Category: English

Source: The Conversation – USA (3) – By Vivian Ho, Professor and Chair of Health Economics, Rice University

Health insurance premiums in the U.S. significantly increased between 1999 and 2024, outpacing the rate of worker earnings by three times, according to our newly published research in the journal JAMA Network Open.

Premiums can rise if the costs of the medical services they cover increase. Using consumer price indices for the main components of medical care – such as services provided in clinics and hospitals as well as administrative expenses – based on federal data and data from the Kaiser Family Foundation, we found that the cost of hospital services increased the most, while the cost of physician services and prescription drugs rose more slowly.

Some of the premium increases can be attributed to an increase in hospital outpatient visits and coverage of GLP-1 drugs. But research, including our own, suggests that premiums have rapidly escalated mostly because health system consolidation – when hospitals and other health care entities merge – has led hospitals to raise prices well above their costs.

Hospital CEOs prioritize profit

Hospitals are aggressively raising their prices because hospital CEOs have incentives to do so.

One study found that for nonprofit health systems, the greatest pay increases between 2012 and 2019 went to hospital CEOs who grew the profits and size of their organizations the most. However, the financial reward of delivering above-average quality of care declined. Increased charity care – free or discounted health services nonprofit hospitals must provide some of their patients who cannot afford medical care – was not significantly tied to CEO compensation.

Board members set performance criteria that determine the base salary and bonus payments for CEOs. Over half of board members at top U.S. hospitals have professional backgrounds in finance or business. As a result, researchers and advocates have raised concerns that financial success is the dominant priority at these institutions.

One way to help ensure that nonprofit hospitals make the health of their local communities a top priority is to require their boards to disclose their executive compensation guidelines for salary and bonuses, similar to the information that for-profit health care companies disclose to their stockholders. The general public could pressure companies to put greater weight on affordability and quality of care when setting performance targets for nonprofit hospital executives.

Some economists suggest that hospital prices be regulated. This approach involves capping prices for health care services at the most expensive hospitals and restricting price growth for all hospitals. Regulators would also focus on flexible but service-specific oversight to quickly respond to unintended market disruptions.

What employers can do

Costs for health insurance coverage provided by employers are expected to surge by 9.5% in 2026.

Employers, who bear the bulk of premium increases when purchasing insurance for their workers, could include more price sensitivity when designing benefits for their employees to help keep insurance affordable for workers.

One study found that a health insurance plan that introduced three copayment levels corresponding to three hospital tiers of low, medium and high prices achieved savings of 8% per hospital stay after three years, with no evidence of a reduction in quality.

Roughly one-third of large employers are offering nontraditional health plans in 2026. For example, a variable copay plan has no or low deductibles and sets higher copayments for services at providers charging higher fees.

Holding hospitals to account

The mission statements of the largest nonprofit health care systems in the U.S. often express a desire to improve the health of the communities they serve, especially the most vulnerable.

Restraining price growth among nonprofit hospitals would introduce greater price competition to the health care market, likely forcing for-profit providers to lower their prices as well.

Vivian Ho has received grant funding from HCSC Affordability Cures Initiative and ArnoldVentures. She is a Fellow at Rice University’s Baker Institute for Public Policy

Salpy Kanimian does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

– ref. Health insurance premiums rose nearly 3x the rate of worker earnings over the past 25 years – https://theconversation.com/health-insurance-premiums-rose-nearly-3x-the-rate-of-worker-earnings-over-the-past-25-years-271450

Source: The Conversation – USA – By Steven Lautzenheiser, Assistant Professor of Biological Anthropology, University of Tennessee

Curious Kids is a series for children of all ages. If you have a question you’d like an expert to answer, send it to curiouskidsus@theconversation.com.

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Why can’t I wiggle my toes individually, like I can with my fingers? – Vincent, age 15, Arlington, Virginia

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One of my favorite activities is going to the zoo where I live in Knoxville when it first opens and the animals are most active. On one recent weekend, I headed to the chimpanzees first.

