BARCELONA, Spain (AP) — Hikers navigating rugged terrain may have noticed more people speeding along the same trail while leaping over rocks and roots like two-legged mountain goats.

Trail running has exploded in popularity in recent years. The sport encompasses everything from off-road jogs on unpaved coastal paths to alpine ultra-marathons. Extreme versions are known as mountain running, which involves moving and sometimes scrambling uphill on varied surfaces, and sky running, which is done with even steeper inclines at altitudes above 6,562 feet.

Few elite athletes have done more to bring long-distance running in the wilderness to the mainstream than Kilian Jornet. The star Spanish mountain athlete from the Catalan Pyrenees holds numerous world records in both trail running and ski mountaineering. He is a four-time winner of Europe’s Ultra-Trail du Mont-Blanc, an ultramarathon that includes 32,808-foot elevation gain over 105 miles, and a five-time winner of the Hardrock Hundred, a similarly grueling endurance race in Colorado.

Jornet, 38, completed his most recent feat in early October: climbing 72 of the 14,000-foot mountains in the American West in 31 days while traveling from peak to peak only by foot or bicycle. But he says anyone can start trail running as long as they respect their natural surroundings and use common sense to stay safe.

Jornet shared his tips for beginners in an interview with The Associated Press. The interview was conducted via email because he and his wife were caring for a new baby at their home in Norway. Answers were edited for length.

AP: What is the most important advice for someone who wants to start trail running?

Jornet: Don’t rush and enjoy it. Enjoy nature and the landscape, and gradually adapt your body to the terrain, the effort and the environment. You might start walking, then add short running sections. Choose easy trails, and focus on feeling good and safe.

AP: What is the most common mistake new trail runners make?

Jornet: Trying to go too far or too fast too early. The body needs time to adjust to elevation, technical terrain and impact. People also often underestimate weather changes or overestimate their energy. Don’t take athletes like me as an example! I’ve been trying every day for more than 30 years so my body is adapted to it, but if you’re starting it might be completely different.

AP: What would be a good distance and difficulty level for beginners?

Jornet: A 1.8-3.1-mile loop with gentle elevation and wide, non-technical trails. If you finish feeling you could continue, that’s a great sign of healthy progression. Two or three times a week is enough at the beginning. Mix walking and running. Focus on enjoyment more than volume.

AP: Should you already be a good runner before trying trail running?

Jornet: No. Road running can help, but it’s not a prerequisite. Trail running also requires other things like balance, coordination, and terrain awareness, all of which you can learn once you start.

AP: How is it different from running on a road or track in terms of safety?

Jornet: The terrain is more unpredictable (rocks, roots, mud) so you need more attention and stability. Weather changes faster in the mountains and help can be farther away, so you need to be prepared.

AP: Is it a sport for everyone or a specialist sport with risks?

Jornet: It’s for everyone, but it requires responsibility. You can choose routes that match your ability, from very easy to very technical. Always follow some basic safety (Let your loved ones know where you go, etc.), respect your limits and progress gradually. And don’t forget to enjoy!

AP: Is it critical to run with someone else?

Jornet: Not critical, but helpful for beginners. Running alone can be wonderful, if you’re prepared. Whether alone or not, always tell someone your route and estimated return time.

AP: What should you do before setting off?

Jornet: Plan your route, check the weather, tell someone where you’re going, and know how to contact local emergency services. In many mountain regions, specialized rescue teams exist, and knowing how to reach them is important. You can also consider using apps that have tracking so your loved ones know where you are.

AP: What equipment should you carry?

Jornet: Try to carry only what you need: proper shoes, a light jacket, water, food, and basic safety gear. I always carry my phone with enough battery, and if I plan a longer activity I would carry a jacket to protect me from the weather. For beginners, it might also be interesting to get a small first-aid kit and a thermal blanket. Hydration depends on heat and distance. I usually carry water and simple, quick-energy foods like gels, nuts, dried fruits or bars. Eat and drink consistently, small amounts often.

AP: Which other sports combine well with trail running?

Jornet: Hiking, skiing, cycling, climbing — anything that builds endurance or strength with low impact. Cross-training helps prevent injuries. You can also add some gym exercises to improve strength, flexibility and balance.

AP: When should a new trail runner enter a competition?

Jornet: When running feels natural and you can complete your usual routes comfortably. A short 5–10 km race is a great first step. It should feel exciting, not stressful.

AP: Do you have a recommended age limit for starting trail running?

Jornet: Not really. Kids can start by hiking and exploring trails. Adults can start at almost any age, if they adjust intensity. In any case, the important part is to enjoy the process.

AP: How much has the sport grown since you started?

Jornet: The growth has been huge. When I was younger, it was rare to meet people in the mountains — they told me I was crazy! Now it’s way more common, and the sport has boomed. To me, it’s great to see more people out there enjoying the mountains, but it must be with respect for the environment and taking care of it.

AP: Are there sometimes too many people on the trails?

Jornet: Some trails can get crowded, especially near popular spots and in the summer. I prefer solitude and being alone in the mountains, so I tend to choose places more remote.

AP: Have you seen trail runners pollute the environment? How can they avoid this?

Jornet: Yes, unfortunately: litter, noise or damage to fragile areas. New runners should remember that nature is a living place and we need to take care of it. Stay on marked trails if you can, leave no trace, respect wildlife and be nice to other people you encounter in the mountains.

The beauty of trail running isn’t in speed but in discovering landscapes, learning about yourself, and feeling connected to nature.

Follow AP’s Be Well coverage, focusing on all aspects of wellness, at https://apnews.com/hub/be-well

In 2013, before the Affordable Care Act helped millions get health insurance, California’s Placer County provided limited health care to some 3,400 uninsured residents who couldn’t afford to see a doctor.

For several years, that number has been zero in the predominantly white, largely rural county stretching from Sacramento’s eastern suburbs to the shores of Lake Tahoe.

The trend could be short-lived.

County health officials there and across the country are bracing for an estimated 10 million newly uninsured patients over the next decade in the wake of Republicans’ One Big Beautiful Bill Act. The act, which President Donald Trump signed into law this past summer, is also expected to reduce Medicaid spending by more than $900 billion over that period.

“This is the moment where a lot of hard decisions have to be made about who gets care and who doesn’t,” said Nadereh Pourat, director of the Health Economics and Evaluation Research Program at UCLA. “The number of people who are going to lose coverage is large, and a lot of the systems that were in place to provide care to those individuals have either gone away or diminished.”

