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Texas School Shooting: Yes, Gun Violence Is a Health Crisis



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With thousands of lives lost to gun violence every year, a growing number of experts believe we need to reframe how we think about it and begin addressing it as a health crisis. Andrew Lichtenstein/Getty Images
  • In the United States, there are more than 100 gun deaths each day and about 38,000 each year.
  • Despite the number of deaths, lingering health impacts from gunshot wounds, and the psychological impact a gun death or injury can have on a household or community, gun violence is framed as a political or criminal justice issue rather than a health issue.
  • Many experts say there’s a great need to begin reframing the impact of gun violence as a medical issue, not a political one.

On Tuesday, 18-year-old gunman Salvador Ramos walked into Robb Elementary School in Uvalde, Texas, where he shot and killed 19 young children and two teachers.

According to reports from the Associated Press, the gunman used an AR-style rifle, which was one of two he legally bought days before the attack.

AP also reports that Ramos had shared photos of the two rifles on social media, where he’d also hinted that he was planning the attack, writing that “kids should watch out.”

The attack is the deadliest school shooting in the U.S. since December 2012, when a gunman murdered 20 kids and six adults at Sandy Hook Elementary in Newtown, Connecticut.

The rampage is also part of a worrying trend in recent years that’s seen gun violence increase across the county.

While high-profile mass shootings like the most recent one in Texas understandably grab the world’s attention, less-highlighted, smaller-scale incidents of gun violence nationwide have continued to make this a central health threat endemic to American daily life.

Healthline spoke with experts about the pressing threat of gun violence in this country, how it’s a public health concern, and ways to raise awareness in order to enact needed change.

Gun violence in and of itself certainly isn’t a phenomenon endemic solely to the U.S., but the statistics are worrying when compared to the rest of the world.

Globally, an estimated 2,000 people are injured and 500 die each day, while there were a total of 1.4 million deaths tied to firearms between 2012 and 2016, according to Amnesty International.

What about domestically?

In the United States, there are more than 100 gun deaths each day and about 38,000 each year, according to Giffords, the gun control advocacy and research organization co-founded by former U.S. Representative Gabby Giffords.

A new 2022 report from the Johns Hopkins Center for Gun Violence Solutions takes a deep dive analyzing firearm fatality data from the Centers for Disease Control and Prevention (CDC). The data comes from 2020 and is the most recent currently available.

Johns Hopkins’s analysis revealed that overall 2020 firearm-related deaths totaled 45,222 — an increase of 15 percent from the previous year.

This is the highest reported by the CDC since it started recording these firearm statistics in 1968.

To put that number in perspective, 124 people on average died from gun violence each day. Additionally, firearm homicides saw a 35 percent increase in 2020, which means an increase of 5,000 more of these homicides compared to 2019, according to a Johns Hopkins press release.

A 2022 analysis of the same CDC data published in The New England Journal of Medicine found that gun violence also surpassed car accidents as the leading cause of death among American youth in 2020. The researchers found an increase of 29.5 percent in gun-related deaths among U.S children and adolescents up to the age of 19 from 2019 to 2020.

This was “more than twice as high as the relative increase in the general population,” reads the paper.

Given that issues of mortality, lingering health impacts of a gunshot wound, and the psychological impact a gun death or injury can have on a household or community at large, why isn’t this discussed as a public health crisis on par with the current pandemic impacting our lives nationwide?

It partly has to do with the fact that gun violence is framed as a “political or criminal justice problem,” said Dr. Megan Ranney, MPH, FACEP, associate professor of emergency medicine at Rhode Island Hospital/Alpert Medical School of Brown University, and a director and assistant dean of the Brown Institute for Translational Science.

“The forgotten underlying issue is when someone pulls the trigger, it causes health problems — the pulling of a trigger is no different than someone eating unhealthily or using substances or driving without a seatbelt on,” said Ranney, who’s a practicing emergency room physician as well as health policy researcher.

Ranney, who serves as chief research officer of AFFIRM at the Aspen Institute, a nonprofit that addresses gun violence through a public health approach, told Healthline that this approach involves relying on data, education, and collaborating directly with community stakeholders.

It’s been effective in the past with other health crises.

She pointed to how we’re addressing car crash deaths as a public health problem.

The institution of seatbelt enforcement and public education campaigns around driving while drunk reduced car crash deaths by over 70 percent in this country.

