New evidence suggests that a disease-causing tapeworm that has been spreading across the United States and Canada has arrived in the Pacific Northwest. The tapeworm, called Echinococcus multilocularis, lives as a parasite in coyotes, foxes and other canid species and can cause severe disease if passed to domestic dogs or humans.

E. multilocularis has long been recognized as a public health threat in parts of the Northern hemisphere, including Europe and Asia, but was considered extremely rare in North America until approximately 15 years ago, when cases in humans and dogs began cropping up in Canada and the midwestern U.S., indicating that the parasite was spreading.

This study, led by 91̽�� researchers, is the first to detect E. multilocularis in a wild host on the west coast of the contiguous U.S. Researchers surveyed 100 coyotes in the Puget Sound region, and found E. multilocularis in 37 of them. The results were .

“This parasite is concerning because it has been spreading across North America. There have been numerous cases of dogs getting sick, and a handful of people have also picked up the tapeworm,” said lead author , who recently graduated from the 91̽��with a doctorate in environmental and forest science. “The fact that we found it here in one-third of our coyotes was surprising, because it wasn’t found anywhere in the Pacific Northwest until earlier this year.”

When E. multilocularis infects an animal or person, it causes cancer-like cysts to form in the liver and sometimes other organs. If untreated, infection can be fatal.

However, not all carriers become sick. E. multilocularis has a complex life cycle that involves multiple hosts. Canids, which host adult parasites, can support thousands of worms in their intestines without becoming sick. The worms shed eggs that are then passed in their feces.

Rodents — another host — become infected by eating food contaminated with coyote feces. Once consumed, the parasite eggs migrate to the liver and form cysts, ultimately weakening or killing the rodents. The parasite’s life cycle begins again when coyotes prey upon infected rodents.

Humans and domestic dogs are categorized as accidental hosts. Humans may pick up the parasite by consuming tapeworm eggs — in food that is contaminated with coyote or dog feces, for example — and can develop a disease called , characterized by slow-growing metastatic cysts. Symptoms may not appear for five to 15 years after exposure, which complicates diagnosis and treatment.

Alveolar echinococcosis is considered the third most important food-borne illness globally, and one of the top 20 neglected tropical diseases by the World Health Organization. Many countries have developed robust protocols for tracking it.

Domestic dogs that are exposed to E. multilocularis may or may not become sick, depending on where the parasite is in its life cycle at exposure. It is more common for dogs to carry the parasite and shed eggs without developing disease, but dogs that are exposed to parasite eggs may develop the same cancer-like cysts as other infected animals.

“To minimize the risk of dogs getting infected with E. multilocularis, owners should not let them prey on rodents or scavenge their carcasses,” said co-author , an associate professor and director of the Parasitology Diagnostic Laboratory at the Texas A&M University College of Veterinary Medicine and Biomedical Sciences.

Owners can also give dogs preventative medication for worms and ticks and ensure routine veterinary care, which should include diagnostic tests for parasites, Verocai said.

Although the researchers found E. multilocularis in more than one-third of local coyotes tested, there is little evidence of the infection spreading to other hosts. One study in Washington, Oregon and Idaho since 2023, five of which were in Washington. Few human cases have been reported in the U.S., and none on the West Coast.

“The reason that it’s so high in coyotes is because they are regularly eating raw rodents, and that is the primary way for them to get infected. Most domestic dogs are not eating the raw livers of wild rodents,” Hentati said.

Before the uptick in the 2010s, there were several reports of E. multilocularis on remote islands in northwestern Alaska. Those cases were caused by a parasite with different origins than the current outbreak. Genetic analysis pins the earlier cases to a tundra variant while these recent cases are driven by a more infectious variant with European origins. The coyotes in this study carried the newer variant, now thought to be the predominant variant in the U.S. and Canada.

Neither Canada nor the U.S. require dogs to undergo deworming upon arrival, which may explain the spread. Previous studies also proposed that E. multilocularis could have come over in red foxes imported for hunting 100 years ago, but no one knows for sure.

“The main takeaway is that Echinococcus multilocularis is here, it’s pretty prevalent in the local coyote population and people should be aware of potential risks,” Hentati said.

Co-authors include , lab manager at UW; , 91̽��doctoral graduate in environmental and forest science; , a 91̽��professor of environmental and forest science; , a 91̽��associate professor of aquatic and fishery science; of the College of William and Mary; Erika Miller of Sound Data Management; of DePaul University; and of UC Berkeley. This study was funded by The National Science Foundation and the 91̽�� Hall Conservation Genetics Fund.

For more information, contact Hentati at yhentati26@gmail.com.

In the three-and-a-half years since the U.S. Supreme Court overturned the constitutional right to an abortion in Dobbs v. Jackson Women’s Health Organization, the fragmented state of abortion access has put medical professionals in a precarious position. Many states have tightened abortion restrictions, with some enacting criminal penalties up to in for physicians who perform abortions. Medical schools have

New research led in part by the 91̽�� found that the new restrictions are not only affecting the current medical workforce — they may be shaping the next generation of physicians. The study, , found that applications to medical residency programs in states that enacted new abortion restrictions dropped sharply following the Dobbs ruling.

