A blog covering the health/care ecosystem and people.

National health care spending growth slowed in 2017 to the post-recession rate of 3.9%, down from 4.8% in 2016. Per person, spending on health care grew 3.2% to $10,739 in 2017, and the share of GDP spent on medical care held steady at 17.9%. Healthcare spending in America is a $3.5 trillion micro-economy…roughly the size of the entire GDP of Germany, and about $1 trillion greater than the entire economy of France. These annual numbers come out of the annual report from the Centers for Medicare and Medicaid Services, published yesterday in Health Affairs. Underneath these macro-health economic numbers is

Most American families with children at home are concerned about paying bills on a monthly basis. One in two people have had at least one personal “economic crisis” in the past year, we learn in the American Family Survey 2018, released last week from Deseret News and The Brookings Institution. The project surveyed 3,000 U.S. adults across the general population, fielded online by YouGov. This poll, conducted since 2005, looks at the state of U.S. families through several issue lenses: the state of marriage and family, parents and teenagers, sexual harassment (with 2018 birthing the #MeToo movement), social capital and

From culture to travel, food and drink to retail and beauty, health will be baked into consumer goods and experiences in 2019. Welcome to The Future 100: 2019 from The Innovation Group at JWT. In the 100 emerging trends across ten categories, the future is clearly health-driven, according to the tea-leaf readers at JWT.a Health is all over, Culture Tech and innovation Travel and hospitality Brands and marketing Food and drink Beauty Retail Luxury Health (as a category itself) Lifestyle. I’ve mined this report in previous years – you can review my findings from the 2017 report here in the Health

Most patients wish their doctors would have a conversation with them about non-medical issues. The Doctor-Patient Conversation, a survey conducted for the Samueli Foundation by the Harris Poll, examined how patients feel about their health, healthcare, and relationships with physicians. The Samueli Institute, has several missions including integrative health with a focuses on evidence-based practices for healing, wellbeing and resilience. Patients are keen to learn about non-medication alternatives, like food-as-medicine, meditation, and acupuncture. But most doctors base their conversations with patients on purely medical options like lab test results and surgical procedures. The top issues doctors discuss with patients are

“Happiness is within, but not within you alone as it is among us. If we can create happiness in a community, then we will be able to attain happiness as individuals,” observed Saamdu Chetri speaking at the International Psychological Congress last week. Chetri is head of Bhutan’s Gross National Happiness Centre, which developed the Gross National Happiness Index. The phrase “Gross National Happiness” was first mentioned in 1972 by the 4th King of Bhutan, King Jigme Singye Wangchuck in an interview with the Financial Times. King Wangchuck said that, “Gross National Happiness is more important than Gross Domestic Product.” The GNH

Food deserts aren’t just a U.S. phenomenon. They’re found all around the world. This week as I explore social determinants of health and technology solutions in several parts of Europe, I’ve learned more about food access challenges in the UK. These are discussed in a report published this month by the Social Market Foundation asking, What are the barriers to eating healthily in the UK?  The research was supported by Kellogg’s, the food manufacturer. The first table comes from the report, and the topline shows that about 4 in 10 Britons shopped at a cheaper food store in response to high

The future of healthcare is not about being sick, Prof. Dr. Koen Kas believes. Having spent many years in life sciences in both research and as an entrepreneur, Koen now knows that getting and staying healthy isn’t about just developing medicines and med-tech: optimally, health requires a tincture of delight, Koen advises in his breakthrough, innovative book, Your Guide to Delight. Healthcare must go beyond traditional user-centered design, Koen’s experience has shown, and aspire toward design-to-delight. The concept of “delight” in healthcare, such as we experience in hospitality, grocery stores, and entertainment, is elusive. I’ve observed this, too, in my

Most physicians feel some level of burnout, hassled by electronic health records and lost autonomy. No wonder, then, that a majority of doctors favor some type single payer health system — one-quarter fully single payer, a la Britain’s National Health Service; and another one-third a single payer combined with a private insurance option, discovered in the 2018 Survey of America’s Physicians report on practice patterns & perspectives, published by The Physicians Foundation. Eight in ten physicians are working at full-capacity or are over-extended, the survey found. Furthermore, 62% of doctors are pessimistic about the future of medicine. Physician burnout is a

