possible, and participants are urged to continue showing up at appointments and using their eWIC cards as normal “until otherwise directed.”

The loss of food aid could have negative consequences for children’s health and education, said Mindy Binderman, executive director of the Georgia Early Education Alliance for Ready Students, a nonprofit advocacy group.

An Emory University survey of 987 Georgians conducted between January and March found that more than 36% of Georgia households with children are food insecure.

“If they don’t get the right nutrition, they can face conditions, things like anemia, asthma,” she said. “It can impact how brain development is affected, how they grow.”

People may have to choose between paying for food and paying for needed prescriptions, Floyd said.

Some Head Start programs will have to close

A third program that supports Georgia families – Head Start – will also be unable to access funds after Friday. Five of Georgia’s Head Start programs that serve about 6,300 children across 53 sites will be impacted because their contracts with the federal government are up for renewal on Saturday. The federal staffers working on those programs have been furloughed, so they have not been able to renew their contracts, Binderman said.

Three of the Head Start programs in Atlanta – run by Easter Seals North Georgia, Sheltering Arms, and the YMCA – have been offered a bridge loan by the Community Foundation of Georgia so they can continue operating for 45 more days.

However, one program in South Georgia – the Action Pact program headquartered in Waycross – will have to close after Friday if other means of funding are not found, Binderman said. A fifth program in Randolph County will continue operating through November.

Head Start provides a range of health programs, said Angela Brown-Gorham, who directs the Sheltering Arms Stonewall Tell Center in South Fulton County.

Brown-Gorham said the program provides two nutritious meals and a snack each day to children. The program also provides health services, like early screenings for developmental problems, physicals, and dental services.

Students who were receiving physical therapy and other services through Head Start will also lose access, Binderman said.

Angela Brown-Gorham, who directs an Atlanta Head Start center, and Juanita Yancey, the executive officer of the Georgia Head Start Association, say if the program shuts down, children will lose crucial health and food benefits.

Brown-Gorham, who was a Head Start student as a child, said the program also provides important mental health benefits.

“I did have other kids to talk to and play with, and teachers that loved me,” she said.

Beyond the health impacts, there could be economic impacts. If Head Start shuts down, parents won’t have a safe place to send their children, and many will be unable to work, Brown-Gorham said.

Teachers and staffers at the centers will also be furloughed, Brown-Gorham said.

“It’s a shutdown for everyone, but it’s a shutout for parents, because they’re not going to be able to sustain if they don’t have this program,” she said.

Families who are enrolled in Head Start also rely on SNAP for food aid, meaning the Nov. 1 cutoff will be a double whammy, Binderman said.

“The families who are used to having their kids eat at these child care programs are now going to have to ensure that their kids get nutritious meals at home at a time where they don’t have SNAP benefits,” she said.

Local government officials and community groups are stepping in to help Georgians in need.

Fulton County Commission Chairman Rob Pitts said this week he would ask the commission to provide about $750,000 in food aid to residents. Atlanta Mayor Andre Dickens announced that the city would suspend water shutoffs and evictions from city-owned and -funded housing until the shutdown ends or Jan. 31, whichever comes first.

Dom Kelly, president and CEO of the nonprofit advocacy group New Disabled South, said his organization established a fund earlier this week to provide $100 and $250 cash payments to disabled people across the South. In two days, the program received more than 8,003 applications from Georgians, amounting to requests for $1.8 million. It had raised $70,000 to fund the program as of Thursday.

Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Write to her and let her know how the shutdown is impacting you at rgrapevine@healthbeat.org.

Refugees will be among the first to lose food stamps under federal changes

2025-10-30T15:06:54+00:00

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CLARKSTON, Ga. — After fleeing the war-torn Democratic Republic of Congo, Antoinette landed in the Atlanta area last November and began to find her footing with federal help.

Separated from her adult children and grieving her husband’s death in the war, she started a job packing boxes in a warehouse, making just enough to cover rent for her own apartment and bills.

Antoinette has been relying on the Supplemental Nutrition Assistance Program, formerly known as food stamps, for her weekly grocery trips.

But now, just as life is starting to stabilize, she will have to deal with a new setback.

President Donald Trump’s massive budget law, which Republicans call the One Big Beautiful Bill Act, slashes $187 billion — or nearly 20% — from the federal budget for SNAP through 2034. And separate from any temporary SNAP stoppages due to the federal shutdown, the law cuts off access completely for refugees and other immigrant groups in the country lawfully. The change was slated to take effect immediately when the law was signed in July, but states are still awaiting federal guidance on when to stop or phase it out.

For Antoinette, 51, who did not want her last name used for fear of deportation and likely persecution in her native country, the loss of food aid is dire.

“I would not have the means to buy food,” she said in French through a translator. “How am I going to manage?”

Throughout its history, the United States has admitted into the country refugees like Antoinette, people who have been persecuted, or fear persecution, in their homelands due to race, religion, nationality, political opinions, or membership in a particular social group. These legal immigrants typically face an in-depth vetting process that can start years before they set foot on U.S. soil.

Once they arrive — often with little or no means — the federal government provides resources such as financial assistance, Medicaid, and SNAP, outreach that has typically garnered bipartisan support. Now the Trump administration has pulled back the country’s decades-long support for refugee communities.

The budget law, which funds several of the president’s priorities, including tax cuts to wealthy Americans and border security, revokes refugees’ access to Medicaid, the state-federal health insurance program for people with low incomes or disabilities, starting in October 2026.

From Khartoum to Clarkston: How a Sudanese nurse is filling a gap in health care

But one of the first provisions to take effect under the law removes SNAP eligibility for most refugees, asylum seekers, trafficking and domestic violence victims, and other legal immigrants. About 90,000 people will lose SNAP in an average month as a result of the new restrictions narrowing which noncitizens can access the program, according to the Congressional Budget Office.

“It doesn’t get much more basic than food,” said Matthew Soerens, vice president of advocacy and policy at World Relief, a Christian humanitarian organization that supports U.S. refugees.

“Our government invited these people to rebuild their lives in this country with minimum support,” Soerens said. “Taking food away from them is wrong.”

Refugees pay more in taxes than they receive in benefits

The White House and officials at the United States Department of Agriculture did not respond to emails about support for the provision that ends SNAP for refugees in the One Big Beautiful Bill Act.

But Steven Camarota, director of research for the Center for Immigration Studies, which advocates for reduced levels of immigration to the United States, said cuts to SNAP eligibility are reasonable because foreign-born people and their young children disproportionately use public benefits.

Still, Camarota said, the refugee population is different from other immigrant groups. “I don’t know that this would be the population I would start with,” Camarota said. “It’s a relatively small population of people that we generally accept have a lot of need.”

Federal, state, and local spending on refugees and asylum seekers, including food, health care, education, and other expenses, totaled $457.2 billion from 2005 to 2019, according to a February 2024 report from the Department of Health and Human Services. During that time, 21% of refugees and asylum seekers received SNAP benefits, compared with 15% of all U.S. residents.

In addition to the budget law’s SNAP changes, financial assistance given to people entering the United States by the Office of Refugee Resettlement, a part of HHS, has been cut from one year to four months.

The HHS report also found that despite the initial costs of caring for refugees and asylees, this community contributed $123.8 billion more to federal, state, and local governments through taxes than they received in public benefits over the 15 years.

It’s in the country’s best interest to continue to support them, said Krish O’Mara Vignarajah, president and CEO of Global Refuge, a nonprofit refugee resettlement agency.

“This is not what we should think about as a handout,” she said. “We know that when we support them initially, they go on to not just survive but thrive.”

Since arriving in the United States last year from Ethiopia, Lukas has been visiting the Mosaic Health Center in Clarkston, Georgia, to address diabetes-related complications. Food stamps allow him and his family to afford fresh vegetables like spinach and broccoli.

Food is medicine

Food insecurity can have lifelong physical and mental health consequences for people who have already faced years of instability before coming to the United States, said Andrew Kim, co-founder of Ethnē Health, a community health clinic in Clarkston, an Atlanta suburb that is home to thousands of refugees.

Noncitizens affected by the new law would have received, on average, $210 a month within the next decade, according to the CBO. Without SNAP funds, many refugees and their families might skip meals and switch to lower-quality, inexpensive options, leading to chronic health concerns such as obesity and insulin resistance, and potentially worsening already serious mental health conditions, he said.

Polio can still be eliminated – it just may take longer with $1.7B shortfall

After her husband was killed in the Democratic Republic of Congo, Antoinette said, she became separated from all seven of her children. The youngest is 19. She still isn’t sure where they are. She misses them but is determined to build a new life for herself. For her, resources like SNAP are critical.

From the conference room of New American Pathways, the nonprofit that helped her enroll in benefits, Antoinette stared straight ahead, stone-faced, when asked about how the cuts would affect her.

Will she shop less? Will she eat fewer fruits and vegetables, and less meat? Will she skip meals?

“Oui,” she replied to each question, using the French for “yes.”

Since arriving in the United States last year from Ethiopia with his wife and two teen daughters, Lukas, 61, has been addressing diabetes-related complications, such as blurry vision, headaches, and trouble sleeping. SNAP benefits allow him and his family to afford fresh vegetables like spinach and broccoli, according to Lilly Tenaw, the nurse practitioner who treats Lukas and helped translate his interview.

His blood sugar is now at a safer level, he said proudly after a class at Mosaic Health Center, a community clinic in Clarkston, where he learned to make lentil soup and balance his diet.

“The assistance gives us hope and encourages us to see life in a positive way,” he said in Amharic through a translator. Lukas wanted to use only his family name because he had been jailed and faced persecution in Ethiopia, and now worries about jeopardizing his ability to get permanent residency in the United States.

Hunger and poor nutrition can lower productivity and make it hard for people to find and keep jobs, said Valerie Lacarte, a senior policy analyst at the Migration Policy Institute.

“It could affect the labor market,” she said. “It’s bleak.”

More SNAP cuts are coming

While the Trump administration ended SNAP for refugees effective immediately, the change has created uncertainty for those who provide assistance.

State officials in Texas and California, which receive the most refugees among states, and in Georgia told KFF Health News that the USDA, which runs the program, has yet to issue guidance on whether they should stop providing SNAP on a specific date or phase it out.

And it’s not just refugees who are affected.

Nearly 42 million people receive SNAP benefits, according to the USDA. The nonpartisan Congressional Budget Office estimates that, within the next decade, more than 3 million people will lose monthly food dollars because of planned changes — such as an extension of work requirements to more people and a shift in costs from the federal government to the states.

In September, the administration ended a key report that regularly measured food insecurity among all U.S. households, making it harder to assess the toll of the SNAP cuts.

The USDA also posted on its website that no benefits would be issued for anyone starting Nov. 1 because of the federal shutdown, blaming Senate Democrats. The Trump administration has refused to release emergency funding — as past administrations have done during shutdowns — so that states can continue issuing benefits while congressional leaders work out a budget deal. A coalition of attorneys general and governors from 25 states and the District of Columbia filed a lawsuit on Tuesday contesting the administration’s decision.

Cuts to SNAP will ripple through local grocery stores and farms, stretching the resources of charity organizations and local governments, said Ted Terry, a DeKalb County commissioner and former mayor of Clarkston.

“It’s just the whole ecosystem that has been in place for 40 years completely being disrupted,” he said.

Muzhda Oriakhil, senior community engagement manager at Friends of Refugees, an Atlanta-area nonprofit that helps refugees resettle, said her group and others are scrambling to provide temporary food assistance for refugee families. But charity organizations, food banks, and other nonprofit groups cannot make up for the loss of billions of federal dollars that help families pay for food.

“A lot of families, they may starve,” she said.

This story was originally published at KFF Health News, Healthbeat’s national reporting partner.

Where NYC’s mayoral candidates stand on city-run groceries

2025-10-24T14:00:00+00:00

I’m back on the New York health beat after a week of global biosecurity workshops at the World Health Organization and the United Nations (a huge thank you and shoutout to the Johns Hopkins Emerging Leaders in Biosecurity program!) — and a much-needed vacation. Conversations ranged from cross-border collaboration to public health surveillance and crisis communication.

But I’m still thinking about one moment in particular: standing in front of the UN inscription from the 1948 Universal Declaration of Human Rights. “All human beings are born free and equal in dignity and rights.”

Outside the World Health Organization in Geneva, Switzerland.

It was a powerful reminder that public health isn’t just global, it’s local. What we build here in New York echoes far beyond our borders. And the basics still matter. Dignity, rights, and health begin with access to the essentials: housing, health care, and food.

So let’s talk about food — specifically, city-owned grocery stores, which have come up repeatedly in the New York City mayoral race. Through FAQs, I’ll break down what they are, their track records in other cities, and where mayoral candidate s stand. (During the primary election, I broke down some of the health-related topics candidates supported or opposed here.)

And as a reminder, the city’s mayoral general election is less than two weeks away! Here are key dates to get on your calendars:

Voter registration deadline: Saturday
Vote by mail application deadline: Saturday
Early voting: Saturday-Nov. 2
Election Day: Nov. 4

Let’s jump in.

What are city-owned grocery stores?

City-owned groceries, sometimes called “city-run groceries” or “public option groceries,” are supermarkets owned or operated by a city. Because of city ownership and operation, these stores often don’t need to pay rent or property taxes, and can buy foods wholesale, reducing overhead costs and increasing savings for shoppers. Cities can also support them with free utilities or direct subsidies.

If the city itself owns the building or land, it’s automatically exempt from property taxes — publicly owned property used for a public purpose isn’t taxed under New York State law. When a municipality owns and operates a facility (like a library or firehouse), it doesn’t pay taxes to itself.

Why is this a public health issue?

A major goal of establishing city-owned groceries is to make food, and importantly nutritious foods, more accessible. Food prices in New York City have soared, rising faster than the national average, up 56% between 2012 and 2023, compared to 46% nationally. (Income has also increased in the city, but it’s not keeping up with climbing food costs.) At the same time, food insecurity — when someone doesn’t have enough to eat at least some of the time — affects 1.2 million New Yorkers in the city. This is up 76% since 2021, with 1 in 6 households with children lacking enough to eat. The figure is higher than the 55% increase seen nationwide.

In New York City, rates are highest in the Bronx, where 1 in 5 residents and 1 in 3 children experience food insecurity. Staten Island has the lowest, with 11.5% of residents experiencing this problem.

This isn’t just a big-city issue. Across New York state, 1 in 8 (12.5%) of residents lived in food insecure households from 2021 to 2023, including 1 in 6 children. On top of that, cuts to the Supplemental Nutrition Assistance Program in the “Big Beautiful Bill” — signed into law over the summer — will likely further exacerbate food insecurity in New York, as they reduce food assistance for low-income families.

But the issue runs deeper than not having the income to pay for enough food. Many neighborhoods don’t even have grocery stores. Several New York neighborhoods are considered “food deserts” — where it’s difficult to buy healthy, nutritious food at an affordable price. These deserts often occur when large grocery companies avoid investing in lower-income neighborhoods because they have less purchasing power compared to wealthier neighborhoods, despite high demand for groceries.

A way to measure this in New York City is to look at the ratio of bodegas to supermarkets across neighborhoods. The Bronx, which has the highest food insecurity in the city, has about 35 bodegas per 1 supermarket.

With these challenges in mind, mayoral candidates are proposing various solutions to address food insecurity and improve access to healthy, affordable food across the city.

What are the candidates proposing?

Mamdani

Zohran Mamdani, an assembly member and mayoral hopeful, has proposed opening five city-owned stores (one in each borough) at an estimated cost of $60 million. The idea is to place them in areas where private grocers won’t go, sell food closer to wholesale cost, and exempt them from rent and property taxes.

Cuomo

Former Gov. Andrew Cuomo has opposed city-owned groceries, and instead proposes a $250 million targeted subsidy program for about 350,000 New Yorkers whose income is just above SNAP eligibility (around 131% to 150% of the federal poverty line). Under his plan, benefits would scale by income — roughly $1,200 a year for a family at the low end.

His rationale is that aid should go directly to families, not into running a government grocery chain. He also believes that city-owned grocery stores could undercut or compete with small grocers and bodegas.

This puts Cuomo in contrast to Mamdani’s approach. He prefers benefits that follow families in specific income brackets, while Mamdani’s plan aims to shift the supermarket structure itself.

Sliwa

Republican candidate Curtis Sliwa has criticized the public grocery store model as government overreach. His proposal to combat food insecurity does not detail specific plans, but includes pushing for bridge funding to cover cuts to the SNAP program, reducing red tape for food distributors, and improving access to wholesale markets for small grocers.

Does NYC already have city-owned markets?

Yes. The city runs Essex Market on the Lower East Side, La Marqueta in East Harlem, and Moore Street Market in Williamsburg. These are smaller public markets rather than full-service supermarkets, but they provide a precedent. There are three other public retail markets, which are directly managed by the housed tenants.

The city’s Economic Development Corporation has tax and zoning subsidies granted to developers and grocers willing to open in so-called food deserts. In other words, public dollars already flow to the grocery sector in New York City — just indirectly.

Where else have city-owned groceries been tested?

Most city-owned grocery stores in the United States have been in rural communities:

St. Paul, Kansas, a town of 600, has a city-run grocery store that’s been in operation since 2008.
Baldwin, Florida, a town of roughly 1,400, operated its own supermarket after private chains left. The market closed last year due to lack of customer support.
Madison, Wisconsin signed a lease for a city-owned grocery store in late 2024, but it has not yet opened.

Some big cities are beginning to experiment with city-owned grocery stores.

Atlanta opened a city-owned grocery store this summer in a USDA-designated low-income, low-access neighborhood. During its first two months, it served over 20,000 customers. During its first month, fresh produce sales represented 11.6% of its sales, higher than the national average of 10%.
Chicago is exploring options for a public-run market, where multiple vendors could sell groceries and local produce.

Would city-owned grocery stores hurt small businesses?

Potentially. City-owned grocery stores could move customers from bodegas and small supermarkets. But supporters argue that city-owned stores should be strategically placed in true food deserts, where access to more grocery options is needed, and designed to complement, not compete with, neighborhood grocers. It’s not totally clear to me how they would be designed to not compete with bodegas or small grocery stores, though. I would like to see Mamdani clarify this.

Where would the money to fund this come from?

The short answer is that we don’t know. It could be reappropriated from FRESH funding, which already supports increasing availability of fresh foods in underserved neighborhoods. It could come from other city funds. Or possibly from new appropriations or tax revenue. No information has been provided on where funding for these new grocery stores would come from.

What are my thoughts?

Food insecurity is a serious and growing issue in New York. Too many families can’t afford nutritious food, or can’t access it where they live. It’s time for our leaders to step up. If that is through city-owned grocery stores, great, but we need clear and defined plans for how to pay for them, where they’ll be located, and how to minimize competition with small local businesses.

If the solution is through direct financial support to families, also great. But funding alone isn’t enough — we still need to ensure access. The problem won’t go away if we expect families to commute long distances to get groceries.

And New Yorkers are on board. Two-thirds of New Yorkers support city-owned grocery stores, with 85% reporting their grocery bills have gone up in the past year.

Personally, I lean slightly toward city-owned grocery stores because the proposal addresses both affordability and access.

Bottom line

We need to do something to reduce food insecurity. City-owned grocery stores could be a great option, but we need additional details on how they would be paid for, sustainability plans, and how to reduce competition with smaller markets and bodegas. Access to healthy food should not be optional — it’s a human right for all New Yorkers.

Love,

Your NY Epi

The U.S. is facing an obesity epidemic. New report details the best and worst states.

2025-10-16T04:01:00+00:00

Public health, explained: Sign up to receive Healthbeat’s free national newsletter here.

The number of U.S. states where 35% or more of adults were obese dropped slightly in 2024, according to a report released Thursday analyzing federal health data.

Nineteen states had these particularly high rates of adult obesity, down from 23 states a year earlier.

“That’s actually the first time that there’s been a decrease in the number of states that are at or above that 35% level since this dataset began in 2011,” said Dr. J. Nadine Gracia, president and CEO of the Trust for America’s Health, the nonpartisan public health research and policy organization that released its annual “State of Obesity” report.

The states where obesity declined below this threshold were Alaska, Illinois, Missouri, and New Mexico.

Yet what may be progress in some parts of the country is set against a backdrop of a continuing national obesity epidemic, the data show. Across the country, 4 in 10 U.S. adults have obesity, which is defined as a body mass index of 30 or above.

“The rates of obesity in the nation remain alarmingly high,” Gracia told Healthbeat. “The data show that over more than two decades, obesity rates have increased by 32% among adults and 52% among children and adolescents.”

Each year the organization analyzes data from the Centers for Disease Control and Prevention to track U.S. obesity rates and offer policy solutions. This year’s recommendations include reversing cuts to federal nutrition programs and urging the U.S. Food and Drug Administration to require nutrition labels on the front of packages.

Key takeaways from this year’s 140-page report:

Worst states had obesity rates near or above 40%

West Virginia at 41.4%; Mississippi at 40.4%; and Louisiana at 39.2% had the highest adult obesity rates, according to the group’s analysis of 2024 data from the CDC’s Behavioral Risk Factor Surveillance System.

Georgia had an adult obesity rate of 35.4%, ranking No. 19 in the nation.

Best states had obesity rates of about 25%

Colorado at 25%; Washington, D.C., at 25.5%; and Hawaii and Massachusetts both at 27% had the nation’s lowest adult obesity rates.