The decrease occurred among both male and female applicants. Applications to specialties related to reproductive health — obstetrics and gynecology, family medicine, internal medicine and emergency medicine — saw the largest decreases.

The new study builds on that had shown decreased application rates to residency programs in states with abortion restrictions by applying causal methodologies to understand the impact of the Supreme Court decision and isolating results from male and female applicants.

“This research provides important empirical evidence about how state-level policy changes following Dobbs may influence decisions made by medical trainees about where to pursue their graduate medical education,” said co-author , a 91̽��professor of health economics and director of the Comparative Health Outcomes, Policy, and Economics (CHOICE) Institute.

To learn more about the research, 91̽��News sat down the paper’s three authors: Basu; lead author , assistant professor of medicine at the University of North Carolina at Chapel Hill; and co-author , assistant clinical professor of internal medicine at the University of Arizona. Both Ganguly and Morenz completed their internal medicine residencies at the 91̽��School of Medicine.

The medical residency match process is quite different from traditional higher-ed applications. Can you explain how that works, and how it relates to your study’s findings?

Dr. Anna Morenz: Applicants may apply to as many programs as they want, with some applying to dozens of programs. At the end of interviews, they’ll rank those programs based on their preferred landing spots. The programs, in turn, will rank all the applicants that they received. A computer algorithm then matches everyone with the goal of filling all the residency slots, and it’s very good at that. We know that . So programs are still filling their residency slots even in states with restrictions.

What concerns us about these findings is that there’s an early signal of people avoiding applications to these states. That has potential implications for the quality of the applicants to restricted states, which could not be assessed in our data. There’s typically a high likelihood that people stay where they train for their residency, but if you landed in a restricted state that was low on your rank list, you may be more likely to complete your training and then leave to a non-restricted state. We aim to look at this very important question in projects to come.

Anisha and Anna, you’re both practicing primary care physicians. How big a part of a physician’s training is abortion and other pregnancy-related care?��

Dr. Anisha Ganguly: It’s not a big part of our training traditionally, though there has been a movement to integrate more abortion care into primary care residencies. That’s more the case in family medicine rather than internal medicine, because medication abortion has now become the most common means for abortion care. As internists, we commonly diagnose pregnancies and care for women with medical conditions as they consider family planning.

AM: I do think it’s important to note that a huge percentage of primary care physicians are trained in family medicine. And family medicine physicians are trained in delivery of babies, management of prenatal care, miscarriage management, contraception and abortion. Anisha and I trained in internal medicine, and there is increasing interest to include medication abortion training in internal medicine, as it is fully within our scope of practice.

The effects of the Dobbs decision have been well-documented, and previous work on this topic highlighted changes in OB/GYN residency applications. What’s new in your study specifically?��

Anirban Basu: We had a much longer pre-period than previous studies. We looked back to 2019 to see what had been happening to application rates in these two kinds of states — those that eventually restricted abortion access and those that didn’t — and we showed that these rates had been moving similarly until the ruling. That gives a little more weight to the evidence to say the change is due to the ruling.��

The second big thing is that previous studies did not distinguish whether men and women were changing their behavior similarly. I think that’s a very important finding in our study, that male applicants are changing their behavior at an even higher rate.��

AG: I agree that the gender stratification was an important contribution. The other stratified analysis that we explored was about how specialty type may be driving some of the effects that we saw. A lot of people can reason that OB/GYN applicants would be affected by this directly, and there’s a lot of literature to support that. But what we’re showing is that it’s not just the OB/GYN workforce that’s going to be impacted. It’s the primary care workforce and the emergency medicine workforce.��

We’re hoping that message spreads a little more broadly. This is not just about women’s health. It’s about the future of primary care and the person who’s going to save you from your heart attack in the future.

Let’s talk a little more about that gender stratification. You found that male applicants changed their application preferences at a greater rate than female applicants, which looks like a surprising result. What’s going on there?��

AG: When we generated our original hypotheses, we thought we were going to see increased effects among women applying to residency, but we actually ended up seeing that there were long-term disparities that existed pre-Dobbs between restricted and non-restricted states. This was likely because of the and other state-level laws that were affecting women’s behavior. What we’re seeing is that women had been reading the tea leaves about access to reproductive health care prior to the Dobbs decision, but the decision did unmask a wider problem that drove a lot of new behavior among men.

One of the messages that we are getting from this paper is this is an “all of us” problem. It’s not just about women physicians. It’s about men who are also making choices about their professional autonomy and also about access to reproductive health care for their families. Women have been and will be considering their personal access to care and autonomy before this decision, but perhaps these state restrictions after Dobbs may have newly increased awareness among men.��

Among all these shifts, you found one group whose application rates didn’t change significantly: people applying to highly competitive medical specialities. What do you think explains that stickiness?��

AG: Anna and I had brainstormed about this being a potential effect modifier, because people who are applying in highly competitive specialties like orthopedic surgery or dermatology apply very broadly and don’t get to exercise a lot of choice about where to go. Whereas for large specialities like internal medicine, family medicine or pediatrics, there are a lot of programs in a lot of places, so applicants have more options. In those cases, state-level policies like abortion restrictions can factor more into people’s decision-making.

