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Rural Americans don’t live as long as those in cities − new research

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theconversation.com – Elizabeth Currid-Halkett, James Irvine Chair in Urban and Regional Planning and Professor of Public Policy, University of Southern California – 2025-02-11 07:45:00

Rural Americans don’t live as long as those in cities − new research

Part of the problem is that people living in rural areas don’t always have easy access to health care.
cstar55/iStock via Getty Images

Elizabeth Currid-Halkett, University of Southern California; Bryan Tysinger, University of Southern California, and Jack Chapel, University of Southern California

Rural Americans – particularly men – are expected to live significantly shorter, less healthy lives than their urban counterparts, according to our research, recently published in the Journal of Rural Health.

We found that a 60-year-old man living in a rural area is expected on average to live two fewer years than an urban man. For women, the rural-urban gap is six months.

A key reason is worse rates among rural people for smoking, obesity and chronic conditions such as high blood pressure and heart disease. These conditions are condemning millions to disability and shortened lives.

What’s more, these same people live in areas where medical care is evaporating. Living in rural areas, with their relatively sparse populations, often means a shortage of doctors, longer travel distances for medical care and inadequate investments in public health, driven partly by declines in economic opportunities.

Our team arrived at these findings by using a simulation called the Future Elderly Model. With that, we were able to simulate the future life course of Americans currently age 60 living in either an urban or rural area.

The model is based on relationships observed in 20 years of data from the Health and Retirement Study, an ongoing survey that follows people from age 51 through the rest of their lives. Specifically, the model showed how long these Americans might live, the expected quality of their future years, and how certain changes in lifestyle would affect the results.

We describe the conditions that drive our results as “diseases of despair,” building off the landmark work of pioneering researchers who coined the now widely used term “deaths of despair.” They documented rising mortality among Americans without a college degree and related these deaths to declines in social and economic prospects.

The main causes of deaths of despair – drug overdoses, liver disease and suicide – have also been called “diseases of despair.” But the conditions we study, such as heart disease, could similarly be influenced by social and economic prospects. And they can profoundly reduce quality of life.

We also found that if rural education levels were as high as in urban areas, this would eliminate almost half of the rural-urban life-expectancy gap. Our data shows 65% of urban 60-year-olds were educated beyond high school, compared with 53% of rural residents the same age.

One possible reason for the difference is that getting a bachelor’s degree may make a person more able or willing to follow scientific recommendations – and more likely to work out for 150 minutes a week or eat their veggies as their doctor advises them to.

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Rural communities are increasingly hampered by their lack of access to health care.

Why it matters

The gap between urban and rural health outcomes has widened over recent decades. Yet the problem goes beyond disparities between urban and rural health: It also splits down some of the party lines and social divides that separate U.S. citizens, such as education and lifestyle.

Scholarship on the decline of rural America suggests that people living outside larger cities are resentful of the economic forces that may have eroded their economic power. The interplay between these forces and the health conditions we study are less appreciated.

Economic circumstances can contribute to health outcomes. For example, increased stress and sedentary lifestyle due to joblessness can contribute to chronic health issues such as cardiovascular disease. Declines in economic prospects due to automation and trade liberalization are linked to increases in mortality.

But health can also have a strong influence on economic outcomes. Hospitalizations cause high medical costs, loss of work and earnings, and increases in bankruptcy. The onset of chronic disease and disability can lead to long-lasting declines in income. Even health events experienced early in childhood can have economic consequences decades later.

In tandem, these health and economic trends might reinforce each other and help fuel inequality between rural and urban areas that produces a profoundly different quality of life.

What still isn’t known

It should be noted that our results, like many studies, are describing outcomes on average; the rural population is not a monolith. In fact, some of the most physically active and healthy people we know live in rural areas.

Just how much your location affects your health is an ongoing area of research. But as researchers begin to understand more, we can come up with strategies to promote health among all Americans, regardless of where they live.