Consumers who have long purchased over-the-counter medicines, anti-dandruff shampoo, whitening toothpaste, and cosmetics-with-benefits at food, drug and mass merchant retailers are switching to other places to shop for health, new data from AT Kearney and GMDC have found. The two organizations have collaborated to launch a new  benchmarking study into health-beauty-wellness (HBW) sales, launched this weekend at the GMDC HBW Conference in Orlando. Overall, 2017 to 2018 year-on-year, HBW sales were flat-to-no growth, notwithstanding the consumer and influencer buzz around the categories.       This study uncovered some very important trends underneath the macro numbers that tell a story

Among industries that consumers frequent, one continues to delight people more than most: pharmacies. J.D. Power’s 2018 ratings on U.S. pharmacies finds that consumers do indeed still love their pharmacies after ten years of rating customer satisfaction with brick-and-mortar and mail order channels. “U.S. consumers love their pharmacies,” J.D. Power asserts in its first study finding. In terms of total points across all pharmacies, Wegmans pharmacy was the overall top-ranked Rx retail channel with a total ranking of 906 out of 1,000 points. J.D. Power evaluated four categories of pharmacy: Brick-and-mortar chain drug stores, ranking Good Neighbor Pharmacy number one.

The two top stressors in American life are jobs and finances. “My weight” and my family’s health follow just behind these across the generations. Total Well-Being, a research report from Fidelity Investments, looks at the inter-connections between health and wealth – the combined impact of physical, mental, and fiscal factors on our lives. The first chart summarizes the study’s findings, including the facts that: One-third of people have less than three months of income in the bank for emergency Absenteeism is 29% greater for people who don’t have sufficient emergency funds saved People who are highly stressed tend not to

America’s agricultural roots go deep, from the native Patuxet tribe that shared maize with Mayflower settling Pilgrims in southern New England, to biodynamic and organic winemakers in Sonoma County, California, operating today. In 2016, 21.4 million full- and part-time jobs were related to agriculture and food sectors, about 11% of total U.S. employment. Farming is an integral part of a nation’s food system, so the Union of Concerned Scientists developed the 50-State Food System Scorecard to gauge the state of farming and food in the U.S. on several dimensions: diet and health outcomes, farming as an industry and economic engine,

          The U.S. gets relatively low ROI for its relatively exorbitant spending on healthcare, noted once again in the latest Health at a Glance, the annual OECD report on member nations’ healthcare systems. The report includes U.S. country data asking, “How does the United States compare?” with its sister OECD countries. The answer is, “not well across most population health, access, and mortality measures.” For the Cliff’s Notes/Where’s Waldo top-line of the research, find the two long bars in this chart heading “south” of the OECD average, and one long blue bar going “north.” The northern climbing bar

“The world today is mostly deaf,” the Pontiff observes in Pope Francis: A Man of His Word, Wim Wenders’ documentary on this religious leader who likes to quote Dostoevsky, joke about mothers-in-law, and advocate for the sick, the poor, the disenfranchised, and Planet Earth. He is, I realized while watching this film and hearing this man of words, a public health advocate. Throughout the film, we see clips of Pope Francis washing the feet of prisoners in Philadelphia, comforting dying children in a pediatric clinic in central Africa, and speaking out to the U.S. Congress about the dangers of climate

Be the change you wish to see in the world, Gandhi has been attributed as saying. This sentiment was echoed by Lauren Singer as we brainstormed the social determinants of health and the factors that underpin healthy communities. Our Facebook Live session was convened by the Aetna Foundation, which sponsored research on the Healthiest Communities in 2018.  In addition to Lauren, founder of Trash Is For Tossers, Dr. Garth Graham, President of the Aetna Foundation, Dr. Pedro Noguera, Distinguished Professor of Education at UCLA, and I joined the quartet, moderated with panache and sensitivity by Mark J. Ellwood, journalist. Each

One-third of Americans are following a specific eating pattern, including intermittent fasting, paleo gluten-free, low-carb, Mediterranean diet, and Whole 30, among dozens of other food-styles in vogue in 2018. It’s mainstream now that Americans are shopping food for health, with eyes focused on heart health, weight, energy, diabetes, and brain health, according to the 2018 Food & Health Survey from IFIC, the International Food Industry Council Foundation. But underneath these healthy eating intentions are concerns about the cost of nutritious foods, IFIC reports. And this aspect of home health economics can sub-optimize peoples’ health. Consider the first graph on consumers’

Healthcare has a reputation halo in the eyes of U.S. consumers, who ranked the sector as the only industry whose reputations rose between 2017 and 2018. But consumers separate the pharma industry from healthcare: prescription drug manufacturers’ reputation took the second-largest fall, just behind the airline industry. Pharma and airlines were the lowest-ranked industries, along with telecomms and energy. The Reputation Institute has published its annual 2018 US RepTrak Industry Rankings, finding that all industries but healthcare took negative hits on reputation from 2017 to 2018. The study asks consumers to rate the most reputable companies in their daily lives.

