Latest news with #urban
CBC
a day ago
- General
- CBC
Native Friendship Centres say Ottawa needs to do more to bring down barriers to health care
Speaking from Montreal, Native Friendship Centres from across Canada are calling on the federal government to improve equitable health-care access for Indigenous people living in urban areas, away from their home communities.
Medscape
a day ago
- Business
- Medscape
New Data: Wide Disparities in Access to Lecanemab
Access to lecanemab among Medicare beneficiaries with Alzheimer's disease (AD) or mild cognitive impairment (MCI) was marked by racial, ethnic, and socioeconomic disparities, a new study suggested, with early use significantly higher in men than in women, and in non-Hispanic White individuals than in Asian or Pacific Islander, Black, and Hispanic patients. METHODOLOGY: Researchers performed a cross-sectional analysis and examined early trends in lecanemab use among 842,192 US Medicare beneficiaries with at least 11 months of coverage. In all, 1725 Medicare beneficiaries who received at least one lecanemab infusion between 2023 and 2024 were identified (mean age at initiation, 75.7 years). The researchers identified beneficiaries with AD and MCI using claims in the previous year. The analysis included age, sex, race/ethnicity, urban-rural status, and socioeconomic status. TAKEAWAY: Of those who received lecanemab, 51.5% were women; 90.5% were White, 1.3% Asian or Pacific Islander, 1.2% Black, and 2% Hispanic individuals; 1.3% were socioeconomically disadvantaged; and 88% resided in urban areas. Among all patients with AD or MCI, lecanemab use was significantly higher in men than in women (0.27% vs 0.17%; P < .01), in urban residents than in rural patients (0.22% vs 0.14%; P < .01), and in socioeconomically advantaged patients than in those who were socioeconomically disadvantaged (0.27% vs 0.01%; P < .001). < .01), in urban residents than in rural patients (0.22% vs 0.14%; < .01), and in socioeconomically advantaged patients than in those who were socioeconomically disadvantaged (0.27% vs 0.01%; < .001). Lecanemab use was significantly higher among non-Hispanic White patients (0.23%) than among Asian or Pacific Islander (0.09%), Black (0.04%), and Hispanic (0.07%) patients ( P < .001 for all). < .001 for all). By the end of the study, 407 patients (23.6%) had discontinued lecanemab treatment, indicating substantial early discontinuation rates. IN PRACTICE: 'Even among beneficiaries who meet initial Medicare coverage requirements for lecanemab by having documented MCI or AD, early uptake of lecanemab still appears to be marked by racial, ethnic, and socioeconomic disparities. This dynamic is consistent with a recurring historical pattern of inequitable access to breakthrough therapies administered by specialized centers, and underscores how a costly and likely low-value treatment, which contributes to higher Medicare spending, is seemingly being disproportionately utilized by advantaged populations,' the study authors wrote. SOURCE: This study was led by Frank F. Zhou, David Geffen School of Medicine, University of California at Los Angeles (UCLA). It was published online on May 15 in JAMA Network Open . LIMITATIONS: Data for Medicare Advantage beneficiaries were not available. The use of diagnosis codes to identify patients with AD or MCI underestimated MCI prevalence, misdiagnosed AD, did not consider additional lecanemab eligibility criteria, and could not distinguish between mild and moderate or severe AD, where only mild cases are eligible for lecanemab treatment. DISCLOSURES: This study received funding from the National Institute on Aging, National Institutes of Health, US Deprescribing Research Network, UCLA Resource for Minority Aging Research/Center for Healthcare Improvement of Minority Elders, and National Center for Advancing Translational Sciences. Three investigators reported receiving grants from or having other ties with various sources. Details are provided in the original article.
