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US

Minnesota governor signs bill codifying ‘fundamental right’ to abortion into law

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CNN
 — 

Minnesota’s Democratic Gov. Tim Walz signed a bill into law Tuesday that enshrines the “fundamental right” to access abortion in the state.

Abortion is already legal in Minnesota, but in the aftermath of the US Supreme Court overturning Roe v. Wade, the Protect Reproductive Options Act goes a step further by outlining that every person has the fundamental right to make “autonomous decisions” about their own reproductive health as well as the right to refuse reproductive health care.

“This is very simple, very right to the point,” Walz said Tuesday on “CNN Tonight.” “We trust women in Minnesota, and that’s not what came out of the [Supreme Court’s] decision, so I think it’s critically important that we build a fire wall.”

With the passage of the bill, Minnesota is now the first state to codify abortion via legislative action since Roe v. Wade was reversed, the office of the bill’s lead author in Minnesota’s state Senate, told CNN.

“Last November, Minnesotans spoke loud and clear: They want their reproductive rights protected – not stripped away,” Walz said in a news release. “Today, we are delivering on our promise to put up a firewall against efforts to reverse reproductive freedom. No matter who sits on the Minnesota Supreme Court, this legislation will ensure Minnesotans have access to reproductive health care for generations to come. Here in Minnesota, your access to reproductive health care and your freedom to make your own health care decisions are preserved and protected.”

The bill states that local government cannot restrict a person’s ability to exercise the “fundamental right” to reproductive freedom. It also clarifies that this right extends to accessing contraception, sterilization, family planning, fertility services and counseling regarding reproductive health care.

“The Pro Act also goes beyond just granting those rights to abortion, it really says all reproductive healthcare decisions aren’t our business, including access to contraception, including access to really anything that is related to personal and private decisions about your reproductive life,” Megan Peterson, the executive director of pro-abortion rights campaign UnRestrict Minnesota, told CNN following Walz’s signing of the bill.

In a letter to Walz ahead of the signing, Republican legislature leaders argued that the bill went too far and urged the governor to veto what they called “an extreme law.”

“As the PRO Act was being rushed through the legislature, Republicans offered reasonable amendments with guardrails to protect women and children,” state Senate Minority Leader Mark Johnson and House Minority Leader Lisa Demuth wrote, “Sadly, each of these amendments were struck down by a Democrat majority.”

In 1995, the Minnesota Supreme Court ruled in Doe v. Gomez that abortion was a fundamental right protected under the state’s constitution. The Protect Reproductive Options Act ensures that even in the event of a new state Supreme Court reversing the ruling, the right to abortion will be protected under state law.

“By passing this law, Minnesotans will have a second layer of protection for their existing reproductive rights. A future Minnesota Supreme Court could overturn Doe v. Gomez, but with the PRO Act now in State law, Minnesotans will still have a right to Reproductive healthcare,” Luke Bishop, a spokesperson for Democratic State Sen. Jennifer McEwen, the bill’s author in the Senate, told CNN over email.

Following the governor’s signature of the bill, the White House applauded Minnesota’s efforts, pointing to the popular support for women’s rights to make their own health care decisions.

“Americans overwhelmingly support a woman’s right to make her own health care decisions, as so clearly demonstrated last fall when voters turned out to defend access to abortion – including for ballot initiatives in California, Kansas, Kentucky, Michigan, Montana, and Vermont,” White House press secretary Karine Jean-Pierre said in a statement.

“While Congressional Republicans continue their support for extreme policies including a national abortion ban, the President and Vice President are calling on Congress to restore the protections of Roe in federal law,” she wrote. “Until then, the Biden-Harris Administration will continue its work to protect access to abortion and support state leaders in defending women’s reproductive rights.”

This story has been updated with additional information.

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Health

First cases of gonorrhea resistant to several classes of antibiotics identified in the U.S.

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CNN
 — 

Public health officials says they have found two cases of gonorrhea that appear to have reduced susceptibility to every kind of antibiotic available to treat them. It’s the first time strains of gonorrhea this resistant to antibiotics have been identified in the United States.

Increased sexual activity during the pandemic, coupled with fewer people getting routine health screenings, supercharged the spread of sexually transmitted infections around the world.

