A study shows that when a wife out-earns her husband, she downplays her income while he exaggerates his
A new study finds that many spouses would prefer to keep that fact on the down-low. Researchers analyzed Census Bureau data and discovered that in heterosexual marriages where the wife out-earns her husband, both spouses misreport in census surveys how much they actually make.
In these cases, both spouses tend to exaggerate the husband's income while deflating the wife's earnings.
The study, co-authored by Marta Murray-Close and Misty Heggeness, found that husbands who earn less than their wives reported their income to be 2.9% higher than what was on their tax returns. However, researchers found that wives inflated their husband's earnings even more than the husband did.
When it comes to reporting the wife's income, the opposite was true.
While both spouses downplayed the wife's salary in census surveys -- reporting her income to be 1.5% lower than what she actually earned -- they found husbands tended to underestimate their wife's income more than she did.
Of the couples the authors analyzed, almost 1 in 4 were in marriages where the wife was the primary breadwinner.
So why are spouses fibbing about how much they make?
According to Murray-Close, there's a psychosocial explanation for the behavior.
"Survey researchers have long known that peoples' desire to present themselves in a positive light may lead them to understate socially undesirable behaviors and overstate socially desirable behaviors," she said. "Some people who give inaccurate answers on surveys may know they're distorting the truth, but many people probably do it unconsciously."
The researchers say the findings show how stubborn societal norms -- in this case, the idea of a "traditional" marriage, where the husband is the primary financial provider -- can seep into how we self-report on surveys.
"Our findings suggest that social norms and expectations haven't completely caught up with contemporary work and family arrangements," Murray-Close said.
A transgender woman says a pharmacist refused to fill her hormone prescription
The treatment would spur the physical changes in Hall's body that would reflect her identity as a transgender woman, she said.
"I was finally going to start seeing my body reflect my gender identity and the woman I've always known myself to be," she said.
Her elation quickly turned to anxiety when the pharmacist refused to fill her prescription and humiliated her in front of other customers, she said.
Hall said she called the CVS customer service line twice. When no one addressed her concerns, she decided to file a complaint with the Arizona State Board of Pharmacy on Thursday.
In a statement to CNN, CVS said the pharmacist violated company policies and is no longer employed.
"We also apologize for not appropriately following up on Ms. Hall's original complaint to CVS, which was due to an unintentional oversight, " the statement added. "We pride ourselves in addressing customer concerns in a timely manner and we are taking steps to prevent this isolated occurrence from happening again."
CVS has a perfect score on the Human Rights Campaign's (HRC) Corporate Equality Index, which ranks businesses based on their support for LGBTQ equality.
What Hall says happened
The pharmacist did not give Hall a clear reason for the refusal, she said in a blog post describing the encounter published on the American Civil Liberties Union's website.
"He just kept asking, loudly and in front of other CVS staff and customers, why I was given the prescriptions," she said.
"Embarrassed and distressed, I nearly started crying in the middle of the store," she wrote. "I didn't want to answer why I had been prescribed this hormone therapy combination by my doctor. I felt like the pharmacist was trying to out me as transgender in front of strangers. I just froze and worked on holding back the tears."
In addition to an apology from CVS, Hall also sought an assurance that they do not condone discrimination against transgender customers -- or anyone else for that matter.
"My family supports me, fortunately, and helped me work through the anger and humiliation this experience caused," she wrote. "But many other transgender people are not as fortunate as I am. I don't want to think about what might happen if this pharmacist mistreats a transgender person who does not have a good social support system."
CVS, for its part, made good on both requests. The chain said the pharmacist's action "does not reflect our values or our commitment to inclusion, nondiscrimination and the delivery of outstanding patient care.
"CVS Health extends its sincere apologies to Ms. Hall for her experience at our pharmacy in Fountain Hills, Arizona last spring," the company said.
ACLU Senior Staff Attorney Joshua Block said the assurances from the pharmacy chain are important at a moment in time when the Trump administration has signaled its intent to roll back health care protections for transgender and non-binary individuals.
"No one should be denied health care because of who they are," Block said. "It is critical that CVS ensures no one is harassed when taking a valid prescription into one of their pharmacies."
