George Soros: Trump is an imposter

George Soros

“An imposter, a [political] conman and a would-be dictator,” is the verdict of billionaire investor George Soros on Donald Trump.

Speaking to a packed audience at his annual dinner at the World Economic Forum in Davos, Mr Soros said he was confident Mr Trump’s powers would be limited by Congress.

“He won’t be able to get away [with being a dictator],” he added.

Ultimately, Mr Soros said he expected Mr Trump to fail.

“The ideas that guide him are fundamentally contradictory. He has three chiefs of staff instead of one and his cabinet are very fragmented and fighting with each other,” he said.

Hedge fund boss Dalio: Trump will boost growth

Trump ‘would win’ trade war with China

Trump has ‘enormous respect’ for Merkel

Davos coverage in full

Mr Soros has been unrelentingly critical of Mr Trump since his shock election victory, and the pair have a history of friction.

During the 2016 campaign, Mr Soros donated around $10m to Trump rival Hillary Clinton.

Donald TrumpImage copyrightGETTY IMAGES
Image captionMr Trump will be inaugurated as president on Friday

The hedge fund manager, who initially became famous for having made $1bn by betting on the devaluation of the pound in 1992, is reported to have lost close to $1bn after the stock market rallied following Mr Trump’s win.

Mr Soros attributed the rise in the markets to Mr Trump’s pledge to cut regulation and taxes, but said when Mr Trump takes office – in under 24 hours – “reality will prevail”.

He also said that it’s impossible to predict exactly how Mr Trump will act because he hadn’t expected to win, and had only started thinking seriously about what he would do after he was elected.

He also warned that Mr Trump would also divide the US further.

“Anyone who disagrees with him is not part of the people,” he says.

Asked what advice, he would give to businesses preparing for the impact of the new presidency, he said, “I’d keep as far away from it as I can.”

Mr Trump’s team was approached for comment by the BBC.


Larsen ice crack continues to open up

Larsen C graphic

The crack that looks set to spawn a giant iceberg in the Antarctic has continued to spread.

The rift in the Larsen C Ice Shelf has grown a further 10km since 1 January.

If the fissure propagates just 20km more, it will free a tabular berg one-quarter the size of Wales.

That would make it one of the biggest icebergs ever recorded, according to researchers at Swansea and Aberystwyth universities, and the British Antarctic Survey.

News of the lengthening crack in the 350m-thick floating ice shelf on the eastern side of the Antarctic Peninsula comes from the EU’s Sentinel-1 satellite system.

Comprising two spacecraft, this orbiting capability can continuously monitor Larsen C no matter what the weather is doing because its radar sensors see through cloud.

Their data indicates the fissure now extends for some 175km. But just how long it will take before the 5,000 sq km block finally breaks free is anyone’s guess, says Swansea’s Prof Adrian Luckman.

“The rift tip has just entered a new area of softer ice, which will slow its progress,” he told BBC News.

“Although you might expect any extension to hasten the point of calving, it actually remains impossible to predict when it will break because the fracture process is so complex.

“My feeling is that this new development suggests something will happen within weeks to months, but there is an outside chance that further growth will be slow for longer than that.

“Sometimes rift growth is triggered by ocean swell originating elsewhere, which is also hard to predict.”

ice shelf riftImage copyrightNASA
Image captionImages taken in November last year illustrate the scale of the rift

When the berg splits away, interest will centre on how the breakage will affect the remaining shelf structure.

The Larsen B Ice Shelf further to the north famously shattered following a similar large calving event in 2002.

The issue is important because floating ice shelves ordinarily act as a buttress to the glaciers flowing off the land behind them.

In the case of Larsen B, those glaciers subsequently sped up in the absence of the shelf. And it is the land ice – not the floating ice in a shelf – that adds to sea level rise.

If Larsen C were to go the same way it would continue a trend across the Antarctic Peninsula.

In recent decades, a dozen major ice shelves have disintegrated, significantly retreated or lost substantial volume – including Prince Gustav Channel, Larsen Inlet, Larsen A, Larsen B, Wordie, Muller, Jones Channel, and Wilkins.

