LISTEN: Distracted. Reckless. Drunk. Americans’ driving has gotten since the covid pandemic. Chaseedaw Giles appeared on WAMU’s “Health Hub” on Nov. 26 to share her reporting on that deadly trend.

Traffic deaths have climbed nationwide over the past decade. In some major cities, traffic deaths have . But this year, Washington, D.C., has recorded a in these kinds of deaths. Chaseedaw Giles, audience engagement editor with Ñî¹óåú´«Ã½Ò•îl Health News, appeared on WAMU’s “Health Hub” on Nov. 26 to share her reporting on the ways design and better enforcement can contribute to safer streets.

This article first appeared on Ñî¹óåú´«Ã½Ò•îl Health News and is republished here under a .

Oldways Ambassadors Brenda Atchison and Glorya Fernandez walked a KHN reporter through two cooking demonstrations to showcase modern takes on cultural classics — like a cold black-eyed pea salad just in time for the new year, and a garlicky dill mojo sauce served over spinach salad.

Last year, Kelly LeBlanc, director of nutrition at Oldways, shared the organization’s heritage-based food guide pyramids with KHN for a report on USDA food guidelines. It’s the 10-year anniversary of Oldways’ A Taste of African Heritage nutrition curriculum, and this year, the curriculum became part of the Department of Agriculture’s , a collection of interventions from the Supplemental Nutrition Assistance Program educational effort focused on helping low-income households make healthier food choices and reinforce healthy eating habits.

This article first appeared on Ñî¹óåú´«Ã½Ò•îl Health News and is republished here under a .

People have been styling their teeth for centuries across the globe throughout North and South America, Africa, and Asia. But social media — particularly TikTok, where everything old and new is nip/tucked into short videos with trendy sounds and served up fresh to young eyes — has breathed life into trends like tooth gems. Drake, Rihanna, and Bella Hadid wore them years ago. Now, some TikTok influencers are selling DIY gem kits.

But it doesn’t stop there. There are DIY tooth replacement kits and bedazzled grills available online for under $25, and recipes for homemade toothpaste and whitening treatments. The TikTok hashtag #DIYdentist has 2.6 million views. It’s enough to make any licensed dentist or orthodontist cringe.

The professionals wholeheartedly agree that DIY dentistry is a very bad idea. Dental care can be expensive, and orthodontic treatment is usually considered cosmetic and not covered by dental insurance — which 65 million Americans don’t have. And, according to the , people who are low-income, uninsured, members of racial minority groups, immigrants, or living in rural areas are more likely to have poor oral health.

So, is the high cost of dental treatment driving these viral trends among young people, or is it the lure of supposedly painless, instantly changed smiles?

, a Fremont, California, dentist and spokesperson for the American Dental Association, said she can understand why patients want to try DIY dentistry at home. “I just don’t know how [they] could do it safely,” she said, especially altering the shape of their teeth. While filing teeth is something a dentist might do to smooth out imperfections or create space between teeth during treatment for braces, for instance, some people are doing it themselves to smooth away chips in teeth or create vampire-like fangs for aesthetic reasons. “When we practice dentistry, we do it with the background information of years of training, X-rays, and the experience that helps us decide when and how to do the treatment,” Sahota said.

Even tooth gems applied correctly with oral bonding materials are troublesome, she said, because they “are adding something to your teeth that will also attract bacteria. You’re increasing your risk of cavities, of gum infections. And you’re increasing your risk of chipped teeth, of inflammation inside your mouth.”

DIY prices are certainly part of the allure. On Amazon, a was selling for $12.99 from Tondiamo, a brand that also sells children’s earwax removal tools, waterproof adhesive bandages, and chainsaw chains. The kit comes with 10 rhinestones, a mini-LED keychain to cure the adhesive, four wooden sticks, five disposable applicator brushes, and five cotton rolls.

But no instructions.

Reviews on Amazon complained of the gems not sticking. Some suggested using nail glue — which is toxic and can damage tooth enamel. But among Amazon’s “frequently bought together” suggestions: a bottle of epoxy resin glue.

A for $7.98 from TCOTBE and a set of for $10.99 from OOCC both advertised that “one size fits most,” but reviewers said otherwise. “Save your money and use foil (old school way) if you want a grill lol,” one buyer warned. Bleeding gums were a common complaint among the reviewers.

Perhaps the most bizarre DIY find was a temporary tooth repair kit for under $25 from CZsy. It came with plastic “veneers” in different shapes for missing teeth, and moldable plastic beads for repairs.

It also did not come with printed instructions, but these were buried in the product description on Amazon’s site:

1. Drop into hot water above 130 degrees for about two minutes.
2. Shape the size what you want.

No company information or websites could be found for some of these brands, but the products had one thing in common: a bar code sticker reading “Made in China.” Instead of responding to a request by KHN for an explanation of its policies, Amazon . The other items were still available to order at publication time.

It’s not just DIY dentistry giving licensed professionals a toothache. Vendors touting certificates to apply composite veneers and partials — dentures that replace missing teeth when someone still has multiple natural teeth in place — are sprouting up on social media. Vendors like in Philadelphia will apply composite veneers over less-than-perfect smiles — in this case, starting at with a $499 deposit — as a lower-cost alternative to porcelain veneers, which require shaving down the natural teeth. The merchant advertises for $5,999. Marie’s Beauty Bar did not respond to emails or voice messages seeking comment.

DIY dentistry isn’t just a phenomenon of young people on social media. “There are teens, adolescents, even adults that are trying these things,” said , a dentist in Marietta, Georgia, and a state director for , a Boston company. “A major contributing factor is lack of access to dental care.”

DIY can appear a viable alternative, especially since a person with severely damaged teeth, in severe pain, or with mounting dental bills from repairing DIY damage rarely displays the disappointing results on TikTok. Social media users, for the most part, display carefully curated highlights, not adverse reactions.

“The ‘cool thing’ right now is all these hacks to make things supposedly easier or more accessible,” she said. Caveat emptor, or let the buyer beware, she cautioned. Reviews from influencers who often receive free services in exchange for promotional posts may be biased. Bonnaig warned that complications could occur many days, weeks, or months after treatment.

Even when people aren’t daring to drill their own teeth, they can do damage with other social trends like drinking a concoction of balsamic vinegar — which has a higher acid content than the actual soft drink — and flavored carbonated water. It’s a recipe for severe erosion of tooth enamel.