More than 36 kids die in hot cars every year and July is usually the deadliest month
The tragedy can happen almost anywhere, and while hotter months are always the riskiest, the circumstances surrounding child vehicular heatstroke are varied.
Hot car deaths are a consistent problem
According to the safety organization Kids and Cars, an average of 37 children die each year in hot cars. These include instances where a child has been forgotten in a car, accidentally locks themselves in a car or trunk, or, in a small number of cases, when a child has been intentionally left in a car.
NoHeatStroke.org, a data site run by a member of the Department of Meteorology & Climate Science at San Jose State University, has been collecting data on these incidents since 1998. Since that time, the highest number of deaths per year was in 2010, with 49 deaths. 2015 had the lowest rate of incidents, with 24. 2017 was also an unusually deadly year, with 42 recorded deaths.
It can happen anywhere
It seems obvious that states with the highest temperatures are usually where the most deaths by vehicular heatstroke happen, but there have been instances recorded in nearly every state.
According to NoHeatStroke.org, Texas had the most such deaths from 1998 to 2015, with 100. Florida had 72 deaths, California had 44, Arizona had 30 and North Carolina had 24.
It should be noted that these figures do not adjust for population, so a larger state such as Texas or California may, statistically, have more deaths regardless of climate.
Summer always brings an onslaught of deaths
The hottest months inevitably bring the highest numbers of hypothermia incidents, so summer, late spring and early fall are the most treacherous times. As of July 20, 26 children have already lost their lives this year in hot car death incidents.
On July 18th, a 3-year-old boy in Houston died when he was left in a bus after a day care field trip. Records from the day care show the boy had erroneously been accounted for as the group reassembled after the trip. By the time the deadly oversight was realized, he had been in the bus for at least three and a half hours. When police arrived, the temperature in the bus was 113 degrees.
Earlier this year, in May, a 1-year-old girl died in Tennessee after her father forgot to drop her off at her daycare before heading out of town on a business trip. He parked his car in the family's driveway with the daughter still in it, and then used a ride share service to depart for the trip. This sort of situation -- where a parent or guardian forgets a child because of a lapse in temporal memory and a disrupted routine, is very common.
Younger children are more at risk
A vast majority (87%) of vehicular heatstroke victims are 3 or younger. More than half (55%) are 1 or younger. As Kids and Cars' research notes, the prevalence of backseat safety seats, especially rear-facing ones, may account for the young age of most victims, since the children are out of the driver's view and can't effectively communicate.
Laws governing the circumstances vary
While leaving a child in a hot car can certainly bring about serious legal charges, only 19 states have concrete laws on the books that make it illegal to leave a child alone in a car in the first place.
Most of these laws refer to either "leaving a child unattended" or, more broadly, "endangering a child."
Kids and Cars reports 15 other states have proposed similar laws.
However, most organizations that combay child vehicular heatstroke argue that such laws aren't what prevent hot car deaths, since they are almost always accidental. Kids and Cars supports several initiatives to encourage awareness and communication among drivers and caregivers.
Additionally, many states have Good Samaritan laws that protect citizens if they intervene, reasonably, in an emergency or life-threatening situation.
Children are especially at risk because of their biology
There are some physiological differences that make children especially susceptible to heat stroke. Here are some important facts to illustrate why vehicular heatstroke is such a problem:
Kids aren't built for heat: Children's body temperatures rise 3-5 times faster than adults.
Seconds count: The temperature of a car can climb 20 degrees in 20 minutes.
It doesn't have to be hot: Heatstroke can occur in the shade, with the windows down, and even at temperatures as low as 57 degrees.
Foodborne illness may be on the rise. Here's why
A 17-year-old paid the ultimate price when he ate two hamburgers "with everything, to go" and died days later.
These are the stories behind the faces on the "Honor Wall" of Stop Foodborne Illness, the national nonprofit that represents and supports those who suffered a drastic consequence following the most ordinary act: eating.