New York had an adult obesity rate of 29.5%, ranking No. 43 in the nation.

Obesity data continue to show disparities

Obesity rates varied by race, ethnicity, education, and where people lived.

Black adults had the highest rate of obesity at 49.9%, followed by adults who were Hispanic (45.6%), white (41.4%), and Asian (16.1%).

There tended to be more obesity among people living in rural areas than in metro areas. People with college degrees and higher incomes also tended to have lower obesity rates, the report notes.

“We know factors like poverty, like food insecurity, having access to healthy and nutritious foods, housing instability, and access to health care, all of these influence increased risk of chronic diseases, including obesity,” Gracia said.

Politics provide opportunities and challenges

Chronic disease has been highlighted as a priority issue by the Trump administration, which has created the Make America Healthy Again Commission. Yet the report notes the administration has laid off federal health workers and restricted funding of programs that address obesity, chronic disease, and nutrition.

A key example cited in the report is the “near total elimination” in the president’s fiscal year 2026 budget request of the CDC’s National Center for Chronic Disease Prevention and Health Promotion, which leads and funds “cornerstone” obesity and chronic disease programs at the local, state, and national levels. The report recommends keeping and strengthening this CDC center.

Ultra-processed foods draw attention from policymakers

The report says that while there are currently no federal statutes or regulations that specifically define or regulate ultra-processed foods in the United States, there is mounting evidence connecting such foods with obesity and other negative health effects.

In July, federal health agencies sought public input on how to develop a uniform definition of ultra-processed foods. The report notes that while state legislators have introduced a number of bills related to ultra-processed foods, there has been limited movement. However earlier this month, California became the first state to prohibit certain ultra-processed foods in public school meals, a policy that will be phased-in over 10 years.

Alison Young is Healthbeat’s senior national reporter. Contact Alison at ayoung@healthbeat.org.

‘We don’t want anyone to lose benefits’: Advocates urge Georgians to prepare for SNAP changes

2025-09-12T15:53:36+00:00

This story was originally published at Capital B Atlanta. Public health, explained: Sign up to receive Healthbeat’s free Atlanta newsletter here.

Georgia residents who receive food assistance through the Supplemental Nutrition Assistance Program could begin seeing significant changes as soon as this fall, and local advocates warn SNAP recipients should prepare for these updates as soon as possible.

Among the most significant changes are expanded work requirements for adults receiving benefits, and restrictions on immigrant eligibility. Black Georgia residents, who are overrepresented on the SNAP rolls, could be hit the hardest by the incoming changes to the program.

“I am concerned about work requirements disproportionately affecting Black SNAP clients. The same problems that contribute to higher poverty rates and SNAP participation are the same factors that will make it hard for Black SNAP clients to meet a work requirement,” Ife Finch Floyd, director of economic justice at the Georgia Budget and Policy Institute, told Capital B Atlanta.

In 2020, Black people made up 33% of the state’s population and more than half of SNAP participants, according to the Georgia Budget and Policy Institute. Additionally, Black residents are facing food insecurity at higher rates compared to white residents.

“There is a larger percentage Black SNAP recipients than the share of Black people in the state populations, and it’s for all the reasons that Black people tend to have higher poverty rates,” Floyd said, pointing to historical red lining, racial discrimination in the labor market, barriers to education and training that lead to better paying jobs, and high rates of people with a criminal conviction, which can limit job prospects.

In addition, Floyd also said Black residents living in rural parts of the state face additional barriers, such as lack of public transit and limited slots for job training.

To prepare for the upcoming SNAP changes, recipients and community members are encouraged to take action now. Start by contacting a local SNAP outreach partner or the Georgia Department of Human Services for help navigating paperwork and ensuring compliance with the new rules.

Advocates also suggest closely monitoring any mail from Georgia DHS, as it may contain important updates about work requirements or changes to eligibility. It’s also a good idea to begin gathering key documentation, including income records, proof of work or volunteer hours, and any caregiving responsibilities.

What’s changing with SNAP?

SNAP program updates, stemming from the “Big, Beautiful Bill” that President Donald Trump signed into law in July, introduces sweeping reforms nationwide and cuts around $186 billion from the program.

Under the new federal rules, more SNAP recipients will be required to meet work requirements. Previously, able-bodied adults between the ages of 18 and 54 without dependents had to work or do community service for at least 20 hours per week to maintain benefits. The new law raises that age limit to 64 and also removes previous exemptions for certain groups, including veterans, unhoused individuals, and young adults who’ve aged out of foster care.

Additionally, parents or guardians of children ages 14 to 17 will now be expected to meet these work requirements, which is a major shift from earlier rules that exempted parents with dependents.

Another provision of the law eliminates SNAP eligibility for certain immigrants who previously qualified, including those granted refugee or asylum status and others with humanitarian protections.

With respect to the funding cuts to SNAP, Floyd argues that the cuts could force states to make tough decisions on how to adjust their budgets to fill in the gaps, which could potentially cause states to reduce their SNAP benefits altogether.

According to The Atlanta Journal-Constitution, based on a July 11 memo sent out to state departments by Gov. Brian Kemp’s budget office, agencies are being instructed to deduct any money they’ve lost in federal funding from their budgets rather than ask the state to make up the difference.

“While the governor remains committed to meeting the needs of our growing state, conservative fiscal management means prioritizing spending to live within our means and keeping more tax dollars in the pocketbooks of our citizens,” wrote state budget office director Richard Dunn.

Where to go for SNAP assistance?

The law was passed months ago, but Georgia has not yet begun implementing these expanded requirements, largely because it has been waiting on guidance from the U.S. Department of Agriculture. That guidance was issued last week, and even then, advocates say, it lacked clarity.

“It is confusing,” Floyd said. “The law was written so quickly, and the changes are so dramatic that it’s going to take time to fully process what it all means and how best to implement it.”

A DHS spokesperson told Capital B Atlanta in an email that the state is assessing the changes to the SNAP program and is expecting to receive “additional, detailed guidance” from USDA toward the end of the month.

As of Tuesday, Floyd said she was unaware of any SNAP recipients in Georgia who have received formal notices about the new work requirements.

Several organizations around the state are available to help individuals navigate the SNAP system, including:

Floyd and staff at the Atlanta Community Food Bank say it’s critical that SNAP recipients, especially those who may now fall under new requirements, get help in understanding what’s changing.

“We don’t want people to lose benefits simply because they didn’t know the rules had changed or didn’t get the right paperwork in,” said Kyle Waide, the food bank’s CEO.

Alyssa Johnson is Capital B Atlanta’s enterprise reporter.

NYC tightens food standards for schools, hospitals, banning processed meats

2025-08-29T17:24:25+00:00

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Meals in public schools and city-run hospitals are set to become healthier, as New York City rolls out new food standards that ban processed meats, restrict artificial colors, and promote whole foods.

The new standards, which take effect on July 1, will impact about 219 million meals and snacks served annually by 11 city agencies, from school lunches and hospital meals to home-delivered meals for elderly New Yorkers.

“I often say, when it comes to your health, it’s not just what is in your DNA, it’s also what is in your dinner,” Mayor Eric Adams said in a statement. “I’ve turned my life around from being pre-diabetic to living a plant-based diet, and when we came into office, we committed to ensuring all New Yorkers have access to healthy, fresh foods.”

New York City will tighten restrictions on artificial colors, low-calorie sweeteners, and certain additives and preservatives. Processed meats will be banned, with a recommendation against food products that are pre-prepared by deep-frying, including chicken nuggets, mozzarella sticks, and potato tots. Under the updated standards, the city will recommend whole or minimally processed food, meals cooked from scratch, and locally sourced ingredients whenever possible.

U.S. food makers are still using dyes linked to hyperactivity in kids. Parents want them banned.

First established in 2008, the city’s food standards are required to be revised every few years. The new standards build on the city’s existing restrictions on artificial ingredients and processed meats. They also reflect a citywide effort to combat chronic and diet-related diseases, which are leading causes of death for all New Yorkers and disproportionately impact Black residents.

Dr. Jennifer Cadenhead, an assistant professor at the CUNY Graduate School of Public Health & Health Policy, described the new food standards as “very thoughtful” and said that they would positively impact families who rely on city-distributed meals. The expanded restrictions on sweeteners, artificial colors, additives, and preservatives were especially important, she said.

“The things that they’re prohibiting have either not been well studied in humans, or there has been some indication that they could cause illness in humans,” she said. “So why would we feed our children food that we’re not really certain about?”

Cadenhead noted that the more that children are exposed to healthier options when they are young, the more likely they are to accept those foods when they are older. Reducing exposure to unhealthy foods can help “delay, or maybe prevent, other illnesses or adverse health conditions,” she said.

As part of HealthyNYC, the Health Department’s campaign to increase New Yorkers’ life expectancy, the city aims to decrease heart- and diabetes-related deaths by 5%, and screenable cancer deaths by 20%, by 2030. Poor nutrition, tobacco consumption, physical inactivity, and excessive alcohol use are the key drivers of most chronic diseases, according to the U.S. Centers for Disease Control and Prevention.

Acting Health Commissioner Dr. Michelle Morse said in a statement that the new standards “underline our longstanding work to ensure New Yorkers have access to healthier foods while advancing our commitment to health equity and climate health.”

On the federal level, Health and Human Services Secretary Robert F. Kennedy Jr. has emphasized the link between poor diet and chronic disease and has made the elimination of food dyes and other additives a top priority. And while the city’s new food standards may reflect a point of alignment with the federal government, experts caution that the Trump administration’s cuts to programs like SNAP and Medicaid are poised to significantly harm New Yorkers’ health.

“These standards are really important,” said Dr. Nevin Cohen, an associate professor at the CUNY Graduate School of Public Health & Health Policy and director of the CUNY Urban Food Policy Institute, whose team discussed the standards with city agencies while they were in development. “But to improve population health also requires support for households through programs like SNAP and WIC and access to medical care through programs like Medicaid.”

He added that if the scale of cuts to those programs is as extensive as expected, “these changes at the local level in food standards will be outweighed by the negative impacts of these larger national policy changes.”

Eliza Fawcett is a reporter covering public health in New York City for Healthbeat. Contact Eliza at efawcett@healthbeat.org.

The number of older New Yorkers is at a record high. Many struggle to get enough to eat.

2025-08-20T11:00:00+00:00

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On a hot August morning, Jeremy Kaplan knocked loudly on the front door of an apartment in Midtown Manhattan and called out, “Lunch!”

Phyllis Radcliff, 60, opened the door with a smile, clapped her hands, and said, “God bless you!”

Radcliff ushered in Kaplan, the executive director of Encore Community Services, a nonprofit serving older adults. He handed out hot meals of chicken adobo, yellow plantains, and steamed vegetables to Radcliff and her husband, Edward Perez, 71.

“The food is great, and I appreciate you, because we have health issues sometimes, and we can’t get out,” Radcliff said.

Phyllis Radcliff, 60, and Edward Perez, 71, recently began receiving meals at their Midtown home.

Older New Yorkers like Radcliff and Perez are part of a growing demographic in New York City for whom food insecurity is a significant concern. Over the past decade, the population of New Yorkers at least 65 years old has grown by a third, reaching an all-time high, according to recent research from the Center for an Urban Future, a nonpartisan policy organization. In that time, the number of older New Yorkers living in poverty surged by 41%.

Accessing healthy, affordable food is often a challenge. The cost of food is on the rise, while federal cuts imperil food pantries. And looming cuts for federal programs like SNAP, Medicaid and Medicare leave older New Yorkers in an especially vulnerable position.

“The impact of the government cuts on the people we serve could be catastrophic,” said Beth Shapiro, the chief executive of Citymeals on Wheels, a nonprofit that works with providers like Encore to deliver meals to homebound older New Yorkers.

Even those tapped into available services like home meal delivery programs aren’t getting enough to eat, experts and advocates say. In 2023, researchers from the CUNY Urban Food Policy Institute partnered with Citymeals on Wheels to survey 500 older New Yorkers using older adult centers or home-delivered meal programs. Nearly half of the respondents reported food insecurity in the previous 12 months. Among those who received home-delivered meals, 60% reported food insecurity.

Oscar Arce serves lunch to visitors at one of Encore Community Services's older adult centers.

For older New Yorkers, physically accessing to food can be a challenge, but it’s “poverty that is really the root cause of food insecurity in this population,” said Dr. Nevin Cohen, an associate professor at the CUNY Graduate School of Public Health and director of the CUNY Urban Food Policy Institute. He noted that 65% of respondents were living on $15,000 a year or less.

A broader survey, recently published by the New York City Department for the Aging, found that among 8,600 older New Yorkers, about 30% reported difficulty or a complete inability to purchase affordable, healthy food in their communities.

Service providers working to alleviate hunger say they are unable to fill the depths of the need they encounter.

“Many of the people who we deliver to tell us it’s their only source of food,” Kaplan said. “Many of them are rationing out the one meal we give them, throughout the day. It’s just not enough, any way you cut it.”

The Department for the Aging’s Home Delivered Meal program funds the delivery of one meal per day on weekdays and holidays to homebound older New Yorkers. In the 2024 fiscal year, the agency served a total of 4,209,261 meals to 24,572 people, a 9% decline in meals and 11% decline in recipients over the previous year, which the agency attributed in a city report to “provider transition and staffing deficits.”

At Encore, city funding supports weekday and holiday meal delivery, while Citymeals on Wheels funds weekend and emergency meals, Kaplan said. Neither source fully covers the organization’s operations, requiring private fundraising, he noted.

One of Encore’s older adult centers is tucked away from Times Square in the basement of a church on West 49th Street. Recently, workers and volunteers prepared meals for home delivery, scooping broccoli, pasta, and chicken parmesan out of vats and into individual trays. Others packaged bundles of milk, bread, and fresh fruit.

Encore Community Services's kitchen in the basement of St. Malachy Roman Catholic Church makes efficient use of a limited space.

One of those meals ended up in the hands of Nini Johannesen, 68.

“Doing okay, Nini?” Kaplan asked as he entered her apartment. In addition to providing nutritious food, the meal deliveries function as a brief point of social contact and a wellness check.

Johannesen said she was doing well, though her vision and balance bothered her — and her home attendant was on vacation. The meals were a bright spot, she said.

“It’s the only way I eat some vegetables,” she said.

Cohen, of the CUNY Urban Food Policy Institute, noted that providing older adults with adequate nutrition is key to ensuring that they “remain healthy and independent as long as possible.” Poor nutrition, he said, is a leading cause of chronic disease.

Nonprofits across the city have launched innovative approaches to meeting older New Yorkers’ needs, reversing the traditional food pantry model. The West Side Campaign Against Hunger has partnered with Citymeals on Wheels to create a pilot program delivering free boxes of groceries to older adults in the Bronx who are still able to cook, said Stephanie Moshier, the organization’s director of partnerships and community engagement.

Staff and volunteers pack meals for delivery at Encore Community Services's kitchen.

“A lot of these programs we’ve developed are more about bringing food to people, meeting people where they are,” Moshier said. “They don’t have to spend money on transportation to come to the Upper West Side to get food.”

Perez said he and his wife started receiving Encore’s home-delivered meals this summer. Issues with his knees, shoulders and back make it difficult to shop for groceries, he said.

The food has been excellent and well-seasoned, Perez said. He only wished the portions could be bigger. But the meals had made a difference.

“It’s a helping hand, financially,” he said. “And it’s also great to know that people care enough to cook you a good meal.”

Eliza Fawcett is a reporter covering public health in New York City for Healthbeat. Contact Eliza at efawcett@healthbeat.org.

Food rescue grows in response to federal funding cuts

2025-08-05T16:21:09+00:00

This story was originally published by THE CITY. Sign up to get the latest New York City news delivered to you each morning. Public health, explained: Sign up to receive Healthbeat’s free New York City newsletter here.

Nestled inside a small warehouse room in Hunts Point Produce Market on a recent Tuesday, workers for the nonprofit organization Sharing Excess chucked flawed cucumbers into a large cardboard box.

As forklifts zig-zagged across the food rescue organization’s dock, the team members assessed the remaining stash of cucumbers, checking for signs of decay such as mold, mushy textures, and rotten smells. They then sorted the viable cucumbers into mixed and single-item pallets of produce.

Sharing Excess retrieves unsellable food from market wholesalers, inspects it, and then distributes what’s still good to eat to more than 150 food pantries and other organizations that serve food-insecure New Yorkers. Founded in Philadelphia in 2018, Sharing Excess took root in New York City two years ago as part of a national expansion and now distributes about a million pounds a month of whatever it can glean from the market.

Days when the sounds of machinery, chatter, and shuffled boxes and pallets fill the air are typical at Sharing Excess, said its New York program director Miranda Potmesil. But the operation has grown increasingly busy as some food banks and pantries turn to food rescue to fill the gap left by the elimination of federal programs that previously helped them buy food from local farmers and producers.

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In March, the U.S. Department of Agriculture notified states that it was canceling future rounds of the Local Food Purchase Assistance Cooperative Agreement program. Known in the state as New York Food for New York Families, the program provides funding to food banks, pantries, schools, and other community organizations to purchase fresh vegetables, fruits, meats, dairy products, and breads from local farmers and producers.

The state’s Department of Agriculture and Markets had received a total of $49.6 million through two previous rounds, but an expected new influx of $24 million will not be coming from the USDA.

Since the federal program’s cancellation, Potmesil said Sharing Excess’ Hunts Point operation has added 18 organizations to its weekly and biweekly pickup schedules, as well as 12 additional groups for one-time or occasional pickups, resulting in 70,000 additional pounds of redistributed produce each week.

“This increase represents scarcity of resources — on the ground for the families and individuals we serve, but also for the organizations which have seen deep budget cuts to social safety net programs,” Potmesil said.

Common Pantry workers pack produce at their Bronx warehouse on July 29, 2025.

One of the emergency food providers adding more rescued food to its mix is New York Common Pantry — which procured 28,000 pounds of rescued food from Sharing Excess in June, up from just 9,000 in March. The group had received a $2 million grant through the state’s USDA-funded program — accounting for 13% of the organization’s operating budget, its executives told THE CITY in April.

“None of us are equipped,” said Judy Secon, the group’s deputy executive director. “We all need to be working together to confront this problem, and none of us have the available resources to do that.”

Rescued food takes ‘weight off our shoulders’

A few blocks from the Sharing Excess warehouse, Cristofer Jorge operated a forklift at the Common Pantry warehouse, plopping large pallets of fresh cantaloupes, apples, and grapes in between industrial racks stacked with canned lentils and tuna.

In an opposite corner, coworkers placed fresh grapes, peaches, potatoes, and onions into clear bags, turning delivered boxes and pallets of food into groceries.

The rescued food “takes a weight off of our shoulders,” said warehouse supervisor Anthony Lallave, as he oversaw the packaging of grocery bags for distribution to schools, places of worship, housing projects, and other community-based organizations, as well as Common Pantry’s own sites in East Harlem and Crotona Park East.

The New York Food for New York Families program helped Common Pantry purchase fresh fruits, vegetables, meats, and breads — foods that make up the bulk of the nutritionally balanced meals that pantries strive to offer their visitors. The USDA generally recommends that fruits and vegetables make up half of a meal, with proteins and grains making up the rest.

Sharing Excess is not the only group gleaning unwanted food: The Food Bank for New York City also rescues produce from the Hunts Point Market, and City Harvest has rescued and distributed to soup kitchens and pantries since the 1980s.

As in Philadelphia, Sharing Excess streamlines the process of rescuing food by operating from inside the wholesale market.

Fresh produce in the Common Pantry Bronx warehouse is ready for delivery to food banks on July 29, 2025.

“Just based on work that we did there — we were capturing millions and millions of pounds even in the first year — we were like, okay, obviously this is something that is needed within the broader food supply chain,” Potmesil said. “Let’s see if we can make this work in another market.”

That level of access, Potmesil said, means that the organization can streamline supplies to a wide range of food providers, including other food rescue nonprofits.

Sharing Excess works with nearly all of the produce market’s vendors to retrieve foods that they otherwise can’t sell, potentially because the vendor has a surplus of a particular item. Supermarkets and other wholesale buyers also tend to want food that has a long shelf life, lasting up to a week after receiving it from a vendor, Potmesil said. With food rescue, she said, food is typically gleaned from the vendors, sorted, and then distributed all on the same day.

A federal program helps NYC families eat healthy meals. Trump’s new legislation cuts it.

The partnership is beneficial to the produce market’s vendors, too. Tossing food they haven’t yet sold requires vendors to pay for the cost of disposal, she said. But through the partnership, they receive tax deductions based on the poundage that they turn over to Sharing Excess.

For them, the thinking is also, “‘Why would I dump this stuff as opposed to feeding thousands of people?’” Potmesil said.

On a recent Friday, Jessica Ponce joined a line of dozens of people waiting to enter Corsi Houses Neighborhood Senior Center in East Harlem, where the nonprofit Ending Homelessness & Building a Better NYC was giving away food received from Sharing Excess.

Her 83-year-old mother lives in nearby senior housing and has been coming to the center for more than 20 years. She didn’t know that the food had been rescued from places like Hunts Point Market.

“Great!” she said, while looking at the idling Sharing Excess truck nearby. “If it’s gonna get damaged, you might as well give it to those who need it.”