Sahota has seen what these viral trends can do. “Patients have been drinking or swishing with lemon water, or maybe apple cider vinegar, and that has caused acid or erosions on their teeth,” she said. “The patients will say, ‘Oh, yeah, you know, I saw online that, you know, this will be better for my health. And so I’ve been doing it every night.’ That’s when I’ll bring a mirror and show them exactly what the effect of that trend has made on your teeth.”

Such low-cost hacks may end up costing patients far more in the long run. Sahota suggested that consumers looking for safe ways to enhance their smiles can scour the products on the site that sports the . Bonnaig and Sahota both implore patients to discuss their oral and cosmetic concerns with a dentist.

Every tooth and every mouth is unique, and there is no safe one-size-fits-all DIY hack. “You can have a beautiful smile,” Sahota said, “even if it’s not perfect.”

This article first appeared on Ñî¹óåú´«Ã½Ò•îl Health News and is republished here under a .

So it gnawed at me, a Black woman, when I recently walked into a supermarket in a lower-income L.A. neighborhood and was greeted instead by an array of processed, high-sugar, high-sodium foods — often offered with a nice discount: Coca-Cola products, five 2-liter bottles for $5; sugary cereals, two for $4; boxed brownie and cake mixes, four for $5.

The pandemic had underlined long-standing health disparities of Black and brown communities. Covid had resulted in a for Black Americans, compared with 1.2 years for white Americans. Research had consistently shown that among the underlying factors giving rise to those poor health statistics — high rates of diabetes and heart disease, for example — is poor diet, fueled by a lack of healthy food options in their neighborhoods.

“I could go into a supermarket, and I can tell everything about the people who live [in the area] based on what’s in their carts, based on what’s at eye level, what’s not at eye level,” said Phil Lempert, also known as the “.”

In retail, specific product placement — not just a store’s inventory — heavily influences a shopper’s experience. So shouldn’t responsible markets encourage shoppers to make better choices?

“There’s a lot of racism, to be honest, I think, behind these decisions, whether it’s unconscious or implicit,” said Andrea Richardson, a policy researcher focused on nutrition epidemiology at the Rand Corp. and professor at the Pardee Rand Graduate School. The presence of a supermarket in your neighborhood should signal that you aren’t living in a food desert, but, I wondered, if the supermarket isn’t guiding you toward more healthful food choices, you might as well be.

So when I flew home for Thanksgiving, I enlisted my mother, Lilie — who always cared about her kids’ diets — to help with more research. I have vivid childhood memories of her scouring multiple grocery stores — often traveling to different parts of town — for the freshest ingredients when none were available close by. We set out one Sunday last fall to buy 12 items on a simple “healthy eating” shopping list at five locations of Stop & Shop, a supermarket chain with stores in a cross section of Boston neighborhoods.

First the good news: We were able to find every item we wanted at each store. But, just as I’d experienced in L.A., healthy foods were easier to find in higher-income neighborhoods. In lower-income areas, junk food was more likely to be front and center.

At the Stop & Shop I recall from my childhood in Jamaica Plain, the food choices had become much more balanced, with a plentiful organic food section in the front of the store. My mom can now buy fresher greens locally.

But that likely in part reflects the gentrification that has taken place since I was a kid. Jamaica Plain now has a of almost $77,000 — though the poverty rate is 18.3% and the aroma of Dominican and Haitian patties still scented the air as we approached the entrance.

Our next two stops were in even fancier areas, Brookline (median income over ) and Somerville — both green oases compared with many of Boston’s grittier neighborhoods.

At the Brookline location, each aisle started with low-fat, low-sugar choices like Crystal Light and V8, and the candy section was minuscule. In Somerville, the produce section was spacious, leaving plenty of room to browse the bins of guava and dragon fruit.

Our next Stop & Shop was in South Boston — a working-class, Irish Catholic community. It was strikingly different than our first three stops. The organic section consisted mostly of breakfast bars and cereals. The produce section positioned caramels, candied apples, and pumpkin-spice doughnuts in a bin alongside regular apples — at the bargain price of two packages for $3. The “International Foods” aisle sold everything you need for a very American Taco Tuesday, while a big part of this section was dedicated to Italian and Irish foods.

In the Grove Hall neighborhood in Dorchester — a predominantly Black neighborhood with a — the offerings were downright dispiriting.

Soda was displayed prominently near one entrance. And as we walked the aisles it seemed that many of the “sale” items were sugary soda products, chips, or cookies. This store had a dizzying array of snack food options, including 20 kinds of Oreos. And there wasn’t an organic food section at all.

The chain has been “doing a lot of work” to make sure that stores are “culturally relevant and [reflect] the demographics of the neighborhood,” said Jennifer Brogan, director of Stop & Shop’s corporate external communications and community relations.

How a store is stocked depends on size, product movement, shelf size, and a mixture of customer feedback and data. That data comes from companies like , that provides consumer, shopper, and retail market intelligence and analyses.

Lempert, the “supermarket guru,” further explained that companies and brands pay retailers “promotional dollars” to put their goods “at eye level” or on sale, or make them available for consumers to sample.

But in making these largely commercial decisions, markets make it more difficult for people in low-income areas to eat healthfully, encouraging those with poor diets to continue the habits that landed them with diet-related illnesses.

“It has been well documented that junk-food companies spend significantly more money advertising in certain communities,” said Kelly LeBlanc, director of nutrition , a Boston-based food and nutrition nonprofit. A , for instance, found that junk-food advertising disproportionately targeted Black and Hispanic youth.

Stop & Shop has started to try to redress the inequity, with changes coming first to its Dorchester location, including an in-store dietitian. The Grove Hall store also sends out an ad circular that features promotional pricing on better-for-you items, which may include fish, vegetables, and fruit. It has joined the food prescription program that allows participating doctors to prescribe to patients a prepaid Visa card that can be used to purchase fruits and vegetables.

Still, why not simply cut down on the soda and bewildering number of Oreos, I wondered. “I think our job is to give customers a choice,” Brogan said. “I also think we have a responsibility to help them make healthier choices.”

I’m glad my mom taught me how to make those choices early on.

