Michigan officials report lowest infant mortality rates in state history
Michigan is recording its lowest infant mortality in history, with a combination of mother-and-baby health initiatives credited for pushing up survival rates.
The topic was among those discussed during the annual Maternal Infant Health Summit, which met June 17 and 18 in Lansing. The event, hosted by the Michigan Department of Health and Human Services, included sharing ideas on how to improve the health of Michigan's new mothers and babies.
"We are proud of the improvements we are making and will continue to make when it comes to the health of moms and babies," said Elizabeth Hertel, MDHHS director, in a press release about the conference.
Infant mortality is defined as the death of a baby who was born alive but died before their first birthday. The most common causes include prematurity, low birth weight, congenital anomalies and accidents. The data provided by state officials is as follows:
During 2023, 607 Michigan infants under the age of 1 died. That's a ratio of 6.1 infant deaths per 1,000 live births.
During 2022, there were 650 deaths for a ratio of 6.3 deaths per 1,000 live births.
The Healthy Moms, Healthy Babies initiative, launched in 2021, is getting credit for this improvement. The specific pieces in that initiative include continuing Medicaid coverage to one year after birth, making doula services available to expecting parents and the CenteringPregnancy model of care.
Doulas are trained to provide guidance, educational and emotional support during prenatal, labor and delivery and postpartum times. There are more than 700 doulas on Michigan's Doula Registry; nearly 500 of whom are Medicaid-enrolled providers.
CenteringPregnancy is an approach that integrates routine prenatal care with additional education about health, pregnancy and parenting within a group setting. In Michigan, there are currently 35 CenteringPregnancy sites and three CenteringParenting sites, including some medical providers and clinic locations in Ann Arbor, Detroit, Livonia, Pontiac, Sterling Heights, Westland and Ypsilanti.
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WebMD
40 minutes ago
- WebMD
Why It's Important to Finally Define 'Fitness' for Yourself
June 19, 2025 — For most of my life, if you asked me if I was fit, I would say yes without hesitation. I spent my childhood playing year-round sports, was on a D1 lacrosse team in college, became a certified trainer, and spent more than a decade as a fitness director for a major women's magazine. By pretty much any objective measure, my fitness hovered somewhere above average. More than that, I loved it: the stress relief, the sense of accomplishment, the high after a tough workout; the grit I developed in (and out) of sports. It wasn't hard for me to feel connected to and passionate about exercise. But as I sit here in the midst of a stressful season of life — a few months out from unexpected abdominal surgery, among other joys — I am so very far from that version of me. I know I don't have the speed, strength, or cardiovascular endurance I've had in the past. And for the first time (maybe ever), I'm not sure what to call myself. Am I fit? Woefully out of shape? What, exactly, does any of that mean? As I talked to experts on the topic, I learned something pivotal: the most important definition of fitness isn't in a textbook — it's a truth you define for yourself. What Is Fitness? Let Us Count the Ways While there are objective measures of physical fitness — your VO2 max and grip strength, for example — not every expert will agree on which ones matter most. Medical doctors view physical fitness through a lens of disease. Are you exercising enough to help you avoid poor health outcomes? Longevity zealots will zero in on 'health span.' Are you doing workouts that will lengthen the vibrant, active years of your life? (And, of course, posting all about it on social media so everyone knows). Athletes will look to specific performance metrics that deliver success in their particular arena. Where does your pace per mile fall within the rest of the runners your age? How many pushups can you do in a minute? Pullups? What's your bench-squat-deadlift total? Resting heart rate? And on and on. And for you, maybe none of the above. ' What we know for sure is that there's a million different ways to look at how to even define what fitness is,' says Boston-based sports psychology coach Emily Saul. For Saul's money, everything you read and hear about defining fitness is noise. Consider one thing only: 'What feels meaningful?' 'It really comes down to the individual,' she says. 