Food banks, schools, and other organizations historically used federal funding to grow their operations by expanding their hours, bringing in more product and volunteers, or changing their purchasing practices.

The Food Bank for New York City, for instance, used its New York Food for New York Families funding to develop a program where 30 BIPOC farmers learned more about marketing their products. The program also resulted in those farmers distributing 900,000 pounds of food through the Food Bank.

In 2022 and 2023, United Way of New York City used its $800,000 award to team up with the worker cooperative Brooklyn Packers, which distributed 300,000 pounds of fresh produce gleaned from 15 farm businesses.

Now, say executives, they are losing funding just as the people they serve are enduring a cost-of-living crisis.

“To lose a grant in communities where we have seen 132% of cost of living going up, and wages only going up by 75%, it’s detrimental to the organization, but also to the community,” said President and CEO of United Way of New York City Grace Bonilla.

The Met Council, a Jewish nonprofit that mostly distributes kosher and halal products, has also resorted to securing private funds, said CEO and Executive Director David Greenfield. Its previous $2 million grant helped the organization boost its ability to distribute foods like eggs, yogurt, chicken, and milk, a service that he said they’ve now had to limit.

“We’re going to have to rely on city, state, and private philanthropy to make up the difference, but no single source is going to be enough,” Greenfield said.

Mia Hollie is a data reporting fellow at THE CITY, where she supports the newsroom on data-related projects.

An after-school program reenvisioned wellness for NYC middle-schoolers. The USDA terminated it.

2025-07-24T17:02:02+00:00

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Dr. Tashara M. Leak spent years developing a pioneering program in nutrition education for adolescents in New York City.

Through the Advanced Cooking Education 4-H After School Club, seventh- and eighth-graders met once a week to learn about wellness, develop culinary skills, and gain exposure to careers in food and nutrition. The 12-week program worked with Brooklyn and Manhattan schools where a significant share of students come from low-income households.

“People think about hunger, but to be able to prioritize nutrition is a privilege,” said Leak, an associate professor in the Division of Nutritional Sciences at Cornell University and an associate dean at the College of Human Ecology in New York City.

Dr. Tashara M. Leak, an associate professor at Cornell University, created a wellness program for New York City teens.

The U.S. Department of Agriculture funded the ACE program with a 5-year, $990,000 grant, and Leak envisioned it as a new model for 4-H, expanding the reach of the agency’s youth development program. In January, Leak received a 2025 Presidential Early Career Award for Scientists and Engineers, the highest honor bestowed on early-career scientists and engineers by the federal government.

But in May, her program came to a sudden halt. Leak received a stop work order from the USDA, part of a wave of federal research grant terminations across the country.

Now, she’s hoping to find a way to continue the ACE program, which has been fully operational for two years and has served at least 60 students.

Here’s an interview with Leak about the program and the impact of the grant termination. The interview has been edited for length and clarity.

How did the ACE program come to be?

If I think about nutrition education, it’s teaching a lot of adolescents how to make yogurt parfaits and fruit kebabs. But we have a whole subgroup of adolescents who are actually responsible for entire meals from start to finish. I thought about that “adultified” adolescent, and was like, “How do we support them? Where are they located?”

A lot of times, they’re located in big cities. They’re usually “adultified” for very specific reasons, maybe because they live in a single-parent household, or even in two-income households with shift work. Oftentimes, it’s affiliated with poverty. In New York City, you’ve got middle-schoolers riding to and from school on subways by themselves by the time they’re 10. We have quite a few “adultified” adolescents in New York City. What about their health and well-being, and how do we support them? That’s why I created the Advanced Cooking Education 4-H After School Club.

What does the ACE program involve?

It’s 12 weeks, specifically targeting seventh- and eighth-graders at schools that receive Title I funding. What we’re doing is exposing them to careers in food and nutrition, hoping that if they see themselves working in the field, maybe they will want to eat healthier and role model healthy eating. What we’re not doing is saying, “Eat healthy. Don’t eat this.” These are teenagers; they have a lot of autonomy.

The careers we’re exposing them to include food science, urban agriculture, and food photography. Culinary science is a huge part of this. Every other week, we send them home with a bag of groceries, and they take it home and complete a cooking lab at home. This isn’t just cooking for their family. They’re actually learning about sensory evaluations and various knife skills and, “Oh, this tasted too salty. How do you alter the recipe so it’s less salty?” At the end, they have a public speaking competition, which functions almost like a job interview.

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At the beginning of every session, we have a mindfulness component. We start with a brief meditation, and then they stretch, and there’s a journal prompt that’s informed by the CASEL Framework around social and emotional learning. When we decided to do this, it was in response to so many of the adolescents talking about how stressed they were, not just about applying to high school, but just stressed about life.

You could tell that they have been exposed to adult-level issues, and they were aware of their neighborhood poverty or various social issues. While I can’t solve these bigger problems, our goal is to give them tools to center themselves and create quiet spaces, even in the midst of living in this very large city.

With the recipes, we made sure to inquire about the identities of students in New York City and also the cuisines they’re exposed to. So they’re making plant-based dishes from various cultures — they’re making Korean food, they’re making Caribbean food. This idea that you have to abandon your cultural food to be healthy is not, indeed, factual. Whenever they’re cooking the dishes, they also learn about the cultural significance of the dish and the ingredients used in that dish.

The Advanced Cooking Education 4-H After School Club aims to help middle-schoolers learn about wellness, develop culinary skills, and explore careers in food and nutrition.

What would you hear from students about the program?

We’ve only gotten really positive feedback. With the mindfulness piece, we conducted focus groups at the end of every cohort, and [students] talked about how they use it during school, if they’re studying for a test, and how they acquired some tools to center themselves during challenging times.

Trying new foods is actually quite a privilege. If you’re on a limited income, it’s really hard to try new foods because you are concerned about food waste, and every dollar counts. The students talked about preparing dishes that they have never prepared before. They were like, “I didn’t know I would like a black bean burger, but I’m so glad I was able to try that in this program.”

With the public speaking competition, they are so nervous when they’re preparing, and then at the end, they always talk about how proud they are of themselves. They all have amazing skills, but I think they didn’t know how to tap into those skills, and then how to articulate that.

What was the research component of the program?

From a research standpoint, we wanted to know how the program was impacting their nutritional status. We were curious if, by the conclusion of the program, were they eating healthier? We use something called the Healthy Eating Index. It has 13 sub-components, and it really allows the students to choose where they want to improve, so it could be that they decide to eat more whole-grain snacks, or it could be that they decide to eat more vegetables or more fruits. We didn’t look at one food group. We gave them the option to set goals each week around how they wanted to improve their nutrition.

That was the primary outcome: their diet intake. Then we also were looking at cooking skills, attitudes, and self-efficacy. If these are kids who are at risk for being “adultified,” I can’t change the fact that now, or maybe in a couple years, you are going to have household cooking responsibilities; but maybe I can help you cook more efficiently and healthfully with limited resources.

With the mindfulness, we’re looking at improvements in their stress: Are they reporting that they’re less stressed? And then we also looked at a sense of purpose and identity: Do they see themselves in this program, and do they feel more centered and grounded in purpose after participating in this?

What was it like to receive the stop work order?

I was really blindsided, just because I’ve been so well supported by USDA for like a decade. This particular study has received so much local, statewide, and national attention. Then I get [the stop work order], and I’m supposed to call parents the next day and say, “Sorry, your kid can’t show up to after school.” I just couldn’t do that, especially since we were so close to the end of the school year. So I’m very grateful that I had some money in reserves at my job, that I was able to use those funds to finish out the school year.

I was able to piece together funds so that the students weren’t aware of what was happening. But these schools, they’re expecting we were going to do this another year, and right now, I don’t have any funding for another year. I’m working really hard to identify alternate funding sources so I can fulfill my commitment to the schools and to the students.

Does it seem likely that you’ll be able to find other funding sources?

These are real people. I know these students, I know these teachers. I know these principals and the school nurses. I have been integrated into their communities. And so while I don’t know, today, how I’m going to pull this off, I’m going to pull it off. I can’t sleep at night knowing that I made a promise to schools that have historically had so many people make promises and break those promises. I know that all of my sites know that this is not of my choosing, but I am going to find a way to fulfill my commitment. I’m going to figure this out, because it’s just too important.

Eliza Fawcett is a reporter covering public health in New York City for Healthbeat. Contact Eliza at efawcett@healthbeat.org.

Cuts to food benefits stand in the way of RFK Jr.’s goals for a healthier national diet

2025-07-22T13:34:43+00:00

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ALBANY, Ga. — Belinda McLoyd has been thinking about peanut butter.

McLoyd, 64, receives a small monthly payment through the federal Supplemental Nutrition Assistance Program, previously known as food stamps.

“They don’t give you that much to work with,” she said. To fit her tight budget, she eats ramen noodles — high on sodium and low on nutrition — multiple times a week.

If she had more money, said McLoyd, who has been diagnosed with multiple sclerosis and heart problems, she’d buy more grapes, melons, chuck roast, ground turkey, cabbage, and turnip greens. That’s what she did when lawmakers nearly doubled her SNAP benefit during the pandemic.

But now that a GOP-led Congress has approved $186 billion in cuts to the food assistance program through 2034, McLoyd, who worked in retail until she retired in 2016, isn’t sure how she will be able to eat any healthy food if her benefits get reduced again.

Georgia shows rough road ahead for states as Medicaid work requirements loom

McLoyd said her only hope for healthy eating might be to resort to peanut butter, which she heard “has everything” in it.

“I get whatever I can get,” said McLoyd, who uses a walker to get around her senior community in southwestern Georgia. “I try to eat healthy, but some things I can’t, because I don’t have enough money to take care of that.”

The second Trump administration has said that healthy eating is a priority. It released a “Make America Healthy Again” report citing poor diet as a cause of childhood illnesses and chronic diseases. And it’s allowing states — including Arkansas, Idaho, and Utah — to limit purchases of unhealthy food with federal SNAP benefits for the first time in the history of the century-old anti-hunger program.

President Donald Trump also signed a tax and spending law on July 4 that will shift costs to states and make it harder for people to qualify for SNAP by expanding existing work requirements. The bill cuts about 20% of SNAP’s budget, the deepest cut the program has faced. About 40 million people now receive SNAP payments, but 3 million of them will lose their nutrition assistance completely, and millions more will see their benefits reduced, according to an analysis of an earlier version of the bill by the nonpartisan Congressional Budget Office.

Researchers say SNAP cuts run counter to efforts to help people prevent chronic illness through healthy food.

“People are going to have to rely on cheaper food, which we know is more likely to be processed, less healthy,” said Kate Bauer, an associate professor of nutritional sciences at the University of Michigan School of Public Health.

“It’s, ‘Oh, we care about health — but for the rich people,’” she said.

Belinda McLoyd and other residents in southwestern Georgia’s Dougherty County face steep barriers to accessing healthy food, from tight budgets and high poverty rates to limited access to grocery stores and transportation.

Research links food insecurity to health problems

About 47 million people lived in households with limited or uncertain access to food in 2023, according to the U.S. Department of Agriculture. The agency’s research shows that people living in food-insecure households are more likely to develop hypertension, arthritis, diabetes, asthma, and chronic obstructive pulmonary disease.

The Trump administration counters that the funding cuts would not harm people who receive benefits.

“This is total fearmongering,” said White House spokesperson Anna Kelly in an email. “The bill will ultimately strengthen SNAP for those who need it by implementing cost-sharing measures with states and commonsense work requirements.”

McLoyd and other residents in Georgia’s Dougherty County, where Albany is located, already face steep barriers to accessing healthy food, from tight budgets and high rates of poverty to a lack of grocery stores and transportation, said Tiffany Terrell, who founded A Better Way Grocers in 2017 to bring fresh food to people who can’t travel to a grocery store.

More than a third of residents receive SNAP benefits in the rural, majority-Black county that W.E.B. Du Bois described as “the heart of the Black Belt” and a place “of curiously mingled hope and pain,” where people struggled to get ahead in a land of former cotton plantations, in his 1903 book, “The Souls of Black Folk.”

DeKalb County has the highest rate of TB in Georgia. A new clinic aims to help.

Terrell said that a healthier diet could mitigate many of the illnesses she sees in her community. In 2017, she replaced school bus seats with shelves stocked with fruits, vegetables, meats, and eggs and drove her mobile grocery store around to senior communities, public housing developments, and rural areas.

But cuts to food assistance will devastate the region, setting back efforts to help residents boost their diet with fruits, vegetables, and other nutritious food and tackle chronic disease, she said.

Terrell saw how SNAP recipients like McLoyd ate healthier when food assistance rose during the pandemic. They got eggs, instead of ramen noodles, and fresh meat and produce, instead of canned sausages.

Starting in 2020, SNAP recipients received extra pandemic assistance, which corresponded to a 9% decrease in people saying there was sometimes or often not enough food to eat, according to the Institute for Policy Research at Northwestern University. Once those payments ended in 2023, more families had trouble purchasing enough food, according to a study published in Health Affairs in October. Non-Hispanic Black families, in particular, saw an increase in anxiety, the study found.

“We know that even short periods of food insecurity for kids can really significantly harm their long-term health and cognitive development,” said Katie Bergh, a senior policy analyst on the food assistance team at the Center on Budget Policy and Priorities. Cuts to SNAP “will put a healthy diet even farther out of reach for these families.”

The Trump administration said it’s boosting healthy eating for low-income Americans through restrictions on what they can buy with SNAP benefits. It has begun approving state requests to limit the purchase of soda and candy with SNAP benefits.

“Thank you to the governors of Indiana, Arkansas, Idaho, Utah, Iowa, and Nebraska for their bold leadership and unwavering commitment to Make America Healthy Again,” said Health and Human Services Secretary Robert F. Kennedy Jr. in a press release about the requests. “I call on every governor in the nation to submit a SNAP waiver to eliminate sugary drinks — taxpayer dollars should never bankroll products that fuel the chronic disease epidemic.”

Although states have asked for such restrictions in the past, previous administrations, including the first Trump administration, never approved them.

In 2017, Tiffany Terrell replaced school bus seats with shelves stocked with fruits, vegetables, meats, and eggs and drove around her mobile grocery store to senior communities, public housing developments, and rural areas of Georgia.

‘It’s not about soda and candy. It’s about access.’

Research shows that programs encouraging people to buy healthy food are more effective than regulating what they can buy. Such limits increase stigma on families that receive benefits, are burdensome to retailers, and often difficult to implement, researchers say.

“People make incredibly tough choices to survive,” said Gina Plata-Nino, the deputy director of SNAP at the Food Research & Action Center, a nonprofit advocacy group, and a former senior policy adviser in the Biden administration.

“It’s not about soda and candy,” she said. “It’s about access.”

Terrell said she is unsure how people will survive if their food benefits are further trimmed.

“What are we thinking people are going to do?” said Terrell of A Better Way Grocers, who also opened a bustling community market last year that sells fresh juices, smoothies, and wellness shots in downtown Albany. “We’ll have people choosing between food and bills.”

That’s true for Stephen Harrison, 22, whose monthly SNAP benefit supports him, along with his parents and younger brother. During the pandemic, he used the extra assistance to buy strawberries and grapes, but now he comes into A Better Way Grocers to buy an orange when he can.

Harrison, who is studying culinary arts at Albany Technical College, said his family budgets carefully to afford meals like pork chops with cornbread and collard greens, but he said that, if his benefits are cut, the family will have to resort to cheaper foods.

“I’d buy hot dogs,” he said with a shrug.

This story was originally published at KFF Health News, Healthbeat’s national reporting partner.

New York City hospitals join ‘food as medicine’ movement, prescribing free boxes of fresh produce

2025-07-16T11:00:00+00:00

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New York city’s public hospital system is joining the “food as medicine” movement, offering “prescriptions” for free boxes of fresh produce — tomatoes, potatoes, broccoli, peaches, bok choy, and fennel — delivered to patients’ homes each month for six months.

More than 500 patients have enrolled in the Lifestyle Medicine Program’s produce box initiative since its August start.

The program focuses on food, as well as other social determinants of health like exercise.

“It’s not just about nutrition, but also physical activity, sleep, stress, because it’s all connected,” said Dr. Michelle McMacken, executive director for nutrition and lifestyle medicine at NYC Health + Hospitals.

The program is related to the emerging food as medicine trend, which acknowledges that many chronic health conditions, such as type 2 diabetes, high blood pressure, and concerns related to excess weight, can be at least partially managed through diet and exercise.

According to a 2023 study, poor diet is associated with 18.2% of cardiovascular issues and type 2 diabetes, and according to the Rockefeller Foundation, an estimated $13.6 billion in health care spending could be saved annually if all eligible Americans received medically tailored meals, nutritionally customized for their specific needs.

How New York is treating chronic health conditions with medically tailored meals

Samuel Rios, an administrative assistant at Con Edison, was diagnosed with pre-diabetes in 2020. A few months later, the pandemic hit and kept everyone indoors. Rios started to “binge on candy, and drink those very sugary Snapple iced tea drinks by the gallon.”

In 2021, he was admitted to Mount Sinai Hospital with blood sugar levels over 700. The doctors prescribed insulin, but he refused to take it. He thought he could beat diabetes on his own.

“It wasn’t very smart of me. I wasn’t [testing] my blood sugar daily. I was eating things I shouldn’t eat,” he said. He fell back into his bad habits: McDonald’s, KFC, french fries, “all the stuff that gets you in trouble.”

On Feb. 8, 2024, Rios felt dizzy, his vision got blurry, and he fainted. His kidneys had started failing, and his blood sugar levels spiked to over 900. He had to be hospitalized at NYC Health + Hospitals/Woodhull.

Over a year later, Rios, 49, has developed new eating habits. Instead of Big Macs and buckets of fried chicken, now he regularly makes his own pesto from fresh basil and olive oil, and eats salad daily. In six months, he has seen his A1C — his average blood sugar levels — improve from 11.3% to 5.7%, and he no longer needs insulin injections.

“This program saved my life,” Rios said.

The produce prescription is not the only perk of the program.

Participants have one-on-one counseling sessions with physicians and nurse practitioners, dietitians, health coaches, and other experts. Fitness instructors give them exercises. Psychologists help them look at the mental aspects of eating behavior. For patients who are financially insecure, community health workers can help find a food pantry or apply for Supplemental Nutrition Assistance Program benefits.

Participants receive counseling on sleep routines, because people who are sleep deprived are much more likely to desire high-calorie foods, research suggests.

They also meet in weekly group support sessions with others trying to achieve better health through lifestyle changes.

“The nutrition science is extremely clear that the foods that we eat are among the most important factors determining our long-term health and our risk of chronic disease,” McMacken said. “What’s challenging is helping people make those changes, especially when they’re facing financial constraints, when they have difficulty accessing some of the foods that we know are the healthiest foods.”

Research shows produce prescriptions yield health benefits

Food as medicine is not a new idea. Hippocrates advocated for it back in the fifth century BCE. But in the past decade, it has gained momentum and the backing of health care providers, said Alexina Cather, interim president of the NYC Food Policy Center at Hunter College. Thanks to a 2016 Medicaid modification, some states allow doctors to screen for food insecurity, provide nutrition education, and provide healthful food to low-income patients.

A produce box from Farm To People delivered to patients.

The Lifestyle Medicine Program at NYC Health + Hospitals began as a pilot at Bellevue Hospital. More than 850 patients enrolled, and in a 2023 study, doctors there documented positive health outcomes. After six months, participants reported an average of 2.4 fewer barriers to adopting a plant-based diet (such as not knowing what to eat that is plant based, or how to prepare those foods). Their physical activity increased by 0.7 days per week, and the number of participants who reported “good” or “very good” quality of sleep increased by 12.2 percentage points.

In a separate 2023 study, researchers also highlighted clinical improvements. Patients with prediabetes or were overweight or had obesity lost weight, and those with type 2 diabetes also saw improvements to their blood sugar levels.

Research conducted elsewhere also suggests that these programs can be effective. A 2021 Penn State study found that after seven months of using vouchers to buy fruits and vegetables, people’s blood sugar levels went down 1.3%. Another study, from Tufts University, showed that after six months of a produce prescription, patients were eating nearly an additional cup of fruits and vegetables daily. The odds of being food insecure also dropped by one-third.

A similar program in the Bronx ran from February 2023 to May 2025, when grant money from the National Institute of Food and Agriculture ran out. Bronx Health REACH, a non-profit organization that aims to eliminate racial and ethnic health disparities, in partnership with the Corbin Hill Food Project, a Harlem-based nonprofit, sold vegetable boxes worth $35 for $2.50 to patients at its affiliated clinics.

The program was a success — some people lost weight, and many lowered their blood pressure and cholesterol levels, said Kenny Escobar, nutrition and physical activity coordinator for Bronx Health REACH.

Not everyone has time or resources to prepare healthy meals

Some experts warn that it can be simplistic to imagine that six months of receiving vegetable boxes and cooking advice can fix complicated structural problems that afflict the health of many people with low incomes from marginalized communities. People who are working two jobs, or taking care of children, may not have time to cook or have access to utensils and a functional stove.

“In 2020, some NYCHA housing units didn’t have heat and gas for months,” Cather said of the New York City Housing Authority. “If you just gave them a bunch of food that they needed to cook, they wouldn’t be able to do that.”

A few of the patients served by Bronx Health REACH reported that they didn’t have enough time to cook vegetables like rainbow Swiss chard, which takes a lot of time to soften. “One patient told me that she would want to utilize these things, but she just doesn’t have time to prepare them,” Escobar said.

