�������ýҕ�l

Just like in other rich countries, fertility rates in the U.S. have been falling. A lot of this decline is probably because people are waiting until they feel ready to become parents. U.S. social policy has emphasized the importance of people's waiting to have children (until they are older, until they are financially stable) for decades. So why isn't the fact that people are delaying their fertility treated like the policy success that it appears to be? Instead, we've seen many news stories bemoaning falling fertility rates, warning of economic collapse and not-so-subtly blaming selfish women for not having enough children. (Amanda Jean Stevenson, 8/10)

As a critical care physician, Kelli Mathew knew her days were spinning in the wrong direction. For one thing, her well of empathy was dry. When unvaccinated people came to her, suffering the effects of COVID, Mathew began snapping back. She had run out of comforting or even neutral things to say. “In my mind, it was like, ‘This is your doing. You chose not to get vaccinated and here you are,’” says Mathew, who works at Deaconess Henderson Hospital in Henderson, Ky. “I would say, ‘You’re probably going to die and this could have been preventable—how sad is that?’ I would walk away. And that’s not who I am.” (Carolyn Barber, 8/9)

Two often-cited emerging trends in the health care space are personalized care and remote care. At first glance, these may sound like they are at odds with each other: How can care become even more individually tailored, if you’ll be spending less time with your care providers? The answer to that question may lie in the use of digital twins — virtual models of individuals that could revolutionize multiple facets of health care. (Ben Alsdurf, 8/10)

In 1911, when my great grandfather, Dr. Isaiah Allen Jackson, opened his primary care practice in Richmond, Virginia's Jackson Ward neighborhood, a Black person couldn't drink from most water fountains and likely lacked access to doctors. His practice started above a pharmacy and offered quality care to the Black community. My grandfather and then my father took over his practice, Dominion Medical Associates, and it has been serving low-income and primarily Black patients for over three generations. But practices like my family's face a dire prognosis. (Mia Jackson, 8/9)

Growing old is an increasingly expensive privilege often requiring supports and services that, whether provided at home or in a facility, can overwhelm all but the wealthiest seniors. With Americans living longer and aging baby boomers flooding the system, the financial strain is becoming unsustainable. Consider the demographics. In 2018, there were 52.4 million Americans age 65 or older and 6.5 million 85 or older. By 2040, those numbers will hit 80.8 million and 14.4 million, respectively. From now until 2030, an average of 10,000 baby boomers will turn 65 every day. Already, demand for care dwarfs supply. The Medicaid waiting list for home-based assistance has an average wait time of more than three years. (Michelle Cottle, 8/9)

The United States has experienced a particularly rapid period of expansion of the older adult population since members of the baby boom generation began entering older adulthood nearly a decade ago. An aging population is the inevitable result of the steady advances that have been made in health innovations, medical research and discovery, and public health initiatives. But for many older adults — a population projected to increase to 80.8 million by 2040 — the reality is that aging co-occurs with gradual decreases in personal freedom and autonomy. (Laura Fraade-Blanar, Ryan Best and Vijeth lyengar, 8/10)