The Sentinel: Healthcare

Microplastics: Why you should worry about in our food supply?

Dr. Ovadia says microplastics may have negative effects on testosterone in men and estrogen and progesterone in women. This could mean reduced muscle mass and libido for men.

A turtle sits on a pile of trash on the beach — A turtle makes his way over a mound of decaying plastic bottles on a beach. The byproduct from the decay are called microplastics or nanoplastics, which are incredibly small pieces of plastic that can get into our body. Scientists don’t fully understand microplastics’ impact on the human body. A lot of research is needed to determine the negative impact on our health.

by Tim Ditman
OSF Healthcare

URBANA - From news reports to social media blurbs to medical studies, they’ve been in the public eye a lot lately. And experts say that likely won’t change.

We’re talking about microplastics or nanoplastics, incredibly small pieces of plastic that can get into our body.

OSF Cardiothoracic surgeon Dr. Philip Ovadia

Photo provided

Philip Ovadia, MD

So, how concerned should we be? Philip Ovadia, MD, a cardiothoracic surgeon at OSF HealthCare, says this issue will continue to be studied for years. But there are things you can do now to optimize your health and reduce your risk of problems.

“We’re increasing our understanding of the toxins in our environment. Our environment has become more toxic, and that’s a challenge to our health,” Dr. Ovadia says. “The best thing for people to do is to control what you can control. What are you eating? What are you using on your body? What is your lifestyle like? How active are you?”

Where do microplastics come from? What harm can they do?

Dr. Ovadia says microplastics can be purposefully manufactured as part of a product. Toothpaste and skin exfoliants are examples. Or, microplastics can occur when larger plastic products, like water bottles, break down. The microplastics can then get into our environment, such as ocean water or our foods and drinks.

“There’s even some evidence that these things can spread in the air, and we can breathe them in,” Dr. Ovadia adds.

Dr. Ovadia points to three areas where ingesting microplastics could be cause for concern.

Intestines: Dr. Ovadia says microplastics can irritate our intestines, leading to inflammation of tissue and a condition called leaky gut.
“That’s when we get a breakdown of the barrier that lines our intestines. That allows some things in our food that aren’t supposed to get across into our bloodstream to get into the bloodstream. Many of these things set off inflammation in the body,” Dr. Ovadia says.
Endocrine system: Dr. Ovadia says microplastics may have negative effects on testosterone in men and estrogen and progesterone in women. This could mean reduced muscle mass and libido for men. For women, it could mean changes in the menstrual cycle, an increased infertility risk and, for young women, earlier start of puberty.
Blood vessels: Dr. Ovadia points to a 2024 study where experts looked at plaque removed from the carotid artery (located in the neck) of study participants.
“For over half of the people, there was evidence of microplastics in those plaques. Furthermore for the people who had those microplastics, over the next three years they had a four-and-a-half times increased risk for a heart attack, a stroke or dying,” Dr. Ovadia says.
“It doesn’t prove that the plastics are causing the problems,” Dr. Ovadia adds. “But it’s certainly concerning data. And I, as a heart surgeon, start to worry. If we see these in plaques in arteries in the neck, are they also in the plaques in arteries of the heart patients I operate on?”

Warming up food in a microwave — Heating food in certain types of plastic containers can be harmful due to the leaching of chemicals into the food. Microwaving food in plastic, especially those not specifically labeled as microwave-safe, can cause chemicals from the plastic to transfer to the food

What should I do?

So, do we need to panic about microplastics? Should the health concerns be akin to smoking?

Not now, Dr. Ovadia says. He reiterates that studies on this topic are in the early stages, and experts don’t fully understand microplastics’ impact on our health.

“It’s an unknown risk at this point,” he says.

But, there are small, everyday steps you can take to reduce the risk of microplastics entering your body.

Drink from a glass or stainless steel bottle, not a plastic bottle.
Use a good water filtration system. That could be built into your home’s water supply, or you could purchase a filter to attach to your faucet or water bottle.
Make food choices that minimize your exposure to plastic wraps and containers. Think the to-go boxes you get at a restaurant. Instead, eat more fresh, non-packaged food. Find these in the outer aisles of the grocery store.
“Eat the things that grow in the ground, and eat the things that eat the things that grow in the ground,” Dr. Ovadia says with a smile. “That’s how I always explain it to people. Try eating more whole, real food. That will minimize your exposure to microplastics.”
Look into the cosmetics and toiletries you use. Dr. Ovadia admits the jargon on a label can be difficult to understand. Instead, research the brands themselves. If, for example, a toothpaste brand is pledging to reduce microplastics in their products, it’s a green flag.

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Amid uncertainty in Washington, Illinois lawmakers pass slimmed-down Medicaid package

Lawmakers in Springfield passed a slimmed-down Medicaid omnibus bill this year as state budget constraints and federal funding uncertainties loomed large.

by Peter Hancock
Capitol News Illinois

SPRINGFIELD - Nearly every year, Illinois lawmakers pass a package of measures dealing with the state’s Medicaid program, the joint federal and state health care program that covers low-income individuals.

Known as the Medicaid omnibus bill, it sometimes includes bold components, like a 2021 initiative that made millions of dollars available to local communities to help them plan and design their own health care delivery systems. Other packages have focused on smaller changes like guaranteeing coverage for specific conditions and medications or adjusting reimbursement rates for different categories of health care providers.

Illinois state news

And most years, the packages receive bipartisan support because they are negotiated, largely behind closed doors, by an unofficial, bipartisan Medicaid Working Group.

This year, however, lawmakers passed one of the narrowest packages in recent memory, due mainly to the Trump administration’s vows to make sweeping cuts in federal funding for the program while state lawmakers faced their own set of budget constraints.

“There were many, many, very worthy program expansions, rate increases that we considered during this process that we were unable to include because of the uncertainty in Washington,” Rep. Anna Moeller, D-Elgin, the current chair of the Medicaid Working Group, said on the House floor Saturday.