The Research Brief is a short take on interesting academic work.The Conversation

Elizabeth Currid-Halkett, James Irvine Chair in Urban and Regional Planning and Professor of Public Policy, University of Southern California; Bryan Tysinger, Assistant Professor of Health Policy and Management, University of Southern California, and Jack Chapel, Postdoctoral Scholar in Economics, University of Southern California

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Even as polarization surges, Americans believe they live in a compassionate country

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theconversation.com – Tara Sonenshine, Edward R. Murrow Professor of Practice in Public Diplomacy, Tufts University – 2025-02-11 12:06:00

Even as polarization surges, Americans believe they live in a compassionate country

Most Americans responding to a survey said compassion is declining but still strong.
stellalevi/DigitalVision Vectors via Getty Images

Tara Sonenshine, Tufts University

Compassion comes easily to me.

As the granddaughter of immigrants from Lithuania and Poland who spoke little English, I understand what it’s like to be treated as a stranger in America.

As a journalist, I covered stories of war and trauma in the 1990s, including the crushing of Chinese protests in Tiananmen Square and the fall of the Berlin Wall in 1989, followed by the Soviet Union’s collapse two years later. I covered the war between Iraq and Iran. I witnessed ethnic strife in South Africa and the toll poverty takes in Mexico.

As a professor of cultural engagement and public diplomacy, I have watched and studied how compassion can help build and strengthen civil society.

And having worked in senior levels of the U.S. government for Presidents Bill Clinton and Barack Obama on international conflict resolution, I have learned that compassion is a key ingredient of peacemaking.

Especially now, as President Donald Trump seeks to deport millions of immigrants living in the U.S. without authorization and to stop funding the U.S. Agency for International Development, which has long spent billions of dollars a year helping the world’s poorest people, compassion seems lacking among U.S. leaders.

Perhaps that all explains my curiosity about a new study on the state of compassion in America – part of the glue that holds communities together.

Defining compassion

Sociologists define compassion as the human regard for the suffering of others, and the notion of using action to alleviate this pain.

The report that caught my eye was issued in January 2025 by the Muhammad Ali Center, which the late boxer co-founded 20 years ago in Louisville, Kentucky, to advance social justice.

As the Ali Center explains, compassion starts with the individual – self-care and personal wellness. It then radiates out to the wider community in the form of action and engagement.

You can see compassion at work in the actions of a Pasadena, California, girl, who started a donation hub for teens affected by fires that ripped through the Los Angeles region in early 2025. She began collecting sports bras, hair ties and fashionable sweaters – helping hundreds of her peers begin to recover from their losses in material and emotional ways.

It’s also visible in the estimated 6.8 million people in the U.S. who donate blood each year, according to the American Red Cross.

Resilience in America

While Ali is best known for his battles in the ring and his outspoken political views, he also helped those in need in the U.S. and other countries through large charitable donations and his participation in United Nations missions to countries like Afghanistan, where he helped deliver millions of meals to hungry people.

The researchers who worked on the Ali Center report interviewed more than 5,000 U.S. adults living in 12 cities in 2024 in order to learn more about the prevalence of compassionate behaviors such as charitable giving, volunteering and assisting others in their recovery from disasters.

They found that the desire to help others still animates many Americans despite the nation’s current polarization and divisive politics.

The center has created an index it calls the “net compassion score.” It approximates the degree to which Americans give their time and money to programs and activities that nurture and strengthen their communities.

Cities with high compassion scores have more community engagement and civic participation than those with low scores. A higher-scoring community performs better when it comes to things like public housing and mental health resources, for example. Its residents report more career opportunities, better communications between local government and citizens, more community programs and more optimism around economic development where they live.

The report provides some clues as to what drives compassionate behavior in a city: a sense of spirituality, good education, decent health care, resources for activities like sports, and opportunities to engage in local politics.

All told, Americans rate their country as a 9 on a scale that runs from minus 100 to 100.

The report also identified some troubling obstacles that stand in the way of what it calls “self-compassion” – meaning how volunteers and donors treat their own mental and physical health. Frequent struggles with self-care can lead to rising levels of isolation and loneliness.

