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July 17, 2026
Reprogramming The Panic: Choosing Conscious Response Over Avoidance
Our nervous systems are made to keep us safe from danger—but what happens when they’re responding to threats that no longer exist? Writer Catherine Swett explores how we can meet these disruptive moments with sovereignty over avoidance, and over time teach our nervous system how to respond to discomfort and anxious moments.
The Trap of Avoidance

People often say, “I have anxiety. I cannot do crowds.” For a long time, I believed that was my whole story. But looking back, it was not just anxiety. It was avoidance. Every time I avoided, I quietly reinforced the fear.

Anxiety is not a monster outside of me. It is my body and brain sounding alarms. The problem is the software is outdated. It is coded from times when my body truly could not escape real threats.

Anxiety is not a monster outside of me. It is my body and brain sounding alarms. Heart racing, tunnel vision, fight or flight, doing exactly what it was designed to do: protect me from danger. The problem is the software is outdated. It is coded from times when my body truly could not escape real threats.

Reprogramming in Real Time

Of course, this does not mean every internal alarm is false. Sometimes our bodies are alerting us to genuine danger, and those protective instincts deserve our attention. The real work is learning to discern when to trust the alarm and when to question it.

When I walk into a crowd—a situation that might feel overwhelming, but that is actually not dangerous for me—and I feel panic rise, I have two choices. I can avoid it and confirm the fear, or I can walk through it and teach my body something new. I choose the latter. Each time I navigate what my nervous system warns is unsafe, I show it that I am safe.

This is not “just anxiety.” It is real-time nervous system reprogramming. I had to walk through crowds until I proved to my system that I was no longer its prisoner.

There is a line most people are never taught to notice. Avoidance often comes from fear, the kind where you spend your life running and the thing you fear keeps chasing you.

Recognizing the Line Between Fear and Choice

There is a line most people are never taught to notice. Avoidance often comes from fear, the kind where you spend your life running and the thing you fear keeps chasing you. That eventually catches up.

But there is another place. A place where you understand yourself. You recognize the environments, dynamics, and stimuli that activate your nervous system in unsafe ways. And you also know this: if you need to walk through it, you can. You are capable. You are conscious. You are not trapped.

You do not need to constantly expose yourself to triggers to prove resilience.

The difference is that you do not need to constantly expose yourself to triggers to prove resilience. Once you face the root of what makes something destabilizing, you gain the ability to choose if and when that exposure belongs in your life. That is not avoidance. That is conscious choice.

Lessons from Monks: Discipline, Not Detachment

I have thought about this in the context of monks. I used to assume they were peaceful because they were detached, above it all. That was ignorance. Monks feel, think, and experience frustration, desire, and disturbance, just like anyone else.

Healing is not about becoming untriggerable. It is not about enduring everything life throws at you. It is about understanding yourself deeply enough to respond consciously.

The difference is what they choose to subject themselves to. They do not abstain out of fear. They abstain with discipline, because they understand their minds. Peace is not passive. It is actively protected. That protection requires internal work, not constant exposure.

Healing is Sovereignty

Healing is not about becoming untriggerable. It is not about enduring everything life throws at you. It is about understanding yourself deeply enough to respond consciously. Thoughts rise. Reactions flare. Old patterns knock, and that is okay.

A life of avoidance with no self-work is fear in disguise.

A life of avoidance with no self-work is fear in disguise. A life of conscious choice, rooted in understanding, is sovereignty. By locating your perception, observing your nervous system, and noticing patterns in real time, you gain the ability to respond instead of react.

Growth Looks Like This

We know that healing is not linear. There will be ups and downs, and that’s normal. But in general, here are grounding statements that reflect the growth process:
- I do not rush to correct my feelings
- I delay decisions until my nervous system settles
- I let context and awareness arrive before action
By treating perception and reactivity as interfaces, not flaws, urgency becomes information instead of command.

By treating perception and reactivity as interfaces, not flaws, urgency becomes information instead of command. Intensity becomes data instead of danger. Insight alone does not stop the spiral, but noticing the system in motion gives me room to respond instead of react.

By seeing perception this way, I can engage with reality as it is. I can separate the present from the echoes of the past and act with awareness instead of just reacting.
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July 17, 2026
New Research Shows That Where Your Sugar Comes From May Matter More Than How Much You Eat
The Blanket Advice May Be Missing Something Important

Reduce your sugar intake. That guidance appears on cereal boxes, in clinical office handouts, and from well-meaning clinicians in virtually every healthcare setting in the country. The message is not wrong. Added sugar in excess is genuinely harmful, and most Americans consume too much of it.

But a growing body of peer-reviewed research suggests that the blanket instruction to simply “eat less sugar” may be overly simplified and may even lead some people to make dietary changes that are neutral or counterproductive for their cardiovascular health. The critical missing variable, researchers say, is where the sugar comes from.

A series of large-scale studies examining hundreds of thousands of individuals over decades of follow-up has found that the food matrix — the biological, chemical, and structural context in which sugar is consumed — appears to meaningfully influence how the body processes that sugar and what its downstream effects are on heart disease risk.

Why This Matters

Heart disease remains the leading cause of death in the United States, according to the CDC. Diet is one of the most powerful modifiable risk factors for cardiovascular disease. Sugar consumption is one of the most debated dietary variables in cardiovascular research — and the guidance on it has evolved significantly.

The 2026 American Heart Association Dietary Guidance to Improve Cardiovascular Health, published in Circulation, recommends minimizing added sugar in foods and beverages — but it simultaneously emphasizes the importance of whole fruits, dairy, and other foods that naturally contain sugars as part of a heart-healthy dietary pattern. That dual guidance reflects an important distinction that the science increasingly supports: not all dietary sugar creates the same cardiovascular risk.

For anyone tracking grams of sugar on nutrition labels and eliminating whole fruit or plain yogurt from their diet out of concern over sugar content, this research has a direct practical implication.

What We Know So Far

A 2024 prospective cohort study published in Nutrition Journal analyzed data from the UK Biobank — a large-scale biomedical database and research resource containing detailed dietary and health information on hundreds of thousands of British adults. Researchers from the Justus-Liebig University of Giessen, Germany, examined the relationship between different types and sources of dietary sugar and the incidence of cardiovascular disease.