In the US, when it comes to life and death, it’s good to live in Hawaii, Utah, Minnesota, North Dakota, and Iowa — the top five states with the greatest life expectancy and healthy life expectancy at birth in 2016. For health and longevity, sorry to see the lowest five ranked states are Washington DC which ranks last, along with Mississippi, Louisiana, South Carolina, and Alabama. This sober geography-is-health-destiny update was published this week in JAMA, The State of US Health, 1990-2016: Burden of Diseases, Injuries, and Risk Factors Among US States. The first chart illustrates states down the left

If it’s true that “your ZIP code is more important than your genetic code,” you’d look for a job in 22046, buy a house there, and plant your roots. You’d find yourself in Falls Church, Virginia, named number one in the Healthiest Communities rankings of 500 U.S. towns. You can see a list of all of the communities here. The project is a collaboration between the Aetna Foundation and U.S. News & World Report, with help from the University of Missouri Center for Applied Research and Engagement Systems (CARES) and a team from the National Committee on Vital and Health

Las Vegas is known for glitzy neon lights brightly shining along the strip and casinos without clocks reminding us of the time, stimulating us to stay awake at all hours of day or night. But inside the Sands Convention Center are a couple dozen technologies and connected things designed to put us to sleep, which is a growing digital health category at the annual CES. Form factors for sleep-things at CES 2018 include masks, beds, lights, apps, and even a huggable sleep “robot.” Why is sleep seeing such a huge influx on the consumer tech-supply side? Because there’s growing, mainstream

While a phrase containing the words “health” and “Las Vegas” may seem a dichotomy, there will be a lot of health-tangent goods and services I’ll be seeking next week at the annual CES. This year, health will be ubiquitous at this huge conference, whose three-letter acronym for “consumer electronics show” typically conjures up images of shiny new things in the guise of automobiles, video games, big TV screens, and drones. At CES 2018, health will go beyond wearable tech and the first phase of fitness that’s been growing at the meeting over the past five years since I began attending

The biggest healthcare spenders in the United States are households and the Federal government, each responsible for paying 28% of the $3.3 trillion spent in 2016. Private business — that is, employers covering healthcare insurance — paid for 20% of healthcare costs in 2016, based on calculations from the CMS Office of the Actuary’s report on 2016 National Health Expenditures. The positive spin on this report is that overall national health spending grew at a slower rate in 2016, at 4.3% after 5.8% growth in 2015. This was due to a decline in the growth rates for the use of

More consumers are seeking health-making opportunities everywhere, both within and outside of traditional healthcare touch-points. That includes peoples’ consumption of beer. We learned from the Edelman Health Engagement Barometer that consumers seek to engage for health beyond healthcare organizations – namely, hospitals, providers, over-the-counter medicines, pharma and insurance. What was perhaps the most surprising industry segment consumers called on for personal health engagement was brewing and alcohol. Fully 8 in 10 consumers expect brewing and spirits companies to engage in health. The bar chart shows this finding, arraying beer and liquor producers on par with retail and consumer technology, along

Above the economy, trust in government, crime, war, terrorism, and taxes, health care is the top cause of stress in America. For ten years, the American Psychological Association has gauged Americans’ collective mood in their ongoing study, Stress in America. The latest report is The State of Our Nation, published this month, finding that we’re at the “lowest point in our nation’s history” according to 59% of Americans. The 2016 national election in the U.S. raised the stress-stakes, when APA released a stress study we discussed here in Health Populi. The election season was a source of stress for 52%

