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• The U.S. Department of Agriculture Food Safety and Inspection Service (FSIS) announced a recall of over 200,000 pounds of Boar’s Head products on July 26 amid a Listeria outbreak.
• Deli meats sliced at the counter have been linked to the outbreak, which led to two deaths and 28 hospitalizations, according to the CDC. 
• You should avoid unheated deli meat if you are pregnant, age 65 or older, or have a weakened immune system.

The U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS) announced a nationwide recall of Boar’s Head deli meats on July 26 that may be contaminated with Listeria monocytogenes.

The recall includes 207,528 pounds of Boar’s Head liverwurst and other deli meat products.

A widespread Listeria outbreak in the United States has resulted in two deaths and 28 hospitalizations across 12 states.

The outbreak has been linked to meat sliced at deli counters, not prepackaged deli meats, according to a July 2024 investigation notice from the Centers for Disease Control and Prevention (CDC).

The CDC warns that Listeria is a bacteria that causes a foodborne illness called listeriosis, which is particularly dangerous for pregnant people and other high risk groups.

The affected individuals span from the Midwest to the East Coast, with lab samples collected between May 29 and July 5. In interviews, most people reported eating deli-sliced meats, particularly turkey, liverwurst, and ham. 

Despite the Boar’s Head recall, the CDC’s investigation into this outbreak is ongoing to determine whether other products sliced or prepared at delis are contaminated with Listeria.

Who is most at risk after Listeria exposure?

Dr. Brian Labus, PhD, MPH, an assistant professor in the Department of Epidemiology and Biostatistics, School of Public Health, University of Nevada Las Vegas, cautioned that certain individuals face a higher risk of severe illness from Listeria.

He told Healthline that while most people consuming contaminated food may experience mild gastrointestinal symptoms that resolve quickly without treatment, high risk groups are particularly vulnerable.

Populations at high risk for serious Listeria infections include: 

• pregnant people and newborns
• individuals aged 65 or older
• those with weakened immune systems 

Symptoms typically appear within two weeks of consuming contaminated food but can manifest as soon as the same day or as late as 10 weeks later. 

Labus said pregnant people who contract the bacteria “often have a very mild illness,” such as fever, muscle aches, or tiredness, “but that illness can lead to [pregnancy loss], premature delivery, or serious [life threatening] infections of the newborn.”

Non-pregnant individuals may also experience fever, muscle aches, and tiredness, along with additional symptoms like headaches and confusion, according to the CDC. 

Labus warns that older adults and people with weakened immune systems can develop dangerous Listeria infections that enter the bloodstream or brain.

This is “a very serious invasive infection that usually requires hospitalization and kills about one out of every six people infected [with invasive listeriosis],” he said.

Why is deli meat causing listeria

Deli meats sliced at the counter carry a higher risk of bacterial contamination, like Listeria, compared to pre-packaged deli meats. 

“The difference is the risk of cross-contamination,” said Labus.

He explained that while both types of deli meats can arrive from the manufacturer already contaminated with Listeria, pre-packaged options minimize this risk by avoiding direct contact with other products.

Slicing meats at the deli can transfer Listeria from contaminated meats to other foods. Equipment and surfaces used for slicing can harbor bacteria, causing contamination of other items prepared in the same area. This significantly raises the risk of bacteria being present in deli counter food products.

“This is why it is so important that we keep Listeria from entering these foods in the first place,” Labus stressed, emphasizing the need for vigilance in food manufacturing and handling practices.   

If you suspect that you have purchased any deli products that may be contaminated, throw them away immediately to ensure your safety and well-being. 

Is it safe to eat meat from the deli?

According to Labus, consumers face challenges when purchasing deli meats because there are no visible signs of Listeria or other foodborne pathogens. “This is why we have a robust food protection system in the country,” he said.

He explains that the food industry and regulators collaborate to ensure that food is prepared and handled safely, including a zero-tolerance policy for Listeria in the food supply.

Labus said the problem is that Listeria “thrives in low-temperature, high-salt conditions — the exact conditions we generally use to prevent bacterial growth in food.” In other words, refrigeration doesn’t prevent or kill Listeria. 

So, for those at higher risk of severe illness, such as pregnant women, the CDC recommends avoiding deli meats altogether or heating them to an internal temperature of 165°F or until steaming hot before consumption.  

Additionally, ready-to-eat products like deli salads, soft cheeses, and cut melons can also become contaminated with Listeria. 

Therefore, the CDC advises high risk individuals to choose safer foods, such as:

• heated meats
• hard cheeses
• homemade deli-style salads (potato, tuna, chicken) 
• fresh melon and other fruit cut at home

Is sliced deli meat healthy?

Kiran Campbell, RDN, a registered dietitian nutritionist and medical nutrition advisor at Dietitian Insights, explained that deli meats are considered ultra-processed foods. 

“While not all ultra-processed items are harmful,” she noted, ultra-processed meats may indeed pose health risks. 

Processed deli meats tend to be high in sodium, saturated fat, and preservatives, contributing to issues like heart disease, diabetes, and certain cancers, she said. 

Campbell also highlighted that the World Health Organization (WHO) classified processed meats as Group 1 carcinogens, meaning there is convincing evidence that processed meats cause cancer in humans.

Every 50 grams of processed meat consumed daily might increase colorectal cancer risk by about 18%.

If you decide to eat deli meats, Campbell advised choosing single-source options like sliced chicken, turkey breast, or roast beef instead of varieties like bologna, salami, and head cheese that contain mixed meats and animal byproducts.

She also recommends selecting:

• minimally processed deli meats with fewer additives
• products lower in sodium and saturated fat 
• organic and grass-fed options, which may be more nutritionally dense
• meats raised without antibiotics  
• options without added nitrites or nitrates, often labeled “uncured” 

However, uncured meats typically use ingredients like celery powder, which still contain natural nitrates. It’s unclear if natural nitrites are actually safer.

Ultimately, while it may take more effort, cooking and cutting lean meats at home is usually the safest and healthiest option for sliced meats.

Takeaway

A multi-state Listeria outbreak in the United States has resulted in 2 deaths and 28 reported illnesses in July 2024. 

The CDC has linked these cases to deli-sliced meats, but the specific products involved in the outbreak have yet to be identified.

High risk groups — particularly pregnant individuals, people ages 65 or older, or those with weakened immune systems — are advised to either avoid deli-sliced meats altogether or ensure that all deli meats are heated to a high internal temperature of 165°F to kill bacteria before consumption.

• A new study found that the drug Sunleca (lenacapavir) has been shown to be 100% effective at preventing HIV in females.
• The drug is given via injection two times a year and is manufactured by the U.S. company Gilead.
• Health experts say the potential to reduce the number of new HIV infections is enormous if the drug can be made widely accessible.