Larsen C imaged byImage copyrightESA/EU/COPERNICUS
Image captionHow the rift appeared to Sentinel-1 at the beginning of the month

Another development to watch will be the behaviour of the free floating berg, and its progress away from the Antarctic.

“Sea ice in the region circulates clockwise with the Weddell Gyre, rather than remaining in one place, and icebergs can be carried with this, sometimes out into the Southern Ocean,” explained Prof Luckman.

“It all rather depends on how soon the iceberg breaks up, and how the iceberg draft compares with ocean depths.

“Ocean depths are not perfectly known in the region precisely because the near continuous ice cover makes ship operations difficult.”

Many of the big tabular bergs produced in this region of the Antarctic get swept up in currents that eventually take them north towards the British overseas territory of South Georgia.

There, they can be caught in shallow waters to gradually wither away.

This ocean conveyor is the same one exploited by Ernest Shackleton to get his crew to safety when their ship, the Endurance, was crushed in thick sea-ice in the Weddell Sea in 1916.

South GeorgiaImage copyrightTHINKSTOCK
Image captionThe remnants of many such bergs end up at South Georgia
A-38Image copyrightNASA
Image captionThe mighty A-38 berg reached South Georgia after six years of drifting


Quiz of the week’s news

Question ImageIt’s the weekly news quiz – have you been paying attention to what’s been going on in the world over the past seven days?

Who did Vladimir Putin say were the best in the world, in a curious boast about his country this week?


Medical doctor run startup that fights lifestyle diseases – NutriHealth


Dr. Shikha’s NutriHealth is a platform offering comprehensive health and diet management programs. She is a medical doctor by training, from Kashmir and it was while working as a Junior Doctor in Cardiology that she realized that most of the patients in the ICU had no idea about the root cause of their heart problem. The patients were also likely to relapse into unhealthy eating after treatment. This prompted her to set up Dr Shikha’s NutriHealth in 2012. The company raised series A funding of Rs 12 crore from Singapore-based OneHealth Ventures Pvt Ltd in 2016.

Since its inception, NutriHealth has been actively working in the field of weight management and the prevention and treatment of lifestyle-related disorders. It brings together Modern Medicine techniques and Ayurvedic principles of different food types for different body constitution. This helps them in preparing personalized diet programs. The services at NutriHealth are delivered through Voice, Video, and App.

Dr. Shikha’s NutriHealth has a tele-nutrition centre with over 175 people including doctors, nutritionists, and technologists. The team believes in women empowerment and this is evident from the fact their service team of nutritionists and doctors comprises all women.

DrShikha’s NutriHealth has serviced a customer base of over 50,000 till date and manages

2, 00,000+ calls every month. The organization has an active base of over 3500 clients at any given point in time who subscribe to their 3, 6, or 12-month services. The mobile app, called YuWow, has an active customer usage of about 85% and the organization gets over 40% new clients through the existing satisfied clients!

Through the App client is assigned a personal doctor and nutritionist. Once proper counseling by the nutritionist is done, the client is given a customized diet plan based on their lifestyle and health conditions.


Dr Shikha started with preventive healthcare consultations. When these did not work out, she re-packaged them as weight loss consultations and that worked! She also worked on integrating Vedic nutrition and Modern Nutrition.

The Eureka moment for her came much later, when she transformed the Clinical brick-and-mortar model into the tele-nutrition centre model, where everything came together more successfully, right from digital marketing to client servicing in a centralized fashion.


Dr. Shikha Sharma – She is 47 years (Medical Doctor from MAMC, New Delhi), and is the Managing Director and Founder of DrShikha’s NutriHealth.


Dr. Shikha Sharma, Founder, Dr Shikha’s Nutri Health

Other members include:

COO – Mr Sanjay Sehgal

AGM- Sales : Parampreet Arora

Service : Dr Vinita Sharma (BAMS), Dr Reena Rawat(BAMS),

Marketing : Aashima Saini(MBA, IIM-I),

B2B : Rohit Kumar(MBA, IIM-K),

Finance: GautamBehl (CA, B.Com),

HR : Richa Singh (MBA-HR),

IT : Sunil Vaishnav (B.Tech, IIT-Delhi), Jai Ram Singh (B.Tech, IIT-Guhawati)


NutriHealth has grown in revenue from 12 lakh annually to 10 crore (trending).