It’s an especially thorny challenge for states like California and New Mexico where counties are legally required to help their poorest residents through what are known as indigent care programs. Under Obamacare, both states were able to expand Medicaid to include more low-income residents, alleviating counties of patient loads and redirecting much of their funding for the patchwork of local programs that provided bare-bones services.

Placer County, which estimates that 16,000 residents could lose health care coverage by 2028, quit operating its own clinics nearly a decade ago.

“Most of the infrastructure that we had to meet those needs is gone,” said Rob Oldham, Placer County’s director of health and human services. “This is a much bigger problem than it was a decade ago and much more costly.”

In December, county officials asked to join a statewide association that provides care to mostly small, rural counties, citing an expected rise in the number of uninsured residents.

New Mexico’s second-most-populous county, Doña Ana, added dental care for seniors and behavioral health benefits after many of its poorest residents qualified for Medicaid. Now, federal cuts could force the county to reconsider, said Jamie Michael, Doña Ana’s health and human services director.

“At some point we’re going to have to look at either allocating more money or reducing the benefits,” Michael said.

Straining state budgets

Some states, such as Idaho and Colorado, abandoned laws that required counties to be providers of last resort for their residents. In other states, uninsured patients often delay care or receive it at hospital emergency rooms or community clinics. Those clinics are often supported by a mix of federal, state, and local funds, according to the National Association of Community Health Centers.

Even in states like Texas, which opted not to expand its Medicaid program and continued to rely on counties to care for many of its uninsured, rising health care costs are straining local budgets.

“As we have more growth, more people coming in, it’s harder and harder to fund things that are required by the state legislature, and this isn’t one we can decrease,” said Windy Johnson, program manager with the Texas Indigent Health Care Association. “It is a fiscal issue.”

California lawmakers face a nearly $18 billion budget deficit in the 2026-27 fiscal year, according to the latest estimates by the state’s nonpartisan Legislative Analyst’s Office.

Gov. Gavin Newsom, who has acknowledged he is mulling a White House run, has rebuffed several efforts to significantly raise taxes on the ultra-wealthy. Despite blasting the bill passed by Republicans in Congress as a “complete moral failure” that guts health care programs, in 2025 the Democrat rolled back state Medi-Cal benefits for seniors and for immigrants without legal status after rising costs forced the program to borrow $4.4 billion from the state’s general fund.

H.D. Palmer, a spokesperson for the state’s Department of Finance, said the Newsom administration is still refining its fiscal projections and that it would be “premature” to discuss potential budget solutions.

Newsom will unveil his initial budget proposal in January. State officials have said California could lose $30 billion a year in federal funding for Medi-Cal under the new law, as much as 15% of the state program’s entire budget.

“Local governments don’t really have much capacity to raise revenue,” said Scott Graves, a director at the independent California Budget & Policy Center with a focus on state budgets. “State leaders, if they choose to prioritize it, need to decide where they’re going to find the funding that would be needed to help those who are going to lose health care as a result of these federal funding and policy cuts.”

Reviving county-based programs in the near term would require “considerable fiscal restructuring” through the state budget, the Legislative Analyst’s Office said in an October report.

No easy fixes

It’s not clear how many people are currently enrolled in California’s county indigent programs, because the state doesn’t track enrollment and utilization. But enrollment in county health safety net programs dropped dramatically in the first full year of ACA implementation, going from about 858,000 people statewide in 2013 to roughly 176,000 by the end of 2014, according to a survey at the time by Health Access California.

“We’re going to need state investment,” said Michelle Gibbons, executive director of the County Health Executives Association of California. “After the Affordable Care Act and as folks got coverage, we didn’t imagine a moment like this where potentially that progress would be unwound and folks would be falling back into indigent care.”

In November, voters in affluent Santa Clara County approved a sales tax increase, in part to backfill the loss of federal funds. But even in the home of Silicon Valley, where the median household income is about 1.7 times the statewide average, that is expected to cover only a third of the $1 billion a year the county stands to lose.

Health advocates fear that, absent major state investments, Californians could see a return to the previous patchwork of county-run programs, with local governments choosing whom and what they cover and for how long.

In many cases, indigent programs didn’t include specialty care, behavioral health, or regular access to primary care. Counties can also exclude people based on immigration status or income. Before the ACA, many uninsured people who needed care didn’t get it, which could lead to them winding up in ERs with untreated health conditions or even dying, said Kiran Savage-Sangwan, executive director of the California Pan-Ethnic Health Network.

Rachel Linn Gish, interim deputy director of Health Access California, a consumer advocacy group, said that “it created a very unequal, maldistributed program throughout the state.”

“Many of us,” she said. “including counties, are reeling trying to figure out: What are those downstream impacts?”

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

FORT COLLINS, Colo. (AP) — Abortion will remain legal in Wyoming after the state Supreme Court struck down laws that include the country’s first explicit ban on abortion pills, ruling Tuesday that they violate the state constitution.

The justices sided with the state’s only abortion clinic and others who had sued over the bans passed since 2022, when the U.S. Supreme Court overturned the landmark Roe v. Wade decision.

Wellspring Health Access in Casper, the abortion access advocacy group Chelsea’s Fund and four women, including two obstetricians, argued that the laws violated a state constitutional amendment ensuring that competent adults have the right to make their own health care decisions.

Attorneys for the state, however, argued that abortion can’t violate the Wyoming constitution because it is not health care.

Voters approved the constitutional amendment in 2012 in response to the federal Affordable Care Act. The justices recognized that the amendment wasn’t written to apply to abortion but said it’s not their job to “add words” to the state constitution.

“But lawmakers could ask Wyoming voters to consider a constitutional amendment that would more clearly address this issue,” the justices wrote in summarizing their 4-1 ruling.

Gov. Mark Gordon, a Republican, said in a statement that he was disappointed by the ruling and called on state lawmakers meeting this winter to pass a proposed constitutional amendment banning abortion that would go before voters this fall.

“This ruling may settle, for now, a legal question, but it does not settle the moral one, nor does it reflect where many Wyoming citizens stand, including myself. It is time for this issue to go before the people for a vote,” Gordon said.

Such an amendment would require a two-thirds vote to be introduced for consideration during the monthlong legislative session devoted primarily to the state budget. But it would have wide support in the Republican-dominated statehouse.

One of the laws overturned Tuesday sought to ban abortion except to protect a pregnant woman’s life or in cases involving rape or incest. The other law would have made Wyoming the only state to explicitly ban abortion pills, though other states have instituted de facto bans on abortion medication by broadly prohibiting abortion.