The Illinois Medicaid program currently costs about $33.7 billion a year, according to the Department of Healthcare and Family Services. Of that, $20.9 billion, or about 62%, comes from the federal government while much of the state’s share comes from taxes levied on hospitals, nursing homes and managed care organizations – money the state uses to draw down federal matching funds.

The program covers nearly 3.5 million people in Illinois, or about a quarter of the state’s population. According to the nonpartisan health policy think tank KFF, the program pays for 40% of all child births in Illinois while covering 69% of all nursing home residents.

This year’s Medicaid omnibus bill, a 231-page amendment inserted into Senate Bill 2437, contains items that could be hugely beneficial to many Medicaid enrollees, but which don’t carry large price tags. In fact, the entire package is estimated to cost just under $1 million.

One of this year’s additions would make it easier for family members of medically fragile children who qualify for in-home nursing care to receive training to become certified family health aides, a designation that would enable them to administer medications, help with feeding and perform many of the same tasks as a certified nursing assistant.

Another provision would require all hospitals with licensed obstetric beds and birthing centers to adopt written policies that permit patients to have an Illinois Medicaid certified doula of their choosing to accompany them and provide support before, during and after labor and delivery.

Although those provisions enjoyed bipartisan support, another provision that extends coverage to certain categories of noncitizens drew Republican opposition Saturday, resulting in a partisan roll call vote.

The program covers noncitizens who meet the income requirements for Medicaid and have pending applications for asylum in the United States or for special visas as victims of trafficking, torture or other serious crimes. Those individuals can receive coverage for up to 24 months, provided they continue to meet the eligibility requirements.

Moeller said the language was not a new extension of health care benefits to noncitizens, but instead a “technical and administrative fix” to an existing program that had been requested by the Department of Healthcare and Family Services.

But for Republicans, the programs sounded too similar to the more controversial programs, Health Benefits for Immigrant Seniors and Health Benefits for Immigrant Adults, that extend health care to a large category of people who are not U.S. citizens, including some who are in the country illegally.

“For us on this side of the aisle, that is the poison pill,” said Rep. Norine Hammond, R-Macomb, the deputy House minority leader. “So in spite of the fact that we have article after article in here, that is very worthy of a yes vote, I would urge a no vote.”

At Gov. JB Pritzker’s request, the budget bill lawmakers passed Saturday night cancels the program for immigrant adults, which had covered about 31,000 noncitizens age 42-64. But it provides $110 million over the next year, all in state funds, for the immigrant seniors program, which covers about 8,900 noncitizens age 65 and over.

The Medicaid bill passed the House late Saturday night, 76-39. It then passed the Senate shortly after midnight, 36-19.

It next goes to Pritzker’s desk for his consideration.

Capitol News Illinois is a nonprofit, nonpartisan news service that distributes state government coverage to hundreds of news outlets statewide. It is funded primarily by the Illinois Press Foundation and the Robert R. McCormick Foundation.

Commentary |
Six ways Trump's budget will damage rural Americans' way of life

Republicans in Congress are jamming through a sweeping bill to fund handouts to the rich - at the cost of jobs, health care, and food in rural America.

by Michael Chameides
OtherWords

Right now, Congress is working on a giant, fast-track bill that would make historic cuts to basic needs programs to finance another round of tax breaks for the wealthy and big corporations.

As the Communications and Policy Director for the Rural Democracy Initiative, I’ve been hearing from rural leaders across the country about the devastating impacts this bill would have.

The good news is it’s not too late. But there’s little time to spare.

This dangerous, unpopular bill would increase costs for rural working families by thousands of dollars per year, leaving millions hungry and without health care — all to provide tax breaks and handouts to the wealthy and special interests.

Here are just six of the worst provisions.

1. It guts rural healthcare.

The bill would drastically cut Medicaid and impose new barriers to care. It would take healthcare away from 13.8 million Americans and increase the cost for millions more. In some states, 50 percent of rural children get healthcare from Medicaid. Millions more rely on access to clinics and hospitals that would likely close because of these cuts.

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2. It takes food off the tables of rural people.

The plan includes approximately $290-$319 billion in cuts to SNAP (the Supplemental Nutrition Assistance Program, formerly known as food stamps) even as the cost of groceries continues to escalate. More than 15 percent of families in small towns and rural areas rely on this support to feed their families.

3. It shifts costs to states and local governments.

State and local governments in rural areas depend more on federal funding from programs like SNAP and Medicaid than other states. Slashing federal funding to states would create new burdens for rural states that are already struggling to provide critical public services like health care, transportation, and emergency response services to local communities.

4. It takes away local control.

Landowners have fought to stop the use of eminent domain for carbon pipelines by passing bans and moratoria, as well as enacting county setbacks and safety requirements to protect their communities.

But this bill would overrule state and local laws and ordinances, override local voices, and deprive residents of a fair opportunity to evaluate the adverse impacts of pipelines. It also sets up a “pay to play” system under which companies can simply pay for pipeline, mining, and drilling permits — and avoid public comment and legal challenges.

5. It ends clean energy and infrastructure funding.

The bill would phase out existing tax credits for wind, solar, batteries, geothermal, clean energy, and advanced manufacturing. It would also take away $262 million in funding for energy efficiency and conservation grants as well as transportation infrastructure.

Ending these tax credits will increase household energy costs, which are already higher in many rural communities. These changes would also reduce new clean energy projects — and jeopardize billions in rural investments in clean energy manufacturing.

6. It gives handouts to agribusiness and mega farms.

Leaders in Congress are using the budget reconciliation process to give big farms a $50 billion windfall. Add the heightened pressures and instability caused by the Trump administration’s erratic trade policy and more family farmers would lose their farms — while Big Ag consolidates more of the market.

In short, this bill would make it harder for rural people to meet their basic needs — all so the wealthy and corporations can avoid paying their fair share of taxes like the rest of us do.

Lawmakers have already heard from the giant corporations who helped write the bill. Now, they need to hear from the rest of us. It’s up to us to alert our communities and tell our lawmakers: Don’t sell rural America out to big corporations and the wealthy.

