Tag: Heres

40% of American Children Ages 6–19 Are Now Nearsighted — Here’s the Evidence-Based Plan to Slow Pediatric Myopia

Forty percent of American children between the ages of 6 and 19 are currently nearsighted, according to the American Academy of Ophthalmology. In Asia, the rate is nearly double. Worldwide, researchers project that if current trajectories continue, 50% of the global population will be myopic by 2050 — a figure that was once considered alarmist and is now regarded as a conservative estimate by the ophthalmology community.

This is not simply an inconvenience that corrective lenses can fix. Myopia, when it progresses to its most severe form, dramatically elevates the risk of potentially blinding conditions: retinal detachment, glaucoma, early cataracts, and myopic maculopathy. According to the AAO, children who develop myopia early and progress to high myopia face a 50% greater risk of glaucoma, are 17% more likely to need cataract surgery, and carry a 6-fold greater risk of retinal detachment and retinal tears. The disease burden that will materialize in adult life as today’s myopic children age represents one of the most significant preventable vision crises in history.

“Kids who develop myopia early in life and progress to high myopia face an uncertain future,” the AAO stated in its myopia epidemic initiative. “The time to intervene is in childhood.”

Why Myopia Is Rising — The Screen Time and Outdoor Time Evidence

The primary drivers of the pediatric myopia epidemic are now well-characterized in the scientific literature, even if the precise mechanisms are still being refined. Two behavioral factors dominate: increased time spent on close-range visual tasks (near work, including screens), and reduced time spent outdoors.

Near work and prolonged close focusing. When the eye focuses on objects at close range for extended periods, it may receive signals that promote axial elongation — the physical lengthening of the eyeball from front to back that defines myopia. The visual cortex signals involved are not yet fully characterized, but the epidemiological pattern is consistent across multiple studies: populations with higher near-work exposure have higher myopia rates.

The COVID acceleration. The pandemic provided an inadvertent natural experiment. As Contemporary Pediatrics documented in its April 2026 comprehensive review, home confinement and distance learning drove children’s average daily screen time from approximately 2.1 hours to 5.6 hours per day. The result was a measurable, documented surge in myopia onset and progression, particularly in children ages 6 to 8 — the developmental window during which the eye’s growth rate is highest, and myopia risk is most acute.

The outdoor time protective effect. This is the finding with the strongest intervention potential. Time spent outdoors — not necessarily time spent looking at distant objects — appears to protect against myopia onset and slow its progression in children who already have it. The AAO attributes this primarily to bright outdoor light (typically 10,000 to 100,000 lux) triggering the release of dopamine in the retina, which signals the eye to slow its axial growth. Indoor lighting typically delivers only 300–500 lux — insufficient to trigger the same protective signal.

As the AAO describes: “A study of a school-based program in Taiwan that encouraged kids to spend 11 hours a week outdoors showed that sunlight can decrease myopia progression.” That 11 hours per week — roughly 80 minutes per day — is the threshold that research identifies as protective. Most American children get significantly less.

Pediatric Myopia Epidemic — Key Data	Detail
U.S. children (ages 6–19) who are myopic	~40% (American Academy of Ophthalmology)
Global myopia projection by 2050	~50% of world population
Asian rates (children and young adults)	80–90% in East/Southeast Asia
U.S. myopia increase in past 50 years	Nearly doubled (from ~21% to ~41.6%)
COVID-era screen time shift	2.1 hrs/day → 5.6 hrs/day (significant myopia acceleration)
Age group most at risk for rapid progression	6–8 years during pandemic school closures
High myopia glaucoma risk increase	50% greater
High myopia cataracts risk increase	17% more likely to need cataract surgery
High myopia retinal detachment risk	6x greater
Protective outdoor time threshold	~11 hours/week (80+ min/day)
Outdoor light vs. indoor light	Outdoor: 10,000–100,000 lux; indoor: 300–500 lux
Mechanism of outdoor protection	Bright light triggers retinal dopamine release, slowing axial growth
Treatment options beyond glasses	Low-dose atropine eyedrops; orthokeratology contact lenses; defocus contact lenses
Age to begin eye exams	First exam by age 1 (AAO recommendation); age 3 for full assessment