Ranney also zeroed in on the early days of the HIV crisis in the nation and how advances in modern science, improved medications and treatments, and awareness campaigns centered on behavioral interventions decreased deaths from complications tied to HIV at the height of the epidemic.

As a nation, Ranney asserted that we need to do the same with firearm use.

We must move the debate from policy and criminal justice, and solely gun rights and gun control discussions, to focus instead on harm reduction, identifying risk factors for gun injury and death, and devising education and clear messaging.

However, there have been many roadblocks erected to prevent this type of action.

It took until December 2020 for gun violence research to receive federal funding — the first time after a 20-year gap.

Ranney said that the long absence of federal support for understanding gun violence in this country made it nearly impossible to create impactful evidence-based programs in the first place.

It’s important to note that the issue of gun violence as a public health concern is complex and multi-faceted.

As with most public health crises — take COVID-19, for example — the umbrella issue of “gun violence” touches on many interlocking facets of our society at large.

The toll of gun violence manifests itself in many different ways.

It’s said that nearly every person in this country will know at least one victim of gun violence over the course of their lifetime, according to Giffords.

The advocacy organization reports that the majority — 59 percent — of gun deaths are suicides, followed by homicides at 38 percent. Police shootings account for 1.3 percent, unintentional shootings are at 1.2 percent, and 0.9 percent make up “undetermined incidents,” Giffords reports.

Like other public health crises, gun violence exposes fissures and inequities in our society.

Unarmed Black civilians are 5 times more likely to be shot and killed by police than their unarmed white peers.

Gun homicides have a high impact on Black people in this country, with Black men comprising more than half — 52 percent — of all gun homicide victims, Giffords reports.

The report from Johns Hopkins reveals young Black males — who represent just two percent of the total U.S. population — made up 38 percent of total gun homicide deaths in 2020.

These statistics for Black children and adolescents are bleak. Johns Hopkins’s analysis reveals 52 percent of deaths of Black teenagers between 15 and 19 years old were killed as a result of gun violence. The analysis found Black young men from 15 to 34 years old were “over 20 times” more likely to die from a gun compared to their white male peers. From 2019 to 2020, the same data shows a 49 percent increase in gun homicides among Black females.

Domestic violence is also another area where gun violence factors heavily.

Victims of domestic violence are 5 times more likely to be killed if their abuser has a gun, while U.S. women are 21 times more likely to be shot and killed by a gun than their peers in other high-income nations.

Robyn Thomas, executive director at the Giffords Law Center, told Healthline that looking at gun violence through a public health lens entails approaching these complicated issues holistically, echoing Ranney that this involves prevention and treatment.

This means handling each of these big issues underneath the umbrella of “gun violence” with sensitivity and nuance.

Dealing with the specific issue of suicide requires its own preventive methods compared to dealing with homicide, for instance.

There isn’t a one-size-fits-all conversation — each of these issues require unique discussions being had between advocacy organizations, doctors, public health officials, lawmakers, and cultural leaders.

Thomas said that organizations like the one she works for are “very committed” to working with medical and public health professionals.

During an early 2021 interview, Thomas expressed optimism at how then President-elect Joe Biden and then-Vice President-elect Kamala Harris would center gun violence as a national concern.

“I’ve heard them speak very clearly with their commitment to reducing gun violence, and now we’ll have both a Senate and a House [of Representatives] that will support gun violence prevention legislation,” Thomas added.

“Now, it’s important that they all be held accountable to make those changes, ensuring they have the information about these policies and programs and the public support they need to move this forward,” she said.

Since that time, we have only continued to witness the plight of gun violence sweep America and political inaction to make a change.

On May 14, 2022, a racially motivated, white supremacy-driven shooting at a Tops supermarket in Buffalo, New York, killed 10 people and injured three more. All 10 of those who were killed were Black. In total, 11 of all shot were Black.

After visiting the site of the hate crime and offering words of condolence at a Buffalo community center, President Biden didn’t speak optimistically that gun reform was possible in the current Washington political climate.

“Not much on executive action [that I can enact]. I’ve got to convince the Congress that we should go back to what I passed years ago,” Biden told reporters at Buffalo Niagara International Airport. “It’s going to be very difficult. Very difficult. But I’m not going to give up trying.”

“We have enough laws on the books to deal with what’s going on now,” Biden continued. “We just have to deal with it. Look, part of what the country has to do is look in the mirror and face the reality. We have a problem with domestic terror. It’s real,” Biden said, as reported by NEWS10 ABC out of Albany, NY.