Michael Chameides is the Communications and Policy Director for the Rural Democracy Initiative. A longer version of this op-ed was originally published by Barn Raiser. This version was distributed for syndication by OtherWords.org.

Illinois pushes to ban ‘forever chemicals’ in firefighter gear due to cancer risk

Numerous scientific studies from the American Cancer Society, National Institutes of Health, and the Centers for Disease Control and Prevention indicate the correlation between exposure to PFAS found in turnout or bunker gear and the increased number of firefighters developing various forms of cancer.

Firemen move a barrel during a firetraining exercisse

by Reilly Cook & Grace Friedman
Medill Illinois News Bureau

SPRINGFIELD - A bill to ban the sale of firefighter protective gear containing “forever chemicals” is gaining momentum in the Illinois General Assembly, as lawmakers, union leaders and firefighters themselves warn that the very equipment designed to save lives may be silently endangering them.

House Bill 2409, co-sponsored by Rep. Mike Kelly, D-Chicago, and Sen. Ram Villivalam, D-Chicago, seeks to expand on the state’s existing PFAS Reduction Act by targeting a lesser-addressed but critical source of firefighter exposure to these harmful substances: their turnout gear.

Turnout gear, also known as bunker gear, is the specialized protective clothing worn by firefighters to protect them when they respond to fires or other hazardous situations.

“We know the damage that PFAs can do to our bodies,” Kelly said in an interview. “While this is supposed to protect us, it’s doing us serious harm.”

PFAS have long been used to make products -resistant to water, heat and staining, but research has increasingly linked them to serious health issues, including multiple forms of cancer. According to the Environmental Working Group, an advocacy organization trying to protect environmental health through better industry standards, PFAS were first added to firefighters’ personal protective equipment in 1976.

The bill is backed by the Associated Firefighters of Illinois, a statewide union representing more than 17,000 firefighters and paramedics in 237 communities. Advocates argue that the legislation is crucial in addressing the leading cause of death among firefighters today—chronic illnesses such as cancer.

“Little did we know that the bunker gear, the very gear that is supposed to protect us, to keep us safe, is actually killing us,” AFFI President and retired firefighter Chuck Sullivan said. PFAS are known as “forever chemicals” because they can stay in the human body a long time.

Numerous scientific studies from the American Cancer Society, National Institutes of Health, and the Centers for Disease Control and Prevention indicate the correlation between exposure to PFAS and the increased number of firefighters developing various forms of cancer. Kelly and Villavalam cited this research as the impetus driving the legislation.

Sullivan said the Illinois bill closely follows similar legislation passed in Massachusetts, Minnesota and Connecticut. Under HB 2409, manufacturers would be banned from selling gear containing PFAS in Illinois after Jan. 1, 2027. In the interim, labeling requirements would take effect beginning in 2026. Fire departments would be mandated to phase out affected equipment, such as self-contained breathing apparatuses or certain rescue harnesses, by 2030.

“When we put our gear on, it's not on the forefront of our mind that that is also dangerous and also giving us additional exposures,” Steve Shetsky, a member of AFFI’s executive board, said. “So this bill would absolutely limit those exposures, which would make this profession safer.”

Retired Chicago Fire Department Lieutenant Jim Tracy knows the risk firsthand. Diagnosed with colon cancer six years ago, he endured chemotherapy, radiation and surgery to eradicate the cancer he blames on the uniform.

“I was 22 years in the field when I got diagnosed,” Tracy said. “It is unfortunately one of those cancers you get from PFAS.”

Tracy, who spent 28 years working as a firefighter, said it was only recently that they received one set of gear that is “99% PFAS free.” The new equipment was delayed in production, he said, because manufacturers had to remove PFAS-laced materials from collars and cuffs and replace them with 100% cotton. Many firefighters, however, still wear older gear that is laden with forever chemicals.

“Personal protective equipment,” Tracy said. “It’s not very protective if it is giving us cancer.”

In addition to his own health battle, Tracy said he has many colleagues in the department who have gotten sick but do not report their illnesses out of fear of losing their jobs.

“They don’t want to get kicked off the job, so they go through it on their own and don’t tell the department,” he said.

‘Financial unknowns, replacements under testing’

HB 2409 passed the House 114-0 on April 10. It passed a Senate committee unanimously and is awaiting final action on the Senate floor before it can head to Gov. JB Pritzker for a signature.

Despite bipartisan support in both legislative chambers, the Illinois Fire Chiefs Association has been vocal in its opposition to the bill, citing concerns about the availability and cost of compliant gear.

Photo: Ken Steele II/Unsplash

Illinois Fire Chiefs Association opposes the bill, citing concerns about the availability and cost of safer equipment for firefighters.

John Buckley, executive director of the IFCA, testified before the Senate Labor Committee on May 6, urging lawmakers to amend the bill to delay the enforcement date.

“Our ask and our solution to the problem was to move the date from Jan. 1, 2027, to Jan. 1, 2029 — to give two years to determine if gear would be available and meet the needs of the firefighters in Illinois,” Buckley said.

While Buckley emphasized that the IFCA supports eradicating PFAS from firefighter gear, he warned that the current timeline does not allow enough time for departments to identify, test and purchase safe alternatives, which he said are not affordable or readily accessible.

“Currently, nothing’s been tested and vetted that meets that requirement,” he said. “The gear that’s out there that is PFAS-free is in very limited use, and some of it does not meet national standards,” Buckley said.

Buckley also pointed out that the proposed legislation lacks a funding mechanism to help departments cover the cost of new gear, which he said could “range from $4,000 to $5,000 per set.”

According to the Office of the Illinois State Fire Marshal, the state has 39,564 firefighters. Outfitting each with PFAS-free equipment could cost between $158 million and $198 million—a significant expense as Illinois faces a tightening budget picture for fiscal year 2026.

