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Analysis by Dr. Joseph Mercola
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• September 14, 2022Download PDF

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By Cara Murez HealthDay Reporter
HealthDay Reporter

TUESDAY, Sept. 13, 2022 (HealthDay News) — Aching joints are common for people over 50, but it’s still important to talk to a doctor about it rather than endlessly self-medicating, experts say.

Now, a new poll from the University of Michigan breaks down joint pain, its impact on those who responded to the survey and how they’ve chosen to react to this painful condition.

Findings from the University of Michigan National Poll on Healthy Aging include that 70% of people over 50 experience joint pain at least occasionally. About 60% have been told they have some form of arthritis.

Among those who have arthritis symptoms, about 45% said they have pain every day and 49% said it somewhat limits their usual activities.

“If you are feeling joint pain frequently, or it interferes with your normal activities, you don’t have to go it alone,” said Indira Venkat, senior vice president of AARP Research. The organization was one of the supporters for the poll. “Talk with your health provider about how you are treating your joint pain and additional strategies that may help.”

About 80% of those with joint pain said they had at least some confidence they could manage it on their own.

About 66% do so with over-the-counter pain relievers such as aspirin, acetaminophen (Tylenol), ibuprofen (Motrin, Advil) or naproxen (Aleve). About 26% reported taking supplements, such as glucosamine or chondroitin. About 11% use cannabidiol (CBD), derived from marijuana, while 9% use marijuana.

About 18% use prescription-only non-opioid pain relievers, 19% get steroid injections, 14% take oral steroids, 14% use opioids and 4% use disease-modifying antirheumatic drugs.

“There are sizable risks associated with many of these treatment options, especially when taken long-term or in combination with other drugs. Yet 60% of those taking two or more substances for their joint pain said their health care provider hadn’t talked with them about risks, or they couldn’t recall if they had. And 26% of those taking oral steroids hadn’t talked with a provider about the special risks these drugs bring,” said Dr. Beth Wallace. She is a rheumatologist and researcher at the VA Ann Arbor Healthcare system, the VA Center for Clinical Management Research and Michigan Medicine.

“This suggests a pressing need for providers to talk with their patients about how to manage their joint pain, and what interactions and long-term risks might arise if they use medications to do so,” Wallace said.

Guidelines from the American College of Rheumatology for osteoarthritis and the more rare rheumatoid arthritis seek to reduce the risk that can happen with long-term use or for those taking multiple medications that can affect patients’ stomach, liver, blood pressure, blood sugar, mood or sleep.

The guidelines for osteoarthritis, which can be caused by wear and tear, emphasize weight loss, exercise, self-management programs with arthritis educators, tai chi, yoga, braces, splints and kinesiotaping, acupuncture or acupressure, cognitive behavioral therapy and applying heat, cold or topical pain relievers on aching joints.

For medication, the guidelines focus on short-term use of over-the-counter medications in low doses, along with steroid joint injections in appropriate patients. They recommend against most supplements, opioids and other prescription drugs.

About 64% of survey respondents who have joint pain do use exercise and 24% have had physical therapy. Far fewer used non-drug options such as braces.

Certain groups of older adults appear to be more likely to experience worse joint pain, said poll director Dr. Preeti Malani, a Michigan Medicine physician with training in infectious diseases and geriatrics.

“Those who say their overall health is fair or poor were twice as likely to say they have moderate or severe joint pain as those in better health. The difference was nearly as great between those who say their mental health is fair or poor than those who reported better mental health,” she said in a Michigan Medicine news release.

“And older adults with fair or poor physical or mental health were much more likely to agree with the statement that there’s nothing that someone with joint pain can do to ease their symptoms, which we now know to be untrue,” Malani said. “Health providers need to raise the topic of joint pain with their older patients, and help them make a plan for care that might work for them.”

The phone poll was administered in January and February 2022 among 2,277 adults aged 50 to 80.

More information

The U.S. Centers for Disease Control and Prevention has more on osteoarthritis.

SOURCE: Michigan Medicine – University of Michigan, news release, Sept. 12, 2022

Overall, the study authors found that about 6 in 10 posts highlighted only the upside of slugging, while only 2 in 10 mentioned possible risks.

“What we found was not necessarily misinformation, but often a lack of information,” Pagani said. “A lot of the time, there was just no inclusion of risks.”

Beyond a heightened risk for facial acne among acne-prone patients, Pagani said there is also the risk that any topical skin medication applied before slugging would essentially become trapped underneath petroleum ointments, and therefore potentially absorbed more deeply — and for longer periods of time — than originally intended.

“Now, slugging is one of the relatively harmless things that can be found on TikTok,” Pagani acknowledged. “But even in the case of mostly benign beauty trends, the hope is that viewers are going to get accurate information from reliable sources, information backed by science based on data and research. Because other trends or beauty products may certainly be more potentially harmful than something like slugging.”