Evidence-Based Interventions — What Actually Slows Myopia in Children

The encouraging news is that myopia progression is not inevitable in the way the epidemic trajectory might suggest. Specific interventions have documented efficacy for slowing or preventing progression:

Outdoor time — the most accessible intervention. Based on the Taiwan school program and multiple subsequent studies, increasing children’s daily outdoor time to 80+ minutes significantly reduces both myopia onset risk and the rate of progression in children who already have it. This does not require structured eye exercises or specific activities — simply being outside in bright natural light appears sufficient. Pediatricians can prescribe outdoor time just as specifically as they prescribe medication.

Low-dose atropine eyedrops. Atropine at 0.01% concentration, applied once daily at bedtime, has been shown in multiple randomized trials to slow myopia progression by approximately 50–60% compared to controls, with minimal side effects. The mechanism is not fully characterized but appears to involve direct effects on retinal signaling rather than the pupil dilation seen with higher atropine doses. Low-dose atropine is increasingly used in pediatric ophthalmology practices for children with documented myopia progression, typically in children between ages 7 and 14.

Orthokeratology (ortho-k) and specialty contact lenses. Rigid gas-permeable contact lenses worn overnight (orthokeratology) reshape the cornea during sleep and simultaneously reduce the peripheral defocus pattern thought to drive axial growth. Soft multifocal contact lenses and “defocus incorporated multiple segment” (DIMS) lenses achieve similar myopia control effects through optical means. These options are typically discussed with a pediatric ophthalmologist or optometrist with myopia management expertise.

Screen time management — necessary but not sufficient alone. Reducing screen time matters, but the primary driver of the protective benefit appears to be adding outdoor time rather than simply reducing screen time. As Clearview Eyes’ 2026 guidelines review noted: “After the restrictions were lifted and screen time was reduced, the trend of myopia worsening or slowing down happened” — but the most effective intervention is the replacement of indoor time with outdoor time, not merely passive reduction of device use.

What Parents and Pediatricians Should Do Starting Now

For parents: Prioritize outdoor play as a health intervention, not merely recreation. Aim for 80+ minutes of daily outdoor time for children from early childhood. Use the AAO and AAPOS screen time guidelines as a starting point (no more than 1 hour per day for ages 2–5, and more flexible but structured limits with outdoor balance for older children). Ensure annual eye exams beginning at age 3, and ask specifically about myopia management options if your child is already myopic and showing progression.

For pediatricians: The AAO and American Association for Pediatric Ophthalmology and Strabismus (AAPOS) joint clinical statement recommends routine vision screening at well-child visits. Asking about daily outdoor time at every well-child visit is a low-cost, high-yield intervention. Children with myopia onset before age 10, documented rapid progression, or parental myopia in both parents warrant early referral to a pediatric ophthalmologist for myopia management discussion.

For schools: The Taiwan evidence suggests that school-based policies increasing outdoor recess and limiting prolonged continuous close work time can measurably reduce population-level myopia rates. Schools with longer, more frequent outdoor breaks show lower myopia prevalence in controlled comparisons.

Frequently Asked Questions

How common is myopia in American children?

The American Academy of Ophthalmology estimates approximately 40% of American children ages 6–19 are currently nearsighted. This nearly doubles the rate from 50 years ago. In East and Southeast Asia, rates reach 80–90% among children and young adults.

Why is myopia becoming an epidemic?

The primary drivers are reduced outdoor time (children now spend significantly less time outside in natural light than prior generations) and increased near-work exposure from screens and close-range learning. The COVID pandemic accelerated myopia onset and progression by dramatically increasing screen time and reducing outdoor activity.

Is high myopia different from regular nearsightedness?

Yes. High myopia (refractive error greater than -6 diopters) is associated with significantly elevated risks of retinal detachment (6x higher), glaucoma (50% higher), cataracts (requiring surgery 17% more often), and myopic maculopathy — a leading cause of blindness in myopic individuals. This is why slowing myopia progression in childhood matters so much.