Another thing I learned: There’s a whole science behind how supermarkets are organized, and depending on where you live, that could say a lot about the surrounding area. So the next time I think about moving, the first place I’m heading to is the local supermarket because, as Lempert told me, “going to that community grocery store is going to tell you about the neighborhood.”

This article first appeared on Ñî¹óåú´«Ã½Ò•îl Health News and is republished here under a .

“If you ain’t rapping about being on no drugs, or you out here in the streets selling some drugs,” he said of his chosen profession, “you ain’t got some of that going on — like, don’t nobody wanna hear what you talking about.”

This snapshot of Williams’ hip-hop life doesn’t seem all that different from that of musicians of other genres for whom the mix of drugs and addiction is a recurring storyline, claiming the lives of artists like Janis Joplin, found dead of a heroin overdose in 1970, and rapper DMX, who died last .

But drug use in the hip-hop community has an ever increasing presence that is intertwined with the music – and one with dire consequences. The catchy lyrics suggest that opioid misuse is part and parcel with fame and wealth, just a normal, and innocuous, component of that life.  

Coverage on the abuse of hard drugs in the community usually focuses on tragedy surrounding certain popular rappers rather than the lyrics and the culture they create. And while public health experts take great pains, for example, to criticize and curtail the promotion of vaping to young people, little attention is paid to the dangerous effects that hip-hop is having on vulnerable listeners by normalizing popping Percocets or drinking cough syrup.

From big cities like Los Angeles to rural towns like Gibsland — population 878 — opioid misuse among some young, hopeful listeners is about emulating their favorite rap star’s enviable image. For others, it is not all about the high life. It’s self-medication.

“Let’s talk about pain,” said Mikiel Muhammad, 38, aka King Kong Gotcha, a member of the rap trio in Virginia. “The pain is so deep. They ain’t got money to go see a psychiatrist, but they got money to go get a Perc-10. They got $10, $15 for that,” Gotcha said, referencing the street value of a 10-milligram Percocet tablet.

According to a , anxiety, depression and thoughts of suicide have increased for young adults in the past year.

Artists like Young Nyke sometimes confront neighborhood and family violence, as well as a general lack of opportunities and resources in their communities — circumstances amplified by the covid pandemic. The poetic detailing the rappers’ experience offer some support. But these phrases can also be fraught.

It’s not just the drug use that is worrisome, said , an associate professor of public health at William Paterson University in Wayne, New Jersey. Often these songs promote using opioids while engaging in high-risk activities like unprotected sex or speeding and, while she is a hip-hop fan, “from a public health perspective, it’s just dangerous,” she said.

That toxicity reaches into populations already plagued by perpetual cycles of poverty, poor health and . There is a need for “culturally relevant interventions” to educate and raise awareness within the hip-hop music audience, which Tettey’s categorizes as primarily composed of youth from “vulnerable and socially disadvantaged” groups.

It is time to turn a critical eye to how opioid misuse permeates hip-hop’s lyrics, creating an entryway for Black young adults into the American opioid epidemic, said Tettey.

In 2017 that epidemic was declared a national public health emergency, with over 47,000 opioid-related overdose deaths reported. Researchers at the Centers for Disease Control and Prevention say fatal drug overdoses nationwide have surged roughly 20% during the covid pandemic, killing more than 83,000 people in 2020. Within this grim statistic the Substance Abuse and Mental Health Services Administration has found inequities.

According to a 2020 from the Department of Health and Human Services’ Office of Behavioral Health Equity and SAMHSA, attention to this crisis has focused more on white suburban and rural communities, even though Black communities are experiencing similar dramatic increases in opioid misuse and death. The report also found that synthetic opioids, like fentanyl, are affecting opioid death rates among Black people more severely than other populations.

A 2020 SAGE journal research found a large increase in prescription opioid overdose deaths among Black people. The paper also found the rate of death almost tripling between 1999 and 2017. In February 2018 the U.S. surgeon general a warning that trends in opioid misuse “may be a precursor to even more opioid overdose fatalities in the black community in coming years.”

“The music industry, all it does is perpetuate whatever’s going on outside,” said Jarrell Gilliard, 40, explaining the pharmaceutical drug presence he’s encountered and how it’s reflected in popular lyrics. “How they pump these pills and all these prescribed medicines through the streets. Once the streets got ’em …” said Gilliard, whose hip-hop alias is Grunge Gallardo.

Grunge is also a member of The Opioid Era, named for their gritty, raw imagery and lyrics. Songs such as “Suboxones,” “Sackler Oath” and “Overdose,” which opens with a haunting 911 of a woman frantically pleading for help with one, contrast sharply with the pill-laced tunes of hip-hop’s mainstream.

“I think that’s the most dangerous thing about it,” said Richard Buskey, 42, who completes The Opioid Era trio as Ambassador Rick. “It’s a disconnect between the youth and them realizing that they’re in the same category as what they would consider a junkie or a fiend.”

Tettey said that’s partly because mainstream artists represent a lifestyle many young adults want for themselves, which can translate into modeling behaviors like opioid misuse.

Feeling the ‘Lean’

Patrick Williams, 26, an independent rapper from Orange, Texas, with the stage name , is no stranger to addiction.

He was 21 when he first sipped “” — a drink made from mixing prescription cough syrup containing the antihistamine promethazine and the opioid codeine with soda, Jolly Rancher candies and ice, served in doubled-up Styrofoam cups. “It’s a variety of colors that you have,” PatvFoo said, referencing the various formulations of codeine cough syrups. Purple syrup ranks as most potent. PatvFoo learned about lean through the Texas rap scene and artists like and then became a user.

“At first, there’s a mellowing high,” said Stevie Jones, 23, also known as Prophet J, an independent rapper in Louisville, Kentucky. He has similar recollections from his first time misusing codeine syrups. He and his friends drizzled some on a blunt — the slang term for a hollowed-out cigar filled with pot. “It just makes it burn slower — like, get you a little bit higher, I guess,” said.

Things can take a bad turn quickly. Although lean is one of the weaker opioids, experts say it is . “The day you go without it you get bad, bad stomach cramps. You feel like you got to just throw up all the time. You sweating. It’s like you got a bad flu,” PatvFoo said.

That flu-like feeling is opioid withdrawal, said Dr. Edwin C. Chapman, a Howard University College of Medicine alum who has practiced internal and addiction medicine in Washington, D.C., for more than 40 years. The symptoms range from runny nose and eyes to diarrhea and usually can be stopped with a gulp of cough syrup or lean, he said.