For her part, Thomas added that one of the “sad side effects” of the current era still marked by the ravages of the pandemic and this rolling wave of violence is that we’ve collectively witnessed huge increases in gun purchasing and gun violence that seem to be unabated.

“Communities have also been impacted by more domestic violence and suicide, people are depressed…and it’s more urgent than ever to take steps to address gun violence with this administration and the Congress that sits behind them,” Thomas stressed.

“We know they all have a lot on their plate, but we think this should be one of their absolute priorities,” she added back in 2021.

One of the most troubling aspects of America’s scourge of gun violence is how so much of it is motivated by hate crimes targeting particularly vulnerable communities.

The recent Buffalo mass shooting was just one of many examples of white supremacist-generated attacks against people of color in the U.S. The shooter at Tops supermarket posted an online manifesto that specifically attributed white supremacy as the influence behind the shootings, according to NEWS10 ABC.

The Brady Plan reports that 56,130 hate crimes were committed in the U.S. “that involved the use of a gun” from the years 2010 to 2016. The wave of mass shootings that have been a horrifying reality for all too many Americans often are tied to hate incidents — whether fueled by racism, misogyny, homophobia, and transphobia, among others.

One prominent example is the 2016 Pulse nightclub shooting in Orlando, Florida, when a gunman shot and killed 49 people and injured 53 others at the LGBTQIA+ space. It is currently considered the deadliest hate crime against LGBTQIA+ people in U.S. history, according to The Brady Plan.

Receiving less press than the mass shooting in Buffalo was a shooting in Dallas, Texas, taking place days before that wounded three Asian women in a hair salon in the city’s Koreatown neighborhood.

A suspect was arrested and his girlfriend told police that he has “delusions that the Asian mob is after him or attempting to harm him,” reports NPR of the alleged racist motivations behind the shooting.

This of course recalled the horrific 2021 mass shooting that resulted in the murder of six Asian women at three spas in the Atlanta metropolitan area over the course of one night.

Antisemitism has also factored into motivations behind American mass shootings. In 2018, the Tree of Life synagogue in Pittsburgh, Penn., became the site of the deadliest antisemitic attack on U.S. soil, when a gunman shot and killed 11 worshippers and wounded six others, according to USA Today.

In all of these examples, different prejudices coupled with America’s still-unchecked gun violence problem resulted in devastating mass shootings targeting specific vulnerable groups.

As hate crimes motivated by racist and anti-LGBTQIA+ sentiments, among others, persist, it makes for something of a perfect storm, with mass shootings hitting groups already vulnerable in American society and prone to negative impacts from other public health crises.

Ranney said that when discussing gun violence from a public health perspective, it’s important not to get too mired in the political and policy debate, especially for the media and cultural commentators who bring it to the public consciousness.

She explained that policy is crucial but it has to be done with care to make sure it doesn’t negatively affect some of the most vulnerable groups in this country.

In many ways it comes down to promoting proper interventions at the community level.

Ranney cited programs that center on interventions with young people who have a history of physical fights, knowing that fights are often a precursor to firearm violence.

When it comes to suicide, she said this is another area where education and prevention are key, especially given that for the majority of people who attempt suicide, a firearm is usually the first option they turn to.

She said there’s a parallel to resistance of COVID-19 prevention when it comes to resistance to having these conversations around guns.

Many Americans might assume they’re unaffected personally by gun violence.

She cited very public events, like the attempted assassination of Giffords in a suburban area just outside Tucson, Arizona 10 years ago, or the school shootings at Sandy Hook Elementary School in Newtown, Connecticut, as moments of awakening for some Americans to the very pressing reality of gun violence.

However, the same attention hasn’t always been paid to the stark realities of gun violence in Black and brown communities. News cameras and political spotlights aren’t often centered on these communities in a sensitive way.

She pointed out that this can be another blind spot in how we address gun violence as a public health threat.

One way to have these conversations is to try to facilitate dialogue between very disparate groups of policy leaders and medical officials.

Back in December 2020, Northwell Health hosted its second annual Gun Violence Prevention Forum, which convened a wide range of experts and leaders to discuss gun violence as a major public health issue.

Due to COVID-19, the event was virtual and attracted 1,300 participants.

Michael Dowling, president and chief executive officer of Northwell Health, told Healthline it’s necessary to hold events like this one that frame gun violence as a public health crisis because it’s one that still goes woefully under-discussed.

He said that if any other health issue or disease were killing more than 40,000 Americans each year, there would be nonstop discussion from all medical officials.