Still, sponsors said protecting firefighters from potentially deadly chemical exposure should take precedence over its price tag and logistical concerns.

“Our first responders deserve to work with equipment and clothing that does not pose a risk to their health,” Villivalam said. “This measure ensures they are able to continue to be protected while doing their work effectively.”

Even if HB 2409 becomes law, Buckley said he plans to continue pushing for a 2029 effective date when the 104th General Assembly reconvenes in January 2026.

Reilly Cook and Grace Friedman are graduate students in journalism with Northwestern University’s Medill School of Journalism, Media, Integrated Marketing Communications, and fellows in its Medill Illinois News Bureau working in partnership with Capitol News Illinois.

Tagged: PFAS found in firefighter gear, Health risks for firefighters, Illinois firefighters exposed to deadly chemical exposure, Making firefighting safer, Manufacturers would be banned from selling gear containing PFAS in Illinois

State health care programs for noncitizens provided significant benefits for Illinois hospitals

The programs have been controversial since they were first proposed. Republicans have been especially critical, saying the programs serve as an incentive for immigrants to cross into the United States illegally and settle in Illinois to receive taxpayer-funded health benefits.

by Peter Hancock
Capitol News Illinois

SPRINGFIELD – Two state-run health care programs that extend Medicaid-like coverage to noncitizens may have provided significant financial benefits for Illinois hospitals.

That’s according to preliminary results of an ongoing study at the University of Chicago that suggests the programs corresponded, at least in part, to a 15% reduction in the amount of bad debt Illinois hospitals incurred each year since the programs have been in full effect.

“The number that we find is a 15% reduction,” Aresha Martinez-Cardoso, an assistant professor and researcher at U of C’s Embodying Racism Lab, where the study is being conducted, said in an interview. “We think that that might be a high estimate, given what we know about perhaps other things that are going on that we can't entirely rule out, but we do think that part of that reduction is associated with the policy.”

That translates to an average of $1.5 million per year, per hospital, according to the report, although the exact amount would vary greatly depending on a hospital’s size and the volume of patients it treats who are covered by the programs. “Our early findings show that this landmark policy isn’t just about access — it also serves as a strategic investment in our hospitals and the health of entire communities,” Martinez-Cardoso said.

Those findings come as Gov. JB Pritzker’s administration is preparing to shut down the larger of the two programs as part of his budget proposal for the upcoming fiscal year. The Health Benefits for Immigrant Adults, or HBIA, currently covers more than 31,000 eligible noncitizens aged 42-64, at a cost of about $21 million per month, according to the most recent data from the Department of Healthcare and Family Services.

The other program, Health Benefits for Immigrant Seniors, covers eligible noncitizens aged 65 and over. That program currently covers about 8,900 individuals at a cost of about $10 million per month. Pritzker has not proposed eliminating it.

The programs were launched in 2020 and 2021, during the COVID-19 pandemic, as a means of extending health coverage to individuals who did not qualify for other publicly funded health care programs solely due to their immigration status. Those include individuals who are in the United States without legal authorization as well as certain legal permanent residents who have not yet been in the country long enough to qualify for Medicaid.

With the state facing slow revenue growth and a projected budget deficit in the coming year, Pritzker surprised many of his supporters in February when he proposed closing the HBIA program.

Eliminating the program for middle-aged adults is projected to save the general revenue fund about $330 million, according to the governor’s office. Pritzker told reporters after his address in February he expects the federal government will stop reimbursing states for costs associated with programs providing services to noncitizens.

A week after the governor’s budget address, the Illinois Auditor General released a report that said enrollment in both programs and their eventual costs had far exceeded their original projection. The cost for the two programs, the report said, exceeded $1.6 billion over the course of four fiscal years.

Unlike Medicaid, which is jointly funded with state and federal funds, the health programs for noncitizens are funded almost entirely with state dollars.

The study looked at publicly available hospital financial reports to analyze changes in the amount of uncompensated care they provided from 2017 to 2023. It also looked at similar data from hospitals in Indiana and Wisconsin, neighboring states that do not provide health benefits for noncitizens.

“We tried to flip it a few different ways,” Martinez-Cardoso said in an interview. “There could be a lot of other things happening. But when we test a bunch of different models … we kind of see a consistent pattern that the policy timing is associated with bad debt.”

She said the results so far are only preliminary and that analysis of the data is continuing. But she said the analysis so far shows a strong link between the enactment of the programs and an overall reduction in uncollectable debt.

Connecting the dots; The Mediterranean diet, exercise and bone loss

There are many factors when it comes to bone loss including age, body weight, diet and physical activity. The key to minimizing bone density loss is the inclusion of weight bearing exercises such as lifting weights.

Mediterranean Food

Photo: Robert Anasch/Unsplash

by Matt Sheehan
OSF Healthcare

ROCKFORD - There’s always plenty of discussion when it comes to the benefits of diets.

In one recent study in the JAMA Network Open, researchers found the lower-calorie Mediterranean diet combined with exercise, helped older women lose weight with beneficial effects on bone mass density.

The study was completed in hospitals and medical centers across Spain and included more than 900 women who ranged in age from 55 to 75. Half the group was instructed to eat a Mediterranean diet with no calorie restrictions and were not required to exercise. The other half was encouraged to walk for at least 45 minutes a day for six days a week and do strength exercises three days a week. This group saw significant improvement in stronger bones.

A lack of calcium and vitamin D are also major factors in bone density loss.

There are many factors when it comes to bone loss including age, body weight, diet and physical activity. Nicole O’Neill, a dietitian with OSF HealthCare, says the Mediterranean diet and exercise can prevent bone loss, if weight bearing exercise, such as lifting weights, is part of the program.

“This was not studied specifically for the Mediterranean diet and bone loss,” she explains. “It was something they found incidentally and then studied it closer. It's not that it's wrong, it's just that it's inconclusive.”