Key findings from that study include:
- Free sugar from beverages showed a significant linear relationship with cardiovascular disease risk — meaning more sugar from drinks translated more directly into higher risk
- Soda and fruit drinks showed the clearest dose-response relationship between consumption and cardiovascular risk
- Fruit juice, while a free sugar source, showed a more complex U-shaped relationship with cardiovascular disease risk — meaning neither very high nor very low consumption was clearly associated with the best outcomes
- Free sugar from solid foods — such as treats, cereals, and baked goods — showed a nonlinear relationship with risk, with the lowest risk at moderate intake levels
- Intrinsic sugars — those naturally present within the structure of whole fruits, vegetables, and dairy products — showed a different pattern: a non-linear descending association with cardiovascular risk at higher intake levels, consistent with protective effects
A 2023 study published in the American Journal of Clinical Nutrition, based on long-term follow-up data from the Harvard Nurses’ Health Study and the Health Professionals Follow-Up Study, reached broadly consistent conclusions. In that analysis of over 80,000 participants followed across several decades, added sugar and fructose from added sugar and juice were associated with higher coronary heart disease risk — but sugar from whole fruits and vegetables was not.

The Food Matrix: Why Context Changes Everything

The concept of the food matrix is central to understanding these findings. When you eat a whole orange, you are consuming not just sugar (fructose and glucose) but also fiber, vitamins, polyphenols, water, and complex cell structures that alter how your digestive system processes the sugar. The fiber slows glucose absorption, reducing blood sugar spikes. The polyphenols have anti-inflammatory effects. The water content affects satiety.

When you drink a glass of orange juice, you consume much of the same sugar with most of the fiber removed. The result is faster glucose absorption, a higher glycemic response, and the absence of the satiety-promoting effects of eating the whole fruit.

When you consume an equivalent amount of sugar from a soft drink, the context is completely different again — there is no nutritional matrix at all, just dissolved sugar and water (or artificial sweeteners in diet versions). The body processes these differently at the cellular, hormonal, and microbiome levels.

This is not a theoretical distinction. It is documented across multiple large prospective studies with thousands of participants and decades of follow-up.

What Doctors and Experts Say

The 2026 AHA Dietary Guidance statement, developed by the American Heart Association, reflects the current evidence synthesis. Amit Khera, M.D., FAHA, vice chair of the AHA dietary guidance writing committee, noted that the connection between sugar-sweetened beverages, hypertension, and cardiovascular risk “is broadly consistent with previous research” — while the same statement recommends consuming vegetables, fruits, and dairy as part of a heart-healthy pattern.

Vasanti Malik, an associate professor of nutrition at the Harvard T.H. Chan School of Public Health and co-author of research in this area, has stated publicly that “sugar-sweetened beverages, such as soda and sports drinks, which are often marketed as somewhat healthy, should be limited.” Regarding juice, Malik has noted that “fruit juice intake may be harmless at low levels yet harmful at higher intake levels. They should always be 100% fruit juice, and even so, consumed only in moderation. Whole fruit should be emphasized over sugary beverages.”

What the Evidence Shows and What It Does Not

This body of evidence is substantial, with long follow-up periods, large sample sizes, and consistent findings across multiple independent research groups. However, all of the studies discussed here are observational — meaning they document associations between diet and cardiovascular outcomes without proving direct causation.

Dietary research faces inherent challenges: people eat many foods simultaneously, dietary recall is imperfect, and researchers cannot fully control for all other lifestyle factors that influence heart disease. No randomized controlled trial has assigned people to different sugar sources for decades and measured cardiovascular outcomes — such a study would be impractical to conduct.

The finding that intrinsic sugars in whole fruits appear to carry less cardiovascular risk than added sugars is consistent across multiple independent studies and is biologically plausible given what is known about fiber, polyphenols, and the food matrix. That consistency across studies strengthens the overall confidence in the direction of the finding.

MedicalDaily Evidence Check
- Primary studies: Schaefer et al., Nutrition Journal, 2024 (UK Biobank, observational cohort); AJCN Harvard cohort study, 2023 (prospective observational)
- What the research shows: Different sources of dietary sugar are associated with different levels of cardiovascular risk; added sugar and sugar from beverages carry the highest risk; intrinsic sugars in whole fruit and dairy show lower or neutral risk associations
- What it does not prove: Direct causation; individual thresholds for harm; that all people will respond identically
- 2026 AHA guidance: Recommends minimizing added sugars while emphasizing whole fruits, vegetables, and dairy as part of a heart-healthy pattern
- Current medical guidance: No major organization recommends reducing whole fruit or plain dairy intake due to natural sugar content
Who Should Pay Closest Attention

The evidence is most relevant to:
- People trying to reduce sugar intake for cardiovascular health who may be cutting whole fruit, plain yogurt, or other naturally sweet whole foods from their diet without realizing those are not the primary risk drivers
- Adults managing prediabetes or type 2 diabetes, for whom the speed of glucose absorption from different sugar sources has direct clinical relevance
- Children and adolescents whose lifelong dietary patterns are being established — the distinction between fruit, juice, and sugary drinks matters profoundly for long-term health
- Adults who consume large quantities of fruit juice as a substitute for whole fruit, believing the nutritional content is equivalent
- People with existing cardiovascular disease, for whom dietary sugar management is a clinically important component of heart health maintenance
Practical Guidance: What to Eat and What to Limit