One key Difference that the Founder feels is that there is integration of Vedic Nutrition with modern Science to create the concept of Nutri-genetics.

Following the concept of Nutri-genetics, NutriHealth analyses the blood test reports and Prakriti, the body type of any individual before designing and prescribing diets. Nutri-genetics is based on the observation that each person is different genetically and that the effect of food on each person varies according to his or her genetic structure. The ‘joy of healthy living’ and ‘Living Light’ inspired the formation of NutriHealth. Life is best experienced when one is healthy. Nutrition management is the most sustainable way to stay healthy in the long run. NutriHealth’s vision is to help each person actualize his or her highest potential for well-being, effectively and with sensitiveness, by providing personalised nutrition advice.


1- B2C Direct sales to people looking at correcting lifestyle disorders, by providing a coaching and counselling program @ their Convenience

2- SHS with Personal Coaching

3- Products for healthier Lifestyle

4- Backend partners for the Hospitals and Polyclinics looking to outsource their Nutrition services and optimising their costs.


NutriHealth has received a funding of US $2 million from Synergy Capital, Singapore.


NutriHealth offers nutrition advisory for the management of weight, diabetes, cholesterol, PCOS, post-pregnancy, etc. Every registered client is assigned a personal doctor and nutritionist who after doing the complete profiling of the client (Prakriti, lifestyle, and health conditions), creates a customized diet plan. Throughout the programme, the nutritionist not only plans the diet but also focuses on the compliance monitoring by way of calling the client two to three times per week. The team believes that compliance monitoring is the key to achieve results.

[Source:-Indian Ceo]

District judge conned wealthy clients to live luxurious lifestyle … lying to his accountant who killed himself after realising he’d been party to the crime

Simon Kenny

Adistrict judge conned wealthy clients to live a luxurious lifestyle and lied to his accountant who then killed himself when he realised he had been party to the crime.

Simon Kenny, 61, and his former lover and assistant Emma Coates, 47, ransacked customers’ funds at CK Solicitors in Selsey, West Sussex, for four years stealing more than £1million.

When their accountant, yacht club member Robert Foskett, discovered he had been duped he took his own life.

Coates used the money to pay off four mortgages, spent £15,000 on a log cabin and a hot tub and bought a Range Rover.

Emma Coates
Solicitor Emma Coates spent over £400,000 of clients’ money on luxury holidays. CREDIT:CENTRAL NEWS/CENTRAL NEWS

She also took 12 friends on one of many lavish trips to Barbados with the stolen cash.

Police later discovered she had been making mortgage payments on four properties – two in Selsey, and two others in Chichester and Bognor Regis.

Kenny, who has business interests in the Far East, told staff he had moved cash to offshore accounts because of the Northern Rock bank crisis.

He had been planning to move abroad prior to going on trial at Southwark Crown Court.

Kenny and Coates had been lovers, but their affair cooled in 2010 and they later tried to blame each other for the fraud.

Simon Kenny
Former judge Simon Kenny faces jail after being convicted of stealing over £1m of clients’ funds. CREDIT: CENTRAL NEWS/CENTRAL NEWS

Southwark Crown Court heard the company’s reporting accountant Mr Foskett committed suicide after he “realised he had been lied to” about the plot.

Prosecutor Richard Milne said: “Mr Foskett’s dawning realisation in February 2011 that he had been duped back in 2009 appears to have been a major factor leading, tragically, to his suicide on 6 March 2011 – just two days before the commencement of the first of the relevant Solicitors Regulation Authority (SRA) investigations.”

Jurors saw his suicide note, which read: “I am so sorry but the pressure mounts on me. I was lured into signing an audit certificate by Simon Kenny which I should not have.

“He assured me funds would be [available] the following week from his family trust but that became untrue.”

Kenny was suspended from his role as a deputy district judge at a county court in Sussex and CK solicitors was shut down by the SRA.

Stephen Hiseman, 60, a ‘fee earner’ from CK Solicitors, also swindled two clients.

The court heard he ‘fraudulently caused the transfer of £60,000 from CK Solicitors client account to an account of Chris Coxill and then to an account in his name’ between November 2010 and March 2011.