ABC News
2 days ago
- Business
- ABC News
Liberals were too focused on homebuyer help and urban sprawl, says Andrew Bragg
The Liberal Party's reliance on urban sprawl to fix the housing crisis was "misguided" and the opposition could prioritise supply by threatening state governments, new spokesperson Andrew Bragg has said. Previously an assistant in the housing portfolio under Peter Dutton, Senator Bragg was promoted on Wednesday to shadow minister by Sussan Ley, who said he would also have "economy-wide" responsibility for productivity and deregulation. "You should have some policies which help prioritise first homeowners, but the thrust of your policy should be on the supply side," he told the ABC in an interview. "We need to look very carefully at how we ensure that the states are going to meet their end of the bargain … We need to look at the carrots and the sticks." Senator Bragg also declared himself a supporter of working from home and suggested he would focus on slashing paperwork for small business owners, whom he said Labor had neglected. Economists panned Mr Dutton's housing platform, which would have allowed first homebuyers tap into their super, secure easier loans, and enjoy tax deductions on their mortgages. Senator Bragg said it was "possible" the approach he helped to craft did too much on the demand side and could have pushed up prices. "We need to find demand-side policies which do tilt the scales in favour of first homebuyers, and which do ensure that the bank of mum and dad is not going to be the only way that a young person can get a house. [But] the supply side is very important." The main Coalition supply policy at the last election was to fund sewer pipes and connecting roads to build new homes on the urban fringe, which then-housing spokesperson Michael Sukkar said should be the location of the "Australian dream". But Senator Bragg said supply policy should not be fixated on outer suburbia. "Our policies going forward will be reviewed, but my disposition is … if we have a housing supply policy it would be deployed everywhere, in the inner city, in the regions, in the outer suburbs. "You need to infill. You need to build up where the transport infrastructure is, and the idea that you would have a scheme that would only apply to outer suburbs, I think, is very misguided … People live everywhere, frankly." Senator Bragg said Labor's proposal for the federal government to build homes itself via grants was "one of the craziest ideas I've ever heard" and would be opposed. Instead, he said the focus should be on knocking down barriers to private sector supply at state and local level and left the door open to withholding GST or other payments from states that don't do enough, an idea he floated as assistant spokesperson. "In NSW for example, Chris Minns talks a big game on housing, but the Rose Hill complex has fallen over, he's had a number of disasters under his premiership … Maybe we look at league tables, we look at working out how exactly we rank states." In his newly created portfolio of productivity and deregulation, Senator Bragg said the priority would be to advocate for unlocking more private investment. "The most jobs created in Australia in the last few years are non-market jobs. The size of the state is getting larger and larger … [but] we haven't even seen from the government discussion of what you can do to get private investment moving." He said Labor had "vacated the field" on stimulating investment and that Australia should focus on "national competitiveness". "We are in a global race to attract more investment into our jurisdiction because that will result in more jobs," he said. Treasurer Jim Chalmers has named productivity as a priority for Labor's second term and tasked the independent Productivity Commission with proposing reforms. Senator Bragg said he would "do a lot of listening" to the commission and others. He added the Coalition would prioritise regulation busting for small businesses. "My sense is that most small businesspeople feel like the government doesn't imagine that they are people," he said. "When they finish their job at the end of the day they go home and they do their compliance tasks for the government, and so they lose their recreation and family time. And so we want to free people up to have their lives back." For larger businesses, he said the federal government's standard process for assessing the impact of regulations was not a "serious process". "I think we've got to be much more rigorous about how we assess the cost of new regulation." Senator Bragg, a leading moderate, made a pointed defence of Australia's target of net zero emissions by 2050, set by the Morrison government as part of the Paris climate accords but opposed by some Nationals. "We're looking at how net zero can best be deployed in Australia as part of our policy review. We are committed to cutting emissions and that can only be done as part of an international framework, so that's our starting point," he said. Ms Ley has declined to confirm that net zero will remain Coalition policy at the end of the review, but Senator Bragg said it was the "starting point". "We signed Australia up to net zero in 2021 … There are different ways of doing that and that's a process now that [energy spokesperson] Dan Tehan will lead," he said.