At an institutional level, what changes could be made to address these trends?��

AG: Institutions can make choices to mitigate some of these effects by supporting candidates with access to reproductive care within the scope of the restrictions that exist. Other industries are building in travel benefits for women who may need to travel to access these services.��

It’s not this aspect of a decision alone that shapes a residency applicant’s choice to go to a specific place or program. But there are other things that institutions can do to make trainees, particularly women, feel supported and valued. If you’re existing in an environment where state policies make women feel a lack of autonomy, then there are workforce policies that can be in place to bolster that sense of autonomy. That could take the shape of parental leave policies, lactation policies, other things that institutions can do to make women feel like, even if this part of your voice has been taken away, we’ll help you with the rest.

AB: One policy that has a long history of literature supporting it is financial incentives. Physicians do respond to financial incentives, but in many cases those incentives need to be quite steep to get people to change their decisions.��

AM: The other option is training opportunities. A lot of programs in states that had laws or restrictions that preceded the Dobbs decision would set up partnerships with organizations in another state where they could send their trainees to learn about pregnancy termination and miscarriage management. That’s a burden on residency programs and residents both. You have to set up housing and travel agreements. But that’s another key thing that programs need to keep in mind in order to recruit applicants.��

For more information or to contact the researchers, contact Alden Woods at acwoods@uw.edu.

Over five decades, the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) has become known as the nation’s. Low-income families receiving WIC benefits — which provides nutritious food in designated categories, nutrition education and access to other social services — have .��

But many families who are income eligible to participate in WIC aren’t receiving those benefits. Research has found that households who don’t use the full amount of their nutrition benefits are more likely to drop from the program.��

New research by the 91̽�� has found that households who redeem more of their benefits in the most popular food categories are more likely to remain in the program long-term. Better understanding these patterns could help WIC agencies identify families who might need a little extra encouragement to stay enrolled.

The study was .��

“Finding ways to identify kids and families that are at risk of dropping out of the program is of high importance,” said , a 91̽��assistant professor of health systems and population health and first author of the study. “That’s basically what we’ve identified — a way to flag families who may be at risk of dropping off.”

WIC provides families with food benefits in , with fruits and vegetables and eggs as the most popular. In partnership with (PHFE WIC), a Southern California WIC agency with a large research and evaluation division, researchers analyzed redemption data from 188,000 participating infants and children 0-3 years old, between the years 2019 and 2023.��

Among those children, higher redemption of fruits and vegetables, eggs, whole milk and infant formula was associated with lower risk of their household discontinuing WIC participation.��

The risk of discontinuation decreased in a somewhat linear fashion as redemption rates increased.

Chaparro hopes that local WIC agencies will build on these findings and seek new ways to engage families at risk of dropping off. All WIC providers must offer nutrition education, which could be an opportunity to target households with lower redemption rates in popular categories.��

The findings come just over a year after the U.S. Department of Agriculture, which oversees WIC, . Among other changes, the 2024 rule significantly increased benefits for fresh fruits and vegetables, which has proven popular.

“The expansion of fruit and vegetable benefits for WIC families has been among the most important policy changes of the last decade,” said , director of research and evaluation at PHFE WIC and co-author of the study. “Families want more fruits and vegetables, and this research demonstrates that their inclusion in the WIC food package is essential for longer-term engagement in the program.”

of the University of Tennessee and PHFE WIC is the corresponding author. This study was funded by .

When uncontrolled wildfires moved from the foothills above Los Angeles into the densely populated urban areas below in January 2025, evacuation ensued and a thick layer of toxic smoke spread across the region. Air quality plummeted. Local hospitals braced for a surge,.����

Research led by the 91̽�� and Kaiser Permanente Southern California sheds new light on how the Los Angeles fires affected people’s health, and how people navigated the health care system during an emergency. In the rapid study, published , researchers analyzed the health records of 3.7 million Kaiser Permanente members of all ages living in the region. They found that health care visits did rise above normal levels, especially virtual services.����

In the week after the fires ignited, Kaiser Permanente members made 42% more virtual visits for respiratory symptoms than expected. Those living near a burn zone or within Los Angeles County also made 44% and 40% more virtual cardiovascular visits, respectively, than expected.��

In-person outpatient visits for respiratory symptoms also increased substantially. Members who lived near a burn zone or within Los Angeles County made 27% and 31% more virtual cardiovascular visits, respectively, than expected.��

Extrapolating to all insured residents of the county, the researchers estimated an excess of 15,792 cardiovascular virtual visits, 18,489 respiratory virtual visits and 27,903 respiratory outpatient visits in the first week of the fires.��

The results suggest that people may rely more heavily on virtual health care during climate-related emergencies, and that providers should better prioritize virtual and telehealth services as they prepare for future crises.��

“We saw over 6,241 excess cardiorespiratory virtual visits in the week following the fire ignition. This represents a substantial increase in care,” said, a 91̽��associate professor of environmental and occupational health sciences and of epidemiology who led the research. “While the fires clearly impacted health, virtual care likely enhanced the ability of providers to meet the health care needs of people experiencing an ongoing climate disaster.”��

In collaboration with Kaiser Permanente Southern California, an integrated health care system with millions of members across the region, researchers analyzed health records of people who were highly or moderately exposed to wildfires. They defined high exposure as living within about 12 miles (20 kilometers) of a burn zone, and moderate exposure as living within Los Angeles County but farther than 12 miles during the time of the fires.����

Researchers looked back three years to estimate how many health care visits to expect in the weeks following Jan. 7 — the first day of the fires — under typical conditions. They then estimated how many people sought care in the first week of the fires, when smoke levels were highest, evacuations took place, and Los Angeles County public schools were closed.

In addition to the spike in cardiovascular and respiratory visits, researchers found a sharp increase in the number of visits for injuries and neuropsychiatric symptoms. On Jan. 7, outpatient injury visits were 18% higher than expected among highly exposed members, and virtual injury visits were 26% and 18% higher than expected among highly and moderately exposed groups, respectively. Among those same groups, outpatient neuropsychiatric visits rose 31% and 28% above expectations, respectively.

While both groups made significantly more visits than expected, proximity to the fires mattered. When researchers zoomed in on respiratory-related virtual visits, they found that minimally exposed members made 31% more visits, moderately exposed members made 36% more, and those living in highly exposed areas made 42% more.����

“While healthcare systems often plan to increase the number of hospital beds available or clinic staffing during an emergency, this work highlights the importance of considering virtual care capacity,” said, a 91̽��doctoral student of epidemiology and co-author on the study. “This may be particularly true for climate disasters like wildfires, during which people are advised to stay indoors or when people must evacuate — motivating them to seek care online if at all possible. As climate disasters increase in frequency and intensity, it is essential that health care systems know how to prepare for a sudden and dramatic surge in health care utilization.”��

Other authors on this study are , and of Kaiser Permanente Southern California; of the University of California, Berkeley; of Kaiser Permanente Hawaii; and of Columbia University; and of the Scripps Institution of Oceanography at UC San Diego; and of the Scripps Institution and the University of Rennes in France.

This research was funded by the National Institute on Aging and the National Institute for Environmental Health Sciences.��

For more information or to reach the research team, contact Alden Woods at acwoods@uw.edu.

About . Birth before 37 weeks can lead to a cascade of health risks, both immediate and long-term, making prevention a vital tool for improving public health over generations.��

In recent years, researchers have identified a potential link between wildfire smoke — one of the fastest-growing sources of air pollution in the United States — and preterm birth, but no study has been big or broad enough to draw definitive conclusions. A new study led by the 91̽�� makes an important contribution, analyzing data from more than 20,000 births to find that pregnant people who are exposed to wildfire smoke are more likely to give birth prematurely.

“Preventing preterm birth really pays off with lasting benefits for future health,” said lead author , a 91̽��postdoctoral researcher in environmental and occupational health sciences. “It’s also something of a mystery. We don’t always understand why babies are born preterm, but we know that air pollution contributes to preterm births, and it makes sense that wildfire smoke would as well. This study underscores that wildfire smoke is inseparable from maternal and infant health.”

In the study, ,��researchers used data from the , a federal research project focused on how a wide range of environmental factors affect children’s health. The sample included 20,034 births from 2006-2020 across the contiguous United States.

Researchers estimated participants’ average daily exposure to fine particulate matter, or PM2.5, generated by wildfire smoke, and the total number of days they were exposed to any amount of smoke. They estimated the intensity of smoke exposure by how frequently participants were exposed to wildfire PM2.5 levels above certain thresholds.

They found that pregnant people exposed to more intense wildfire smoke were more likely to give birth prematurely. In mid-pregnancy, exposure to any smoke was associated with an elevated risk of preterm birth, with that risk peaking around the 21st week of gestation. In late pregnancy, elevated risk was most closely associated with exposure to high concentrations of wildfire PM2.5, above 10 micrograms per cubic meter.

“The second trimester is a period of pregnancy with the richest and most intense growth of the placenta, which itself is such an important part of fetal health, growth and development,” said co-author , a 91̽��professor of environmental and occupational health sciences and of pediatrics in the 91̽��School of Medicine. “So it may be that the wildfire smoke particles are really interfering with placental health. Some of them are so tiny that after inhalation they can actually get into the bloodstream and get delivered directly into the placenta or fetus.”��

The link was strongest and most precise in the Western U.S., where people were exposed to the highest concentrations of wildfire PM2.5 and the greatest number of high-intensity smoke days. Here, the odds of preterm birth increased with each additional microgram per cubic meter of average wildfire PM2.5.

