Category: United States healthcare system

November Decisions and Daylight

In this post I review November’s events in the U.S. impacting health and well-being. Key changes include transitioning to standard time, updating health insurance plans, and participating in midterm elections.

Some notable events happen in November, at least in the United States, and they can directly affect our individual and collective health. Some happen within the first 3 days of November this year.

  • Time- from Daylight Saving to Standard
  • Healthcare-changing Medicare, ACA, or employer-sponsored health plans
  • Elections-Voters choose among candidates to fill multiple federal, state, and local offices

Daylight Saving Time ends on November 1

In most of the United States and Canada, we will resume standard time on Sunday, November 1 at 2 AM. Unless you’re awake at that time, you’ll probably want to change your clocks before going to bed Saturday night, which is Halloween October 31, 2026. (Although many clocks change automatically now.)

That means sunsets will come even earlier than they have been, and there will be fewer daylight hours until the first day of winter, December 21. If you live south of the equator, you welcome more sunshine instead.

Some people may not feel any different as far as sleep and sleepiness due to the change. For most people, “falling back” is less disruptive to sleep than “springing forward.”

Here are some tips to help you adjust to the new day-night schedule of light and dark.

Night before and morning of

  1. Keep your regular bedtime the night before — treat the clock change like a normal night of sleep so you preserve your circadian rhythm.
  2. Avoid a late bedtime because of the “extra” hour — going to bed much later undermines the benefit of the gained hour.
  3. Wake at your usual time on Monday even if you feel rested; consistent wake times anchor sleep timing and help adjust quickly.

Gradual schedule shift if you’re sensitive

  1. Shift sleep-wake by 15–30 minutes for 2–3 days before if you know you’re sensitive to schedule changes.
  2. Split the difference after the change by keeping the new clock time but nudging bedtime slightly earlier for a few nights.

Use light strategically

  1. Get bright morning light as soon as practical after waking to advance circadian timing and reduce morning grogginess.
  2. Dim evening light and avoid screens 60–90 minutes before bed to encourage melatonin production and earlier sleep onset.
A person with short blonde hair lying on a bed surrounded by a laptop, a notebook with writings, a pen, a coffee cup, and a pair of glasses.
Photo by Ketut Subiyanto on Pexels.com

Health Insurance Enrollment for 2027

Many people can change their health insurance in November.

Medicare is available to anyone at age 65 and certain other people. Enrollees can make changes from October 15 to December 7.

Medicare Advantage Plans (Part C), Medicare CostPlans,Demonstrations/Pilots, and Program of All-inclusive Care for the Elderly (PACE).

If you aren’t eligible for Medicare or an employer-sponsored insurance plan, you may get coverage through the Health Insurance Marketplace, with open enrollment starting November 1 through January 15.

If you are covered by an employer-sponsored health plan, you may be required to sign up for next year’s coverage, especially if you want to change coverage options. Otherwise, you may automatically be enrolled into the same plan.

Whatever plan you choose, you should carefully evaluate options, especially out-of-pocket costs. In a previous post, I reported on the problem of medical debt, due to unexpected expenses not covered by insurance.

Your out-of-pocket medical expenses may increase with a less expensive insurance plan if it requires higher deductibles and co-pays than a plan with higher premiums. You should consider the cost of anticipated health care as you choose coverage.

How to Pay for Medical Care: A Guide for Americans

In this post I review how people pay for their healthcare. In the U.S., medical care financing includes employer-provided insurance, Medicaid, Medicare, the Affordable Care Act, and COBRA. Eligibility for these programs varies based on income, age, and employment status. Additional financial assistance exists through Medicare Savings Programs and nonprofit organizations, helping manage medical bills…

Keep reading

Tuesday, November 4-United States Elections

Commonly referred to as the midterms, the United States holds elections for all federal, state, and local offices open due to an expiring term, death, or resignation. We will not elect another President and Vice President until 2028.

📌 Note: Election dates and contests can vary by locality. It’s always best to check with your local election office for the most accurate and up-to-date information.

How Voting Affects Your Health

State and local governments play a vital role in our communities by funding, organizing, and regulating essential health services. State health departments set public health policies, direct disease prevention programs, and manage emergency responses.

Some local governments operate health departments and clinics that provide direct care like vaccinations, maternal health services, and screenings. They also monitor water quality, food safety, and environmental hazards, keeping us safer. 

Since elected officials oversee these services, voting in local elections directly impacts the quality and availability of care. Local leaders decide budgets for hospitals, mental health programs, and emergency medical services, and they influence partnerships with schools, nonprofits, and first responders.

When we vote, we choose the decision-makers who determine how resources are allocated, which programs are prioritized, and how quickly communities can respond to crises. Thus, local elections shape the health systems that touch our lives every day—making participation vital for strong, resilient communities. 

Making Decisions

Most of us are confronted with important decisions this month. Who to vote for? What insurance program to use? How to spend the holidays?