CNET
2 days ago
- Business
- CNET
My Internet Provider Is a Monopoly and Yours Probably Is Too. Here's What It Means For Your Broadband Bill
You know the drill. It's time to shop for home internet, but you only have one or two options, and you're not sure how to decide which one is better. You've heard the woes from friends who signed up with Spectrum and were surprised by two price increases within the same year -- and as Spectrum is one of the biggest internet providers in the country (and may soon be the biggest cable provider in the country), there's a good chance that Spectrum is one of the two options available at your address. So what can you do? First, let's do a little research If you type your address into the Federal Communication Commission's broadband map, you can pull up all of the internet providers that will service your address. If you live in an urban area, you may have as many as seven options, each an alternative to Spectrum if that's a provider you're trying to avoid. But let's say you're trying to stick to a high-speed internet option. Maybe you have a smart TV you use for streaming in crisp 4K, a roommate who games religiously in their room or you're a student who uses Zoom pretty regularly. Whatever the reason, a good rule of thumb is to aim for speeds of 300 megabits per second or higher for average internet use with multiple devices in the home. You can use the FCC broadband map to find a list of internet providers that service your address. FCC The FCC defines "broadband" as an internet connection with speeds of 100Mbps down and 20Mbps up. Using that definition, go back to the FCC broadband map and rule out each provider with advertised speeds of 100Mbps or less. Why? Even though an ISP advertises that speed, you probably won't get it consistently because of how your router and Wi-Fi work. According to the FCC, there are only seven internet providers available at my address. If I eliminate ISPs with speeds of 300Mbps or lower, there are only two. FCC For most people, at this stage in internet shopping, there are only one to three decent options left and if one of them isn't Spectrum, it's most likely AT&T, Cox, T-Mobile Home Internet or Xfinity. While I don't personally have anything against Spectrum (and CNET ranks it as one of the better cable ISPs out there), some people do. The leading cause of those frustrations is usually outages or price increases. It's frustrating not only because your bill increases while your speeds remain the same but also because not having another internet option means you can't switch. Locating local internet providers At this point, your head is probably spinning. Why is shopping for internet providers such a headache? Will those other internet options be any good? Why can't you get more than one decent option at your address? 'According to the New America Foundation, Americans pay the most for broadband [among 38 democratic nations].' Christopher Ali, professor of telecommunications at Penn State University Internet monopolies are far too common in the broadband industry Over a third of Americans only have access to one or no internet provider. According to data from the Institute for Local Self-Reliance, approximately 83 million Americans have internet access through just one provider. Overall, the American broadband industry is dominated by a handful of ISPs with broad footprints: Only six ISPs cover 98% of the mobile internet market, and recent industry changes will make that number even smaller. While Xfinity currently ranks as the country's largest cable internet provider, Spectrum's recent acquisition of Cox will make Spectrum the country's biggest cable provider if the merger is approved. Similarly, AT&T recently announced plans to buy 95% of Lumen's Quantum Fiber and Verizon was recently approved by the FCC to acquire Frontier Communications in a $20 billion deal. The industry is consolidating -- and while your broadband bill may not immediately (or ever) change, that still means fewer choices for consumers when it comes to internet. Various factors, including geographically diverse terrain, high infrastructure costs and the daunting task of competing with prices from a much bigger ISP, can make it costly for smaller businesses to get a foot in the door without significant funding. "Because of the way that we classify broadband service providers, the FCC has very little authority over prices, which means that [ISPs] can pretty much do whatever they want," Christopher Ali, a telecommunications professor at Penn State, told CNET. Because you likely have only one or two internet options at your address, your internet provider can keep inflating your monthly bill, and you can't really do anything about it. Just 10 years ago, our definition of broadband vastly differed from the FCC's