Abortion has remained legal in this conservative state since Teton County District Judge Melissa Owens in Jackson blocked the bans while the lawsuit challenging them went ahead. Owens struck down the laws as unconstitutional in 2024.

Wellspring Health Access and attorneys on both sides of the case didn’t immediately reply to requests for comment.

Last year, Wyoming passed additional laws requiring abortion clinics to be licensed surgical centers and women to get ultrasounds before having medication abortions. The Supreme Court ruling means those limitations could take effect, although a judge in a separate lawsuit has blocked them from taking effect while the case proceeds.

WASHINGTON (AP) — U.S. health officials made broad changes to childhood vaccine recommendations Monday, alarming pediatricians and other medical experts who say they will sow confusion and undermine children’s health.

The overhaul is effective immediately, meaning that the U.S. Centers for Disease Control and Prevention will now recommend that all children get vaccinated against 11 diseases, down from 18 a year ago.

The changes comes as U.S. vaccination rates have been slipping and the share of children with exemptions has reached an all-time high, according to federal data. At the same time, rates of diseases that can be protected against with vaccines, such as measles and whooping cough, are rising.

Here’s what to know about the changes:

Here’s what federal vaccine recommendations have changed

Once broadly recommended, the federal government now only recommends protection against these diseases for certain children at high risk or based on individual doctor advice in what’s called “shared decision-making.”

— Flu

— Hepatitis A

— Hepatitis B

— Meningococcal disease

— Rotavirus

— RSV

— COVID-19, a change made in 2025

Here’s what federal vaccine recommendations stayed the same

The following vaccines were left on the recommended-for-all list:

— Measles, mumps and rubella (MMR)

— Diphtheria, tetanus and pertussis or whooping cough (DTaP)

— Polio

— Chickenpox

— Human papillomavirus, or HPV. But in a surprise, the guidance reduces the number of recommended vaccine doses against HPV from two or three shots to just one.

— Hib, or Haemophilus influenzae type B, bacteria that despite the name isn’t related to flu

— PCV or pneumococcal conjugate vaccine

Why were the vaccine recommendations changed?

The U.S. Department of Health and Human Services said the overhaul was in response to a request from President Donald Trump in December. Trump asked the agency to review how peer nations approach vaccine recommendations and consider revising U.S. guidance accordingly.

HHS said its comparison to 20 peer nations found that the U.S. was an “outlier” in both the number of vaccinations and the number of doses it recommended to all children. Officials with the agency framed the change as a way to increase public trust by recommending only the most important vaccinations for children to receive.

However, many European countries recommend some of the vaccines the U.S. removed from its list.

What do doctors and pediatricians say?

The nation’s large doctors’ groups, including the American Medical Association and the American Academy of Pediatrics, say they will continue to recommend the vaccines that the Trump administration has now demoted. They said there was no new science that warranted the changes, including no signs that the former U.S. vaccine schedule harmed children.

Dr. Sean O’Leary of the AAP said the changes could increase child illness and death from preventable disease. He voiced special concern that the U.S. would no longer recommend flu vaccine for children, just as the flu season is becoming severe and after last winter’s particularly harsh season.

The pediatricians’ group has issued its own child vaccine recommendations. Also, states, not the federal government, have the authority to require vaccinations for schoolchildren. While CDC requirements often influence those state regulations, some states have begun creating their own alliances to counter the Trump administration’s guidance on vaccines.

What will change for families?

It’s not yet clear. Because of the countering recommendations from pediatricians, doctor visits may not change. However, medical specialists say when the U.S. government doesn’t explicitly recommend a shot, it will raise questions among parents, leading to more difficult conversations at the doctor’s office.

If the changes mean fewer children are vaccinated, outbreaks that have historically been prevented by high vaccination rates could spread more widely, leading to more disease and more missed school and work.

Will insurance continue to cover vaccines?

The Trump administration said coverage will continue for families that still want the shots. Health insurers generally find vaccination a good deal, as shots are cheaper than hospitalizations, and many had previously said they’d planned to cover what was recommended last year through 2026.

AP writers Ali Swenson and Mike Stobbe contributed to this report from New York.

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

It turns out, love may benefit from a little less labor.

Couples who spend money on time-saving services — like getting takeout, hiring a housecleaner or calling a dog walker — report greater relationship satisfaction, especially during stressful periods, says Ashley Whillans, a behavioral scientist and professor at Harvard Business School.

Whillans studies the “tradeoffs people make between time and money.”

“When you spend money to save time — hiring an accountant, a babysitter, a cleaner — you feel more control over your life,” she said. “That sense of autonomy boosts well-being.”

Not everyone can afford to outsource bigger household chores. But Whillans says even a little bit can help. She advises couples to take a “time audit” — examining how they spend their hours and what small changes could reclaim even a few moments.

“People underestimate how much these choices matter,” she said. “It’s not about luxury — it’s about freeing up time to connect.”

Whillans’ team tracked busy, dual-income couples — partners working full-time who often report feeling time-starved — and found consistent patterns. In one six-week diary study, couples who made “time-saving purchases” on a given day were happier and more satisfied with their relationships.

Use that saved time for connecting

Simply outsourcing chores isn’t a magic fix, however.

“It’s about being intentional with the time you get back — using it to spend quality time together, to reconnect,” Whillans said.

“Think of that half hour not as an opportunity to send more emails, but as a chance to spend time with your partner.”

Targol Hasankhani, a Chicago-based marriage and family therapist, stressed that while outsourcing domestic labor can ease daily stress, it doesn’t replace communication. Juggling careers and kids takes a toll on families, and housework is often freighted with resentments over who is doing it.

“If conflict around chores is rooted in something deeper — like inequity or not feeling heard — hiring a cleaner won’t solve that,” she said.

Couples must dig deeper to address problems with many layers.

“It opens up time and space, but couples still have to know how to show up for each other in that space,” Hasankhani said.

Casey Mulligan Walsh, 71, a former speech pathologist and author in upstate New York, said the best part about hiring a housecleaner once a week was that it freed up time for her and her husband to spend together.

“My favorite day of the week was coming home to a clean house,” she said. “We’d go get coffee together instead of arguing about who should vacuum.”

A Valentine’s Day gift that stuck

Getting started on delegating household tasks isn’t easy for some couples, Whillans said. Besides the cost, “it takes time to find someone and coordinate — but the long-term payoff is real.”

And making such decisions together can deepen trust and a sense of teamwork.

