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Insights: Sustainability Investment Risks & Opportunities in 2025
Corporate sustainability programs face various headwinds in 2025, with growing discontent among industry, consumers, and investors. Concerns about greenwashing, greenhushing, and the patchwork of regulations in different jurisdictions are creating uncertainty for global businesses. In the video below, Executive Vice President and Environmental, Health & Safety Practice Lead John Peiserich shares more about sustainability investment risks and opportunities covered in the 2025 J.S. Held Global Risk Report. To view the report, visit: 2025 J.S. Held Global Risk Report Looking to know more or connect with John Peiserich about the 2025 J.S. Held Global Risk Report? Simply click on his icon now to arrange an interview today.
Expert Spotlight: Suicide Prevention and Health Care Acccreditation
Recently, Michael Johnson, MA, CAP, CARF International Senior Managing Director of Behavioral Health joined Adam Chu, MPH, from the Suicide Prevention Resource Center, and Kasie Pickart, MPH, from Hope Network in an interesting panel discussion where they shared insights on implementing the Zero Suicide model and integrating CARF's comprehensive suicide prevention standards. The discussion highlighted these key elements: Introduction to Suicide Prevention Resource Center The center's mission is to advance suicide prevention across diverse populations using training, consultation, and resources. CARF accreditation standards: CARF's consultative approach emphasizes quality improvement through peer-surveyed standards. Alignment with the Zero Suicide framework, incorporating risk assessments, safety planning, and care transition protocols. Hope Network's implementation journey: Leveraged a SAMHSA grant to adopt Zero Suicide practices across 200+ Michigan locations. Aligned practices with CARF standards for comprehensive suicide prevention. Developed standardized tools and a suicide care pathway for consistent risk management. Outcomes and challenges: Improved training and organizational culture around suicide prevention. Challenges include ensuring cross-team communication and sustaining practices post-grant funding. View the webinar: The discussion concluded with insights into maintaining long-term quality improvement and the benefits of CARF accreditation for suicide prevention efforts. Michael Johnson is the CARF International Senior Managing Director of Behavioral Health. If you are looking to know more or connect with Michael, view his profile below to arrange an interview today.
ChristianaCare Reduces Health Care Costs by $6.2 Million While Improving Care for Medicaid Patients
ChristianaCare’s Delaware Medicaid Partners Accountable Care Organization (ACO) has set the standard for innovative, high-quality care at lower cost for the State of Delaware’s Medicaid population. According to the most recent data available, ChristianaCare’s ACO reduced health care spending by $6.2 million in 2023 while improving care for nearly 30,000 Medicaid beneficiaries in Delaware, including approximately 8,000 children. “We’re demonstrating that population health works,” said Christine Donohue-Henry, M.D., MBA, chief population health officer, ChristianaCare. “Our neighbors count on us to take care of them — and we can improve their health while also helping the state reduce health care costs. We do this by delivering high-quality care that emphasizes preventive care and proactive management of health conditions, and by investing in our population health infrastructure. “In this way, we can keep people healthier and reduce the need for them to access the most expensive kinds of care, such as emergency care and hospitalization.” ChristianaCare’s Medicaid ACO includes more than 1,900 primary and specialty care clinicians who partner with patients and families to prevent illness, manage chronic diseases and help them achieve their health goals. The ACO makes it easy for adults and children to get the screenings and treatments they need, improving overall health. ChristianaCare’s Medicaid ACO is one of four authorized by the State of Delaware and the only one to voluntarily accept downside financial risk at its launch in 2021, which means that if ChristianaCare’s Medicaid ACO is not successful in reducing cost and improving care for a particular year, the ChristianaCare ACO is required to make a payment to the state. By sharing in both savings and losses, the ACO controls state health care costs while maintaining high-quality care. Bending the Cost Curve by Focusing on High-Quality Preventive Care Alongside financial savings, ChristianaCare’s Medicaid ACO has improved care quality and worked to reduce health disparities. By focusing on preventive care, the ACO has helped adults and children get the screenings and treatment they need, leading to better health outcomes and fewer unmet needs. Since launching in 2021, ChristianaCare’s ACO has met all required quality standards and consistently improved its performance each year on key measures like diabetes management, blood