And there’s a harsh reality in that. Whether it’s Percocet pills or lean, “it’s all in the same class as heroin and fentanyl,” Chapman said.

But learning that opioid use is promoted in popular music came as a revelation to Chapman. “That’s not the music that I listened to,” said the 75-year-old doctor. The medical community, he said, has been focused on curbing the overprescribing of pain medication. “But it’s never talked about … that it’s being advertised overtly to young folks through music or through the media.”

Indeed, abuse of lean, also known as “” and “,” has managed to evade the regulatory spotlight while remaining popular and recognizable — so much so that vaping companies distributed nicotine-containing e-liquids resembling the drink and even mimicked the slang term “double cup” in their labeling. These products triggered a 2019 on the vaping juices. The drugs themselves, however, still pump through the streets, just like the hip-hop lyrics.

And it has altered the market, moving it beyond the street options of heroin and opioids, said hip-hop artist Buskey. “We living in the times where they’re getting it out of the medicine cabinet.”

Phillip Coleman, 34, a rapper in Rochester, New York, who goes by the name , started using at age 15 after being prescribed 5-milligram tablets of Percocet following wisdom tooth extraction. That set him on a path to misusing prescription painkillers, which led to cocaine and then a heroin addiction that eventually landed him in .

Fortunately, Coleman was able to overcome his addictions in rehab and refocus on family and . He cautions that people buying Percocet or other prescription pills on the street have no way of knowing if they are legitimate or “just pressed fentanyl.” He said the reward for opioid addiction isn’t the lifestyles of the rich and famous you see portrayed by some hip-hop artists. “You don’t get to trade in your empty bags like the box tops and get, like, a bike or whatever. Like, you don’t get no hat; you don’t get no fentanyl swag,” he chuckled. “Like, you just die.”

This article first appeared on Ñî¹óåú´«Ã½Ò•îl Health News and is republished here under a .

A full-time artist, Bond, 44, made a living through a patchwork of vocal gigs — performing live at weddings, bars and theaters, recording jingles, teaching vocal lessons and hosting events.

But the coronavirus pandemic found her burning through her savings and struggling to make ends meet in a tiny rental accessory dwelling unit above the tree-lined garage of a home in Hyattsville, Maryland. According to a 2020 report from the , artists were more likely than others to have lost their main source of income — music-related or not — due to the pandemic.

So with few other obvious options, and the world at a standstill for the foreseeable future, she set out to write her first solo album in the small rental she fondly referred to as her “treehouse.”

But cut off from family, friends and other nearby musicians, she devised a way to bring together out-of-work musicians from around the world, people who felt just as abandoned and stuck as she did. What resulted is an extraordinary transnational album — “,” released March 5 — that connected her with a far broader musical community and buoyed their collective spirits during a year of isolation.

The new album is a pandemic-fueled collaboration of musicians such as , PhD. a violinist and acting chair of the strings department at Berklee College of Music in Boston; two-time Grammy-nominated drummer in Nashville; and a percussionist from the British acid jazz band , who sent in his recordings from London. “Everyone jumped on board from wherever they were,” Bond said. And most, she said, “didn’t even stress me for money. We all wanted to create.” She was even able to work with , a songwriter who has written for several artists from Beyoncé to Anita Baker and likely would not have been accessible to her or available pre-pandemic.

They were up against the challenges of not just a pandemic, but also a music industry that has come to rely heavily on curated playlists like Apple Music’s “New Music” or “From Our Editors” to promote new releases. Mainstream artists who have released music during the pandemic have teams of industry professionals ensuring their tunes end up on the most highly trafficked playlists.

Some music- like Apple Music don’t allow third-party playlist curation. So, without a direct connection to their editorial team or partners, landing a spot on these lists isn’t likely. Without being able to perform live at clubs and events this past year, Bond says, some independent artists may feel financial pressure to focus less on the quality of their music and more on finding ways to go viral on social media to tip the scales.

How does an independent artist find new listeners at a time when performing for a crowd isn’t allowed, and they’re battling against more than already on Spotify and Apple Music, respectively?

Bond was not naïve about how the music world works, having been a performer for decades. She and her band, Third Logic, had been performing together since they were in their early 20s, but as time passed and adulthood — marriage, children, increased work responsibilities — set in, finding the time to write music together became nearly impossible. They hadn’t released a new album since “Madam Palindrome” in 2011. Time and distance from her bandmates meant that gigs were few. So, in 2019, she decided to embark on a solo career. Then covid hit.

At first, she despaired about how she would be able to pay for things like rent and food without the hope of recurring live gigs. “The pandemic relief money was really helpful,” she said, because independent artists can sometimes go weeks without making any money even without a global pandemic. Between her stimulus check and unemployment, Bond budgeted $600 a week to live on. She had affordable health insurance through Kaiser Permanente, “thanks to Obamacare,” she said. She cut expenses, stuck to her budget and received modest payments from booking a few covid-friendly, livestreamed events for Washington, D.C.’s Kennedy Center and the Music Center at Strathmore in North Bethesda, Maryland.

She was able to improvise a home-recording studio with mics, speakers, her MacBook and ProTools software and the help of music engineering friends over video conferences. Bond writes song lyrics and performs but doesn’t herself compose music. So, she put out a call to the musicians in her network and found many of them were also at home tinkering with new tunes and willing to share. Bond would “wait until late at night, turn on colored bulbs, blast things through my monitors and write,” she said.

After a rough draft of the album was completed in September, she and independent producer Brandon Lane put out a broader call for help for more live instrumentation. Their pleas circulated and produced a village of talent, as musicians from all over the world sent the singer their high-quality home recordings. “It showed me how many musicians were in the same boat,” Bond said.

Lane, who lived nearby and became part of Bond’s pandemic bubble, would come to her home studio — fully masked-up — as technical support and to co-produce the album. The title “” reflects an appreciation of the importance of trusting your own internal compass, she explained. The project showed Bond “who has my back,” she said, and that in a time of global crisis musicians — many of whom Bond considers friends — would come together to co-create with her.

Bond, who describes herself as having an eclectic Bohemian style and devil-may-care attitude, said she doesn’t want to change herself to jockey for a spot on the Billboard charts or playlists — even in the post-pandemic world.