Their breakfast was still scattered around their enclosure for them to find. Ripley, one of the male chimpanzees, quickly gathered up some fruits and vegetables, sometimes using his feet almost like hands. After he ate, he used his feet to grab the fire hoses hanging around the enclosure and even held pieces of straw and other toys in his toes.

I found myself feeling a bit envious. Why can’t people use our feet like this, quickly and easily grasping things with our toes just as easily as we do with our fingers?

I’m a biological anthropologist who studies the biomechanics of the modern human foot and ankle, using mechanical principles of movement to understand how forces affect the shape of our bodies and how humans have changed over time. Your muscles, brain and how human feet evolved all play a part in why you can’t wiggle individual toes one by one.

Comparing humans to a close relative

Humans are primates, which means we belong to the same group of animals that includes apes like Riley the chimp. In fact, chimpanzees are our closest genetic relatives, sharing almost 98.8% of our DNA.

Evolution is part of the answer to why chimpanzees have such dexterous toes while ours seem much more clumsy.

Our very ancient ancestors probably moved around the way chimpanzees do, using both their arms and legs. But over time our lineage started walking on two legs. Human feet needed to change to help us stay balanced and to support our bodies as we walk upright. It became less important for our toes to move individually than to keep us from toppling over as we moved through the world in this new way.

Human hands became more important for things such as using tools, one of the hallmark skills of human beings. Over time, our fingers became better at moving on their own. People use their hands to do lots of things, such as drawing, texting or playing a musical instrument. Even typing this article is possible only because my fingers can make small, careful and controlled movements.

People’s feet and hands evolved for different purposes.

Muscles that move your fingers or toes

Evolution brought these differences about by physically adapting our muscles, bones and tendons to better support walking and balance. Hands and feet have similar anatomy; both have five fingers or toes that are moved by muscles and tendons. The human foot contains 29 muscles that all work to help you walk and stay balanced when you stand. In comparison, a hand has 34 muscles.

Most of the muscles of your foot let you point your toes down, like when you stand on tiptoes, or lift them up, like when you walk on your heels. These muscles also help feet roll slightly inward or outward, which lets you keep your balance on uneven ground. All these movements work together to help you walk and run safely.

The big toe on each foot is special because it helps push your body forward when you walk and has extra muscles just for its movement. The other four toes don’t have their own separate muscles. A few main muscles in the bottom of your foot and in your calf move all four toes at once. Because they share muscles, those toes can wiggle, but not very independently like your fingers can. The calf muscles also have long tendons that reach into the foot; they’re better at keeping you steady and helping you walk than at making tiny, precise movements.

In contrast, six main muscle groups help move each finger. The fingers share these muscles, which sit mostly in the forearm and connect to the fingers by tendons. The thumb and pinky have extra muscles that let you grip and hold objects more easily. All of these muscles are specialized to allow careful, controlled movements, such as writing.

So, yes, I have more muscles dedicated to moving my fingers, but that is not the only reason I can’t wiggle my toes one by one.

Divvying up brain power

You also need to look inside your brain to understand why toes and fingers work differently. Part of your brain called the motor cortex tells your body how to move. It’s made of cells called neurons that act like tiny messengers, sending signals to the rest of your body.

Your motor cortex devotes many more neurons to controlling your fingers than your toes, so it can send much more detailed instructions to your fingers. Because of the way your motor cortex is organized, it takes more “brain power,” meaning more signals and more activity, to move your fingers than your toes.

Even though you can’t grab things with your feet like Ripley the chimp can, you can understand why.

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Hello, curious kids! Do you have a question you’d like an expert to answer? Ask an adult to send your question to CuriousKidsUS@theconversation.com. Please tell us your name, age and the city where you live.

And since curiosity has no age limit – adults, let us know what you’re wondering, too. We won’t be able to answer every question, but we will do our best.

Steven Lautzenheiser does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

– ref. Why can’t I wiggle my toes one at a time, like my fingers? – https://theconversation.com/why-cant-i-wiggle-my-toes-one-at-a-time-like-my-fingers-256281

Source: The Conversation – USA – By Shelly M. Wagers, Associate Professor of Criminology, University of South Florida

Most Americans imagine human trafficking as a violent kidnapping or a “stranger danger” crime – someone abducted from a parking lot or trapped in a shipping container brought in from another country.

