Robert Gudmestad, Colorado State University

Hank Greenberg might be the best baseball player you’ve never heard of.

Greenberg was the first baseman for the Detroit Tigers during the 1930s and 1940s. His career was relatively short – 13 years – and interrupted by two stints of service in World War II.

Yet outside the war years, there were glorious seasons.

Greenberg led the American League in home runs four times, played in five All-Star Games, twice won the American League’s Most Valuable Player Award and, in 1938, nearly broke what was then the game’s most hallowed record: Babe Ruth’s 60 home runs in one season. In 1956, Greenberg was elected to the Baseball Hall of Fame.

Greenberg was also Jewish, and he is often called America’s first Jewish sports superstar. As Greenberg wrote in his autobiography, that was not an easy honor to bear. Greenberg played during a time of rising antisemitism, and the cruel taunts he suffered from players and fans lasted throughout his career. Vile remarks and bigoted slurs – “kike,” “sheenie” and “Jew bastard” were typical – left a mark on him and the sport he loved.

Along the way, Greenberg also faced a crisis of conscience: his struggle on whether to play during Rosh Hashanah and Yom Kippur, the Jewish High Holidays. He resolved the conflict with a Solomon-like choice, more than 30 years before baseball legend Sandy Koufax pondered the same dilemma during the 1965 World Series.

Today, nearly 80 years after Greenberg retired from baseball, antisemitism is once again on the rise both in the U.S. and worldwide. As a historian of American sport, I suggest there are lessons to be learned on how Greenberg handled the hate.

Horns like the devil

Greenberg signed a contract with the Tigers in 1930 and played in the minor leagues for the next three years. For many of his teammates, he was the first Jewish person they’d ever met. One told Greenberg, quite seriously, that he thought Jewish people had horns, like the devil.

Once brought up to the major leagues, Greenberg was generally accepted by his teammates. The same could not be said of opposing players and fans, who hounded him throughout his career. The fans insulting Greenberg were in the distinct minority, but they were loud, nonstop and got virtually no resistance from other fans or the media.

Greenberg’s response to the abuse: ignore it. But he reacted at least once, during a game against the Chicago White Sox. One Chicago player tried to injure Greenberg – his autobiography does not report how – and another called him a “yellow Jew son of a bitch.” After the game, Greenberg visited the opposing team’s locker room and demanded to know who the name caller was. At 6 feet, 3 inches tall and 200-plus pounds, Greenberg was intimidating. The room fell silent. The White Sox players never antagonized him again.

Other pressures bore down on Greenberg. Detroit was a hotbed of antisemitism in the 1930s. The Dearborn Independent, a newspaper owned by the industrialist Henry Ford, described Jews as “the world’s foremost problem,” an echo of Ford’s antisemitic beliefs. The city was also home to Father Charles Coughlin, a Catholic priest who reviled Jews and spread antisemitic rhetoric during his radio show – which at its height was heard by perhaps 40 million people. Overseas, Adolf Hitler was the fuhrer of Germany, and his persecution of Jews became even more apparent after Kristallnacht, in November 1938, when the Nazi regime went on an antisemitic rampage.

“I came to feel,” Greenberg wrote later, “that if I, as a Jew, hit a home run, I was hitting one against Hitler.”

Playing on Jewish holidays

In 1934, when he was 23, Greenberg decided he would not play on the Jewish New Year, Rosh Hashanah, a holiday when observant Jews were supposed to pray and not work. But the Tigers were in a close race for the American League pennant. The team needed Greenberg, their star player.

A local newspaper reporter interviewed a Detroit rabbi and asked if it was acceptable for Greenberg to play. The rabbi said it was OK. Deciding at the last minute, Greenberg played and hit two home runs. Detroit won the game, 2-1. The Detroit Free Press ran a headline in Yiddish, with an English translation: “Happy New Year, Hank.”

Ten days later came Yom Kippur, the most sacred of all Jewish holidays. Also known as the Day of Atonement, observant Jews are to spend the day in prayer and self-reflection; baseball was not on the agenda. This time, Greenberg did not play, and attended services instead. When he entered the synagogue, the congregation applauded.

The Tigers lost 5-2 to the New York Yankees that day. But Detroit won the pennant anyway.

“I used to resent being singled out as a Jewish ballplayer, period,” Greenberg said in his autobiography. “I’m not sure why or when it changed, because I’m still not a particularly religious person. Lately, though, I find myself wanting to be remembered not only as a great ballplayer, but even more as a great Jewish ballplayer.”