The findings were published recently in the journal Clinics in Dermatology.

It’s that broader issue that concerns Kelly Garrett, director of the School of Communication at Ohio State University.

“It is no wonder that people end up looking for health information in these digital spaces,” said Garrett, who pointed out that social media is familiar, easy to use and can be an empowering way to do research.

And medical professionals are not the sole purveyors of useful health information. “For example, someone who is living with a cancer diagnosis can have important insights, too,” Garrett said.

But the problem, he noted, is that “on social media, content creators’ goals are not always obvious.

“Posts by health care providers are often intended to inform, but other creators may be more interested in providing entertainment, persuading consumers to buy something, or just generating traffic to their content,” Garrett said. “Consumers who misunderstand the creators’ goals can end up being misled about the content, too.”

All of which means it’s critical that social media users be aware of the risks involved when searching for health information online, said Garrett, who was not involved in the study.

This article was featured in One Story to Read Today, a newsletter in which our editors recommend a single must-read from The Atlantic, Monday through Friday. Sign up for it here.      

A decade into her optometry career, Marina Su began noticing something unusual about the kids in her New York City practice. More of them were requiring glasses, and at younger and younger ages. Many of these kids had parents who had perfect vision and who were baffled by the decline in their children’s eyesight. Frankly, Su couldn’t explain it either.

In optometry school, she had been taught—as American textbooks had been teaching for decades—that nearsightedness, or myopia, is a genetic condition. Having one parent with myopia doubles the odds that a kid will need glasses. Having two parents with myopia quintuples them. Over the years, she did indeed diagnose lots of nearsighted kids with nearsighted parents. These parents, she told me, would sigh in recognition: Oh no, not them too. But something was changing. A generation of children was suddenly seeing worse than their parents. Su remembers asking herself, as she saw more and more young patients with bad eyesight that seemed to have come out of nowhere: “If it’s only genetics, then why are these kids also getting myopic?”

What she noticed in her New York office a few years ago has in fact been happening around the world. In East and Southeast Asia, where this shift is most dramatic, the proportion of teenagers and young adults with myopia has jumped from roughly a quarter to more than 80 percent in just over half a century. In China, myopia is so prevalent that it has become a national-security concern: The military is worried about recruiting enough sharp-eyed pilots from among the country’s 1.4 billion people. Recent pandemic lockdowns seem to have made eyesight among Chinese children even worse.

For years, many experts dismissed the rising myopia rates in Asia as an aberration. They argued that Asians are genetically predisposed to myopia and nitpicked the methodology of studies conducted there. But eventually the scope of the problem and the speed of change became impossible to deny.

In the U.S., 42 percent of 12-to-54-year-olds were nearsighted in the early 2000s—the last time a national survey of myopia was conducted—up from a quarter in the 1970s. Though more recent large-scale surveys are not available, when I asked eye doctors around the U.S. if they were seeing more nearsighted kids, the answers were: “Absolutely.” “Yes.” “No question about it.”

In Europe as well, young adults are more likely to need glasses for distance vision than their parents or grandparents are now. Some of the lowest rates of myopia are in developing countries in Africa and South America. But where Asia was once seen as an outlier, it’s now considered a harbinger. If current trends continue, one study estimates, half of the world’s population will be myopic by 2050.

The consequences of this trend are more dire than a surge in bespectacled kids. Nearsighted eyes become prone to serious problems like glaucoma and retinal detachment in middle age, conditions that can in turn cause permanent blindness. The risks start small but rise exponentially with higher prescriptions. The younger myopia starts, the worse the outlook. In 2019, the American Academy of Ophthalmology convened a task force to recognize myopia as an urgent global-health problem. As Michael Repka, an ophthalmology professor at Johns Hopkins University and the AAO’s medical director for government affairs, told me, “You’re trying to head off an epidemic of blindness that’s decades down the road.”

The cause of this remarkable deterioration in our vision may seem obvious: You need only look around to see countless kids absorbed in phones and tablets and laptops. And you wouldn’t be the first to conclude that staring at something inches from your face is bad for distance vision. Four centuries ago, the German astronomer Johannes Kepler blamed his own poor eyesight, in part, on all the hours he spent studying. Historically, British doctors have found myopia to be much more common among Oxford students than among military recruits, and in “more rigorous” town schools than in rural ones. A late-19th-century ophthalmology handbook even suggested treating myopia with a change of air and avoidance of all work with the eyes—“a sea voyage if possible.”

By the early 20th century, experts were coalescing around the idea that myopia was caused by “near work,” which might include reading and writing—or, these days, watching TV and scrolling through Instagram. In China, officials have become so alarmed that they’ve proposed large-scale social changes to curb myopia in children. Written exams are now limited before third grade, and video games are restricted. One elementary school reportedly installed metal bars on its desks to prevent kids from leaning in too close to their schoolwork.