HealthyNYC targets diabetes with expanded support in underserved Brooklyn neighborhoods

For patients who have the time and resources, produce prescriptions can be life changing. After his emergency hospitalization, Rios, who lives at the border of Bushwick and Williamsburg, weighed 292 pounds. At weekly meetings with dieticians and other patients in the program, he learned step by step how to control food portions, go light on olive oil, make salad, and find protein sources other than meat. He learned that he can still eat pasta, but the whole wheat kind is better, as plain pasta “can shoot up your glycemic levels.”

The first meal he learned to cook was lentil soup. He relishes his salads with beans and chickpeas.

“My taste buds have changed. The program allowed me to reboot my mind frame,” he said. “I know that that cheeseburger and fries at McDonald’s taste good, but do I really want my A1C to go up again? Nah, you know what? I can have my broccoli and my asparagus, and I add a little flavor to it, squeeze a little lemon, and have my little fish, and I’m fine with that.”

When family members tempted him with pizza or cake, knowing he would be meeting every week in a support group helped him stick to his goals. “The meetings are like AA meetings because you’re able to sit there with others who are going through the same thing as you, and there’s no judgment,” he said.

Rios has lost 75 pounds, which has helped not only his diabetes but also reduced his sleep apnea and joint inflammation. “I have the energy to walk,” he said. “I take long walks, and it’s just night and day for me.”

This story was produced in partnership with the Health & Science Reporting Program at the Craig Newmark Graduate School of Journalism at CUNY.

U.S. food makers are still using dyes linked to hyperactivity in kids. Parents want them banned.

2025-07-14T11:00:00+00:00

Public health, explained: Sign up to receive Healthbeat’s free New York City newsletter here.

Long Island mom Stefanie Lomuto’s 7-year-old son came home from school one day in April angry and hyperactive. “He was off the wall,” she said.“We were in hell for five days.”

She asked what he had for lunch. A bagel with yogurt. “I was, like, what kind of yogurt did you have? And he’s, like, strawberry. I was, like, oh, no.” She contacted the school and learned that yes, the pink yogurt contained food dye.

When Lomuto’s son was 3 and having behavioral and impulse control issues, she came across an article that recommended cutting out food additives. “First thing we cut out was high fructose corn syrup. We saw a bit of an improvement. Food dyes were the next one on the list. I cut those. And our issues drastically went away.”

The family saw a huge improvement in his behavior, but since then he has become more sensitive to dyes than ever. “He has one maraschino cherry, and our whole week is just destroyed,” she said.

While Lomuto makes sure not to let her son eat artificially colored foods at home, she can’t control what happens at school. His teachers know that he’s dye-free, and Lomuto sends him with his own cupcakes for class parties, but the food that the cafeteria sells is harder to track.

“His friends are buying ice pops, and he asked me for a dollar to buy an ice pop,” she said. “I can’t even let the kid have a simple ice cream at school like his friends.”

Studies have consistently found that artificial food colorings including Red 40, Yellow 5 and 6, and Blue 1 and 2, can make some children hyperactive, inattentive, and irritable. In early 2025, Red 3 was banned in U.S. food products; it was originally banned in cosmetics in 1990 due to cancer links.

Since 2010 in Britain and the European Union, any food containing artificial dyes must carry a warning label that the additives may cause hyperactivity. Many manufacturers stopped using them. But in the United States, until this year, the Food and Drug Administration had stated that dyes were safe, while acknowledging that “some children may experience sensitivities.”

RFK Jr. asks food producers to phase out dyes, but it’s not mandatory

Artificial food dyes are everywhere: in Cheetos, Jolly Ranchers, applesauce, pickles, spinach wraps, ice cream, even Tylenol. A 2016 study found that dyes were present in 43% of the foods marketed to children in a single grocery store.

New Health and Human Services Secretary Robert F. Kennedy Jr. has made food dyes a pillar of his crusade against chronic illness. In March, he directed the FDA to request that food producers phase out dyes by 2026. Compliance will be voluntary.

Trump administration health policies may target ultra-processed foods

“Everyone realized they weren’t talking about actual regulations or a regulatory ban,” said Jensen Jose of the Center for Science in the Public Interest, which has advocated removal of dyes from children’s food. “We’re disappointed in the limited scope.”

New York City public schools already ban a range of additives, preservatives, and sugar alternatives. A bill in the state legislature seeks to ban six common dyes from food served in public schools, but it did not pass this year.

It was drafted by State Assembly Member Dr. Anna Kelles, who holds a PhD in nutritional epidemiology, and State Sen. Brian Kavanaugh, who began working on the issue several years ago after learning about artificial dyes at a conference.

“As more and more legislators become educated about the dangers of these foods, you gain greater support,” said Stanley Davis, a spokesman for Kavanaugh.

Parents of dye-sensitive children said the legislation could change their lives.

“It would be huge,” said Christine Einzig of Corinth, New York, who has 7-year-old triplets who are sensitive to dyes. “We would see a change in behavior for so many kids.”

Behavior of all 300 children in one study was impacted by dyes

What persuaded policymakers in Europe and the United Kingdom to regulate dyes was a 2007 study conducted by researchers at the University of Southampton.

The study followed 300 3- and 8-year-olds who did not have any known behavioral or attention problems. After removing dyes from their home diets, scientists gave the children an identical-looking fruit-flavored drink each day — sometimes containing artificial dyes, sometimes not. Parents, teachers, and external observers recorded the children’s behavior daily, without knowing which ones had consumed the artificial dyes. In addition, the 8-year-olds were given a computerized attention test.

How the FDA opens the door to risky chemicals in America’s food supply

All the children in the study, including ones who had not previously been identified as sensitive, were impacted by dyes. “These changes shift the children along the hyperactivity scale. For children who are already predisposed to attention problems, the impact of dyes can move them far enough up that scale to cause a real problem.” said Dr. Jim Stevenson, the author of the study.

The paper estimated that about 10% of the difference between the behavior of children with ADHD and those without could be attributed to dyes.

“It’s a public health issue, because you cannot identify the kids who are going to react. So the best thing to do is take the dyes out of the food. In Europe, and Britain too, we operate on a precautionary principle. If we have a concern that something may have an effect, then let’s take action,” Stevenson said.

Lisa Lefferts was a part of the 2011 FDA panel tasked with deciding whether U.S. foods should carry warning labels for dyes.

“They did not ask us if we thought dyes were safe,” she said. “What they did ask us is if we thought a causal relationship had been established for certified color additives and hyperactivity.”

In 2011, she said, scientists were not sure about the causal link between hyperactivity and dyes – and the FDA decided not to ask a direct question about whether dyes caused any other kind of “harm.” Looking just at hyperactivity limited the scope of the panel and the power it had to make recommendations – but “they did not ask us if we thought dyes were safe,” Lefferts said.

Limiting children’s exposure to dyes can be burden for parents

In 2021, the California Office of Environmental Health Hazard Assessment published a systematic meta analysis of 27 studies of dyes, exploring their impact on humans and animals. The finding was consistent with the UK study – and with the parental perception – that synthetic dyes impact neurobehavior in some children. And, these days, Lefferts puts a lot of stock in its findings.

“It was informed by a scientific symposium. They asked for public information. They put the report out for public review and comment, as well as peer review,” she said.

And while some officials suggest that parents should be responsible for keeping their children away from food dyes, parent advocates say that could be an undue burden for people who lack educational advantages or are financially struggling.

“Our child had a mother that had the opportunity and the time to investigate. I make all the grocery trips, I spend extra for the treats. There are many families that don’t have that same opportunity,” said Whitney Cawood, director and producer of To Dye For: A Documentary.

Cawood and her husband, who live in Dalton, Georgia, created the documentary, interviewing legislators, scientists, and families to understand how dyes made it into American food and the impact the additives have on individual children and their families.

A former teacher, Cawood said many single parents, parents who struggle with literacy, or those who don’t drive, may not have the resources or awareness to seek out dye-free options. She points out that schools are also a place where students have less control over their diet.

“Many families are dependent upon free and reduced [price] lunch and snack programs within their schools,” she said.

Einzig echoes this sentiment in New York.

Food as medicine: How New York is treating chronic health conditions with medically tailored meals

“We’re in a poorer part of the state,” she said, “and we only have one grocery store in town.” Other parents, she said, might not have the time or the money to go to another store half an hour away.

There’s no medical name or test for a dye sensitivity, but about 8% of children with ADHD were particularly affected, according to a 2012 study in the Journal of the American Academy of Child & Adolescent Psychiatry.

“You want to know the worst thing right now?” Einzig said. Her son has been prescribed a new ADHD medication – “and it’s pink. Why is it pink?”

She is referring to an extended-release version of Vyvanse that contains Blue No. 1, Red No. 3 and Yellow No. 6. Lomuto has had the same experience. “The capsule is pink, but the pill [inside] supposedly doesn’t have dyes - so there’s a chewable version I’m now trying to get.” However, her insurance won’t cover that version because her son can technically swallow a capsule. “Why are we feeding him this thing that’s making him hyper while giving him the medication to make him not hyper? You can’t make that make sense,” she said.

Although not all children are equally sensitive to dyes, children can be affected by the behaviour of their classmates. Even one child struggling to regulate themselves in a class can disrupt teaching for an entire day, educators say. A research overview from Ohio State University in 2012 found that the presence of a child with a dye reaction “may have an aggregated effect on classroom climate.”

Einzig sees this as an important issue to make education better for all children. “How much time are these teachers actually spending teaching, versus behavior management?” she asked.

Einzig hopes that nationwide legislation will eventually phase out all dyes so her kids can go back to eating their favorite foods. “They talk about Doritos a lot,” she said. She’s found another type of cheesy nacho chip that they like – “but, I know they miss it.”

This story was produced in partnership with the Health & Science Reporting Program at the Craig Newmark Graduate School of Journalism at CUNY.

A federal program helps NYC families eat healthy meals. Trump’s new legislation cuts it.

2025-07-11T19:31:11+00:00

Public health, explained: Sign up to receive Healthbeat’s free New York City newsletter here.

On a sweltering afternoon this week, Ana Garcia, 41, and her 3-year-old son, Elliott, arrived at the Goodhue Community Center on Staten Island to pick up their weekly haul of fresh, affordable produce.

Garcia tasted a sample of tabbouleh salad. She and her son surveyed a spread of leafy greens, zucchini, summer squash, and peaches. For eight years, her family has returned regularly to buy a box of locally sourced produce. This week’s box — priced at $14, or $7 for those with Supplemental Nutrition Assistance Program, or SNAP, benefits — included a bounty of fresh fruit and vegetables, plus a recipe for tabbouleh.

“It’s awesome,” Garcia said. “We love coming here.”

But the Food Box program, administered by the nonprofit Children’s Aid, may not exist much longer. President Donald Trump’s “One Big Beautiful Bill” — passed by Congress and signed by Trump last week — eliminated funding for the Supplemental Nutrition Assistance Program Education, or SNAP-Ed, and made other changes to SNAP. SNAP-Ed, which funds nutrition education and anti-obesity initiatives nationwide, is set to expire on Sept. 30.

That will mean the disappearance of programs that help people on a limited budget eat healthier and shop smarter, teach children and families how to cook meals from scratch, and promote physically active lifestyles. Those efforts seem to align with the Trump administration’s Make America Healthy Again, or MAHA, initiative, but will be impacted nonetheless.

Advocates are bracing for how the legislation will affect childhood hunger across the city and state. Changes to SNAP, including new eligibility rules, could result in hundreds of thousands of parents losing their food benefits. In all, New York state is facing up to $1.4 billion in annual SNAP cuts and cost shifts, with the state expected to start covering $1.2 billion for the program by October 2027.

“Not just in New York, but nationwide, we will see increases in child hunger,” said Dr. Jennifer Cadenhead, a research assistant professor at Columbia’s Teachers College, who focuses on diet, food quality, and food insecurity issues. “That really makes me sad.”

While SNAP cuts might affect free school meals in other districts, New York City’s universal breakfast and lunch program is safe because the city’s high poverty rate will continue to qualify the whole school system for the program. But individual families will likely be hit hard, which could in turn lead to higher absenteeism rates and affect student performance.

On Staten Island, Garcia said that the end of the Food Box program would mean less fresh produce in her family’s diet — a loss for her two children.

“I want my kids to have all the vegetables,” she said.

Small program has a big impact

A roughly $536 million annual program with a 30-year history, SNAP-Ed is among the U.S. Department of Agriculture’s largest nutrition education programs. In a 2024 paper from the Journal of Nutrition Education and Behavior, researchers described it as a “critical pillar in the nation’s public health infrastructure.” Still, it’s a fraction of SNAP’s $99.8 billion in total spending in fiscal year 2024.

By offering evidence-based nutrition and food education, SNAP-Ed pays dividends for families’ long-term health, said Cadenhead, of Teachers College.

“A lot of times, a doctor will say, ‘You need to eat better,’ but people don’t know how,” she said. “They don’t know how to prepare a balanced meal. They may not have time. They don’t understand what they need to do, they can get overwhelmed in the grocery store.”

Funded with $29 million in federal dollars, New York’s SNAP-Ed programs reached over 2.2 million individuals across the state last fiscal year, through efforts like Eat Well Play Hard. That program educates preschoolers on how their food is grown and encourages their caregivers to prepare and serve local produce to their families.

Fresh produce is displayed at the Food Box pickup site run by Children's Aid at the Goodhue Community Center on Staten Island on Tuesday.

Darren O’Sullivan, a spokesperson for the state’s Office of Temporary and Disability Assistance, said in a statement that the federal legislation eliminating SNAP-Ed “increases the risk that New Yorkers in need will experience food insecurity, health issues, and economic hardship.”

Through the $1 million grant Children’s Aid gets through SNAP-Ed, the organization operates Food Box sites throughout the city, as well as programs in schools. Currently, the organization is running youth nutrition workshops and cooking demonstrations at Summer Rising sites, the city’s free summer school program.

“We hear from parents that their kids are coming home and asking, ‘Can we make this recipe at home?’” said Taisy Conk, director of food and nutrition programs at Children’s Aid. “This is opening up their palettes and their minds and getting them excited about it. It really makes an impact on children’s health.”

Through SNAP-Ed, Children’s Aid brought nutrition education to 20 sites, including 11 schools last year. The organization analyzed its programs’ impacts for the year before, and found that across its 176 workshops that reached nearly 430 kids, young people improved their vegetable consumption by 35%, with more than 60% reporting eating at least two fruits a day at the end of the course.

Conk said she worries that changes to SNAP will have far-reaching effects, with people assuming they’re no longer eligible or struggling with new requirements. She said Children’s Aid is urging the city and state to explore some bridge funding to keep the programs going and is looking to philanthropy to help plug the gaps.

Families brace for reductions in fresh produce

On Staten Island, the Food Box stand was open during dismissal for a summer camp at the Goodhue Community Center. Some families stopped by to learn about the program or buy armfuls of corn.

“It’s been great to have affordable produce,” said Tara Messenger, 50, as she and her 9-year-old daughter collected their Food Box.

Without the Food Box program, Messenger, an art teacher, said she’d have to rely more on her local grocery store, and they’d likely eat more processed food.

“It wouldn’t be as fresh, as local, as affordable,” she said. “I probably wouldn’t have as many vegetables and fruits in our diet.”

This "Food Box" includes fresh produce, including ingredients for tabbouleh salad and the recipe for it, at the Goodhue Community Center on Staten Island on Tuesday.

Sarah Kabalkin, 46, a local culinary educator, said she worried that cuts to SNAP would have a “devastating” impact on her community, with more residents going hungry.

Losing the Food Box program would affect her family, she said. Without their weekly boxes of fresh produce, Kabalkin said she’d have to find a way to grow more in her community garden plots.

“I can’t produce this kind of variety,” she said. “So it will limit what we’re eating at home.”

Eliza Fawcett is a reporter covering public health in New York City for Healthbeat. Contact Eliza at efawcett@healthbeat.org.

Food as medicine: How New York is treating chronic health conditions with medically tailored meals

2025-07-10T13:39:24+00:00

Public health, explained: Sign up to receive Healthbeat’s free New York City newsletter here.

At a lower west side commercial kitchen nestled underneath rooftop greenery, about 70 meal prep volunteers, dressed in white aprons and clear bouffant caps, move in a tireless flow, ladling soup into plastic containers as chefs oversee massive steam kettles bubbling with broths for the punctual production of medically tailored meals to be delivered across New York City’s five boroughs.

These helpers are from God’s Love We Deliver, a nonprofit that pioneered the use of food as a health intervention during the AIDS crisis. At a time when traditional health services often overlooked nutrition, they stepped in to provide medically tailored meals — designed by registered dietitians — for HIV patients who were too weak or bedridden to cook for themselves.

In 2020, Amida Care became the first Medicaid Special Needs Health Plan in New York to partner with GLWD to offer medically tailored, home-delivered meals as a reimbursable benefit. This initiative aimed to support members living with complex conditions such as HIV/AIDS, diabetes, cancer, and heart failure, particularly those facing challenges in preparing meals due to their chronic health conditions.

“We’ve started seeing ourselves as a health care provider — very similar to the doctor you go to,” said Allyson Schiff, director of business development and community partnerships at GLWD. “Except instead of a prescription for a pill or physical therapy, we’re writing you a prescription for food.”

The New York State Department of Health has launched a $500 million Social Care Network to connect Medicaid members across all health plans with community-based organizations that address social determinants of health — such as food insecurity, housing instability, and transportation. This New York health initiative positions food and nutrition, often referred to as “Food as Medicine,” as essential health supports beyond the traditional clinical setting, and recognizes that medical care can happen in the community, too.

Food as Medicine programs can reduce health care costs

At the core of this network is the delivery of wraparound services — especially nutritional interventions like medically tailored meals — through trusted community-based organizations. All Medicaid members are eligible for screening and navigation to programs like SNAP, the Supplemental Nutrition Assistance Program formerly known as food stamps, and WIC, a nutrition program for women, infants, and children.

But those who meet enhanced eligibility criteria — such as people with cancer, serious mental illness, substance use disorder, or who are pregnant or postpartum — may receive direct services, including medically tailored meals, pantry restocking, nutrition education, housing support, and transportation to health-related appointments. These time-limited benefits are meant to fill critical gaps and complement, rather than duplicate, other supports.

Chef Curtis Wilson stirs the pot at God’s Love We Deliver in New York City.

The growth of Food as Medicine initiatives in New York has been driven not only by improved health outcomes, but also by their potential to reduce health care costs. The NY Food as Medicine Coalition — which includes organizations like GLWD, the Food Pantries for the Capital District, and the Alliance for a Hunger-Free New York — has been a key advocate for integrating medically tailored meals and nutrition services into Medicaid.

Their efforts helped lay the groundwork for New York’s Social Care Network. According to the Rockefeller Foundation, a New York-based philanthropy, diet-related diseases cost the U.S. health care system an estimated $1.1 trillion annually, and scaling Food as Medicine programs nationwide could yield $13.6 billion in annual health care savings.

“Growing awareness of the link between diet and disease, the impact of nutrition on health outcomes, and the health care costs associated with chronic disease have led to increased support for Food as Medicine initiatives and efforts to incorporate them into state policy,” said Rebecca Keister, director of development and communications at Food Pantries for the Capital District.

How medically tailored meals fill gaps in care

The Social Care Network is led by nine nonprofit organizations that partner with community-based organizations to advance health equity. At GLWD, clients receive medically tailored meals developed by in-house chefs and nutritionists, who can remove components like liquids, phosphorus, and potassium for patients with renal disease.

Meal options can be made soft, minced, or pureed, ensuring clients with chewing or swallowing difficulties — like cancer patients who find foods such as chicken legs challenging — still receive vital nutrition, Schiff said. These adaptations also allow GLWD to serve children as young as 2, including those with conditions like sickle cell disease.

HealthyNYC targets diabetes with expanded support in underserved Brooklyn neighborhoods

GLWD provides services without income requirements, and clients do not need to be on Medicaid. To qualify, clients must have a confirmed diagnosis from a doctor, nurse practitioner, or physician assistant, and experience limitations in activities of daily living, such as being unable to shop, stand, or cook due to illness or disability.

GLWD can meet the clinical needs of clients of over 200 diagnoses and delivers 4.2 million heart-healthy, low-sodium, and diabetes-friendly meals annually across all five boroughs and nearby counties with twice-weekly service. Currently, 40% to 50% of the organization’s funding comes through health care reimbursements, Schiff said.

“Medically tailored meals don’t just fill plates — they fill gaps in care. By addressing nutrition as a critical part of health, we help people manage chronic conditions, stay out of the hospital, and live healthier, more independent lives,” Schiff said.

The U.S. Department of Agriculture reports people who are food insecure — lacking access to the necessary foods to meet their nutritional needs — are at a greater risk of developing 10 of the costliest and most deadly diet-related chronic conditions, including hypertension, coronary heart disease, stroke, cancer, and diabetes.

According to the Community Service Society of New York’s 2024 Annual Survey of Housing and Economic Security, even earning three times the federal poverty threshold of $15,650 a year for a single person ($46,950) doesn’t insulate New Yorkers from food insecurity. And having a full-time job is no safeguard either — nearly 1 in 5 full-time workers surveyed still said they struggled to afford enough food. New York has the highest income inequality of any state in the United States, according to data from the U.S. Census Bureau published in 2023.