Based on the current evidence:
- Whole fruit: continue or increase. The sugars in whole fruits come packaged with fiber, water, and bioactive compounds that modulate their effects on the body. Current evidence does not support limiting whole fruit intake for cardiovascular health.
- Fruit juice: moderate. Even 100% fruit juice carries more rapid sugar absorption than whole fruit. Limiting to one small serving (4 to 6 ounces) per day is a reasonable precaution.
- Sugar-sweetened beverages: limit as much as possible. Sodas, sweetened iced teas, sports drinks, and sweetened coffee drinks represent the clearest dietary sugar risk for cardiovascular disease in the current evidence base.
- Plain dairy products: Milk, plain yogurt, and other minimally processed dairy products contain natural lactose, which the evidence does not single out as a cardiovascular risk driver at typical consumption levels. Flavored yogurts and sweetened dairy products contain added sugar and should be evaluated separately.
- Added sugar in processed and packaged foods: This is the category most consistently associated with cardiovascular harm. Label-reading to identify added sugar — rather than total sugar — in packaged foods provides more actionable information for heart health decisions.
What You Can Do Now
- Read nutrition labels for added sugars specifically, not just total sugar. Since 2020, FDA-updated Nutrition Facts labels are required to list added sugars separately from total sugars.
- Replace fruit juice with whole fruit wherever practical. The nutritional benefit is higher, and the cardiovascular signal is clearer.
- Replace sugary beverages with water, unsweetened sparkling water, or unsweetened tea. Even one daily substitution has been shown in multiple studies to reduce cardiovascular risk.
- Do not eliminate plain yogurt, milk, or whole fruit from your diet to reduce sugar intake. These foods are not the primary targets of dietary sugar reduction guidance.
- If you have diabetes, prediabetes, or established heart disease, discuss your specific sugar source choices with your clinician or a registered dietitian who can provide individualized guidance.
Cost and Access: What Patients Should Know

Whole fruits — especially seasonal and frozen varieties — are generally among the most affordable foods in any grocery store. Frozen fruit, which carries the same nutritional profile as fresh fruit at a fraction of the cost, is an excellent option for people on tight budgets. Community nutrition programs, including SNAP (Supplemental Nutrition Assistance Program) benefits, can be used for fresh and frozen fruit purchases.

Registered dietitian consultations for patients with diabetes, cardiovascular disease, or obesity are typically covered by Medicare and most commercial insurance plans. The Academy of Nutrition and Dietetics maintains a searchable directory for patients seeking a credentialed nutrition professional.

What Happens Next

The evidence base on sugar sources and cardiovascular health is expected to continue building. Researchers are particularly focused on understanding how individual metabolic differences — including gut microbiome composition and genetic factors — influence how the body responds to different sugar sources. Personalized nutrition research may eventually allow dietary guidance to be tailored more precisely to individual metabolic profiles.

Updated AHA and USDA Dietary Guidelines, the latter due for revision in 2025 to 2026, are incorporating the food matrix concept increasingly into their recommendations, moving away from nutrient-by-nutrient thinking toward food-pattern-based guidance.

The Bottom Line

Total sugar grams on a nutrition label tell an incomplete story about cardiovascular risk. The source, structure, and food context of sugar matter enormously. Added sugar in processed foods and beverages — particularly sodas and sweetened drinks — carries the clearest cardiovascular risk signal in the current evidence base. Natural sugars in whole fruit, plain dairy, and vegetables appear to behave differently and do not carry the same risk at typical intake levels. That distinction is not a loophole to consume unlimited sugar; it is a refinement that should inform smarter dietary choices: prioritize whole foods, minimize beverages with added sugar, and use total-sugar grams on labels only as a starting point, not a final verdict.
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July 16, 2026
ClinicalTrials.gov: Tuberculosis, Multidrug-Resistant

Source: National Institutes of Health –
Related MedlinePlus Pages: Tuberculosis

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July 16, 2026
The Science Behind Oatmeal and Diabetes
Before Insulin, There Was Oatmeal

Before the discovery of insulin, the lives of many people with diabetes were saved or prolonged by Carl von Noorden’s oatmeal diet. As I discuss in my video Is Oatmeal Good for People with Diabetes?, he published his findings in 1903, which were received with a great deal of skepticism. But the critics were overcome in the following years by the weight of the evidence.

Acclaimed doctor James B. Herrick began to try the oatmeal diet on his patients. Initially very doubtful, he became astonished by the results, which led to the 1909 proclamation that no case of juvenile or adolescent diabetes should be deprived of the benefits of the oatmeal cure.

The great Elliott Joslin, founder of the oldest and largest diabetes clinic in the world, described the effects of oatmeal as “sometimes magical,” calling the oatmeal cure an unsolved mystery, referred to back then as “one of the greatest puzzles in diabetes.” They did have some clues, though. They found that animal protein had to be strictly excluded, as it annihilates the favorable action of oatmeal-type diets.

And now we know, more than a century later, that, indeed, animal protein intake intensiﬁes insulin resistance, which is the cause of prediabetes and type 2 diabetes, whereas plant-based foods enhance insulin sensitivity, which is the opposite.

Is Oatmeal Good for People with Diabetes?

We’ve long known that higher consumption of whole grains, including oats, is associated with a lower risk of diabetes. As I discuss in my video How Does Oatmeal Help with Blood Sugars?, more than a dozen randomized controlled trials found that oats significantly improved both short-term and long-term blood sugar control, in addition to lowering cholesterol levels.

We think the benefits arise from a fermentable ﬁber in oats called beta-glucan. We know one of the underlying cholesterol-lowering mechanisms of oatmeal consumption might be its microbiome-manipulating ability––in other words, having a beneficial effect on our intestinal bacteria.

What’s So Great About the Fiber in Oatmeal?

A little fiber goes a long way. Our good gut flora uses fiber to make short-chain fatty acids that have anti-inflammatory effects. There are dozens of randomized controlled trials showing the types of fiber found in oats and beans can improve long-term blood sugar control in people with diabetes. Why? Because the gut bacteria selectively promoted by dietary fiber intake can help alleviate type 2 diabetes.

The oat fiber itself has been shown to act as a prebiotic, boosting the growth of beneficial bacteria like Lactobacillus and Bifidobacteria. So, between the lack of animal protein, lack of animal fat, and bursting at the seams with prebiotic fiber, it’s no wonder that oatmeal diets grew to become part of the clinical routine in the treatment of diabetes.

How Soon Can You See Results?

As I discuss in my video Oatmeal Diet Put to the Test for Diabetes Treatment, several studies have suggested that a few days of eating oatmeal could have beneficial effects for about a month afterward. In a randomized, controlled, crossover trial, not only did insulin needs drop by about 40% in just two days, compared to just restricting calories alone with a hypocaloric diabetic diet, but a measure of long-term blood sugar control taken four weeks later reflected the benefit.