“I do believe we have an obligation to treat it as a public health issue,” Dowling said.

He echoed both Ranney and Thomas that politics — and the partisan debates it inspires — tend to take up all the oxygen in the room and prevent gun violence from being framed as the health crisis that it is.

“I think it’s been politicized so much. I’ve talked to some of my friends around the country and know they have the same belief systems as mine, but it’s an issue they’re unwilling to take a public stance on because they live in areas where if you say anything about guns, then you are ‘an enemy,’” Dowling explained. “The NRA [National Rifle Association] is very, very powerful.”

He said some of his health administrator peers in parts of the country that might be under more political sway of the NRA than the New York metro area, for instance, are more reluctant to host a forum like this one.

Dowling added that one area where the medical community can take cues from politics is building coalitions to have these conversations, brainstorm solutions and create effective preventive measures, and encourage gun safety and health practices.

He not only cited car safety as one example but also smoking, another health issue that faced opposition from special interest groups and political players.

“I’m a big believer that we can have different viewpoints converge, but it requires logical people and logical questions. It’s all about education, you learn for example from others,” Dowling said.

“Most gun owners support what we are talking about here,” he added. “Most people who are gun owners understand it’s a public health issue, it’s not a debate that is always existing on the fringes of the far left and the far right.”

From a policy standpoint, Thomas said it’s been frustrating to see gun control legislation constantly be stymied by Congress. Before the Biden era, she cited how gun control measures would pass successfully through the Democrat-controlled House of Representatives, but then come up short in a Republican-majority Senate.

Likewise, in this current era, a slim Democrat majority in the Senate has failed to result in any positive movement for gun control efforts.

Thomas said the time is to act is now and it can’t be something that keeps getting pushed aside.

“It is long overdue for the federal government to be looking at gun violence as a public health crisis, as an epidemic,” she said.

And Thomas isn’t alone.

In fact, the American Medical Association officially declared gun violence “a public health crisis” in in 2016 and over the past 20 years has developed a number of policy recommendations to reduce firearm injuries, trauma, and deaths, including:

“People are dying, and it is not a problem that can wait,” Thomas said.

She said that she’s “excited” about the prospect of what can happen if there’s support for research that’s based on public health data, and then see that inform new laws that can make a positive impact.

“Firearms might be part of the heritage or your culture. It might be something important to you, so it is necessary to own them in as safe a way as possible. [But also] be aware of risk factors and what those might be for your family members and yourself,” Ranney said, when discussing helpful ways to approach gun safety with gun owners.

“We should take it out of this political debate and reframe it as a health problem,” she added.

Additional reporting by Jase Peeples.

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Examples of the Effects of Mental Health Stigma



Over the past few decades, we’ve come a long way in how we view and talk about mental health.

And that should come as no surprise, because 1 in 5 adults in the United States lives with a mental health condition. Many people are also becoming more open to the idea of sharing their personal experiences.

But there’s still a stigma surrounding mental health. It’s a stigma, in fact, that affects millions of people around the world who live with mental health conditions. It affects everything from their social relationships and professional opportunities to the way they view themselves.

We’ll explore more about what mental health stigma is, and how we can all work to address this and improve the lives of people living with mental health conditions.

Mental health is often stigmatized because of a lack of understanding about what mental health conditions are and what it’s like to live with a mental health condition. Stigma can also arise from personal thoughts or religious beliefs about people who have mental health conditions.

Generally, the lack of understanding about mental health — as well as the harmful assumptions about people living with mental health conditions — is at the heart of a bias or stigma. This can result in avoidance, rejection, infantilization, and other discriminations against people who are neurodivergent or have a mental health condition.

We often use the word “stigma” to describe the overarching experience that people have. However, there are actually three types of stigma: public stigma, self-stigma, and institutional stigma.

  • Public stigma: This refers to the negative attitudes around mental health from people in society.
  • Self-stigma: This describes the internalized stigma that people with mental health conditions feel about themselves.
  • Institutional stigma: This is a type of systemic stigma that arises from corporations, governments, and other institutions.

While there are many examples of mental health stigma in society, here are some of the more common instances you might notice:

  • When people are viewed as attention-seeking or weak when they try to reach out and get professional help.
  • When others use harmful language, such as “crazy” or “insane”, to judge or trivialize people who have mental health conditions.
  • When people make jokes about mental health or certain conditions.
  • When people avoid others with certain mental health conditions, like schizophrenia, because of fear or misunderstanding.
  • When family or friends tell someone with depression that they can get better if they just “work out and get more sun,” or make other unhelpful judgments.
  • When someone living with a mental health condition views themselves as worthless or talks down to themselves because of their condition.
  • When companies refuse to hire someone or provide them with adequate accommodations because of their mental health.
  • When people view examples of neurodivergence as illnesses or something to be cured.