The music industry is notoriously and male-dominated, she said. The third annual report on the industry, “” from professor and the found that in evaluating gender across eight years of Grammy nominations for Record of the Year, Album of the Year, Song of the Year, Producer of the Year and Best New Artist, 21.7% — or about 1 in 5 artists — were women.

“This is who the f*** I am,” she said. “I’m not 18, but I’m not ‘old’ either.” She wants listeners to have the chance to discover diverse musical options for female entertainers, at different ages, with different sounds and styles to match. By dint of necessity, the pandemic opened new types of doors for performers like her — through which she hopes new types of music will continue to be heard.

“You have to be smart,” she said. “It’s not hard to find new music.” Manually searching streaming apps like SoundCloud and Spotify take no more effort than scrolling through Instagram, she said. Bond hopes that listeners will take a break from the algorithms that sneakily sway our musical interests toward those artists pushed to the top of the charts and follow their own compass.

This article first appeared on Ñî¹óåú´«Ã½Ò•îl Health News and is republished here under a .

It might engender envy, even outrage, especially if the person posting seems to have cut the line. But what if the intention was to encourage others to also get the shot? Does that make it OK?

Since the pandemic began, people around the world are increasingly living out significant portions of their lives online. But with using some type of social media, according to the Pew Research Center, who sets the rules for proper social media etiquette?

“This is a totally new type of world to have a pandemic in,” said Catherine Newman, the etiquette columnist at and author of the book “.” One advantage of using social media, she said, is that people can create waves of public opinion from which everyone can benefit. Newman, who also volunteers at a hospice, was vaccinated and posted a selfie. She said the selfies can help address some of the public health mistrust issues that have contributed to vaccine hesitancy.

“I don’t want to see a picture of your yacht on social media,” she said. She’d rather see covid vaccine selfies but cautions users to be mindful of the caption they choose.

After all, nearly 500,000 American lives have been lost in the pandemic and stark disparities have emerged in vaccination rates — especially among communities of color and older adults who are in the highest risk categories.

It raises the question: Is posting a vaccine selfie on your social media account a faux pas or still par for the course?

, a lifestyle and etiquette expert, a certified mediator in the state of California and the founder of the Swann School of Protocol in Carlsbad, California, echoed those precautions. “RNs and front-line workers have a very different story to tell than a 20-something-year-old who got vaccinated for some obscure reason,” she said.

At the same time, she said, it’s not necessarily clear how someone came to be eligible for the vaccine. A person could present young and healthy at first glance but could have a health condition or other qualifying criteria. “We don’t know,” she said. She advises that posters follow what she calls the three core values of manners: respect, honesty and consideration.

And the same goes for people reacting to the posts.

George Francois, 35, a center director at Children’s National Hospital in Washington, D.C., chronicled his covid vaccination on Facebook. Looking at the overall death and infection rates in the African American community, he considered his post a public service. “I could inspire others to get it without having to talk to them directly,” he said.

It’s a sentiment shared by J. Shawn Durham, 44, an actor in Washington, D.C., and an unintentional He got a call from a friend of a friend to get vaccinated after a scheduled patient missed their appointment — leaving a critical dose that otherwise might have gone to waste. “I am healthy. I am Black. I am scholastic, so I know about our history and the ,” he said. And, given that history, Durham posted his selfies to “lead by example,” he added. “The white and the wealthy are getting vaccinated. I want Black people to want to get vaccinated too.”

Francois didn’t receive any backlash from his post and didn’t think it was a big deal. “A lot of people post their HIV and covid test results,” he said.

Bottom line: It’s common among younger adults to publicly share things some older adults may consider to be far too personal.

“It’s kind of tacky sometimes, I think, but there’s a lot of misinformation out there,” said Emilio Delgado, 31, who was born in Puerto Rico and now lives in D.C. He posted in part to foster confidence in the vaccine — to let his connections “see that someone they knew has taken it and didn’t grow a third eyeball,” he said of his hesitant followers. For that reason, he added, it was worth it.

Delgado, a local actor and patient instructor at the George Washington University School of Medicine and Health Sciences, had access to the vaccine because in this role of “standardized patient” he is often called in to role-play ultrasounds with fourth-year medical students. He makes the bulk of his income through such patient instruction and is frequently at the hospital — a place generally considered high-risk — so he’d rather be vaccinated.

For Signe Hawley, 34, a researcher and volunteer firefighter in the foothills of northwestern Boulder, Colorado, getting the vaccine — and posting about it — was an emotional experience.

Earlier in the pandemic, she made the difficult decision to pull back from her volunteer duties to protect her wife and 2-year-old daughter. But because she had been a first responder in her community, she became eligible for the vaccine sooner than expected. “I wouldn’t cut the line,” said Hawley. “But when given the opportunity, I wouldn’t pass it up either.”

For Hawley, the hardest side effect she faced after getting the vaccine was the depth of grief and sadness that surfaced surrounding the loss of her father, along with thoughts of all of the other lives lost “in the mismanagement of this,” she said.

Her father, Joe Hawley Sr., 67, died in early April from complications of covid-19 at Norwalk Hospital in southwestern Connecticut. His family was not allowed into the intensive care unit at any time during his bout with covid. And her interest in volunteerism and service is something she inherited from her father, a “humanitarian at heart,” who was involved and committed to the New England community where he lived.

“To be vaccinated for something that my father died from is so surreal,” she said, her voice breaking. Sharing her story and the vaccine photo was a way to honor her father. “This is one step to lessening the impact of death and severe health complications with covid, but it’s not the end of it,” she said.

Ultimately, she said, the more people vaccinated the better off we all are.

“We’re all posting this hoping to get buy-in,” said national etiquette expert , an author and founder of the Protocol School of Texas, a company specializing in corporate etiquette training based in San Antonio. Know your audience, she advised. And another important reminder: Follow , which advise against posting vaccination cards containing identifying information that could expose you to identity theft.

This article first appeared on Ñî¹óåú´«Ã½Ò•îl Health News and is republished here under a .

But, as in past iterations, they lack seasoning. They do not acknowledge the nuances of culture and ethnicity at the heart of how Americans feed themselves.

Congress requires a revision of these guidelines every five years to ensure they reflect the best available science and respond to the general population’s health needs.

Ethnic variations have been suggested for years, but there is still little guidance given to Americans of different backgrounds on how to eat more healthfully.