What is the most effective intervention for preventing myopia?

Increasing outdoor time to approximately 80 minutes or more per day is the most accessible and evidence-supported intervention for reducing myopia onset and slowing progression. Bright outdoor light (10,000–100,000 lux, far above indoor lighting) triggers retinal dopamine release that slows the axial eye growth that drives myopia.

What treatments are available if my child already has myopia?

Beyond corrective glasses or contact lenses, evidence-based myopia management options include: low-dose atropine 0.01% eyedrops (approximately 50–60% slowing of progression), orthokeratology (overnight rigid contact lenses that slow axial growth), and specialized soft multifocal contact lenses. These are typically managed by a pediatric ophthalmologist with myopia management expertise.

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June 21, 2026

$50 Billion in Rural Health Funding Won’t Reopen Martin County’s Closed Hospital — Here’s What the Fine Print Actually Says

Stanley Sears was 50 years old when he had a heart attack in Martin County, North Carolina. Emergency crews from a neighboring town worked on him for half an hour, but couldn’t revive him for the long drive to the closest hospital. Martin County’s only hospital had closed a year before his death.

His sister, Debra Pierce, still wonders. “The sad thing is we’ll never know if he could have been saved that night or not, because we don’t have a higher level of care in this county,” she told KFF Health News reporter Sarah Jane Tribble.

In the political moment following the passage of the One Big Beautiful Bill Act, the story of Martin County is being told differently by different people. Republicans point to the $50 billion Rural Health Transformation Program included in the bill as evidence that rural communities will be helped. Martin County Manager Drew Batts, who has walked through the shuttered corridors of Martin General Hospital with federal and state lawmakers, has a simpler assessment: “The $50 billion is not something that is specifically going to help our situation. It’s not going to help us get this place reopened.”

He is correct. And the reasons why are an object lesson in the gap between what a federal health fund promises and what it can actually deliver.

What the $50 Billion Rural Health Fund Is — and What It Isn’t

According to KFF’s comprehensive analysis of the fund, the Rural Health Transformation Program was added to the One Big Beautiful Bill Act in response to concerns from lawmakers representing rural states about the bill’s massive Medicaid cuts. The fund provides $10 billion per year over five years (fiscal years 2026–2030), for a total of $50 billion. CMS has broad discretion over distribution and — critically — those distribution decisions are not subject to administrative or judicial review.

The fund’s structural design creates several limitations that directly affect communities like Martin County:

Limitation 1: The fund goes to existing organizations, not to closed facilities. North Carolina distributes its $213 million first-year allocation among existing health and social service organizations. As KFF Health News reported, federal regulations set limits on how much can be spent on construction and building renovations. Martin General Hospital isn’t open — so it isn’t an existing organization that can receive funds.

Limitation 2: The hub-and-spoke distribution model concentrates money in larger systems. North Carolina’s plan creates a hub-and-spoke model that allots money to six large regional leads, including nonprofits such as ECU Health’s affiliate Access East. Those hubs then distribute to local entities. ECU Health’s affiliate did win a portion of North Carolina’s first-year payout — but the federal money cannot be used to reopen Martin General, according to ECU Health’s Chief Operating Officer Brian Floyd.

Limitation 3: The fund is temporary; the Medicaid cuts are not. KFF analysis shows the $50 billion could offset approximately 37% of the estimated cuts to federal Medicaid spending in rural areas ($137 billion over ten years). But while the rural health fund is limited to five years, nearly two-thirds of the ten-year reductions in federal Medicaid spending occur after fiscal year 2030 — meaning the fund’s support runs out before most of the damage it’s supposed to offset materializes.

Limitation 4: The math doesn’t work for the most rural communities. KFF analysis shows that Connecticut (with 3 rural hospitals by one definition) could receive the same amount as Kansas (with 90 rural hospitals) if both states are approved for funding. The allocation formula gives equal weight to states regardless of rural hospital density, diluting the fund’s impact in states most desperately in need.