Spend too much time scrutinizing text or images right in front of you, the logic goes, and your eyes become nearsighted. “Long ago, humans were hunters and gatherers,” says Liandra Jung, an optometrist in the Bay Area. We relied on our sharp distance vision to track prey and find ripe fruit. Now our modern lives are close-up and indoors. “To get food, we forage by getting Uber Eats.”

This is a pleasingly intuitive explanation, but it has been surprisingly difficult to prove. “For every study that shows an effect of near work on myopia, there’s another study that doesn’t,” says Thomas Aller, an optometrist in San Bruno, California. Adding up the number of hours spent in front of a book or screen does not seem to explain the onset or progression of nearsightedness.

A number of theories have rushed to fill this confusing vacuum. Maybe the data in the studies are wrong—participants didn’t record their hours of near work accurately. Maybe the total duration of near work is less important than whether it’s interrupted by short breaks. Maybe it’s not near work itself that ruins eyes but the fact that it deprives kids of time outdoors. Scientists who argue for the importance of the outdoors are further subdivided into two camps: those who believe that bright sunlight promotes proper eye growth versus those who believe that wide-open spaces do.

Something about modern life is destroying our ability to see far away, but what?

Asking this question will plunge you into a thicket of scientific rivalries—which is what happened when I asked Christine Wildsoet, an optometry professor at UC Berkeley, about the biological plausibility of these myopia theories. Over the course of two hours, she paused repeatedly to note that the next part was contentious. “I’m not sure which controversy we’re up to,” she said at one point. (It was No. 4, and there were still three more to come.) But, she also noted, these theories are essentially two sides of the same coin: Anyone who does too much near work is also not spending much time outside. Whichever theory is true, you can draw the same practical conclusion about what’s best for kids’ vision: less time hunched over screens, more time on outdoor activities.

By now, scientists have moved past the faulty assumption that myopia is purely genetic. That idea took hold in the ’60s, when studies of twins showed that identical twins had more similar patterns of myopia than fraternal ones, and persisted in the academic world for decades. DNA does indeed play a role in myopia, but the tricky factor here is that identical twins don’t just share the same genes; they’re exposed to many of the same environmental stimuli, too.

Glasses, contacts, and laser surgery all help nearsighted people see better. But none of these fixes corrects the underlying anatomical problem of myopia. Whereas a healthy eye is shaped almost like an orb, a nearsighted one is more like an olive. To slow the progression of myopia, we would have to stop the elongation of the eyeball.

Which we already know how to do. Treatments to slow the progression of myopia—called “myopia control” or “myopia management”—exist. They’re just not widely known in America.

Over the past two decades, eye doctors—mostly in Asia—have discovered that special lenses and eye drops can slow the progression of nearsightedness in children. Maria Liu, a myopia researcher who grew up in Beijing, told me that she first became interested in nearsightedness as a teenager, when she began watching classmates at her school for gifted children get glasses one by one. In this intensely competitive academic environment, she remembers spending the hours of 6:30 a.m. to 10 p.m. on schoolwork, virtually all indoors. By the time she finished university, nearly all of her fellow students needed glasses, and she did too.

Years later, when she started an ophthalmology residency in China, she met many young patients who wore orthokeratology lenses—also known as OrthoK—a type of overnight contact lens that temporarily alters the way light enters the eye by reshaping the clear front layer of the eyeball, thus improving vision during the day. Liu noticed, anecdotally, that those who wore OrthoK seemed to have better vision down the line than those who wore glasses. Could long-term use of the lenses somehow prevent elongation of the eye, thus impeding myopia’s progression? It turns out that other scientists and doctors across Asia were noticing the same trend. In 2004, a randomized controlled study in Hong Kong of OrthoK confirmed Liu’s hunch.

By then, Liu had moved to the U.S., and she soon began a doctoral program in vision science at Berkeley to study myopia. Her classmates, she recalls, were tackling exotic-sounding topics such as gene therapy and retinal transplants and wondered why she was studying “something that’s so boring.” She ended up working in Wildsoet’s lab, researching the development of myopia in young chick eyes.

In humans, the majority of babies are born farsighted. Our eyes start slightly too short, and they grow in childhood to the right length, then stop. This process has been finely calibrated over millions of years of evolution. But when the environmental signals don’t match what the eye has evolved to expect—whether that’s due to too much near work, not enough outdoor time, some combination of the two, or another factor—the eye just keeps growing. This process is irreversible. “You can’t make a longer eyeball shorter,” Liu said. But you can interrupt growth by counteracting these faulty signals, which is what myopia control is designed to do.

When Liu became a professor at Berkeley after receiving her Ph.D., she started envisioning a myopia-control clinic—the first of its kind in the U.S.—that could bridge the gap between research and practice. By then, she knew that many doctors in China were already successfully using OrthoK for myopia control.