In fact, trafficking rarely takes this form.

In most cases, traffickers spend months or even years building trust and creating emotional and economic bonds with their victims. They use a variety of coercion and control techniques such as emotional abuse, forced criminality, financial abuse, and physical and sexual abuse to entrap their victims.

Meanwhile, the perpetrators are making money off their victims’ unpaid labor, including unwanted sex work. Human trafficking is estimated to be a US$172 billion industry.

The story of Jeffrey Epstein is just one example of how traffickers use a combination of manipulation, economic dependency and coercion – rather than physical captivity – to entrap vulnerable people and slowly erode their autonomy. Many victims don’t even realize they’re being exploited due to the manipulations of their traffickers.

Epstein’s crimes have attracted the national spotlight due to the fame and power of his clientele. His case demonstrates the harsh reality that human trafficking is far more common and complex than most people imagine.

We are criminologists who research human trafficking. In 2020, we founded the University of South Florida’s Trafficking in Persons Risk to Resilience Lab, known as the TIP lab, to study human trafficking in the state of Florida.

We know that labor and sex trafficking hide in plain sight, embedded in ordinary settings such as hotels, restaurants, farms, massage businesses and private homes.

Most victims are trafficked by someone they know or trust – a family member, intimate partner or employer. Many continue to go to school or work while being exploited.

Misconceptions about what trafficking looks like have made it harder to see and harder to measure. The available data on this crime and its victims has long been fragmented, incomplete and inconsistent. Law enforcement, government organizations such as health departments, and nonprofits that provide advocacy and victim services collect information differently. The same case could be counted multiple times by different agencies, while other victims go entirely uncounted, making it nearly impossible to understand the true scope of trafficking and effectively fight it.

Florida steps up

To address this problem, Florida in 2023 passed Senate Bill 7064, a law requiring all state and local government agencies and nongovernmental organizations that receive federal or state funding to send their human trafficking data to the USF TIP lab.

We developed TIPSTR, Florida’s statewide repository for anonymous human trafficking data. This single, consistent database is the most comprehensive data resource on human trafficking in any state in the U.S.

Our team compiled anonymous data from more than 30 state agencies and nonprofit organizations, including the Florida Department of Children and Families, the Florida Department of Law Enforcement and the Crisis Center of Tampa Bay.

We also conducted a self-report survey in 2024 to learn more about trafficking victims living in Florida. The survey was administered by YouGov using a representative sample of 2,500 Florida residents. And we established BRIGHT – Bridging Resources and Information Gaps in Human Trafficking – which connects survivors directly with services such as housing, mental health counseling, transportation and more, helping them move from crisis to stability. Besides serving as a resource for trafficking victims, BRIGHT allows us to measure and track the availability of victim services relative to the need for them.

Since starting TIPSTR in 2023, we’ve been putting all of the data together to create a picture of the complexities, depth and breadth of trafficking, as well as the resources that address the problem, both statewide and in each of Florida’s 67 counties.

Why Florida faces higher risk

Florida’s economy and geography create a mix of risk factors for trafficking that are distinct from most other states.

With its large tourism, agriculture, construction and entertainment industries, the state depends heavily on temporary and mobile workforces. Its international airports and seaports connect it to global markets. Large sporting events and other entertainment bring in visitors looking for “fun in the sun” from all over the U.S. and the world.

All of these features make Florida economically vibrant – but they also create vulnerabilities. Transient labor markets, seasonal employment and high migration make it easier for traffickers to exploit workers and harder for authorities to detect exploitation. Often, buyers travel into Florida as tourists with the idea that “what happens in Florida stays in Florida,” creating a market for sex trafficking.

What we’ve found so far

2024 was the first full year for which we collected data, and we published our findings in July 2025 in the 2024 TIPSTR Report. The report demonstrates both the scale of the problem and the importance of reliable data.

