Babies are paying the price for their mothers' addiction.
Julia LurieAug. 12, 2016 4:08 PM
The opioid epidemic in America is taking its toll on a class of victims who have received relatively little attention in the crisis: babies. The rate of babies born in drug withdrawal has quadrupled over a 15-year stretch, according to data released Thursday by the Centers for Disease Control and Prevention.
The report looked at the prevalence of babies born between 1999 and 2013 with neonatal abstinence syndrome (NAS), an illness caused by exposure in the womb to addictive drugs, primarily opioids—including heroin, methadone, and prescription painkillers such as oxycodone and hydrocodone (known by brand names OxyContin and Vicodin, respectively).
NAS isn't known to have long-lasting effects, but babies going through it can suffer from tremors, seizures, gastrointestinal problems, and fevers. The increasing rates mirror the skyrocketing use of opioids across the country. In 2014, more than 47,000 Americans died from drug overdoses—a similar number to the fatalities during the HIV epidemic at its peak in the late 1980s and early 1990s. (According to the CDC, NAS can also be caused by non-opioid drugs such as cocaine, amphetamines, and barbiturates, but opioids are detected in the vast majority of cases.)
Only 28 states currently collect data on NAS, and some of those states have kept figures on the condition only for the past few years. But as the chart below shows, the number of babies born dependent on drugs varies drastically by state, with West Virginia, Vermont, and Maine showing the highest rates. That's due in part to different use rates of opioids. West Virginia and Maine have some of the highest prescription opioid rates in the country, while Vermont is struggling with a spiraling heroin problem.
In an attempt to curb the opioid crisis, the CDC released the first national standards for prescribing painkillers this spring. The recommendations, which are not binding, call for doctors to first try ibuprofen or aspirin to treat pain, limit short-term opioid treatment to three days, monitor patients' drug use with regular urine tests and prescription tracking systems, and advise patients—particularly those who are pregnant—about the addictive effects.
Paul O'Neal, 18, was killed July 28 following a chase in the city's South Shore neighborhood.
Julia LurieAug. 5, 2016 2:26 PM
A screenshot of Chicago Police dashcam footage in the aftermath of the Paul O'Neal shooting
The Chicago Police Department released video footage Friday morning of the death of 18-year-old Paul O'Neal, who was fatally shot in the back by police during a chase on July 28. In a nationwide conference call and bulletin, the police department warned of "civil unrest" following the video's release.
The recording shows O'Neal running a stop sign in a stolen Jaguar before hitting a police cruiser. Officers chase O'Neal, who is unarmed, through a yard in the city's South Shore neighborhood while shots are fired. Officers can then be heard swearing at O'Neal, face down with a bloodied shirt, while handcuffing his limp hands.
The officer who fatally shot O'Neal was in the cruiser that was hit. His body camera didn't record when he opened fire; police investigators are looking into whether it was turned on.
Sharon Fairley, head of Chicago's police oversight board, called the video "shocking and disturbing." The board is in the process of investigating the incident, but three officers were stripped of their policing powers after a preliminary investigation found that they had violated department policy. Fairley says the video was released because it didn't jeopardize the investigation.
The O'Neal family has filed a lawsuit against the officers, alleging that they fired "without lawful justification or excuse."
The Independent Police Review Authority released nine videos of the incident, including the one below.
But some scientists say that still won't solve the problem.
Julia LurieJul. 15, 2016 6:00 AM
Water samples from Newark schools at Aqua Pro-Tech Laboratories.
New York, home to more than 2.5 million public school students, may soon pass the nation's first law requiring regular testing of water in those schools for the presence of lead. It likely won't be the last: This year, at least 20 bills in seven states have been introduced to address lead contamination in school water, according to the National Conference of State Legislatures.
The bills reflect a testing frenzy: The water crisis in Flint, Michigan, led dozens of school districts, often at the behest of worried parents, to test water fountains and taps, children's main sources of drinking water on school days. "No one was testing," Robert Barrett, CEO of water testing firm Aqua Pro-Tech Laboratories, told the New York Times. "Now all of a sudden they're all going crazy."
Some results have been worrisome: In Newark, more than half of the city's 67 schools had at least one fountain or sink whose water exceeded the Environmental Protection Agency's threshold for lead contamination. This spring, dozens of schools—in Boston; Ithaca, New York; Portland, Oregon; Tacoma, Washington; and elsewhere—shut off their water after testing found lead in excess of the EPA "action level" of 15 parts per billion.
"At least the lead in school water problem will no longer be completely out of sight and out of mind.”