Those infections, including gonorrhea, are becoming increasingly resistant to antibiotics available to treat them, a problem that is becoming a dire threat to public health.

Globally, infections that are resistant to antibiotics kill approximately 700,000 people each year. That number is expected to rise to 10 million deaths per year by 2050 if steps aren’t taken to stop the spread of resistant organisms.

Experts say it was never a question of when this highly resistant gonorrhea strain would reach the US, but when.

“The concern is that this particular strain has been circulating around the world, so it was only a matter of time before it would hit the US,” says Dr. Jeffrey Klausner, a clinical professor of public health at the University of Southern California’s Keck School of Medicine in Los Angeles.

“It’s a reminder that gonorrhea is becoming increasingly resistant, increasingly hard to treat. We don’t have any new antibiotics. We haven’t had new antibiotics to treat gonorrhea for years and we really need a different treatment strategy,” said Klausner, who sits on the CDC workgroup for gonorrhea treatment.

Gonorrhea is sexually transmitted, and one of the most commonly diagnosed infections in the US. It is caused by the bacteria Niesseria gonorrhoeae, which can infect the mucous membranes in the genitals, rectum, throat and eyes.

People can be infected without having symptoms. Left untreated, the infection can cause pelvic pain and infertility in women and blindness in newborns.

In addition to reduced susceptibility to ceftriaxone, the strains of gonorrhea identified in Massachusetts also showed reduced susceptibility to cefixime and azithromycin; the strains were resistant to ciprofloxacin, penicillin and tetracycline, according to a clinical alert sent to physicians by the Massachusetts Department of Public Health.

The MDPH says it hasn’t yet found any connection between the two cases.

In 2021, the US Centers for Disease Control and Prevention recommended giving a double dose of the antibiotic ceftriaxone in an effort to overcome the bacteria’s building resistance to this antibiotic, and that seems to have worked in these cases, but that antibiotic is the last line of defense against this infection, and experts say a new approach is needed.

Klausner is hoping to win FDA approval for a test that would tailor antibiotic treatment to the genetic susceptibilities of the particular strain of gonorrhea that is infecting a person. This is called resistance-guided treatment, and Klausner says it works for HIV, TB and some other hospital acquired infections, but it’s never really been tried for gonorrhea.

This strain of gonorrhea has been previously seen in Asia-Pacific countries and in the United Kingdom, but not in the US. A genetic marker common to these two Massachusetts residents was also previously seen in a case in Nevada, though that strain retained sensitivity to at least one class of antibiotics.

The first symptoms of gonorrhea are often painful urination, abdominal or pelvic pain, increased vaginal discharge, or bleeding between periods, but many infections are asymptomatic, according to the CDC, making routine screenings important for catching the infection.

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US

Women living in states with abortion bans suffer greater economic insecurity

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New York
CNN
 — 

Women living in states that restrict or ban abortion face greater economic insecurity than those living in states where they have access, new research finds.

Since the nearly seven months since the Supreme Court overturned Roe v. Wade, half of all states – 26 in total – have implemented new abortion restrictions or all-out bans.

In nearly all 26 states, there are lower minimum wages, unionization levels, access to Medicaid and unemployment benefits, as well as higher rates of incarceration than states with more lenient abortion policies, according to new research by the Economic Policy Institute.

“These economic policies all compound on each other. And you add to that an abortion ban, it just compounds this financial stress, this economic insecurity,” said Asha Banerjee, an economic analyst with the institute and the author of the report.

Last year, Treasury Secretary Janet Yellen made a similar argument to the Financial Oversight Council.

“I believe that eliminating the right of women to make decisions about when and whether to have children would have very damaging effects on the economy and would set women back decades,” Yellen told lawmakers in May.

The lack of abortion access has the greatest economic impact on women of color, especially those already in dire financial conditions, according to Banerjee.

“In many of these states, especially the states which have banned abortion, many of the women who are facing economic challenges already are also women of color,” she said.

Raising the minimum wage is a powerful tool that has been known to have significant impact on closing racial income gaps. But nearly two-thirds of abortion restrictive states have a $7.25 minimum wage, the lowest legal hourly wage for most workers in the United States.

The average minimum wage across the 26 states is $8.17, lower than the average $11.92 for states with no restrictions. (Many of those states also have a higher cost of living, however.)