“With Mad Men still in charge, ad campaigns miss the mark,” an editorial published this week in the Financial Times asserts. Leave it to a fiscally conservative British publication to be spot-on about a particularly, but not uniquely, American challenge, in this post-Weinstein (Miramax), -Price (Amazon), and today, -Halperin (MSNBC) moment of sexual harassment revelations. In health/care, women are key consumers, buyers and influencers, yet under-represented in the Mad Men demographic of senior advertising executives, as the data-driven FT essay points out. So it’s especially heartening to find this month a few examples of empowering, inspiring ad campaigns getting health/care marketing

THINK: money and love. To find health, working-aged people seek financial stability and good relationships, according to the Consumer Health POV Report from Welltok, meQuilibrium, and Zipongo, featured in their webinar broadcast today. The online consumer survey was conducted among 2,000 full-time working U.S. adults in August 2017, segmented roughly into thirds by Boomers (37%), Gen Xers (32%), and Millennials (31%). Much lower down the priority list for healthy living are managing food, sleep, and stress based on the poll. Feeling stress is universal across most consumers in each of the three generational cohorts, especially related to work and finance.

After diving into Walnut Lake in suburban Detroit, Adam Niskar sustained a spinal injury that would paralyze much of his body for the rest of his life. The trauma didn’t paralyze his life and living, though. But today, my family will celebrate that life at Adam’s memorial service. Adam was my cousin. He was one of the best-loved people on the planet, and that was part of a therapeutic recipe that sustained him from the traumatic accident in 1999 until Monday, July 31st, 2017, when Adam passed away from complications due to an infection that, this time around, his body

“Helping people on their path to better health” is the mission-mantra of CVS Health. Re-branded from its previous identity as CVS/pharmacy, the organization convened a Health Innovation Summit with its vendor partners whose products fill the front-of-store shelves to empower, inspire and support consumers to manage health and wellness for themselves and their families. I was grateful for the opportunity to provide the first talk for the day, setting the context for the evolving retail health/care landscape with the consumer at the center. The consumer is, at any point in a 24-hour day: a person wearing many hats (a worker,

“Stay well, even on the road,” welcomes the chain of EVEN Hotels. That message from a hospitality company is part of the growth of the retail health landscape, driven by consumers’ desire to live well and make healthy decisions every day – even during business trips. The message is that, “Wellness is more than a word. It’s your way of life. But when it’s time to travel, it all falls apart,” Who among us road warriors for work doesn’t get that message? This is a real trend that engaged health consumers have begun to demand. A friend of mine traveled this week

Americans are overwhelmingly keen to use food for their health, and overwhelmed by the amount of nutrition information they face to make good shopping and eating decisions. Welcome to “food confusion,” a phenomenon gleaned from the 12th Annual Food and Health Survey conducted by the International Food Information Council Foundation (IFIC). This 12th annual survey from IFIC finds that most Americans take many steps to be healthy. In the past year, the most popular health-steps include drinking more for hydration, making small changes to achieve a healthier diet, consuming smaller portions, eating more fruits and vegetables, and eating more whole grains.

Former Surgeon General Dr. Regina Benjamin was the first person who quoted to me, “Health isn’t in the doctor’s office. It’s where people live, work, play and pray,” imparting that transformational mantra to me in her 2011 interview with the Los Angeles Times. I wrote about that lightbulb moment here in Health Populi. Dr. Benjamin was the 18th Surgeon General, appointed by President Obama in 2009. As “America’s Doctor,” she served a four-year term, her mission focused on health disparities, prevention, rual health, and children’s health. Today, Dr. Benjamin wears many hats: she’s the Times Picayune/NOLA.com professor of medicine at

CNN called it, “the ancient perfume store you never heard of,” but the Officina Profumo-Farmaceutica di Santa Maria Novella had its literal roots in medicinal herbs. With scents wafting onto a 13th century Florence piazza, the Farmacia now operates as a pharmacy storefront for homeopathic and herbal supplements, along with perfumes and home scents. A visit to the pharmacy today is a journey into medicinal time-travel, back to the year 1221. I spent time in the pharmacy today to learn about the literal roots of the shop in medicinal herbs cultivated in a monastery garden and reformulated by monks into

The truest form of health reform and consumer-directed health care isn’t in a high-deductible health plan or a health savings account, and it doesn’t come out of Washington DC or your employer’s health benefits office. It comes from you in the form of self-care and DIY healthcare. In this case, think “inspired by sport, powered by you.” I’ll be participating on a panel at this weekend’s South-by-Southwest Festival in Austin, Texas, along with three wellness innovators: Nick Buettner of the Blue Zones project, Mary Liz McCurdy of Google, and John Wilbanks from Sage Bionetworks. Together, our quartet will brainstorm the