'Because your assessment is always within the context of whatever your standard is. So you have to decide for yourself what things are important in terms of the quality of your life.' Sometimes it helps to think of real, life-based situations where you can say to yourself, I want to be able to do that. That makes me feel fit. Maybe it's not having to ask for help when putting your suitcase in the overhead bin. Or maybe you're a grandparent and want to play with your grandkids on the floor. 'It's not going to be the same answer for everyone,' she adds. 'Each person has to decide what's meaningful for them right now.' From there, assessment of your fitness becomes far easier — because it's tied to one very simple metric: your own progress. 'I care more about the person's progress and what they're doing now compared to where they were three months ago,' says Los Angeles-based fitness coach Sohee Lee Carpenter. 'Are you lifting more weight? Are you doing more reps? Has your form improved? Are you moving pain -free? Do you feel better when you do certain movements? Can you run more miles without stopping? Those kinds of things are way better markers of fitness.' Why Finding Your 'Why' Needs a Rethink There's a reason things like the Physical Activity Guidelines for Americans exist: Regular exercise is not really an elective; it's an essential pillar for overall good health. So why does there seem to be this collective eye -rolling, heel-dragging response to it? For starters, some of it stems from our culturally complicated relationship with physical activity. That's a good question to ask: Do I have a positive relationship with physical activity? Research has shown for years that a negative perception or relationship with exercise wrecks your motivation. Maybe you feel intimidated, inadequate, or defeated when you think about exercise. Maybe you see too many super-fit people on Instagram and know that's not you, never was, never will be. The message has been driven home that fitness is a 'have to' not a 'want to' proposition. We also live in a very goals-driven society, which creates this idea that you need to have an ambitious 'why' behind your exercise routine. (In reality, you don't.) 'The social media version of 'what's your why?' is essentially, what's the next thing you're aiming to do?' Saul says. 'It's how people shorthand for what their next goal is, and they talk about it as if that's their bigger meaning. I push back hard when I hear people say something like 'My why is qualifying for Boston.' No, that's not 'your why.' That's the means to what you think is your why. So let's actually get at what's meaningful to you about that.' This is critical to making exercise Your Thing. You have to ask yourself: What are the bigger values driving me? And what about this thing (working out) is connected to my values? 'That can't come from an outside source telling you, 'You've got to do it' or 'This is what I do,'' says Jen Fraboni, DPT, founder of Jen Health. 'It has to come from what you're really hearing from listening within your own body.' Do you believe yourself to be hardworking? Great. 'You can work hard at something that you don't necessarily want to do — not because you're trying to force yourself to like doing the thing but because you value being a hard worker,' says Saul. 'You may never love the thing, but lots of people do things because they like the results and not because they like the activity itself.' There are days you don't feel like going to work, right? But you get up, make your coffee, and go anyway. Because whether you realize it or not, your job is connected in some way to your core values (like taking care of your family or challenging yourself). You need to bring that same perspective to fitness: what about this thing (working out) is connected to your identity? 'The reason most people [exercise] is not because there's always that strong internal motivation or desire for it,' says Saul. 'It's that doing it is in alignment with who I know myself to be — or with who I really want to know myself to be.' That last part is important because it means even if you're not there yet, the way you choose to think about yourself can hold a lot of power. 'It actually starts not with 'I choose to see myself as an active person' but 'I understand the kinds of things that an active person does and I will do them,'' says Saul. 'That's this formulaic statement, right? Like if active people do these things, and I do these things, then I am an active person — and I have to believe that because I'm building evidence of it day after day after day. It's not easy at the start to just see yourself that way, but it becomes harder to not see yourself that way by doing those things.' When fitness crisscrosses with who you are, it feels less like a duty. It becomes something you do whether you're always super excited about it or not. After talking to Saul, I thought about it. I value being someone who tackles hard things. And wouldn't you know: that little flip — focusing on the idea that I want to be someone who does hard things, and right now for a number of reasons fitness is a thing that feels hard — well, it's helped pull me off the couch on days I can't seem to find my usual motivation. The Depths of Perception All too often, the hardest part of working out isn't even the act itself, it's what happens right before. In the thinking about working out. How you perceive exercise in that moment defines what you do. A subtle shift in perception, in perspective, changes how you feel — and ultimately act. 