$50 Billion Rural Health Fund — Key Facts	Detail
Total fund size	$50 billion ($10B/year for FY 2026–2030)
Authorizing legislation	One Big Beautiful Bill Act
CMS discretion over distribution	Broad; not subject to administrative or judicial review
NC first-year allocation	$213 million
Distribution model in NC	Hub-and-spoke; six large regional lead organizations
Can NC funds reopen Martin General?	No — federal rules limit construction; hospital must be operational
Fund’s offset of rural Medicaid cuts	~37% of estimated $137B in rural Medicaid cuts over 10 years
Timing mismatch	Fund runs FY 2026–2030; 64% of Medicaid cuts come after FY 2030
Martin County’s situation	22,000 residents; no hospital since 2023; no paramedics on ambulances
Distance to nearest ER	20+ miles
ECU Health projected Medicaid cut impact	$1 billion over 10 years (CEO testimony)

What Martin County Actually Needs — and What It Would Take

ECU Health signed a letter of intent to reopen Martin General as a rural emergency hospital (REH) — a federal designation that allows smaller facilities to operate with 24-hour emergency services and outpatient care but without inpatient beds. Under that plan, Martin County would pay to refurbish the hospital, and the North Carolina General Assembly would need to provide ECU Health with $210 million — of which $150 million would fund construction of a new inpatient tower at ECU’s Beaufort Hospital.

That legislative appropriation has not materialized. And even if it did, Representative Don Davis, whose district encompasses Martin County, told KFF Health News the rural health fund money “is essentially putting a band-aid on a much, much broader situation that needs dire help.” Davis has introduced legislation to increase Medicaid reimbursements for rural hospitals — the structural fix that would prevent hospital closures — but it has not moved forward.

The closure of Martin General in August 2023 was abrupt. Employees were not notified. Patients being treated were wheeled out on stretchers and transported to other facilities. The company operating the county-owned hospital, Quorum Health, did not notify local elected leaders before filing for bankruptcy.

Martin County also does not have paramedics on its ambulances — only emergency medical technicians (EMTs), who have a more limited scope of practice. The closest emergency rooms are 20 miles or more away, often overcrowded. One woman told KFF Health News she drove 2.5 hours from a small town near the Outer Banks so her 79-year-old aunt could get care at an ECU Health ER in Greenville — and was told to wait outside because of capacity issues.

“It’s a real healthcare crisis that has already proven itself to have lost lives that perhaps didn’t have to be lost,” said ECU Health COO Brian Floyd. “They just want to not die because there’s nowhere to go when you have an emergency.”

Frequently Asked Questions

What is the $50 billion rural health fund?

The Rural Health Transformation Program, included in the One Big Beautiful Bill Act, provides $10 billion per year for five years (FY 2026–2030) for rural health. CMS has broad discretion over distribution, and distribution decisions are not subject to administrative or judicial review.

Why won’t the fund reopen Martin County’s hospital?

Because the fund is distributed to existing health and social service organizations, and federal regulations limit how much can be spent on construction and renovation. Martin General Hospital closed in 2023 — it is not an existing operational facility that can receive funding. Martin County’s situation requires capital investment in a closed hospital that the fund’s design specifically does not accommodate.

Does the $50 billion offset the Medicaid cuts in the same bill?

Only partially. KFF estimates the fund could offset approximately 37% of the $137 billion in estimated cuts to federal Medicaid spending in rural areas over ten years. Critically, the fund runs through FY 2030, but nearly two-thirds of the Medicaid cuts occur after that — meaning the fund’s support ends before most of the cuts’ impact materializes.

What happened to Martin County’s hospital?

Martin General Hospital, the county’s only hospital, closed abruptly in August 2023 when the company operating it (Quorum Health) filed for bankruptcy without notifying local elected leaders or staff. Patients were wheeled out on stretchers. The county has approximately 22,000 residents with no hospital, no paramedics on ambulances, and emergency rooms 20+ miles away.