The contamination stems from a legal loophole the New York bill aims to close: The EPA requires schools to be connected to a local water source that is tested regularly for lead, but utilities are not required to test inside school facilities. The problem is that lead contamination in schools typically comes from pipes and fixtures within school buildings. Lead pipes were legal through the mid-1980s, and up until 2014, faucets and metal fixtures on water fountains and water coolers were allowed to contain up to 8 percent lead. The average American school building is 44 years old.
The New York bill, unanimously supported by the state Senate last month, is expected to be signed into law by Gov.Andrew Cuomo. It compels K-12 public schools to perform "periodic" lead tests at fountains and taps, and provides the funding to do so. If high lead levels are found, schools will be required to notify parents and provide "safe, potable" water for students until further tests show safe water. (The bill doesn't cover universities or private and charter grade schools.) Bills in Michigan, New Jersey, North Carolina, and Rhode Island would also require regular testing. A new Ohio law requires utilities to map spots with a high likelihood of lead contamination and test them regularly. In Congress, Sen. Cory Booker (D-N.J.) has introduced legislation that would require states to help schools test for lead, although it doesn't provide funding.
The ultimate solution, researchers agree, is to replace all lead pipes and fixtures, but few school systems can afford such a project. A cheaper option is to install lead filters, which are effective so long as they are regularly maintained. The New York bill covers the cost of filters, as well as infrastructure fixes for fountains and taps that test at high levels. "While no legislation is perfect, at least the lead in school water problem will no longer be completely out of sight and out of mind," says Marc Edwards, the Virginia Tech professor who helped expose the lead contamination crisis in Flint, Michigan.
"As long as there’s lead-bearing plumbing in a system, lead will leach into the water."
But some experts fear that occasional water testing won't be enough—and may even provide false assurances. This concern stems from what researchers call the "Russian Roulette" phenomenon. Lead particles come out of pipes and fixtures somewhat randomly, so a tap that tests clean one day might show high lead levels the next. Indeed, multiple tests from the same faucet often show very different results.
"As much as I applaud the intent, I do think that the specific policy [in New York] defies the science," says Yanna Lambrinidou, a Virginia Tech scientist and president of Parents for Nontoxic Alternatives. "Testing seems to be happening quite rampantly right now, and it's not a bad thing, but I think it needs to be done properly. The vast majority of buildings in this country have lead-bearing plumbing, and as long as there’s lead-bearing plumbing in a system, lead will leach into the water."
How much lead is tolerable is also a matter of dispute. Most school districts rely on the EPA's 15 ppb as a guide, but the American Association of Pediatrics recently released a statement noting that 15 ppb "is routinely (but erroneously) used as a health-based standard; it was not intended as a health-based standard, nor does it adequately protect children or pregnant women from adverse effects of lead exposure." The association says water from drinking fountains should not exceed 1 part per billion. Indeed, according to the Centers for Disease Control and Prevention, "no safe blood lead level in children has been identified."
The city's homelessness crisis—and its causes—in seven charts.
Julia LurieJun. 30, 2016 6:00 AM
This article is part of the SF Homeless Project, a collaboration between nearly 70 media organizations to explore the state of homelessness in San Francisco.
On any given night, 1 in 200 San Franciscans sleep on the street.Among the nation's large urban areas, the city has the highest per capita rate of unsheltered homeless people—people who live outside, in cars, or in abandoned buildings, as opposed to in shelters or transitional housing. Over the past decade, as the city has experienced a tech boom and sky-high housing prices, the number of homeless people living in the open has increased 64 percent, to nearly 4,400 people, according to the most current (though controversial) count.
San Francisco's growing homeless population
Homelessness isn't unique to San Francisco, of course: All told, there are nearly 600,000 homeless individuals in the United States. That number has dropped slightly over the years, from 647,000 in 2007 to 575,000 last year. But in several big cities—such as New York, Seattle, Miami, San Francisco, and Washington, DC—the number of homeless people has increased over the same period.
Homelessness in 15 largest US cities, 2015
How'd we get here?
Given San Francisco's increasingly visible, stubbornly high homelessness rate, it's easy to forget that homelessness is a relatively recent phenomenon—one that housing experts agree began in earnest in the late '70s and early '80s.
The researchers at all three organizations pointed out a paradox: While homelessness is experienced and witnessed at a local level, the underlying causes are systematic, long term, and largely the results of decisions made at the federal level. These root causes have been well established for decades, says Stacey Murphy, the research director of the California Housing Partnership Corporation: the decline in wages, cuts to welfare and affordable housing, and the lack of mental health services. "It's the same four things. It's mystifying to me," she says. "When people stop thinking about it as one person and think about policy—when you ask, as a nation, why so many people live on the streets and how we can not provide a basic level of services for those people—it raises profound questions about our society."
Here are some factors that have driven San Francisco's—and the nation's—homelessness problem for the past four decades.