The school administration was skeptical. Liu says that the clinical director didn’t see how the clinic would benefit optometry students, or how it could attract enough patients to be worthwhile financially. But in 2013, Liu started it anyway, as a one-woman operation. She began seeing patients on Sundays in borrowed exam rooms with no extra pay and without relinquishing any of her teaching or clinical duties. Within months, her schedule was full. The Berkeley Myopia Control Clinic now runs four days a week and has 1,000 active patients—some of whom drive hours through Bay Area traffic to get there. Liu was one of the only people at the school who anticipated the clinic’s massive success. Jung, who is also an assistant clinical professor at Berkeley, told me that Liu’s knowledge of the latest myopia-control treatments made it feel like she came “from the future.”

When I arrived at the clinic at 8 a.m. on a Saturday morning this past spring—an hour at which the rest of the campus was still quiet—it was already filling up with optometry students and residents who work there as part of their training. Liu, who is petite with neat, wavy hair, moved through the clinic with frightful efficiency. One moment she was examining eyes, the next talking down a parent whose son’s contact-lens shipment had gone missing, the next warning staffers about a malfunctioning printer.

The clinic offers three different treatments: OrthoK, multifocal soft contact lenses, and atropine eye drops. The first two both work by tweaking how light enters the eye, producing a signal for the eyeball to stop lengthening. Atropine, in contrast, is a drug that seems to chemically alter the growth pathway of the eye when used at low doses. (It also dilates the pupil; Cleopatra reportedly used it to make her eyes more beautiful.) These treatments slow myopia progression on average by about 50 percent. The original clinical trials validating them were mostly conducted in Asia starting in the mid-2000s. And the American Optometric Association’s evidence-based committee published a report advising its members on how to use myopia control last year. Until quite recently, though, none of these treatments had been approved by the FDA for myopia control. Any optometrists who wanted to offer them had to go off label. And any patient who wanted to use them had to find the right doctor.

Yascha Mounk: The great American eye-exam scam

It’s not a coincidence that Liu’s clinic found early success in the Bay Area, which has a large Asian population. Eye doctors I spoke with in multiple cities across the U.S. said it was usually Asian parents who came in asking for myopia control. The parents I met at the clinic skewed Asian and, on that Saturday, particularly Chinese—first-generation immigrants who speak Mandarin seek Liu out on the days she is personally in the clinic. Many of them heard about myopia control from fellow immigrants or friends in Asia. George Tsai, whose 8-year-old son was at the clinic for an OrthoK appointment, told me that his wife, who grew up in China, had learned of myopia control through WeChat, the messaging app popular in the country and among the Chinese diaspora.

Liu has a second phone, which she uses to manage three WeChat groups full of parents with kids in myopia control across North America. The questions flood in day and night. “First thing in the morning, I look at this WeChat group. Who has lost a lens? Who has red eyes? Who has other problems?” she said. “And again, before I go to bed.” She started the first group with a parent of one of her patients. When it hit the maximum number of members allowed on WeChat, they created a second, and then a third. The groups now contain a total of 1,500 parents.

In general, Liu told me, Asian parents tend to be a lot more motivated because myopia “is much better perceived or accepted as a disease in Asian culture.” I know this firsthand, as the child of Chinese immigrants. Distressed about my worsening vision in elementary school, my mother would regularly admonish me, standing my pencil case upright to measure the distance between my head and my desk. She also made me do eye exercises developed in China, which I was vindicated to finally learn, in the course of reporting this story, do not work. This was the late ’90s, when there really was nothing to be done about myopia progression. But in the parents I met at the Berkeley clinic, I saw the same determination I once saw in my own. They had uprooted their lives and come to a foreign country and now here they were, hoping to bestow upon their kids any advantage, any edge that modern science could give.

There is another reason that the Bay Area, with its high median income, has been fertile ground for myopia control: The treatments are expensive. Many of the parents I met at the clinic were engineers or doctors. At Berkeley, OrthoK costs more than $450 for one pair of lenses, plus $1,600 for the initial fitting, not including the fees for several follow-up appointments a year. Soft contact lenses can run from several hundred to more than $1,000 a year. And a year’s supply of atropine eye drops costs hundreds of dollars. Kids are typically in myopia control until their mid-teens to early 20s. Vision insurance does not cover any of these treatments.

Multinational eye-care companies now see myopia control as a hot potential market. They’re vying for FDA approval of new lenses and improved formulations of atropine, which can be patented rather than sold as a cheaper generic. The business case is obvious: If half of the world is myopic by 2050, that’s a huge pool of would-be customers. “How often do you have an opportunity to have an impact on a condition that will affect one out of two people? There’s nothing else on the planet that I’m aware of,” says Joe Rappon, the former chief medical officer of SightGlass Vision, a small California company whose myopia-control technology was jointly acquired by the eye-care giants CooperVision and Essilor.