'It's even harder if you are very stuck on 'fitness looks like this' or 'my workouts have to be this way,'' says Carpenter. Even harder still? When you're judging yourself based on a past (younger, fitter) version of you. Carpenter stresses that you have to be willing to recalibrate what is realistic — and what you can perceive as a 'fitness win' — right now. 'Maybe when you were in your marathon days, a fitness win was getting faster in a particular workout,' she says. 'Now, maybe it's 'Hey, I got on a 30-minute workout when I wanted to not do anything at all.' Changing those definitions, maybe even tracking them, and celebrating those little wins can help a lot.' Sometimes those wins might initially feel like a step back. 'I am running a challenge right now and I have someone who actually took a break from doing any kind of deadlifting because of pain,' says Fraboni, also a pregnancy and postpartum corrective exercise specialist (PCES). 'We're starting to ease back into it restarting at the basics — doing mobility and breath work, being so mindful of form — and she's like, 'wow, I'm realizing that if I step back on the weight and don't let the ego drive me on what I should be doing and what I have done in the past, I feel so much stronger and better in my body.'' Whether you're coming back from an injury, illness, having a baby, or dealing with a hectic work schedule, not judging or comparing yourself to past versions of fitness is hard — even for seasoned pros. Take Fraboni, who's a new mother of two: 'I feel like I'm progressing so well in strength pretty quickly postpartum and that feels good. However, I feel like I'm moving in a foreign body,' she says. 'It's almost like two different worlds: so proud of myself for how I'm gaining strength; and, on the flip side, I look in the mirror and think, Whoa, I don't recognize who I am. I've never felt like this. I've never looked like this.' In those phases of life, Fraboni stresses the importance of having empathy for the person you see in the mirror and a solid grip on the reality of your goals. 'It's a new person that I'm moving into,' she says. 'We never are going back to the person we were before. We're never going back into a previous body. We're always moving forward — we're aging, we're changing — so I have to always make that switch in my mind mentally that this is a new body and I'm moving forward.' 'Claim Your Identity as a 'Fit Person'' Nearly a decade ago, I was out to dinner in New York City with the incredibly fit, active, and vibrant LaJean Lawson, PhD, a 63-year-old exercise scientist. I asked her, 'What's your secret to staying in such great shape?' Her answer was simple: Identify your 'basic threshold' of fitness that is impossible to fail. Early on, Lawson decided she had to claim an unrelenting identity as a fit person, and in order to do that, she needed to perform an intentional fitness activity daily. Her basic threshold: one pullup or two full pushups. So at the end of every day, whether she was sick, or traveling, or crazy with work deadlines, she would do one of those two things. It may not sound like much, but, in less than 15 seconds a day, it has enabled her to maintain a very long streak of being a continuously active person. While I loved the philosophy, I was skeptical. But I gave it a shot anyways. My first basic threshold: Rather than taking a cab or subway, I would walk to and from work (about 25 minutes each way). It didn't take long to notice that instead of feeling defeated for missing a spin class, I was proud that I kicked off my heels and hiked home — even if it was raining, snowing, or late. Was the effort comparable? Of course not. But it helped shift my mindset and it made me feel like I was still on track. Lawson's modest approach has stuck with me, and I have repeatedly tested — and proved — its effectiveness. I can choose a bare minimum that works for the season I'm in, not the season I want to be in. These activities don't outweigh or replace my workouts, but they help connect the dots in between missed sessions and breed confidence rather than frustration. As Lawson so perfectly told me, 'In the end, being able to claim your identity as a 'fit person' is as much a state of being as it is a state of doing.' At the heart of true long-term success is repetition. When you take a look at the principal achievement among people who successfully maintain active and healthy lives for years and decades, you'll see a common denominator: They have made being active a consistent part of their way of life. It isn't a switch they turn on before beach season or a big event and then shut off as soon as it's over. What's more, their daily behaviors don't change how they see themselves. They're still active, healthy people — even if they haven't been to the gym in weeks. They don't beat themselves up or give up on their goals because they made one mistake or got nudged off track. It doesn't change how they think of themselves as people. 