Two shots a year of lenacapavir, a drug manufactured as Sunleca by the U.S. company Gilead, was shown to be 100% effective in preventing the transmission of HIV in females, according to a new study funded by Gilead and administered by some of its employees.

More than 5,000 females in Uganda and South Africa were part of the research;  2,134 of them were given the injections, and none of them were reported to have HIV.

The other sections of the study cohort were split into two varieties of oral prevention pills — Descovy and Truvada — on a daily basis, and around 2% of them reported HIV infections.

The results of testing in men have not yet been calculated, but experts say the potential to change the rate of new HIV infections is enormous if the pre-exposure prophylaxis (PrEP) drug can be made widely accessible.

Dr. Amit Achhra, MD, an assistant professor of medicine at Yale School of Medicine who specializes in infectious diseases, told Healthline that the future of HIV prevention was “exciting” in this light.

“While we don’t have HIV vaccine yet, injectable HIV PrEP comes close to what one might see as periodic ‘HIV vaccine,’ i.e. periodic shots that have very high efficacy in preventing HIV infection,” Achhra said. “For those who don’t wish to get the shots, very effective oral HIV PrEP pills will remain an effective option. With more HIV prevention options available, we hope the rate of HIV infections will further decline in the future.”

How does lenacapavir prevent HIV transmission?

Approximately 39 million people worldwide live with HIV, and some of the highest numbers of diagnoses are in sub-Saharan Africa.

In 2022, according to the Foundation for Aids Research, 3,100 young women and girls (ages 15 to 24) contracted HIV every week in sub-Saharan Africa.

Lenacapavir, which is used as a treatment for HIV after it has been contracted in the U.S., Canada, and Europe, is among the group of drugs known as capsid inhibitors. These disrupt the protein shells (capsids) of the HIV virus that is essential to replication, which can interrupt the process of multiplying in the body.

Dr. Monica Gandhi, a professor of medicine and the associate division chief of the Division of HIV, Infectious Diseases, and Global Medicine at UCSF/San Francisco General Hospital, told Healthline that lenacapavir is a “first-in-class new HIV medication” with strong potency.

“The formation of a capsid around the virus is very important at multiple stages of the viral life cycle, including during nuclear transport and release,” Gandhi said. “Lenacapavir is so potent that it can be provided just twice yearly (every 26 weeks), which is its advantage over agents for PrEP (daily oral or cabotegravir, which is given once every 8 weeks).”

Does lenacapavir only work in females?

Rates of HIV are 7.7% higher in men who have sex with other men and 9.2% higher for transgender people, according UNAIDS.

According to Gandhi, the pathways to HIV infection work differently in females and males, but a new study should provide encouraging results for males.

“The PURPOSE 2 trial is being conducted in men, transgender women and non-binary individuals and the results are due out later this year, which is when (if favorable), Gilead will apply for regulatory approval,” Gandhi said. “Some drugs can work differently in men and women due to differential tissue levels at the site where transmission can occur (e.g. anal or vaginal mucosa), so it is important to test these preventive agents in both men and women.”

How much do lenacapavir injections cost?

Current reports have lenacapavir running more than $40,000 for the first year, but it’s been suggested that it could be sold for as little as $40, which would instantly create an enormous path to access worldwide.

“If the drug can be more cheaply made than what the company is suggesting, that would be a huge boon for the field, especially in preventing HIV infection in low-and-middle-income countries,” Gandhi said. 

“The drug is likely to be approved in the US even at a higher price point and should have benefits in controlling HIV infection in the US since the latest data from the CDC is that we still need more uptake of PrEP in this country among women and men,” Gandhi added.

“Currently, oral PrEP pills are significantly cheaper than shots, and in fact, the generic version of Truvada oral PrEP pill is available for very cheap, often less than $1 per pill. However, many people have a hard time keeping up with the daily pill,” Achhra said.

“It will therefore be important to have equally cheaper and accessible injectable PrEP options widely available to make a big dent in the HIV epidemic. Of note, it will be equally important for clinics and hospitals administering these shots to reduce their hospital ‘facility fees,’ which are often exorbitant and prevent access to these medications,” Achhra said.

Takeaway

A capsid inhibitor called lenacapavir, sold as Sunleca by the drug maker Gilead, prevented HIV infection in 100% of the cases in a recent study of more than 5,000 females in South Africa and Uganda.

Lenacapavir has been used as a treatment for HIV, but these twice-yearly shots could revolutionize HIV prevention, experts say.

Results of a study of the drug’s efficacy in males have not been published yet, but experts say full access and a cheaper price point would make an enormous difference globally.

• Most food products have a Nutrition Facts label.
• A good rule of thumb for utilizing this label is the 5/20 rule.
• Under this rule, less healthy nutrients should be kept at 5% DV or less.
• Healthier nutrients, however, should be 20% DV or greater.
• Following this guideline can help you make healthier choices about nutrition.

You’ve probably noticed a nutrition label on the back of the package or can for many of your favorite foods.

The Nutrition Facts label provides important information about the number of calories per serving.

It also states the amounts of various nutrients found in the food and their percent daily value (%DV).

But just what does all this mean, and how can you use it to be healthier and lose weight? One good rule of thumb is the 5/20 rule.

What is the 5/20 rule?

Marta Ferraz Valles, MA, RD, LD, an outpatient dietitian at The Institute for Digestive Health and Liver Disease at Mercy Medical Center in Baltimore, explained that the purpose of the 5/20 rules is to provide a general guide for selecting foods that are low in certain nutrients we don’t want, such as sodium, but high in others that we do want, like fiber, based on the %DV.

The %DV indicates the percentage of each nutrient that a serving of the food provides toward daily nutrient goals or limits based on eating a 2000-calorie diet, she added.

Valles further explained that if the %DV is less than or equal to 5%, the food is considered to be low in this nutrient. On the other hand, if the %DV is 20% or more, it is deemed to be high in this nutrient.

“For example, if a food label indicates that the food contains 2% DV of sodium [per serving], that means that the food is low in sodium,” she said.

Valles additionally noted the importance of serving size.

“If the serving size of the previous [sodium] example were 2 tablespoons and a person would eat 1 cup,” then that person would no longer be consuming low amounts of sodium, she remarked.

“Thus, the rule may be helpful as long as individuals eat the serving size indicated in the label,” said Valles.

How can the 5/20 rule help improve your health?

The 5/20 rule can help you make healthy food choices. For example, it can help you decrease the amount of foods you eat that are high in harmful nutrients like saturated fats and sodium while increasing the amount of beneficial ones like vitamins and fiber.

This can help reduce the risk of critical diseases like diabetes and cardiovascular disease.