“If the person denied an abortion is also working a minimum wage job, the negative economic effect is compounded,” the report states.

Many of those low-wage jobs also do not offer benefits like health care, which is why access to Medicaid is critical.

“Medicaid is a lifeline for low-income families and low-income women when jobs might not offer adequate healthcare. Medicaid in the immediate postpartum period is especially important,” said Banerjee.

Just 12 states have not expanded Medicaid benefits since the 2010 Obamacare law, and all of them have restrictive abortion policies.

However, some states with total abortion bans, with few exceptions, have expanded Medicaid, including Missouri. And in five other abortion restrictive states (Idaho, Missouri, Nebraska, Oklahoma and South Dakota later this year) residents voted to expand the benefit.

Access to unemployment insurance is another key indicator of a state’s commitment to economic support for residents. Forty-two percent of residents have access to unemployment benefits in states that have abortion protections. Compare that to 30% in states with abortion restrictions.

Even if unemployment is accessible, the amount differs from state to state. For example, in Mississippi, a state with a total abortion ban with limited exceptions, weekly unemployment checks average $217. Meanwhile in Massachusetts, which has a more protective 24-week abortion ban – checks average $556 weekly.

“When you have unemployment insurance it helps create financial stability. These states which have abortion bans also have really terrible unemployment insurance systems with really low benefits which do not help one support oneself,” said Banerjee.

Although women make up a smaller percentage of those incarcerated than men, it is the economic category with the greatest difference between abortion protected and abortion-restricted states. The rate of incarceration in states with restrictive or total bans on abortion is more than one and a half times higher than the rate of incarceration for states with abortion protections.

“It’s very much a racial justice issue because Black and Hispanic women are very disproportionately incarcerated. And that has huge economic impacts on future earnings and the ability to get a job,” said Banerjee.

In some states with abortion restrictions and higher rates of incarceration – legislation has suggested also criminalizing women, doctors or anyone aiding a woman in seeking an abortion.

“The incarceration argument is especially important because in these states where abortion bans have come into play, there’s a huge criminalization aspect,” said Banerjee.

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Health

US cancer death rate drops 33% since 1991, partly due to advances in treatment, early detection and less smoking, new report says

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CNN
 — 

The rate of people dying from cancer in the United States has continuously declined over the past three decades, according to a new report from the American Cancer Society.

The US cancer death rate has fallen 33% since 1991, which corresponds to an estimated 3.8 million deaths averted, according to the report, published Thursday in CA: A Cancer Journal for Clinicians. The rate of lives lost to cancer continued to shrink in the most recent year for which data is available, between 2019 and 2020, by 1.5%.

The 33% decline in cancer mortality is “truly formidable,” said Karen Knudsen, chief executive officer of the American Cancer Society.

The report attributes this steady progress to improvements in cancer treatment, drops in smoking and increases in early detection.

“New revelations for prevention, for early detection and for treatment have resulted in true, meaningful gains in many of the 200 diseases that we call cancer,” Knudsen said.

In their report, researchers from the American Cancer Society also pointed to HPV vaccinations as connected to reductions in cancer deaths. HPV, or human papillomavirus, infections can cause cervical cancer and other cancer types, and vaccination has been linked with a decrease in new cervical cancer cases.

Among women in their early 20s, there was a 65% drop in cervical cancer rates from 2012 through 2019, “which totally follows the time when HPV vaccines were put into use,” said Dr. William Dahut, the society’s chief scientific officer.

“There are other cancers that are HPV-related – whether that’s head and neck cancers or anal cancers – so there’s optimism this will have importance beyond this,” he said.

The lifetime probability of being diagnosed with any invasive cancer is estimated to be 40.9% for men and 39.1% for women in the US, according to the new report.

The report also includes projections for 2023, estimating that there could be nearly 2 million new cancer cases – the equivalent of about 5,000 cases a day – and more than 600,000 cancer deaths in the United States this year.

During the early days of the Covid-19 pandemic, many people skipped regular medical exams, and some doctors have seen a rise in advanced cancer cases in the wake of pandemic-delayed screenings and treatment.