pressure control and breast cancer prevention. Year over year, breast cancer screenings have increased by 4%, while patients with high blood pressure (hypertension) have shown improvement in blood pressure control. Notably, healthy blood sugar levels (HbA1c less than 8%) have also improved in patients with diabetes by 7%. In collaboration with its Medicaid health plan partners, ChristianaCare primary care and imaging teams host patient-centered health and wellness day events to increase access to care, close quality gaps and improve the overall health of the communities they serve. These events help patients get preventive screenings and services, supporting the ACO’s goals of better care and health equity. The ACO’s success is driven by its focus on caring for entire families, including addressing the needs of pregnant mothers and supporting children and adults throughout their lives, according to Rose Kakoza, M.D., MPH, senior clinical network director, ChristianaCare Clinical Alliance. Key programs include enhanced maternity care to support mothers and infants, expanded mental health services and social support programs that address food and housing needs. By integrating clinical care with social support — such as help with food and housing — the ACO is working to break cycles of poor health across generations. This approach also has practical benefits. For example, the improved mental health of a parent strengthens the family environment, supporting children’s well-being and development. “By making significant investments in population health and addressing both medical needs and the social drivers of health, we’ve not only improved health outcomes but also more effectively managed costs for Delaware’s most vulnerable residents, helping to reduce state spending,” Kakoza said. About Delaware Medicaid Partners Delaware Medicaid Partners ACO, led by ChristianaCare, uses a family-centered approach to save money and improve care for Medicaid patients. By combining medical care with social support, the ACO addresses the unique needs of Medicaid patients, improving health and promoting equity. Care coordination is provided by ChristianaCare’s CareVio®, whose team of nurses, social workers, and pharmacists help patients with serious health conditions get the care they need. CareVio uses real-time data to prevent complications that could lead to unnecessary hospital stays or emergency visits. Through ongoing collaboration and innovation, Delaware Medicaid Partners ACO aims to set an example for other states working to improve care while managing costs.
J.S. Held Releases 2025 Global Risk Report Addressing Critical Risks Amid Uncertainty
On the first day of the new presidential administration in the United States, global consulting firm J.S. Held unveils its annual report focused on critical areas impacting industries and economies worldwide. Explore the 2025 J.S. Held Global Risk Report here: In an increasingly uncertain and volatile global landscape, businesses, governments, and investors face a growing array of challenges that demand immediate attention and innovative solutions. The 2025 J.S. Held Global Risk Report explores five interconnected topics that organizations must consider in managing risk and opportunity in the year ahead. These include: 1. Sustainability Investments & Headwinds: With various ESG regulations across jurisdictions and increasing scrutiny over corporate environmental and social practices, experts explore how organizations can align with evolving frameworks while driving innovation. 2. Global Supply Chain Challenges: From geopolitical conflicts to climate disruptions, the report analyzes how companies can build more resilient and sustainable supply chains. 3. Crypto & Digital Asset Intensification: As the crypto landscape transitions through regulatory shifts and technological advancements, the report highlights both the risks and opportunities for businesses and investors. 4. Artificial Intelligence, Data & Digital Regulatory Response: With Artificial Intelligence (AI) systems reshaping industries, experts examine the regulatory, ethical, and operational challenges, as well as the competitive advantages for organizations that harness this transformative technology responsibly. 5. Cybersecurity Complexities: From AI-powered cyberattacks to evolving data protection laws, the report provides insights into how organizations can safeguard operations and maintain customer trust in a rapidly shifting digital environment. The 2025 J.S. Held Global Risk Report includes an analysis of these categories of risk and actionable opportunities for companies to gain a competitive edge while addressing critical vulnerabilities. “The 25 technical, scientific, financial, and strategic advisory experts who contributed to the J.S. Held Global Risk Report have collaboratively parsed not only each risk independently but also at their unique points of intersection to create a framework to support business decision-making,” noted Greg Esslinger, Executive Vice President and Global Investigations Practice Leader. “Our experts’ deep understanding of