It's the "wakeup calls along the way" that prove to the industry "how imperative a strong food safety culture is," said Mike Taylor, co-chairman of the nonprofit's board and a former deputy commissioner for foods and veterinary medicine at the FDA.
Foodborne illness hits one in six Americans every year, the US Centers for Disease Control and Prevention says, estimating that 48 million people get sick due to one or another of 31 pathogens. About 128,000 people end up in the hospital while 3,000 die annually.
Globally, almost 1 in 10 people are estimated to fall ill every year from eating contaminated food and 420 000 die as a result, according to the World Health Organization.
Preventing foodborne illness in the United States is the job of the US Department of Agriculture's Food Safety and Inspection Service, which oversees the meat, poultry and processed egg supply, and the US Food and Drug Administration, responsible for domestic and imported foods.
With frequent news of outbreaks, which are investigated by the CDC, many people might wonder whether foodborne illness is on the rise -- and whether safety measures across the nation adequately protect our food supply.
Is foodborne illness on the rise?
Matthew Wise, deputy branch chief for outbreak response at the CDC, said the agency usually gets "about 200 illness clusters" to evaluate each year. Wise described these clusters as "potential outbreaks."
"Outbreaks are the very, very, very end of a long process," he said. An outbreak investigation includes collecting evidence, confirming an illness-causing pathogen and tracing contacts; most of this work is performed by state health departments, though it is coordinated by the CDC.
Only about 15 of the 200 illness clusters investigated each year turn out to be actual outbreaks. As of Thursday, the CDC has declared 13 multistate outbreaks so far this year.
Preliminary data from the most recent CDC FoodNet report -- which documents trends in foodborne illness outbreaks -- hints that some forms may be on the rise: "The overall number of Campylobacter, Listeria, Salmonella, Shigella, Vibrio, and Yersinia infections diagnosed ... increased 96% in 2017 compared with the 2014-2016 average."
Catherine Donnelly, a professor of food science at the University of Vermont, said this increase may be partly due to improved tools both for detecting contamination in food and for outbreak surveillance, reporting and investigation.
"Surveillance has drastically improved, and state public health labs are linked to databases at CDC, allowing quick identification of patterns of illness and links to food products. As a result, we see more reports of foodborne illness," Donnelly wrote in an email.
Her view is widely shared; Taylor agrees but said the question of whether foodborne illness is increasing is a "complicated" one.
"In some areas, like E. coli O157:H7, concerted strategies by government and industry have sharply reduced the number of illnesses associated with that pathogen," Mike Taylor said. O157:H7, a particularly harsh strain of E. coli, causes bloody diarrhea and sometimes kidney failure or even death.
Still, reductions in salmonella, listeria and other key pathogens have not occurred, he said.
Reported outbreaks may have fewer cases today than in the past, Taylor said. The ability to detect outbreaks more rapidly, due to whole genome sequencing, also means the CDC can follow through and contain an outbreak more swiftly.
Donnelly notes that the proportion of Americans considered to be at risk for foodborne illness is also increasing -- yet many people do not know or understand that they might be at risk, she said.
"Pregnant women, the elderly and persons with suppressed immune systems due to cancer treatment, diabetes, liver and kidney disease are just a few examples of conditions that increase the risk for foodborne illness," Donnelly said. "Young children are also vulnerable to developing serious illness from foodborne disease."
Outbreaks are also influenced by seasonal and environmental factors, she said.
"We do see more outbreaks of foodborne illness reported in the warmer summer months, where opportunities for food abuse arise [leaving foods unrefrigerated for periods of time, for instance]," she said. Flooding from storms has been associated with fresh produce outbreaks, while Vibrio illness linked to eating oysters may occur as a result of rising ocean temperatures.
The bottom line, Taylor said: "We have too much foodborne illness. It's largely preventable. There's a lot that has been done to reduce risk, and there's a lot more that can be done."
All of safety, though, begins with an understanding of our food system.
The US food system is, in a word, global. "The reality is that there's a ton of movement of food into and outside the US," Wise said.
The volume of imports from all over the world contributes to the risk of foodborne illness because it is challenging to oversee all this diverse activity, Taylor said.