  1. What decision is most important to you now?
  2. What resources will you use to help you make the best decision?
  3. What do you need to do now to be ready? How will you make sure you follow through?
A person holding a small American flag beside a lightbox sign that says 'KEEP CALM AND VOTE'.
Photo by cottonbro on Pexels.com

Exploring the HEART of Health

Thank you for reading this post. I strive to make them worth your time.

I share information and inspiration that sparks transformation in your body, mind, and spirit.

You can follow this blog in two easy ways. One is to put your email address into the box below.

Another way is to follow me on Facebook, where I share new posts, timely topics, photos, and an occasional cartoon.

Watercress Words by Dr. Aletha

Dr. Aletha

When Food Isn’t Safe: Protecting Your Family

The cyclospora food contamination issue, highlighted by a record outbreak linked to iceberg lettuce, has raised concerns about food safety amid federal funding cuts affecting health agencies. With over 17,000 cases this summer, experts question the government’s response timing and ability to handle outbreaks, urging better investment in public health infrastructure.

Although the cyclospora food contamination problem has been the subject of humorous memes on social media, illness due to food borne infections is not to be taken lightly.

At home, you are responsible for thoroughly washing the food you prepare. But elsewhere you have little to no control over the safety of the food you are served.

Here is a recap of the public health response to the outbreak of diarrhea due to cyclospora in the United States this summer. It is followed by some practial advice on protecting your families from foodborne illness.

Thanks to Stateline, Oklahoma Voice, and Anna Vollers for the free use of the following article.

A summer of recalls exposes holes in the nation’s food safety net

by Anna Claire Vollers, Oklahoma Voice
August 31, 2026

Jalapenos. Frozen berries. Beef. Alfalfa sprouts.

A summer of food recalls, including the record-shattering cyclosporiasis outbreak tied to iceberg lettuce that has sickened thousands, has raised many Americans’ fears of contracting a foodborne illness.

The recalls have focused attention on the Trump administration’s decision to cut funding and staff at several public health agencies, and prompted questions about whether those changes have made consumers more vulnerable.

In fact, this year’s tally of food recalls is roughly in line with the numbers in recent years. About 48 million people each year get sick from a foodborne illness. But experts worry that the scope, severity, and scale of outbreaks and their associated food recalls are growing.

Cyclospora

While the United States sees some cyclosporiasis cases every year, this year’s outbreak has crushed records: Since May, the federal Centers for Disease Control and Prevention has confirmed more than 17,000 cases, with another nearly 12,000 reported cases still under investigation. The outbreak has resulted in at least 922 hospitalizations and two deaths.

this word slide lists, what in 1996, were those infections that were coming to bear, and reads as follows: “• Ebola in nonhuman primates, Texas; • Raccoon rabies, Ohio; • Cyclospora gastroenteritis, multiple states; • Malaria, Georgia and Florida; • Yellow fever (imported), Tennessee; • E. coli O157:H7 in apple juice, multiple states”.CDC, public domain

Federal officials have blamed this year’s multistate outbreak on processed iceberg lettuce from central Mexico. The lettuce was brought to the U.S. by Taylor Farms, a distributor that supplies foods to thousands of restaurants and grocery stores, including Target, Taco Bell, Whole Foods, Kroger, Walmart, Costco and Jack in the Box.

Quotation

I think there are valid questions around the timing of the response, the time it took for agencies to recognize the outbreak and to start to investigate it, get boots on the ground in Mexico.

– Jennifer McEntire, food microbiologist and founder of Food Safety Strategy

The CDC and the Food and Drug Administration are investigating at least six other clusters for which a source hasn’t yet been confirmed.

Cuts at the CDC and FDA haven’t necessarily increased consumers’ chances of food contamination or outbreaks, said Jennifer McEntire, a food microbiologist and the founder of a food safety consulting firm. However, McIntire said, “I do think the cuts may have influenced the way outbreaks unfold.”

“I think there are valid questions around the timing of the response, the time it took for agencies to recognize the outbreak and to start to investigate it, get boots on the ground in Mexico,” she said.

Darin Detwiler, a food safety expert and professor emeritus at Northeastern University, noted that the U.S. is seeing more recalls affecting multiple states, rather than a small area. He added that more recalls are being tied to a problem earlier in the food chain — such as contaminated irrigation water at a large lettuce farm rather than, say, improperly stored deli meat at a sandwich shop  — which can spread the pathogen to a far higher number of people and make it harder to track and contain.

“We’re seeing so many people impacted, so many states impacted, and the recalls are dragging on for a long time,” Detwiler. “There’s ambiguity or lack of transparency over who’s even behind a recall.”

The White House dismissed concerns about the federal government’s ability to handle outbreaks.

“The Trump Administration has never cut FDA food inspectors or other frontline personnel for domestic disease response,” White House spokesperson Allison Schuster told Stateline in an email. “

President Trump’s top priority is the health and safety of the American people, and the federal government remains capable of robustly addressing any future outbreaks.”

Fewer Staff, Less Funding

Last year, the Trump administration laid off thousands of employees at federal public health agencies including the CDC, which tracks and responds to disease outbreaks, and the FDA, which oversees and regulates food safety.