'From a health behavior perspective, we know that higher levels of self-compassion are correlated with more perseverance,' says Carpenter. 'You're more likely to keep trying in pursuit of a goal if you're not as hard on yourself about it. So when you miss a day, you're not beating yourself up about it — and because you're not beating yourself up about it, you're less likely to throw in the towel.' An important caveat: 'Self-compassion and self-love do involve being brutally honest with yourself, too,' she adds. 'I think it's super important to be accountable. Sometimes you need to call yourself out.' The truth is, there have been plenty of moments over the past few months where I have given myself a pass to skip the gym, when I know my body (and soul) would have felt better doing something. Whether you're working towards the best shape of your life or you're far away from your goals, there is one metric above all others that can serve as a powerful gut check: Are you consistent? 'For most people, the thing that we're wanting more than anything is just a feeling of progress, " says Saul. 'That's one of the core basic psychological needs.' That has become my new barometer. If I'm checking the boxes day after day, then I know I'm moving in the right direction. If I've given myself too many days off, it's time for an honest look in the mirror. Not to guilt or shame or beat myself up, but just to reset. 'There's this overwhelming pressure to be perfect every single day, and that's not the reality for anyone,' says Fraboni. 'But what if you just chose to choose again the next day? OK, I didn't do it today, but I can choose again tomorrow. What a gift to be able to do that — to get the choice to choose again.'
Associated Press
an hour ago
- Associated Press
How to stay cool in the heat wave hitting parts of the US --even without air conditioning
The first big heat wave of 2025 has arrived, coinciding with the official start of summer . More than 40 million people in the U.S. were under heat alerts Friday, according to the National Weather Service. Temperatures in the Midwest are expected to crest well into the 90s Fahrenheit (30s Celsius) this weekend. Triple-digit highs could pop up in New York, Philadelphia, Washington and Denver. The peak will likely hit the East Coast early next week. Meanwhile, British health officials are also issuing heat warnings for the U.K . Climate change has been exacerbating heat waves, and the problem isn't going away any time soon. An increasingly hot planet — due largely to burning fossil fuels such as coal, oil and natural gas — means already hot regions are getting worse . Heat doesn't just mean canceled events . It also poses a health risk, especially for children, older people and those with certain health conditions. So here are some tips to stay safe. When does heat become dangerous? The answer depends on more than the temperature. The most detailed measurement is called the wet bulb globe temperature (WBGT), which includes temperature, humidity, cloud cover and wind. The heat index, which measures temperature and humidity, is less descriptive but easier to find on weather apps. Both explain why a shaded soccer field on a 90 degree F day (32 degree C) in arid Phoenix may be less risky than an exposed park on an 80 degree F (27 degree C) day in soupy Little Rock. Just based on heat index, NOAA has a chart that calculates how dangerous prolonged exposure can be. For example, a day where temperatures reach 96 degree F (36 degrees C) and 45% humidity would fall into the 'danger' category for prolonged exposure or strenuous activity. The WBGT threshold isn't exact, but recent research suggests that even some young, healthy people can't endure hours of exposure to high heat and humidity. How to cool down Overnight lows can be a particularly dangerous part of a heat wave, said Ashley Ward, director of the Heat Policy Innovation Hub at Duke University. 'Your body needs a reprieve,' she said. 'You don't get that overnight, we start the next day at a deficit.' Heat can worsen labor productivity and lead to more visits to the emergency room. 