For one Colorado couple, outsourcing started as an act of love.

“When I started dating, my now-husband noticed how hard I was working — at my job, at home and as a single mom,” said Melissa Jones, a 45-year-old teacher in Pueblo.

His Valentine’s Day gift? A deep housecleaning.

“It was truly amazing,” Jones said. “After that, I kept it up on my own for years. When my husband and I moved in together, we decided to continue.”

“We’re able to make memories with each other, our kids and our families instead of spending weekends scrubbing floors,” she said.

Dinnertime can be a stress point

In Miami, Elizabeth Willard, 59, runs The Pickled Beet, a culinary service preparing customized meals.

“Most of the people I cook for are trying to invest in their health but don’t have the time,” she said, noting that families often juggle mixed dietary needs. “Sometimes the husband’s a carnivore and the wife’s vegetarian, one child’s celiac. They’re exhausted trying to make everyone happy.”

Her clients, often families with children and two working parents, are “not fighting over what’s for dinner. It’s one less daily decision.”

Whether ordering a pizza, paying a teenager to mow the lawn, or calling a car service to save 20 minutes, the outcome can be the same: Buying back time can buy peace.

WASHINGTON (AP) — The U.S. took the unprecedented step Monday of cutting the number of vaccines it recommends for every child — a move that leading medical groups said would undermine protections against a half-dozen diseases.

The change is effective immediately, meaning that the U.S. Centers for Disease Control and Prevention will now recommend that all children get vaccinated against 11 diseases. What’s no longer broadly recommended is protection against flu, rotavirus, hepatitis A, hepatitis B, some forms of meningitis or RSV. Instead, protections against those diseases are only recommended for certain groups deemed high risk, or when doctors recommend them in what’s called “shared decision-making.”

Trump administration officials said the overhaul, a move long sought by Health Secretary Robert F. Kennedy Jr., won’t result in families who want the vaccines losing access to them, and said insurance will continue to pay. But medical experts said the decision creates confusion for parents and could increase preventable diseases.

States, not the federal government, have the authority to require vaccinations for schoolchildren. While CDC requirements often influence those state regulations, some states have begun creating their own alliances to counter the Trump administration’s guidance on vaccines.

The change comes as U.S. vaccination rates have been slipping and the share of children with exemptions has reached an all-time high, according to federal data. At the same time, rates of diseases that can be protected against with vaccines, such as measles and whooping cough, are rising across the country.

Review came at the request of President Trump

The U.S. Department of Health and Human Services said the overhaul was in response to a request from President Donald Trump in December. Trump asked the agency to review how peer nations approach vaccine recommendations and consider revising U.S. guidance accordingly.

HHS said its comparison to 20 peer nations found that the U.S. was an “outlier” in both the number of vaccinations and the number of doses it recommended to all children. Officials with the agency framed the change as a way to increase public trust by recommending only the most important vaccinations for children to receive.

“This decision protects children, respects families, and rebuilds trust in public health,” Kennedy said in a statement Monday.

Trump, reacting to the news on his Truth Social platform, said the new schedule is “far more reasonable” and “finally aligns the United States with other Developed Nations around the World.”

Among those left on the recommended-for-everyone list are vaccines against measles, whooping cough, polio, tetanus, chickenpox and human papillomavirus, or HPV. The guidance reduces the number of recommended vaccine doses against HPV from two or three shots depending on age to one for most children.

Medical experts said Monday’s changes without what they said was public discussion or a transparent review of the data would put children at risk.

“Abandoning recommendations for vaccines that prevent influenza, hepatitis and rotavirus, and changing the recommendation for HPV without a public process to weigh the risks and benefits, will lead to more hospitalizations and preventable deaths among American children,” said Michael Osterholm of the Vaccine Integrity Project, based at the University of Minnesota.

Dr. Sean O’Leary of the American Academy of Pediatrics said countries carefully consider vaccine recommendations based on levels of disease in their populations and their health systems.

“You can’t just copy and paste public health and that’s what they seem to be doing here,” said O’Leary. “Literally children’s health and children’s lives are at stake.”

Most high-income countries recommend vaccinations against a dozen to 15 serious pathogens, according to a recent review by the Vaccine Integrity Project, a group that works to safeguard vaccine use.

France today recommends all children get vaccinated against 14 diseases, compared to the 11 that the U.S. now will recommend for every child under the new schedule.

Doctors’ groups criticize decision

The changes were made by political appointees, without any evidence that the current recommendations were harming children, O’Leary said.

The pediatricians’ group has issued its own childhood vaccine schedule that its members are following, and it continues to broadly recommend vaccines that the Trump administration demoted.

O’Leary singled out the flu vaccine, which the government and leading medical experts have long urged for nearly everyone starting at age 6 months. He said the government is “pretty tone deaf” for ending its recommendation while the country is at the beginning of a severe flu season, and after 280 children died from flu last winter, the most since 2009.

Even a disease that parents may not have heard of, rotavirus, could come roaring back if vaccination erodes, he added. That diarrheal disease once hospitalized thousands of children each winter, something that no longer happens.

The decision was made without input from an advisory committee that typically consults on the vaccine schedule, said senior officials at HHS. The officials spoke on the condition of anonymity because they weren’t authorized to discuss the changes publicly.

The officials added that the new recommendations were a collaborative effort between federal health agencies but wouldn’t specify who was consulted.

Scientists at the CDC’s National Center for Immunization and Respiratory Diseases were asked to present to the agency’s political leadership about vaccine schedules in other countries in December, but they were not allowed to give any recommendations and were not aware of any decisions about vaccine schedule changes, said Abby Tighe, executive director of the National Public Health Coalition, an advocacy organization of current and former CDC employees and their supporters.

“Changes of this magnitude require careful review, expert and public input, and clear scientific justification. That level of rigor and transparency was not part of this decision,” said Dr. Sandra Fryhofer, of the American Medical Association. “The scientific evidence remains unchanged, and the AMA supports continued access to childhood immunizations recommended by national medical specialty societies.”

Kennedy is a longtime vaccine skeptic

The move comes as Kennedy, a longtime activist against vaccines, has repeatedly used his authority in government to translate his skepticism about the shots into national guidance.

In May, Kennedy announced the CDC would no longer recommend COVID-19 vaccines for healthy children and pregnant women — a move immediately questioned by public health experts who saw no new data to justify the change.

In June, Kennedy fired an entire 17-member CDC vaccine advisory committee — later installing several of his own replacements, including multiple vaccine skeptics.