It’s possible those results were more precise simply because the West experiences more wildfire smoke on average, making the exposure model perform better, Sherris said. But there may be other factors behind the regional differences.��

The composition of wildfire smoke is different across the country. In the West, smoke tends to come from fires nearby, while in places like the Midwest, smoke has typically drifted in from faraway fires. and reacts with sunlight and airborne chemicals, which could have affected the results. Researchers also noted that external factors like co-occurring heat or housing quality may have effects that aren’t fully understood.��

Researchers hope that future studies will examine the exact mechanisms by which wildfire smoke might trigger preterm birth. But in the meantime, Sherris said, evidence for a link is now strong enough to take action.��

“There are a couple avenues for change,” Sherris said. “First, people already get a lot of public health messaging and information throughout pregnancy, so there’s an opportunity to work with clinicians to provide tools for pregnant people to protect themselves during smoke events. Public health agencies’ messaging about wildfire smoke could also be tailored to pregnant people and highlight them as a vulnerable group.”

Co-authors include , doctoral student of environmental and occupational health sciences at the UW; , clinical associate professor of environmental and occupational health sciences at the UW; , professor of biostatistics at the UW; , associate professor of environmental and occupational health sciences and of epidemiology at the UW; , postdoctoral fellow of epidemiology at the UW; and , assistant professor of environmental and occupational health sciences at the UW. A full list of co-authors is included with the paper.

This research was funded by the Environmental influences on Child Health Outcomes (ECHO) program at the National Institutes of Health under multiple awards. A full list of ECHO funding awards is included with the paper.��

For more information or to contact the researchers, email Alden Woods at acwoods@uw.edu.

A statewide initiative to put more healthy, climate-friendly grains on people’s plates has received a $19 million boost, which will sustain every step in building a network from the field to the fork.

The initiative, a public-private partnership led by Washington State University with support from the 91̽��, received a $10 million BioInnovation Grant from the and matching funds from several other organizations, including more than $3 million from the Washington Grain Commission.

It targets a global health problem: the lack of whole grains in people’s diets, which contributes to widespread health problems.

The funding will allow WSU researchers to continue developing new crop varieties for farmers. It will fuel efforts to bring more whole grains to the public, including into school lunchrooms and will expand Washington state’s commercial infrastructure for storing, transporting, milling and marketing whole grains. The funding will also support the establishment of a commercial kitchen at the 91̽��to help entrepreneurs bring whole-grain foods to market.

“This work is about making sure that nutritious grains reach the people who need them,” said , a professor of environmental and occupational health sciences at the UW. “By understanding the policies, systems, and human decisions that shape food production and the supply chain for school meals, we can help bridge the gap between innovation and impact.”

Two teams of 91̽��researchers will contribute to this effort.��

, professor of industrial & systems engineering and of mechanical engineering at the UW, will help lead development of ready-to-eat meals and will support private organizations using 91̽��facilities to produce sample meals for school breakfast and lunch.��

The UW’s implementation science team, which includes Otten, assistant professor of environmental and occupational health sciences , and assistant professor of epidemiology , will examine how innovations in grain breeding and food product development can be successfully adopted in school settings. They will study what policy, budgetary, and social factors help ensure that new whole grain and legume varieties are embraced across the supply chain and, ultimately, by school-aged children who rely on them for the nutrition they need to grow and thrive.

This team will also lead study-away programs, where students can learn about new whole grains and legumes in both urban and rural areas of Washington state. Curriculum from these five-week summer programs will be made publicly available.��

“The timing of the grant is perfect,” said , a WSU professor of international seed and cropping systems and director of the WSU Breadlab, who will lead the grant work. “We’re right at the stage where we’ve got a critical mass of cross-disciplinary research, encompassing a range of agricultural, food and health sciences. Now we can start commercializing, getting these crop varieties to farmers, getting whole grains on our plates and into schools.”

The grant funding will be matched by contributions from the Washington Grain Commission, the USA Dry Pea and Lentil Council, the American Heart Association, The Land Institute, and food and technology companies.

“This is truly a historic investment for Washington farmers,” said Casey Chumrau, CEO of the Washington Grain Commission.

Adapted from . For more information or to reach the project team, contact Alden Woods at acwoods@uw.edu or WSU’s Shawn Vestal at shawn.vestal@wsu.edu.

In the 10 years since the federal government , studies have suggested the policy has wide-ranging benefits. Students in participating schools , are and .

Now, as cuts to food assistance programs threaten to slash access to universal school meals, a new study led by the 91̽�� finds another potential benefit to the programs: Students in participating schools were less likely to have high blood pressure, suggesting that universal free meals might be a powerful tool for improving public health.��

“High blood pressure is an important public health problem that isn’t studied as much on a population level as obesity,” said , a 91̽��postdoctoral researcher of health systems and population health and lead author of the study. “We have evidence that CEP increases participation in school meals, and we also have evidence that school meals are more nutritious than meals that kids obtain elsewhere. This is a public health policy that is delivering nutritious meals to children who may not have previously had access.”