Hiseman also told client Samuel Swanton he had settled his debts with Lombard North Central for £15,000 between June 2010 and December 2011 – but he had actually only settled for £10,000, forcing Mr Swanton to sell his house to raise funds.

Emma Coates
Solicitor Emma Coates has been convicted of stealing clients’ funds. CREDIT: CENTRAL NEWS/CENTRAL NEWS

The Solicitors’ Regulatory Authority shut down CK Solicitors in May 2011, but within months Coates had set up another firm, Coates and Co, and stole £85,000 from an elderly client’s will when she died in 2011.

Mr Milne told jurors: “Over a period of several years client monies were misappropriated by Simon Kenny, Emma Coates and Stephen Hiseman.

“In the case of Mr Kenny and Miss Coates, the misappropriation mainly took the form of diverting client money from the company’s client account to the office account and then expending that money not in relation to the client matter in question, but for their own use or for the use of the firm.”

A jury convicted Kenny, of  Catsfield, near Battle, East Sussex, of two counts of fraud totalling £1million and Coates, of Selsey, West Sussex, of two counts of fraud totalling more than £415,000.

The pair were remanded in custody ahead of their sentencing on 27 January.

Hiseman, of Morzine, France, was released on conditional bail after he was convicted of two counts of fraud.


Sedentary lifestyle and women: Do some exercise daily, else you’ll age faster

Highlight Story

Elderly women who sit for more than 10 hours a day with low physical activity have cells that are biologically older by eight years than those who are less sedentary, a new study has warned.

Researchers at University of California San Diego School of Medicine in the US found elderly women with less than 40 minutes of moderate-to-vigorous physical activity per day have shorter telomeres — tiny caps found on the ends of DNA strands that protect chromosomes from deterioration and progressively shorten with age.

As a cell ages, its telomeres naturally shorten and fray, but health and lifestyle factors, such as obesity and smoking, may accelerate that process. Shortened telomeres are linked to cardiovascular disease, diabetes and major cancers.

“Our study found cells age faster with a sedentary lifestyle. Chronological age does not always match biological age,” said lead author Aladdin Shadyab from UC San Diego.

Researchers believe they are the first to objectively measure how the combination of sedentary time and exercise can impact the ageing biomarker.

Nearly 1,500 women, aged 64-95, participated in the study.

The participants completed questionnaires and wore an accelerometer on their right hip for seven consecutive days during waking and sleeping hours to track their movements.

“We found that women who sat longer did not have shorter telomere length if they exercised for at least 30 minutes a day, the national recommended guideline,” said Shadyab.

“Discussions about the benefits of exercise should start when we are young and physical activity should continue to be part of our daily lives as we get older, even at 80 years old,” he said.

The study was publishing in the American Journal of Epidemiology.


Donald Trump Just Derailed California’s Boldest Health Care Plan

Donald Trump speaks during a campaign rally on Sept. 14, 2015 in Dallas, Texas.

A California lawmaker is calling the state’s recent decision to nix a proposal that would provide health insurance to undocumented immigrants under Obamacare “the first California casualty of the Trump presidency,” the Sacramento Bee reports.

The Golden State has been pursuing a controversial federal government waiver that would open up health coverage to as many as 390,000 undocumented adults in California. Democratic Governor Jerry Brown signed a bill to that effect last summer.

Click here to subscribe to Brainstorm Health Daily, our brand new newsletter about health innovations.

But final approval for the proposal, which would allow undocumented people to buy individual health plans through the state’s Obamacare marketplace, Covered California, relied on clearance from the Obama administration since such immigrants are specifically barred from receiving coverage under the law. (California’s proposal also would not have provided federal tax subsidies to help these residents buy insurance, meaning money for premiums and deductibles would have come entirely out of the immigrants’ own pockets.)

Bill sponsor state Sen. Ricardo Lara said that he and Brown agreed to withdraw the waiver request given Trump’s antipathy towards undocumented immigrants and Obamacare at large, and fears that these residents’ privacy would be in danger.