When it comes to nutrients that you’ll want to limit, keep an eye on your sodium intake. This can help when it comes to blood pressure and your heart.

The 5/20 rule is also helpful if you are working to lose weight, as reducing your calorie intake is often an important component of weight management.

Additionally, the rule can help identify foods low in added sugars and saturated fats (5% or less of DV) and decrease calorie intake from unhealthy sources.

On the other side of the coin, the 5/20 rule can help you improve your intake of vital nutrients like vitamins, fiber, and minerals, which are good for overall health. You’ll want to choose foods with 20% or more DV of these beneficial nutrients.

Putting the 5/20 rule into action

“Generally, individuals want to choose products with less sodium, saturated fat, and added sugars, and with more dietary fiber, calcium, potassium, and iron,” advised Valles. “However, it is important to consult with a registered dietitian, as this does not apply for everyone.”

Valles cited irritable bowel syndrome (IBS) as one example of when you might be advised to alter this recommendation.

“For example, some people with IBS (irritable bowel syndrome) may have more gastrointestinal symptoms, including cramping and diarrhea, if they have too much of certain types of fiber,” she said.

However, others with IBS are advised to increase their intake of certain fibers. So, if you have IBS or other gastrointestinal conditions, it’s important to talk to your doctor or registered dietitian about what types of fiber, and how much, might be best for symptom management.

Valles said that she also tells her patients to use the rule to compare food products so they can select which is the better choice. For example, when choosing between two tomato sauces, you could opt for the one with less sodium and added sugars.

She added, however, that it’s your overall diet that matters most. You might still be able to buy the tomato sauce with higher sodium and sugar if your overall diet is low in these less-desirable nutrients.

Valles concluded by saying that, although the 5/20 rule can be helpful, it’s also important to read the ingredients list.

“Some products may look very healthy when we look at the label (low sodium, low saturated fat, low added sugars, and high dietary fiber), but if we were to read the ingredient list, it may contain highly processed ingredients that we cannot pronounce,” she said.

“In this case, this may not be the healthiest choice, and people should discuss this with their registered dietitian,” said Valles.

Takeaway

The 5/20 rule is a guideline for using the Nutrition Facts label in order to make healthier choices.

Less healthy nutrients — like sodium, added sugar, and saturated fat — should generally be kept at or below 5% DV.

Healthier nutrients — like fiber, calcium, and potassium — should be consumed in larger amounts at or above 20% DV for most healthy adults.

Following this rule can help you lose weight, protect your heart, and generally be more healthy.

However, be aware that this is a general rule of thumb. Certain medical conditions, such as IBS, may require more or less of certain nutrients.

As our world becomes increasingly interconnected and the climate changes, the UK faces challenges that we might associate with more exotic destinations. One such challenge is the potential introduction of invasive mosquito species, particularly the tiger mosquito (Aedes albopictus). This …

• Environmental pesticide exposure due to industrial agriculture potentially increases cancer risk to a degree similar to smoking.
• In a new study, researchers correlated cancer rates in geographic regions based on pesticide usage.
• The study does not demonstrate causation. More research is needed to understand how environmental pesticides affect cancer risk.

Is pesticide exposure as bad for you as smoking in terms of cancer risk?

Potentially, yes, claims a new scientific study.

The research, published in the journal Frontiers in Cancer Control and Society, found a strong association between the presence of environmental pesticides and several cancers, including leukemia, non-Hodgkin’s lymphoma, bladder, lung, and pancreatic cancer.

The authors used population and geographic data from sources, including the CDC, Department of Agriculture, and US Geological Survey, to investigate the correlation between rates of these cancers and pesticide usage in various regions across the United States.

This type of study, known as an ecological study, is used to identify broad trends but does not demonstrate a causal link, which the study authors readily admit.

The trends identified between pesticides and cancer risk are akin to those you would typically see with smoking.

“We found that every cancer is affected. So, everything is affected by pesticides. And it is very similar to what you see in smoking. If you increase how much you smoke, you increase your risk for every cancer, even when some of those are more affected than others. And that is exactly what happened here,” Isain Zapata, PhD, an Assistant Professor of Research and Statistics at the Rocky Vista University and Senior Author of the study, told Healthline.

Loren Lipworth, ScD, a Professor of Medicine and Associate Director of the Division of Epidemiology at Vanderbilt University Medical Center who wasn’t affiliated with the research, told Healthline that, due to its design, we need to be cautious about interpreting this study’s findings.

“The conclusions that can be drawn from this type of study are that there may be some etiologic clues, there may be some signals of associations between various types of cancer and pesticide use patterns at this large ecologic population level, but in terms of individual-level data, the study does not provide that,” she said.

Mapping the potential link between pesticides and cancer

The study is the first comprehensive examination of the effects of pesticides on cancer risk across large geographic regions and populations in the United States.

Researchers used reporting data for sixty-nine different pesticides to create geographic regions. Essentially, they carved out areas of the US used for agriculture based on reported pesticide usage.

For example, the Midwest, the country’s leading region for corn production, has the highest presence of environmental pesticides. Meanwhile, the Great Plains region, from northern Texas to North Dakota, has the least.

Once the authors established these geographic regions, they then looked at rates of cancer in these areas. 

They hypothesize that cancer risk is likely tied to the amount of pesticide use and different kinds of agricultural production since pesticide usage also varies based on activity. For example, California, the nation’s largest vegetable producer, would likely have different cancer outcomes than the Midwest, where corn is the predominant crop.

Zapata told Healthline that this methodology gives a more holistic impression of how exposure can occur, noting that individuals are rarely ever exposed to a single pesticide but rather a “cocktail” of different contaminants in the real world.

“You’re going to be exposed to the pesticides that might be floating around from the farms that are close to where you live. There might be industrial residues that are unique to the agricultural activity of that area,” he said.

Specific pesticide outcomes

Sixty-nine nationally reported pesticides were included in the study. Individually, many were linked to different cancer outcomes.

• Atrazine is used to control grasses. The study found that it was consistently a top contributor for increased risk of all cancers and colon cancers.
• Glyphosate is commercially available as a weed killer named Roundup and is associated with an increased risk of all cancers, colon cancer, and pancreatic cancer.
• Dicamba is commonly used in corn and soybean agriculture. It was linked to an increased risk of colon cancer and pancreatic cancer.
• Dimethomorph is a fungicide. It was identified in regions with a high risk of leukemia and non-Hodgkin’s lymphoma.

Despite these findings, Zapata told Healthline that the goal of their study is not to stop pesticide usage.

“We aren’t trying to tell the Midwest, OK, you cannot grow corn anymore,” he said.