Other new studies have shown the same thing. Two days of oatmeal significantly reduced the required amount of insulin and improved blood sugar levels, with beneficial effects noted for up to four weeks. Consider this: Patients with uncontrolled type 2 diabetes on the two-day oatmeal diet experienced a 40% reduction of insulin dose, accompanied by almost normalization of average blood sugars. Although the intervention only lasted for two days, researchers observed a lasting significant reduction of insulin dosage and ameliorated mean blood sugars for weeks after the participants were dismissed from the study—and that was after they resumed their regular diets.

Put people on a diet packed with oats, beans, fruits, vegetables, and nuts, and the number of their gut fiber-feeders churning out beneficial short-chain fatty acids shoots up, and fasting diabetic blood sugars drop by about 25% within one month. The more fiber-feeders they fostered, the better their blood sugar control. When the fiber-promoted short-chain fatty acid producers were present in greater diversity and abundance, participants had better improvement in their hemoglobin A1c levels (which is a measure of longer-term blood sugar control).

Are There Any Downsides to Oatmeal?

If you try an oatmeal diet, your physician should be ready to rapidly deprescribe your blood sugar drugs or else you could become dangerously overmedicated. Oatmeal interventions should not be performed in patients who might have difficulties in reporting symptoms of low blood sugar. The downside of trying oatmeal days is that it may work a little too well, so it must be done under close medical supervision.

The Glycemic Index of Oatmeal

Whole grains are good, but intact whole grains are better. The wholiest of grains: groats.

Oat groats have their inedible outer husks removed during processing. They can then be sliced into two to four pieces to make steel-cut (also known as pinhead or Irish) oats, which are considered a low-glycemic-index food, averaging under 55.

Oat groats can also be coarsely ground into Scottish oatmeal or steamed and flattened into “old-fashioned” rolled oats, which have a glycemic index of 55.

Instant oats are steamed longer and rolled even more thinly. Scoring 79, it’s considered a high-glycemic-index food, but not as bad as some breakfast cereals, which can get into the 80s or 90s.

Jazzing Up Oatmeal

Oatmeal is a classic whole-grain breakfast, and there are plenty of ways to enjoy it.
- Of course, fruit and nuts are popular additions. A berry banana oatmeal bowl is quick and easy, and cinnamon baked apples make for a cozy breakfast. Assemble overnight oats or baked carrot cake oatmeal the night before to simplify your morning.
- To add another type of fiber for your gut flora, mash cannellini beans into your oatmeal—my friend Paul swears you can’t even see or taste them.
- I like to start my mornings with what I call my BROL bowl. BROL stands for barley, rye, oats, and lentils. I use oat groats (also called hull-less and hulled oats). I premix all the ingredients in a 1:1:1:1 ratio and then cook one scoop of dry BROL and two scoops of water in an electric pressure cooker. That makes a base with great texture.
Once you have your BROL base, pick your toppings. When I feel like something sweet, my go-to is a chocolate-covered-cherry sensation. I make it with frozen dark red cherries, cocoa powder, dates, and walnuts or pumpkin seeds.

You can easily turn that BROL bowl savory; here’s a version made with sautéed greens. Google “savory oatmeal” for all sorts of interesting dishes involving mushrooms, herbs, curry, roasted vegetables—you name it!
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July 15, 2026
Jazz Guard Trey Alexander Exits Summer League Early on Stretcher After Rough Contact
The Utah Jazz guard, Trey Alexander, was taken off the court on a stretcher after sustaining a serious-looking injury during the team’s NBA Summer League game against the Chicago Bulls. The incident occurred when Alexander collided with Bulls rookie Caleb Wilson while driving toward the basket.

Following the contact, Alexander immediately doubled over, clutching the left side of his torso before falling to the floor in visible pain. Medical personnel quickly attended to him, and after several minutes, he was immobilized and transported off the court on a stretcher. He did not return to the game. Neither the Jazz nor the Summer League officials immediately disclosed the nature or severity of the injury.

The Aftermath of Alexander’s Abrupt Exit

As of the latest updates, the Jazz have not announced a formal diagnosis, and it remains unclear exactly which structure was injured during the collision. A video of the play showed Alexander taking contact to the left side of his torso before immediately grabbing the area and collapsing in pain. The fact that he required a stretcher and was unable to leave the floor under his own power prompted medical staff to stabilize him before transport. Such precautions are common in sports medicine when an athlete experiences severe pain or when the extent of an injury cannot be determined immediately.

Without imaging studies or an official medical update, it is not possible to determine the specific injury. Further evaluation, which may include physical examination and diagnostic imaging such as X-rays, ultrasound, or computed tomography (CT) scans, would typically be used to identify injuries involving the ribs, abdominal organs, muscles, or other structures in the torso.

The Possible Reasons That Led to the Immediate Medical Attention

As of now, there is no confirmed Alexander’s diagnosis, and any discussion of the injury must remain general. What is known about the injury is that it was a direct impact to the left side of the torso, which can affect several organs or bones.

According to Medical News Today, possible injuries following this type of impact include:
- Rib contusions or fractures: A forceful blow can bruise or break one or more ribs, causing immediate pain that often worsens with movement, deep breathing, coughing, or twisting.
- Intercostal muscle strain: The muscles between the ribs can be stretched or torn during a collision, resulting in localized pain and difficulty moving the torso.
- Abdominal wall injury: Muscles and soft tissues of the abdominal wall can sustain bruising or tears after blunt trauma.
- Injury to internal organs: The spleen, which sits on the upper left side of the abdomen, is particularly vulnerable to blunt abdominal trauma. Although uncommon, splenic injuries require prompt medical assessment because they can cause internal bleeding. Other abdominal organs may also be evaluated depending on the mechanism of injury and symptoms.
A sudden impact to the torso can trigger intense pain, causing an athlete to instinctively bend forward or clutch the affected area, as Alexander did following the collision. Severe pain may also make standing or walking difficult until the injury is evaluated.