A 2021 study explored the trends of mental health stigma in the United States over a period of more than 20 years, between 1996 and 2018. In the study, researchers reviewed surveys from across the country on attitudes toward various mental health conditions, including schizophrenia, depression, and alcohol dependence.

According to the study results, from roughly 1996 to 2006, people became more knowledgeable about mental health — including acknowledging differences between daily experiences and symptoms of diagnosable conditions.

And from around 2006 to 2018, there was a significant decrease in social stigma against depression — specifically, less desire to be socially distanced from people with depression. However, when it came to schizophrenia and alcohol dependence, not only did social stigma increase but so did negative perceptions of these conditions.

Another earlier study from 2018 took a slightly different approach in analyzing the social perception of mental and physical health conditions. In this study, researchers used automated software to track over a million tweets related to mental health and physical health over a 50-day period.

According to the results of the study, mental health conditions were more likely to be stigmatized and trivialized than physical health conditions. And the results varied by condition — with schizophrenia being the most stigmatized, and obsessive-compulsive disorder (OCD) being the most trivialized.

Intersectionality refers to how someone’s intersecting identities — such as race, gender, sexuality, or class — contribute to their own unique experience with discrimination and oppression.

When it comes to mental health, intersectionality can play a huge role not only in someone’s overall mental health, but also in how mental health stigma affects them.

For example, research suggests that Black and Latino people experience mental health conditions more severely and persistently than other racial or ethnic groups. Much of this imbalance stems from factors like institutionalized racism, prejudice, and other outside circumstances.

Another study from 2021 looked into the use of mental health services by young Black gay, bisexual, and other men who have sex with men in HIV care.

According to the researchers, less than 20% of the men who were referred to mental healthcare from the clinic continued to receive the recommended care — often as a result of increased social and professional stigma for men to go without mental healthcare of any kind.

Mental health stigma can have a hugely negative impact on the lives of people living with mental health conditions. In fact, stigma can often lead to mental, social, or even professional consequences for the people who are stigmatized.


People living with mental health conditions are more likely to experience low self-esteem and lower self-confidence if they’re stigmatized.

Stigma may lead to difficulty seeking treatment or even following through with treatment. And some people may experience increased symptoms of their condition, or even develop new ones — like anxiety or depression — because of experiencing stigma.

Self-stigma may even hinder someone’s ability to recover from a mental health condition. In one smaller study from 2018, researchers found that higher levels of self-stigma were associated with a decrease in recovery from mental health conditions.


Social mental health stigma may lead to isolation from friends or family. People with mental health conditions may experience bullying or harassment from others — or possibly even physical violence.

And when others have a judgmental view of mental health, it can be difficult for people living with these conditions to build relationships with them.

Research has shown that perceived and experienced social stigma may also play a role in suicidality among people with mental health conditions. According to the literature, people who experience discrimination (even anticipated discrimination), social stigma, and self-stigma may be more likely to experience suicidal ideation.


Stigma in the professional world can lead to fewer opportunities to excel at school and fewer opportunities to advance at work. People living with mental health conditions may have difficulty fulfilling school or work obligations — especially if they have trouble with classmates, teachers, coworkers, or bosses.

It’s not just classmates or colleagues who contribute to mental health stigma in a professional setting, either. Research suggests that when healthcare professionals exhibit negativity toward people with mental health conditions, or have a lack of understanding about these conditions, it can prevent people from accessing high quality care.

Stigma comes from everywhere — institutions, society, and even ourselves. But we can all take steps to address and reduce the stigma of mental health:

  • Learn about mental health: One of the most important steps toward reducing mental health stigma is to learn more about it. Learning what mental health conditions look like and who they can affect can help reduce some of the fear, misunderstanding, and judgment around them.
  • Use words carefully: When we use words with negative associations, like “insane” or “crazy”, we contribute to the judgment and stigmatization of others. It may take some effort to change the way we speak, but it can help reduce the stigma that people with mental health conditions face.
  • Take part in campaigns: Many mental health organizations, like NAMI, create fundraising campaigns to help bring awareness and provide funding for mental healthcare. Even if you can’t get directly involved, these campaigns are a great way to learn more about people living with mental health conditions.
  • Share your story: If you’re someone living with a mental health condition, one of the most powerful tools for reducing stigma is to share your story. By educating people on what it’s like to live with a mental health condition, we can help reduce the misunderstanding and judgment that people feel.