“We need to eat. We need to have products derived from agriculture. And to have the efficiency that we need to be economically sustainable, we need to use those chemicals. So it becomes a cost-benefit, risk-benefit approach,” said Zapata.

Strengths and weaknesses of the study

The study authors controlled for major confounding factors, including smoking, socioeconomic factors, and the area of agricultural land. However, when using population data, not all confounding factors can be accounted for.

To be clear, even in a region with high rates of cancer and pesticide usage, the study’s nature doesn’t allow one to be attributed to the other. It does, however, provide a signal that more research is needed.

“There’s no causal inference that can be drawn between individuals or a group of people’s actual pesticide exposure and their individual cancer risk,” said Lipworth.

The study doesn’t differentiate between groups of people, such as farm workers who may have direct exposure to pesticides, and members of the surrounding community whose exposure could vary based on proximity and other factors. 

“It’s really important that we have person-level exposure assessment. There are people who are occupationally exposed, and there are farmers, but in the same area, there are people living with farmers who are exposed in a different way. So, personal level exposure assessment is really critical for us to understand this type of scientific association,” said Lipworth.

The bottom line

A national population study has found a broad association between environmental pesticide usage and various forms of cancer.

Across different US geographic regions, sixty-nine different pesticides were associated with increased risk of colon, pancreatic, lung, and other cancers.

The design of the study only shows association, not causation. More research is needed to better understand how environmental pesticide exposure affects cancer risk on a personal level.

• A new state-by-state report ranking women’s healthcare has been released.
• It finds that the overturning of Roe v. Wade has made getting reproductive care difficult.
• Also, women are dying from preventable cancers like breast and cervical cancer.
• Women living in states with worse healthcare can self-advocate to get better care.
• However, legislation will be necessary to close the gaps.

A new report prepared by The Commonwealth Fund states that women’s health and reproductive care in the United States is in a “perilous place,” and there are growing disparities in these areas.

They note that more women than ever are dying from preventable causes, and there are large differences in maternal mortality and breast and cervical cancer deaths.

Additionally, women’s life expectancy is at its lowest since the year 2006.

Their state-by-state analysis further draws attention to the fallout from the Supreme Court’s historic decision overturning Roe v. Wade, which made it increasingly more difficult for women to obtain needed reproductive healthcare.

Dobbs v. Jackson Women’s Health Organization has also created a climate where contraception and in vitro fertilization (IVF) are at risk, says the report.

They further discuss the impacts of state-level post-pandemic policies that have left millions of low-income women either without health insurance or with gaps in their coverage.

Additionally, these losses in coverage have left the providers who serve these low-income women in danger of closing their offices.

The 2024 State Scorecard on Women’s Health and Reproductive Care, their first effort to examine women’s healthcare in all 50 states and the District of Columbia, is part of an ongoing series of reports on how well state healthcare systems are fulfilling their missions.

It uses 32 measures to gauge each state’s performance in terms of healthcare access and affordability, health care quality and prevention, and health outcomes.

Where healthcare for women ranks highest and lowest

According to the report, Massachusetts, Vermont, and Rhode Island are some of the best-performing states in terms of healthcare access, quality, and outcomes.

Other top-ten states, ranked from higher to lower, were Connecticut, New Hampshire, Maine, the District of Columbia, Minnesota, Hawaii, and New York.

On the other end of the spectrum, Mississippi, Texas, and Oklahoma ranked the worst on these measures.

Other states among the bottom ten, from lower to higher, were Nevada, Arkansas, Georgia, Alabama, Arizona, Tennessee, and Wyoming.

Among the notable findings of the report is the fact that all-cause mortality for women of reproductive age is highest in southeastern states. At the high end of the spectrum was West Virginia, with an all-cause mortality rate of 203.6 per 100,000. At the low end was Hawaii, with 70.5 per 100,000.

The highest rates of maternal mortality were found in the Mississippi Delta region, which includes Arkansas, Louisiana, Mississippi, and Tennessee. Vermont, California, and Connecticut had the lowest mortality rates.

Another salient finding was that deaths from breast and cervical cancer, which are deemed to be preventable with proper screening and healthcare, were highest in southern states.

The authors of the report noted that northeastern states generally have higher screening rates and the lowest mortality while southern states have lower screening rates and higher mortality rates.

What to do if you live in a state where quality care is less accessible

Nicole Levine, MD, who is a physician focusing on preventive care, nutrition, and lifestyle medicine as well as the founder of Health Strive, said one step you can take is to seek out your local nonprofits and community organizations who provide healthcare.

She also suggests becoming active in lobbying for better healthcare policies.

Additionally, you can make use of telehealth services when care is not available near where you live or travel to other states when necessary healthcare services are denied.

“By taking these steps, the gap in access to high quality healthcare can be closed, she said.

However, she noted that narrowing the gaps between the states and improving women’s health outcomes will involve “more access to comprehensive healthcare and legislation that supports it.”

Rachel Goldberg, a Licensed Perinatal, Infertility, and Eating Disorder Therapist at Rachel Goldberg Therapy, seconded the idea of self-advocacy, making many of the same suggestions as Levine.

“The report also highlights how policy decisions, such as the lack of Medicaid expansion, abortion restrictions, and fertility limitations, directly impact women’s health outcomes,” she added. “This underscores the need for more advocacy and policy changes, which require significant resources and effort.”

Goldberg suggests that increasing awareness through social media, sharing personal stories, and engaging celebrities in the discussion are some grassroots ways to highlight the inequities in women’s health care among the various U.S. states and the District of Columbia.

Takeaway

A new report from The Commonwealth Fund details which states provide the highest and lowest quality healthcare for women.

Massachusetts, Vermont, and Rhode Island are some of the best, while Mississippi, Texas, and Oklahoma rank as the worst.

Some of the important issues identified include higher all-cause mortality in southeastern states and higher rates of preventable cancers like breast and cervical cancer in southern states.

Experts say self-advocacy is an important way women can improve health care for themselves.

However, real progress in narrowing the gaps will require legislation to support it.

• Some people report that GLP-1 anti-obesity medications like Wegovy have helped improve their rheumatoid arthritis.
• Body fat and higher BMIs have been associated with a higher risk of developing rheumatoid arthritis.
• Health experts say more research is needed to understand the connection.

The weight-loss benefits of GLP-1 medications like Ozempic, Wegovy, and Zepbound are widely known.

However, as more and more people take these medications, there appear to be other benefits, such as reducing one’s risk of heart disease, stroke, kidney disease, and colon cancer.

Recently surfacing are anecdotal accounts of GLP-1 medications also helping people with rheumatoid arthritis (RA) manage their pain and experience a decrease in flare-ups.