Three people pose for a picture in front of an Ali Center backdrop
Jeni Stepanek, left, chair of the Muhammad Ali Index; Lonnie Ali, co-founder and vice chair of the Muhammad Ali Center; and DeVone Holt, the center’s president and CEO, at the launch of the Muhammad Ali Index on Jan. 16, 2025.
Bryan Bedder/Getty Images for Muhammad Ali Center

Doubting their own capacity

The 2025 Compassion Report’s findings show that many Americans still want to live in a compassionate country but also that Americans view the country as less compassionate today than four years ago.

The report delves into gaps in compassion. About one-third of those interviewed acknowledged that there are groups toward whom they feel less compassionate toward, such as people who have been convicted of crimes, immigrants living in the U.S. without authorization and the rich.

Only 29% said they feel compassion toward everyone.

The report also identifies gender gaps. Despite expressing greater awareness of systemic challenges, the women surveyed reported less self-compassion than men.

It’s not the first compassion study ever done. But I believe that this one is unique due to its focus on specific cities, and how it assessed limits on the compassion some people feel toward certain groups.

Helping health and humanity

The Compassion Institute, another nonprofit, seeks to weave compassion training into health care education to “create a more caring and humanitarian world.” It cites the benefits of compassion for human beings, with everything from reducing stress to alleviating the effects of disease on the mind and body.

Academic institutions, including Stanford University, have conducted many studies on how teaching compassion can guide health care professionals to both treat patients better and achieve better outcomes.

A team of Emory University researchers examined how training people to express more compassion can reduce stress hormones levels, triggering positive brain responses that improve immune responses.

Offering an advantage

Although there are plenty of adorable videos of dogs and cats behaving kindly with each other or their human companions, historically compassion has differentiated humans from animals.

Human beings possess powers of emotional reasoning that give us an edge.

Scholars are still working to discover how much of human compassion is rooted in emotional reasoning. Another factor they’ve identified is the aftermath of trauma. Studies have found evidence that it can increase empathy later on.

You might imagine that in a world of hurt, there’s a deficit of compassion for others. But the Ali Center’s report keeps alive the notion that Americans remain compassionate people who want to help others.

My experiences around the world and within the U.S. have taught me that human beings both have the power to be violent and destructive. But despite it all, there is, within all of us, the innate ability and desire to be compassionate. That is a net positive for our country.The Conversation

Tara Sonenshine, Edward R. Murrow Professor of Practice in Public Diplomacy, Tufts University

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Decluttering can be stressful − a clinical psychologist explains how personal values can make it easier

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theconversation.com – Mary E. Dozier, Assistant Professor of Psychology, Mississippi State University – 2025-02-11 07:47:00

Decluttering can be stressful − a clinical psychologist explains how personal values can make it easier

Asking how discarding an item fits with a person’s goals can help them decide whether to keep it.
MoMo Productions via Getty Images

Mary E. Dozier, Mississippi State University

I recently helped my mom sort through boxes she inherited when my grandparents passed away. One box was labeled – either ironically or genuinely – “toothpick holders and other treasures.” Inside were many keepsakes from moments now lost to history – although we found no toothpick holders.

My favorite of the items we sorted through was a solitary puzzle piece, an artifact reflecting my late grandmother’s penchant for hiding the final piece to a jigsaw puzzle just to swoop in at the last moment and finish it.

After several hours of reminiscing, my mom and I threw away 90% of what we had sorted.

“Why did I keep this?” is a question I hear frequently, both from my family and friends and from patients. I am a licensed clinical psychologist whose research focuses on the characterization, assessment and treatment of hoarding disorder, particularly for adults 60 years of age or older. As such, I spend a great deal of my time thinking about this question.

What drives the need to keep stuff?