In November 2019, the FDA green-lighted the first—and currently only—treatment specifically designed to slow the progression of myopia in the U.S., a soft contact lens from CooperVision called MiSight. Many more treatments, though, are in trials in the U.S., including several types of spectacles that tweak the way light enters the eye in order to slow its growth. Some are already on the market in Europe and Canada.

Once those glasses get approved in the U.S., “that’s going to open the floodgates of myopia management,” Barry Eiden, an optometrist in Deerfield, Illinois, told me. The earlier you can start slowing myopia progression in kids, the better the outcome, he explained, but parents sometimes balk at the idea of putting drugs or contacts into the eyes of their young children. They don’t have the same problem with glasses.

In the future, Liu told me, she hopes FDA approvals will spur vision insurance to cover myopia control at least partially, making the treatments affordable to more parents. Meanwhile, CooperVision has already revved up its MiSight marketing machine. It’s targeting exactly the parents you would expect: In my own Brooklyn neighborhood of Park Slope, where you regularly see toddlers in $1,000-plus Uppababy strollers, an optometry shop recently hung a big banner advertising MiSight with two smiling kids. An optometrist in downtown San Francisco told me that parents who have seen MiSight’s ads are now coming into her office asking for it by name. The word-of-mouth era of myopia control is ending; the mass-advertising era is beginning.

Within the optometry business, myopia control often gets compared to braces—another treatment for which middle- and upper-class parents who want the best for their kids will dutifully shell out thousands of dollars. This comparison feels apt in a different way, too. Braces are also a modern solution to a relatively modern affliction. The teeth of cavemen, anthropologists have marveled, were incredibly straight. Crooked teeth appear in the archaeological record only when our ancestors transitioned from chewing raw meat and vegetables to eating cooked and processed grains. Our jaws are now smaller and weaker from disuse, our teeth more crowded and crooked. Today, braces are the way we retrofit our ill-adapted bodies for contemporary life.

We may not know exactly how ogling screens all day and spending so much time indoors are affecting us, or which is doing more damage, but we do know that myopia is a clear consequence of living at odds with our biology. The optometrists I spoke with all said they try to push better vision habits, such as limiting screen time and playing outside. But this only goes so far. Today, taking a phone away from a teenager may be no more practical than feeding a toddler a raw hunter-gatherer diet.

So this is where we’ve ended up, for those of us who can even afford it: adding chemicals and putting pieces of plastic in our eyes every day, in hopes of tricking them back to their natural state.

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This article appears in the October 2022 print edition with the headline “The Myopia Generation.”

Emilie Leyes, 27, works with actors in New York to build mental resilience and manage work stress. When she started scrolling through TikToks about attention deficit hyperactivity disorder (ADHD), it was because she wanted to learn more about people with ADHD—so that she could better help clients who had the condition.

Leyes quickly discovered, though, that she identified strongly with the people in these videos.

“​​I truly had no idea I had ADHD until I joined TikTok,” she says.

Leyes is one of many women to conclude that they have ADHD after spending time on the platform. The ADHD hashtag on TikTok has 14.5 billion views; #adhdawareness has more than 500 million, and the videos themselves can have hundreds of thousands—if not millions—of hits. Some clips list symptoms; others offer tips for coping with daily life with ADHD. A number aim to reduce the shame and stigma often attached to the condition. They could be comedy skits about getting distracted or struggling to clean the apartment, opening with phrases like, “People with ADHD will understand this video on a different level.” Others are explanatory videos about ways to stick to a routine or organize your space.

For many women who see these videos in their feed, it’s the first time they’ve learned about some of the symptoms of ADHD, beyond the most widely known: hyperactivity and trouble focusing. “As an overachieving child who got good grades, [ADHD] was never on my radar,” Leyes told TIME in an email. “I was shocked to discover through TiKTok that my experiences were consistent with ADHD.”

At the same time, experts in psychology say that it can be dangerous to rely on social media platforms such as TikTok for information on mental health conditions that require a professional’s diagnosis. And although many social media platforms share information on mental health, TikTok is a particularly effective place for health-based messages to spread—for better or worse. Because of how the algorithm works, it’s likely to show you content you didn’t even know you’d want to see—or, for that matter, tell you about a condition you didn’t know you might have.

Why women are turning to TikTok for advice on ADHD

Leyes isn’t alone in her shock to discover, well into adulthood, that she has ADHD. In a essay published in 2018 in the Brown University Child and Adolescent Behavior Letter, Anne Walters, clinical professor of psychiatry and human behavior at Brown, writes that studies estimate as many as half to three-quarters of all women with ADHD are not diagnosed, and many of the cases were overlooked in childhood because “ADHD in girls and women looks different than symptoms in boys or men.”