Garlic rows await harvest for food prescription boxes at Pitney Meadows Community Farm in Saratoga Springs, New York.

Food sovereignty: Some projects work with local farms

Several nonprofits across New York are going a step beyond individualized meals and are embracing food sovereignty, prioritizing community control over food systems through grassroots Food as Medicine initiatives.

Pitney Meadows Community Farm in Saratoga Springs has launched a pilot program in collaboration with Saratoga Hospital’s Community Health Center, supported by Health Care Without Harm. This initiative delivers biweekly boxes of fresh, locally grown produce — such as kale, carrots, garlic, onions, sweet corn, summer squash, lettuce, tomatoes, green beans, and apples — to residents of three low-income housing communities. Most of the produce is cultivated on-site at Pitney Meadows, with additional items sourced from nearby farms.

Daniel Williams, food sovereignty and farm engagement coordinator at Pitney Meadows Community Farm in Saratoga Springs, New York, holds a freshly picked radish.

Hospital nutritionists work with the farm to develop educational materials that help participants incorporate the produce into their diets to support specific health goals. The pilot aims to evaluate how integrating fresh, local food into health care can affect health outcomes, with an eye toward expanding the model regionally.

Daniel Williams, Pitney Meadows’ food sovereignty and farm engagement coordinator, said they draw inspiration from movements in South America and Africa. These movements united to affirm Indigenous peoples’ rights to grow and eat food on their own terms, in line with their traditions and practices.

“There’s a need to have the people of our community have access to good food that’s grown, that comes from within the community, and feeds the community,” Williams said.

HHS drops waivers that funded Food as Medicine programs in New York

At the January 2024 Food Is Medicine Summit, the U.S. Department of Health and Human Services launched a national effort to expand nutrition-based interventions through Medicaid managed care and Section 1115 waivers, which let states test innovative Medicaid programs, including social care funding.

But in April, the agency reversed course, announcing it will no longer approve or renew these waivers. This threatens New York’s Health Equity Reform Waiver, which funds Social Care Networks and expires in March 2027.

For God’s Love We Deliver, this risks 40% of its funding from Medicaid reimbursements tied to regional managed care pilots, like Amida Care’s In Lieu of Services initiative, which rely on the waiver’s federal matching funds.

“Given that such a huge part of our funding comes from health care right now, what happens after 2027 when the waiver ends, is a very big question mark for us,” Schiff said. “We’re currently in the midst of strategy and planning to see how we can continue our growth and our good work in a post-waiver world.”

This story was produced in partnership with the Health & Science Reporting Program at the Craig Newmark Graduate School of Journalism at CUNY.

New York City food pantries work to give immigrants a taste of home. Trump’s aid cuts are making it harder.

2025-06-18T14:30:00+00:00

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For Alfred Atherley-Ward, food means family.

The 42-year-old former chef fondly recalls memories of home-cooked meals with their daughter back in their native Guyana.

“My daughter would always look forward to when I was going to be in the kitchen cooking up food, especially dal, that we would sit together and enjoy,” Atherley-Ward said. “The look on her face, and she with her little hands in the bowl – those moments are so precious to me.”

Atherley-Ward views cooking meals rooted in their Indo- and Afro-Caribbean background as a way to feel closer to the now 19-year-old daughter they left behind while seeking asylum in the United States in 2021. The move followed years of persecution for Atherley-Ward, who identifies as queer and uses they/them pronouns. In Guyana, homosexuality is considered a crime.

The experience of fleeing violence back home coupled with struggles to access food and housing upon relocating to New York City made them all the more grateful for the culturally inclusive food items available at the Food Justice Program, an initiative of the Queens-based Caribbean Equality Project, which provides legal and social services to Indo- and Afro-Caribbean LGBTQ+ immigrants and asylum seekers.

“We go through so much mental health trauma,” said Atherley-Ward, who experienced an 18-month period of homelessness shortly after moving. “All we’re looking for is a place of acceptance on this journey.”

The Food Justice Program is one of a growing number of food pantries in New York City working to provide culturally responsive help for the city’s immigrant communities. A lifeline amid the Covid-19 pandemic, these programs now find their sustainability threatened by the Trump administration’s cuts to federal food aid.

“The pandemic was a spark for an increase in food needs, and that need never dissipated,” said Caitlin Caspi, director of food security initiatives at the Rudd Center for Food Policy and Health at the University of Connecticut. “In the last few years, we’ve seen high levels of federal food assistance, but all of that now is being stripped away.”

NYC food insecurity nearly doubled at start of pandemic

Research shows that New York City’s incidence of food insecurity, which is defined as uncertain access to adequate food at the household level, nearly doubled during the first six months of the pandemic. A 2020 report found that the number of food-insecure individuals increased from 1.2 million in March 2020 to 2 million in August 2020, an incidence rate of nearly 14.6%.

The pandemic’s impact on communities of color, including immigrant populations, was particularly pronounced, with more than half of Black, Latino, and Asian New Yorkers reporting an inability to buy groceries during the period, compared to 42% of white New Yorkers. Issues of limited food access, which can lead to increased risks of obesity, diabetes, and cardiovascular disease as a result of a nutrition-poor diet, continue to persist among those groups.

“They say Covid is over, but the folks we’re providing service to, it’s never over for them. Their rent has increased, their daily expenses have increased, but their wages haven’t.”
Mohammad Razvi, CEO of the Council of Peoples Organization

More recent data, including 2024, shows that while the citywide food insecurity rate remains elevated at pandemic levels, the rates of food insecurity for communities of color are two to three times higher in every borough compared to their white counterparts.

Jennifer Cadenhead, executive director of the Laurie M. Tisch Center for Food, Education and Policy at Teachers College, Columbia University, said people of color’s heightened food vulnerability is due to low wages and a lack of worker protections in service-based industries, such as restaurants, which employ many immigrants and were disproportionately impacted by the pandemic.

“In terms of food security, people of color tended to do worse both during Covid and in their ability to get back to baseline,” Cadenhead said.

The economic downturn of the pandemic contributed to increased use of food pantry services. One in three New Yorkers reported using a food pantry at least once post-pandemic compared to 1 in 5 New Yorkers pre-pandemic, according to a 2024 report issued by the Robin Hood Foundation.

Why access to cultural food options matters

Immigrant recipients of food pantry services state being unsure of how to cook American foods, research shows. A lack of access to culturally inclusive foods is also associated with poorer mental health outcomes, such as increased feelings of shame and stigma, in immigrant communities.

Culturally inclusive food pantries are essential to creating a more dignified experience for clients by allowing them to choose their own food, Caspi said.

“Food pantries have been trying to move toward more choice-based programs that allow people to feel like they’re shopping in a grocery store,” she said.

Caribbean Equality Project staff, volunteers and community partners gather for a Food Justice Program pantry distribution.

The Caribbean Equality Project’s Food Justice Program, which launched in Flatbush in 2020 following the pandemic, caters to the city’s Caribbean diaspora and has served more than 55,000 people. Among its offerings are ingredients for balanjay, a Guyanese dish made with eggplant, potatoes, cumin, and other traditional spices; as well as lentils and flour.

Atherley-Ward, who now works as a community adviser at the Caribbean Equality Project, said the organization’s commitment to distributing fresh produce, such as cabbage and tomatoes, which serve as ingredients for traditional curries, supports the nutritional needs of the Caribbean diaspora.

“I’m not just getting food, but rather food that I’m accustomed to, that I can create healthy meals with,” they said. “It helps with the daily stress of wondering ‘what can I make with this?’”

Trump cuts to food aid threaten local programs

The Trump administration’s cuts to federal funding for food banks and other emergency assistance food programs threaten projects like the Food Justice Program. In March, the administration announced that $500 million in support of the Local Food Purchase Assistance Cooperative Agreement Program, a federal initiative that enables food banks to purchase goods from local farms, would be cancelled.

Later that month, the administration pulled another $500 million dedicated to The Emergency Food Assistance Program, which distributes emergency food assistance to states, from the federal budget.

The Caribbean Equality Project’s executive director, Mohamed Amin, worries about the impact. He points to a recent letter from the organization’s food assistance partner, the Campaign Against Hunger, that warns of reduced food aid deliveries in the coming months.

At present, the Campaign Against Hunger provides the Food Justice Program with monthly food aid for 250 families. A decrease in resources would put additional financial strain on the organization, he said, which already spends $5,000 a month to support additional pantry clients.

“These cuts not only have a direct impact on the community members that we serve, but also on programs like ours that fill the gap,” Amin said. “And now we’re seeing this gap become wider and more disproportionate.”

Fresh produce is available at a Food Justice Program pantry distribution.

The structure of the emergency food system also places extra financial burden on organizations like the Caribbean Equality Project, which strives to meet the needs of communities of color. TEFAP food aid, which flows down to local pantries like the Food Justice Program, is made up of staple items like apples and beans, meaning it doesn’t always meet the cultural needs of communities, Caspi said.

Amin and his colleagues remain committed to utilizing existing pantry funding to purchase culturally inclusive products.

“We are not willing to negotiate the needs of our communities,” he said.

Food prices up 20% over five years ago

The funding cuts come at a time of greater need for food aid, much of it driven by increases in the cost of living. According to Federal Reserve Economic Data, prices on goods, including food, are up 20% over five years ago.

“They say Covid is over, but the folks we’re providing service to, it’s never over for them. Their rent has increased, their daily expenses have increased, but their wages haven’t,” said Mohammad Razvi, CEO of the Council of Peoples Organization, a Brooklyn-based group that provides social services to low-income immigrant families, a majority of whom are South Asian and Muslim.

The council, which operates a weekly halal food pantry started shortly before the pandemic, has become increasingly reliant on food donations from local businesses. The donations, which help make up for reduced goods from local food banks, are critical to serving the pantry’s more than 2,000 weekly clients.

In recent months, though, Razvi has observed shorter pantry lines, which he attributes to the Trump administration’s immigration policies and threats of mass deportation.

“People are saying, ‘Can I take this for my friend? He’s afraid to come’,” he said.

Fearful clients are requesting home delivery, but Amin said it’s hard to establish new services in a time of limited resources.

“We don’t have the infrastructure to deliver to families who are undocumented, who are afraid to come because of fears of ICE,” he said of Immigration and Customs Enforcement.

Support for such food pantry operational costs are the focus of efforts by local advocacy organizations. Grace Bonilla, president and CEO of United Way of New York City, said the organization is working to double the city’s funding to $100 million in the upcoming fiscal year for Community Food Connection, a program supporting more than 700 community kitchens and food pantries.

“When the dust settles, and people begin to emerge, we could see spikes in food need,” she said of the political climate against immigrants. “We have to be prepared for that.”

Amin, though, remains hopeful.

“I think about abundance, and I dream about abundance, and I manifest abundance because that is what the immigrant community needs right now,” he said. “We need an abundance of resources to make sure that we are not just surviving, but thriving.”

This story has been updated to correct that the Caribbean Equality Project is based in Queens, not Brooklyn.

This story was produced in partnership with the Health & Science Reporting Program at the Craig Newmark Graduate School of Journalism at CUNY.

FDA monitoring bird flu in raw milk cheese, and two NYC cats test positive for disease. Here’s what to know.

2025-03-26T11:00:00+00:00

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I’m back on the public health beat in New York after taking a vacation in Hawaii. (Take me back to snorkeling 🐠 and mai tais🍹please!)

A lot happened in New York public health this week. From bird flu in cats to rabies in raccoons, here’s what you need to know.

Bird flu in two New York City cats

Earlier this month, two cats from separate households in New York City tested positive for bird flu. Both died. The likely source of infection? Raw pet food.

The Food and Drug Administration has said uncooked and unpasteurized pet food from cattle or poultry — think raw meat, eggs, or unpasteurized milk — can make pets sick with bird flu. Both New York City cats that died ate raw, canned chicken from Savage Cat Food.

Since 2022, more than 100 domestic cats nationwide have been infected with bird flu, and their infections have been particularly bad. Most have died. (Though they may have been more likely to be tested because of serious illness). The risk of cat-to-human transmission is low but possible — in 2016, a veterinarian was infected with a different type of bird flu (H7N2) after treating a sick cat.

NYC Health Dept. warns against raw food after two cats die from bird flu. Here’s how to protect your pet.

For dog lovers, it’s worth noting bird flu doesn’t seem to be as common or severe in dogs. One study found signs of infection in hunting dogs with a lot of contact with waterfowl, but the dogs did not have serious symptoms.

What pet owners need to know

Avoid feeding pets, especially cats, raw meat, raw milk, or uncooked eggs.
Avoid letting pets roam where they are exposed to wild animals. Cats can get infected by exposure to wild birds, animals, or animal droppings.
Contact your veterinarian if your pet becomes ill after eating raw meat or dairy products. Call ahead so that the veterinarian can be prepared when you arrive.

New York and FDA monitoring for bird flu in raw milk cheese

New research from Cornell University and the FDA found bird flu survived the 60-day aging process in raw milk cheese. While no bird flu has been found in cheeses sold in retail markets, and no human cases have been linked to eating raw cheese, this raises questions about food safety.

Raw milk cheese is made with unpasteurized milk. In the United States, cheese from raw milk must be aged for at least 60 days to reduce pathogen risk. The aging process creates a more difficult environment for bacteria to grow (higher acidity, salty environment, less moisture). This study suggests that it’s not enough to rid cheese of active bird flu virus.

Monitoring will be key to ensuring that our cheese supply remains safe:

FDA will continue sampling at least 300 cheese products nationwide, including aged raw milk cheeses, as part of its ongoing surveillance system.
New York participates in the National Milk Testing Strategy led by the USDA. We’re one of 28 states testing raw milk for H5N1.

What you need to know

Most cheeses in our markets are made from pasteurized milk and are safe to consume. Raw milk products are higher risk, not just for bird flu but also for other bacteria that can make you sick.
Check labels to know if the cheese has been made with raw milk. There is no federal requirement to label whether raw or pasteurized milk was used, but many cheeses label it in the ingredients. Restaurants should also know, too, if you ask.

Rabies in Suffolk County

Rabies, nearly 100% fatal for humans, circulates in the wild animals around us. For the first time since 2009, rabies has been detected in Suffolk County raccoons: Two have tested positive since January.

In 2024, Westchester and Erie counties had the highest rabies detections of New York counties.

However, this shouldn’t be too worrisome for a few reasons:

1-Rabies is common in New York wild animals. New York state frequently leads the nation in the number of rabid animals. (A raccoon rabies outbreak hit New York in the ‘90s, spreading rabies in wild animals across the state.) Infections are most common in raccoons, bats, skunks, and foxes. Among domestic animals, cats are most frequently diagnosed in New York.

2-We have tools to help.

a. Wildlife: We reduce wild animal rabies by vaccinating wildlife. Many communities, including in New York, distribute baits containing oral rabies vaccine across parks and wooded areas (sometimes using helicopters). When raccoons and other animals eat the baits (which smell like fish), they become immunized, protecting them against rabies.

b. Pets that come into contact with wild animals are at greatest risk of rabies. All cats, dogs, and ferrets should be vaccinated for rabies—in New York, state law requires it. Unvaccinated dogs or cats that are exposed are required to be euthanized or isolated for up to 6 months under observation.

c. Humans: People who work directly with animals have occupational risk, and should be vaccinated for rabies. People who may have been exposed to rabies (through an animal bite or scratch) will need post-exposure prophylaxis of the vaccine (getting vaccinated after exposure).

Vaccination and post-exposure prophylaxis have made human rabies rare: We see just 1 to 3 cases in the United States annually. Still, animal bites are common. About 60,000 Americans need post-exposure prophylaxis following an animal bite annually. Thanks to vaccination, New York City hasn’t seen a single human rabies case since 1947.

What you can do

Ensure that your pets are vaccinated for rabies. All New York counties offer free rabies vaccination clinics. For more information, contact your local health department.
Do not touch or get close to wild animals, including feral cats. If you are bitten, immediately wash the wound with soap and water and contact your medical provider. Advise children to immediately tell an adult if they are bitten or scratched by an animal.
If you see a wild animal that doesn’t look well or encounter a dead animal, contact your local health department or 311 if you are in New York City. Rabies symptoms in animals include tiredness, confusion, difficulty moving, aggression, drooling, and chewing objects like wood, soil, or stones.

Getting vaccinated is crucial if a wild animal bites you. I learned that firsthand in college when a monkey bit me while I was traveling — and I’m thankful I got the shots.

Bottom line

The health of our furry friends plays a big role in our community health, even in urban centers like New York City. Consuming raw animal products (milk, meat, eggs, etc.) is risky for people and animals alike. And rabies remains a deadly threat to us and our pets. But keeping pets vaccinated, practicing good food safety, and talking to a provider if you’re exposed or bitten can protect you, your family, and your pets.

Love,

Your Local Epidemiologist

Dr. Marisa Donnelly, a senior epidemiologist with wastewater monitoring company Biobot Analytics, has worked in applied public health for over a decade, specializing in infectious diseases and emerging public health threats. She holds a PhD in epidemiology and has led multiple outbreak investigations, including at the California Department of Public Health and as an Epidemic Intelligence Service Officer at the Centers for Disease Control and Prevention. Marisa has conducted research in Peru, focusing on dengue and Zika viruses and the mosquitoes that spread them. She is Healthbeat’s contributing epidemiologist for New York in partnership with Your Local Epidemiologist, a Healthbeat supporter. She lives in New York City. Marisa can be reached at mdonnelly@healthbeat.org.

NYC Health Dept. warns against raw food after two cats die from bird flu. Here’s how to protect your pet.

2025-03-20T11:00:00+00:00

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Following the bird flu-related deaths of two cats, the New York City Department of Health and Mental Hygiene is advising owners to avoid raw pet food.

Since 2022, the U.S. Department of Agriculture has reported more than 90 confirmed cases of bird flu in domestic cats. Those cats have typically lived on dairy farms or roamed outdoors. But cases have started to emerge of house cats being infected with bird flu, often from raw food or unpasteurized milk.

In New York City, bird flu was detected in two cats and a possible third cat in the recent months, in connection to raw poultry sold by Savage Cat Food, according to the Health Department. The company sells “prey-based” raw cat food, in flavors like chicken, rabbit and lamb, and duck, according to its website.

“We strongly encourage New Yorkers whose cats are experiencing illness after consuming Savage Cat Food products or other raw meat or dairy products to contact their veterinarian,” Dr. Michelle Morse, the acting health commissioner, said in a recent statement.

The highly pathogenic H5N1 bird flu, an influenza virus, has spread widely across the United States in recent years, primarily among birds and dairy cows. The Centers for Disease Control and Prevention has reported 70 human cases since the start of 2024, and one human death. There is no evidence of human-to-human transmission of the virus in the current outbreak.

In New York, bird flu has been occasionally detected in wild birds, backyard flocks and poultry across the state since 2022. Last month, the state temporarily shuttered all live bird markets in New York City after detecting the virus among poultry.

Cats appear to be especially vulnerable to bird flu. While there have been no confirmed cases of cat-to-human transmission during the current outbreak, it has happened before. In New York City in 2016, a veterinarian was infected with a different type of bird flu after interacting with a sick cat.

Here’s what to know about cats and bird flu.

How do cats get bird flu?

While bird flu has been detected in many animal species, cats are “very susceptible to this infection,” said Dr. Bruce Kornreich, the director of the Cornell Feline Health Center.

Cats can pick up the virus in a number of ways, including by eating raw meat and poultry products or drinking raw cow’s milk. They can also get infected by coming into contact with infected livestock, poultry, wild birds, or people and their clothing.

Last year, bird flu was detected in domestic cats in different households in Michigan. In both cases, according to a CDC report, the cats lived with people who worked on dairy farms, and the cats developed respiratory and neurologic illnesses. One cat owner worked transporting unpasteurized milk to farms, including those with cattle infected with bird flu, and their cat would often roll around in their work clothes.

What should pet owners know about raw food?

In New York City, the Health Department traced the two recent feline deaths back to raw food sold by Savage Cat Food. One of the cats became ill after eating a chicken product and was hospitalized with fever, loss of appetite and severe respiratory infection before dying.

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A second cat was diagnosed with bird flu and died following a fever and severe respiratory and liver disease. While that cat had not eaten Savage Cat Food, it had been exposed to a third cat, which became ill after eating Savage Cat Food, but survived. Testing on the second cat indicated that it had been infected with a bird flu strain found in the raw food.

In a letter to consumers, Savage Cat Food said that it issued a recall for the contaminated food and contacted retailers. The bird flu cases were connected to Savage Cat Food packets with lot number 11152026.

While some pet owners opt to feed their pets raw diets, the American Veterinary Medical Association and the CDC discourage the practice due to the risks to animal and human health.

Kornreich advised pet owners to provide their pets with cooked food and avoid raw diets.

“It’s just not worth the risk,” he said.

What are the symptoms of bird flu in cats?

Early symptoms of bird flu in cats include fever, loss of appetite and lethargy. As the illness progresses, cats might exhibit eye and nose discharge, respiratory issues, coughing, sneezing, and neurologic signs, including lack of coordination, seizures and blindness.