“There’s different ways you can be racist,” said Esosa Edosomwan, a certified nutrition specialist and behavioral coach in Washington, D.C. “You can be racist by omitting people, by making guidelines that only cater to a specific group.” Edosomwan — a Nigerian American also known as the — began her nutrition journey while trying to find a diet that would help alleviate persistent acne. She found a raw food class and began writing about her food-as-medicine reeducation on her blog, Raw Girl Toxic World.

“I was trying to figure out what I could become that would allow me to treat people with nutrition,” she said. “I saw mostly white women in this field that were celebrity nutritionists.”

“A white dietitian, she’s probably going to tell you to have some Greek yogurt with a handful of almonds and a serving of protein the size of your fist, when what you really want is egusi soup,” Edosomwan said, referring to the West African dish made from the ground, , vegetables and meat or fish. Food is a big part of culture, and you can’t dismiss where a client comes from, she said. Her clients are encouraged to cook within their culture, but to make changes to ingredients when needed to improve nutritional quality.

“These guidelines are completely incompatible with us achieving our best health,” Edosomwan said of the government guidelines. Statistics bear this out. According to a 2017 JAMA , nearly half of all U.S. deaths from heart disease, stroke and Type 2 diabetes may be attributed in part to poor diet. These health conditions disproportionately affect people of color. For instance, 11.7% of Black people, 12.5% of Hispanics and 9.2% of non-Hispanic Asians have been diagnosed with diabetes, versus 7.5% of non-Hispanic whites, according to the .

The USDA boasts of providing “science-based dietary guidance to the American public” and frequently revising it. It goes back to before World War II. An attempt to correct overeating came with the “Food Pyramid” — first published in 1992. The recommendations have more recently been branded simply as “My Plate,” with an app that can be downloaded to any mobile device. But simplifying the recommendations may make them less relevant.

“Culture is everything,” said Inez Sobczak, certified nutritionist and owner of Fit-Nez in Arlington, Virginia. Sobczak was born in Miami to Cuban refugees and has been a nutritionist for 15 years, specializing in weight loss, hormone management and emotional and crisis eating.

While USDA guidelines can’t account for every food culture, Sobczak said, they could be more inclusive. And while she can’t create a new food pyramid overnight — it’s a more complicated process than one would think — she tries to teach people of color how to eat better.

, a Boston-based organization, has been trying for decades. It first developed a Mediterranean food pyramid in 1993 and has since created charts for African, Latin American and Asian diets, as well as ones for vegetarians and vegans. It also offers classes, such as a six-week Taste of African heritage program. Kelly Toups, director of nutrition at Oldways, said the organization also participates in sessions with the USDA. But not much has changed.

“It would be great to see more cultural representations more explicitly shown in the guidelines,” she said.

Why has it never happened? Partly because the process is elaborate: A government committee of about 20 scientists and health experts study the National Health and Nutrition Examination Survey. The attempts to discover what people are eating and how healthy they are. The interviews, conducted in either English or Spanish, leave out Americans who speak .

Next, the committee conducts “” by looking at different food groups, the nutrients they provide and how much of each group is needed at each stage of life to establish recommendations.

These recommendations are set by age and gender but do not consider variables such as ethnicity, geographic location or access to healthy foods. “If I had to guess, you’re mostly looking at things that are available in typical grocery stores in the U.S.,” said Sarah Reinhardt, the lead food systems and health analyst in the food and environment program at the Union of Concerned Scientists.

In July the USDA released a whopping 835-page that formed the basis for the 2020-2025 Dietary Guidelines, released at the end of December.

Wait, there’s more. The federal committee also examines piles of food research. But it cannot evaluate research that isn’t available. Vegetarian and Mediterranean diets have been rigorously examined, but not many studies are looking at West African or Native American diets, for example.

The USDA acknowledges this gap. In the 2020 report, the members highlighted the issue. “Nutrition science would benefit from scientists in the field conducting primary research in more diverse populations with varying age groups and different racial, ethnic and socioeconomic backgrounds,” a USDA spokesperson said.

Still, the food industry dominates and guides the discussion. Due to a lack of public funding, Reinhardt said, a lot of nutrition research is funded by industry. “Science isn’t unbiased. It really depends on who is setting the agenda,” she said.

One issue is that the African American diet isn’t a monolith. “There are many immigrants in this country who are Black but hail from different cultural backgrounds,” Edosomwam said.

For instance, the African diet involves lots of tubers — things like yams and cassava, she said. But some African American diets, especially those traced back to slavery, are based on the “soul food” concept, which comes from the practice of making meals from leftover scraps that slave owners would allow them to eat — foods such as pig intestines, called chitterlings.

“Cultural foods and traditions matter,” she said. But part of the challenge is helping people “reimagine these dishes to make them healthier by changing the ingredients and creating new traditions.” Unfortunately, she added, “there’s no plant-based substitute for chitterlings.”

This article first appeared on Ñî¹óåú´«Ã½Ò•îl Health News and is republished here under a .

The industry’s destination festivals had excluded many diverse performers and types of music, she said, adding: “Urban music is so much more than what we hear on the radio.”

Although the COVID crisis dealt a blow to entertainment events worldwide, it also gave birth to new channels of entertainment. Netflix, Fever and Secret Cinema joined forces to create the ,” an immersive drive-thru concept that leads patrons through the world of the Netflix series “Stranger Things” from the safety — and distance — of their cars. A R I Z O N A, a band signed by Atlantic Records, performed an immersive livestream concert from Nashville on Oct. 29 through mySongbird, a new live-performance streaming app. Comedian Dave Chappelle has been hosting at Wirrig Pavilion in Yellow Springs, Ohio, since May.

And Selico’s Helix Festival seemed primed for the COVID era.

Her goal was to feature less-mainstream offerings in a protected Caribbean environment — reportedly more affordable this year because COVID-19 has greatly eaten into conventional tourism. The lineup included , a Bermuda-born DJ based in the U.S. known as Collas who fuses Caribbean carnival music with electronic dance, Nigerian-American Afrobeats star Davido, and contemporary R&B/hip-hop artist Ty Dolla $ign.

“It’s called Helix Festival because we’re talking about our DNA,” said Selico, a University of Southern California graduate and health care administrator in Los Angeles. The festival was scheduled for October and sales were hot, with tickets in the $1,800-$3,000 price range.