Nicole O’Neill, Dietitian

A lack of calcium and vitamin D are also major factors in bone density loss. “The Mediterranean diet overall limits the amount of dairy, so most people get the majority of their calcium and vitamin D from dairy products,” says O’Neill. “So, say you were doing three glasses of milk a day. If you switched to a Mediterranean diet and dropped down to one glass of milk, you could cause bone loss because you're getting less calcium and vitamin D if you're not careful.”

The typical American standard diet includes plenty of processed foods and lacks in fruits and vegetables.

Key Takeaways:

A study found the Mediterranean diet combined with exercise may have some positive effect on bone mass density in older women.
The key is the inclusion of weight bearing exercises such as lifting weights.
The Mediterranean diet is popular because it promotes fruits and vegetables and fewer processed foods.
Always consult with your provider before starting any diet.

The Mediterranean diet is popular because it features simple, plant-based cooking, with each meal featuring fruits and vegetables, whole grains, beans and seeds and an emphasis on extra-virgin olive oil. The diet is rich in nutrients that help bone health. Vitamin C from fruits and vegetables can help support bone cells and vitamin K found in spinach can help with bone formation.

“I really do like the Mediterranean diet,” O’Neill says. “There are a lot of pros. The cons are it’s a little fussy. You have to push and pull things around, and you have to be careful to fill in the gaps with foods that are appropriate. If you're not used to having that bigger load of fruits and vegetables and whole grains, that's a lot of fiber that maybe your guts are not used to. So, a slow, incremental approach might be the best way to start.”

Regarding any study, O’Neill says it’s important to read and do your research before coming to any conclusions. Don’t rely on information from the Internet, she adds. You’re likely to get misleading information. Instead, talk to your provider or a dietitian who can interpret the numbers found in the study.

“There are really a lot of moving parts,” O’Neill says. “When you start a new diet, we don't want a crash course. We want it to be sustainable. We want it to be long term, and we want it to be something that fits for you and that makes sense.”

Got hives? Here is what we know you are itching to learn about Chronic Urticaria

Urticaria is a rash causing round, swollen areas on the skin. It can be tender, itchy and/or painful. People with light skin may see red, raised bumps or welts.

BPT - If you've had hives, you know how challenging they can be. But you may not know that there is more than one type of hives, or urticaria, and that treatments are available. A brief episode of hives is a nuisance, but when symptoms persist for weeks, months or years, it can take a physical and psychological toll.

What is urticaria?

Urticaria is a rash causing round, swollen areas on the skin. It can be tender, itchy and/or painful. People with light skin may see red, raised bumps or welts. In people of color, hives may match the color of surrounding skin or appear slightly lighter or darker. They may appear all over your body or in one area.

Urticaria occurs when chemical compounds involved in the body's inflammatory and immune responses are released. One of these chemicals is histamine, which is released by mast cells and basophils. When this release happens in the skin's outer layers, it results in hives.

Most hives resolve quickly, but they can become chronic. Acute urticaria refers to hives lasting one day to six weeks. Chronic urticaria means the hives have lasted for six weeks or longer. For many people, the cause is unknown.

Chronic urticaria eventually goes away by itself.

Chronic urticaria is a rare condition that occurs in only 23 out of 10,000 people, though the actual number may be higher, since many people do not report or recognize the symptoms. Chronic urticaria is most common in adults aged 40-59. More women than men are affected, and more Black Americans and other ethnic groups are affected. There are two types:

Chronic idiopathic urticaria (also called chronic spontaneous urticaria) is not triggered by external factors. In many cases, the cause could be an autoimmune condition, another systemic disease like cancer, or unknown.
Chronic inducible urticaria is caused by certain environmental and physical factors.

Identifying urticaria triggers

Common triggers include:

Allergens, including certain foods
Exposure to heat/cold
Tight clothing
Insect stings and bites
Infections and viruses
Medications such as antibiotics and NSAIDs
Diseases including asthma, celiac disease, diabetes, lupus, rheumatoid arthritis, thyroid disease, vasculitis and vitiligo
Stress

Diagnosis and treatment

The cause of your chronic urticaria may be hard to identify. It's best to see a specialist such as a board-certified allergist or dermatologist for diagnosis and treatment.

Your doctor may perform allergy tests, lab tests or a skin biopsy to rule out other conditions that involve or resemble hives. You can help by keeping a diary that tracks your symptoms.

Chronic urticaria eventually goes away by itself. Management focuses on the most appropriate treatment to control symptoms, usually starting with the first line of treatment: a long-lasting antihistamine.

Antihistamines block production of histamine to reduce or eliminate hives and ease itch and swelling. Ask your doctor for a non-sedating antihistamine.

Topical itch creams may provide mild relief for hives that do not cover the entire body.

Corticosteroids: Topical corticosteroids reduce inflammation, irritation and itching. By reducing inflammation, they also promote healing. For a severe hives flare-up, a short course of oral corticosteroids (prednisone) can help reduce inflammation and itching. These medications can cause serious side effects, especially if taken long-term. It's important to follow your doctor's instructions when taking oral corticosteroids.

Advanced treatments

It's important to work closely with your doctor if your hives don't respond to treatment. If antihistamines alone do not help, your doctor may recommend combining them with other medications, including leukotriene modifiers or H2 blockers. New advanced treatments are available, and more are in clinical trials or undergoing FDA review.

Biologics: Omalizumab is a biologic medication used to treat chronic urticaria when antihistamines haven't worked. Two more biologics are in development as chronic urticaria treatments: dupilumab is in FDA review and briquilimab is in clinical trials. Biologics work by targeting cells and interrupting the inflammatory process. This stops or reduces symptoms. Biologics are injectable medications typically given once per month.

Cyclosporine: This is an oral medication that calms the immune system to prevent hives from occurring. It can be taken along with antihistamines. Since cyclosporine is an immunosuppressive, it can decrease the body's ability to fight infections. Talk with your doctor about side effects and the benefits vs. risks of taking this medication.