definition today (it was previously a mere 4Mbps down and 1Mbps up). Our conversations about home internet needing to be more accessible, affordable and sustainably fast for average household needs are a relatively recent development. "The amount of money the average American is spending [on internet] relative to their income is about the same [compared to 10 years ago]," said Blair Levin, a policy analyst from New Street Research and former executive director at the FCC. "In that sense, we have a much faster, better product at about the same price point. Sure, you could say that's good. Does that mean it's affordable? Not for a lot of Americans it is not affordable and affordability is a key problem." Although there are thousands of local internet providers, our options often boil down to one or two of the country's ISP giants. Admittedly, CNET often reviews those top providers and may recommend them as viable internet options because those ISP giants aren't necessarily always bad home internet options. They typically offer an efficient cost per Mbps compared with plans from local ISPs, often DSL or fixed wireless options with slower speeds targeted to rural homes. In rural areas that may not have a big or local ISP presence, internet options are even more limited, and people usually have to fall back on the slow speeds and high costs of satellite internet. Although satellite internet offers extensive availability and has proven an invaluable internet option in rural areas, it tends to average less than 100Mbps in download speeds, not quite fast enough for average to above-average internet use. According to data from the FCC, Xfinity (red) and Spectrum (purple) are the two largest cable internet providers in the country. FCC Although competition among ISPs is often limited, there are pockets of regions where competition -- and fast, cost-efficient internet options -- thrive. Wireless internet providers, specifically, have a strong presence in rural areas, which are harder to reach with wired internet services. "There are about 1,500 wireless internet service providers in America, largely in rural, under-resourced and Tribal parts of the country," Mike Wendy, the communications director of WISPA, the Association for Broadband Without Boundaries, told me in an email. "They serve about 10 million Americans through primarily fixed wireless access." In other cases, municipal broadband networks (such as the community-owned fiber networks in Wilson, North Carolina, or Chattanooga, Tennessee) and public middle-mile networks offer much faster speeds for lower prices than a private-owned ISP. Still, those success stories aren't ubiquitous, effectively creating what Ali calls a "Swiss cheese pattern of broadband availability" throughout the country. All too often, people face high price increases, limited high-speed options and inconsistent connectivity with home internet. Even in urban areas, which typically have higher concentrations of internet serviceability, some low-income neighborhoods may see much slower speeds and fewer options at their address than a higher-income neighborhood across town. A study from the Markup and the Associated Press in 2022 zeroed in on the trend of inequitable internet access across neighborhoods with marginalized or low-income communities, raising questions about "digital redlining" by ISPs. Why the difference in the US? You may find it surprising that the high cost of the internet in the US isn't necessarily replicated in other countries. According to a study by the New America Foundation, US consumers pay the highest average costs for broadband compared across all studied regions. The average cost of internet service in the UK sits at around £27 ($34) a month, while the US averages $63 in monthly internet costs -- not including hidden fees, equipment costs and those yearly price hikes. Some researchers point to the concentration of US markets compared to the UK, noting that the concentrated telecommunication industry warrants high internet costs and low capital expenditures from both a consumer and investor perspective. Others point to the tendency of US policy to favor larger ISPs, limiting competition and driving up prices. 