Kennedy in November also personally directed the CDC to abandon its position that vaccines do not cause autism, without supplying any new evidence to support the change.

Swenson reported from New York. Associated Press writer Mike Stobbe contributed to this report.

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

Even as a kid, Alice Lovatt was always getting in trouble for being late.

She was often embarrassed after letting down friends for her tardiness, and she was routinely stressed about arriving at school on time.

“I just don’t seem to have that clock that ticks by in my head,” said Lovatt, a musician and group-home worker in Liverpool, England.

It wasn’t until she was diagnosed with ADHD at 22 that she learned she was experiencing a symptom sometimes called “time blindness.”

Russell Barkley, a retired clinical neuropsychologist at the University of Massachusetts, is often credited with linking time impairment with people with ADHD or autism. In 1997, he called it “temporal myopia.”

But recently, time blindness has sparked a social media debate: Where is the line between a genuine condition and someone who is disorganized or just plain rude?

When arriving late means more

Time blindness is the inability to determine how long a task will take or conceptualize how much time has passed. It relates to executive function that occurs in the frontal lobes of the brain, and it is a well-documented characteristic of many people with ADHD, said Stephanie Sarkis, a psychotherapist in Tampa Bay, Florida.

“Anyone can have issues with running late, just with ADHD there’s functional impairment,” said Sarkis, author of “10 Simple Solutions to Adult ADD.” “It impacts family life and social life. It impacts work, money management, all areas of life.”

Sarkis said if a person’s chronic tardiness is “one star in the constellation of symptoms,” then it could be evidence of a treatable disorder. She cited research that stimulant medication prescribed for other ADHD symptoms, such as inattention or restlessness, is also effective at treating time blindness.

That’s not to say, however, that everyone who is chronically late has ADHD — or a built-in excuse.

Consider the reason for being late

Jeffrey Meltzer, a therapist in Bradenton, Florida, counsels people who never show up on time to examine the core issue behind their lateness.

Some people who hate small talk fear arriving early, which could point to anxiety as the underlying issue, Meltzer said. Others may feel they don’t have much control over their lives, so they try to reclaim a few minutes from responsibilities.

“It’s the same psychology concept behind revenge bedtime procrastination,” he said, referring to the urge one may have to stay up later to recoup personal time after a busy day.

In those cases, one tool is to create a small “coping card” to refer to regularly, he said. After determining a reason for chronic lateness, take an index card and write down a reframed thought about that reason and a consequence of being late.

For instance, on one side write, “Attending this meeting doesn’t mean that I lose my freedom.” On the other side, write: “Being late again will upset people at work.”

Meltzer said the hardest reason to change the habit would be something that early-arrivers often attribute to late-comers — a sense of entitlement. People who feel their time is more important than others’ time may give themselves permission to be late.

But Meltzer said those people would also exhibit entitlement in other areas, such as parking in a spot designated for people with disabilities or tending to make a grand entrance at an event.

“Maybe they’re 20, 30 minutes late, and it’s like, ‘Oh, look who is here,’” he said. “So it’s a way to kind of get attention.”

What to do about it

Whether a person has ADHD or not, they’re still responsible for their actions, said Sarkis, who was also diagnosed as an adult and struggles with managing time.

The good news is that the same interventions that help people with ADHD can work for all late-arrivers.

Sarkis said using a smart watch to set alerts can help with knowing when you need to leave, although having analog clocks around also helps. Relying only on your phone to see the time creates more distractions.

She also suggested breaking tasks down into a checklist of smaller parts and resisting the urge to cram too many activities into one day.

Lovatt has learned to give herself much more time than she thinks she needs. She also uses Forest, a time management app, and another app to lock herself out of other apps on her phone to help keep track of time while concentrating.

Particularly helpful has been making granular lists of how long things take. Getting out the door in the morning felt like it took 20 minutes until Lovatt listed every step from bed to door.

“Walk downstairs, one minute. Find shoes, one minute. And I had a list that was a whole page long of literally walking between rooms,” she said.

She learned it instead took 45 minutes.

“It doesn’t work, like, 100% of the time. But generally, I am a lot more reliable now.”

Albert Stumm writes about food, travel and wellness. Find his work at https://www.albertstumm.com.

NEW YORK (AP) — U.S. flu infections surged over the holidays, and health officials are calling it a severe season that is likely to get worse.

New government data posted Monday — for flu activity through the week of Christmas — showed that by some measures this season is already surpassing the flu epidemic of last winter, one of the harshest in recent history.

COVID-19 infections also have been rising, other federal data show, though they remain less common than flu.

Forty-five states were reporting high or very high flu activity during the week of Christmas, up from 30 states the week before.

The kind of flu that’s been spreading may be driving the higher numbers, public health experts say.

One type of flu virus, called A H3N2, historically has caused the most hospitalizations and deaths in older people. So far this season, that’s the type most frequently reported. Even more concerning, more than 90% of the H3N2 infections analyzed were a new version — known as the subclade K variant — that differs from the strain in this year’s flu shots.

Flu seasons often don’t peak until January or February, so it’s too early to know how big a problem that mismatch will be.

Last flu season was bad, with the overall flu hospitalization rate the highest since the H1N1 flu pandemic 15 years ago. Child flu deaths reached 288, the worst recorded for regular U.S. flu season.

Nine pediatric flu deaths have been reported so far this season. For children, the percentage of emergency department visits due to flu has already surpassed the highest mark seen during the 2024-2025 season.

The percentage of doctor’s office and medical clinic visits that were due to flu-like illness also was higher late last month than at any point during the previous flu season.

The U.S. Centers for Disease Control and Prevention estimates at least 11 million illnesses, 120,000 hospitalizations and 5,000 deaths from flu have already occurred this season.

The agency recommends that everyone 6 months and older who has not yet been vaccinated this season get an annual influenza vaccine.

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

PHILADELPHIA — Leon Harris, 35, is intimately familiar with the devastation guns can inflict. Robbers shot him in the back nearly two decades ago, leaving him paralyzed from the chest down. The bullet remains lodged in his spine.

“When you get shot,” he said, “you stop thinking about the future.”

He is anchored by his wife and child and faith. He once wanted to work as a forklift driver but has built a stable career in information technology. He finds camaraderie with other gunshot survivors and in advocacy.

Still, trauma remains lodged in his daily life. As gun violence surged in the shadows of the COVID pandemic, it shook Harris’ fragile sense of security. He moved his family out of Philadelphia to a leafy suburb in Delaware. But a nagging fear of crime persists.