“It is well established that autoimmune patients with obesity fare worse than those without. [They] have higher symptoms and less response to traditional therapies,” Dr. Elizabeth Ortiz, rheumatologist and clinical advisor at WellTheory, told Healthline. “I have seen patients lose weight and then require less immunosuppressant therapy for their condition.”

The connection between obesity and rheumatoid arthritis

According to a systematic review and meta-analysis of cohort studies, there is a positive association between levels of body fat and the risk of developing RA. Additionally, higher BMI (in middle age and in early adulthood) and waist circumference were associated with a higher risk of RA.

Obesity has been associated with worse autoimmune and inflammatory symptoms and with less favorable response to standard therapy for RA, added Ortiz.

“In addition to keeping autoimmune patients from feeling their best in the short term, the combination of obesity and autoimmunity can have a major impact on health in the long term,” she said. “Those with rheumatoid arthritis and other autoimmune diseases carry a higher risk of cardiovascular disease than those without these conditions. Our best defense against this is tight control of autoimmune inflammation and all other cardiovascular disease risk factors, such as obesity.”

Because of this, she said managing obesity should be a part of a holistic care plan for anyone with RA or another autoimmune disease.

Emerging “obesity first” approach may help treat rheumatoid arthritis

Dr. Fatima Cody Stanford, associate professor of medicine and pediatrics at Harvard Medical School, said by reducing weight, patients may experience less joint pain and inflammation, improved mobility, and reduced disease activity.

“Moreover, weight loss can improve overall health, reduce comorbidities such as cardiovascular disease and diabetes, and enhance the effectiveness of RA medications,” Stanford told Healthline.

Treating obesity first to help with other conditions has been coined the “obesity first” approach. Stanford said it is an emerging and promising strategy because addressing obesity directly can have a broad range of positive effects on multiple chronic conditions.

“By targeting obesity first, healthcare providers can potentially improve or even resolve associated conditions like type 2 diabetes, hypertension, and dyslipidemia,” she said. “This holistic approach recognizes obesity as a root cause rather than a consequence, aiming to improve overall patient health and simultaneously reduce the burden of multiple chronic diseases.”

However, Ortiz believes it is too early to take an “obesity first” approach for autoimmune disease. While a proportion of patients with autoimmunity may have positive results by solely focusing on obesity, she said this will not be the case for everyone.

“The biologic triggers for any particular individual’s autoimmune disease are complex and personal, and taking an ‘obesity first’ approach without also addressing the underlying autoimmune disease may expose patients to unnecessary risk from poorly controlled inflammation,” she said.

Will GLP-1 drugs be used to treat rheumatoid arthritis?

As the complex relationships between obesity, metabolic health, and chronic diseases deepen, Stanford said it’s clear that collaboration between obesity medicine physicians, endocrinologists, rheumatologists, cardiologists, and primary care providers is needed to create comprehensive treatment plans that address the root causes of these conditions.

“As new therapies and strategies emerge, they offer hope for improved quality of life and outcomes for patients struggling with obesity and associated chronic diseases,” she said. “Continued research and innovation will be key in advancing these efforts and providing evidence-based care.”

Given the anti-inflammatory properties that GLP-1 drugs provide and their effects on the immune system, Standford said these medications could be promising in the context of autoimmune diseases. She anticipates more research regarding their potential benefits.

“Preliminary research has suggested that GLP-1s may modulate immune responses and reduce inflammation, which could benefit conditions like RA, systemic lupus erythematosus (SLE), and inflammatory bowel disease (IBD),” said Stanford. “Further research is needed to understand the mechanisms involved and to evaluate their efficacy and safety in these contexts.”

Ortiz agreed. She said those treating autoimmune diseases don’t want to turn to GLP-1 drugs without a better understanding of how and why autoimmune patients may benefit from them.

For instance, key questions that need to be answered include:

• What are the anti-inflammatory effects of GLP-1s, and how do they impact those with autoimmune disease?
• What type of autoimmune disease patient would benefit from this type of treatment, and what kind of effect can be expected?
• What is the effect of these medications on the microbiome, and how does that impact autoimmune disease?
• How much weight loss (if any) is needed to see an impact?
• Are the benefits of GLP-1s in RA patients solely from weight loss?

Understanding the effects of GLP-1 drugs on a person with an autoimmune disease like RA who is not overweight or obese needs further research.

“As we continue to discover [GLP-1s] biologic effects on inflammation and our immune systems and continue to accrue data in people using them for obesity and diabetes, we may find they are a useful tool against autoimmunity, aside from their impact on obesity,” said Ortiz. 

Any positive impact would have to be weighed against potential risks of using these medications, such as the risk of muscle loss, as muscle loss can lead to osteoporosis, a condition often associated with autoimmune diseases, she noted.

Overall, more time is needed to determine whether or not GLP-1 drugs can be used to control autoimmunity and inflammation in those with or without obesity and how best to utilize the medications for these purposes.

“What is likely to be addressed more quickly is how these medications can be utilized as a supplement to standard autoimmune therapy to improve metabolic syndrome and decrease an autoimmune patient’s cardiovascular risk,” said Ortiz.

• People online are spreading misinformation with claims that low protein diets are better for longevity and weight loss.
• Experts say adequate protein intake can promote satiety and the development of muscle mass, which are important factors for weight loss. 
• A mix of plant-based and animal-based protein sources is best for a healthy diet. 

A high protein diet has long been recognized for its weight loss and health benefits. However, misinformation is spreading on social media platforms like TikTok and Reddit that a low protein diet is best. 

Proponents claim that we need less protein than previously thought and that reducing your intake could trigger weight loss. 

One recent example is a TikTok video that was posted by dietitian @endocrinenutritionist. In the video, she claimed the most compelling argument for a low protein diet is that human breast milk contains just 6% protein and that in the first six months of life, humans double in size. 

“Theoricatallicy, that should be all the protein we need,” she said. 

Furthermore, she also claimed that the reason we think animal protein is better than plant-based protein is because of “amino acid studies that were done back in the early 1900s on rats.” 

However, this particular influencer’s claims are not true.

For example, the nutritional content of breast milk contains 1% protein, not 6%, and a study conducted on older community-dwelling men in 2020 found that low protein intake was associated with a modest increase in risk of all-cause and cause-specific mortality among older men. 

Yet a growing number of influencers online are spreading misinformation like this about the benefits and risks of nutrition trends.

The link between low protein diets and weight loss

Kelsey Costa, registered dietitian and science communications officer at Examine, says there has been renewed interest in the notion that restricting protein intake or certain essential amino acids might extend life span.

“Studies in rodents have also shown that cutting down on protein, without cutting calories, might extend the life span of these animals. However, the evidence is limited and based on animal studies,” she said. 