Mental health stigma plays a significant role in the lives of people with mental health conditions — from the way that they’re treated to the way they feel about themselves. But we can take steps to reduce this stigma.

By being more mindful about how we speak to others, learning more about what it’s like to live with a mental health condition, and sharing our stories when we’re living with these conditions, we can help reduce the stigma surrounding mental health.

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Can People with Diabetes Eat Candy?



Eating candy can be a controversial topic for people with diabetes.

Misconceptions about sugar and candy being off-limits for people with diabetes can be found in the public mindset, in media and entertainment, and within the medical community itself.

With the Halloween season upon us, both kids and adults with diabetes as well as their loved ones and friends may face this issue even more often than at other times of the year.

This article will explore if people with diabetes can actually eat (and enjoy) candy, how much may be allowed, and whether sugar-free candy is worth considering.

Short answer: Yes, people with diabetes can eat candy.

Adults and children with diabetes (no matter the type) are just as entitled to a sweet treat occasionally as anyone else. Like everything else, details and context matter most, and moderation is key for anyone living with diabetes when it comes to food choices. High sugar foods and drinks can impact glucose levels more quickly and dramatically, so understanding how those influence your diabetes management is important.

People with diabetes must consider extra planning if they want to eat candy. They need to be cognizant about counting carbohydrates and dosing insulin correctly if they happen to use that hormone to help manage their condition.

It’s important to remember, too, that people with diabetes are typically watching the total carbohydrate count of food and drink, and not necessarily honing in on the sugar content.

While candy can make blood sugars rise more quickly, it’s that carb count that needs to be watched when consuming a piece of candy. The same applies to sugar-free candy, which also contains a certain amount of carbohydrates and that needs to be considered when factoring that food choice into your diabetes management.

Certain candies, such as those containing peanut butter or nuts, can take longer to impact blood sugars and won’t lead to as dramatic spikes immediately after eating them. However, other regular candies with sugar can cause quick spikes in blood sugar, and some medical professionals suggest eating a piece of candy closer to mealtime in order to “soften the blow” of a sudden spike in blood sugar.

Of course, you’ll still need to account for the calories and carbs contained within the candy.

While sugar-free candy certainly doesn’t get an award for being “healthy” per se, many people with diabetes (especially children) turn to it as an alternative to regular candy. The thought is that sugar-free candy may be healthier for blood sugar levels.

Sugar-free candy is made with artificial sweeteners, meaning that it can have a lighter impact on blood sugar levels.

However, a common misconception is that sugar-free candy does not impact blood sugar. It does, in fact, contain carbohydrates and calories. That means you still need to dose insulin or take glucose-lowering diabetes medications for those sugar-free candies.

If someone with non-insulin dependent diabetes is being mindful of their weight, eating sugar-free candy is not a free pass for sweets. These sugar-free options may sabotage weight loss efforts due to their high calorie content.

A non-diabetes-related benefit of sugar-free candy is that it’s kinder to teeth. Absent of the higher sugar contents, these sugar-free treats don’t lead to as much tooth decay or cavities often linked to frequent sugar consumption.

Additionally, there’s usually not a very big difference in terms of total fat or protein content in sugar-free versus regular candy.

Examples of artificial sweeteners used in sugar-free candy include:

  • stevia
  • sucralose
  • aspartame
  • saccharin

The big issue with sugar-free candy comes down to sugar alcohols in those treats, which can have some negative effects depending on how much you eat.

In this older study, researchers gave study participants either sugar or one of two kinds of sugar alcohol (erythritol and xylitol).

Side effects included:

  • diarrhea
  • nausea and upset stomach
  • bloating
  • excess gas

The study participants who were given sugar experienced no such side effects.

Sugar alcohols are considered fermentable oligosaccharides, disaccharides, monosaccharides, and polyols, or a type of FODMAP. These are food molecules that some people cannot digest easily, especially when eaten in large quantities.

Sugar alcohols can also cause a laxative effect, especially if you’re prone to stomach issues.

While they contain fewer calories than sugar, they’re not calorie-free. Eating any treat in excess can inhibit weight loss or cause weight gain.