California has the country’s largest undocumented population at 2.4 million. While providing health care to people in the country illegally ruffles political feathers, some public health advocates argue it’s far more effective to give these immigrants some form of coverage rather than have them rely solely on expensive emergency rooms, which legally cannot turn them away, during a medical emergency. The state already allows undocumented children receive coverage under its Medicaid program.

Lara ultimately sounded a defiant note despite the setback. “California is committed to a healthier future for all, and we will continue to seek ways to expand health coverage even as Republicans in Washington move to take it away,” he said in a statement.


Athlete-Turned-Trucker Works To Improve Truckers’ Health

On a chilly winter morning, dozens of truck driver trainees file into a classroom at the headquarters of Prime Inc., a trucking company based in Springfield, Mo.

At the front is Siphiwe Baleka, an energetic former swimming champion in his mid-40s. He delivers grim news about trucker health to the new recruits.

“If you haven’t started to think about this, you need to start right now,” Baleka says. “You are about to enter the most unhealthy occupation in America.”

That’s not an official designation, but truckers do have more health problems, compared to U.S. averages. Around 70 percent of truck drivers are obese and at high risk for conditions like heart disease and diabetes, and many in the trucking business worry that the poor health of drivers is threatening the industry.

Baleka tells the new drivers he’s here to help.

He’s the company’s coach for drivers’ health and fitness, tasked with improving the health of the 7,000 drivers for Prime; they spend around 11 hours a day behind the wheel.

It’s a struggle he knows personally. Baleka was once an Olympic hopeful, and he earned a degree in philosophy at Yale.

About 20 percent of drivers who leave the trucking profession each year do so for health reasons, Baleka warns new recruits at Prime, a trucking firm based in Springfield, Mo. In addition to teaching volunteer wellness classes, Baleka takes questions from Prime drivers by phone on how to stay fit on long-haul trips.

Alex Smith

But about six years ago, after his professional athletic aspirations faded, he took a job as a trucker. He found his life reduced to the inside of a cab and the truck stops — where he’d rest, refuel and take comfort in convenience foods.

“Life on the road is tough. It’s lonely,” Baleka says. “There’s not a whole lot to make you feel good. So eating is one of the things you kind of have some freedom with, to make you feel good.”

Baleka discovered just how quickly trucking can take its toll. During his first two months of driving, the trim swimmer gained 15 pounds. He tried every diet and exercise routine he could find — even doing workout DVDs inside his cab at truck stops before sunrise.

Eventually he turned his health around with a regimen that combined a low-carb, high-protein diet with short bursts of high-intensity exercise.

Then he approached company management with an idea. The trucks, the trailers and their cargo are all carefully monitored while on the road. Why not do the same thing for the drivers, using devices like heart rate and body composition monitors?

“At that time, the only thing that we didn’t have any real-time information on was the driver — the physiological state of the driver,” Baleka says. “These digital health devices now allowed me to do that. I can monitor the physical condition of the driver just like we do with a truck.”

This is good for health, and potentially something the industry needs. There’s been a shortage of drivers and, in part, that has to do with health.

A recent transportation industry report shows 21 percent of drivers who left the field in recent years did so for health reasons.

With his voluntary wellness programs, Baleka encourages his drivers to do short bursts of exercise to boost metabolism, cut carbs and eat lots of protein every few hours. He remotely coaches around 3,000 drivers as they crisscross the country.

In one of his coaching calls, Baleka listens over the speakerphone to a husband-and-wife driving team, who tell him their exercise routine was derailed by bad weather in Oregon. They ask his advice on how to adapt their regimen when they can’t leave the truck. He suggests running in place or shadowboxing, and encourages them to do something, even if they’re stuck inside.

Baleka is treated almost like a celebrity by drivers passing through Prime’s headquarters, including Rick Menolascina, a driver from Oregon in his late 50s.

Menolascina says that Baleka helped him lose weight and bring down his blood pressure just by helping make him more aware of his diet and exercise habits — without requiring Menolascina to completely swear off favorite comfort foods.

“When I eat something, I know what I’m eating,” Menolascina says. “If I’m going to eat that macaroni and cheese, I know exactly what I’m putting in my body. And sometimes I’ll pick that macaroni and cheese over a salad or some low-sodium soup, or something like that. I’m making that choice because I’m human.”