Winning Big Always Comes with Its Risks

Trey Alexander’s injury puts the physical demands of basketball on full display, where high-speed collisions, falls, and contact around the basket can sometimes result in significant injuries despite protective rules and immediate medical care.

Not every collision leads to a serious injury, but impacts involving the chest or abdomen warrant careful evaluation as they may affect bones, muscles, or internal organs. Prompt assessment by athletic trainers and physicians helps determine whether emergency treatment or additional imaging is needed before an athlete can safely return to play.

Contact injuries cannot be completely prevented; several measures can help reduce the risk. Maintaining core strength, using proper body positioning during contact, improving overall conditioning, and following safe playing techniques may lower the likelihood of some musculoskeletal injuries. Equally important is ensuring that athletes receive immediate medical attention when they experience severe pain after a collision, rather than attempting to continue playing.
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July 15, 2026
Unlock Your Fastest Belly Fat Loss Journey Yet!

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July 15, 2026
Start Your Career | HHS.gov
There are many different types of health careers. Which one interests you? Do you like interacting with people? Working behind the scenes? A flexible schedule? You have many options!

NIH Job: Biologist

Biologists at the NIH are scientifically challenged daily through exciting life science research. NIH offers opportunities for biologists to gain new skills and techniques in nearly all specialty areas of biomedical research to meet the agency’s mission and address national needs. Biologists are tasked with investigating ways to prevent, treat, and even cure common and rare diseases.

Why health: careers you can feel good about

Health careers allow you to choose a job that reflects your values:
- Helping others: Health is a field that is dedicated to helping individual patients manage their care. You can prevent disease, promote healthy living, address public health concerns, and more.
- Treating everyone with dignity: Nearly a quarter of American adults (22.8% or 58.7 million people) report that they had a mental illness in the past year. You can help by providing support and treatment.
- Making a difference: Your time, talent, and experience can help reduce health disparities and build healthier communities.
Pathways into health: work while you’re in school

Did you know that you can get started working in health without enrolling in an expensive or time-intensive degree or certificate? You could start your journey in high school. Pathway programs let you try out different types of health career paths.

Work while you learn

Jobs that are in demand today and tomorrow

The U.S. Bureau of Labor Statistics (BLS) has information on health occupations and their education requirements and average pay. The projected rate of growth of health occupations is 21%, compared to the average of 4% for all occupations. Here are a few of the roles that should have the highest number of new jobs available.

Home health and personal care aides

Home health and personal care aides support older adults and people with disabilities or chronic illnesses and help them with daily living activities.

Entry-level education: High school diploma or equivalent
Median pay: $33,530
Typical pay range: $23,910 to $42,450

Occupational therapy assistants

Occupational therapy assistants help people who have injuries, illnesses, or disabilities by providing them with independent living skills.

Entry-level education: Associate’s degree
Median pay: $67,010
Typical pay range: $48,670 to $89,230

Medical and health services managers and directors

Medical and health services managers and directors plan, direct, and coordinate the business activities of health employees, clinics, or public health agencies.

Entry-level education: Bachelor’s degree
Median pay: $110,680
Typical pay range: $67,900 to $216,750

Opportunities in rural and underserved communities

Over 60 million people live in rural America. They face their own unique health challenges, and there are often fewer health workers serving these communities. Working in rural communities can help to address disparities in health care. It also connects patients with local resources to address social needs, which can be particularly challenging in rural and tribal areas.

Individuals who work in rural communities often have a lower cost of living and can enjoy the perks of living in a smaller, more interconnected community. The federal government provides scholarships, research grants, trainings, postings of open jobs, and more to support health professionals ready to work in rural areas:

Opportunities in mental health and substance use treatment

Millions of Americans are being treated or seeking treatment for mental health conditions or substance use disorders. Providers are needed more than ever to keep up with the demand for services. A career in behavioral health services gives you an opportunity to change people’s lives.

Behavioral health describes a wide range of services including mental health promotion and treatment, substance use disorder prevention and treatment, and recovery support. Careers usually require certification or licensure at the state level — ranging from peer support counselors who have lived experience to roles requiring medical degrees. Learn more about behavioral health jobs:
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July 14, 2026
States Have Until October 2027 to Fix SNAP Error Rates, with Reviews That Could Trigger Penalties Already Underway
For the first time in the more than 50-year history of the Supplemental Nutrition Assistance Program, states are now financially on the hook for how accurately they manage food benefit payments, and the data being collected right now will determine how much they owe.

The USDA released its annual SNAP payment error rate report on June 24, 2026, revealing a national average error rate of 10.62 percent for fiscal year 2025 — far above the 6 percent threshold that the One Big Beautiful Bill Act (OBBBA) set as the trigger for financial penalties. Beginning October 1, 2027, states with error rates at or above that threshold will be required to cover a portion of their own SNAP benefit costs — from 5 percent for states with rates between 6 and 8 percent, to 15 percent for states above 10 percent.

Only nine states had payment error rates below 6 percent in fiscal year 2025, allowing them to avoid the new cost-sharing requirement. The remaining 41 states and the District of Columbia face financial consequences unless they reduce their error rates before the penalty calculation is finalized.

Critically, states can choose to use either their fiscal year 2025 or fiscal year 2026 error rate — whichever is lower — to calculate what they owe. That means the data being generated right now, through the end of fiscal year 2026 in September 2026, still matters. States that act aggressively in the next several months to reduce errors may be able to lower their financial exposure.

Why This Matters

SNAP — the Supplemental Nutrition Assistance Program — provides grocery assistance to approximately 42 million Americans, including children, elderly adults, people with disabilities, and low-income working families. For the entirety of its history, SNAP benefits have been paid entirely by the federal government. The OBBBA ended that guarantee.

The practical consequences are large. Using fiscal year 2025 error rates, the Center on Budget and Policy Priorities estimates states collectively could owe roughly $9 billion in SNAP cost-sharing. For individual states with already-strained budgets — many of which are also absorbing Medicaid cost shifts from the same legislation — the new SNAP obligations arrive at a particularly difficult fiscal moment.