Any of those signs is a cause for concern, Kornreich said, especially if the cat has eaten raw food, been exposed to sick pets or people, preyed upon a dead bird, or been exposed to poultry or a dairy barn. If a pet owner notices those symptoms, the cat should be isolated from other pets and people, the owner should thoroughly wash their hands, and immediately contact a veterinarian, he said.

If infected with bird flu, cats have “very high morbidity and mortality,” Kornreich said.

There is no cure for bird flu in cats, and treatment is primarily supportive.

What about dogs?

The American Veterinary Medical Association notes that the likelihood of dogs being infected with bird flu is very low. Still, dogs could become sick from eating ill or dead infected birds, drinking unpasteurized milk, or eating undercooked, or raw meat.

The CDC advises pet owners to prevent their animals from interacting with wild birds, backyard poultry, cows, or indoor animals; to keep pets away from clothing, surfaces, and areas that could be contaminated with bird flu; and to avoid feeding pets raw food or milk.

Additionally, the Health Department advises New Yorkers to avoid dead or sick animals while walking their dogs.

Eliza Fawcett is a reporter covering public health in New York City for Healthbeat. Contact Eliza at efawcett@healthbeat.org.

How the FDA opens the door to risky chemicals in America’s food supply

2025-03-13T18:30:00+00:00

Joseph Shea, who sells athletic wear in Myrtle Beach, South Carolina, wonders and worries about the food he eats.

The chemical ingredients with mystifying names. The references on product labels to unspecified natural or artificial flavors. The junk food that fits his budget but feels addictive and makes him feel unwell.

Shea, one of 1,310 people who responded to a poll the health policy research group KFF conducted on health care priorities, said he assumes the FDA is making sure the ingredients are safe.

In many cases, it is not.

The FDA’s restraints on food ingredients are limited and relatively feeble, especially compared with those in Europe, a KFF Health News examination found. There are at least 950 substances in our food that are not permitted in Europe, according to one expert’s estimate, and chemicals linked to health concerns show up in hundreds of products that line the shelves of American supermarkets.

Robert F. Kennedy Jr., the new head of the Department of Health and Human Services, has railed about the risks of food additives for years and has said he wants to end “the mass poisoning of American children.” At a March 6 confirmation hearing, Marty Makary, President Donald Trump’s nominee to head the FDA, expressed concern about foods “with a lot of molecules that do not appear in nature.”

“These are chemicals that the industry insists are safe, a subset of which are concerning,” he said.

But the Trump administration’s initial moves to reduce staff at the FDA led the director of its food safety unit, Jim Jones, to resign last month and raised fears among food safety specialists that the administration could weaken oversight.

To a great extent, the FDA leaves it to food companies to determine whether their ingredients and additives are safe. Companies don’t have to tell the FDA about those decisions, and they don’t have to list all ingredients on their product labels.

Though pharmaceutical companies are required to share research on humans with the FDA, the agency is largely blind to what food-makers know about their products.

“The food industry does massive amounts of research that we have no access to,” Robert Califf told a Senate committee in December on his way out as FDA commissioner.

As a result: The FDA’s oversight of food additives is much weaker than its oversight of prescription drugs.

“There is good reason to be concerned about the chemicals that are routinely included in much of our food,” Califf testified.

Food is a big business. American consumers spend almost $1.7 trillion annually on food and beverages, according to Circana, a research and advisory firm.

Yet American food companies keep secret much of what they put in their products.

KFF Health News asked nine of the largest food manufacturers — The Coca-Cola Co., Conagra Brands, General Mills, Kellanova (successor to Kellogg), The Kraft Heinz Co., Mondelēz International, Nestlé, PepsiCo, and Unilever — for the number of ingredients, if any, that go unnamed on their product labels and the names of those ingredients deemed safe without involvement by the FDA, and substances used in their products in the United States but not in Europe, and vice versa.

None provided answers to those questions.

“We focus on the quality of the ingredients that we use, and all comply with applicable regulatory requirements,” Nestlé spokesperson Dana Stambaugh said.

Chemicals such as titanium dioxide and potassium bromate, whose safety has been debated, are allowed in foods in the United States but not in Europe.

Corporations may turn a blind eye to potential dangers, a July 2024 FDA-funded report warned.

Potentially harmful ingredients “are not necessarily required to be named on a product label,” the Reagan-Udall Foundation for the FDA, an adjunct to the agency, said in the report, which was based largely on interviews with representatives of companies across the food supply chain.

“Companies may choose not to track the presence of these ingredients/compounds due to concern about future litigation,” the report said.

Some additives can remain hidden from the public behind such catchall terms as “spices” and “artificial flavors,” as the Center for Science in the Public Interest has reported, or shrouded by other exemptions from disclosure requirements.

And some ingredients that should have been listed on product labels — potential allergens such as milk, wheat, eggs, and dyes — have at times gone undisclosed, according to a series of food recalls. Gaps in oversight have alarmed political leaders on both sides of the aisle, the U.S. Government Accountability Office, watchdog groups such as the CSPI, and academic researchers.

Adding to the concern: the profusion of ultra-processed foods, which use a wide array of chemicals to add flavor and color, extend shelf life, reduce cost, control texture or consistency, and generally tempt people to eat more. Ultra-processed foods now make up 73% of the U.S. food supply, researchers have estimated. Sen. Bernie Sanders of Vermont, the ranking member of the Senate Health, Education, Labor and Pensions Committee, has said there’s growing evidence they are “deliberately designed to be addictive,” contributing to an epidemic of obesity — a rare point of agreement between him and Kennedy.

At his confirmation hearing, Makary said some ingredients cause a chronic, low-grade inflammatory reaction in the gastrointestinal tract. “And what are we doing? We are drugging our nation’s children at scale,” he said.

The KFF poll found that 58% of respondents want the Trump administration to prioritize setting stricter limits on chemicals in the U.S. food supply.

The Consumer Brands Association, which represents many of the largest food-makers, defends the regulatory system as “rigorous,” “evidence-based,” and “proven.” The system enables companies “to innovate to meet consumer demand,” Sarah Gallo, the association’s senior vice president of product policy, said in a statement to KFF Health News.

“Food manufacturers attest to the safety of an ingredient through the development of extensive scientific evidence and third-party expert review,” Gallo added.

More than a decade ago, Pew Charitable Trusts estimated that there were about 10,000 additives allowed in food in the United States — and that the FDA had not reviewed the safety of about 3,000 of them.

“The system is fundamentally broken,” said Thomas Neltner, one of the authors of the Pew study. “It’s so bad, nobody knows — not even FDA knows — what’s in our food.”

Banned Abroad

The FDA allows titanium dioxide to be used to enhance the appearance of foods, among other purposes. According to an Environmental Working Group database, it’s listed as an ingredient in more than 1,900 products, including many candies.

The European Union takes a more cautious approach. In 2021, an EU regulatory panel concluded that titanium dioxide “can no longer be considered as safe when used as a food additive.” The panel said it couldn’t rule out the possibility that titanium dioxide could damage chromosomes.

The FDA allows potassium bromate to be used in baking, and, according to the EWG database, it’s listed as an ingredient in more than 200 products, including bread, buns, and bagels.

Potassium bromate has been banned from food in many countries, including those of the European Union, Canada, India, and Peru. In 2023, California banned it from food effective in 2027. The United Kingdom prohibited it in 1990. The International Agency for Research on Cancer identified it as possibly carcinogenicmore than 25 years ago. A joint committee of the United Nations and the World Health Organization identified it as a “genotoxic carcinogen” in 1992.

On its website, the FDA says it has worked with industry to minimize potassium bromate levels and is reviewing the chemical, among others.

The EWG says that it created the database to help consumers make healthier choices and that the raw data on product labels is supplied by Label Insight — which is owned by NielsenIQ, a major provider of data to industry. The EWG has called for tighter regulation of foods.

Based on a review of FDA and European Commission databases, it appears that at least 950 more additives are used in foods in the United States than are allowed in the European Union, said Erik Millstone, an emeritus professor at the University of Sussex in England who has been studying food safety policy since the 1970s.

Direct comparisons are difficult because the two regulatory systems and the way they keep their records differ greatly.

A definitive count is elusive because the FDA doesn’t require industry to inform it of everything used in foods in the United States.

“That kind of casual neglect totally would be unacceptable in Europe,” Millstone said.

‘Several Decades Behind Europeans’

When the FDA formally approves substances for use in food, it can let decades pass without reassessing them — even when subsequent research raises doubts about their safety.

In January, when the FDA banned Red Dye No. 3 from foods, it cited research published in 1987. (The FDA said it had no evidence the dye puts people at risk; invoking one of the stricter consumer protections, it said a law from 1960prohibits the use of additives found to induce cancer in animals.)

In the European Union, substances used in foods must pass regulatory approval before being introduced. The EU has also required that its regulators reassess all additives that were on the market before Jan. 20, 2009, a process that is ongoing.

“In the FDA, although we have authorization to do post-market reviews, there’s no statutory mandate to do them,” Jones, the former deputy commissioner of the FDA’s Human Foods Program, told a Senate committee in December. “We are several decades behind Europeans and our Canadian counterparts because they have legal mandates to reevaluate chemicals that have been authorized at some point in the past.”

The FDA website lists 19 post-market determinations since 2010 that substances were not “generally recognized as safe.” Four involve chemical constituents of one mushroom and the mushroom itself. Others include an anabolic steroid, caffeinated alcoholic beverages, cannabidiol (CBD), Ginkgo biloba, melatonin, and partially hydrogenated oils.

Meanwhile, trichloroethylene, banned by the Environmental Protection Agency in December as “an extremely toxic chemical known to cause liver cancer, kidney cancer, and non-Hodgkin’s lymphoma,” is still allowed under FDA rules for use as a solvent in the production of foods.

FDA spokesperson Enrico Dinges said the agency will work with new leadership at HHS “to safeguard the food supply through pre-market and post-market safety evaluations of chemicals in the food supply.”

‘The Loophole Swallowed the Law’

The biggest gap in the FDA’s oversight of foods goes back generations.

In 1958, Congress mandated that, before additives could be used in foods, manufacturers had to prove they were safe and get FDA approval. However, Congress carved out an exception for substances “generally recognized as safe,” which came to be known simply as GRAS.

As conceived, GRAS promised regulatory relief for standard ingredients like salt, sugar, vinegar, and baking powder — along with many chemicals.

Over time, “the loophole swallowed the law,” said a 2014 report by Neltner and Maricel Maffini for the Natural Resources Defense Council.

Companies can unilaterally decide their ingredients are already recognized as safe and use them without asking the FDA for permission or even informing the agency.

A better translation of GRAS would be “Generally Recognized as SECRET,” the Natural Resources Defense Council report said.

A federal watchdog reached a similar conclusion. “GRAS substances can be marketed without FDA’s approval or even its knowledge,” the Government Accountability Office warned in 2010.

That spared the FDA from spending time reviewing countless substances.

For advice on whether ingredients are GRAS, companies may convene panels of specialists. The FDA has noted that panel members could be paid by the companies commissioning the review, but, in guidance to industry, it says “such compensation is not itself an unacceptable conflict.”

About 3,000 flavoring ingredients have been deemed GRAS by a panel of scientists working for an industry group, the Flavor and Extract Manufacturers Association of the United States, known as FEMA, said George Southworth, the organization’s executive director.

The scientists on the FEMA panel “adhere to stringent conflict-of-interest policies,” and their GRAS determinations are submitted to the FDA, which includes them in an online database, Southworth said.

Southworth described the panel as independent, and the FEMA website says panel members have never been employees of companies in the food industry.

Asked how many times FEMA’s panel found that a flavoring didn’t meet the test, Southworth wouldn’t say. He indicated that some reviews are called off before a conclusion is reached.

“Publicly reporting these numbers without full context could lead to misinterpretations about the safety of substances,” he added.

Another Way

Food companies have another option: They can voluntarily notify the FDA that they believe their product is GRAS for its intended use and lay out their reasons — giving the FDA a heads up and essentially seeking its blessing.

If they take that route, they don’t have to wait for an answer from the FDA to begin marketing the product, the agency has said.

And they don’t risk much. If the FDA spots weaknesses in a company’s argument or reasons to worry about a chemical’s safety, it routinely calls off its review instead of declaring the substance unsafe.

FDA records posted on the agency’s website show that the FDA often coaches companies to ask the agency to cease its evaluation. That, too, leaves the company free to sell the product, food watchdogs said.

For companies that voluntarily run their products past the FDA, victory is a letter saying the agency has no questions.

But if companies market products as “generally recognized as safe” without firm grounds, they run the risk that the FDA could one day take enforcement action, such as issuing a warning or stopping sales. That’s if the FDA notices.

Psyched Out

On March 8, 2022, a Canadian company, Psyched Wellness, issued a news releasesaying it had a green light to market products in the United States.

An “independent review panel of scientific experts” concluded that an extract the company developed, AME-1, was “Generally Recognized As Safe,” paving the way for it to be sold in bulk and used as an ingredient, the company said.

The company described the panel’s judgment as a successful “certification” and “a key milestone.” The extract was derived from a hallucinogenic mushroom, Amanita muscaria, which the company said “has incredible healing and medicinal powers.” As the company later put it in a news release, it had obtained “self-Gras status.”

In June 2024, the company announced that it would soon release Amanita muscaria watermelon gummies.

However, the FDA later took issue with the company and its product.

In a memo dated Sept. 9, 2024, an FDA toxicologist said Psyched Wellness’ claim of GRAS certification was false. The firm failed to show that its extract was generally recognized as safe, the FDA memo said.

Speaking of the mushroom, its extracts, and its known “pharmacologically active constituents,” the FDA memo posted on the agency’s website said they have “potential for serious harm and adverse effects on the central nervous system.”

The FDA was focusing on the mushroom against the backdrop of a spate of medical problems linked to another company’s “Diamond Shruumz” brand chocolate bars, gummies, and infused cones. When it recalled those products in June 2024, that other company announced that a chemical found in Amanitamushrooms was a possible cause of symptoms, including seizures and loss of consciousness.

The FDA memo discussed that recall and said one death and 30 hospitalizations might have been related.

The memo did not connect Psyched Wellness to the outbreak or the Diamond Shruumz products.

The chief executive of Psyched Wellness, Jeffrey Stevens, did not respond to an interview request or written questions.

As recently as Feb. 1, Psyched Wellness said in a securities filing that it will “continue to market its products in the U.S. using the Self-GRAS designation.”

‘Probably Poisoning Us’

If food ingredients cause acute reactions — sending people to emergency rooms, for example — the potential dangers may be relatively easy to identify, and regulatory action might naturally follow. Some critics of the system say they worry more about health effects that could take years or decades to develop.

Then, when it’s too late, it could be hard to trace the harm to any particular ingredient.

All that leaves Joseph Shea of Myrtle Beach in a tough spot.

For a while, Shea tried shopping at a market that has a lot of organic offerings, he said in an interview. That proved too expensive.

Shea said the entire picture is “incredibly frustrating.”

“They’re probably poisoning us, and we don’t know,” he said. “We’ll figure it out 30 years down the road when we get sick.”

This story originally published at KFF Health News, Healthbeat’s national reporting partner.

New Emory survey finds Americans agree on public health priorities: affordable care, food and water safety, chronic diseases

2025-02-07T21:33:25+00:00

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Here’s a few public health priorities that Americans can agree on: making health care more accessible and affordable, ensuring the safety of food and water, and fighting chronic diseases.

Those were named as the top priorities in survey results released this week by Emory University in Atlanta and Gallup.

“We wanted to make sure we had essentially a pulse check for where Americans wanted us to go,” said Dr. Stephen Patrick, an Emory professor who helped design the survey of 2,121 adults 18 and older.

The survey was conducted in December after President Donald Trump’s election.

“How can we, early on in a new administration, highlight what Americans really want out of public health in the next four years?” Patrick said of the impetus for the survey.

Responses were weighted to match national demographics by gender, age, race/ethnicity and other factors.

“There’s a fair amount of agreement across political parties, across demographics” in the findings, Patrick said.

Most respondents named these priorities in their Top 3:

Improving health care access and affordability (52%)
Ensuring safe water and food (37%)
Reducing chronic diseases (32%)

Patrick said he wasn’t surprised that those issues ranked high. He hears concerns from parents of patients in his neonatology practice about finding and paying for care.

Food and water safety are highly local issues, Patrick said. “It’s the local public health department that makes sure the restaurant up the street meets safety codes.”

Some believe U.S. has ‘lost ground’ on opioids, mental health

The survey asked people about progress on 10 health issues, Patrick said. The results showed many see a lack of progress on opioids and mental health.

Fifty-four percent of respondents thought America had lost ground on the opioid epidemic, and 50% said the country had lost ground on mental health.

Republicans and Republican-leaning respondents were more likely than other groups to say the United States has lost ground on mental health (59%) and opioid (69%) issues.

“We still treat mental health and substance use as pretty darn separate,” Patrick said. “Perhaps that’s an area where we can focus the next couple of years to be really comprehensive in the way we approach the opioid conversation and really have a broader conversation about mental health.”

It’s an issue that affects his practice, too.

“As a neonatologist, infants are the fastest-growing group in foster care today, most due to parental substance use,” Patrick said. “You just see the trickle effects of some of these problems that Americans are highlighting that really could take all of us to begin to address.”

Republicans and Democrats agree that the federal government plays a key role in health care, Patrick said.

For example, many said the federal government was better equipped than state governments to address a wide range of health issues, including ensuring safe water and food and addressing health effects from weather and climate change.

For other issues, like loneliness and rural health, many more people said state governments are better equipped.

Democrats and Republicans trust the CDC

The survey found some agreement about trusted sources of public health information, with some differences by age, education and party affiliation.

In general, the country’s Top 3 trusted public health sources – chosen from a list of 15 -- were:

Doctor, nurse or health care provider
Scientific research and studies
The Centers for Disease Control and Prevention

Democrats (60%) and Republicans (17%) ranked the CDC among their Top 5 sources for trusted information.

Other top trusted sources include medical websites and state health departments.

When it comes to social platforms, 9% of respondents ranked social media as a Top 3 trusted source, and 6% of respondents chose YouTube and other influencers.

That is more pronounced among young people. Sixteen percent of young people between ages 18 and 29 said social media is a Top 3 trusted source, the survey found.

“That’s one area where perhaps we need to be more effective” in public health messaging, Patrick said.

“I do think it’s incumbent upon social media companies to do a better job of ensuring that what we have on social media is more accurate,” Patrick said. “As a pediatrician and as a parent of adolescents, I have profound worries about what social media continues to do to our youth.”

Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Contact Rebecca at rgrapevine@healthbeat.org.

RFK Jr.’s embrace of raw milk follows ‘health freedom’ movement

2025-01-29T10:00:00+00:00

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In summertime, cows wait under a canopy to be milked at Mark McAfee’s farm in Fresno, California. From his Cessna 210 Centurion propeller plane, the 63-year-old can view grazing lands of the dairy company he runs that produces products such as unpasteurized milk and cheese for almost 2,000 stores.

Federal regulators say it’s risky business. Samples of raw milk can contain bird flu virus and other pathogens linked to kidney disease, miscarriages, and death.

McAfee, founder and CEO of the Raw Farm, who also leads the Raw Milk Institute, says he plans to soon be in a position to change that message.

Robert F. Kennedy Jr., the anti-vaccine activist President Donald Trump has tapped to run the Department of Health and Human Services, recruited McAfee to apply for a job as the FDA’s raw milk standards and policy adviser, McAfee said. McAfee has written draft proposals for possible federal certification of raw dairy farms, he said.

Virologists are alarmed. The Centers for Disease Control and Prevention recommends against unpasteurized dairy that hasn’t been heated to kill pathogens such as bird flu. Interstate raw milk sales for human consumption are banned by the FDA. A Trump administration that weakens the ban or extols raw milk, the scientists say, could lead to more foodborne illness. It could also, they say, raise the risk of the highly pathogenic H5N1 bird flu virus evolving to spread more efficiently, including between people, possibly fueling a pandemic.

“If the FDA says raw milk is now legal, and the CDC comes through and says it advises drinking raw milk, that’s a recipe for mass infection,” said Angela Rasmussen, a virologist and co-editor-in-chief of the medical journal Vaccine and an adjunct professor at Stony Brook University in New York.

The raw milk controversy reflects the broader tensions Trump will confront when pursuing his second-administration agenda of rolling back regulations and injecting more consumer choice into health care.

Many policies Kennedy has said he wants to revisit — from the fluoridation of tap water to nutrition guidance to childhood vaccine requirements — are backed by scientific research and were established to protect public health. Some physician groups and Democrats are gearing up to fight initiatives they say would put people at risk.

Raw milk has gained a following among anti-regulatory conservatives who are part of a burgeoning health freedom movement.

“The health freedom movement was adopted by the tea party, and conspiracy websites gave it momentum,” said Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia, who has studied the history of the anti-vaccine movement.

Conservatives denounce efforts to restrict raw milk sales

Once-fringe ideas are edging into the mainstream. Vaccine hesitancy is growing.

Arkansas, Utah, and Kentucky are weighing legislation that would relax or end requirements for fluoride in public water. And 30 states now allow for the sale of raw milk in some form within their borders.

While only an estimated 3% of the U.S. population consumes raw milk or cheese, efforts to try to restrict its sales have riled Republicans and provided grist for conservative podcasts.