The American Psychological Association reports that Americans are experiencing greater levels of stress in 2017 for the first time since initiating the Stress in America Survey ten years ago in 2007. This is a statistically significant finding, APA calculated. The member psychologists of the American Psychological Association (APA) began to report that patients were coming to appointments increasingly anxious about the 2016 Presidential election. So the APA polled U.S. adults on politics for the first time in ten years of conducting the Stress in America survey. Two-thirds of Americans are stressed and/or anxious about the future of the nation, and

Consumer electronics (CE) aren’t just big screen TVs, sexy cars, and videogames anymore. Among the fastest-growing segments in CE is digital health, and health-tech will be prominently featured at the 2017 CES in Las Vegas hours after the champagne corks have popped at the start of the new year. On the second day of 2017, I’ll be flying to Las Vegas for several days of consumer technology immersion, learning about connected and smart homes and cars, and shiny new things all devoted to personal health. Welcome to my all-health lens on CES 2017, once referred to as the Consumer Electronics

“Thanksgiving.” Merriam-Webster’s dictionary defines the word, first, as “the act of giving thanks.” Second, it’s “a prayer of expressing gratitude.” And, third, the word means a public acknowledgment or celebration of divine goodness. We each have our stories about how a loved one’s life has ended. If we’re lucky, that beloved person had a good death: in sleep, perhaps, or simply of old age with no hospital events or trauma. Then there are the Rest-of-Us who have the stories of long and painful endings, in institutional settings and costly, futile care. When you’re already in the situation of making tough health

60% of Americans are currently trying to lose weight. So it shouldn’t be a surprise that when asked, “what’s the most serious health problem in the United States?” Americans say it’s obesity, tied with cancer, and ahead of heart disease and diabetes. Overweight and obesity are top-of-mind for most Americans, according to research conducted by the American Society for Metabolic and Bariatric Surgery (ASMBS) and NORC at the University of Chicago. This research has created two reports which can be accessed at the link. The survey, conducted among 1,509 consumers in August and September 2016, found that Americans’ understanding of

Managing stress, weight, mental health, sleep, and heart function are among the top-most desired reasons already-connected health consumers are interested in further connecting their health, according to The 2016 HealthMine Digital Health Report. The most popular tools people use to digitally manage their health deal with fitness and exercise (among 50% of connected health consumers), food and nutrition (for 46%), and weight loss (for 39%). 3 in 4 people who use digital health tools say they have improved their health by connecting to these tools. 57% of digital health users also say going health-digital has lowered their healthcare costs. The survey

The promise of digital, connected health to engage all health citizens cannot be fully realized until people have access to the new social determinant of health: broadband connectivity. The World Health Organization considers social determinants of health inputs like education, safe drinking water, nutritious food, safe neighborhoods for walking, employment and transportation access. Together, these factors bolster personal/individual and public health. See the map of the U.S., and note whee the concentrations of aqua blue are. These are areas that lack broadband access. Telehealth and other digital health tools can get health care to under-served people in under-served geographic areas….where broadband

Health care payment responsibility continues to shift from employers to employee-patients, More of those patients are morphing into financially burdened health consumers, according to TransUnion, the credit agency and financial risk information company, in the TransUnion Healthcare Report published in June 2016. Patients saw a 13% increase in their health insurance deductible and out-of-pocket (OOP) maximum costs between 2014 and 2015. At the same time, the average base salary in the U.S. grew 3% in 2015, SHRM estimated. Thus, deductibles and OOP costs grew for consumers more than 4 times faster than the average base salary from 2014 to 2015.  In

Coloring books are best sellers in bookstores, craft merchandisers, newspaper stands, and on Amazon. Now, they’re joining the health and wellness world. The market growth of coloring books has been recognized in national media like the Washington Post, who called the phenomenon, “a bright spot in the financial results of publishers and retailers alike.” Nielsen Bookscan estimated that 12 million were sold in 2015, up from 1 million in 2014. Publishers Weekly covered the craze in November 2015. A Forbes column said, “The adult coloring craze continues and there is no end in sight.” Some of the mental health benefits