What would it take to reopen Martin General?

ECU Health has a letter of intent to reopen it as a rural emergency hospital (REH), but the plan requires the North Carolina General Assembly to appropriate $210 million to ECU Health and Martin County to fund building refurbishment. Those appropriations have not materialized. ECU Health’s CEO has separately warned the system expects to lose $1 billion over the next 10 years from Medicaid cuts under the One Big Beautiful Bill Act.

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June 19, 2026

NYC Defied Washington and Rejoined the WHO — Here’s What That Really Means

On January 22, 2026, the United States officially completed its withdrawal from the World Health Organization — the culmination of an executive order signed by President Trump on his first day back in office. The U.S. halted all funding, recalled its personnel from Geneva, and ceased participation in WHO governance bodies.

Less than two weeks later, New York City went the other direction.

On February 5, 2026, the NYC Department of Health and Mental Hygiene announced it had joined the WHO’s Global Outbreak Alert and Response Network (GOARN) — becoming the first municipal health department in the United States to formally align with a WHO-affiliated body after the federal withdrawal. New York State, California, and Illinois have since followed with their own GOARN memberships.

The move was framed as a public health necessity. Critics see it as something else: a city government using a bureaucratic workaround to defy a federal policy decision made by the elected president of the United States.

What Is GOARN — And What Did NYC Just Sign Up For?

GOARN is not the WHO itself, but it is coordinated by the WHO and operates as an arm of its global outbreak infrastructure. The network includes more than 360 technical institutions — national health agencies, UN bodies, academic institutions, and nongovernmental organizations — and its stated mission is rapid detection and response to infectious disease outbreaks worldwide.

By joining, NYC’s health department gains:

Early-warning outbreak intelligence — weekly briefings on emerging global health threats before they reach American shores
Access to international laboratory networks — direct coordination with global health labs during active outbreaks
Workforce training through real-world international response deployments
Direct communication channels with global health partners during major health events

NYC Acting Health Commissioner Dr. Michelle Morse framed it in practical terms: “New York City is a global city with 8.5 million residents and more than 12 million international visitors every year,”she said. “To best prevent disease outbreaks and public health emergencies and to protect New Yorkers and visitors from them, the NYC Health Department is joining hundreds of public health institutions worldwide that share critical public health information.”

That logic has force. NYC is, in fact, a global disease entry point — as the city’s own 2026 measles cases (all linked to international travel) demonstrate.

The Political Reality

But the public health rationale doesn’t fully explain the timing or the tone.

Mayor Zohran Mamdani — a Democratic Socialist inaugurated on January 1, 2026 — has been on a collision course with the Trump administration since before he took office. Trump openly backed his opponent, warned he would withhold federal funding if Mamdani won, and called the new mayor a “communist” on national television. Mamdani, for his part, has signed executive orders directly countermanding federal immigration enforcement, vowed to use “every tool of the law” against White House threats, and now — through his health department — has formalized a relationship with the very international body the president just paid $490 million in arrears to exit.

The U.S. had committed to providing the WHO with $490 million in voluntary contributions for 2024 and 2025, which the Trump administration refused to pay before withdrawal — leaving the organization with a significant funding shortfall.

Governor Hochul’s own statement on joining GOARN at the state level made the political intent explicit: “New York has always led in public health and safety and now we’re doing our part to protect lives while the federal government puts Americans’ health at risk.”

That’s not a public health statement. That’s a campaign ad.

What the Federal Government Actually Did — And Why

The Trump administration’s HHS fact sheet on the WHO withdrawal cited three core reasons for leaving:

The WHO’s mishandling of the COVID-19 pandemic — specifically its deference to China in the early months of the outbreak
Persistent refusal to adopt internal reforms
Lack of accountability, transparency, and independence from political influence of member states

These are not fringe complaints. They have been raised by public health experts across the political spectrum. As the WHO’s largest historical funder— contributing between $160 million and $815 million annually over the past decade — the U.S. had unique leverage to demand reform. Walking away, the argument goes, was the only credible threat left.