Therefore, these results are not necessarily applicable to humans. Moreover, Costa said any potential benefit of long-term protein restriction is likely offset by an increased risk of sarcopenia, an age-related and progressive loss of muscle and strength.

Dietitian and author of How Not to Eat Ultra-Processed, Nichola Ludlam-Raine, said the shift in popularity from high protein diets to low protein diets reflects a broader understanding of balanced nutrition beyond just macronutrient focus.

However, she said the claim that low protein diets may be better for weight loss is nuanced.

“High protein diets are known to promote satiety, preserve muscle mass during weight loss, and increase thermogenesis,” Ludlam-Raine explains. “On the other hand, lower protein diets could potentially lead to weight loss due to reduced calorie intake if protein-rich, calorie-dense foods are replaced with fruits, vegetables, and whole grains.” 

Crucially, though, Ludlam-Raine said that a low protein diet might not be sustainable for everyone as protein is critical for maintaining muscle mass and overall metabolic health.

Similarly, Costa explained how low protein intake may make weight loss difficult in the long term.

“A very low protein diet may initially result in weight loss, likely due to resulting calorie restriction overall, like any other highly restrictive diet,” she said. “But without adequate protein intake, this calorie restriction can result in the loss of both body fat and muscle mass.”

“The loss in muscle mass may ultimately decrease metabolism and lead to further weight regain when the diet is stopped,” she added. 

Low protein intake: health benefits and risks  

Weight loss aside, you might be wondering how a low protein diet affects overall health and longevity. 

Ludlam-Raine said that reduced intake of some proteins, such as red meat, may be linked to increased life span, but this is likely due to the heart health benefits rather than the reduction in protein.

“It’s important to remember that protein is essential for life, with a minimal requirement of at least 0.8g of protein per Kg of body weight a day,” she notes. 

Another potential benefit may be disease prevention, especially for some people with pre-existing conditions.

“Lower protein intake has been associated with reduced risks of certain diseases, such as kidney disease (in those with uncontrolled diabetes) and some cancers in certain people – particularly those who may eat a lot of processed red meat,” Ludlam-Raine explains. 

“However, these benefits largely depend on the quality and source of the proteins, as well as the overall diet composition,” she points out. 

There are also notable risks with eating a low protein diet. 

“Inadequate protein can lead to muscle atrophy, particularly in older adults,” says Ludlam-Raine. 

It can also cause nutrient deficiencies. “Proteins are essential for providing certain vitamins and minerals, and a low protein diet may result in deficiencies in nutrients like B12, iron, and zinc,” she explains. 

Additionally, a weakened immune function may be another by-product of low protein intake. 

“Proteins are crucial for the immune system, and insufficient intake can impair the immune response,” Ludlam-Raine explains. 

Healthy protein types 

As is often the case with nutrition, how much of a specific nutrient you need is highly individual. 

“The recommended daily intake of protein varies by age, sex, and activity level,” says Ludlam-Raine. 

“Generally, 0.8 grams of protein per kilogram of body weight is sufficient for most adults, while athletes and older adults may require more, around 1.0 to 2.0 grams per kilogram.” 

The kind of protein you eat matters, too. 

Protein sources can be divided into: 

Animal Proteins: Meat, poultry, fish, eggs, and dairy

“These are complete proteins containing all the essential amino acids that we need. 

“They are beneficial for muscle mass maintenance and overall health due to essential nutrients such as vitamin B12 and calcium as well as iodine, but should be consumed in moderation in comparison to plant-proteins,” says Ludlam-Raine. 

Plant Proteins: Beans, lentils, tofu, tempeh, nuts, seeds, and whole grains

While some plant proteins may be incomplete, Ludlam-Raine said they can be “combined to provide all essential amino acids (think beans on toast).”

“They are generally lower in saturated fat and therefore can be beneficial for heart health and weight management,” she said.

Processed Proteins: Protein bars, shakes, and other supplements

While convenient, Ludlam-Raine says many of these are technically classed as ultra-processed and should not replace whole foods. She recommends choosing healthier versions of protein supplements that don’t contain added sugar.

To ensure adequate protein intake, Ludlam-Raine recommends including protein at every meal and choosing protein-based snacks. 

“It’s a good idea to mix plant and animal protein sources to ensure a variety of amino acids and other nutrients,” she adds. 

Takeaway 

Eating a very low protein diet isn’t beneficial for health or achieving sustainable weight loss.

For most people, it’s best to eat around 0.8 grams of protein per kilogram of body weight.

Including both animal-based and plant-based protein sources will provide the most benefit.

• Misconceptions about the benefits and risks of GLP-1 drugs like Ozempic, Wegovy, Mounjaro, and Zepbound are common.
• Not all GLP-1 drugs are the same, and different medications may affect people differently.
• Before starting a GLP-1 drug, talk with a healthcare professional about the potential risks and benefits.

It likely won’t surprise you to hear that the GLP-1 drugs semaglutide (better known by the brand names Wegovy and Ozempic) and tirzepatide (sold under the brand names Monjouro and Zepbound) were among the top 10 most popular drugs by U.S. spending in 2023.

The medications have been heralded has game-changing treatments for diabetes and obesity. But as their popularity has grown, so too have persistent myths and misinformation about them.

“The reality is that each of these is prescribed to achieve different health goals, and like any medication, they each come with potential risks that patients should be educated on in order to make informed decisions with their healthcare providers,” says HaVy Ngo-Hamilton, Pharm.D., pharmacist and clinical consultant for BuzzRx.

In an effort to clarify common misconceptions, Healthline spoke with experts who helped identify and debunk the eight most common myths currently being shared about GLP-1 drugs.

Myth: Taking a GLP-1 drug guarantees significant weight loss 

The short answer: “Nothing guarantees weight loss,” says Dr. Mir Ali, MD, a board certified bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center.

Ali notes that these drugs certainly have a high success rate for aiding with weight loss, primarily because of their ability to slow stomach emptying, helping people feel fuller longer.

In a clinical trial, patients who took weekly 2.4 mg doses of semaglutide lost “clinically significant weight” within 68 weeks.

A 72-week trial for tirzepatide suggested that 91% of people who took the maximum 15 mg dose saw a weight reduction of 5% or more. Over half of the participants (57%) lost 20% of their body weight.

Those numbers are good, but they are not perfect. Doctors generally recommend patience — to a point.

“The FDA has given us guidelines when using these medications, in that we expect at least 5% total body weight loss at 12 weeks,” says Dr. Janese Laster, MD, who is board certified in internal medicine, gastroenterology, obesity medicine, and nutrition. She is also the founder of Gut Theory Total DigestiveCare.