The relatively small lifestyle changes that Baleka promotes could be enough to make a life-changing difference in the health of many truck drivers, says Dr. Clayton Cowl, chief of preventive, occupational and aerospace medicine at the Mayo Clinic in Rochester, Minn.

“The drivers themselves — they don’t need to be running marathons, necessarily,” Cowl says. “It’s finding those times when there is some downtime, where they are able to find several days per week to do activities that they enjoy and find ways to reduce stress.”

Cowl studies commercial driver health and sees drivers in his clinical practice. While he’s supports the kind of wellness program Baleka manages, it would be improved by addressing driver’s mental health.

The isolation and lack of control of one’s life that are endemic to trucking can contribute to anxiety and depression.

“I think having the employer understand those stressors, recognizing it for what it is and trying to accommodate some of the needs of the drivers certainly goes a long way to quelling some of those stresses out there,” Cowl says.

Baleka’s program is encouraging, says Scott Grenerth, the regulatory affairs director of the Owner-Operator Independent Drivers Association. But improving trucker health is pushing against the tide, he says, in an industry that’s been demanding more and providing less to drivers in the past few decades.

Baleka says nearly half of all trucking companies operating in the U.S. don’t have any wellness programs, and many of those that do are focused on driving safety.


If Obamacare Dies, Cities Will Feel It

Every year, about 300 children under age 6 turn up with elevated blood-lead levels among the thousands of lab tests surveilled by Houston’s Childhood Lead Poisoning Prevention program. In the vast majority of cases, their staff follows up.

Health officers reach out to parents to ensure that their kids are receiving care. Lead inspectors visit the aging homes in which those kids often live, and remediation crews scrape and replace the toxic paint from window frames and siding. Educators knit themselves into communities, educating schools, churches, PTA groups, and organizations devoted to incoming refugees.

To pay for many of these tasks, the city of Houston relies on about $300,000 in direct annual funding from the Centers for Disease Control and Prevention. The CDC receives that money from the $1 billion Prevention and Public Health Fund, which is part of the Affordable Care Act. If the ACA is repealed—which it could be, if Republicans in Congress get their way—the Prevention Fund could be eliminated along with it.

That could mean vanishing resources for programs like this, and many others around the country. It’s not just Houston, or Flint; thousands of American communities have off-the-charts blood-lead levels. “We make sure our children aren’t getting poisoned,” says Kaavya Domakonda, Houston’s lead poisoning prevention program manager. “It would be hugely detrimental if those funds went away.”

Most news coverage of the Republican crusade to eliminate ”Obamacare” has focused, rightly, on the 20 million Americans who stand to lose coverage if the signature components of the ACA were torn down. Those include the expansion of Medicaid, new coverage offered through the Health Insurance Marketplace, and changes in private insurance pertaining to young adults and people with pre-existing health conditions.

But those changes to the health insurance marketplace weren’t all that the ACA achieved. It also established the nation’s first mandatory dollar-stream devoted to improving public health: the Prevention and Public Health Fund. “You can feel it,” says Richard Hamburg, the executive vice president and COO at the Trust for America’s Health, a nonpartisan organization that advocates for disease prevention. “That fund has led to actual programs that are impacting people at the local level.”

These are meaningful fixes to health and environmental concerns that shape daily life in towns and cities. According estimates cited by the American Public Health Association, every 10 percent funding increase for community-based public health programs can reduce preventable deaths by 1 to 7 percent.

The PPHF works to “improve health outcomes, and to enhance health care quality,” primarily by funding about 12 percent of the CDC’s annual budget, or roughly $890 million. The CDC passes those dollars on to state, municipal, and community-run programs that respond to a host of public health issues. (An additional $40 million of PPHF funds go to the Administration for Community Living and the Substance Abuse and Mental Health Services Administration.)

Houston is one of six cities that gets direct funds from PPHF for its childhood lead poisoning prevention program. Los Angeles, Washington, D.C., Chicago, New York, and Philadelphia have also received millions of dollars to monitor lead poisoning risks, educate communities, and keep tabs on children’s treatment. (All of these cities are approaching the end of a three-year grant.) With those PPHF dollars, the CDC also funds state-backed anti-lead programs; it spent $13 million on lead prevention programs nationwide in 2016.