Hoarding disorder is a psychiatric condition defined by urges to save items and difficulty discarding current possessions. For adults with “clinically severe” hoarding disorder, this leads to a level of household clutter that impairs daily functioning and can even create a fire hazard. In my professional experience, however, many adults struggle with clutter even if they do not meet the clinical criteria for hoarding disorder.

Holding on to things that have sentimental value or could be useful in the future is a natural part of growing older. For some people, though, this tendency to hold on to objects grows over time, to the point that they eventually do meet criteria for hoarding disorder. Age-related changes in executive function may help explain the increase in prevalence of hoarding disorder as we get older; increasing difficulty with decision-making in general also affects decisions around household clutter.

The traditional model behind hoarding disorder suggests that difficulty with discarding comes from distress during decision-making. However, my research shows that this may be less true of older adults.

A room full of piles of papers, stacked shelves and a tricycle.
Time to declutter.
Kurt Whitman/Education Images via Getty Images

When I was a graduate student, I conducted a study in which we asked adults with hoarding disorder to spend 15 minutes making decisions about whether to keep or discard various items brought from their home. Participants could sort whatever items they wanted. Most chose to sort paper items such as old mail, cards or notes.

We found that age was associated with lower levels of distress during the task, such that participants who were older tended to feel less stressed when making the decision about what to keep and what to discard. We also found that many participants, particularly those who were older, actually reported positive emotions while sorting their items.

In new research publishing soon, my current team replicated this finding using a home-based version of the task. This suggests that fear of making the wrong decision isn’t a universal driver of our urge to save items.

In fact, a study my team published in August 2024 with adults over 50 with hoarding disorder suggests that altruism, a personality trait of wanting to help others, may explain why some people keep items that others might discard. My colleagues and I compared our participants’ personality profiles with that of adults in the general population of the same gender and age group. Compared with the general population, participants with hoarding disorder scored almost universally high on altruism.

Altruism also comes up frequently in my clinical work with older adults who struggle with clutter. People in our studies often tell me that they have held onto something out of a sense of responsibility, either for the item itself or to the environment.

“I need it to go to a good home” and “my grandmother gave this to me” are sentiments we commonly hear. Thus, people may keep things not out of fear of losing them but because saving them is consistent with their values.

YouTube video
Your values can help guide which possessions should stay in your life and which ones should go.

Leaning into values

In a 2024 study, my team demonstrated that taking a values-based approach to decluttering helps older adults to decrease household clutter and increases their positive affect, a state of mind characterized by feelings such as joy and contentment. Clinicians visited the homes of older adults with hoarding disorder for one hour per week for six weeks. At each visit, the clinicians used a technique called motivational interviewing to help participants talk through their decisions while they sorted household clutter.

We found that having participants start with identifying their values allowed them to maintain focus on their long-term goals. Too often, people focus on the immediate ability of an object to “spark joy” and forget to consider whether an object has greater meaning and purpose. Values are the abstract beliefs that we humans use to create our goals. Values are whatever drives us and can include family, faith or frivolity.

Because values are subjective, what people identify as important to keep is also subjective. For example, the dress I wore to my sister’s wedding reminded me of a wonderful day. However, when it no longer fit I gave it away because doing so was more consistent with my values of utility and helpfulness: I wanted the dress to go to someone who needed it and would use it. Someone who more strongly valued family and beauty might have prioritized keeping the dress because of the aesthetics and its link to a family event.

Additionally, we found that instead of challenging the reasons a person might have for keeping an item, it is helpful to instead focus on eliciting their reasons for discarding it and the goals they have for their home and their life.

Tips for sweeping away the old

My research on using motivational interviewing for decluttering and my observations from a current clinical trial on the approach point to some practical steps people can take to declutter their home. Although my work has been primarily with older adults, these tips should be helpful for people of all ages.

Start with writing out your values. Every object in your home should feel value-consistent for you. For example, if tradition and faith are important values for you, you might be more inclined to hold onto a cookbook that was made by the elders at your church and more able to let go of a cookbook you picked up on a whim at a bookstore.