Many conservatives denounced last year’s execution of a search warrant when Pennsylvania agriculture officials and state troopers arrived at an organic farm tucked off a two-lane road on Jan. 4, 2024. State inspectors were investigating cases of two children sickened by E. coli bacteria and sales of raw dairy from the operation owned by Amish farmer Amos Miller, according to a complaint filed by the state’s agricultural department.

Bundled in flannel shirts and winter jackets, the inspectors put orange stickers on products detaining them from sale, and they left toting product samples in large blue-and-white coolers, online videos show. The 2024 complaint against Miller alleged that he and his wife sold dairy products in violation of state law.

The farm was well known to regulators. They say in the complaint that a Florida consumer died after being sickened in 2014 with listeria bacteria found in raw dairy from Miller’s farm. The FDA said a raw milk sample from the farm indicates it was the “likely source” of the infection, based on the complaint.

Neither Miller’s farm nor his lawyer returned calls seeking comment.

The Millers’ attorney filed a preliminary objection that said “shutting down Defendants would cause inequitable harm, exceed the authority of the agency, constitute an excessive fine as well as disparate, discriminatory punishment, and contravene every essential constitutional protection and powers reserved to the people of Pennsylvania.”

Regulators in Pennsylvania said in a press release they must protect the public, and especially children, from harm. “We cannot ignore the illnesses and further potential harm posed by distribution of these unregulated products,” the Pennsylvania agricultural department and attorney general said in a joint statement.

Unpasteurized dairy products are responsible for almost all the estimated 761 illnesses and 22 hospitalizations in the United States that occur annually because of dairy-related illness, according to a study published in the June 2017 issue of Emerging Infectious Diseases.

But conservatives say raiding an Amish farm is government overreach. They’re “harassing him and trying to make an example of him. Our government is really out of control,” Pennsylvania Republican Sen. Doug Mastriano said in a video he posted to Facebook.

Videos show protesters at a February 2024 hearing on Miller’s case included Amish men dressed in black with straw hats and locals waving homemade signs with slogans such as “FDA Go Away.” A court in March issued a preliminary injunction that barred Miller from marketing and selling raw dairy products within the commonwealth pending appeal, but the order did not preclude sales of raw milk to customers out of state. The case is ongoing.

With Kennedy, the raw milk debate is poised to go national. Kennedy wrote on X in October that the “FDA’s war on public health is about to end.” In the post, he pointed to the agency’s “aggressive suppression” of raw milk, as one example.

Raw milk leader seeks to set national standards

McAfee is ready. He wants to see a national raw milk ordinance, similar to one that exists for pasteurized milk, that would set minimal national standards. Farmers could attain certification through training, continuing education, and on-site pathogen testing, with one standard for farms that sell to consumers and another for retail sales.

The Trump administration didn’t return emails seeking comment.

McAfee has detailed the system he developed to ensure his raw dairy products are safe. He confirmed the process for KFF Health News: Cows with yellow-tagged ears graze on grass pastures and are cleansed in washing pens before milking. The raw dairy is held back from consumer sale until it’s been tested and found clear of pathogens.

His raw dairy products, such as cheese and milk, are sold by a variety of stores, including health, organic, and natural grocery chains, according to the company website, as well as raw dairy pet products, which are not for human consumption.

He said he doesn’t believe the raw milk he sells could contain or transmit viable bird flu virus. He also said he doesn’t believe regulators’ warnings about raw milk and the virus.

“The pharmaceutical industry is trying to create a new pandemic from bird flu to get their stock back up,” said McAfee, who says he counts Kennedy as a customer. His view is not shared by leading virologists.

In December, the state of California secured a voluntary recall of all his company’s raw milk and cream products due to possible bird flu contamination.

Five indoor cats in the same household died or were euthanized in December after drinking raw milk from McAfee’s farm, and tests on four of the animals found they were infected with bird flu, according to the Los Angeles County Department of Health.

In an unrelated case, Joseph Journell, 56, said three of his four indoor cats drank McAfee’s raw milk. Two fell sick and died, he said. His third cat, a large tabby rescue named Big Boy, temporarily lost the use of his hind legs and had to use a specialized wheelchair device, he said. Urine samples from Big Boy tested positive for bird flu, according to a copy of the results from Cornell University and the U.S. Department of Agriculture.

McAfee dismissed connections between the cats’ illnesses and his products, saying any potential bird flu virus would no longer be viable by the time his raw milk gets to stores. He also said he believes that any sick cats got bird flu from recalled pet food.

Journell said he has hired a lawyer to try to recover his veterinary costs but remains a staunch proponent of raw milk.

“Raw milk is good for you, just not if it has bird flu in it,” he said. “I do believe in its healing powers.”

This story was reported by KFF Health News, Healthbeat’s national reporting partner.

Georgia works to contain spread of bird flu from commercial poultry farm

2025-01-21T17:33:00+00:00

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Georgia’s $7.75 billion commercial poultry industry – one of the largest in the nation – was working Tuesday to keep bird flu from spreading after a case was confirmed in an operation in Elbert County.

The Georgia Department of Agriculture said avian influenza breached the first commercial poultry operation in the state, confirming the diagnosis late Friday. About 45,000 broiler breeders were on the site and being destroyed.

Gilda Pedraza, executive director of the Latino Community Fund of Georgia, said Tuesday her organization sprang into action to help protect poultry workers.

The organization created materials to inform them about the new detection of bird flu, including safety information for those who keep backyard flocks.

“From our members, we have learned poultry plants continue to operate, and some have given masks to workers and have set up a nurse 24/7,” Pedraza said. “We have asked people that if they experience symptoms, to report them to their employers and to send us a message so we have some idea of what is going on at the ground level.”

How America lost control of the bird flu, setting the stage for another pandemic

State agriculture officials emphasized that the food supply is safe. Poultry operations near the contaminated farm were subjected to “additional surveillance” to find out whether the H5N1 virus has spread, Mike Giles, president of the Georgia Poultry Federation, said in a Friday press release.

The state did not name the company where bird flu was detected, but put all commercial poultry operations within 6.2 miles under quarantine and said they would be tested for at least two weeks.

The state also indefinitely suspended all poultry exhibitions, shows, swaps, meets, and sales.

“This is a serious threat to Georgia’s #1 industry and the livelihoods of thousands of Georgians who make their living in our state’s poultry industry. We are working around the clock to mitigate any further spread of the disease and ensure that normal poultry activities in Georgia can resume as quickly as possible,” Georgia Agriculture Commissioner Tyler Harper said Friday in a news release.

“The risk of an infected bird entering the food supply chain is low,” the state said.

How to keep backyard chickens safe from bird flu

Andrew Pekosz, a professor of microbiology and immunology at Johns Hopkins Bloomberg School of Public Health agreed.

“The risk of H5N1 in the food supply is very low, partly because H5N1 kills poultry so quickly, and poultry rarely survive infection.” With a mortality rate of 100%, poultry or eggs “never make it off a commercial farm before the outbreak is detected.”

Previously, some 30,580 birds had been culled in Georgia due to bird flu since the start of the current outbreak in February 2022, according to the U.S. Department of Agriculture. About 30,000 of those came from an infected flock at a commercial duck breeder in Sumter County in 2023.

The detection of bird flu in a small backyard chicken flock confirmed in Clayton County on Jan. 10 was the fourth instance in Georgia since the outbreak started.

Most human cases have come from dairy cattle

The Centers for Disease Control and Prevention has confirmed 68 human cases in the United States since 2022, as of earlier this month. The first human death was reported this month in Louisiana, in an elderly person who had other underlying health conditions and was likely exposed via a backyard flock.

Most infected people were likely exposed via contact with dairy cattle, according to the CDC, while others came from contact with poultry on farms.

No human cases have been reported in Georgia.

The state’s dairy operation is much smaller than the poultry industry. The Georgia Agriculture Department had tested 1,000 dairy cows by the end of December for bird flu and found no cases.

The state this month joined 27 others enrolled in a USDA program to test milk stored in silos at processing facilities for bird flu.

Commercial poultry producers test birds for avian influenza “at every stage of their life” as part of the state’s participation in the National Poultry Improvement Plan, Department of Agriculture spokesperson Liz Rivera-Brown told Healthbeat last week.

They have strong protocols in place to prevent bird flu because the industry is so important to the state, Giles said.

“The most important thing that we can do is prevent the virus from entering the poultry farms,” he said, adding that there is a focus on “consistent reinforcement” of existing protocols.

Poultry farms try to prevent infection by “drawing a line of separation” between the chicken houses and the outside world. That includes measures like foot pans to disinfect workers’ shoes, or changing footwear, Giles said.

Poultry workers need access to health care, sick leave

More than 37,000 people are directly employed in Georgia’s poultry industry, according to the U.S. Poultry and Egg Association. Many of them do not come into direct contact with birds, Giles said.

For those who do, it’s important for workers to know about bird flu and to have access to healthcare and financial support like sick leave, said Emory University epidemiology professor Jodie Guest, who helped with Covid testing efforts among poultry workers.

Guest said an on-site, mandatory bird flu testing system might not be a silver bullet solution, however.

“The best thing possible would be for there to be active surveillance [i.e. widespread testing at the facilities] but also paid sick leave,” Guest said. “If we’re going to require [testing], we need to support access to paid sick leave also.”

“Their access to health care has a tremendous number of barriers,” and workers could be reluctant to get tested because of concerns over losing wages or putting their immigration status at risk, Guest said.

Because many poultry workers, and others, may be reluctant or have a hard time accessing health care, and because bird flu often presents with only minor symptoms, human bird flu cases could fly under the radar, Guest said.

Amid bird flu, farmworkers tending sick cows with only gloves to protect them

There’s a higher risk for those workers who will have to deal with the dead birds after the culling process is complete, Pekosz said. “There are documented cases of poultry workers getting infected with H5N1 during the cleanup of commercial poultry buildings.”

“All workers involved will need to wear eye and respiratory protection, as well as disposable outer suits in order to prevent infection. Those items will then be decontaminated and destroyed after being used,” he said.

Some of the main symptoms in humans include fever, cough, sore throat, and pink eye (conjunctivitis).

The United States has a stockpile of 4.5 million H5N1 vaccines, but it’s unclear how well they would work because they are based on an older mutation formula, epidemiologist Dr. Katelyn Jetelina, a Healthbeat partner and supporter, wrote in a recent edition of her newsletter, Your Local Epidemiologist.

Finland last year started vaccinating at-risk farmworkers, and some experts have called on the CDC to do the same.

A federal program compensates commercial poultry owners if birds are infected and have to be destroyed.

Bird flu has also infected cats in some states, and Georgia is included in a recall of Northwest Naturals raw pet food.

Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Contact Rebecca at rgrapevine@healthbeat.org.

Trump administration health policies may target ultra-processed foods

2025-01-17T19:11:39+00:00

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The new Trump administration could be coming for your snacks.

For years, the federal government has steered clear of regulating junk food, fast food, and ultra-processed food.

Now attitudes are changing. Some members of President-elect Donald Trump’s inner circle are gearing up to battle “Big Food,” or the companies that make most of the food and beverages consumed in the United States. Nominees for top health agencies are taking aim at ultra-processed foods that account for an estimated 70% of the nation’s food supply.

Based on recent statements, a variety of potential politically charged policy options to regulate ultra-processed food may land on the Trump team menu, including warning labels, changes to agribusiness subsidies, and limits on which products consumers can buy with government food aid.

The push to reform the American diet is being driven largely by conservatives who have taken up the cause that has long been a darling of the left. Trump supporters such as Robert F. Kennedy Jr., whose controversial nomination to lead the Department of Health and Human Services still faces Senate confirmation, are embracing a concept that champions natural foods and alternative medicine.

It’s a movement they’ve dubbed “MAHA,” or Make America Healthy Again. Their interest has created momentum because their goals have fairly broad bipartisan support even amid a bitterly divided Congress in which lawmakers from both sides of the aisle focused on the issue last year.

It’s likely to be a pitched battle because the food industry wields immense political influence and has successfully thwarted previous efforts to regulate its products or marketing. The category of “food processing and sales companies,” which includes Tyson Foods and Nestle SA, tallied $26.7 million in spending on lobbying in 2024, according to OpenSecrets. That’s up from almost $10 million in 1998.

“They have been absolutely instrumental and highly, highly successful at delaying any regulatory effectiveness in America,” said Laura Schmidt, a health policy professor at the University of California-San Francisco. “It really does feel like there needs to be a moment of reckoning here where people start asking the question, ‘Why do we have to live like this?’”

Lawsuits may try to link foodmakers to chronic conditions

“Ultra-processed food” is a widely used term that means different things to different people and is used to describe items ranging from sodas to many frozen meals. These products often contain added fats, starches, and sugars, among other things. Researchers say consumption of ultra-processed foods is linked — in varying levels of intensity — to chronic conditions like diabetes, cancer, mental health problems, and early death.

Nutrition and health leaders are optimistic that a reckoning is already underway. Kennedy has pledged to remove processed foods from school lunches, restrict certain food additives such as dyes in cereal, and shift federal agricultural subsidies away from commodity crops widely used in ultra-processed foods.

The intensifying focus in Washington has triggered a new level of interest on the legal front as lawyers explore cases to take on major foodmakers for selling products they say result in chronic disease.

Make America Healthy Again: Unconventional movement may have found its moment

Bryce Martinez, now 18, filed a lawsuit in December against almost a dozen foodmakers such as Kraft Heinz, The Coca-Cola Co., and Nestle USA. He developed diabetes and non-alcoholic fatty liver disease by age 16, and is seeking to hold them accountable for his illnesses. According to the suit, filed in the Philadelphia Court of Common Pleas, the companies knew or should have known ultra-processed foods were harmful and addictive.

The lawsuit noted that Martinez grew up eating heavily advertised, brand-name foods that are staples of the American diet — sugary soft drinks, Cheerios and Lucky Charms, Skittles and Snickers, frozen and packaged dinners, just to name a few.

Nestle, Coca-Cola, and Kraft Heinz didn’t return emails seeking comment for this article. The Consumer Brands Association, a trade association for makers of consumer packaged goods, disputed the allegations.

“Attempting to classify foods as unhealthy simply because they are processed, or demonizing food by ignoring its full nutrient content, misleads consumers and exacerbates health disparities,” Sarah Gallo, senior vice president of product policy, said in a statement.

Other law firms are on the hunt for children or adults who believe they were harmed by consuming ultra-processed foods, increasing the likelihood of lawsuits.

One Indiana personal injury firm says on its website that “we are actively investigating ultra processed food (UPF) cases.” Trial attorneys in Texas also are looking into possible legal action against the federal regulators they say have failed to police ultra-processed foods.

“If you or your child have suffered health problems that your doctor has linked directly to the consumption of ultra-processed foods, we want to hear your story,” they say on their website.

FDA chief likens junk food to opioid addiction

Meanwhile, the FDA on Tuesday announced it is proposing to require a front-of-package label to appear on most packaged foods to make information about a food’s saturated fat, sodium, and added sugar content easily visible to consumers.

And on Capitol Hill, Sens. Bernie Sanders, I-Vt., Ron Johnson, R-Wis., and Cory Booker, D-N.J., are sounding the alarm over ultra-processed food. Sanders introduced legislation in 2024 that could lead to a federal ban on junk food advertising to children, a national education campaign, and labels on ultra-processed foods that say the products aren’t recommended for children. Booker cosigned the legislation along with Sens. Peter Welch, D-Vt., and John Hickenlooper, D-Colo.

The Senate Committee on Health, Education, Labor and Pensions held a December hearing examining links between ultra-processed food and chronic disease during which FDA Commissioner Robert Califf called for more funding for research.

Food companies have tapped into “the same neural circuits that are involved in opioid addiction,” Califf said at the hearing.

Sanders, who presided over the hearing, said there’s “growing evidence” that “these foods are deliberately designed to be addictive,” and he asserted that ultra-processed foods have driven epidemics of diabetes and obesity, and hundreds of billions of dollars in medical expenses.

Research on food and addiction “has accumulated to the point where it’s reached a critical mass,” said Kelly Brownell, an emeritus professor at Stanford who is one of the editors of a scholarly handbook on the subject.

Attacks from three sides — lawyers, Congress, and the incoming Trump administration, all seemingly interested in taking up the fight — could lead to enough pressure to challenge Big Food and possibly spur better health outcomes in the United States, which has the lowest life expectancy among high-income countries.

“Maybe getting rid of highly processed foods in some things could actually flip the switch pretty quickly in changing the percentage of the American public that are obese,” said Robert Redfield, a virologist who led the Centers for Disease Control and Prevention during the previous Trump administration, in remarks at a December event hosted by the Heritage Foundation, a conservative think tank.

Claims that Big Food knowingly manufactured and sold addictive and harmful products resemble the claims leveled against Big Tobacco before the landmark $206 billion settlement was reached in 1998.

“These companies allegedly use the tobacco industry’s playbook to target children, especially Black and Hispanic children, with integrated marketing tie-ins with cartoons, toys, and games, along with social media advertising,” Rene Rocha, one of the lawyers at Morgan & Morgan representing Martinez, told KFF Health News.

The 148-page Martinez lawsuit against foodmakers draws from documents made public in litigation against tobacco companies that owned some of the biggest brands in the food industry.

Similar allegations were made against opioid manufacturers, distributors, and retailers before they agreed to pay tens of billions of dollars in a 2021 settlement with states.

The FDA ultimately put restrictions on the labeling and marketing of tobacco, and the opioid epidemic led to legislation that increased access to lifesaving medications to treat addiction.

Food enforcement has a limited budget

But the Trump administration’s zeal in taking on Big Food may face unique challenges.

The ability of the FDA to impose regulation is hampered in part by funding. While the agency’s drug division collects industry user fees, its division of food relies on a more limited budget determined by Congress.

Change can take time because the agency moves at what some critics call a glacial pace. Last year, the FDA revoked a regulation allowing brominated vegetable oil in food products. The agency determined in 1970 that the additive was not generally recognized as safe.

Efforts to curtail the marketing of ultra-processed food could spur lawsuits alleging that any restrictions violate commercial speech protected by the First Amendment. And Kennedy — if he is confirmed as HHS secretary — may struggle to get support from a Republican-led Congress that champions less federal regulation and a president-elect who during his previous term served fast food in the White House.

“The question is, will RFK be able to make a difference?” said David L. Katz, a doctor who founded True Health Initiative, a nonprofit group that combats public health misinformation. “No prior administration has done much in this space, and RFK is linked to a particularly anti-regulatory administration.”

Meanwhile, the U.S. population is recognized as among the most obese in the world and has the highest rate of people with multiple chronic conditions among high-income countries.

“There is a big grass-roots effort out there because of how sick we are,” said Jerold Mande, who served as deputy undersecretary for food safety at the Department of Agriculture from 2009 to 2011. “A big part of it is people shouldn’t be this sick this young in their lives. You’re lucky if you get to 18 without a chronic disease. It’s remarkable.”

Stephanie Armour and David Hilzenrath reported this story for KFF Health News, Healthbeat’s national reporting partner.

Whooping cough and food insecurity levels are on the rise in New York

2024-12-04T13:41:52+00:00

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I hope everyone had a great Thanksgiving! Here’s what you need to know about New York public health this week.

Whooping cough is spreading in New York and nationally

Whooping cough (pertussis) cases have surged in New York and nationally, returning to pre-pandemic levels. New York has reported 2,337 cases this year, compared to 687 last year. Nationally, there has been almost a fivefold increase in infections this year compared to last.

This bacterial infection causes runny/stuffy nose, sneezing, fever, and intense and sometimes uncontrollable coughing fits. Newborns are especially at high risk — the name “whooping” cough comes from the sound babies make between coughing fits. Among infants under 2 months who contract whooping cough, about half require hospitalization, and 1 out of 100 die. This is why vaccination of pregnant women and close contacts is critical to protecting newborns before they can receive their own vaccines.

One reason whooping cough may resurge is that vaccine protection wanes over time. New vaccines are being developed to provide more durable protection, but they aren’t yet on the market. Currently, there are two types of combination vaccines (meaning they protect against multiple things) available:

DTap
Tdap

These vaccines protect against whooping cough, tetanus (the “T” in the name), and diphtheria (the “D/d” in the name). Children younger than 7 years receive DTaP, while older children and adults receive Tdap.

Whooping cough vaccine guidelines from the Centers for Disease Control and Prevention

The CDC recommends that everyone be vaccinated against whooping cough.

For people who are pregnant, getting a shot of Tdap during the 27th-36th week of pregnancy is crucial to boost the baby’s immunity, helping protect them from whooping cough when they are most vulnerable to it. Tdap vaccination during pregnancy protects 9 in 10 babies from being hospitalized with whooping cough.
Babies, young children, preteens, and teens can follow vaccination schedules for their initial DTap and Tdap shots and boosters.
It’s a good idea for adults who have never received Tdap to get it — it can be given anytime.

When we see whooping cough increase, our response as a community is mainly aimed at protecting babies through vaccination and ensuring those around babies are vaccinated.

Hunger and food insecurity are on the rise in New York

Last week, while most gathered to share Thanksgiving meals, many faced a very different reality. Food insecurity, meaning someone doesn’t have enough to eat at least some of the time, affects 1.9 million New Yorkers. This is up 76% since 2021, with 1 in 6 households with children lacking enough to eat, and is higher than the 55% increase seen nationwide.

Food insufficiency in New York state and New York City metropolitan area, 2021 vs 2024.