Meeting Robinson

1947 was Jackie Robinson’s rookie year and Greenberg’s last. Robinson, the first baseman for the Brooklyn Dodgers, had broken the color line and was baseball’s first Black player of the modern era; he was enduring enormous abuse, something Greenberg, now with the Pittsburgh Pirates, clearly understood. They played against each other for the first time at Forbes Field in Pittsburgh in May.

In the fourth inning, Greenberg got to first on a walk, and according to newspaper accounts, he had a few words for Robinson: “I know it’s plenty tough,” he said. “You’re a good ballplayer, and you’ll do all right.”

Greenberg also publicly supported Robinson, one of the few opposing players to do so.

Nearly a half-century later, Supreme Court justices Ruth Bader Ginsburg and Stephen Breyer were considering whether the Supreme Court should meet on Yom Kippur. They too found inspiration from Greenberg; Ginsburg noted that Greenberg did not “betray his conscience.” The Supreme Court did not meet on Yom Kippur that year, and it hasn’t since.

Although there has been tremendous progress, racial and ethnic slurs persist in American sports. In 2024, some fans directed racially abusive comments at two Black players on the U.S. men’s national soccer team. In English football – known as soccer in the U.S. – Muslim players reported widespread discrimination and abuse. Things have changed, but not enough.

Although not a devout Jew, Greenberg understood that to endure the abuse, he had to embrace his identity. Those athletes of today, recently stung by the vitriol of bigots and trolls, may wish to take heed of the lessons learned by this reticent hero from the previous century, a man whose quiet dignity spoke volumes.

Robert Gudmestad, Professor and Chair of History Department, Colorado State University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Angelica P. Ahrens, University of Florida; Eric W. Triplett, University of Florida, and Johnny Ludvigsson, Linköping University

Early screening for neurodevelopmental disorders such as autism is important to ensure children have the support they need to gain the essential skills for daily life. The American Academy of Pediatrics recommends that all children be screened for developmental delays, with additional screening for those who are preterm or have a low birth weight.

However, the U.S. Preventive Services Task Force has called for more research into the effectiveness of current autism screening practices. Primarily based on milestone checklists and symptoms, autism diagnoses also currently rely on observations of behavior that often manifests after crucial developmental stages have passed.

Researchers and clinicians are working to develop simple, reliable tools that could identify early signs or risk factors of a condition before symptoms are obvious. While early screening can lead to the risk of overdiagnosis, understanding a child’s developmental needs can help guide families toward resources that address those needs sooner.

We are researchers who study the role the microbiome plays in a variety of conditions, such as mental illness, autoimmunity, obesity, preterm birth and others. In our recently published research on Swedish children, we found that microbes and the metabolites they produce in the guts of infants – both found in poop and cord blood – could help screen for a child’s risk of neurodevelopmental conditions such as autism. And these differences can be detected as early as birth or within the first year of life. These markers were evident, on average, over a decade before the children were diagnosed.

Microbes as biomarkers

Biomarkers are biological indicators – such as genes, proteins or metabolites in blood, stool or other types of samples – that signal the presence of a condition at a certain point in time. There are no known biomarkers for autism. Efforts to find biomarkers have been largely hindered by the fact that autism has many potential pathways that lead to it, and researchers tend to ignore how these causes may work together as a whole.

One potential biomarker for neurodevelopmental conditions such as autism are gut microbes. The connection between the gut and brain, or the gut-brain axis, is an area of considerable interest among scientists. Gut microbes play significant roles in health, including in immunity, neurotransmitter balance, digestive health and much more.

A lot of work has been done around mapping what a “typical” microbiome looks like based on age and organ system. Researchers have shown that the microbiome is personalized enough that it can distinguish two people or two households even better than genetics, with differences in colonization starting very early in life.

The microbiome undergoes immense changes during childhood. It shapes and is shaped by the immune system and influenced by life changes and events. It is also influenced by factors like genetics, environment, lifestyle, infection and medications.

Gastrointestinal symptoms such as diarrhea, pain and constipation are common in children with autism and ADHD, with as many as 30% to 70% of autism patients also diagnosed with functional gastrointestinal disorders. Untreated GI issues can also lead to additional sleep and behavioral disorders among these children. A small pilot study found that children with autism showed improvements in gastrointestinal and autism-related symptoms after having healthy microbes transferred into their guts, with some benefits lasting up to two years.