the external factors related to the topics that keep CEOs, CFOs, COOs, CLOs, and Boards of Directors up at night drives the curated insights shared in the report and helps clients navigate risks and capitalize on emerging opportunities in the year ahead,” adds John Peiserich, Esq., Executive Vice President and Environmental, Health, & Safety Practice Leader. The depth and breadth of J.S. Held’s work in the insurance market provides a strong foundation in risk assessment, data analysis, global awareness, regulatory compliance, technological adaptability, and risk mitigation. Collectively, these skills better equip the firm’s experts to assess business risk across diverse geographies, geopolitical landscapes, compliance frameworks, and digital advancements. "In a world where uncertainty is the only constant, there is a need for something solid you can hold onto," observes J.S. Held Chief Executive Officer Jonathon Held. "Our name is our promise," he adds. "Our role as strategic advisor is emblematic of this promise, even in the face of the most daunting risks, clients have the expertise and guidance to act with confidence" "Agile, collaborative, and creative client-centric teams provide solution-forward advisory to our clients across the globe, no matter the scope or complexity of a project; the J.S. Held Global Risk Report is reflective of the trusted advisor role we have earned over the last 50 years," noted J.S. Held President and Chief Operating Officer Lee Spirer. J.S. Held's expertise in strategic advisory is built upon five decades of experience in the most rigorous venues – state, federal, and international courts – and spans more than 150 different industry segments. If you have any questions or would like to further discuss the risks and opportunities outlined in the report, please email GlobalRiskReport@jsheld.com. To connect with John Peiserich simply click on the expert's icon now. For any other media inquiries - simply contact : Kristi L. Stathis, J.S. Held +1 786 833 4864 Kristi.Stathis@JSHeld.com
More than half of U.S. states allow the sale of raw milk directly from farms to consumers, a number that would likely increase if Robert F. Kennedy Jr. – a raw milk advocate – is confirmed to lead the Department of Health and Human Services (DHHS). Kali Kniel, a professor of microbial food safety at the University of Delaware, can discuss the dangers and potential benefits of drinking raw milk. Some have celebrated the legalization of raw milk around the country, claiming it tastes better and has some nutritional benefits. Meanwhile, the U.S. Food and Drug Administration, one of the DHHS agencies Kennedy would lead, cautions against drinking raw milk, which comes directly from cows, sheep or goats and has been banned from being sold across state lines since the 1980s. Concerns regarding raw milk have been elevated as a deadly strain of bird flu is infecting dairy farms around the country. In the following Q&A, Kniel talks about the pathogens that may be present in raw milk, ways to communicate food safety to the public and other topics. Milk and other dairy products that sit on shelves at the grocery store are pasteurized. What does this process involve and why is it important for dairy products? Pasteurization of milk is a process of heating milk and passing it between heated stainless steel plates until it reaches 161 degrees Fahrenheit. It is held at that temperature for around 15 seconds before it is quickly cooled to 39 degrees Fahrenheit. This process is intended to kill the pathogenic bacteria that could make a person sick. How does this process affect milk’s quality and nutritional value? Scientific studies have shown that pasteurization does not significantly change the nutritional value of milk. Unpasteurized milk may have more vitamin C, which does not survive the pasteurization process, but milk is not considered a good source of vitamin C, as it contains less than 10% of the Recommended Dietary Allowance (RDA), the average amount of nutrients it takes to meet a healthy person’s needs. There are no beneficial bacteria in raw milk. Milk (pasteurized or raw) is not a good source of probiotic or potentially beneficial bacteria, so for that consumers should choose yogurt and other fermented dairy products as well as other fermented products. Scientific studies using animal models have shown no difference in how calcium in raw milk and pasteurized milk is absorbed by the human body. Popularity in drinking raw milk is increasing, despite the U.S. Food and Drug Administration advising that it’s not safe to drink. What are the health risks that come with drinking raw milk? Raw milk may contain pathogenic bacteria, including Campylobacter, Salmonella, pathogenic types of E. coli, Listeria and Brucella, as well as the protozoan parasite Cryptosporidium. These are all zoonotic microbes, which means they can be transmitted from animals to humans. Often the animal does not appear ill, so it is not possible to determine if an ill animal is shedding these pathogens in its feces that can contaminate milk. Microbial testing of the finished product