During 2021-23, 1.2 million people in New York City (14% of the population) lived in food-insecure households. New York City’s rates are highest in the Bronx, where 1 in 5 residents and 1 in 3 children experience food insecurity.

To combat food insecurity, food assistance programs provide free or reduced-cost food. There are three main ways to access food assistance in New York:

From THE CITY: How to get help paying for food and groceries in NYC

SNAP (Supplemental Nutrition Assistance Program): A federal program that issues EBT cards for purchasing food.
- About 35% of New Yorkers qualify for SNAP, but only 75% of eligible New York City residents are enrolled. There’s a lot of room for improvement.
- See the New York SNAP website for eligibility criteria.
Free or reduced-price meals for children in school.
- New York City public schools offer free meals to all students during the school year. Learn more here.
- Many schools outside New York City also offer free or reduced-price meals — eligibility details are available here.
Food banks, pantries, and soup kitchens. These organizations offer free or low-cost food across New York.
- Use the Food Help NYC tool or call 311 to find nearby locations, or view a list of food assistance providers across the state here.

If you’re not food-insecure and want to help:

Donate food: Drop off items at supermarket collection points, send them via online shops, or donate money to food banks.
Volunteer: Help sort, pack, cook, serve meals, or assist with home deliveries.

To find ways to get involved, reach out to your local food bank or soup kitchen.

New York is still in a drought while fires die down

While recent rain in New York helped wildfire suppression and improved air quality, much of the state is still under drought warning. New York City’s reservoir is still below 20% of historical standards.

Data and figure from the New York Department of Environmental Conservation

During the drought, New Yorkers are urged to conserve water:

Shorten showers: Save 5–7 gallons a minute.
Turn off faucets: While shaving, brushing teeth, or doing dishes (faucets use 2–3 gallons a minute).
Fix leaks: A slow drip wastes 15–20 gallons daily.
Report fire hydrant leaks: Call 311.

More tips are available here.

Dry conditions have increased wildfire risks in New York. The Jennings fire, which burned 5,304 acres along the New York-New Jersey border in November, is fully contained. Thank you to all the firefighting professionals and volunteers who responded.

Freezing temperatures in New York City trigger Code Blue warnings

A Code Blue Weather Emergency notice is issued when the temperature drops below freezing (32 degrees Fahrenheit or less) between 4 p.m. and 8 a.m. No one will be denied shelter in New York City during a Code Blue. Should you see a vulnerable person out in the cold, call 311, and an outreach team will be dispatched to offer assistance. We expect more frequent Code Blue warnings to be issued now that temperatures have dropped this season.

Bottom line

You’re all caught up on this week’s New York public health news. See you next week!

Love,

Your Local Epidemiologist

Make America Healthy Again: Unconventional movement may have found its moment

2024-11-26T13:53:22+00:00

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Within days of Donald Trump’s election victory, health care entrepreneur Calley Means turned to social media to crowdsource advice.

“First 100 days,” said Means, a former consultant to Big Pharma who uses the social platform X to focus attention on chronic disease. “What should be done to reform the FDA?”

The question was more than rhetorical. Means is among a cadre of health business leaders and non-mainstream doctors who are influencing President-elect Donald Trump’s focus on health policy.

Trump’s return to the White House has given Means and others in this space significant clout in shaping the nascent health policies of the new administration and its federal agencies. It’s also giving newfound momentum to “Make America Healthy Again,” or MAHA, a controversial movement that challenges prevailing thinking on public health and chronic disease.

Its followers couch their ideals in phrases like “health freedom” and “true health.” Their stated causes are as diverse as revamping certain agricultural subsidies, firing National Institutes of Health employees, rethinking childhood vaccination schedules, and banning marketing of ultra-processed foods to children on TV.

Public health leaders say the emerging Trump administration’s interest in elevating the sometimes unorthodox concepts could be catastrophic, eroding decades of scientific progress while spurring a rise in preventable disease. They worry the administration’s support could weaken trust in public health agencies.

Georges Benjamin, executive director of the American Public Health Association, said he welcomes broad intellectual scientific discussion but is concerned that Trump will parrot untested and unproven public health ideas he hears as if they are fact.

Experience has shown that people with unproven ideas will have his ear and his “very large bully pulpit,” he said. “Because he’s president, people will believe he won’t say things that aren’t true. This president, he will.”

But those in the MAHA camp have a very different take. They say they have been maligned as dangerous for questioning the status quo. The election has given them an enormous opportunity to shape politics and policies, and they say they won’t undermine public health. Instead, they say, they will restore trust in federal health agencies that lost public support during the pandemic.

“It may be a brilliant strategy by the right,” said Peter McCullough, a cardiologist who has come under fire for saying Covid-19 vaccines are unsafe. He was describing some of the election-season messaging that mainstreamed their perspectives. “The right was saying we care about medical and environmental issues. The left was pursuing abortion rights and a negative campaign on Trump. But everyone should care about health. Health should be apolitical.”

Some MAHA ideas championed by far left

The movement is largely anti-regulatory and anti-big government, whether concerning raw milk or drug approvals, although implementing changes would require more regulation. Many of its concepts cross over to include ideas that have also been championed by some on the far left.

Robert F. Kennedy Jr., an anti-vaccine activist Trump has nominated to run the Department of Health and Human Services, has called for firing hundreds of people at the NIH, removing fluoride from water, boosting federal support for psychedelic therapy, and loosening restrictions on raw milk, consumption of which can expose consumers to foodborne illness. Its sale has prompted federal raids on farms for not complying with food safety regulations.

Means has called for top-down changes at the U.S. Department of Agriculture, which he says has been co-opted by the food industry.

Though he is not trained in science or medicine, he has said, without evidence, that people had almost no chance of dying of Covid-19 if they were “metabolically healthy,” referring to eating, sleeping, exercise, and stress management habits, and has said that about 85% of deaths and health care costs in the United States are tied to preventable foodborne metabolic conditions.

A co-founder of Truemed, a company that helps consumers use pretax savings and reimbursement programs on supplements, sleep aids, and exercise equipment, Means says he has had conversations behind closed doors with dozens of members of Congress. He said he also helped bring RFK Jr. and Trump together. RFK Jr. endorsed Trump in August after ending his independent presidential campaign.

“I had this vision for a year, actually. It sounds very woo-woo, but I was in a sweat tent with him in Austin at a campaign event six months before, and I just had this strong vision of him standing with Trump,” Means said recently on the Joe Rogan Experience podcast.

The former self-described never-Trumper said that, after Trump’s first assassination attempt, he felt it was a powerful moment. Means called RFK Jr. and worked with conservative political commentator Tucker Carlson to connect him to the former president. Trump and RFK Jr. then had weeks of conversations about topics such as child obesity and causes of infertility, Means said.

“I really felt, and he felt, like this could be a realignment of American politics,” Means said.

He is joined in the effort by his sister, Casey Means, a Stanford University-trained doctor and co-author with her brother of “Good Energy,” a book about improving metabolic health. The duo has blamed Big Pharma and the agriculture industry for increasing rates of obesity, depression, and chronic health conditions in the country. They have also raised questions about vaccines.

“Yeah, I bet that one vaccine probably isn’t causing autism, but what about the 20 that they are getting before 18 months,” Casey Means said in the Joe Rogan podcast episode with her brother.

Backlash against vaccine, mask mandates fueled MAHA

The movement, which challenges what its adherents call “the cult of science,” gained significant traction during the pandemic, fueled by a backlash against vaccine and mask mandates that flourished during the Biden administration. Many of its supporters say they gained followers who believed they had been misled on the effectiveness of Covid-19 vaccines.

In July 2022, Deborah Birx, Covid-19 response coordinator in Trump’s first administration, said on Fox News that “we overplayed the vaccines,” although she noted that they do work.

Anthony Fauci, who advised Trump during the pandemic, in December 2020 called the vaccines a game changer that could diminish Covid-19 the way the polio vaccine did for that disease.

Eventually, though, it became evident that the shots don’t necessarily prevent transmission and the effectiveness of the booster wanes with time, which some conservatives say led to disillusionment that has driven interest in the health freedom movement.

Federal health officials say the rollout of the Covid vaccine was a turning point in the pandemic and that the shots lessen the severity of the disease by teaching the immune system to recognize and fight the virus that causes it.

Post-election, some Trump allies such as Elon Musk have called for Fauci to be prosecuted. Fauci declined to comment.

Joe Grogan, a former director of the White House’s Domestic Policy Council and assistant to Trump, said conservatives have been trying to articulate why government control of health care is troublesome.

“Two things have happened. The government went totally overboard and lied about many things during Covid and showed no compassion about people’s needs outside of Covid,” he said. “RFK Jr. came along and articulated very simply that government control of health care can’t be trusted, and we’re spending money, and it isn’t making anyone healthier. In some instances, it may be making people sicker.”

The MAHA movement capitalizes on many of the nonconventional health concepts that have been darlings of the left, such as promoting organic foods and food as medicine. But in an environment of polarized politics, the growing prominence of leaders who challenge what they call the cult of science could lead to more public confusion and division, some health analysts say.

Jeffrey Singer, a surgeon and senior fellow at the Cato Institute, a libertarian public policy research group, said in a statement that he agrees with RFK Jr.’s focus on re-evaluating the public health system. But he said it comes with risks.

“I am concerned that many of RFK Jr.’s claims about vaccine safety, environmental toxins, and food additives lack evidence, have stoked public fears, and contributed to a decline in childhood vaccination rates,” he said.

Measles vaccination among kindergartners in the United States dropped to 92.7% in the 2023-24 school year from 95.2% in the 2019-20 school year, according to the Centers for Disease Control and Prevention. The agency said that has left about 280,000 kindergartners at risk.

Stephanie Armour is a reporter for KFF Health News, Healthbeat’s national reporting partner.

DeKalb health needs: Better access to providers and healthy food, report finds

2024-11-22T02:01:32+00:00

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DeKalb County residents want more options for physical activity and healthy food and better access to health care providers, according to the latest Community Health Needs Assessment.

DeKalb Public Health CEO Dr. Sandra Valenciano presented the findings at a quarterly meeting of DeKalb Public Health’s board Thursday.

Lack of access to those services impact Black, lower-income and South DeKalb residents in particular, according to the assessment. Published in June, it was conducted for DeKalb Public Health by OMNI Institute and incorporated results from a survey of 122 residents and focus groups, along with quantitative data.

Race and location are important in understanding people’s access to health, Valenciano said. In DeKalb, 55% of the population is Black, 7% is Asian, and 9% is Hispanic. Sixteen percent of residents are foreign born, and 19% speak a language other than English at home.

“When we examine the landscape of DeKalb, it’s important to incorporate factors that aren’t necessarily medical factors that can still impact health, and these factors are called the social determinants of health,” Valenciano said.

The county public health agency is focusing on improving trust and information-sharing with the help of a U.S. National Institutes of Health grant.

Staff turnover at the public health agency is also a problem.

DeKalb residents voice need for access to healthy food

Eleven percent of DeKalb residents were food insecure in 2020, according to the report, and 9% of low-income residents had limited access to healthy foods.

Meanwhile, 25% of residents did not have access to large grocery stores.

Four in five residents in a community survey of 122 said the county should focus on improving food access. Some listed nutrition among their top five priorities.

Respondents urged the county to expand access to farmers’ markets and food pantries, promote community gardens, engage with the faith community, and use DeKalb Public Health’s mobile units as farmers’ markets.

The DeKalb Public Health board presented a report assessing the community's health needs on Thursday in Decatur.

While more adults in DeKalb reported adequate access to exercise opportunities than most Georgians, about a quarter reported no leisure-time activity, at about the same rate as all Georgians.

Meanwhile, nearly 70% reported it is very important for the county to focus on improving opportunities for physical activity. They suggested adding and improving sidewalks and paths for running and walking and making gym memberships and other wellness services more affordable.

More South DeKalb residents asked for more sidewalks, bike paths, recreation centers and parks than those who live in other areas.

Access to health care better in DeKalb, but still low

The ratio of health care providers to the population is better in DeKalb than in the rest of the state, including primary care physicians, mental health providers, and dentists, the report said.

Still, almost a quarter of residents had not seen a doctor in the past 12 months, the report found. Data from 2017 indicated cost and a lack of health insurance as obstacles.

“Among community survey respondents, over 80% of respondents said it is very important for DeKalb County to improve the availability and accessibility of health care providers, to focus on more primary care options, and to provide more support and education on health insurance enrollment and benefits,” Valenciano said.

“One in three respondents reported that there was a time in the past 12 months when they or a loved one who did medical care but could not get it, and, of these individuals, over a third stated that they could not get medical care, due to the lack of insurance,” she added.

Valenciano did not directly address steps the agency plans to take to address the needs identified in the report. Spokesperson Eric Nickens said the findings will be used to develop a Community Health Improvement Plan.

But she said she plans to have the needs assessment done every year, instead of every five years as was the practice before Covid arrived.

Improving information, fighting disinformation are priorities

A lack of information about public health services, and more broadly, health misinformation, are major challenges for DeKalb public health.

Over a third of respondents identified health care providers as the source of most of their health information, and another 20% said they got most health information online.

Some people, including physicians, don’t realize all the services the Department of Public Health offers, Valenciano said. She gave the example of taking her child to the pediatrician and that doctor not realizing the public health department offers flu shots.

“Our providers don’t know where can their patients seek services or things that we’re providing at low cost or no cost,” she said.

On the flip side, some residents who access WIC, the Women Infant and Children supplemental nutrition program, via DeKalb Public Health are also surprised to learn about the many other health services the agency offers, Valenciano said.

Misinformation is also a problem. DeKalb Public Health is one of three pilot sites (the other two are in Mississippi and North Carolina) participating in the second phase of a pilot project to address health disinformation.

Sponsored by the NIH, the Knowledge Monitoring and Response System seeks to leverage community organizations to address health misinformation.

The plan is to use weekly surveys to inform health information and to leverage “trusted messengers.”

The public health department will work with a wide range of community health groups, from the Hispanic Health Coalition of Georgia to New Birth Missionary Baptist Church.

Health department sees high turnover in workforce

About two-thirds of the agency’s roughly $50 million budget goes to personnel costs, said finance manager Phuong Le.

DeKalb Public Health has budgeted for 436 full- and part-time jobs, of which 349 are filled, Nickens said.

Between Aug. 1 and Oct. 31, DeKalb Public Health hired 25 new employees but lost 24 employees. Sixteen resigned, six left because of the ending of seasonal assignments, and two left due to terminations, Valenciano said.

“Our turnover … obviously impacts our ability to carry [out] initiatives,” Valenciano said.

This story has been updated with additional information about staffing and DeKalb Public Health’s plans for addressing community needs.

Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Contact Rebecca at rgrapevine@healthbeat.org.

NYC health department promised 1,000 fresh produce permits nearly two decades ago. Just 149 vendors had them this year.

2024-10-18T18:39:02+00:00

This story was originally published by THE CITY. Sign up to get the latest New York City news delivered to you each morning.

In 2008, the city health department opened up 1,000 permits for street vendors to sell fresh fruits and vegetables in New York City’s food deserts.

But just 149 vendors held those Green Carts permits as of the end of May, while 1,445 others remained on a waitlist for a chance to apply for the 851 that were still up for grabs, according to a new analysis of data THE CITY obtained from the health department last month via a public records request.

When the permits were launched 16 years ago, then-mayor Michael Bloomberg touted the program as an “important public health initiative that responds to the need for fresh produce close to home,” and said it would “provide opportunities for vendors to make a living selling fresh fruits and vegetables in communities where healthy food can be difficult to find.” Five years after the program’s launch, in 2013, more than 500 vendors held those produce permits.

But the gap between what the city promised and what it has delivered has widened since then. Nearly 1,500 vendors are now on the permit waitlist, which has been sealed off since May 2022 after briefly opening for the three months prior.

Carina Kaufman-Gutierrez, deputy director of the non-profit Street Vendor Project, said the disconnect is indicative of an “extremely onerous bureaucratic process” that’s created unnecessary delays for prospective vendors.

“Clearly there’s an issue there,” Kaufman-Gutierrez said. “People who want to be able to work as Green Carts vendors should be able to just apply to do it. There shouldn’t be this huge backlog of months and months or years and years of waiting, to the point where it might not even be relevant for the person who got on the waitlist back in the day.”

Vendors who have been called off the waitlist, in fact, do not generally turn in an application to begin the permitting process, the data shows. Last year, just 91 of the 600 vendors called off the queue officially applied.

Some vendors find painfully slow wait

For vendors who are still interested, however, the wait to put in an application has been painfully slow, with months sometimes passing before a new group of applicants — no more than 160 at a time in recent years — was offered permits.

About a month after THE CITY submitted its request for the vendor data in April, the department called 750 vendors off the waitlist. The department didn’t say how many of them accepted a permit.

Shari Logan, a department spokesperson, told THE CITY it is “working on ways to speed up the application process,” including by issuing more applications at once.

She added that 309 Green Carts vendors now have permits — meaning the number more than doubled since THE CITY obtained the data last month.

Advocates have called on the city to do more to permit legal vending, and more so as newly arrived migrants have turned to vending over the last two years. Although the health department in 2022 amended regulations to allow Green Carts vendors to also sell water, nuts, and cut fruits and vegetables — in addition to whole produce as was allowed before — the permit waitlist has yet to reopen.

“There are tons of cut fruit vendors in New York City, but they can’t get permits,” said Matthew Shapiro, Street Vendor Project’s legal director. “And ostensibly, now there are permits available that these vendors could use but because of the waiting list or because of all of the rules, they’re not able to do it. So the government has failed to figure out a way to make it so these vendors can actually do what they’re doing legally.”

Green Carts setup is expensive

Logan said the health department is now reaching out to vendors to understand why only a handful of them have turned in applications after being called off the Green Carts waitlist.

But Shapiro, who helps vendors navigate permits, said it is in part due to the difficult economics of running a perishable food business within the health department’s restrictive regulations.

Green Carts permits are allocated by boroughs, with set quotas for each, and legally operable only within police precinct areas where “the rate of fresh produce consumption is substantially lower than the citywide average.” And unlike produce vendors at farmer’s markets who can more or less operate from impromptu set-ups, Green Carts vendors are required by law to operate from set-ups that meet specific standards — which Shapiro estimated cost about $5,000 to procure.

Ernesto Garcia, a 39-year-old native of the Mexican state of Puebla, said it cost him and his mother at least $36,000 to start up their Green Carts business in Soundview, Bronx when his mother’s name was called off the waitlist in 2022, after what he said had been more than a decade of waiting.

First it was $30,000 for a van to transport his produce, then it was another $6,000 for the cart itself. Then there was the $500 monthly rent he had to pay a health department–approved facility to park his cart nightly, on top of another $500 he spent about four times a week to source fresh produce from the Hunts Points produce market.

Even after working 17 hour days — starting from when he’d arrive at the produce market at 5 a.m. to when he’d return to his van to a garage at 10 p.m. — Garcia said he would gross no more than $230 on a good day, and often lose money on a bad day.

“The gains wouldn’t last because I was only dedicated to the business, and I didn’t have another job aside from this. And sometimes the produce would go bad, and I would not recover the money,” Garcia told THE CITY in Spanish. “Sometimes I would come out short, and I would have to ask my siblings to lend me money.”

Seven months ago, Garcia said, he and his mother decided to shutter their Green Carts because of his mother’s old age and because they can no longer sustain the business’s losses.

“I feel very frustrated and sad that it didn’t turn out as planned, and I don’t know if it was because I didn’t put in enough effort, or because the economy is bad, but I’m sad that we had to make that decision,” said Garcia, who’s now working nights in a pizza shop.

Other vendors who’ve been called off the Green Carts waitlist have also surrendered their opportunity to apply for a permit after considering possible profits and losses.

That includes Adelaida Simon Carrasco, who had been selling tamales and pozoles outside the N train station on Bay Parkway since 2016, until she was hit by a car in 2022 and took a break from vending to focus on recovery.

Street vendors can only hold one permit at a time

Simon Carrasco recalled submitting her name to the Green Carts waitlist around 2016 after receiving a $1,000 fine for unlicensed sales. And while she had been primarily interested in selling prepared food, she entered the produce permits waitlist because no other vending waitlist had been open at the time.

When the 40-year-old was called off the waitlist in 2022, however, she ultimately chose not to pursue a permit because she wasn’t confident that the business was going to be profitable.

“It’s not a good business for me, because fruits are seasonal — maybe in the summer, I can sell a lot. But what I want is a food permit,” Simon Carrasco said.

And because street vendors can hold only one permit at a time, Kaufman-Gutierrez added, a number of sellers also end up abandoning the opportunity to apply for a Green Carts permit once they’re called off the waitlist, so they can hold onto startup costs in case they’re selected from other waitlists to apply for permits that could yield more lucrative incomes — food vending permits, for example.

Garcia, meanwhile, is making the food and working the register at a pizza shop. The 39-year-old said he has been selling gum, chocolates and candies with his mother and late father on subway cars and on streets since they emigrated to New York when he was 7 years old — and hopes to return to vending produce one day.

But to do that, he would first have to find a way back to the Green Carts waitlist when it next reopens, because current regulations would not allow for his mother to transfer the permit into his hands.

“I want to add myself to the Green Carts waitlist if it ever opens again,” Garcia said in Spanish. “It’s an experience that serves as a lesson for the future when I want to open a business so I have an idea of how to work.”