For the study, , researchers linked two datasets that rarely interact. They obtained medical records of patients ages 4-18 from community health organizations, and used patients’ addresses to identify the school they attended. The data encompassed 155,778 young people attending 1,052 schools, mostly in California and Oregon.

Researchers estimated the percentage of students with high blood pressure before and after schools opted into universal free meals, and compared those results against eligible schools that had not yet participated in the program. They also tracked students’ average systolic and diastolic blood pressure readings. All data were aggregated at the school level.��

They found that school participation in the CEP was associated with a 2.71% decrease in the proportion of students with high blood pressure, corresponding to a 10.8% net drop over five years. School participation in CEP was also associated with a decrease in students’ average diastolic blood pressure.��

“In previous work on the health impacts of universal free school meals, our team found that adoption of free meals is associated with decreases in and , which are closely linked to risk of high blood pressure,” said , a professor of health, society and behavior at the University of California Irvine’s Joe C. Wen School of Population & Public Health and senior author of the study. Jones-Smith conducted much of this research while on faculty at the 91̽��School of Public Health. “So in addition to directly affecting blood pressure through provision of healthier meals, a second pathway by which providing universal free meals might impact blood pressure is through their impact on lowering risk for high BMI.”��

Improved nutrition of school meals may have helped drive the decrease, researchers said. The 2010 law that established the CEP also created stronger nutritional requirements for school meals. As a result, those meals now more closely resemble the , which to be an effective tool for managing hypertension.��

Despite the evidence supporting the DASH diet’s effectiveness, public health officials previously lacked an effective mechanism to encourage people with high blood pressure to follow its recommendations. “We know there are a lot of barriers to people eating this diet,” Localio said, but the combination of universal free meals and increased nutritional standards likely helped students overcome those barriers.

The study also contradicts the common misperception that universal free meals mostly benefit wealthier students, because students from low-income families would already receive free meals. The study sample consists primarily of low-income patients, with 85% of included students enrolled in public health insurance such as Medicaid.

“There is a perception that providing universally free school meals will only improve outcomes for students of relatively higher-income families, but our findings suggest that there are benefits for lower-income children as well,” Jones-Smith said. “Potential mechanisms for this include decreasing the income-related stigma around eating school lunch by providing it free to all students and eliminating the time and paperwork burden of individually applying, thus decreasing barriers to participation in school meals.”

These findings come at an uncertain time for universal free meals. A school is eligible to participate in the CEP if . In this way, recent cuts to the Supplemental Nutrition Assistance Program (SNAP), the nation’s largest food assistance program, may affect schools’ access to the program.

“We’re in a contentious time for public health, but it seems like there’s bipartisan support for healthy school meals,” Localio said. “There’s legislation being considered in a number of states to expand universal free meals, and these findings could inform that decision-making. Cutting funding to school meals would not promote children’s health.”��

Co-authors on the study include , research professor emeritus of health systems and population health at the UW; , teaching professor of economics at the UW; Wyatt Benksen and Aileen Ochoa of OCHIN; and , associate professor of nursing at the UW. This study was funded by the Eunice Kennedy Shriver National Institute of Child Health & Human Development.��

For more information or to contact the researchers, email Alden Woods at acwoods@uw.edu.

Warmer weather across the globe is reshaping the landscape of human health. Case in point:��Dengue fever incidence could rise as much as 76% by 2050 due to climate warming across a large swath of Asia and the Americas, according to a new study led by , a researcher at the 91̽��.��

Dengue fever, a mosquito-borne disease once confined largely to the tropics, often brings flu-like symptoms. Without proper medical care, it can escalate to severe bleeding, organ failure, and even death. ��

The study,, is the most comprehensive estimate yet of how temperature shifts affect dengue’s spread. It provides the first direct evidence that a warming climate has already increased the disease’s toll.����

“The effects of temperature were much larger than I expected,” said Childs, a 91̽��assistant professor of environmental and occupational health sciences who conducted much of the research as a doctoral student at Stanford University. “Even small shifts in temperature can have a big impact for dengue transmission, and we’re already seeing the fingerprint of climate warming.”��

The study analyzed over 1.4 million observations of local dengue incidence across 21 countries in Central and South America and Southeast and South Asia, capturing both epidemic spikes and background levels of infection.����

Dengue thrives in a “Goldilocks zone” of temperatures — incidence peaks at about 27.8 degrees Celsius, or 82 degrees Fahrenheit, rising sharply as cooler regions warm but dropping slightly when already-hot areas exceed the optimal range. As a result, some of the largest increases are projected for cooler, high-population regions in countries such as Mexico, Peru and Brazil. Many other endemic regions will continue to experience larger, warming-fueled dengue burdens. By contrast, a few of the hottest lowland areas may see slight declines.����

Still, the net global effect is a steep rise in disease.��

The findings suggest that higher temperatures from climate change were responsible for an average 18% increase of dengue incidence across 21 countries in Asia and the Americas from 1995 to 2014 — translating to more than 4.6 million extra infections annually, based on current incidence estimates. Cases could climb another 49% to 76% by 2050 depending on greenhouse gas emissions levels, according to the study. At the higher end of the projections, incidence of dengue would more than double in many cooler locations, including areas in the study countries that are already home to over 260 million people.����

“Many studies have linked temperature and dengue transmission,” said senior author, a professor of biology in the. “What’s unique about this work is that we are able to separate warming from all the other factors that influence dengue — mobility, land use change, population dynamics — to estimate its effect on the real-world dengue burden. This is not just hypothetical future change but a large amount of human suffering that has already happened because of warming-driven dengue transmission.”��

The researchers cautioned that their estimates are likely conservative. They do not account for regions where dengue transmission is sporadic or poorly reported, nor do they include large endemic areas such as India or Africa where detailed data is lacking or not publicly available. The researchers also highlighted recent locally acquired cases in California, Texas, Hawaii, Florida, and in Europe — a signal of the expanding range of dengue. Urbanization, human migration and the evolution of the virus could amplify risks, while medical advances may help blunt them, making projections uncertain.��

Aggressive climate mitigation would significantly reduce the dengue disease burden, according to the study. At the same time, adaptation will be essential. This includes better mosquito control, stronger health systems and potential widespread use of new dengue vaccines.��

In the meantime, the findings could help guide public health planning and strengthen efforts to hold governments and fossil fuel companies accountable for climate change damages. Attribution studies are increasingly entering courtrooms and policy debates, used to assign responsibility for climate damages and to support funds compensating countries most affected.����

“Climate change is not just affecting the weather — it has cascading consequences for human health, including fueling disease transmission by mosquitoes,” Mordecai said. “Even as the U.S. federal government moves away from investing in climate mitigation and climate and health research, this work is more crucial than ever for anticipating and mitigating the human suffering caused by fossil fuel emissions.”��

Co-authors of the study include of Arizona State University, of the University of Maryland, and of Stanford. Lyberger and Harris completed much of their work while at Stanford.������

The research was funded by the Illich-Sadowsky Fellowship through the Interdisciplinary Graduate Fellowship program at Stanford University; an Environmental Fellowship at the Harvard University Center for the Environment; the National Institutes of Health; the National Science Foundation (with the Fogarty International Center); �ٳ��  �ٳ��  and the Stanford Woods Institute for the Environment.��

Adapted from a. For more information or to contact the researchers, email Alden Woods at acwoods@uw.edu.

Joth Davis adjusted his waders and stepped into the cool waters of Thorndyke Bay, his Crocs disappearing under a layer of thick, forest-green seaweed. Behind him, jagged Olympic peaks poked above the hilltops. Before him stretched 30 acres of oysters, clams and geoducks — the shellfish farm he’d run for 35 years. ��

A hundred feet from shore, Davis stooped over and reached a hand toward the muck, where a native cockle clam sat on the surface. “This right here,” he said, scooping up the clam, “this is the problem.”��

Under ideal conditions, cockles bury themselves in sand or mud, resting in shallow waters. But the conditions at are not always ideal. Every summer, Davis and shellfish farmers across the Washington coastline contend with an abundance of , a native seaweed that flourishes in tidelands. Commonly called “sea lettuce,” Ulva grows thick and heavy. Left unmitigated, it can smother life underneath.��

Some shellfish, like the cockle in Davis’s hand, can force themselves through the sludge and onto the surface, where they’re more likely to survive. Others — including the oysters and geoducks that are the heart of Baywater’s business — can only suffer on the seabed.����

“Too much seaweed grows in proliferation, and just piles up on top of the (shellfish). We definitely have seen mortalities among geoducks because of the Ulva,” said Davis, who is also a trained marine biologist and affiliate professor of aquatic and fisheries sciences at the UW. “And it’s getting worse.”��

For years, Baywater has removed excess Ulva by hand. Teams of workers hunch over to scoop fistfuls of seaweed into oversized buckets. It’s an expensive, time-consuming, laborious process that creates yet another conundrum — what to do with hundreds of pounds of unwanted seaweed.����

Researchers at the 91̽�� saw an opportunity. Ulva is rich in carbon and other nutrients, which can cause problems when left in the sea. But those same nutrients are vital for land-based agriculture. What if shellfish farmers like Davis could turn all that extra seaweed into an organic soil amendment for vegetable farms?����

“It seemed like a real no-brainer,” said Sarah Collier, a 91̽��assistant professor of environmental and occupational health sciences and the project lead. “What has been a problem for shellfish farms could be a great opportunity for farms on land.”��

That insight led to , a multi-year collaboration between the UW, Baywater Shellfish, , Washington State University, and farm business incubator The project aimed to test the viability of Ulva as a soil amendment, and, if successful, develop a market for sea-based farmers to sell excess seaweed to their counterparts on land. Along the way, Collier’s team would study the supply chain’s agricultural, economic and climate impacts.����

Project leaders hoped their findings would help to solve a problem faced not only in Washington, but also in coastal communities around the globe.����

“Our farm is really a research platform,” Davis said. “We’re doing this because it helps the farm, but it’s really the science that we want.”����

In December 2023, the U.S. Department of Agriculture awarded the program nearly $5 million over five years. The project launched the following year, removing more than 17,000 pounds of seaweed from shellfish beds and applying it to crops on four local farms, who received financial support for their participation.����

The project generated widespread excitement. Anecdotes from participating farms suggested an increased crop yield, and nearly 70 farms expressed interest in participating in the second year. The project team built a prototype raft-based system to accelerate seaweed removal. Early data suggested a significant economic benefit.��

Then the USDA pulled the plug. In April 2025, federal officials canceled a $3 billion initiative to fund climate-forward agricultural projects such as Blue Carbon, Green Fields.����

“We had to immediately shut everything down,” Collier said. Now the project is at a standstill: Farmers who had been eager to participate were unable to do so, and researchers haven’t been able to fully analyze the first year’s data. The raft-based harvester sits ready, but has no supply chain for the seaweed it collects.��

As the summer unfolds, project leaders have scrambled to maintain what they can, collecting essential data and storing seaweed samples for later analysis. Collier is searching for alternative funding and working with the USDA to potentially tweak the project to fit the Trump administration’s priorities.����

For now, though, a solution to the seaweed problem remains just out of reach.����

“The thing that’s really frustrating is that this is absolutely a win-win,” Collier said. “It makes sense. It solves a problem. It’s just something that makes sense from every perspective whether you’re thinking about the economics, the environmental impacts or�� building resilience and health in the system. It just makes sense from every possible angle.��

“So to have to stop doing this work is just so frustrating.”��

Every year, nearly 2 million young Americans experience homelessness. which can be both a crucial source of emotional support and a barrier to receiving services such as housing or medical care. Studies have shown that Some may choose veterinary care for their animals over obtaining health care for themselves. ��

The Seattle One Health Clinic was designed to address those barriers. Led by the operated in collaboration with the Washington State University College of Veterinary Medicine, and supported by two nonprofit organizations, the clinic offers free veterinary care alongside its medical services. A paper ��in the Journal of Primary Care & Community Health found that the integrated approach increased access to preventative medical care for both people and their pets.��

“It’s truly integrated — human and animal providers working together is a unique approach,” said , lead author of the paper and a postdoctoral researcher in the Center for One Health Research.��

At the One Health Clinic, a nurse practitioner and veterinarian, often accompanied by veterinary students, provide primary care services while 91̽��students volunteer as patient navigators, helping to coordinate care and address shared health needs such as extreme weather, environmental contaminants and zoonotic disease. The clinic also helps clients document their pets as emotional support animals, which enables them to access a wider range of housing and other services. ��

“The data clearly shows that this model of care is building trust,” Rejto said. “It’s special to see holistic care that takes into account the environment, the animal, the person and their relationships in society, to provide care to these young people. It’s incredibly important for people to have preventative care, and that in turn has a great impact on public health.” ��

The study analyzed medical and veterinary records of clinic visits between 2019 and 2022. The majority of human participants were 23 years old or younger. Of the 88 human clients who visited the clinic during that period, 75 saw a health care provider at least once, and 40 patients established care for the first time in at least the past two years. Most of those patients returned for at least one follow-up appointment within two years of their first visit.��

Most significantly, nearly 80% of all visits to the One Health Clinic resulted in clients receiving human health care. That includes 69% of visits where clients initially intended to seek care only for their pets.��

“Adding veterinary care to a primary care clinic creates a supportive environment that is vastly different from a typical medical care facility”, said co-author , one of the founders of the One Health Clinic and director of the 91̽��Center for One Health Research, who is also a 91̽��professor of environmental and occupational health sciences and an associate professor of medicine in the 91̽��School of Medicine. “This unique atmosphere encourages clients to seek care for themselves as well as their animals.”������

A fully integrated model may be a new concept to many, requiring novel partnerships between human health and veterinary professionals, Rejto acknowledged. But the results suggest that health care providers should give greater consideration to the health impact of the human animal bond between people and their pets.����

“Potentially a good start would be to increase collaboration and communication between animal and human health care, to have human health facilities that are in communication with veterinary facilities. That could help identify diseases and shared environmental risks,” Rejto said. “It’s about expanding providers’ and human health care workers’ framework for addressing health.”��

Other authors include , senior research coordinator and center manager at the Center for One Health Research; , a 91̽��assistant professor of global health and of epidemiology and deputy director of the Center for One Health Research; Hannah Fenelon, Michael Xie, Alice Tin and Erin Tabor of the 91̽��Center for One Health Research; of the Washington State University College of Veterinary Medicine; Kate Schneier and Andrew Nee of Neighborcare Health; and Amanda Richer of Uplift Consulting.��

This research was funded by the National Institutes of Health, National Institute of Nursing Research Training Program in Global Health Nursing at the UW, the New Tudor Foundation, and by a gift from the now-shuttered Y/YA Shelter “Peace for the Streets by Kids from the Streets.” Funding for the publication of this study was provided by the American Society for the Prevention of Cruelty to Animals’ (ASPCA) Open-Access Publishing Fund.