While some of the layoffs were reversed through lawsuits or by Congress, the nation’s public health agencies remain at diminished capacity. The CDC workforce has been reduced by 28% since December 2024, according to a Stateline analysis of data from the U.S. Office of Laboratories and Research (OL which responds to outbreaks, was downsized last year by the Department of Government Efficiency from 11 people to three.

Sandra Eskin, a food safety expert who worked in the office of food safety at the U.S. Department of Agriculture during the Biden administration, likened federal public health cuts to the game Jenga, where players construct a tower of wooden blocks and then remove the blocks one at a time while trying not to make the tower fall.

“I think that’s what we’re seeing,” said Eskin, who now leads a public health nonprofit called Stop Foodborne Illness, which advocates for stronger food safety policies. “Whether it’s cuts in staff, cuts in funding that trickle down to the states, or late responses to outbreaks — these are all pieces of wood in that game where you start pulling them out and then the whole thing collapses.”

The federal government also has delayed requiring companies to comply with new food safety rules, included in a law enacted more than a decade ago, that would help regulators track where food comes from and where it’s going during outbreaks.

Detwiler and other experts say the new rules could have helped speed the government’s sluggish response to the cyclospora outbreak investigation after Taylor Farms initially tried delaying the recall.

Last year, the Trump administration also drastically scaled back FoodNet, an early warning surveillance system that required tracking of infections caused by eight different foodborne pathogens. The federal-state collaboration is now only required to track two pathogens: Salmonella and Shiga toxin-producing E.coli. The other six pathogens, including cyclospora, were made optional.

This pie chart illustrates the breakdown of the origins of salmonella infections amongst 500 salmonella outbreaks between 1966 and 1975. Sources of infection included pets (3%), dairy products (4%), eggs (6%), person-to-person (10%), meat (13%), poultry (17%), miscellaneous (19%), and unknown (28%).CDC/ Dr. Mike Miller, public domain

The CDC says the change was made because other surveillance systems monitor those pathogens. But McEntire and other food safety experts want them reinstated on FoodNet.

Funding Cuts’ Impact on States

Infectious outbreaks like cyclosporiasis are typically investigated by state and local health departments, which largely rely on federal dollars distributed through the FDA and CDC. Public health has been chronically underfunded for decades under several administrations, experts say.

But the Trump administration since last year has terminated $5.78 billion in CDC grants — funds that were appropriated by Congress but had not yet been spent.

Michigan, at the center of the cyclosporiasis outbreak with the highest number of cases and clusters, is one of 23 states (plus the District of Columbia) that successfully sued the Trump administration in June 2025 over federal funding cuts.

Changes to federal funding last year affected public health infrastructure across Michigan, a representative from the Michigan Department of Health and Human Services told Stateline. During the cyclosporiasis outbreak, the state used its own resources to bolster local responses.

“While we are able to support this investigation on a local level, sustained investment in public health capacity is essential to ensuring Michigan can respond effectively to future regional and statewide public health threats,” said department spokesperson Lynn Sutfin.

Stateline reporter Anna Claire Vollers can be reached at avollers@stateline.org

This story was originally produced by Stateline, which is part of States Newsroom, a nonprofit news network that includes Oklahoma Voice, and is supported by grants and a coalition of donors as a 501c(3) public charity.

Oklahoma Voice is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Oklahoma Voice maintains editorial independence. Contact Editor Janelle Stecklein for questions: info@oklahomavoice.com.

The graphics used in the article were not part of the original publication.

Keeping Your Family Safe

4 STEPS TO FOOD SAFETY

The CDC offers these tips for food safety.

To prevent food poisoning, follow the four steps to food safety: Clean, Separate, Cook, and Chill. Keep hands and surfaces clean, keep risky foods separate from other foods, cook food properly, and refrigerate promptly.

Some foods are more likely to contain harmful germs, including:

  • Raw or undercooked poultry, meat, seafood, or eggs
  • Raw or undercooked sprouts
  • Unwashed fruits and vegetables
  • Cut melon
  • Unpasteurized milk, juice, cider, or soft cheese
  • Raw dough or raw batter made with uncooked flour

Explore this topic further at CDC FOOD SAFETY

The most common sources of fatal infections were meat and poultry, much due to Salmonella and Listeria, from the CDC website

Next Steps

Take time to consider what you learned from this article and what else you might need to know.

Consider inspecting your own home for how well it protects your family from food-related illness. While much of the health advice we offer now involves the types of food we eat, the basics of food storage and meal preparation are still important.

How important is this to you and what are your next steps? I’d like to know, so please comment. I try to respond to all comments.

Exploring the HEART of Health

Thank you for reading this post. I strive to make them worth your time.

I share information and inspiration that sparks transformation in your body, mind, and spirit.

You can follow this blog in two easy ways. One is to put your email address into the box below.

Another way is to follow me on Facebook, where I share new posts, timely topics, photos, and an occasional cartoon.

Watercress Words by Dr. Aletha

Dr. Aletha