Bruton's tyrosine kinase (BTK) inhibitor: Remibrutinib is an oral medication in clinical trials. It works by blocking the activation of mast cells and basophils. These cells release histamine and other inflammatory mediators that cause hives, swelling and itching. By blocking this process, remibrutinib can reduce or eliminate symptoms.

Hives and mental health

It's important not to blame yourself for your hives. If you're feeling anxiety, depression or embarrassment about your skin condition, talk with your healthcare provider or a mental health specialist. Support groups for people with urticaria also let you share experiences and know you are not alone.

Don't let chronic urticaria impact your quality of life. Talk to your doctor. Check out the Chronic Urticaria Toolkit at ChronicHives.info.

Op-Ed |
New study reveals obesity ages individuals by 27 years

Findings highlight wide-ranging health impacts and alarming cost implications

by Patty Starr
President and CEO, Health Action Council

Newly released claims data from more than 220,000 people reveal the latest evidence on the role obesity plays in health and health care costs, underpinning the need for supportive measures and interventions.

The new study, which analyzed Health Action Council (HAC) members with health plans administered by UnitedHealthcare, found that people with obesity cost their employers 2.3 times more than those without the condition and paid 66% more out-of-pocket ($662) per year than their peers without obesity. Notably, Millennials with obesity incurred over 8% higher per member per month (PMPM) costs than Baby Boomers without obesity who were 27 years older, due to the increased likelihood of chronic condition diagnoses.

Multifaceted health consequences

Comorbidities such as diabetes, hypertension, high cholesterol, and musculoskeletal issues were major cost drivers. The more comorbidities a person with obesity experienced, the higher their costs became. Obesity significantly increased the risk of various cancers, including breast, colon, rectum, and upper stomach cancers, and increased the risks for anxiety, substance use disorders, and depression.

Obesity among women of childbearing age

The report highlighted a 19-percentage-point rise in obesity rates between Gen Z women (9%) and Millennial women (28%), the largest generation in today’s workforce. This was particularly concerning due to the heightened maternal mortality risks and mental health issues associated with obesity.

The ripple effect on children

Children of parents with obesity are generally twice as likely to develop the condition themselves, but this risk tripled for children of HAC members if at least one parent had obesity. These children were also 44% more likely to experience depression, 39% more likely to have ADHD, and had higher rates of developmental disorders, asthma and diabetes.

Whole person weight management solutions

Effective strategies will require more than GLP-1s, which are unlikely to meaningfully impact obesity rates due to their high costs and low compliance rates. Consistent with the Food and Drug Administration’s label, these medications should be used in tandem with a life-style modification program for the treatment of obesity.

Strategies for employers

Following are a few steps employers can take to build a healthier workplace culture.

Understand your population. Analyze claims to determine the percentage of your workforce and dependents impacted by obesity. Identify prevalence, most impacted groups, as well as other health risks and social drivers of health.
Foster a healthy environment. Encourage a positive relationship with food, activity, and stress management by offering classes on exercise, nutrition, and mindfulness and providing non-processed foods at meetings, events, and in common areas. Encourage daily physical activity, less screen time, and quality sleep.
Offer comprehensive health solutions. Implement wellness solutions that integrate whole-person health by providing access to virtual providers such as network dietitians, digital health tools like mental health apps, and wearable technologies such as continuous glucose monitors.

About the author ~

Patty Starr, CEO of Health Action Council

Patty Starr is President and CEO of Health Action Council and is responsible for driving the strategic direction of the organization--build stronger, healthier communities where business can thrive.

Advocates push for mandatory minimum nurse staffing ratios at Illinois hospitals

The Illinois Health and Hospital Association, the Association of Safety Net Community Hospitals and the Illinois Critical Access Hospital Network issued a statement saying they strongly oppose HB 3512.

by Grace Friedman
Medill Illinois News Bureau, Capitol News Illinois

SPRINGFIELD — Health care unions continue to rally for legislation to address understaffing they say strains hospitals and threatens both patient safety and staff well-being.

Lawmakers are considering the Hospital Worker Staff and Safety bill, which would establish mandatory nurse-to-patient staffing ratios and increase support for underfunded hospitals.

The proposed legislation, Senate Bill 21 and House Bill 3512, aims to establish minimum staffing ratios in hospitals and fund critical safety-net hospitals across the state. Advocates with health care worker unions have been holding a series of rallies at the Capitol in support of the legislation in recent weeks.

“Our hospitals are staffed unsafely,” Kawana Gant, a certified nursing assistant at UChicago Medicine Ingalls Memorial Hospital in Harvey, said at a recent Statehouse rally. “I have worked short shifts where there are 30 patients and only one CNA on the floor. How can you give quality care? It is not safe.”

Gant, who has worked at Ingalls Hospital for nearly 30 years, says she has watched many of her colleagues quit due to the mental and physical toll the short staffing has had on their bodies.

“This is an opportunity for legislators to hear us, to know that these hospitals are not safe.” Gant said.

But similar versions of the proposed legislation have been introduced at the Statehouse for recent years and have failed to gain traction. Generally backed by unions representing nurses, such as the Service Employees International Union, previous staffing ratio measures have run into opposition from hospital groups that say they’re unworkable.

The proposed legislation filed this year has yet to receive a hearing in a substantive committee, meaning it will be an uphill battle for it to move by the time the legislature adjourns at the end of the month.

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Like previous versions, it would mandate that hospitals “employ and schedule sufficient staff to ensure quality patient care and safety.” In addition, hospitals would have to share annual staffing metrics with the Illinois Department of Public Health to help ensure they are at proper staffing levels.

“This bill gives you a real voice,” Rep. Kam Buckner, D-Chicago, said to rallygoers. “It gives you a way to speak up when things are unsafe for you and the people who you care for.”

However, not all lawmakers are convinced that now is the right time to implement staffing ratios.

“You can mandate the staffing ratios, but if those professionals don’t exist, what have you really done?” said Rep. Norine Hammond, R-Macomb. “We’ve been trying for years to get more people into the health care field, especially after COVID, and we’re just not there yet.”