and environmental monitoring programs may be helpful, but do not guarantee that the raw milk is absent of these pathogens. Milk can be contaminated with these pathogens from direct contamination with feces or from environmental conditions. Cross-contamination from dairy workers can also happen, even when people are trying their best to reduce the risk of cross-contamination. The likelihood of a disease outbreak occurring associated with a person consuming raw milk is relatively high given that others may also be exposed. Unpasteurized milk will have a relatively short shelf life and may not be available for testing. Following good hygiene practices on the farm and during milking such as biosecurity around the farm, appropriately sanitizing equipment and monitoring the health of animals can reduce the chance of milk contamination, but not eliminate it. There have been numerous outbreaks of illness associated with raw milk as well as cheese made from raw milk. Persons most at risk of illness associated with drinking raw milk include children, in particular 5 years of age and under, individuals aged 65 and over, pregnant women and immunocompromised individuals. It should be noted that all outbreaks of illness associated with raw milk have included individuals under 19 years of age. Children may be most vulnerable, as they cannot voice an opinion on consumption and risk of raw milk if it is in their household. The Center for Disease Control and Prevention (CDC) collects data on foodborne disease outbreaks voluntarily reported by state, local or territorial health departments. According to the CDC from 2013 to 2018 there were 75 outbreaks of illness linked to raw milk consumption. These outbreaks include 675 illnesses and 98 hospitalizations. Most of these illnesses were caused by Campylobacter, shiga-toxigenic E. coli, or Salmonella. An increase in outbreaks has been correlated with changes in the availability of raw milk. For example, between 2009 and 2023, there were 25 documented outbreaks in the state of Utah, which has 16 raw milk retailers licensed by the Utah Department of Agriculture and Food. In all of these outbreaks, the raw milk was contaminated with the bacteria Campylobacter, which typically causes gastroenteritis symptoms like diarrhea and nausea, but may also cause chronic illness, including Guillain-Barré syndrome which can cause paralysis. How likely are these illnesses to happen from drinking raw milk? It is difficult to say. Foodborne illness is often underreported, depending on how severe people’s symptoms are. According to one study, only about 3.2% of the U.S. population drinks raw milk, while about 1.6% eats cheese made from raw milk. But compared with consumers of pasteurized dairy products, they are 840 times more likely to experience an illness and 45 times more likely to be hospitalized. The authors of this work used the CDC’s national reporting system to analyze data from 2009 to 2014. Despite health risks, why do some people still drink raw milk? Some people feel a nostalgic connection to raw milk, and others may feel that foods that are not treated with heat retain certain nutrients and enzymatic activity. I am not aware of any peer-reviewed rigorous scientific studies that indicate the nutritional benefits of consuming raw milk over time, given the risks of potential for illness, combined with a well balanced diet full of healthful food choices. It remains that raw milk is particularly risky for children to consume, as children can get sick from consuming fewer bacterial cells compared to adults. More than 900 cases of highly pathogenic avian influenza — the disease commonly known as bird flu — have been detected in dairy cattle across 16 states, and at least 40 people have been infected with the disease from close contact with dairy cows. Raw milk is being tested for the virus. With raw milk gaining interest among consumers, what are the possible consequences? Does it elevate the risk of bird flu spreading further to people? There remain clear risks of transmission of pathogenic bacteria through consumption of raw milk, and now with the potential for contamination of raw milk with avian influenza, it is even more important that consumers protect themselves by drinking pasteurized milk. The people most at risk right now are those involved with the milking process and in the handling of dairy cattle. So it is important that those individuals be aware of the risks and take appropriate precautions, including hand washing and wearing appropriate personal protective equipment like protective clothing, gloves, face shields and eye protection. As of December, the U.S. Department of Agriculture is requiring 13 states to share raw milk samples so the agency can test for bird flu viruses. How could this testing better help us understand the virus? I think it is very smart that USDA is leading the National Milk Testing Strategy, which will help us understand the extent of infected herds. Surveillance of microorganisms is an important way to assess risk so we can develop appropriate strategies to reduce and control these risks.