The report also analyzes Florida counties with populations above 500,000, evaluating each county’s risk, resilience and response capacity on a scale from low to high.

Our self-report survey found that an estimated 500,000 current Florida residents were exploited or trafficked at work, and an estimated 200,000 were trafficked for sex. Minors made up half of those trafficked for sex and a quarter of those exploited at work. Although many of these survivors were exploited outside of Florida, these people need services locally to help get their lives on track.

Of those reporting human trafficking, only 9% to 12% reported this crime to law enforcement, confirming our concerns that it remains largely hidden from view. This is why it’s critical that TIPSTR doesn’t solely rely on law enforcement data.

Our analysis of the available data revealed wide variation across Florida counties in both the level of risk and the robustness of response systems. Some regions show strong resilience due to coordinated task forces and survivor services, while others struggle with underreporting and limited resources.

Translating data into action

At the same time, there are encouraging signs. The TIPSTR data shows prosecutions are increasing, and coordination among law enforcement, service providers and community organizations has strengthened.

Going forward, we hope our analysis of the data collected by TIPSTR will help the reporting agencies find new ways to respond. And tracking trends can allow policymakers to measure the effectiveness of programs run by different groups.

In fact, this is already happening. One sheriff’s office shared with us that when it saw how many illicit massage businesses were in its county, it started investigating them. In another instance, a nonprofit told us it had used the report to show why it needs more funding to expand its programs.

Seeing where trafficking is most concentrated and where services are missing is already helping the Florida Legislative Working Group on Human Trafficking identify potential policy changes.

Law enforcement can now use TIPSTR’s cross-agency data to connect cases. Service providers can coordinate care across counties, reducing duplication and ensuring continuity for survivors.

We hope that the report will also be used to develop broader awareness campaigns and better victim identification practices.

The importance of a long-term database

The system we’ve created will allow us to track the data for years to come. From a research perspective, this is critical, because it means our team can assess whether new policies and prevention strategies are making a measurable impact over time.

As criminologists, we believe that what Florida has built through TIPSTR can serve as a model for other states. Data alone cannot end human trafficking, but without it, we are fighting a hidden problem we cannot fully see.

Read more stories from The Conversation about Florida.

Shelly M. Wagers receives funding from National Institute of Justice and Mel Greene Foundation.

Joan A. Reid receives funding from National Institute of Justice and Mel Greene Foundation.

– ref. Florida’s new reporting system is shining a light on human trafficking in the Sunshine State – https://theconversation.com/floridas-new-reporting-system-is-shining-a-light-on-human-trafficking-in-the-sunshine-state-265935

Source: The Conversation – USA (2) – By Seth T. Kannarr, Ph.D. Candidate in Geography, University of Tennessee

Ocmulgee Mounds, a site in central Georgia with 12,000 years of Indigenous history, may be on the verge of becoming the newest U.S. national park. This is the flagship designation of the National Park Service system, which includes many types of properties in addition to formally designated national parks.

Although this redesignation may not include much change for the site itself, it could mean quite a lot to visitors, supporters and locals alike.

The 3,000-acre park protects land and features important to the Mississippian culture, which built the mounds there starting roughly 3,000 years ago, and the Muscogee (Creek) Nation, for which the site is an ancestral homeland.

The site includes seven enormous ceremonial and burial mounds made of earth, the largest of which is 55 feet (15 meters) tall and covers about 2 acres, as well as a museum containing millions of cultural artifacts, including pottery, stone tools, jewelry and bells.

The National Park Service has managed the site since the 1930s, first as a national monument and since 2019, as a national historical park. There are no legal or practical differences in protection between these redesignations, though the branding and marketing of the site may change.

As a geographer who studies parks and the naming of places, I have seen that when a National Park Service unit is redesignated as a national park, as a pending bill in Congress currently proposes for Ocmulgee Mounds, it does not typically change the funding available to run the site. That’s especially true at a time when National Park Service funding and personnel are being cut. However, a park redesignation does serve political purposes and affects how visitors perceive that park.

How parks are designated

The National Park Service manages 433 units with 19 different designations, such as “national battlefields,” “national lakeshores” and “national scenic trails.” Only 63 of these units carry the formal title or designation of “national park.”