'According to the New America Foundation, Americans pay the most for broadband in any country in the OECD," Ali told CNET. "We're averaging somewhere between $74 and $84 a month -- and there is no technological reason why costs are this high. Zero. It is entirely price-gouging.' The size of internet companies such as AT&T, Google, Verizon and T-Mobile is staggering when you consider not only how sizable their footprints are but also how much of the infrastructure (from undersea cables to vast middle-mile fiber networks) they own. Although there are countless other local providers, many have to pay network fees to larger providers to use parts of the "middle mile" for internet services. Plus, it's often easier for those bigger companies to buy out another company and merge their networks than to build out a new network. For example, Verizon bought Frontier Fiber early this year in an attempt to expand its Verizon Fios fiber internet brand. Brightspeed edged into the playing field by buying parts of Lumen's CenturyLink DSL network in 2022, and Charter (Spectrum) bought Time Warner Cable in 2016 -- effectively establishing the company's footing as a top cable internet provider. Fixed wireless internet services might make a difference So far, we've mostly discussed wired internet services, which are tricky networks to establish because of zoning, equipment and labor costs. What about other internet connection types, such as satellite or 5G home internet? Although a fixed wireless internet service is generally touted as a solution to broadband accessibility because it's easier to establish than a wired network, only a handful of big companies dominate the fixed wireless internet market, namely, Starlink, T-Mobile and Verizon. Starlink, which edged into the satellite internet market in 2020, established itself as a top name in satellite internet by deploying roughly 7,000 low-Earth-orbit satellites and offering speeds up to 220Mbps and relatively low latency (the time it takes for data to get to the server and back). In contrast, competitors Hughesnet and Viasat fall behind with speeds that top out at 100 and 150Mbps, respectively. T-Mobile presents a popular alternative to rural internet with its network of high-powered cell sites and licensed 5G frequencies. To date, T-Mobile has the largest footprint of any single US internet provider, thanks to the reach of those frequencies. The catch? Starlink costs roughly $120 a month, not including the hefty up-front cost of satellite equipment, which runs $349 for the basic package. By comparison, T-Mobile offers a much more competitive price. For $50 monthly, you can get speeds around 87 to 318Mbps. There's no equipment rental charge, just the $35 activation fee you pay when you start service. But although Starlink and T-Mobile are popular choices for people with limited internet access, neither provider can offer a consistent speed of 300Mbps over a fixed wireless internet connection, which is why, although neither provider enforces a data cap, your speeds likely will be throttled during peak congestion periods. You won't see the quick, consistent gigabit speeds that you'd get from a cable or fiber internet provider (or at least, not yet). Additionally, more than 1 million people are on a waitlist for T-Mobile services, delayed because of network capacity. The internet services offered by Starlink and T-Mobile are an attractive alternative to solving internet accessibility in underserved or hard-to-reach areas, but the quality of those internet connections and the affordability of monthly prices, equipment and additional fees, are an imperative consideration. What does this all mean for you and me? So, what's being done to ease internet connectivity and affordability? How can we ensure that people have more than one or two options for internet service and that the costs of that internet stay low? No one really has the answers yet. Since the ILSR published its findings on telecom and cable internet monopolies, Congress portioned $90 billion toward bridging the digital divide. That money was split among various groups, including the Tribal Connectivity Program, but most of it has been funneled into the Broadband Equity Access and Deployment Program (BEAD) -- the largest investment that the federal government has made in internet accessibility. The Affordable Connectivity Program, which offered more than 23 million low-income Americans a monthly discount from $30 to $75 monthly, was perhaps the most significant attempt at ensuring accessible, high-speed internet nationwide. After the ACP ended in May 2024, policymakers disagreed over how to ensure that ISPs offer low-cost plans to their customers. So far, BEAD funding has become tangled with competing interests about how best to use it -- including disagreements with the organization tasked with administering BEAD funding, the National Telecommunications and Information Administration. The NTIA set guidelines for ensuring a low-cost plan with a baseline cost of $30 monthly, but many states have already planned a price increase for that baseline. Despite that, the plight of internet monopolies, high monthly internet costs and lack of adequate connectivity still hang in the balance. In the meantime, the most you can do to trim down your monthly internet costs is to either reduce your monthly data consumption or look for a cheaper internet provider.