If this weight loss doesn’t occur, Laster says a healthcare professional will discuss lifestyle factors, including:

• Dosing
• Whether the patient is taking the medication correctly
• Diet
• Exercise

However, a small percentage of patients won’t respond, which doesn’t mean they did anything “wrong.” 

“Obesity already carries a lot of unnecessary societal stigma and shame, so it’s important that patients understand that it is largely out of their control regarding who is a responder or a non-responder,” says Dr. Michael Glickman, MD, the CEO and founder of Revolution Medicine. “It is likely a genetic explanation or…your unique physiology.”

Though Mounjaro and Ozempic are approved for the treatment of type 2 diabetes, one 2022 narrative review suggested that individuals living with type 2 diabetes who take these drugs may see less weight loss.

Myth: You don’t have to exercise while taking GLP-1 drugs

Even the label says otherwise.

“If you look at the package insert for Wegovy or Zepbound, the instructions are to use these medications with a ‘reduced calorie diet and increased physical activity,’” Ngo-Hamilton explains. “In reality, the amount of diet and exercise will vary among users, leading to various degrees of weight loss. However, consistent physical activity is vital to achieve and maintain the desired weight loss.”

A 2023 article suggested that physical activity is important in helping patients maintain lean muscle mass, which can be lost along with weight. Glickman emphasizes that resistance training is especially critical for these efforts.

“If we are not exercising during the weight loss journey, ultimately our metabolism can suffer because patients will lose a significant amount of muscle mass too,” Glickman says.

Myth: You don’t need to eat a healthy diet if you’re taking a GLP-1 drug

Again, the label suggests the opposite, but social media captions may not.

“These medications are not magical, despite what is seen in the media/social media,” Laster says.” Patients will not have success if they do not also make lifestyle and diet changes. Nonadherence to dietary changes is one factor we consider if a patient is not losing weight as we expect on these medications.”

Glickman suggests a plant-forward or Mediterranean-style diet, which emphasizes certain fats, lean and plant-based proteins, and leafy greens and deprioritizes ultra-processed and high-sugar foods and drinks.

Dietary choices are also important for reducing side effect risk and severity.

“Because these medications trigger insulin production, slow the emptying of the stomach, and cause you to feel full faster and for longer periods of time, eating unhealthy foods or larger portions of food may cause negative gastrointestinal side effects, including abdominal pain, nausea, or vomiting,” Ngo-Hamilton says.

Myth: Side effects are unbearable (or no big deal)

Ultimately, the severity of side effects is relative. 

“Unbearable is a subjective term, and individual thresholds for discomfort may vary significantly from person to person, as may the side effects individuals experience while taking the medication,” Ngo-Hamilton says.

Backing up, Ngo-Hamilton says common side effects of GLP-1s include:

• Vomiting
• Nausea
• Diahrrea 

She says the side effects are often temporary and resolve as the patient adjusts to the medication. Ali says that’s why providers gradually increase doses.

“If side effects are an issue, medications to counteract the side effects can be given,” Ali says, adding it’s unusual for a patient to stop taking a GLP-1 for side effects.

However, that doesn’t mean none do.

“If the side effects aren’t effectively controlled with symptom management and don’t decrease or resolve after three or more months on the medication with dosage increases, you should talk to your doctor about switching to a medication with a different mechanism of action or exploring a different category of weight loss drugs entirely,” Ngo-Hamilton says. 

Myth: Using compounded GLP-1 drugs is just as safe as brand-name medications

Doctors advise using caution before opting to obtain compounded GLP-1 drugs.

“While compounded drugs are certainly an important — and sometimes necessary — option for patients who require access to a drug that is in shortage or otherwise commercially unavailable, these are formulated by specialty pharmacies combining active ingredients they source themselves,” Ngo-Hamilton says. “Unlike the brand name drugs that are clinically tested by the manufacturers for safety and efficacy according to FDA guidelines, compounded drugs are not held to those same standards and are not FDA-approved medications.”

Ali suggests discussing options with a healthcare professional and getting their take on compounded GLP-1 drugs and reputable pharmacies.

“If you are getting medication…through social media or questionable online sources, you may end up with something that does not work or, worst-case scenario, causes harm,” he says.

Myth: Your insurance will cover the cost if you’re a prime candidate

Not always. Cost is a barrier for some individuals who would like to go on GLP-1 medication, and not all insurance will help cover it. Medicare does not cover GLP-1s for weight loss.

“Insurance coverage will vary by person and by insurance policy, and recently, more insurance plans have opted not to cover the cost of GLP-1 agonists, particularly those that are being prescribed for off-label use,” Ngo-Hamilton says. “For example, when someone doesn’t have type-2 diabetes, their healthcare provider prescribes Ozempic as off-label use for weight management.”

A month’s supply of Ozempic can cost about $1,000, similar to Zepbound’s prices.

“Prescription discount cards can be a helpful resource for patients whose insurance plans don’t cover these medications,” Ngo-Hamilton says.

Myth: All GLP-1 drugs are the same

They are similar but not the same. Even Ozempic and Wegovy, though both semaglutide, have some distinctions.

“Ozempic and Wegovy are both semaglutides, which stimulate the GLP-1 receptor to reduce appetite and slow stomach emptying,” Ali says. “Ozempic is indicated for diabetes, whereas Wegovy is for weight loss.”

The maximum weekly dose of Ozempic is 2.0 mg, while Wegovy’s is 2.4 mg. 

Zepbound and Mounjaro have the same weekly dose (15 mg), and the lone distinction between them is that Zepbound is for weight management, and Mounjaro is for diabetes treatment. They are different from semaglutide but possess commonalities. 

“Mounjaro and Zepbound are both tirzepatide which affects two receptors, GLP-1 and GIP, again reducing appetite and slowing stomach emptying,” Ali says.

Zepbound is “better” than Wegovy for weight loss

Some data suggests that patients will lose more weight on Zepbound than Wegovy. Eli Lily-conducted trials (SURMOUNT-3 and SURMOUNT-4) indicated that people taking tirzepatide lost more than a quarter (26.6%) of their body weight in 84 weeks, which is more than the 15% of people taking Wegovy for 68 weeks lost.

The timeframe was different for these trials, and Glickman says experiences can vary, too. 

“Not every patient tracks perfectly along the average weight loss curve,” Glickman says. “Some patients can be non-responders to one brand and responders to the other. Some patients can also be average responders to one brand and super responders — above average — to the other. It can be a little unpredictable.”

Currently, Glickman says that close monitoring is sometimes the best way to determine long-term fit. However, more research in precision medicine may change this strategy.

Takeaway

Misconceptions about the benefits and risks of GLP-1 drugs like Ozempic, Wegovy, Mounjaro, and Zepbound are commonly spread.

Though these medications can help people lose weight, not everyone responds to them.