The counter-argument: without U.S. participation, countries like China, Russia, India, and Saudi Arabia now have greater influence over WHO’s priorities and guidelines. That has real consequences for how global health crises are managed — and what information the U.S. receives in the early hours of an emerging outbreak.

The 2026 FIFA World Cup Factor

There is one genuinely nonpartisan reason NYC’s move to GOARN carries urgency: the 2026 FIFA World Cup.

Matches will be played across North America this summer, with the final at MetLife Stadium in East Rutherford, New Jersey. Greater New York alone is expected to draw more than one million international visitors in a matter of weeks. The city’s health infrastructure will need to track disease threats from dozens of countries simultaneously — exactly the kind of scenario GOARN was designed for.

This is the one context where the “we need global intel” argument for GOARN membership is hardest to dismiss on partisan grounds.

What This Means for New Yorkers

In practical terms, day-to-day healthcare in New York City is not changing. GOARN membership does not give the WHO authority over NYC’s public health policy, vaccination mandates, or healthcare system. It is an information-sharing and coordination arrangement — not a governance transfer.

What it does represent is a growing patchwork of sub-national governments — cities and states — making independent foreign health policy decisions, in direct contrast to the federal government. That trend, if it accelerates, raises legitimate questions about who actually sets American public health priorities when Washington and major population centers are pulling in opposite directions.

For New Yorkers, the immediate question is simpler: does having earlier access to international outbreak intelligence make the city safer? The data suggests yes. Whether the political theater surrounding it helps or hurts is a separate question entirely.

Breaking This Week: The WHO Assembly the U.S. Isn’t Attending

The stakes of NYC’s GOARN move come into even sharper focus this week. The 79th World Health Assembly is currently underway in Geneva, Switzerland (May 18–23, 2026) — and for the first time in nearly 80 years, the United States has no seat at the table.

The assembly is moving forward without Washington on several fronts that directly affect New York City and American public health:

The WHO Pandemic Agreement annex negotiations. The WHO Pandemic Agreement — adopted by 120 countries in May 2025, without U.S. participation — is still being finalized. The critical PABS annex, which governs how countries share pathogen data and access vaccines during a future pandemic, is being negotiated at this assembly. The U.S. is not part of those talks. When the next pandemic begins, Washington will have no formal access to the early pathogen intelligence sharing system its own scientists helped build.

Global health architecture reform. The assembly this week voted to establish a Member State-led reform process for the entire global health architecture — redesigning how the world coordinates on outbreaks, funding, and emergency response. The U.S. has no voice in shaping that redesign.

The direct GOARN impact. In his address to the assembly on May 19, WHO Director-General Dr. Tedros Adhanom Ghebreyesus highlighted that GOARN coordinated 58 deployments to 16 countries in the past year alone — including rapid responses to Ebola in the DRC, Marburg virus in Tanzania and Ethiopia, and the ongoing hantavirus situation aboard the MV Hondius cruise ship. NYC’s GOARN membership means the city’s health department now receives that real-time intelligence directly. The federal CDC does not.

The financial vacuum. The assembly opened under what UN News described as “the shadow of Ebola, hantavirus and funding cuts.” Ghana’s president, in his keynote, said his country lost $78 million in health funding following USAID cuts, with critical malaria and HIV programs affected. The U.S. withdrawal has forced the WHO to scale back operations globally — creating gaps in exactly the outbreak surveillance infrastructure that NYC is now trying to plug through GOARN membership.

The irony is not subtle: as Washington steps back from the global health table, New York City has pulled up its own chair.

Timeline: How We Got Here

Date	Event
Jan 20, 2025	President Trump signs Executive Order 14155, initiating WHO withdrawal
Jan 22, 2026	U.S. officially exits WHO; all funding terminated, personnel recalled
Feb 5, 2026	NYC Health Dept. joins GOARN — first U.S. municipality to do so
Feb 10, 2026	NY State joins GOARN under Gov. Hochul
Feb–March 2026	California and Illinois health departments also join GOARN