The American Cancer Society researchers were not able to track “that reduction in screening that we know we all observed across the country during the pandemic,” Knudsen said. “This time next year, I believe our report will give some initial insight into what the impact was in the pandemic of cancer incidence and cancer mortality.”

The new report includes data from national programs and registries, including those at the National Cancer Institute, the US Centers for Disease Control and Prevention and the North American Association of Central Cancer Registries.

Data showed that the US cancer death rate rose during most of the 20th century, largely due to an increase in lung cancer deaths related to smoking. Then, as smoking rates fell and improvements in early detection and treatments for some cancers increased, there was a decline in the cancer death rate from its peak in 1991.

Since then, the pace of the decline has slowly accelerated.

The new report found that the five-year relative survival rate for all cancers combined has increased from 49% for diagnoses in the mid-1970s to 68% for diagnoses during 2012-18.

The cancer types that now have the highest survival rates are thyroid at 98%, prostate at 97%, testis at 95% and melanoma at 94%, according to the report.

Current survival rates are lowest for cancers of the pancreas, at 12%.

The finding about a decreasing cancer death rate shows “the continuation of good news,” said Dr. Otis Brawley, an oncology professor at Johns Hopkins University who was not involved in the research.

“The biggest reason for the decline that started in 1991 was the prevalence of smoking in the United States started going down in 1965,” said Brawley, a former chief medical officer of the American Cancer Society.

“That’s the reason why we started having a decline in 1991, and that decline has continued because the prevalence of people smoking in the United States has continued to go down,” he said. “Now, in certain diseases, our ability to treat has improved, and there are some people who are not dying because of treatment.”

Although the death rate for cancer has been on a steady decline, the new report also highlights that new cases of breast, uterine and prostate cancer have been “of concern” and rising in the United States.

Incidence rates of breast cancer in women have been increasing by about 0.5% per year since the mid-2000s, according to the report.

Uterine corpus cancer incidence has gone up about 1% per year since the mid-2000s among women 50 and older and nearly 2% per year since at least the mid-1990s in younger women.

The prostate cancer incidence rate rose 3% per year from 2014 through 2019, after two decades of decline.

Knudsen called prostate cancer “an outlier” since its previous decline in incidence has reversed, appearing to be driven by diagnoses of advanced disease.

On Thursday, the American Cancer Society announced the launch of the Impact initiative, geared toward improving prostate cancer incidence and death rates by funding new research programs and expanding support for patients, among other efforts.

“Unfortunately, prostate cancer remains the number one most frequently diagnosed malignancy amongst men in this country, with almost 290,000 men expected to be diagnosed with prostate cancer this year,” Knudsen said. Cancer diagnosed when it is confined to the prostate has a five-year survival rate of “upwards of 99%,” she said, but for metastatic prostate cancer, there is no durable cure.

“Prostate cancer is the second leading cause of cancer death for men in this country,” she said. “What we’re reporting is not only an increase in the incidence of prostate cancer across all demographics but a 5% year-over-year increase in diagnosis of men with more advanced disease. So we are not catching these cancers early when we have an opportunity to cure men of prostate cancer.”

Breast, uterine and prostate cancers also have a wide racial disparity, in which communities of color have higher death rates and lower survival rates.

In 2020, the risk of overall cancer death was 12% higher in Black people compared with White people, according to the new report.

“Not every individual or every family is affected equally,” Knudsen said.

For instance, “Black men unfortunately have a 70% increase in incidence of prostate cancer compared to White men and a two- to four-fold increase in prostate cancer mortality as related to any other ethnic and racial group in the United States,” she said.

The data in the new report demonstrates “important and consistent” advances against cancer, Dr. Ernest Hawk, vice president of cancer prevention and population sciences at the University of Texas MD Anderson Cancer Center, said in an email.

“Cancer is preventable in many instances and detectable at an early stage with better outcomes in many others. When necessary, treatments are improving in both their efficacy and safety. That’s all great news,” Hawk wrote.

“However, it’s well past time for us to take health inequities seriously and make them a much greater national priority. Inequities in cancer risks, cancer care and cancer outcomes are intolerable, and we should not be complacent with these regular reminders of avoidable inequities,” he said. “With deliberate and devoted effort, I believe we can eliminate these disparities and make even greater progress to end cancer.”

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