If, instead, health and creativity are your core values, it might be more important to hold onto a cookbook of novel ways to sneak more vegetables into your diet.

Defining value-consistent goals for using your space can help to maintain motivation as you declutter. Are you clearing off your desk so you can work more efficiently? Making space on kitchen counters to bake cookies with your grandchildren?

Remember that sometimes your values will conflict. At those moments, it may help to reflect on whether keeping or discarding an object will bring you closer to your goals for the space.

Similarly, remember that values are subjective. If you are helping a loved one declutter, maintain a curious, nonjudgmental attitude. Where you might see a box filled with junk, your grandmother might see something filled with “toothpick holders and other treasures.”

For additional resources and information on hoarding disorder, visit the International OCD Foundation website.The Conversation

Mary E. Dozier, Assistant Professor of Psychology, Mississippi State University

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Mirror life is a scientific fantasy leading to a dangerous reality − a synthetic biologist explains how mirror bacteria could conquer life on Earth

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theconversation.com – Kate Adamala, Assistant Professor of Genetics, Cell Biology and Development, University of Minnesota – 2025-02-11 07:46:00

Mirror life is a scientific fantasy leading to a dangerous reality − a synthetic biologist explains how mirror bacteria could conquer life on Earth

Synthetic biology offers many tantalizing possibilities, but scientists consider some projects too risky to pursue.
DBenitostock/Moment via Getty Images

Kate Adamala, University of Minnesota

Most major biological molecules, including all proteins, DNA and RNA, point in one direction or another. In other words, they are chiral, or handed. Like how your left glove fits only your left hand and your right glove your right hand, chiral molecules can interact only with other molecules of compatible handedness.

Two chiralities are possible: left and right, formally called L for the Latin laevus and D for dexter. All life on Earth uses L proteins and D sugars. Even Archaea, a large group of microorganisms with unusual chemical compositions, stick to the program on the handedness of the main molecules they use.

For a long time, scientists have been speculating about making biopolymers that would mirror compounds in nature but in the opposite orientation – namely, compounds made of D proteins and L sugars. Recent years have seen some promising advancements, including enzymes that can make mirror RNAs and mirror DNAs.

Diagam of two molecular models that are mirror images of each other, like the two hands they're superimposed on
Chirality refers to something that is not superimposable on its mirror image – like your hands.
NASA

When scientists observed that these mirror molecules behave just like their natural equivalents they considered that it would be possible to make a whole living cell from them. Mirror bacteria in particular had the potential to be a useful basic research tool – possibly allowing scientists to study a new tree of life for the first time and solve many problems in bioengineering and biomedicine.

This so-called mirror life – living cells made from building blocks with an opposite chirality to those that make up natural life – could have very similar properties to natural living cells. They could live in the same environment, compete for resources and behave like you would expect of any living organism. They would be able to evade infection from other predators and immune systems because these opponents wouldn’t be able to recognize them.

These features are why researchers like me were so attracted to mirror life in the first place. But these qualities are also huge bugs of this technology that make it a problem.

I am a synthetic biologist who studies using chemistry to create living cells. I am also a bioengineer who develops tools for the bioeconomy. As a chemist by training, engineering mirror life initially seemed like a fascinating way to answer foundational questions about biology and practically apply those findings to industry and medicine. As I learned more about the immunology and ecology of mirror life, however, I became aware of the potential environmental and health consequences of this technology.

Real concerns about hypothetical mirror life

It’s important to note that researchers are likely at least 10 to 30 years away from creating mirror bacteria. On the timescale of a fast-moving field like synthetic biology, a decade is a very long time. Creating synthetic cells is difficult on its own. Creating mirrored ones would require several technical breakthroughs.

However, it would come with a risk. If mirror cells were released into the environment, they would likely be able to quickly proliferate without much restriction. The natural mechanisms that keep ecosystems in balance, including infection and predation, would not work on mirror life.