Hammond expressed concern that enforcing strict staffing requirements without enough qualified workers in the pipeline could place unrealistic burdens on hospitals. She warned that such mandates might unintentionally strain facilities already struggling with labor shortages and lead to adverse financial consequences, especially for smaller or rural hospitals.

Hospital trade groups echo those concerns, calling the legislation unworkable, burdensome and an ineffective way to solve a problem that should be addressed by the specific needs of each hospital or care center. The Illinois Health and Hospital Association, the Association of Safety Net Community Hospitals and the Illinois Critical Access Hospital Network issued a statement saying they strongly oppose HB 3512.

They said it was introduced “as a backdoor effort pushed by organized labor to impose unworkable, government-imposed health care staffing ratios in Illinois.”

“This proposal would relegate the essential, complex and nuanced protocols established to safely and efficiently staff a hospital 24/7/365, to a series of burdensome forms and onerous paperwork that hospitals would be required to submit to the (IDPH) to establish minimum staffing standards for every hospital worker, in each hospital unit,” the groups said in the statement.

Still, according to a recent Service Employees International Union survey of Chicago area hospital workers, 70% of respondents reported understaffing, and over 25% reported unsafe or unmanageable workloads. Additionally, in the same survey, 47% of the respondents stated an intent to leave their jobs soon.

To help enforce safety standards, the legislation introduces “assignment despite objection forms” that give hospital workers the opportunity to document and report any assignments that they believe are unsafe. Hospitals are then required to provide this information to IDPH, which would have to publish an annual report on all these staffing metrics. The legislation would also require IDPH to “make recommendations for minimum staffing standards for hospital workers in each hospital unit.”

In addition to protecting staff, advocates said this bill would allocate proper essential resources to underfunded hospitals around the state, including Mount Sinai Hospital on Chicago's West Side, a Level 1 trauma center that helps underserved and violence-impacted communities.

“Mount Sinai saved my son's life,” said Sonya Brown, who traveled from Chicago to Springfield recently to advocate for the safety-net hospital that treated her son after he was shot seven times in 2020.

“He was shot in the head, he was shot in the neck, he was shot in the chest, the abdomen and shoulder, and the arm,” Brown said. “If they wouldn't have gotten to him in time, he would have died.”

Mount Sinai serves as a health care provider for communities on both the South and West sides of Chicago, areas that experience some of Chicago's highest rates of gun violence. If the hospitals are not protected by measures in this legislation, advocates said, the victims in these neighborhoods risk longer travel times to alternative trauma centers.

They said the bills would help allocate essential resources and enforce staffing standards at safety-net hospitals to continue effectively serving vulnerable communities.

“All of our staff is overworked,” said Jessica Mendoza, a nursing assistant at Edward Hines Jr. VA Hospital in Hines. “A lot of our veterans are coming into the VA to get help with their health, but we do not have the staff to provide it.”

Mendoza, who has worked at the Hines VA Hospital for nearly two years, said that due to the low number of staff, they rarely get a break. She noted that the lack of sufficient staffing makes it difficult to provide the level of care that the veterans need.

The health care workers and advocates gathering in Springfield at the recent rally emphasized that without sufficient staffing and resources, the quality of patient care throughout Illinois hospitals will continue declining, and worker burnout will escalate.

“They expect you to do the job of five or six people but pay you for one.” Sen. Lakesia Collins, D-Chicago, said at the rally. Prior to joining the General Assembly, Collins was a CNA in nursing homes.

As the legislation stagnates at the Capitol, hospital workers and advocates said they plan to keep organizing and sharing their stories. They said they're calling on lawmakers to prioritize frontline health care workers and the patients who depend on them.

Grace Friedman is a student in the Medill Illinois News Bureau, a program at the Medill School of Journalism that provides local news outlets with state legislature and government coverage. She can be reached at gracefriedman2025@u.northwestern.edu.

Capitol News Illinois is a nonprofit, nonpartisan news service that distributes state government coverage to hundreds of news outlets statewide. It is funded primarily by the Illinois Press Foundation and the Robert R. McCormick Foundation.

This article first appeared on Capitol News Illinois and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.

Measles cases reach 600: Experts warn of contagion risk and vaccine importance

by Matt Sheehan
OSF Healthcare

PEORIA - As measles cases continue to climb across the United States, the long-term implications can’t be ignored.

The respiratory viral infection, although thought eliminated in the U.S. in 2000, has reemerged, especially among unvaccinated individuals. As of early April 2025, the Centers for Disease Control and Prevention (CDC) has reported more than 600 confirmed cases of measles.

Measles is extremely contagious

"The key to measles is how highly infectious it is. Each person that has measles will infect between 12 and 18 people in an unvaccinated situation," says Doug Kasper, MD, an infectious disease specialist with OSF HealthCare. "The key for controlling measles is widespread vaccine use."

Doug Kasper, M.D.
OSF Infectious Disease Specialist

For reference, each influenza patient, on average, will infect one to two others.

The measles vaccine is normally offered once a child has reached one year of age. It's a two-shot series, which came on the market in 1963. Dr. Kasper says this gives medical experts decades of data that show a correlation between people receiving the vaccine, and close to zero circulation of the virus in the United States.

The states with measles outbreaks are in unvaccinated people, and no breakthrough cases (in those who have received the vaccine) have been reported, Dr. Kasper adds.

The long-term risks for unvaccinated measles patients

"There is emerging information that vaccination not only protects an individual from not becoming ill or having less severity of illness with a viral exposure, whether that's measles, chicken pox, influenza or COVID-19, but that there are long-term risks from viral infections that we do not appreciate in the moment," Dr. Kasper says. "Some of these have been associated with memory loss or dementia as somebody ages. Some of these are associated with organ disease like hepatitis or kidney disease."

Subacute Sclerosing Panencephalitis (SSPE)

SSPE is a rare, deadly degenerative disease of the central nervous system that can happen seven to 10 years after a measles infection. Young children, pregnant women and immunocompromised people are the most at-risk for SSPE. One to three out of every 1,000 children who become infected with measles will die from respiratory and neurologic complications, the CDC says.