'When we have overnight temperatures that don't drop below 75 degrees' F (24 degrees C), she said, 'You start to see some pretty extraordinary outcomes with respect to heat illness and heat stroke, and even mortality.' Ward's answer: Find air conditioning. That might be at home, but she said census data overcounts how many people have access. If you can't afford to cool the whole house, Ward said, create a 'cool corner' and sleep there, so your body is prepared to tackle the next day. Evaporative or 'swamp' coolers can help in dry heat, but they increase humidity and can make it more difficult to cool down. In humid places, just use a fan. If you don't have air conditioning, find public places that do, including movie theaters, malls and libraries. Some communities set up cooling centers. Depending on where you live, the Low-Income Home Energy Assistance Program can help you buy a window air conditioning unit, according to the National Council on Aging . Some local nonprofits and civic organizations can also help you access one if cost is a burden. Know your rights if you work outside Knowing what workplace protections you have is important. But there are no federal heat rules to protect workers in the United States. Some states have them, including Washington, Oregon, California, Nevada, Colorado, Minnesota and Maryland, according to the National Resources Defense Council. Other states don't have any. If your state has work rules, try to learn them — though there are still challenges to ensuring regulations are actually enforced, said Bharat Venkat, director of the University of California, Los Angeles Heat Lab. He notes that sometimes shaded areas are too far for workers to take breaks without losing wages, or that management can make it impossible for workers to advocate for themselves. 'Most workers don't actually have control over their time or control over where they work,' he said. Within those constraints, finding ways to stay hydrated and lower your body temperature are paramount. You can do this by drinking lots of fluids, wetting clothing or putting cold water or a cold rag on your hands, feet, armpits and neck. A portable handheld fan or a cooling vest can also help. If you're exercising, avoid the hottest times of day and bring more water than you think you need. Knowing heat illness symptoms Heat illness symptoms can vary by person, Venkat said. Medications or underlying conditions can also make it harder to regulate body temperature or notice you're getting too hot. Early trouble signs include heavy sweating, muscle cramps and headache. That's when you stop what you're doing and cool yourself off — for example, by splashing yourself with cold water or finding an air conditioned space. As heat exhaustion sets in, new symptoms arrive, including faster heart rate and dizziness. Next comes heat stroke, which can include confusion, slurred words and fainting. Ward said that's when to call 911. 'Don't be embarrassed to call 911 or go to urgent care when you think you might have overdone it in the heat,' he said. ___ Walling reported from Chicago. Wells reported from Cleveland. ___ The Associated Press' climate and environmental coverage receives financial support from multiple private foundations. AP is solely responsible for all content. Find AP's standards for working with philanthropies, a list of supporters and funded coverage areas at .
Medscape
an hour ago
- Medscape
Key Abstracts in Early-Stage NSCLC From ASCO 2025
Dr Jonathan Goldman of the University of California, Los Angeles, highlights key abstracts in early-stage NSCLC from ASCO 2025. Dr Goldman begins with updated results from CheckMate 816, comparing neoadjuvant chemotherapy (chemo) vs chemo + nivolumab. Median overall survival (OS) in the nivolumab arm remains unreached vs 73.7 months with chemo alone. Event-free survival (EFS) is durable at 59.6 vs 21.1 months, as evidenced by 5-year EFS of 49% in the combination arm. Next, he reviews the NeoADAURA trial evaluating neoadjuvant osimertinib ± chemo in resectable EGFR-mutated stage II-IIIB NSCLC. Major pathologic response was higher in osimertinib-containing arms (26% and 25%) vs 2% in the chemo arm, although long-term outcomes remain pending. Dr Goldman also discusses the SWOG/NRG S1914 trial of perioperative stereotactic body radiotherapy ± atezolizumab, which did not show improvements in OS or progression-free survival (PFS). He then highlights a prospective, low-dose CT screening study of the Mississippi Delta cohort, which showed a 4.7% lung cancer detection rate overall and 4.5% in patients with incidental pulmonary nodules — underscoring the utility of low-dose CT as a modality in early detection. In closing, he reports on two studies in small cell lung cancer. The IMforte study showed that lurbinectedin + atezolizumab in 1L maintenance improved PFS (HR, 0.54). In the DeLLphi-304 study, second-line tarlatamab improved OS compared to chemo (HR, 0.6), which is a potentially practice-changing update.