According to the Mayo Clinic, ADHD is “a mental health disorder that includes a combination of persistent problems, such as difficulty paying attention, hyperactivity and impulsive behavior.” Although ADHD is commonly thought of as a disorder of hyperactivity, the U.K.’s National Health Service says that girls are more likely to show inattentiveness in a quieter way, with less classroom disruption.

Some experts say the problem is made worse by the pressure on girls to “mask” their ADHD—that is, to conceal their symptoms. “Little girls for so long were just meant to be quiet and pretty and to not make a fuss,” says Lorraine Collins, a counselor and psychotherapist in London. “So many will edit themselves in order to feel accepted.”

A 2014 research review also found that ADHD is sometimes discounted in women because other, more commonly diagnosed disorders are diagnosed instead—like anxiety or depression. “‘Maybe it’s just anxiety’ is a very common copout,” explains Dr. Inna Kanevsky, a psychology professor at San Diego Mesa College. The waters can be muddied, she says, because untreated ADHD can sometimes cause anxiety, but ADHD could co-exist. Nonetheless, many women walk away with only one diagnosis.

That’s if they access medical care at all.

“The waiting list is so long, you think ‘Well, it can’t be that serious, it’s not being prioritized. I’ll just get on with it,’” Collins says. “But your life starts becoming unmanageable, because you’re getting more and more distressed.” In the U.K., Reddit forums are flooded with people complaining about waiting for years for a diagnosis, unless they pay for private healthcare.

Similarly in the U.S., “It’s really expensive to find out if you have ADHD,” Kanevsky says. “If you can’t get insurance then you have to go private, and if you go private it’s thousands of dollars. Not everybody has the resources.”

Because of racism and discrimination, Black women may face extra barriers in getting an official diagnosis. For one thing, most research on the disorder has focused on white men, researchers concluded in a 2009 report published in the journal Women & Health. Another issue is how Black women are treated when they step into the doctor’s office.

A 2019 study published in Health Services Research analyzed the reasons for unmet need for mental health care among Black people in America, and reported that “discrimination based on mental illness and on race was even more exacerbated among Black women.” The study goes on to say that, for both men and women, those negative experiences with mental health care affected whether or not they continued to seek treatment.

Many Black women report not being believed or heard when they go down the official route. Stereotypes can contribute to this. “For Black women who are seen as ‘the strong Black woman,’ things get missed,” Collins says, such as emotional pain and struggle. “There’s the perception that ‘the strong Black woman’ can just get on with it.”

By contrast, women watching TikToks about ADHD symptoms may feel welcomed into an online community of like-minded people who not only behave like them, but believe them.

The problem of misleading information

Still, it’s important that TikTok users understand where their information is coming from and that not all health information they encounter is reliable. Professionals do use the platform to educate people about the condition, but unqualified people with limited knowledge do, too. The sheer volume of ADHD videos means that some myths about the condition inevitably abound.

Anthony Yeung, at the University of British Columbia, is the co-author of a study published in the Canadian Journal of Psychiatry in 2022 which found that approximately half of the ADHD TikToks it analyzed were misleading. “We noticed videos which said, ‘If you don’t like doing homework, you have ADHD’; ‘If you zone out during meetings, you probably have ADHD,” he says. “These are extremely common things, especially now that the pandemic has shifted the way we work.”

Yeung says these videos often include Barnum statements (named after the showman P. T. Barnum), which are assertions vague enough that almost everyone feels that it applies to them. Yeung explains: “But if everyone has a mental health disorder or a psychiatric condition, that means no one does. So we do need mental health providers and clinicians to make that distinction.”

Information from TikTok can be difficult to verify, says Lola Garant, who runs an ADHD-focused coaching business and an account on TikTok under the username @theweirdocoach. “This is always the danger that comes with a social media platform,” Garant tells TIME in an email. “You can’t validate where the information comes from and the main driving force behind the platform is fame. People want to get more views or followers and are sometimes willing to say things that aren’t 100% true to gain those things.”

The role of the algorithm

TikTok’s highly engaging algorithm and ‘For You’ page is key to all of this.

When Yeung started studying ADHD videos, he noticed something interesting: “The TikTok algorithm started to recommend more and more [ADHD] videos. I thought: ‘Wow. I’m now starting to see how this can create a very personalized algorithm.’” The TikTok algorithm is eerily good at predicting what people might like to watch. After detecting user interest in a certain topic, it will keep recommending similar videos. So if you’ve shown an interest in TikToks about ADHD, you’re probably going to see a lot more of them. According to Yeung’s findings, this means that you’ll probably be exposed to more misleading claims about the condition.

TikTok also predicts what you will enjoy by looking at the preferences of people who are similar to you, explains Sarah Cen, a researcher at the department of electrical engineering and computer science at MIT. This process is known as collaborative filtering. “For instance, if two people click on a bunch of similar videos, the algorithm infers that they have similar tastes,” Cen says.

Misinformation about ADHD could therefore potentially enter your feed simply because of your shared interests with other users. It’s easy to see how users get sucked down a rabbit hole.