The accountability logic behind the policy is straightforward: states that miscalculate eligibility or benefit amounts generate either overpayments (giving recipients more than they should receive) or underpayments (giving them less). SNAP payment error rates measure how often and by how much those miscalculations occur. But advocacy groups and many state officials note that error rates are not a measure of fraud — they reflect administrative and systems errors, many of which occur when complex federal and state rules interact with limited state administrative capacity.

What We Know So Far

The USDA’s June 24 release established the FY 2025 error rate as the first benchmark that will be used to calculate potential cost-sharing obligations. Under the law, states may elect to use either the FY 2025 or FY 2026 error rate — whichever produces a lower obligation.

The penalty structure, as described by Grocery Dive and confirmed by the USDA press release:
- States with error rates between 6% and 8%: responsible for 5% of their SNAP benefit costs
- States with error rates between 8% and 10%: responsible for 10%
- States with error rates above 10%: responsible for 15%
One important carve-out: states with error rates above 13.32 percent in FY 2025 qualify for a two-year delay in the cost-sharing requirement. Alaska (23.15%), Oregon (14.14%), Illinois (14.67%), Georgia (15.21%), Delaware (16%), and New Mexico (16.81%), as well as the District of Columbia (18.66%), qualify for this delay— meaning they will not face penalties until fiscal year 2030.

Perversely, this created an incentive problem. Maryland dropped its error rate from 13.64 to 13.08 percent — an improvement — but in doing so, fell just below the 13.33 percent threshold that would have qualified it for the two-year delay. The states that made less progress are being shielded from near-term consequences, while Maryland faces an earlier and larger financial burden for having improved.

Where the Impact Is Highest

Maryland’s situation is among the most closely watched. State analysts project Maryland could be on the hook for at least $240 million just for the new cost-sharing requirements in fiscal year 2027, with more exposure expected in subsequent years from other OBBBA provisions. The state’s current error rate of 13.08 percent places it in the 15 percent cost-sharing tier — the maximum penalty level.

Maryland’s Acting Secretary for Human Services Stacy L. Rodgers told Maryland Matters that the agency is “laser-focused” on bringing the error rate down and that the notion of qualifying for a delay by maintaining a high error rate has not been the agenda. But she acknowledged that FY 2026 data will not be released until June 2027 — months after the Maryland General Assembly finalizes the state budget — creating a structural planning problem.

Oklahoma’s situation illustrates the scale in other states: with an error rate of 11.04 percent, Oklahoma projects it could owe approximately $250 million in SNAP benefit costs. California, at a lower 5 percent bracket, is projected to face over $627 million in additional spending.

Some states are acting quickly. Arkansas is investing in AI tools to improve eligibility systems and has allocated $5 million in its FY 2027 budget to the state inspector general’s office to detect vulnerabilities. Minnesota allocated $90 million to replace 35-year-old county software used for SNAP processing. These technology investments may reduce error rates before the penalty-determining data closes.

What Officials and Experts Say

Agriculture Secretary Brooke Rollins, in announcing the FY 2025 data, said the payment error rates are further proof that state accountability is severely lacking in SNAP, and urged other states to prioritize needy families and the American taxpayer over politics.

Maryland’s Stacy Rodgers offered a sharply different framing. She told WYPR that Maryland has led the nation in reducing its error rate over the past three years — from 35.56 percent in fiscal year 2022 to 13.08 percent today — but is still being penalized for a rate that remains above the threshold. She said there was simply no runway for states to drive the error rate down to 6 percent given the structural complexity of SNAP administration.

Carolyn Vega, associate director of policy analysis for No Kid Hungry, told Maryland Matters the penalty structure creates a “really perverse incentive” — a state has almost an incentive to do worse, since dropping below 13.33 percent removes the protection of the two-year delay.

Brookings Institution researchers warned that the combination of SNAP benefit cost-shifting, Medicaid reductions, and other OBBBA provisions could lead some states to drop out of the SNAP program entirely — an outcome that would eliminate food assistance for all participants in those states. Analysts across the political spectrum have described this as the single most significant structural change to SNAP in the program’s history.

What the Evidence Shows and What It Does Not

MedicalDaily Policy Check
- Policy source: One Big Beautiful Bill Act (OBBBA), signed July 4, 2025
- USDA data release: FY 2025 SNAP payment error rates, June 24, 2026
- National average FY 2025 error rate: 10.62%
- Total FY 2025 improper payments: $10.1 billion (per USDA)
- Cost-sharing effective date: October 1, 2027 (federal fiscal year 2028)
- States below 6% (exempt): 9 states
- States with delay (above 13.32%): Alaska, Oregon, Illinois, Georgia, Delaware, New Mexico, DC — delay until FY 2030
- Key option: States may choose FY 2025 or FY 2026 error rate, whichever produces a lower obligation — FY 2026 data collection is ongoing through September 2026
- What this policy does not constitute: A measure of SNAP fraud — error rates measure administrative accuracy, including both overpayments and underpayments, often caused by eligibility or calculation mistakes
Who Is Most Affected?

The financial impact of the new SNAP cost-sharing rules will fall on several groups:
- State SNAP administrators and human services agencies, who must reduce error rates under extreme time pressure with limited resources
- State legislators and budget directors, who must now plan for large new obligations that were not anticipated in recent state budgets
- Advocacy organizations that serve SNAP recipients, who are concerned that states facing financial pressure may tighten eligibility or create bureaucratic barriers to enrollment
- SNAP recipients themselves — particularly in states where budget pressure from SNAP cost-sharing leads to service reductions, staffing cuts, or changes to how applications and renewals are processed
- Residents of states with the highest error rates: Maryland (13.08%), Hawaii (10.92%), Oklahoma (11.04%), and many others where the cost-sharing obligation will be highest
What You Can Do Now
- If you receive SNAP benefits, respond promptly to any renewal requests, verification requests, or correspondence from your state’s human services agency. Delayed or incomplete responses are a common source of administrative errors that inflate error rates and may affect your own benefit accuracy.
- If you are a state resident concerned about SNAP funding in your state, contact your state legislators — particularly those on budget and human services committees — to ask how the state is planning to manage new cost-sharing obligations.
- Advocacy organizations tracking this issue include the Food Research and Action Center, the Center on Budget and Policy Priorities, and No Kid Hungry. All publish state-specific data and advocacy resources.
- If your state has announced changes to SNAP administration or access in response to budget pressure, contact the USDA’s Food and Nutrition Service or a legal aid organization if you believe your SNAP benefits have been incorrectly reduced or terminated.
Cost and Access: What Families Should Know

SNAP error rates measure administrative accuracy — not whether eligible families are being helped. But the financial consequences of this policy will inevitably affect how states administer the program. States may respond by hiring more caseworkers, investing in technology, tightening verification processes, or — advocates fear — creating administrative barriers that make it harder for eligible families to receive benefits.