Affordable housing cuts
Reaganomics brought prosperity for some, but its small-government policies led to massive funding cuts tofederal affordable housing programs and social services. "When we look at the affordable housing crisis today, there's a direct line back to really severe cuts that were made to critical affordable housing programs under the Reagan administration," says Diane Yentel, the president of the National Low Income Housing Coalition. She points out that, unlike other federal safety nets like Social Security and Medicare, affordable housing isn't automatic even if you qualify for it. "When public housing agencies open up a waiting list, you'll see long lines of people waiting just to add their name to the waiting list—and they're waiting literally decades," she says. Today, there are just three affordable and available housing units for every 10 extremely low-income families, according to the NLIHC.
(The spike in 2009 was the effect of the American Recovery and Reinvestment Act stimulus package, which included one-time funding for housing.)
Sagging incomes, soaring rents
As the chart below shows,family income roughly doubled across all income groups in the two decades after World War II. But starting in the mid-'70s, income disparities widened: Families in the top bracket continued to see their incomes rise while the incomes of middle-class and low-income families stagnated.
While income has flatlined for many Americans, rents are rising—and fast—in many cities. This is partly a matter of supply and demand: In cities like San Francisco, the supply of housing units has not kept up with population growth.
The gap between income and rent is particularly extreme among San Francisco's low-income residents. Over the past decade, the monthly income of a low-income San Francisco household (one that makes 30 percent of the median, which is currently $107,700 annually) has increased by 14 percent, not adjusting for inflation. Over the same period, the median rent for a modest two-bedroom apartment rose 38 percent. In order to make that rent without spending more than 30 percent of their annual income, a person would need to make $44 an hour, or more than $91,000 per year.
Until 1996, poor families could count on federal welfare benefits, says Murphy. "It didn't say you would get a lot, but if you were poor and met requirements, the federal government footed the bill. Welfare reform changed that." The Personal Responsibility and Work Opportunity Reconciliation Act signed by President Bill Clinton gave states the power to decide who would receive federal assistance. States imposed stricter eligibility rules, and all families were limited to a total of five years on welfare.
In 1995, three of four families with children in poverty received welfare benefits. By 2014, that number had dropped to one in four. Since welfare benefits are largely spent on rent, the reduction in benefits means fewer families in poverty are able to afford a home. "If you're not receiving cash assistance at all, [welfare] is not helping you pay for housing," says Liz Schott, a senior fellow at the Center on Budget and Policy Priorities.
Benefits don't go as far
As the number of poor families on welfare has declined, so has the value of those benefits. In 1980, a family of three living in the Bay Area received a maximum benefit of $473 a month, or $1,361 in 2015 dollars. In 2015, the maximum such a family could receive was $704, an effective cut ofnearly 50 percent. "Very few people are on assistance. but those who are say they can't meet their basic needs like housing by just relying on assistance," says Ife Floyd, a policy analyst at the Center on Budget and Policy Priorities. "It's the same story across the country."
Health advocates predict the move could spark a nationwide trend.
Julia LurieJun. 16, 2016 6:43 PM
On Thursday, Philadelphia became the first major US city to adopt a tax on carbonated and sugary drinks. The 1.5 cent-per-ounce tax will apply to sodas, diet sodas, and other drinks with added sugar like Gatorade, lemonade, and iced tea.
The policy is a huge step for soda tax advocates: Similar proposals have been defeated in at least 40 cities or states—with the help of more than $100 million from the American Beverage Association, PepsiCo, and Coca Cola. Until now, relatively small and liberal Berkeley, California was the only city with an existing policy.
But Philadelphia is the fifth largest city in the country, and among the poorest. Unlike other cities, whose politicians touted the potential health benefits of a soda tax, Philadelphia Mayor Jim Kenney focused on the money: the policy is expected to bring in nearly $400 million over five years, most of which will go to expand pre-K education and maintain parks, community centers, and schools.
"When history looks back on this, Philadelphia will be seen as what launched a much broader wave of these taxes," says Kelly Brownell, the dean of the Sanford School of Public Policy at Duke University who focuses on food policy. Between the relatively high tax (Berkeley's is only one cent per ounce) and the focus on city revenue, the policy is a "forecast of what will happen in the rest of the country," he says.
Of course, not everyone is happy about the new law: The American Beverage Association, which spent nearly $5 million campaigning against the measure, has promised legal action. "The fact remains that these taxes are discriminatory and highly unpopular—not only with Philadelphians, but with all Americans," read a recent ABA statement.
In the meantime, several large, diverse cities are likely to use Philadelphia's policy as a model for their own policies, says Jim Krieger, of Healthy Food America: San Francisco, Oakland, and Boulder are set to consider soda taxes this year.