Los Angeles wildfires: Experts address health concerns and evacuation strategies
Major wildfires are once again raging in California, this time in Los Angeles County. According to news reports, they have so far been responsible for two deaths, 1,000 damaged structures and the evacuation of more than 30,000 residents. Experts from the University of Delaware's Disaster Research Center can comment on health impacts, evacuation strategies and how to manage pets and animals during disasters. Below are three of the Disaster Research Center core faculty and the topics they can discuss related to the current wildfires: Jennifer Horney, founding director of UD’s epidemiology program: Health impacts of disasters (mental and physical) as well as evacuation. Additionally, exposure to wildfire smoke which increases risk of respiratory infections; the scale of these fires during a very high period for these infectious diseases (flu, RSV, COVID) may also put pressure on public health and health care systems. Tricia Wachtendorf, co-director of the Disaster Research Center and professor of sociology and criminal justice: Disaster donations, social vulnerability and evacuation. Sarah DeYoung, associate professor of sociology and criminal justice: Pets and animals during evacuations.
AI Everywhere: Where Artificial Intelligence and Health Care Intersect
Imagine a world where AI doesn’t just support health care providers, but anticipates their next move — detecting diseases faster than human eyes, analyzing patterns and patient data that humans might overlook and revolutionizing health care decision making at every level. Driven by data, AI can identify which patients are most likely to have repeated emergency department visits or thrive from personalized medicine. With the power of robotics enhanced by AI, people with medical needs can gain more independence, managing daily tasks such as taking medication, monitoring their health and receiving personalized care, all from the comfort of their own homes. And this is just the beginning. “AI is transforming – and is going to continue transforming – every industry, especially health care,” said Bharat Rao, a notable figure in the fields of health care, technology and AI. Rao himself has made significant contributions to artificial intelligence, machine learning and data analytics, particularly in health care innovation. His current start-up, CareNostics, uses AI technology to identify patients at increased risk for chronic disease. “We take this for granted,” he said, “but it’s like what I used to see on Star Trek as a kid. The opportunities are limitless.” Rao was a keynote speaker at ChristianaCare’s inaugural Innovation Summit, a two-day conference at ChristianaCare’s Newark campus in Delaware, in fall 2024. During panel discussions and keynotes, more than 200 attendees heard about current and future health tech from national innovators and thought leaders, as well as technical advice for inventors who want to patent ideas and protect intellectual property in a world where “AI Is Everywhere,” the conference’s theme. Speakers emphasized that it’s not just technologists, but also researchers, clinicians and other health care professionals who play an essential role in implementing AI-based health care solutions. “There’s no AI without HI, which is human intelligence,” said Catherine Burch, MS, CXA, CUA, vice president of innovation at ChristianaCare. “You want to help shape the future, not wait for it to shape you.” How AI helps improve patient care “AI is incredibly good at reducing noise in images,” said speaker David Lloyd, a technical leader at Amazon, who discussed the use of AI in radiology. “It can detect anomalies, and it can automate radiologist reports, which saves time for radiologists.” Data informatics is another example of the power of AI to help health professionals determine which patients are at an increased risk for falls, malnutrition or recurrent asthma attacks, enabling them to optimize patient health and prevent hospitalizations. “Some patients with asthma go to the ER repeatedly because their treatment plan isn’t working,” said speaker Vikram Anand, head of data at CareNostics. When patients have uncontrolled asthma, data-rich platforms like CareNostics can provide treating physicians with guidelines and other support to improve patient care, which may lead to evidence-based medication changes or other therapies, he said. Using robots as part of the health care team in patient homes may sound like science fiction, but speakers discussed the current evolution of consumer robotics, like Amazon’s Astro. Astro follows patients around their home, interacts with them and supports their care. When ChristianaCare tested Astro’s impact on HomeHealth patients, they found that it reduced feelings of isolation by 60%. “Astro is like