"Some 95% of the seafood consumed in the US is imported; 50% of the fresh fruit and about 25% of the vegetables are imported," he said.
"People are tending to eat more produce and eat it in different forms, and those are good things, because we want people to eat more fresh produce, but when that happens, you're likely to increase the risk," Taylor said. This risk is due to the fact that fresh produce is "sold and prepared without any kill step," such as cooking or canning, which can destroy illness-causing germs.
Wise also noted a new wave of foodborne illness due to sprouted products, such as chia seeds, as well as "commercially produced raw products that are popular." Still, he said, the main question behind any outbreak -- how did the food get contaminated? -- is not a question the CDC can answer; it is the job of regulators and industry.
"Foods travel longer distances to get from farms to consumers, and pathogens can be introduced along the way," Donnelly said. "There is wider geographic distribution of centrally produced foods, so when something goes wrong during production, the impacts are widespread.
"Many outbreaks linked to poultry, eggs and meat can be traced back to farms where intensive production practices can lead to [the] spread of highly virulent pathogens," she said, while some are reflective of "poor food handling practices."
But it's not just one or some areas of the food system that are at issue, it's the entire evolving system, Taylor said. "There are lots of different changes in the food system that affect risk over time, and so the food safety problem, therefore, evolves over time."
A culture of safety
Among the most significant wakeup calls for the entire food industry was the 1993 E. coli outbreak from contaminated beef patties at Jack in the Box. Four children died while 178 others sustained permanent injury, including kidney and brain damage. Sometimes called the "9/11 for the meat industry," this event is what inspired the formation of Stop Foodborne Illness, Taylor said.
"Since Jack in the Box, there's just been enormous development of the understanding of the practices, the interventions that can work to reduce hazards," Taylor said. For example, industry has focused on practices that can reduce pathogens on processing equipment and using microbial testing in food production systems to verify sanitation.
Many food companies have adopted "a best-practices continuous-improvement sort of philosophy," he said. This comes down to "doing everything you can through the technology you're using, the practices you're using, the training that you're using, the way in which you're motivating employees. Are you doing everything you can so that every day, the right thing is happening?"
A culture of self-improvement is also what allows some companies to embrace the message delivered by Stop Foodborne Illness, which focuses on the vital importance of food safety.
"People actually die. People actually have their lives permanently changed with severe illnesses," Taylor said. Leaders of companies use stories from the Honor Wall to motivate their employees and reinforce why it is so important for everyone to do the right thing every day to reduce the risk of illness from contaminated food.
"There's no magic wand. It's a day-in, day-out process," Taylor said.
Industry may play the leading role, but the government must also perform at a high standard.
The politics of safety
The Food Safety Modernization Act became law in 2011.
The act "is still being implemented, but it basically codified this principle that everybody responsible for producing food should be doing what the best science says is appropriate to prevent hazards and reduce the risk of illness," Taylor said. "So we're moving in the right direction."
Under the new requirements, state governments will be the frontline inspectors and overseers and supporters of food safety compliance for produce at the farm level, Taylor said. "They need resources to do that. There started to be resources available, but that funding is incomplete."
Also under the act -- and for the first time -- the FDA will directly oversee the importers and evaluate whether they have in place the newly required foreign supplier certification program, Taylor explained. The program requires that importers know their foreign sources of supply (and their practices) and verify that suppliers are meeting US requirements.
The FDA's greatest challenge, then, is that there are about as many overseas facilities registered to manufacture and sell food here as there are US-based facilities, Taylor said.
"Congress has gotten about halfway to what it said was needed to successfully implement" the act, Taylor said. Although it is still being phased in, the funding is incomplete.
"The commissioner of FDA, Scott Gottlieb, is supportive of FSMA," Taylor said. "He's continuing all those things that we've been doing during the previous administration and pushing forward on them. It's not for lack of commitment and effort and FDA folks wanting to charge forward.
"Historically, food safety and nutrition have never been adequately funded at FDA," Taylor said, based on his experience at the agency from the 1970s through 2016.