Now he is thinking about buying a gun.

Harris is one of tens of thousands of Americans killed or injured each year by gun violence, a public health crisis that escalated in the pandemic and churns a new victim into a hospital emergency room every half hour.

Over the past two decades, the firearm industry has ramped up production and stepped up sales campaigns through social media influencers, conference presentations, and promotions. An industry trade group acknowledged that its traditional customer was “pale, male and stale” and in recent years began targeting Black people and other communities of color who are disproportionately victimized by gun violence.

The Trump administration has moved to reduce federal oversight of gun businesses, heralding a new era announced by the Bureau of Alcohol, Tobacco, Firearms and Explosives as “marked by transparency, accountability, and partnership with the firearms industry.”

The pain of gun violence crosses political, cultural, and geographic divides — but no group has suffered as much as Black people, such as Harris. They were nearly 14 times as likely to die by gun homicide than white people in 2021, researchers said, citing federal data. Black men and boys are 6% of the population but more than half of homicide victims.

Washington has offered little relief: Guns remain one of few consumer products the federal government does not regulate for health and safety.

“The politics of guns in the U.S. are so out of whack with proper priorities that should focus on health and safety and most fundamental rights to live,” said attorney Jon Lowy, founder of Global Action on Gun Violence, who helped represent Mexico in an unsuccessful lawsuit against Smith & Wesson and other gunmakers that reached the Supreme Court. “The U.S. allows and enables gun industry practices that would be totally unacceptable anywhere else in the world.”

KFF Health News undertook an examination of gun violence during the pandemic, a period when firearm deaths reached an all-time high. Reporters reviewed academic research, congressional reports, and hospital data and interviewed dozens of gun violence and public health experts, gun owners, and victims or their relatives.

The examination found that while public officials imposed restrictions intended to prevent COVID’s spread, politicians and regulators helped fuel gun sales — and another public health crisis.

As state and local governments shut down schools, advised residents to stay home, and closed gyms, theaters, malls, and other businesses to stop COVID’s spread, President Donald Trump kept gun stores open, deeming them essential businesses critical to the functioning of society.

White House spokesperson Kush Desai did not respond to interview requests or answer questions about the Trump administration’s efforts to reduce regulation of the firearm industry.

During the pandemic, the federal government gave firearm businesses and groups more than $150 million in financial assistance through the Paycheck Protection Program, even as some businesses reported brisk sales, according to an analysis from Everytown for Gun Safety, an advocacy group.

Federal officials said the program would keep people employed, but millions of dollars went to firearm companies that did not say whether it would save any jobs, the report said.

About 1 in 5 American households bought a gun during the first two years of the pandemic, including millions of first-time buyers, according to survey data from NORC at the University of Chicago.

Harris is keenly aware of what drives the demand.

“Guns aren’t going away unless we get to the root of people’s fears,” he said.

Surveys show most Americans who own a gun feel it makes them safer. But public health data suggests that owning a gun doubles the risk of homicide and triples chances of suicide in a home.

“There’s no evidence that guns provide an increase in protection,” said Kelly Drane, research director for the Giffords Law Center to Prevent Gun Violence. “We have been told a fundamental lie.”

Record deaths

Less than a year into the pandemic, 20-year-old Jacquez Anlage was shot dead in a Jacksonville, Florida, apartment. Five years later, the killing remains unsolved.

His mother, Crystal Anlage, said she fell to her knees and wailed in grief on her lawn when police delivered the news.

She said Jacquez overcame years in the foster care system — living in 36 homes — before she and her husband, Matt, adopted him at age 16.

Jacquez Anlage had just moved into his own apartment when he was shot. He loved animals and wanted to become a veterinary technician. He was kind and loving, Crystal Anlage said, with the 6-foot-4, 215-pound physique of the football and basketball player he’d been.

“He was just getting to a point in life where he felt safe,” Crystal Anlage said.

Gun violence researchers say parents like Crystal Anlage carry trauma that destroys their sense of security.

Anlage said she endures post-traumatic stress disorder and anxiety. She is terrified of guns and fireworks.

But she has made something meaningful of her son’s killing: She co-founded the Jacksonville Survivors Foundation, which works to raise awareness about the impact of homicide and to support grieving parents.

“Jacquez’s death can’t be in vain,” she said. “I want his legacy to be love.”

His legacy and that of other young men killed by guns is muted by firearm manufacturers’ powerful message of fear.

During the pandemic, gun marketers told Americans they needed firearms to defend themselves against criminals, protesters, unreliable cops, and racial and political unrest, according to a petition filed by gun control advocacy groups with the Federal Trade Commission.

In a since-deleted June 18, 2020, Instagram post from Lone Wolf Arms, an Idaho-based manufacturer, a protester is depicted being confronted by police officers in riot gear between the words “Defund Police? Defend Yourself,” the petition shows. The caption says, “10% to 25% off demo guns and complete pistols.”

Impact Arms, an online gun seller, posted a picture on Instagram on Aug. 3, 2020, showing a person putting a rifle in a backpack, the document says. “The world is pretty crazy right now,” the caption reads. “Not a bad idea to pack something more efficient than a handgun.”

The National Rifle Association in 2020 posted on YouTube a four-minute video of a Black woman holding a rifle and telling viewers they need a gun in the pandemic. “You might be stockpiling up on food right now to get through this current crisis,” she said, “but if you aren’t preparing to defend your property when everything goes wrong, you’re really just stockpiling for somebody else.”

The messaging worked. Background checks for firearm sales soared 60% from 2019 to 2020, the year the federal government declared a public health emergency.

The same year, more than 45,000 Americans died from firearm violence, the highest number up till then. In 2021, the record was broken again.

Weapons sold at the beginning of the pandemic were more likely to wind up at crime scenes within a year than in any previous period, according to a report by Democrats on Congress’ Joint Economic Committee, citing ATF data.

Gun manufacturers “used disturbing sales tactics” following mass shootings in Buffalo, New York, and Uvalde, Texas, “while failing to take even basic steps to monitor the violence and destruction their products have unleashed,” according to a separate memo released by congressional Democrats in July 2022 following a House Oversight and Reform Committee investigation of industry practices and profits.

The firearm industry has marketed “to white supremacist and extremist organizations for years, playing on fears of government repression against gun owners and fomenting racial tensions,” the House investigation said. “The increase in racially motivated violence has also led to rising rates of gun ownership among Black Americans, allowing the industry to profit from both white supremacists and their targets.”