As Cen says, key to this is that “regulation of social media, especially in the U.S., is lax right now… it’s got to the point where there’s way too much information and we can’t sort through it properly. We don’t have any way to tell who’s credible and who’s not. Who can we trust?”

A TikTok spokesperson told TIME: “We’re proud that TikTok has become a place where people can share their personal experiences with mental health and support one another, and we take our responsibility to keep our platform a safe space for these important conversations seriously. That’s why we continue to invest in digital literacy education aimed at helping people evaluate and understand content they engage with online. We encourage anyone seeking mental health advice, support or diagnosis to reach out to a qualified professional.”

Collins says, when it comes to finding trustworthy information, “It’s about being discerning about where you go [on the platform]. Make sure whoever’s speaking is registered and accredited, and they back everything up with research and data. Then, follow it up. Go to official websites where you can get some solid advice.”

Reducing stigma, understanding a diagnosis

As with every social platform, TikTok offers positives and negatives. One positive is that people are using the platform to open up about ADHD. “There have been lots of attempts [on TikTok] to reduce the stigma about mental health conditions. As a psychiatrist, I think that’s great,” Yeung says.

The platform also provides much-needed community and support for people who aren’t finding it elsewhere. “When they see other people talking about their experiences—and all their quirks that made them feel like they were weird can be explained with 4 letters—it can be a relief,” Garant says.

It can also provide guidance on how to manage symptoms. Leyes says that after watching TikToks about ADHD, “I began to understand why my brain works the way it does.”

She also adds that it helped her secure an official diagnosis: “If it hadn’t been for the resources I gained from social media, I wouldn’t have known what to ask for, how to describe my experience, and how to navigate the diagnosis once it became official.”

Collins agrees that social media tips can be useful. “For finding ways to self-regulate your emotions and to manage your time, it can be brilliant,” she says. But, she says, TikTok is not a replacement for proper healthcare. “Yes, you want to understand yourself and get to the bottom of how you’re feeling—that’s good, that’s part of self-care—but also know that you need the guidance of a health care professional.”

Contact us at [email protected].

The Census Bureau released some heartening news Tuesday.

Child poverty is at a historic low, according to the bureau’s annual report on income, poverty and health insurance. And the rate of Americans without health insurance also dropped in 2021 compared to the previous year.

But the good news may be short lived. Both gains were driven by temporary pandemic-related policies, and without action by policymakers, they could quickly unravel.

Child tax credit key to drop in poverty

Childhood poverty dropped substantially in 2021, falling from 9.7% in 2020 down to 5.2%. The overall poverty rate for all age groups was just under 8% — a decline from 9.2% in 2020.

These figures are based on the Supplemental Poverty Measure, which takes into account all kinds of expenses families have, as well as that range of pandemic aid many families received.

Poverty experts attribute much of this improvement to the child tax credit which Congress boosted in 2021 in the American Rescue Plan. Congress also expanded it to include millions more low-income families.

The child tax credit gives families more money to spend on essentials, says Sharon Parrott, who has researched the issue for the Center on Budget and Policy Priorities.

“They spend it on their housing, food, education, they’re able to do some of those extracurricular activities that high income families take for granted,” she says. “They are investing in their kids and their families are able to make ends meet in really important ways.”

And Parrott says all these things can have long term benefits for kids, like doing better in school and being healthier.

Uninsured rate approaches record lows, thanks to Medicaid

The census numbers show 8.3% of Americans – or 27.2 million people – did not have any health insurance in 2021. That’s an improvement from 2020, when 8.6% of people were uninsured.

The force behind this trend is Medicaid, the public health insurance option for people with low incomes, according to census officials who briefed reporters Tuesday.

“The reason the Medicaid rates have increased is because of a COVID relief bill that Congress passed in March of 2020,” says Sabrina Corlette of the Georgetown University Center on Health Insurance Reforms.

The Families First Coronavirus Response Act essentially mandated that state Medicaid programs not force enrollees to requalify for the program – so states could enroll new people but not kick anyone off. Because of this “continuous enrollment provision,” Medicaid has grown significantly.

Another area of growth was Medicare, though census officials noted that that’s due to more people turning 65 and becoming eligible, not because of a policy change.

What happens when pandemic measures end

Policy experts say this week’s good news may be fleeting. The expanded child tax credit ended in December, just as inflation was starting to climb to historic highs. The policy supporting more people getting health insurance is set to run out in a few months.

“As soon as the public health emergency is declared over – which could be as early as January – that safety net that was in that COVID relief bill goes away,” says Corlette. “And so we could see this historic increase in the rates of the insured be reversed.”

More than 15 million people could lose Medicaid, according to an estimate from the Department of Health and Human Services released last month. The analysis suggests nearly half of those losing coverage will be because of administrative issues – such as challenges with filling out the paperwork to reapply – and not because they no longer qualify for coverage. Some will be able to get coverage elsewhere, but millions more may become uninsured.