What else does the PPHF provide for, through the CDC? Last year, $40 million bolstered the CDC’s Epidemiology and Laboratory Capacity program, which enhances the ability of state and local labs to respond to infectious disease outbreaks. More than 25 percent of total ELC grants went to Zika research, in all 50 states and a number of cities. The CDC distributed another $160 million of PPHF dollars to Preventive Health and Health Services Block Grants, a monumental program that supports tailor-made health solutions in states and local communities. A few examples: In recent years those funds have allowed California to expand its health alert network, which notified statewide hospitals to local outbreaks during the 2014 Ebola outbreak; Fairfield, Connecticut rolled out its first bike route, and Allen County, Kansas used its block grant to set up a network of farmers markets; in New Mexico, students formed and sustained an exercise club in a pueblo.

Money from the PPHF has also kept a remarkable program called Racial and Ethnic Approaches to Community Health (REACH) afloat. The CDC distributes nearly $51 million to 49 “REACH” partners in communities around the country, which help connect minority communities with high health risk factors to care and prevention services. Example: In the southwest Bronx—the poorest urban county in the U.S., where residents are more than five times likelier to die of diabetes than those in wealthy New York neighborhoods—the local REACH branch runs workshops in local churches on how diabetic congregants can control their condition, advocate for their health, and access better medical information.

That’s just one of the many programs it runs, across the 280,000 Bronx County residents it serves. Other, earlier REACH programs show results: From 2001 to 2009, pneumonia vaccination rates in REACH grantee communities areas rose 10 percent among blacks, from 12.5 percent among Latinos, 22 percent among Alaskan/Pacific Islanders, and 11 percent among Native Americans.

These are still only a fraction of the programs, services, and research funded by the PPHF. All told, states would lose more than $3 billion over the next five years from grants and programs supported by the fund, according to a recent analysis by the Trust for America’s Health. That means every major city stands to see millions of dollars, and life-giving programs, go away. So do small towns and rural places.

Congress could choose to continue to fund any these community-based programs in the absence of the ACA. Many of them, including the REACH program and lead poisoning prevention services, were around prior to the ACA, supported by various discretionary funds that were generally passed on to states first. But even if Congress decides it liked to keep one program funded or another, it won’t have the same dedicated funding stream—which, by the way, is set to double by 2022—to do it. It would have to take cash from other agencies, like the departments of Labor, Education, or Health and Human Services, and leave holes in their budgets.

Several GOP leaders and the president-elect have promised a comprehensive healthcare plan to fill the vacuum created by an ACA repeal, but no concrete ideas have been offered. For now, no one can say what the full implications for health coverage, and public health, will be. “Without the Prevention Fund in place, will the federal government figure out how to make up for it?” asks Hamburg. “Until anyone tells us, we have to assume it won’t be available.”

[Source:-City Lab]

Trump could gut public health funding at the exact time we need it most

We’re hearing a lot about the 22 million people who may lose their health insurance if the Affordable Care Act is repealed. But there’s another, quieter tragedy that could play out if the ACA is gutted: States could lose critical funding for public-health efforts like responding to outbreaks, vaccination programs, and anti-smoking and anti-obesity campaigns.

When the ACA was enacted in 2010, the law established the Prevention and Public Health Fund, with an annual appropriation that began at $500 million in 2010. The goal of the fund was simple: boost public-health funding, much of it for the US Centers for Disease Control and Prevention (CDC), to support activities that prevent people from getting sick. (At a time when more Americans would be gaining insurance, keeping people healthy and out of the health care system carried extra appeal for lawmakers.)

But over the years, the fund has been subject to a slew of cuts. It’s been a prime target for Republicans, who have called it “a slush fund for jungle gyms.” The House Reconciliation Bill, led by Trump’s HHS pick Tom Price, promised to terminate the fund. (The bill passed in the Senate but was vetoed by President Barack Obama.) If the Affordable Care Act is repealed, the fund will most certainly go away — and with it, $890 million of the CDC’s annual budget. Within the next five years, states will lose more than $3 billion, according to a new analysis by the Trust for America’s Health.