Hippocrates is often quoted as saying, “Let food be thy medicine and medicine be thy food.” While some researchers argue that Hippocrates knew the difference between ‘real’ medicine and clinical therapy, there’s no doubt he appreciated the social determinant of health and wellness that food was 1,000 years ago and continues to be today. Taking a page, or prescription note, from the good doctor’s Rx pad, food retailers, healthcare providers, local food banks, and State healthcare programs are working the food-as-medicine connection to bolster public health. One approach to food-as-medicine is promoting the purchase of fresh fruits and vegetables — the

Where you live in America determines what you might pay for healthcare. In this health economic scenario, as Napoleon is rumored to have said, “geography is destiny.” If you’re searching for low-cost health care, Ohio may just be your state of choice. The map illustrates these health care disparities across the U.S. in 2015, when the price of a single service could vary by more than 200% between one state and another: say, Alaska versus Arizona, or Wisconsin compared to Florida. Even within states, like Ohio, the average price of a pregnancy ultrasound in Cleveland ran nearly three times that received in

Financial stress impacts health, relationships, and work productivity and attendance for employees in the U.S. It’s the American worker’s trifecta, a way of life for a growing proportion of people in the U.S. PwC’s 2016 Employee Financial Wellness Survey for 2016 illustrates the reality of fiscally-challenged working women and men that’s a national epidemic. Some of the signs of the financial un-wellness malaise are that, in 2016: 40% of employees find it difficult to meet their household expenses on time each month 51% of employees consistently carry balances on their credit cards (with a large increase here among Baby Boomers

April 7 is World Health Day, and the World Health Organization (WHO) has named #diabetes the big public health challenge for 2016. What’s striking about this year’s World Health Day is the “Stay Super” public health ad campaign that WHO has developed featuring figures of super-people. THINK: Superman and Wonderwoman meet Doctors Welby, Kildare, and McDreamy. I’ve included several of the posters in the blog today to show how engaging health messaging works well when it works. The materials can be downloaded at this link. This week also saw the publication of America’s Health Rankings, spotlighting the impact of unhealthy behaviors.

All over the world, people define their health and wellness across many dimensions…physical, mental, financial, and appearance. In Florence, Italy, I happened upon a riff on this last component on “look good, feel good” at the Coin Department store located on Via Del Calzaiuoli in central Firenze. Welcome to Coin’s Health&Beauty Store. The two photos tell a story about health, where we live, work, play, and shop, the mantra for public health focused on the social determinants of health beyond healthcare. Here at Coin, adjacent to the holistic brands of Clarins and other luxury labels, is a pharmacy along with

Where you live in the U.S. is a risk factor for your health. Hawaii, Alaska, Montana, Colorado and Wyoming rank highest on the State of American Well-Being 2015 State Well-Being Rankings, the Gallup-Healthways Well-Being Index. Well-Being is based on an index of five components that people self-assess: purpose, social, financial, community, and physical. See the map: the darker blue the state, the healthier the population perceives itself to be. Note more light blue to the northeast and south, and dark blue in the mountain states, Alaska and Hawaii. Some states have stayed in the top-tier of wellness since 2012: Hawaii

The Internet of Healthy and Medical Things will proliferate at CES 2016 in Las Vegas next week – the annual Consumer Electronics Show. This is the yearly mega-convention organized by the Consumer Technology Association, and digital health has been among the fastest-growing marketplaces at the CES for several years in a row. The two-day Digital Health Summit will complement the vendors ont he convention floor with content, education, and networking for the industry. Here’s a link to my latest Huffington Post column on Health at the 2016 Consumer Electronics Show – What to Expect. Health Populi’s Hot Points: The Consumer

Food + Drink, Beauty, Tech + Innovation, Retail, Lifestyle…JWT pulls out their crystal ball for 2016, and I see health, everywhere. The Future 100 – Trends and Change to Watch in 2016 is J. Walter Thompson Intelligence Innovation Group’s annual trend forecast, which I highly value and mine each year to help THINK-Health continue to hone our own environmental analyses for health and healthcare. [Here’s what I wrote one year ago about JWT’s 2015 forecast]. Health is baked into JWT’s 2016 trendscape, well beyond their “Health” chapter. Even the report’s introduction is health-flavored: “As forecasters, we’re watching the rapid metabolism