If you believe you are eligible for SNAP and have been denied or had benefits reduced, you have the right to request a fair hearing through your state’s human services agency. The USDA’s Food and Nutrition Service maintains state-level contact information and complaint procedures. For families in financial crisis, local food banks remain a parallel resource — find one near you at feedingamerica.org.

What Happens Next

FY 2026 error rate data — the second data point states can use to calculate their obligation — will not be released until June 2027. That timing creates a difficult planning window: states will not know their final FY 2026 number until after most state legislatures have finalized their fiscal year 2027 budgets.

Maryland’s Stacy Rodgers is banking on the National Governors Association successfully lobbying Congress to delay the penalty deadline. That lobbying effort is ongoing. Some states are filing Corrective Action Plans with USDA as required for states above the 6 percent threshold. The outcome of those plans and any Congressional action on the deadline will significantly shape how this policy ultimately affects both state budgets and SNAP recipients.

MedicalDaily will continue tracking state error rate developments, Congressional responses, and the downstream effects on SNAP access as the October 2027 implementation date approaches.

The Bottom Line

The USDA’s FY 2025 SNAP error rate data revealed that 41 states and the District of Columbia exceed the threshold that will trigger financial penalties starting October 2027 — a deadline that is 15 months away. For Maryland, the potential liability exceeds $240 million. For California, it exceeds $627 million. For Oklahoma, it approaches $250 million. The data being collected right now — through September 2026 — will shape those final numbers. States that invest in better eligibility systems, caseworker capacity, and technology in the next several months may reduce their exposure. Those that do not may find themselves choosing between cutting other services, raising taxes, or creating barriers that effectively push eligible families off SNAP assistance.
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July 14, 2026
Ebola Fight Disrupted as Congo Response Workers Strike Over Unpaid Wages
The workers at the epicenter of Congo’s Bundibugyo Ebola outbreak — the surveillance teams tracking contacts, the burial teams managing the dead, the community outreach workers trying to build trust in frightened neighborhoods — went on strike this week. They have not been paid since the outbreak was declared on May 15, 2026, according to reporting from the Associated Press and Reuters.

The work stoppage — centered in Bunia, the capital of Ituri Province, and the neighboring town of Rwampara — has directly compromised continuity of essential health services at the front of an outbreak that has infected 1,759 people and killed at least 600 as of the latest government data, according to Reuters. Bunia and Rwampara together account for roughly 847 confirmed infections — nearly half of Congo’s total.

No Ebola cases associated with this outbreak have been confirmed in the United States. The risk to U.S. residents remains low, according to the CDC. But a response team that cannot function directly threatens the global containment of a disease for which no approved vaccine or specific treatment exists.

Why This Matters

Ebola containment depends entirely on the human beings willing to do the most dangerous work in public health: identifying and following up with contacts of confirmed cases, isolating the sick before they can infect others, and safely burying the dead in a disease where bodily fluids at the moment of death carry the highest viral load.

When those workers stop working, chains of transmission that would otherwise be interrupted continue unchecked. New cases that would have been caught through contact tracing are not caught. Burials conducted without trained teams become sources of additional infection. The mathematical progress the response has made — tracking contacts, sequencing isolates, mapping transmission chains — stops accumulating.

The World Health Organization representative in Congo, Dr. Anne Ancia, said this week that the virus continues to spread, fueled by population movements and insecurity, and that some treatment centers are at near-full capacity. She has stated that the outbreak is spreading faster than the response can contain it — a warning issued before the strike added a new complicating factor.

What We Know So Far

According to the Associated Press, front-line workers told reporters they had not received wages or bonuses since the outbreak was declared on May 15. The affected workers span multiple roles: epidemiological surveillance committee members, community outreach and sensitization teams, burial teams, and security personnel.

Workers at the Rwampara Ebola treatment center staged a protest on Monday, setting tires alight outside the facility. Police intervened to restore order. A senior worker confirmed to the AP that the action was continuing.

“Since the Ebola virus disease outbreak was declared, we’ve been demanding payment for our work,” Dr. Biensi Kano, a member of the epidemiological surveillance committee in Bunia, told the AP. “The non-payment of benefits exposes us and our families to significant socio-economic difficulties and seriously undermines our living conditions.”

Dr. Ghislain Maneba, an epidemiologist and community investigator in the Rwampara health zone, described the scope of the problem: “We are doing everything we can to make the public understand how dangerous this disease is. I came here to save people’s lives, but this is how I am being thanked. We are working day and night without being paid.”

Congo’s Health Minister Samuel Roger Kamba acknowledged the payment problems publicly, attributing part of the delay to logistical disruptions — specifically the closure of the Bunia airport, which has complicated both the delivery of supplies and the transfer of funds to frontline workers.

Where the Response Is Most At Risk

The Bunia and Rwampara health zones — where the strike is most concentrated — account for close to half of Congo’s confirmed Ebola cases. They represent the geographic and epidemiological core of the outbreak. A functional lapse in contact tracing, burial safety, or community engagement in these zones is not a marginal disruption; it strikes at the most critical pressure points in the containment effort.

Bloomberg reported that Congo’s National Institute of Public Health confirmed in a report on Wednesday that continuity of essential health services in Bunia and Rwampara has been compromised.

The outbreak is also occurring in a region with persistent armed conflict — a factor that has repeatedly impeded response operations by restricting travel, diverting law enforcement attention, and driving population displacement that makes contact tracing vastly more difficult. The Bunia airport closure attributed by health officials as a payment bottleneck is itself a product of the security situation in eastern Congo.