Eating sugar-free candy made with artificial sweeteners can also cause side effects, including interrupting the gut microbiome that is important to your health.

A 2019 study and older research show that saccharin, sucralose, and Stevia change the composition of gut microbiota. In one study, people who had disrupted gut bacteria also showed worse blood sugar control 5 days after eating the artificial sweetener.

While it may not be the healthiest low snack, treating any low blood sugar with fast-acting sugar can be helpful.

Some candies that contain sugar are very fast-acting. However, some others (including those with chocolate or peanut butter) have higher fat content and are slower to digest and take longer to impact blood sugars, so they may not be appropriate to treat severe hypoglycemia quickly enough.

Another con of eating candy to treat low blood sugars is that it can react quickly and if you eat too much, it may cause higher blood sugars (rebound highs).

Make sure to consult your diabetes care team about any concerns or questions relating to candy and treating low blood sugars.

Yes, children and adults with diabetes can and do eat candy. The key is moderation and making sure to track the number of carbohydrates and calories eaten. Sugar-free candies can be better for blood sugar levels, but they still contain carbs and calories. The sugar-alcohols in these treats can also cause upset stomach, nausea, diarrhea, and excess gas.

Candy can be used to treat hypoglycemia, but it may not always be appropriate for urgent low blood sugars requiring glucagon or emergency medical assistance.

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Where Can I Go for Medical Care Without Insurance?



Finding affordable healthcare without insurance may seem daunting, but there are more options than you may think. Here are more than 18 resources that can provide assistance.

It’s no secret that accessing healthcare can be very expensive. If you don’t have insurance, those costs are even higher. In fact, 85% of uninsured people in the United States reported that paying for healthcare was difficult in 2022.

Fortunately, there are resources that can help you find and pay for medical care without insurance. You can find care at low or no cost with a variety of programs designed to help people without health insurance get the care they need.

Yes, you can get medical care if you don’t have health insurance.

In the United States, hospital emergency rooms are required to provide treatment regardless of insurance or ability to pay.

Additionally, there are many medical facilities that provide routine care to people who don’t have insurance. You will be asked to pay for any care you receive, but there are ways to find healthcare at a lower cost.

There are a variety of options for seeking care if you don’t have insurance. Many of these options are designed to be affordable. In some cases, you might be able to get certain healthcare services for free.

You can find low cost or free care in several locations:

Community health centers

Community health centers are nonprofit health clinics that offer low cost or free care. Often, fees are set on an income-based sliding scale, and staff will work with you to determine your costs.

The exact services offered by a community health center depend on the location but generally include:

  • preventive healthcare
  • basic healthcare
  • family planning services
  • vaccinations
  • chronic condition management

Some community health centers also offer prescription medications and dental care. You can search for community health centers near you by checking here.

State or county departments of health

Your state or county department of health might cover certain healthcare services for eligible residents. Often, this includes access to preventive care, such as vaccines or screenings.

You might need to register in advance and prove that you reside in the county or state to receive free care.

You can search for your local department of health here.

Urgent care and walk-in clinics

Urgent care centers and walk-in clinics offer care without an appointment. Often, these facilities offer reduced cost care for people who don’t have insurance. Some urgent care centers list costs for standard services on their websites.

You can also call ahead to talk with a representative about fees and possible cost reductions for people without insurance.

Pharmacy care clinics

Pharmacies, including the pharmacies inside major national chains such as Walmart, often provide preventive care services for free. These services are normally provided during health clinics held on specific days.

Services offered can vary but typically include:

You can check with your local pharmacy about any upcoming clinics, or search online for pharmacy clinics in your area.

Teaching hospitals

If you have a teaching hospital in your area, you might be able to receive care at a reduced rate. The exact care you can access at a reduced rate depends on the hospital and the needs of the medical students.

You can call the teaching hospital and ask whether they offer any reduced cost care.

Employer-sponsored wellness programs

Some employers offer wellness programs to their employees. In many cases, this includes preventive healthcare, such as annual vaccines and healthcare screenings.

You can check in with your human resources department if you’re not sure what healthcare benefits are part of your employer’s wellness program.

The National Association of Free & Charitable Clinics

You can use the National Association of Free & Charitable Clinics website to search for health clinics and pharmacies in your area that offer free or low cost services.

The association is dedicated to caring for people who are uninsured or underinsured. There are more than 1,400 clinics and pharmacies in the association.

If you need assistance paying for care, you have a handful of options:

Charity care

Some states offer charity care that reduces the cost of medical care for people who meet income requirements. If you qualify, you can receive low cost or free medical care.