Map showing which states would be hardest hit by the proposed budget cuts from repealing ACA

“The unintended consequence of the elimination of the Affordable Care Act could be the elimination of 12 percent of CDC’s budget,” said John Auerbach, the president and CEO of Trust for America’s Health and former associate director for policy at the CDC.

Not every state will be impacted in the same way. Some of the preventive-health funding is population-based and some of it is grant based, though the Trust for America’s Health said the biggest states tend to be hardest hit because they have more municipalities that can receive grants.

Removing the funding will mean less money for responses to outbreaks, less money to fight the opioid epidemic, less money to fight superbugs in hospitals, and less money for vaccination programs. It’ll also mean more scrambling for cash at already cash-strapped public health offices. “The indirect impact of the ACA repeal,” Auerbach added, “is that the funding has to come from somewhere else.”

Here’s what that looks like at the state level

Public health departments have always struggled to wrangle enough cash. Unlike health care providers, public health officials work on preventing illness and injury. They devise plans to prepare for those increasingly frequent pandemic threats, like Ebola and Zika, and regulate tobacco use to give us smoke-free environments.

The work isn’t sexy and prevention isn’t newsworthy. Compared to health care — drugs, doctors, and hospitals to keep us alive when we’re sick — public health gets a tiny portion of the health spending pie. As of 2012, only 3 percent of the health budget went to public health measures, the rest mostly to personal health care.

More cuts will be felt deeply, health officials on the ground told me. In Texas, as Zika made its way to America and Congress squabbled over funding the fight against the virus last year, Dr. Umair Shah — the head of public health for Harris County, Texas — had to scramble to find money to pay for his department’s Zika response.

Some of that cobbled-together cash — to spray for mosquitoes, raise awareness about the virus in his community, and test and track the virus — came from the Prevention and Public Health Fund. “As a public health system in this nation, we are under-funded,” Shah said. “We’ve made some progress in funding — with this increase in dollars — and now we have that real concern that it’s going backward.”

In Louisiana, a state with some of the worst health outcomes in America and a massive deficit, it’ll further knock down an already struggling public-health system, said Dr. David Holcombe, who looks after public health for central Louisiana. “We have employees who are [paid through the fund] to do immunizations, STD prevention,” he explained. “In Louisiana, we are number one in syphilis, number one in gonorrhea, number two in chlamydia, and number two in HIV/AIDS. It’s hard to imagine how we could get worse in all this stuff.”

Public health already gets a tiny portion of the health funding pie

There are a few reasons why public health is so chronically under-funded. In a 2010 op-ed the New England Journal of Medicine, Harvard’s David Hemenway explained that our brains are wired to focus on short-term issues, which deliver more immediate rewards, instead of long-term challenges, like public health. “Since it takes willpower to delay gratification, individually and collectively we sometimes underinvest in the future,” he wrote.

Whether its improving road safety, preventing a pandemic, or limiting the effects of climate change — all of which fall under the remit of public health — they “incur costs today but don’t provide benefits until sometime in the future.” Not exactly a politically palatable option.

When public health works, it’s often invisible. When we have mosquito-control programs that prevent Zika from spreading, it’s a non-story. When we aren’t poisoned by our food, it’s a non-story. It’s also more difficult to talk about the benefits of public health: They tend to be long term, slow to show up, and affect entire populations instead of individuals. “Public health has little news value — saving statistical lives doesn’t make for good human-interest stories or photo ops,” Hemenway writes.

Cutting the public-health funding any further, the outgoing CDC director, Tom Frieden, told Vox in an interview, “would [lead to] tens of thousands of additional illnesses and more than 10,000 additional deaths.”

At a time when life expectancy in the US has declined for the first time in decades, nearly half the population is overweight or obese, and deaths from opioids have more than quadrupled in just 15 years — we could use more public health efforts to prevent these things for happening in the first place. Instead, we may be moving in the opposite direction.

In Trump’s health care reform position statement, he said, “The best social program has always been a job — and taking care of our economy will go a long way towards reducing our dependence on public health programs.” It’s not clear how job creation would stop an Ebola outbreak, or control tobacco, or test people for STDs. But we will soon find out.