SSPE symptoms happen over four stages.

Stage 1: Personality changes, mood swings or depression. There may also be fever and headaches, this stage can last up to six months
Stage 2: Muscle spasms and uncontrolled movement problems. Loss of vision, dementia and seizures can occur
Stage 3: Twisting movements and rigidity. Sometimes death
Stage 4: Serious brain damage, including areas of the brain that control breathing, heart rate and blood pressure, leading to coma and death

Immune amnesia

Another long-term impact of measles is known as immune amnesia. The American Society for Microbiology (ASM) calls immune amnesia “one of the most unique and most dangerous features of measles pathogenesis.” The extremely rare condition causes people’s immune systems to “forget” how to fight off infections and makes the person more susceptible. The ASM determined it normally takes two to three years after a measles infection for protective immunity to return.

A measles outbreak was declared in Northeast Illinois in early 2024 and declared “over” by the Illinois Department of Public Health (IDPH) in June. The expectation of statewide health experts is that measles will return to Illinois in the coming months. This is mainly due to heavy travel through Chicago airports and summer festivals. County health departments have now been tasked with keeping an eye on their measles vaccine rates and identifying areas where vaccine rates are low.

Peoria County's measles vaccine rate is quite high, around 95%. But outlying communities in central Illinois have lower vaccine rates, normally more rural counties. Health experts at Michigan Medicine call the Great Lake State “ripe for a measles outbreak,” as only 66% of toddlers receive the recommended childhood immunizations.

Measles symptoms

"Measles typically presents with a high fever, typically much higher than what we'd see with seasonal colds or influenza. Fevers can be 104 or 105 degrees Fahrenheit," Dr. Kasper says. "That's followed by a runny nose and a characteristic rash. This typically develops on the head and then spreads down the rest of the body."

“We don’t want to go back”

"Measles at its peak, in the 1950s before the vaccine, led to a significant number of hospitalizations in young children. Around 50,000 hospitalizations were estimated per year and about 500 deaths," Dr. Kasper says. "We don't want to go back to that scenario in any capacity, where we have a large number of unvaccinated people. The outcomes could be too severe."

Immunocompromised people like those who have received an organ transplant, cancer patients or those on long-term therapies that could impact their immune system, are at high risk for measles.

Why vaccines are so important right now

Summer travel along with large crowds at places like airports and theme parks, will likely bring more measles cases to the United States.

"This time, as good as any time, is to make sure somebody is updated on their vaccinations. If somebody isn't sure if they were vaccinated as a child, they should talk to their primary care provider about testing or receiving the vaccine. If someone is immunocompromised and they might be at a higher risk for measles through travel in areas that have exposure, they should talk to their primary care provider about the vaccine," Dr. Kasper says. "If someone has young children or is at an age where vaccine is recommended, we wholly recommend for them to discuss with their provider to remain up to date on their vaccine series."

Vaccine hesitancy continues to be a topic of discussion, one that Dr. Kasper recommends patients openly discuss with their medical provider.

Natural immunity is not a viable option with measles. The highly infectious nature of the virus, along with the severity of symptoms and potential for long-term complications, make it an illness people need to try and avoid entirely.

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Facing inequities in maternal health care, Black mothers are more at risk to receive lower quality care

For Black women, one of the biggest issues is finding their voice when confronting health issues.

by Paul Arco
OSF Healthcare

As a practicing OB/GYN, Lisa Davis, MD, sees the maternal health challenges Black women deal with every day.

Lisa Davis, M.D.
OSF HealthCare Saint Anthony Medical

“Some of the issues that face black women when it comes to maternal health are issues with blood pressure,” says Dr. Davis, chief medical officer for OSF HealthCare Saint Anthony Medical Center in Rockford, Illinois. “So what we would call preeclampsia, a risk of preterm birth, which can result in low birth weight of the infant, postpartum hemorrhage, or hemorrhage that occurs right after delivery or during the latter stages of delivery.”

And it can lead to even more serious consequences. According to the Centers for Disease Control and Prevention (CDC), the pregnancy-related death rate for Black women is three times the rate for mothers of other racial and ethnic groups.

Nationally, April 11-17 is Black Maternal Health Week, a time to raise awareness and take action to improve the health of Black mothers.

Dr. Davis says for Black women, one of the biggest issues is finding their voice when confronting health issues, which include disparities such as getting quality healthcare, dealing with underlying chronic conditions and social drivers such as income, housing, transportation or child care.

Dr. Davis stresses to her patients the importance of making their own health a high priority.

“I think for black women in the maternal health space, it's being heard and too often, there is a misperception that sometimes is out there regarding their response to pain, their use of drugs and things that are all misconceptions,” she says. “That is a big challenge for us, and that includes me, to overcome. It doesn't matter what level of education or where you live. The research has shown that it is still an issue.”

Dr. Davis adds that the medical community can do better when it comes to listening and responding to their patients’ needs. “Every patient is special and different for us to slow down and really look at that person as the person, and understand and listen,” she says. “Sometimes patients, if they're not comfortable, won't disclose what's going on in the first few minutes, but as you get ready to leave, then you might start to get the real back story. And so, it's important for us to slow down and be in the moment.”

Another need is for more Black providers, according to Dr. Davis. She says studies have shown that Black patients tend to relate to someone their own color. “It's very important, I think, for that message to be out there and to encourage young people to look at health care as an option, especially young people of color, because in the future, that's what we're going to need.”

But there are things patients can do for themselves. Dr. Davis stresses to her patients the importance of making their own health a high priority. That includes maintaining a healthy diet, getting enough rest and exercise and attending prenatal appointments.

“If you're not at your best, how can you be good for anyone else?” she asks. “I think what moms suffer from is everyone's important, but sometimes they need to take that step back and focus on themselves, so they can be 100% for their kids, for their spouse, for their parents, for their siblings.”