Most studies on the microbiome and neurodevelopmental conditions, however, are restricted to people who are already diagnosed with ADHD, autism or other conditions, and these studies often show mixed results. These limitations raise an important question: Does the microbiome play a direct role in the development of autism and other neurodevelopmental conditions, or are changes in microbiome composition a consequence of the conditions themselves?

Some investigations have proposed that the microbiome has little or no association with future autism. However, these studies have a notable limitation: They don’t examine microbial imbalances prior to diagnosis or symptom onset. Instead, these studies focus on children already diagnosed with autism, comparing them to their siblings and unrelated neurotypical children. In most cases, dietary data and samples are collected several years after diagnosis, meaning the study cannot test for whether microbial imbalances cause autism.

Microbes matter

We wondered whether studying the bacteria residing in small children before they are diagnosed or show symptoms of autism or other conditions could give us a clue into their neurodevelopment. So, we examined the cord blood and stool collected at approximately 1 year of age from participants of an ongoing study called All Babies in Southeast Sweden, which follows the health of approximately 17,000 children born between 1997 and 1999 and their parents. We have followed these children since birth, nearly 1,200 of whom were later diagnosed with a neurodevelopmental disorder by age 23.

We found significant differences in bacterial composition and metabolite levels that developed before symptoms of neurodevelopmental conditions – such as gastrointestinal upset, crankiness and sleep problems – as well as formal medical diagnoses. These differences spanned many conditions, including autism, ADHD and speech disorders.

Next, we linked bacteria to neurotransmitters – chemical signals that help brain cells communicate – and vitamins such as riboflavin and vitamin B in the child’s stool. Given previous research on children and adults already diagnosed with a neurodevelopmental disorder, we expected to find differences in the microbiome composition and health between those with and without neurodevelopmental conditions.

But we were surprised to discover just how early these differences emerge. We saw variability in the microbes and metabolites that affect immune and brain health, among others, in the stool collected from the diapers of children around 1 year of age and in umbilical cord blood collected at birth.

The imbalance in microbial composition – what microbiologists call dysbiosis – we observed suggests that incomplete recovery from repeated antibiotic use may greatly affect children during this vulnerable period. Similarly, we saw that repeated ear infections were linked to a twofold increased likelihood of developing autism.

Children who both repeatedly used antibiotics and had microbial imbalances were significantly more likely to develop autism. More specifically, children with an absence of Coprococcus comes, a bacterium linked to mental health and quality of life, and increased prevalence of Citrobacter, a bacterium known for antimicrobial resistance, along with repeated antibiotic use were two to four times more likely to develop a neurodevelopmental disorder.

Antibiotics are necessary for treating certain bacterial infections in children, and we emphasize that our findings do not suggest avoiding their use altogether. Parents should use antibiotics if they are prescribed and deemed necessary by their pediatrician. Rather, our study suggests that repeated antibiotic use during early childhood may signal underlying immune dysfunction or disrupted brain development, which can be influenced by the gut microbiome. In any case, it is important to consider whether children could benefit from treatments to restore their gut microbes after taking antibiotics, an area we are actively studying.

Another microbial imbalance in children who later were diagnosed with neurodevelopmental disorders was a decrease in Akkermansia muciniphila, a bacterium that reinforces the lining of the gut and is linked to neurotransmitters important to neurological health.

Even after we accounted for factors that could influence gut microbe composition, such as how the baby was delivered and breastfeeding, the relationship between imbalanced bacteria and future diagnosis persisted. And these imbalances preceded diagnosis of autism, ADHD or intellectual disability by 13 to 14 years on average, refuting the assumption that gut microbe imbalances arise from diet.

We found that lipids and bile acids were depleted in the cord blood of newborns with future autism. These compounds provide nutrients for beneficial bacteria, help maintain immune balance and influence neurotransmitter systems and signaling pathways in the brain.

Microbiome screening at well-child visits

Microbiome screening is not a common practice in well-child visits. But our findings suggest that detecting imbalances in beneficial and harmful bacteria, especially during critical periods of early childhood development, can provide essential insights for clinicians and families.

There is a long way to go before such screening becomes a standard part of pediatric care. Researchers still need validated methods to analyze and interpret microbiome data in the clinic. It’s also unclear how bacterial differences change across time in children around the world – not just which bacteria are present or absent, but also how they may be shaping immune responses and metabolism. But our findings reaffirm the growing body of evidence that the early gut microbiome plays a key role in shaping neurodevelopment.