When it comes to poverty, inflation could start to affect these rates. In fact, one group already is seeing more poverty in the 2021 numbers and that is seniors. Census officials say this is likely because they’re on fixed incomes, and already last year inflation was starting to tick up, really squeezing their budgets.

But again, Census officials stressed that Social Security did keep more than 26 million people out of poverty, and that includes several million children being raised by grandparents.

How to hold on to temporary gains

In terms of U.S. trends over time, the Census numbers released Tuesday on child poverty and health insurance are encouraging, experts say, and it’s now up to policymakers to act to keep these gains.

“Any of the improvements that we see – whether it’s insurance or poverty – are a reflection of political choices,” says Jamila Michener – a professor of government at Cornell and an expert on Medicaid.

The Biden administration and many Democrats would like to make the expanded child tax credit permanent. The U.S. House passed such a measure but it did not survive in the Senate. Several Republican Senators have proposed more limited ways to expand the child tax credit.

“What we don’t know is the trade-offs,” says Angela Rachidi, a senior fellow at the American Enterprise Institute. “We know inflation increased dramatically over the past year. To what extent did all this government transfer of income contribute to that, I think, is still a question.”

Some researchers note that the U.S. has a long way to go with gains in health and insurance rates, when compared to similar high-income countries.

“[Among] our peer countries, we have one of the highest rates of uninsurance in the world and also poorer health outcomes,” notes Corlette. “And that’s been an issue for us even before the pandemic.”

A landmark study in 2013 enumerated the many ways Americans don’t have as healthy or long lives as people do in similarly wealthy countries.

One striking illustration of this came with the new life expectancy numbers released two weeks ago. Countries all over the world had a drop in life expectancy after the first year of the pandemic, but many have been able to rebound.

America has not – instead life expectancy dropped for two years in a row, the first time that’s happened in the U.S. in a century.

By Robin Foster HealthDay Reporter
HealthDay Reporter

TUESDAY, Sept. 13, 2022 (HealthDay News) — President Joe Biden made a renewed push for his cancer moonshot initiative on Monday.

Speaking at the famed John F. Kennedy Presidential Library and Museum in Boston, Biden likened JFK’s space race to his own effort to slash cancer rates by 50% in the next 25 years.

“He established a national purpose that could rally the American people and a common cause,” Biden said of Kennedy’s space effort.

“And I believe we can usher in the same unwillingness to postpone, the same national purpose, that will serve to organize and measure the best of our energies and skills to end cancer as we know it and even cure cancers once and for all,” he added.

In his speech, Biden said the U.S. National Cancer Institute (NCI) has launched a study that will look at using blood tests to screen against multiple cancers.

Danielle Carnival, the White House coordinator for the cancer effort, told the Associated Press that the Biden administration sees huge potential in such blood tests.

“One of the most promising technologies has been the development of blood tests that offer the promise of detecting multiple cancers in a single blood test and really imagining the impact that could have on our ability to detect cancer early and in a more equitable way,” Carnival said.

Carnival said the National Cancer Institute study was designed so that any promising findings could be quickly put into clinical practice while the longer study — expected to last up to a decade — continues. She said the goal is to detect cancers through routine bloodwork instead of invasive tests and biopsies.

The issue is personal for Biden, who lost his son Beau in 2015 to brain cancer. After Beau’s death, Congress passed the 21st Century Cures Act, which dedicated $1.8 billion over seven years for cancer research and was signed into law in 2016 by President Barack Obama.

Despite that, the cancer initiative lacks the same level of funding that the space program had. More than $20 billion, equal to more than $220 billion in 2022 dollars, was poured into the Apollo space program, the AP reported.

While touting the cancer initiative on Monday, Biden announced that Dr. Renee Wegrzyn would become the inaugural director of the Advanced Research Projects Agency for Health (ARPA-H), which has been tasked with studying potential treatments and cures for cancers, Alzheimer’s, diabetes and other diseases. Biden also announced a new NCI program that will fund young scientists studying treatments and cures for cancer, with a focus on underrepresented groups.

Even without new breakthroughs, progress can be made by making cancer care more equitable, Dr. Crystal Denlinger, chief scientific officer for the National Comprehensive Cancer Network, told the AP.

But any effort to cut the cancer death rate will need to focus on the biggest cancer killer, which is lung cancer, the AP reported. Mostly attributable to smoking, lung cancer now causes more cancer deaths than any other cancer.

Lung cancer screening is helping. The American Cancer Society says such screening helped drive down the cancer death rate 32% from its peak between 1991 and 2019, the AP reported.

More information

Visit the U.S. National Cancer Institute for more on the cancer moonshot program.

SOURCE: White House, news release, Sept. 12, 2022; Associated Press