Of course, with the pandemic spreading, Selico realized that festival patrons would see more health and safety precautions implemented. That could mean limited-capacity tickets with potentially higher price tags, suggesting that, in turn, artists and promoters would have to offer more of an experience in exchange for those sales.

At USC, Selico majored in cultural arts, with an emphasis in classical voice. She loved singing opera but felt shut out of the operatic world due to race. As a Black woman, she said, she felt pressured to fit into the limited mainstream molds Black artists are often pressed into: mainly hip-hop and R&B. She created Helix Festival to elevate and broaden the urban music menu.

Selico had been planning the luxury, urban music festival for two years before the pandemic hit. Because the festival was designed to be high-end, boasting private accommodations for attendees, she and her crew pushed forward with planning and promoting through the summer months, even as established festivals were canceling (many not offering refunds). “We’ll be on lockdown for two weeks, then two weeks turns into two months … but the ticket sales continued and no one’s asking for refunds,” she said.

Some large festivals such as Tomorrowland — a two-week-long Belgian electronic dance music festival — went fully virtual using streaming services, but Selico’s was planned for overseas, on an island — Jamaica — with a low COVID case count. And at an expansive resort — the Bahia Principe Grand in Runaway Bay — where safe outdoor enjoyment and social distancing seemed plausible.

The festival’s COVID-19 precautions were developed using the same protocols established by Jamaica’s Ministry of Tourism, Ministry of Health & Wellness (MoHW), the Jamaica Tourist Board and the Tourism Product Development Co. From intake to departure, Selico said, coronavirus precautions would be in place.

She knew she would have to orchestrate her first festival with more precautions than any prior such event and less of a fun-filled, devil-may-care attitude: “If someone gets dehydrated and passes out, we’ve got to test them for everything now,” she said.

Because of the setting, Selico reasoned that COVID-era safety adjustments wouldn’t seem onerous. Even before the pandemic, a luxury component of Helix was private beach “pods” for patrons spaced at least 6 feet apart for lounging on the beach. And “everything is digital,” she said. There would be no exchange of physical money or tickets at Helix Festival, similar to procedures restaurants across America are adopting, along with doing away with physical menus.

She put extra safeguards in place:

• Attendees would be required to submit negative COVID test results 48 hours before arrival and, in lieu of rum punch, would be greeted with temperature checks at the airport, at other transit points and before entering the festival grounds. Face masks would be required on all trips to and from the airport and resort.
• If an attendee exhibited COVID-19 symptoms, the Helix Festival site stated, they would be moved into a designated isolation room at the venue for screening by a COVID-19 Safety Point Person — an employee designated to conduct spot checks, which the Jamaican government now requires of both the hotel and festival organizers. The MoHW would be contacted and, if necessary, the attendee would be put into mandatory quarantine.
• During concerts, guests would be seated in every other seat in all open seating areas, while groups who arrive together could sit next to one another. A minimum distance of 6 feet would be maintained between patrons and performers on designated stage areas, an easy feat considering the Helix Festival’s main stage was to be set in the middle of a small bay on the resort.
• For an even more enhanced luxury experience, and elevated social distancing, guests could purchase such upgrades as a VIP cabana for up to six people, or for $6,000 guests could rent a private catamaran — the festival’s version of box seats — for up to 10 people, docked around the floating stage.

When patrons weren’t getting their urban music palates expanded by acts on the main stage, would feature visual artists, fire dancers and even a hologram light show presented by , a 3D designer with Nike. These activities — including any water sports — would be limited to follow social distancing requirements, the festival’s site stated.

According to the festival site, no food or beverages would be sold on festival grounds — another break from pre-COVID music festivals. Prepaid top-shelf liquor and snack boxes would be prepackaged and individually sealed before distribution at check-in. Hand-sanitizer stations would be strategically placed throughout the festival grounds, as well as touchless waste bins.

As of Dec. 10, Jamaica — the fourth-most-populous country in the Caribbean — had seen over , according to the government’s ministry of health and wellness website. Currently, travelers to Jamaica must apply for , including an upload of the results from a valid PCR test performed no more than seven days from their arrival date.

With the average ticket pricing starting at around $2,000 and no sure way to guarantee attendees would be permitted across the Jamaican border or quarantined, in late August Selico decided to postpone the festival until fall 2021. Tickets to the nearly sold-out event were refunded at 100%. “We’re going to add more artists. We’re going to be able to expand on this health care aspect,” Selico said.

And, since COVID-19 is likely to be around for a while, vaccine or not, she is confident she has developed the expertise to be a pandemic-friendly festival promoter. “I think this is the model for festivals going forward,” Selico said.

This article first appeared on Ñî¹óåú´«Ã½Ò•îl Health News and is republished here under a .

“Stay home!” another user replies.

The Facebook group called “” has been flooded with pointed, exasperated comments urging travelers to stay away. This is a marked change. Before the pandemic, the exchanges between vacationers and island residents resonated with promises of excitement and fun. Now, tour operators from the mainland who administer the Facebook page quickly try to delete any expressions of anger.

In nearby Puerto Rico, the friction has spilled into real life. have detailed multiple episodes in which tourists, having escaped pandemic restrictions back home, became violent and destroyed store merchandise after being asked to wear a mask.

The COVID-19 pandemic has pitted economic interests against public health guidance all across the United States. Puerto Rico and the Virgin Islands feel this tension acutely, as both U.S. territories rely on tourism to generate revenue and provide jobs. Increasingly, locals have begun to wonder now if welcoming visitors to these islands is worth the risk.

Tourism represents more than half of the Virgin Islands’ gross domestic product. In Puerto Rico, the industry accounts for 80,000 jobs and about 6.5% of the island’s total economy.

But islanders are not only vulnerable to COVID-19’s economic disruptions. Residents of both Puerto Rico and the Virgin Islands are diagnosed with chronic health conditions like diabetes and cardiovascular illness at higher rates than in most U.S. states, which puts them at higher risk for the virus’s complications.

In short, the very industry that represents an economic lifeline for islanders threatens their ability to protect their health.

One Step Forward

When COVID-19 triggered alarms in late winter, Puerto Rico and the USVI adopted strong COVID prevention strategies before most U.S. states did.