Angelica P. Ahrens, Assistant Research Scientist in Data Science and Microbiology, University of Florida; Eric W. Triplett, Professor and Chair of Microbiology and Cell Science, University of Florida, and Johnny Ludvigsson, Professor Emeritus of Biomedical and Clinical Sciences, Linköping University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Jennifer Horney, University of Delaware

Hurricane Helene’s flooding has subsided, but health risks are growing in hard-hit regions of the North Carolina mountains, where many people lost access to power and clean water.

More than 150 deaths across the Southeast had been attributed to Hurricane Helene within days of the late September 2024 storm, according to The Associated Press, and hundreds of people remained unaccounted for. In many areas hit by flooding, homes were left isolated by damaged roads and bridges. Phone service was down. And electricity was likely to be out for weeks.

As a disaster epidemiologist and a native North Carolinian, I have been hearing stories from the region that are devastating. Contaminated water is one of the leading health risks, but residents also face harm to mental health, stress that exacerbates chronic diseases and several other threats.

Water risks: What you can’t see can hurt you

Access to clean water is one of the most urgent health concerns after a flood. People need water for drinking, preparing food, cleaning, bathing, even flushing toilets. Contact with contaminated water can cause serious illnesses.

Floodwater with sewage or other harmful contaminants in it can lead to infectious diseases, particularly among people who are already ill, immunocompromised or have open wounds. Even after the water recedes, residents may underestimate the potential for contamination by unseen bacteria such as fecal coliform, heavy metals such as lead, and organic and inorganic contaminants such as pesticides.

In Asheville, the flooding caused so much damage to water treatment facilities and pipes that officials warned the city could be without running water for potentially weeks. Most private wells also require electricity to pump and filter the water, and many people in surrounding areas could be without power for weeks.

State and federal agencies began delivering extra bottled water to the region shortly after the storm, but supplies were limited, and it’s likely that a number of people won’t be able to reach the distribution sites soon. Access to fresh food is another concern for many areas with roads and bridges washed out.

Inside homes, floodwater can create more health risks, particularly if mold grows on wet fabrics and wallboard. Standing water outside also increases the risk of exposure to mosquitoes carrying diseases such as West Nile virus. Mosquitoes are still active in much of the region in the fall.

Inundation, isolation and access to health care

Many of the images in the news after the hurricane hit showed roads, hospitals and entire towns inundated by floodwaters. In North Carolina, more than 400 roads were closed, blocking access to the major regional health care hub of Asheville, as well as many smaller communities.

While supplies can be airlifted to clinics, residents needing urgent access to treatments such as dialysis or daily medications for substance use disorders may have been cut off. Health care workers may be unable to access their clinics as well.

Cuts and other injuries are common in the aftermath of storms, as people clean up debris, and even small wounds can become infected. The stress, exertion and exposure to heat can also exacerbate chronic conditions such as cardiovascular and respiratory diseases.

Mental health and long-term effects

Beyond the risks to physical health, the fear, stress and losses can affect mental health.

Research has consistently shown that emergency responders’ mental health can suffer in widespread disasters, particularly when they know disaster victims, deal with severe injuries or feel helpless. All of those conditions were present as Hurricane Helene’s floodwaters swept away dozens of people, with many more still listed as missing.

Stigma, cost and a lack of mental health care providers all add to the ongoing challenges to mental health after disasters. Research shows that a large percentage of people face mental health challenges after disasters.

According to the Substance Abuse and Mental Health Services Administration, two federal grant programs provide mental health services support to individuals and communities after disasters. However, one of those sources of funding ends after 60 days, the other after one year. Given the decades of recovery facing western North Carolina after Hurricane Helene, I believe these programs are woefully inadequate to meet the mental health needs of the populations affected by the storm.

Flooded regions will need long-term help

Western North Carolina is often described as a “climate refuge” because of its cooler summers. And Asheville in particular has become a popular place for retirees and new residents. Recent data shows the city has the second highest migration rate in the nation.

But Helene and other extreme storms that have flooded the region make its vulnerabilities clear.

In the aftermath of the flooding, newcomers unfamiliar with the risks and longtime residents alike will be dealing with ongoing health concerns as they try to clean up and rebuild from the storm. Even as attention shifts to other disasters, the people in this region will still need help to recover for months and years to come.

Jennifer Horney, Professor of Epidemiology and Core Faculty of Disaster Research Center, University of Delaware

This article is republished from The Conversation under a Creative Commons license. Read the original article.