Donnelly said that "Beyond budget, there is a lack of trained food inspectors at FDA. Food companies complain that FDA's approach to inspection is punitive, versus a more educational approach taken at [USDA], where on-site inspectors work with food processors to assure safe food production."
Meanwhile, lawyers have replaced government scientists at the FDA in many instances, and so there is a lack of understanding of how certain foods are produced, she said.
"Without knowledge of production practices, it is difficult to offer guidance to processors to effectively manage risks. This is why education is key," Donnelly said.
"As consumers demand more products that are fresh and locally produced, providing more hands-on education to producers to effectively manage risks can help produce safer foods," she said.
Consumers also play a role in food safety well beyond their "demands" and purchases.
"This story is not complete if we don't remind consumers they are part of the food system as well," Taylor said.
The fifth pillar
The five pillars of foodborne illness prevention are farms; processing; transportation and storage; retail; and consumers, Taylor said: "It's everybody's problem and everybody's solution at the end of the day."
Donnelly noted that "the percentage of overall foodborne disease outbreaks linked to restaurant settings increased to 60% in 1998-2015, while outbreaks reported in the home dropped significantly to 8%."
"Consumers with compromised immune systems need to reconsider their food choices," she said. "As consumers age, their immune systems become less functional, increasing their risk. In a recent Listeria outbreak involving cantaloupe, the median age of persons who developed illness in the outbreak was 84."
Wise said that whenever an outbreak occurs, the CDC repeatedly asks itself: "Have we reached a point to communicate?"
"If I go home and I think that there's something I should tell to my mom or my wife about not eating, then that should be in the public domain at that point," he said. "We do tend to communicate when we have identified a product with enough specificity that would allow someone to be able to take an action."
In each outbreak communication, the CDC informs the public about where sickness is occurring, the severity of illness, symptoms and product recall information, if any. It helps when people who believe that their own illness may be part of an outbreak talk to their doctors.
"People should know that there's a lot of high tech, high-powered science going into figuring out how to do better at preventing foodborne illness," Taylor said. "People should know that the system -- government and industry -- they're not just sitting back."
Is sparkling water as hydrating as regular water?
If that's all you needed to know, you can stop reading. But if you want to know why, enjoy this cool, refreshing glass of explanation.
Sparkling water contains carbon dioxide, either naturally or added, which provides the carbonation, explained Melissa Majumdar, a registered dietitian, personal trainer and spokeswoman for the Academy of Nutrition and Dietetics.
But whether a beverage is carbonated has little effect on how well it keeps you hydrated, according to Ronald Maughan, a professor at the School of Medicine at St. Andrews University in Scotland and author of a recent study comparing the hydrating effects of beverages including still water, sparkling water, milk, colas, juice and coffee.
"The presence of carbonation has little effect on the body's response to ingested water," Maughan said. "We know that most of the gas comes out of solution in the stomach." An increased volume may slightly speed how quickly the beverage is emptied from the stomach and then absorbed in the small intestine and ultimately excreted from the body, he explained, "but the effect is small."
"Since water and carbonated water have the same base ingredient, they are in theory equally hydrating," Majumdar said. However, carbonation may affect how much water is actually consumed. "Some people find having the bubbles or a flavor help them drink more, while others feel full and bloated and may drink less with carbonated waters."
Other factors of carbonated drinks, aside from carbonation, can affect hydration. For example, waters with sugar, other nutrients or electrolytes are more hydrating than plain water or plain carbonated water.
"Adding large amounts carbohydrates or fat [such as natural sugars in orange juice or the fat in milk] will slow gastric emptying," Maughan said. Additionally, sodium (aka salt) in beverages acts like a sponge to hold water in the body. Potassium has been less well-studied than sodium, but there is some evidence that it can also help promote water retention in the body, according to Maughan.
So athletes who sweat a lot might be better off drinking lightly sweetened beverages or drinks with electrolytes -- but not necessarily carbonated beverages.
"During exercise, flat or still water is best," Majumdar said. That's because carbonation may cause bloating during physical activity and can prevent an athlete from drinking enough. Non-carbonated water is also best for anyone recovering from gastrointestinal surgery or for patients who feel full sooner than normal, Majumadar explained.