In Puerto Rico, Gov. Wanda Vázquez issued an executive order, effectively locking down the island by imposing a curfew, a stay-at-home order and business closures. The first coronavirus cases on the island were reported March 13.

Similarly, Virgin Islands Gov. Albert Bryan Jr. issued prohibiting hotels, villas and other accommodations from accepting leisure guests between March 25 and June 1. The area remained open to business travelers, flight crews, health officials, emergency personnel, government guests and residents. According to a March 20 Department of Health , the territory had — at that time — six confirmed COVID cases and 43 pending test results.

Neither territory, however, was able to close its airports. Local officials do not have the authority to do so because the federal government regulates aviation.

“Part of the challenge of being a U.S. colony, in particular, is that, you know, we don’t have control over our borders,” said Hadiya Sewer, president and co-founder of St. JanCo: the St John Heritage Collective, a cultural heritage preservation and land rights organization on the small island of St. John, U.S. Virgin Islands.

Still, the aggressive measures — while effective — came at a price for residents like Melina Aguilar.

Before the lockdown, the 31-year-old entrepreneur worked as a tour guide for Isla Caribe, a company she founded that offers historical walking tours of Ponce, Puerto Rico. The stay-at-home order in March shut down Aguilar’s business for three months and sequestered her in her house.

Aguilar said the sacrifice would have been worth it if the island could have maintained control of the spread by closing the border and enforcing the 14-day quarantine for travelers. It didn’t work out that way. According to from The New York Times, the seven-day average for cases on May 1 — while Puerto Rico was still in lockdown — was 42 cases per day. On July 1, the seven-day average was 102 cases. By July 15, the average was 233.

“We could’ve basically had the fruits of being locked up for three months,” Aguilar said. “But now we’re stuck.”

Reopening the Gateway

By summer, both territories were itching to get back to business. With many overseas vacation destinations banning U.S. travelers, it seemed like the nearby mainland would be full of beachgoers, who, after living under stay-at-home orders for months, would be ready to travel — no passport required — to the sun and sand.

The U.S. Virgin Islands formally welcomed tourists back to its shores on June 1 — with caveats. Travelers from coronavirus hot spots needed to submit COVID-19 test information through an to receive a negative result “certification code.” Those who didn’t were required to quarantine for 14 days or until they had documentation of a negative test result.

But locals and tourists alike said COVID enforcement measures haven’t been consistent. Capt. Matthias Bitterwolf, owner of Antillean Yacht Charters on St. Thomas, said he delivered a boat to Puerto Rico and was not allowed off the vessel until local police could verify his COVID paperwork. His COVID status was not checked upon returning to St. Thomas.

The Virgin Islands’ case counts soon began ticking up. Between June and mid-July, the case count increased by more than 3,500%, according to one.

Gov. Bryan responded by issuing other to regain control of the outbreak, including prohibiting beach visits after 4 p.m. and not allowing patrons to stand or eat at bars located in restaurants. As of Aug. 24, the USVI had a total of .

Puerto Rico formally welcomed tourists on July 15 while still imposing some COVID-related restrictions. As in the Virgin Islands, officials required travelers to present documentation of a negative COVID test result upon arrival.

Dr. Victor Ramos, president of the island’s medical association who is involved with the, said these decisions tended to expose the rift “between the medical task force that favors closing things and the economic task force that wants to leave everything open.”

By July, the local economy was in shambles. The Department of Labor reported over 21% of the island’s workforce was receiving unemployment assistance related to the pandemic in the .

But rising case counts attributed to travel prompted local officials to encourage that only essential travel be allowed. As of Aug. 24, had recorded over 30,700 COVID cases and at least 395 deaths, according to the New York Times database.

Government data, though, indicated Puerto Rico’s climbing case numbers were not being triggered by tourists. They are not the culprits, insisted Leah Chandler, chief marketing officer of Discover Puerto Rico, the island’s official tourism website. Rather, the spread was linked to island residents coming home after visiting COVID hot spots like Texas and Florida.

Life on the Ground

Despite the global pandemic and the restrictions, both territories have experienced no shortage of vacationers. “We would have expected this to be a slow moment for us in terms of tourism,” said Sewer. “It’s very busy.”

Still, the trend lines for COVID case counts weren’t moving in the right direction for either territory, so it was no surprise when Puerto Rico closed days after reopening and the USVI followed suit on Aug. 19.

The underlying socioeconomic and health issues put residents in both places at high risk. It’s not just the prevalence of chronic health conditions like diabetes and cardiovascular disease. The high number of multigenerational households in both areas complicates a family’s ability to socially distance from its most vulnerable members. Roughly of the population in Puerto Rico and the Virgin Islands is age 65 or older, and poverty is widespread.

At the same time, both territories have limited health care infrastructure — making it difficult to envision that they can care for their own populations in an emergency let alone visitors who could become ill and island-bound if the virus were to surge.

Currently, the USVI has two main hospitals — one in St. Thomas and one in St. Croix — and a health clinic in St. John. The territory has 20 intensive care unit beds and about 100 one-time-use ventilators for its residents, said Justa Encarnacion, the USVI’s health commissioner. Each island has about 30 full-capacity ventilators.

In Puerto Rico, about of the island’s ventilators for adults were available as of Aug. 24. However, ICU beds are harder to come by, said Ramos. They are filled with COVID patients and those whose conditions worsened after avoiding care out of fear of catching the virus, he said.

The string of problems that have besieged these islands magnifies the effects of the pandemic. That includes debt crises and infrastructure damage from hurricanes and earthquakes. Island residents also fear the possibility of battling a hurricane and a coronavirus outbreak at the same time — a reality that they’ve already confronted when COVID hampered the USVI’s emergency management agency’s ability to distribute sandbags ahead of a storm in .

Colorado State University hurricane researchers predict an 2020 Atlantic hurricane season.

“At this point, we literally have disasters layered on top of disasters,” said Sewer, of the St. John’s Collective.

Still, Joseph Boschulte, tourism commissioner for the Virgin Islands, is cautiously optimistic about finding a balance between health and economic interests.

“We appreciate the concerns of our tourism partners and stakeholders,” he said. But with the spike in cases, he said, “we must reset, take stock, safeguard human life and prepare for restarting our tourism economy at a later date.”

This article first appeared on Ñî¹óåú´«Ã½Ò•îl Health News and is republished here under a .