Diet and exercise are still important factors for sustainable weight loss while taking a GLP-1 medication.

Before starting a GLP-1 drug, talk with a healthcare professional about the potential risks and benefits.

• Actor Shannen Doherty recently passed away at age 53 after many years of treatment for breast cancer, which had spread to her bones and brain.
• The “Charmed” and “Beverly Hills, 90210” star said in a lawsuit that a lapse in health insurance delayed doctors diagnosing her with breast cancer.
• Annual screening mammograms are recommended for women starting at age 40. These can detect breast cancer in earlier stages when it is easier to treat.

Actor Shannen Doherty recently passed away at age 53. Her cause of death was breast cancer.

“On Saturday, July 13, she lost her battle with cancer after many years of fighting the disease,” according to a statement from the “Charmed” and “Beverly Hills, 90210” star’s publicist Leslie Sloan.

Doherty was diagnosed with breast cancer in 2015. She received chemotherapy and radiation therapy and underwent a mastectomy.

Two years later, she announced she was in remission. But she revealed in 2020 it had returned as stage 4 breast cancer.

The cancer later metastasized, or spread, to her brain and bones. In 2023, she underwent brain surgery for her cancer.

Doherty said a lapse in her health insurance in 2014 caused a delay in doctors diagnosing her with breast cancer, reports the Los Angeles Daily News.

The actress settled a lawsuit against her former business management firm, which she accused of mismanaging her money and failing to pay her medical insurance premiums.

Earlier detection improves survival from breast cancer

Breast cancer is the second most common cancer among women in the United States, according to the Centers for Disease Control and Prevention.

In 2021, around 272,000 women in the United States are diagnosed with breast cancer, and around 42,000 women die from breast cancer, the CDC reports.

Detecting breast cancer at an early stage, when it is easier to treat, can improve the chances of long-term survival.

“A screening mammogram is probably the best tool we have at improving survival for breast cancer,” said Christopher McGreevy, MD, a breast cancer surgeon at Hackensack University Medical Center.

“It’s been shown in numerous studies that screening mammograms increase the chance of a woman surviving breast cancer,” he told Healthline.

The 5-year survival rate for stage 1 breast cancer — cancer that has not spread beyond the initial site — is over 99%, according to the National Cancer Institute. The survival rate drops to 32% once the cancer has spread to distant parts of the body.

People whose breast cancer is detected earlier “may also potentially avoid additional treatments such as chemotherapy, and they generally have more options for surgery,” said McGreevy.

Monica M. Yepes, MD, associate director of breast imaging at the Sylvester Comprehensive Cancer Center, part of the University of Miami Miller School of Medicine, said most guidelines recommend that females with average breast cancer risk get a screening mammogram every year starting at age 40.

One exception is the U.S. Preventive Services Task Force (USPSTF), which recommends screening mammograms every other year starting at age 40.

However, “we know that two years is too long, especially in the 40 to 50-year age group, because the younger patients are the ones that have the more aggressive cancers,” Yepes told Healthline.

Why screening is vital for people with higher risk

When should people who are at an increased risk of breast cancer start screening? It depends on their specific situation.

“If their risk is based off of a genetic mutation, then we would definitely start screening earlier,” said McGreevy, “and their screening would involve a little bit more, such as including additional things such as MRIs.”

“For women whose increased risk is solely based off of family history, when they should start their screening depends upon the age at which their family members were diagnosed with breast cancer,” he said.

Yepes said many patients don’t know they have a higher risk of breast cancer until they start screening mammograms at age 40.

That’s why “the American College of Radiology recommends that every woman should identify their risk factors and their lifetime risk of developing breast cancer as early as age 25,” she said. “So if they do need to start early screening, they’re prepared for it.”

Risk assessments can be done with a primary care doctor, an OB-GYN, or through a referral to a specialist.

Doctors use risk assessment tools to determine a person’s breast cancer risk based on their personal medical and reproductive history, as well as their family history of breast cancer.

In addition, “genetic testing allows us to identify mutations in genes,” said Tran Ho, DO, FSSO, a breast surgical oncologist at El Camino Health in the San Francisco Bay Area. “Most commonly, you may hear about BRCA1 and BRCA2, genes which can have mutations linked to an increased risk of breast cancer.”

While many physicians will discuss breast cancer risk with patients in their 20s, Ho encourages women to be proactive about their health.

“If patients find that their physician isn’t bringing it up, they should feel empowered to mention it to their doctor,” she told Healthline. “This might even mean asking their doctor to refer them to someone who would be able to review their history and calculate their breast cancer risk.”

Health disparities in breast care

Yepes said certain groups have a higher risk of having breast cancer and of having very aggressive breast cancers.

For example, “there is a subtype of breast cancer called a triple-negative breast cancer that is very common in African American women,” she said.

Yepes also pointed out that minority females dying of breast cancer have a 127% higher risk of dying before the age of 50 compared to their white counterparts.

In addition, people without health insurance and certain racial and ethnic groups are much less likely to be up to date with recommended screenings, according to the 2024 AACR Cancer Disparities Progress Report released in May.

In 2021, 53% of American Indian and Alaska Native women and 67% of Asian women were up to date with breast cancer screening, compared to 76% of non-Hispanic white women, the report showed.

The report also found that women under age 65 without health insurance were half as likely to be up to date with breast cancer screening compared to women under age 65 who had private insurance.

Yepes said these disparities are due to a number of factors, including a higher genetic risk of having cancer or a more aggressive cancer, socioeconomic factors and a lack of knowledge about the importance of breast cancer screening.

Lack of access to the healthcare system can also prevent women from being up to date with screenings. This includes living in areas without adequate healthcare, not having insurance or being underinsured, lack of transportation, being unable to take time off from work, and other barriers.

Since 2010, the Affordable Care Act has required most private health insurance plans to cover the cost of women’s preventive healthcare, including mammograms. 

If you don’t have insurance or your insurance doesn’t cover breast cancer screening, the National Breast and Cervical Cancer Early Detection Program provides access to breast cancer screening for low-income, uninsured, and underinsured women ages 40-64. 

Takeaway

Actor Shannen Doherty died July 13 at age 53. Her cause of death was breast cancer.

The “Charmed” and “Beverly Hills, 90210” star was first diagnosed with breast cancer in 2015. Two years later, she announced her cancer was in remission, but it returned later as stage 4 cancer.

In a lawsuit against her former business management firm, Doherty said a lapse in her health insurance delayed doctors diagnosing her breast cancer. She accused the firm of failing to pay her medical insurance premiums.

A screening mammogram can detect breast cancer at an earlier stage when it is easier to treat.

In the United States, women with an average breast cancer risk have the option of starting screening mammography at age 40.