Associated Press
3 days ago
- General
- Associated Press
Tiny outdoor space? Turn it into an inviting retreat
Whether it's a modest balcony, a pocket-size patio or a tiny backyard, small outdoor spaces have big potential. With a few smart design choices and some creative flair, even the most limited square footage can become a welcoming and rejuvenating retreat. The very constraints of a small area can inspire more thoughtful — and impactful — design decisions. Here's how to make the most of your petite patio, balcony or urban garden and turn it into a space that wows. Think vertically: Make use of walls and railingsWhen floor space is at a premium, the only way to go is up. Vertical gardening is a game-changer for small spaces. Hanging planters, wall-mounted herb gardens and tiered plant stands help you layer in greenery without sacrificing room for seating or movement. And it will help with privacy as well. 'If you're squished up against your neighbor in an urban setting, strategically placed containers with vining plants can form a green privacy wall,' said House Beautiful editor Kate McGregor. 'You could also try trellis panels or fencing, to ensure you don't feel like you're always on display when you're outside.' Vining plants with attractive flowers include black-eyed Susan vine, mandevilla, sweet pea, star jasmine and trumpet honeysuckle. If you've got actual ground to work with, on a small outdoor patio for instance, consider something heftier, like climbing hydrangea or shrub rose. Trellises, rail planters and vines create the illusion of a taller, larger space, as they draw your eye upward. Mini gardens and container plants Containers allow you to grow herbs, flowers or a few veggies just about anywhere. Go minimalist with a couple of sleek planter boxes, or add visual interest with some artsy pots in different materials and sizes. Layering plant heights —from low succulents to tall grasses or small trees — adds depth and makes the area feel lush and vibrant. Low-maintenance options like lavender, rosemary and ornamental grasses can add greenery with minimal upkeep. Grasses can look pretty in a breeze, and anything with a scent is worth planting. Ahh, al fresco Put a sturdy bin or basket near your patio or balcony entryway to stash yoga mats and small weights. You'll have a handy 24-7 meditation or workout space, right outside the door. Fill a planter with zesty citrusy-scented lantana, soothing lavender or night-blooming moonflower to add a mood maker. Fold it, stack it, store itWhen space is tight, think flexible, lightweight and dual-purpose furniture. Foldable bistro tables and chairs can be tucked away when not in use, while storage benches offer a place to sit and stash outdoor cushions, garden tools or a cozy throw blanket for chilly evenings. Stackable stools or nesting tables can be pulled out when you're entertaining and tucked away when you want more open space. Look for all-weather and multi-functional pieces. Cozy lighting, big ambianceLighting can completely transform an outdoor area, especially in the evening. A string of simple battery-operated fairy lights, a solar-powered lantern or LED candles add warmth and a festive vibe, without needing an outlet. For extra impact, combine lighting types — overhead string lights with a couple of lanterns at ground level can make a space feel layered and create a cozy atmosphere. Rugs, textiles and textureBring the comfort of indoors out by adding textiles. All-weather rugs come in dozens of patterns and textures. Use peel-and-stick tiles, if you're permitted. Either will define a living area and help bring in whatever décor style you're going for. Cushions and throws come in loads of colorful, weather-resistant fabrics, adding homey softness to the space. Style with personalityJust because a space is small doesn't mean it has to be boring. Treat your outdoor nook like any other room in your home by infusing it with personal style. Use outdoor-safe mirrors to reflect light and make the area feel larger. Hang weatherproof artwork or decorative panels to add a creative focal point. Accent with items that reflect your taste — whether that's a boho lantern, a modern metal sculpture or even a vintage watering can repurposed as décor. A consistent color scheme can tie it all together, whether you go for calming neutrals or punchy brights. Shade and shelterFree-standing umbrellas, or more space-saving, free-standing retractable awnings, are renter-friendly options that require no installation. Besides protecting you from the elements, these items also help define your outdoor space, making it feel more private and purposeful. So whether you're sipping your morning coffee on a city balcony or hosting a few friends on a tiny patio, it's not about how much space you have — it's about what you do with it. ___ New York-based writer Kim Cook covers design and decor topics regularly for The AP. Follow her on Instagram at @kimcookhome. For more AP Lifestyles stories, go to