In certain states, people are screened automatically. In other states, you will need to apply for the program.


Medicaid is a federal program that provides healthcare for people who meet income requirements. Each state oversees its own Medicaid program. Income limits and exact coverage vary by state.

You can find your state’s Medicaid website here.

Children’s Health Insurance Program (CHIP)

The Children’s Health Insurance Program (CHIP) is a federal program that provides healthcare for children. Just like Medicaid, qualifying for the program depends on income level. Each state sets its own income limits and coverage varies.

You can read about CHIP in your state here.

The Hill-Burton program

The Hill-Burton program provides funds to participating hospitals and healthcare facilities in exchange for offering a set amount of free or low cost care to people who meet income requirements.

You will need to apply for the Hill-Burton program with the admissions or business department of the healthcare facility. You can find a directory of Hill-Burton facilities here.

Aunt Bertha

Aunt Bertha is a social and human services database you can search to find programs in your area. This includes programs that can help you pay for healthcare.

You can enter your ZIP code and a category to find programs that will meet your needs.

Keeping prescription costs low is a great way to lower your overall healthcare costs. Here are some options:

Prescription drug manufacturer programs

The makers of many prescription drugs offer programs to help people afford their medications. You can often join these programs to get your medication at low or no cost. You might need to meet certain income requirements to qualify.

You can use RXAssist to search a database of manufacturer programs.


GoodRx is a website that will show you the prices of your medication at stores in your local area. It can also show prices at online and mail-order pharmacies. By comparing pharmacies, you can find the lowest price.

Plus, GoodRx will even help you find coupons and manufacturer discounts.

Pharmacy memberships

Walmart, CVS, and other pharmacies have membership programs that can save you money. By signing up for these programs, you can get access to discounts on your medication. You can also earn discounts to use on other pharmacy purchases.

Grants for charitable organizations can cover your medical costs. Some examples include:

The PAN Foundation

The PAN Foundation helps uninsured people who have received a diagnosis of a life threatening, chronic, or rare disease pay for their medical care. You can see a list of conditions the foundation currently provides assistance for on its website.

If you have a condition listed on the site, you can instantly check your eligibility and can then apply online for a grant.

The HealthWell Foundation

The HealthWell Foundation helps uninsured people with certain medical conditions pay for their medical expenses. You can see their list of covered conditions on its website.

If you have a condition covered on the site, you can apply for a grant that will cover your medical expenses.

Good Days

Good Days is an organization that can help people with chronic and acute conditions pay for their medical treatments. You can check out the list of covered conditions here.

Applications for assistance are available in both English and Spanish.

There are a few additional options you can explore to get access to lower cost or free healthcare. If you haven’t already, consider doing the following:

  • Ask the hospital or doctor’s office about installment payment programs.
  • Search for programs specific to a health condition you have.
  • Apply for low cost health insurance on the Health Insurance Marketplace.
  • If you’re a veteran, apply for VA benefits.
  • Sign up for clinical trials in your area to help researchers study new treatments.
  • Consider telehealth for conditions that don’t need in-person care.

You can learn more about accessing medical care without insurance by reading answers to common questions.

When can I enroll in Medicaid?

If you qualify for Medicaid, you can enroll at any time. Check out your state’s Medicaid website for income limits and other details.

What if I can’t pay an emergency room bill?

In an emergency, getting care is your No. 1 priority. But this can leave you with a bill that is outside of your budget, especially if you don’t have insurance.

However, medical bills are often negotiable. In many cases, you can call the hospital’s billing department to work out a plan.

If you’re unable to work out a plan with the hospital, there are nonprofit organizations that can help you apply for debt forgiveness.

Will healthcare professionals treat me if I don’t have insurance?

It’s illegal for healthcare professionals to refuse care in an emergency.

This isn’t the case for nonemergency care. Most healthcare professionals will list payments they accept on their websites.

If private pay is listed, you can get treatment without insurance. If it’s not, it’s best to call in advance to make sure the healthcare professional accepts patients who don’t have insurance.

You have options for receiving medical care even when you don’t have health insurance. There are several sources you can turn to for care, prescriptions, payment help, and more. Some programs are limited to certain states or certain health conditions.

Additionally, you will need to meet income requirements to qualify for some of these programs. If you don’t, options like telehealth and urgent care can help you cut costs.

You can also look into getting affordable insurance through the Health Insurance Marketplace.

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