Bacteria, like most life forms, are susceptible to viral infections. These bacterial viruses, or bacteriophages, enter bacteria by binding to their surface receptors and then use their cellular machinery to replicate. But just as a left glove doesn’t fit a right hand, natural bacteriophages wouldn’t recognize mirror cell receptors or be able to use its machinery. Mirror life would likely be resistant to viruses.

Microscopy image of many geometric balls attached to a translucent sphere by thin strands
Mirror bacteria may be able to evade the bacteriophages that would otherwise help keep them in check. Here, multiple bacteriophages are attached to a bacterial cell wall.
Professor Graham Beards/Wikimedia Commons, CC BY-SA

Microorganisms foraging in the environment also keep bacterial populations in check. They differentiate food from nonfood by using chemical “taste” receptors. Anything those receptors bind to, such as bacteria and organic debris, are considered edible, while things that cannot bind to those receptors, such as rocks, are classified as inedible. Think about how a dog foraging on the kitchen floor will eat a bread roll but only sniff a spoon and move on. Mirror life would be, to the bacterial predators, more like a spoon than bread – predators would “sniff” it with their receptors and move on because these cells can’t bind.

Safety from being eaten would be great news for mirror bacteria, because it would allow it to replicate freely. It would be much worse news to the rest of the ecosystem, because mirror bacteria might hog all the nutrients and spread uncontrollably. Even if mirror bacteria don’t actively attack other organisms, they would still consume food sources other organisms need. And since mirror cells would have much lower death rates than regular organisms due to a lack of predation, they would slowly but surely take over the environment.

Even if mirror cells grow more slowly than normal cells, they would be able to grow without anything stopping them.

Insufficient immunity

Another biological control mechanism that wouldn’t be able to “sniff” out mirror cells is the immune system.

Your immune cells constantly check everything they find in your blood. The decision tree of an immune cell is fairly simple. First, decide whether something is alive or not, then compare it with its database of “self” – your own cells. If it is alive but is not a part of you, then it needs to be killed. Mirror cells likely wouldn’t pass the first step of that screen: it would not induce an immune response because the immune system would not be able to recognize or bind to mirror cell antigens. This means mirror cells could infect an unprecedentedly wide variety of hosts.

You might think an infection from mirror bacteria could be treated with antibiotics of the same handedness. It would probably work, and may even be easier on your gut than regular antibiotic therapy. Because antibiotics are also handed, mirror versions of these drugs would not affect your gut microbiome, just like how regular antibioics would not affect mirror cells.

But humans are a relatively small part of the ecosystem. All other animals and plants may also be susceptible to infection from mirror pathogens. While it is possible to imagine developing mirror antibiotics to treat human infections, it is physically impossible to treat the entire plant and animal world. If all organisms are susceptible to even a slow-moving infection by mirror bacteria, there is no good treatment that could be deployed across the entire ecosystem.

Better safe than sorry

Mirror life is an exciting research subject and a potential tool with some practical applications in medicine and biotechnology. But for many scientists, including me, none of those benefits outweigh the serious consequences to human health and the environment that mirror life poses.

I and a group of researchers in immunology, ecology, biosafety and security – including some who used to actively work on mirror life – conducted a thorough analysis of possible concerns regarding the creation of mirror life. No matter how we looked at it, straight up or in the mirror, the conclusions were clear: The potential benefits of engineering mirror life are not worth the risk.

YouTube video
Mirror life is scientifically tantalizing but ethically unwise.

There is no way to make anything completely foolproof, and that includes any safeguards built into a mirror cell that could prevent the risk of accidental or deliberate release into the environment. Researchers working in this space, including us, may find this disappointing. But not making mirror cells can ensure the safety and security of the planet. More discussion among the global scientific community about what kinds of research on mirror biomolecules and related technologies are safe – as well as how to regulate this research – can help safeguard against potential harms.

Keeping mirror cells inside the mirror, rather than making them a physical reality, is the clearest path to staying safe.The Conversation

Kate Adamala, Assistant Professor of Genetics, Cell Biology and Development, University of Minnesota

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

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