What Officials and Workers Say

Akilimali Pierre, incident manager at Congo’s National Institute of Public Health, told the AP that the airport closure “is hampering the very implementation of the response, particularly certain aspects of the flow of funds. This is one of the reasons that may account for the delay in payment.”

Africa CDC official Wessam Mankoula, speaking at an online press conference, said the agency was working with Congolese authorities to speed up payments. According to Reuters, Africa CDC has provided Congo approximately $2 million to support the Ebola response — some of which could be directed toward delayed worker payments.

“This is very important to keep the morale,” Mankoula said of ensuring payment to frontline workers.

The WHO’s Dr. Ancia had described the situation in Ituri as one where she witnessed “firsthand the dedication of staff who continue to serve their communities despite enormous challenges” — a dedication now being tested by the absence of compensation for those same workers.

What the Evidence Shows — and What It Does Not

As of July 10, 2026, the Bundibugyo Ebola outbreak has produced 1,759 confirmed cases and more than 600 confirmed deaths in Congo, plus 20 cases and 2 deaths in Uganda, and one imported case in France. No U.S. cases have been confirmed.

The outbreak’s case fatality rate in the current outbreak is approximately 20% to 30%, lower than the Zaire strain of Ebola but still among the most lethal infectious diseases circulating anywhere in the world. There is no approved vaccine for Bundibugyo virus. A clinical trial of two experimental therapies — the monoclonal antibody MBP134 and the antiviral remdesivir — began July 2 but has produced no results yet.

Whether the strike will materially worsen outbreak trajectory depends on its duration and whether payment resolutions can be reached quickly. If the work stoppage lasts days, the damage may be containable. If it lasts weeks, the modeling predictions for outbreak growth could shift significantly.

MedicalDaily Outbreak Status Summary
- Congo confirmed cases: 1,759 (as of latest government data)
- Congo deaths: 600+
- Uganda cases: 20; Uganda deaths: 2
- Imported case: France (1)
- U.S. cases: Zero confirmed
- Approved vaccine: None for Bundibugyo strain
- Approved treatment: None; clinical trial underway (MBP134 + remdesivir)
- Strike status: Active as of July 9–10, 2026, in Bunia and Rwampara
- Services compromised: Contact tracing, burial teams, community outreach in hardest-hit zones
- U.S. entry restriction order: Active through approximately July 21, 2026
Who Is Affected and Who Is at Risk

Front-line health workers in Ituri Province face the most direct and immediate harm from the payment failure: they are working in conditions of extreme danger — physical violence from suspicious residents, biological exposure risk, and the psychological burden of managing an uncontrolled outbreak — without compensation.

The secondary impact falls on all Congolese residents in the outbreak zone, whose exposure risk increases as contact tracing lapses.

For U.S. residents: the CDC continues to assess the risk of Bundibugyo virus reaching the United States as low, based on the virus’s biology (direct contact with bodily fluids required; no airborne transmission), the country’s public health infrastructure, and the current entry screening measures in place at four U.S. airports. No U.S.-based cases have been confirmed from this outbreak.

Travelers who have been in DRC, Uganda, or South Sudan within the past 21 days should monitor for fever or illness and contact their local health department before visiting a healthcare facility if symptoms develop.

Symptoms and Warning Signs to Watch For

For travelers who have recently returned from DRC, Uganda, or South Sudan, the following symptoms — appearing within 21 days of last potential exposure — warrant immediate contact with a public health authority (before going to a clinic):
- Sudden fever
- Severe headache
- Muscle pain and weakness
- Vomiting or diarrhea
- Unexplained bleeding or bruising
- Rash
Do not go to a hospital or clinic without calling your local health department first. Public health teams need to coordinate safe isolation and transport procedures to protect healthcare workers and other patients.

What You Can Do Now

For U.S. residents who have recently traveled to DRC, Uganda, or South Sudan:
- Monitor your health for 21 days after your last possible exposure to the outbreak area.
- If you develop fever or other symptoms, call your local health department first — before going to a hospital.
- Check the CDC Ebola situation page for current travel advisories and entry screening information.
- Plan ahead for travel to this region: U.S. entry restrictions currently in place require routing through designated screening airports and post-arrival monitoring.
For anyone who wants to support the Ebola response in DRC, Médecins Sans Frontières (Doctors Without Borders) and International Medical Corps are among the organizations with active operations in the affected area.

Cost and Access: What Patients Should Know

Any U.S. resident who is evaluated for suspected Ebola will be tested and cared for through the public health system at no direct cost, as part of emergency infectious disease protocols. No prior authorization or insurance is required for emergency isolation and testing under these circumstances.

If a case were confirmed in the United States, treatment would occur at one of ten federally designated biocontainment units. The nearest facilities to major U.S. cities include Emory University Hospital (Atlanta), Nebraska Medical Center (Omaha), and the NIH Clinical Center (Bethesda, Maryland).

What Happens Next

Whether Congo can rapidly resolve the payment dispute will determine how much damage the strike causes to the outbreak trajectory. Africa CDC’s offer to redirect $2 million in existing funds toward delayed payments suggests a path to resolution, but the logistical challenge of the closed Bunia airport means financial transfers may still face delays.

The U.S. entry restriction order from June 21 expires around July 21 — 11 days from now. The CDC’s decision on whether to renew will be shaped in part by the outbreak’s trajectory in the coming days. A strike-related worsening of case trends could shift that calculus toward extension.

MedicalDaily will continue monitoring both the strike situation and the outbreak’s overall trajectory.

The Bottom Line

Ebola response workers in Congo’s hardest-hit provinces walked off the job this week because they have not been paid since the outbreak began two months ago. The strike threatens to degrade the contact tracing, burial safety, and community engagement operations that are the primary tools for containing an outbreak for which no approved vaccine or specific treatment exists. The outbreak has already infected 1,759 people and killed more than 600. The risk to U.S. residents remains low — but a failing response anywhere in the world raises the probability of wider spread, which is why the U.S. has maintained entry restrictions and airport screening since May.
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July 13, 2026