All but one of these categories can be bestowed only by Congress. National monuments, however, can be created by the president directly, under the provisions of the Antiquities Act of 1906.

For example, the Antiquities Act allowed President Barack Obama to designate 1.3 million acres in Utah as Bears Ears National Monument in a December 2016 proclamation. That same act allowed President Donald Trump to shrink the protected area to 200,000 acres in 2017 – and President Joe Biden to re-expand it to 1.3 million acres in 2021.

Other examples of redesignation

In rare cases, a community, group or other organization proposes adding an area that is not currently managed by the National Park Service to the system, but this takes a lot of time and is different from the more common process of changing the formal designation of a property already within the system.

For instance, Indiana Dunes National Lakeshore became Indiana Dunes National Park in 2019. That same year, White Sands National Monument in New Mexico became White Sands National Park. And in 2020, New River Gorge National River in West Virginia became New River Gorge National Park and Preserve.

Why redesignations make a difference

My analysis of the contentious redesignation of the Jefferson National Expansion Memorial in St. Louis to Gateway Arch National Park in 2018 found that it was not done to offer additional protection to this site of national importance. Rather, the move was meant to take advantage of the public significance of the “national park” label and thereby attract more tourists and tourism revenue to the local economy.

The effort to make it a national park was part of a local campaign to renovate the underground visitor center, revitalize the park grounds and increase tourism. But the law that formalized the change included no additional funding, resources or protections for the Gateway Arch.

Changing the designation contradicted the park service’s own declaration that the term “national park” should be used for an area that “contains a variety of resources and encompasses large land or water areas to help provide adequate protection of the resources.”

During congressional hearings, the deputy director of the National Park Service, Robert Vogel, recommended the site not be labeled a national park but rather a national monument, because the site “is too small and limited in the range of resources the site protects and interprets to be called a national park.”

Gateway Arch National Park is now the smallest-area park in the U.S., at less than 200 acres, and is home to a large steel arch, an open lawn area, a museum and a single historic building – a courthouse where one of the Dred Scott trials was heard, along with other civil rights cases. It does not have the wildlife viewing, spectacular geologic features, outdoor recreation opportunities and sense of wilderness that the public has come to expect from national parks.

The park’s website admits “it is unusual for a national park to have no natural plant life” and describes the park as adjacent to the “concrete jungle of downtown St. Louis.”

What actually would change for Ocmulgee Mounds?

The redesignation effort for Ocmulgee Mounds has two primary aspects. First, it would declare the area a national park.

Second, it would add additional land to this protected area, designating that portion as a national preserve. The distinction matters: Public hunting, including traditional Indigenous hunting, is not allowed in national parks, but it is allowed in national preserves. And while national parks are managed by the National Park Service under the Department of Interior, national preserves can be managed in collaborative partnership with other groups, including local Indigenous people with cultural ties to the land.

The changes for Ocmulgee Mounds are supported by members of both political parties in both houses of Congress. And the redesignation does not appear to have triggered opposition from local communities, who in other places have objected for several reasons, including fear of increased tourism and desire to preserve any long-standing uses of the land that would be banned if it were to become a national park.

There are redesignation efforts underway seeking to make national parks in other locations as well, including the Delaware Water Gap National Recreation Area in New Jersey and Pennsylvania, Chiricahua National Monument in Arizona, Buffalo National River in Arkansas, and Apostle Islands National Lakeshore in Wisconsin.

The only real changes in these places, though, would be in marketing – the signs, brochures and merchandise sold in gift shops. But these changes would have an important effect: The tagline of “new national park” markets well and is believed to help attract more visitors to the site. But it won’t actually protect these landscapes any better than they already are under the stewardship of the National Park Service.

Seth T. Kannarr does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

– ref. What does it mean to be a new national park? Ocmulgee Mounds in Georgia may soon find out – https://theconversation.com/what-does-it-mean-to-be-a-new-national-park-ocmulgee-mounds-in-georgia-may-soon-find-out-268474