In 2024, then-President Joe Biden’s Department of the Interior provided a $215,000 grant to the National Shooting Sports Foundation, a leading firearm industry trade group, to help companies market guns to Black Americans.

The Federal Trade Commission is responsible for protecting consumers from deceptive and unfair business practices and has the power to take enforcement action. It issued warnings to companies that made unsubstantiated claims their products could prevent or treat COVID, for instance.

But when families of gun violence victims, lawmakers, and advocacy groups asked the FTC in 2022, during Biden’s term, to investigate how firearms were marketed to children, people of color, and groups that espouse white supremacy, officials did not announce any public action.

This summer, the National Shooting Sports Foundation pressed its case to the FTC and derided “a coordinated ‘lawfare’ campaign” that it said gun control groups have waged against “constitutionally-protected firearm advertising.”

FTC spokesperson Mitchell Katz declined to comment, saying in an email that the agency does not acknowledge or deny the existence of investigations.

Serena Viswanathan, who retired as an FTC associate director in June, told KFF Health News that the agency lost at least a quarter of the staff in its advertising practices division after Trump came into office in January.

Gun companies Smith & Wesson, Lone Wolf Arms, and Impact Arms did not respond to requests for comment. Neither did the National Shooting Sports Foundation or the NRA.

In an August 2022 social media post, Smith & Wesson President and CEO Mark Smith said gun manufacturers were being wrongly blamed by some politicians for the pandemic surge in violence, saying cities experiencing violent crime had “promoted irresponsible, soft-on-crime policies that often treat criminals as victims and victims as criminals.”

He added, “Some now seek to prohibit firearm manufacturers and supporters of the 2nd Amendment from advertising products in a manner designed to remind law-abiding citizens that they have a Constitutional right to bear arms in defense of themselves and their families.”

Guns and race

In 2015, the National Shooting Sports Foundation gathered supporters at a conference in Savannah, Georgia, and urged the firearm industry to diversify its customer base, according to a YouTube video and reports from Everytown for Gun Safety and the Violence Policy Center.

Competitive shooter Chris Cheng gave a presentation called “Diversity: The Next Big Opportunity.” Screenshots from the conference include slides purporting to show “demographics,” “psychographics,” and “technographics” of Black and Hispanic shooters.

The slides described Black shooters as “expressive and confident socially, in a crowd” and “less likely to be married and to be a college grad.” They said Hispanic shooters were “much more trusting of advertising and celebrities.”

Nick Suplina, senior vice president for law and policy at Everytown for Gun Safety, said industry marketing shifted in the latter half of the 20th century as the popularity of hunting declined. The new sales pitch: guns for personal safety.

“They said, ‘We need to break into new markets,’” Suplina said. “They identified women and people of color. They didn’t have a lot of success until the pandemic, the Black Lives Matter movement, and the death of George Floyd. The marketing says, ‘You deserve the Second Amendment too.’ They are selling the product as an antidote to fear and anxiety.”

Gun manufacturers were harshly criticized in the Oversight Committee’s 2022 investigation for marketing products to people of color, as gun violence remains a leading cause of death for young Black and Latino men.

At the same time, some companies also promoted assault rifles to white supremacist groups who believe a race war is imminent, the investigation found. One company sold an AK-47-style rifle called the “Big Igloo Aloha,” a reference to an anti-government movement, it said.

Still, Philip Smith wants more Black people to get guns for protection.

Smith said he was working as a human resources consultant a decade ago when he got the idea to form the National African American Gun Association, which helped the National Shooting Sports Foundation compile its report on communicating with Black consumers.

Smith encourages Black people to buy firearms for self-defense and get proper training on how to use them.

After 10 years, Smith said, his group has about 45,000 members nationwide. Single members pay $39 a year and couples $59, which gives them access to discounts from the organization’s corporate partners, including gunmakers, and raffles for gun giveaways, according to its website.

The police killing of Michael Brown in Ferguson, Missouri, and the shooting death of Florida teenager Trayvon Martin helped spark early interest from doctors, lawyers, and others in joining the group, he said. But interest took off during the pandemic, he said, even among Democrats who had resisted the idea of owning a gun.

“Hundreds of people called me and said, ‘I don’t agree with anything you’re saying, but what kind of gun should I buy,’” Smith recalled.

Smith, describing himself as “quiet, nerdy, and Afrocentric,” said criticism of guns misses the point.

“My ancestors bled for us to have this right,” he said. “Are there some racist white people? Yes. But we should buy guns because there is a need. No one is forcing us to buy guns.”

‘American amnesia’

During the pandemic, gun violence took its greatest toll on racially segregated neighborhoods in places such as Philadelphia, where roughly 1 in 4 residents live in poverty.

A city report says a one-year period in the pandemic saw more than 2,300 shootings, or about six a day. Many of the cases haven’t been solved by police.

City officials cited the boom in gun sales in the report: Fewer than 400,000 sales took place in Pennsylvania in 2000, but in 2020 it was more than 1 million.

Gun sales have dropped since the pandemic ended, but the harm they’ve caused persists.

At a conference last year inside the Eagles’ football stadium, victims of firearm violence or their relatives joined activists to share accounts of near-death experiences and the grief of losing loved ones.

Paintings flanked the stage and the meeting space to commemorate people who had been fatally shot, nearly all young people of color, under messages such as “You are loved and missed forever” and “Those we love never leave.”

Marion Wilson, a community activist, said he believes the nation has forgotten the suffering Philadelphia and other cities endured during the pandemic.

“We suffer from the disease of American amnesia,” he said.

Harris was on his way home from a job at Burlington Coat Factory nearly two decades ago when robbers followed him from a bus stop and demanded money. He said he had none and was shot.

Harris had spent his early life fixing cars with his grandfather, when he wasn’t at school or attending church. He remembers lying in a hospital bed, overcome with a sense of helplessness.

“I had to learn to feed myself again,” he said. “I was like a baby. I had to learn to sit up so I could use a wheelchair. The only way I got through it was my faith in God.”

Harris endured years of rehabilitation and counseling for PTSD. As someone in a wheelchair, he said, he sometimes fears for his safety — and a gun may be one of the few ways to protect himself and his family.

“I’m mulling it over,” Harris said. “I’m afraid of my trauma hurting someone else. That’s the only reason I haven’t gotten one yet.”

©2025 KFF Health News. Distributed by Tribune Content Agency, LLC.

When Yraida Faneite was on trial for drug-related charges, the judge had to halt proceedings at one point because her period was so heavy that blood was running down her legs.

The same struggle followed her into a federal prison in Florida after she was convicted. For about a decade, officials allowed her only a small ration of menstrual products, and she couldn’t afford extra pads from the commissary. She bartered with other women. On her worst days, she tore up her own T-shirts and used them as makeshift pads.

When she told officers she needed to see a doctor and couldn’t safely continue a mandatory kitchen shift, she said, she was placed in solitary confinement. She eventually found out that her heavy bleeding was caused by cysts.

“I didn’t have enough napkins to use during my period. … No matter what you say, they don’t care,” recalled Faneite, who was released from prison in 2006 and went on to found the prison reentry nonprofit YG Institute.

Her experience echoes what researchers, advocates and formerly incarcerated people describe across prisons and jails nationwide: Even where menstrual products are available, limited supplies, low-quality products, strict disciplinary rules and delays in medical care can result in incarcerated people facing potentially avoidable health issues or disciplinary write-ups.

Access to menstrual products also has been a persistent issue in immigration detention centers, with recent reports and lawsuits alleging that women in some facilities have been unable to obtain or outright denied feminine hygiene products despite federal standards and law requiring sufficient and timely access.

A new report from the Prison Policy Initiative, a research and advocacy organization, says that menstruation is still regularly treated as a disciplinary matter — through contraband rules, work violations and sanitation write-ups — even in prisons and jails that provide free products.

These disciplinary actions can affect everything from parole eligibility to access to programming and services.

Women make up a growing share of the state prison population, which rose about 5% nationwide from 2022 to 2023, according to the latest data from the federal Bureau of Justice Statistics.

In recent years, more states have begun taking steps to improve access to menstrual products in jails and prisons, and to address the overall conditions that shape incarcerated women’s experiences.

The Ohio legislature last month passed legislation to strengthen access to period products for incarcerated people in jails and prisons. The bill is awaiting the governor’s signature. And Wisconsin lawmakers introduced a bill on the issue this month.

At least 24 states and Washington, D.C., require that people in state prisons or local jails have free access to menstrual products, according to the National Conference of State Legislatures. Federal correctional facilities have provided free products since 2017.

More than a dozen states have passed versions of the Dignity of Incarcerated Women Act, which includes provisions to improve basic conditions, such as access to and the quality of period products and pregnancy care.

Still, in most of the country, access depends on a patchwork of laws and corrections department policies. Nearly every state has a rule on the books about providing menstrual products, but the specifics, implementation and enforcement vary widely. Advocates say that leaves many incarcerated people without the consistent access they need.

“In the system that we have where there’s very little oversight, accountability, transparency, you have no easy way of enforcement,” said Miriam Vishniac, the founder and director of the Prison Flow Project, a database tracking access to menstrual products in U.S. jails and prisons.

In Alabama, the state Department of Corrections says it provides menstrual products — pads and tampons — free of charge. People can choose a monthly allotment of 30 pads, 30 tampons or a mix of both. Housing unit staff keep small supplemental supplies on hand and can issue additional products as needed, according to Rand Champion, the agency’s chief of communications.

In Colorado, corrections officials said staff are prohibited from using access to menstrual products as a behavior-management tool, and facilities are required to keep products stocked and available regardless of an individual’s financial status.

Maryland’s policy requires correctional facilities to provide menstrual products at no cost during admission or transfer, on a monthly basis and upon request. The state says it offers tampons, winged pads, and both light- and heavy-flow pads. The products must be provided in quantities appropriate to each person’s health needs. Corrections officials told Stateline there have been no recent challenges with implementation.

In the months after a Maryland law requiring correctional facilities to provide free menstrual products and maintain a sufficient supply took effect in 2018, advocates said women at the Correctional Institution for Women were still paying for tampons and relying on flimsy pads handed out each month. State officials acknowledged the policy was not being implemented consistently systemwide.

Rules and restrictions

The new report from the Prison Policy Initiative outlines several ways that prison and jail rules can indirectly penalize people who menstruate.

Some facilities classify having more pads or tampons than the allowed number as contraband, which can lead to confiscation or formal disciplinary actions. Rules on property and hygiene mean that leaking through uniforms or bedding may be treated as a violation.

Asking for additional menstrual products can sometimes be interpreted as abusing medical rules or “feigning illness.” And trading or sharing products with other incarcerated people may also be prohibited under unauthorized exchange rules, the report said.

“It’s just another reminder that they have no autonomy over themselves, over their bodies, over their lives,” said Alycia Welch, the associate director of the Prison and Jail Innovation Lab at the University of Texas at Austin.

Access is further complicated by shower schedules and clothing allocations, which can make it difficult to change products regularly. Items available for purchase at the commissary — including pads, tampons and pain relief — are often costly.

Transgender men, nonbinary people and older women who menstruate or experience irregular cycles may face additional scrutiny or confusion from staff when requesting menstrual products, creating further barriers, according to prison policy experts.

Disciplinary actions can include fines, loss of commissary privileges, restrictions on phone or visitation access or placement in segregation units.

Many advocates and formerly incarcerated people say that even in facilities that provide free menstrual products, the supplies are often of poor quality, with thin pads and low-absorbency tampons.

“We can’t just stop at creating these rules that mandate that people have access to these products,” Vishniac, of the Prison Flow Project, said. “There needs to be some kind of way of ensuring that it’s actually happening.”

Strengthening access in Ohio

The bill Ohio lawmakers unanimously passed would require that all incarcerated women in state or local correctional facilities have free access to feminine hygiene products. It also would mandate that facilities allow incarcerated women to shower once per day while menstruating.

The bill also would require safe, designated disposal containers for used menstrual products and prohibit denial of products based on race, sex, income, charge, disability or other protected traits and identities.

In 2022, the Ohio Department of Rehabilitation and Correction adopted a new policy requiring state prisons (but not jails) to provide free menstrual products; advocates, however, say there’s no mechanism to hold staff or facilities accountable.

While the bill does not lay out an explicit oversight mechanism, its language would give incarcerated women a clear legal standard they can reference if access is denied, said Kayelin Tiggs, an advocate who helped author the bill’s language. Tiggs created the Ohio Coalition for Menstrual Equity.

“The fact that we were able to pass it here with that anti-discrimination language is a good sign,” Tiggs said. “I feel like we could take this nationally.”

Stateline reporter Amanda Watford can be reached at ahernandez@stateline.org.

©2025 States Newsroom. Visit at stateline.org. Distributed by Tribune Content Agency, LLC.