Alexa on wheels,” said speaker Pam Szczerba, PT, MPT, CPHQ, director of ChristianaCare’s HomeHealth quality, education and risk management, who studied patients’ experiences with Astro. “People like interacting with Alexa, but they can only interact in the room they’re in. Astro’s mobility lets it go to the patient.” Based on early successes, health professionals are assessing robots as an extension of clinicians in the home. Early results show that patients with robots show improved activation with their care plans. This may lead to more widespread distribution of household robots to newly diagnosed patients to help prevent disease complications, avoidable emergency department visits and re-hospitalizations. How AI helps ease provider burden Speakers also discussed the potential of AI to improve health care delivery and patient outcomes by handling more administrative work for health professionals. “We can reduce some of the redundancy of work to free up time for people to be creative,” said speaker Terrance Bowman, managing director at Code Differently, a company that educates and prepares people to work in technology-driven workplaces. “AI should be taking the ‘administrivia’ – administrative trivial tasks – out of your life,” said speaker Nate Gach, director of innovation at Independence Blue Cross. “When you want folks to do the creative part of the job that takes brain power, have ChatGPT respond to easy emails.” Other examples shared included the power of AI to record meetings, create summaries and send participants automated meeting minutes. Benefits can be seen across industries. Specific to health care, eliminating the need for note-taking during visits enables more personalized and attentive provider-patient interaction. With the evolution of ambient speech apps, clinicians are no longer just dictating notes into the electronic health record. Now AI is listening to the conversation and creating the notes and associated recommendations. “The physician is no longer spending ‘pajama time’ doing catch-up work, at home late into the evening,” said speaker Tyler Flatt, a director and leading expert in AI and digital transformation at Microsoft. “Especially as we’re dealing with burnout, it’s better for patient and physician satisfaction.” AI may also help caregivers uncover details that they hadn’t noticed, helping them diagnosis patients with subtle symptoms. “We feed a large quantity of data and have it suggest commonalities about patients,” said speaker Matthew Mauriello, assistant professor of computer and information sciences at the University of Delaware. “Some things are very insightful, but humans miss them.” AI has also been used for patient engagement, including chatbots that can assist with tasks like scheduling clinical appointments or acknowledging patient questions. “One of the things AI is great at is natural language understanding,” said David Lloyd. “You can alleviate a lot of the burden if you have something that can talk to your patients, especially if it’s an administrative task.” Creating new health innovations “The key is to think of something you’ve done that’s original and non-obvious,” said Rao, who holds more than 60 patents in AI. “The process of writing about it will help you flesh it out.” Turning breakthrough ideas into game changers is just the start — protecting these innovations is what ensures they shape the future, rather than fade into the past. “Keeping it secret and internal to your organization until you know what you want to do with it is important,” Greg Bernabeo, partner at FisherBroyles, LLP, said. “Otherwise, the opportunity is lost, and you can’t get the genie back in the bottle.” Benefits of non-obvious thinking People who pursue “non-obvious” ideas are often on the cutting edge of technology in and out of health care, said keynote speaker, Ben DuPont, while discussing innovative ideas with Randy Gaboriault, MS, MBA, senior vice president and chief digital and information officer at ChristianaCare. “Amazon was not founded by a book retailer; Airbnb was not founded by somebody who was in hospitality,” said DuPont, author, entrepreneur, and co-founder and partner at Chartline Capital Partners venture capital fund. “Before Uber, the founders were running around Paris and they couldn’t get a taxi.” Innovative ideas often arise when people consider non-obvious points of view while thinking about solutions, DuPont said. Non-experts have the ability to cut through the clutter and find the frustration, which can lead to innovative solutions, which DuPont explores in his book “Non-Obvious Thinking: How to See What Others Miss.” Health providers, for example, may discover ideas when they move out of their comfort zones. “If you want to be a better doctor, go do something that has nothing to do with medicine,” he said. “Innovation happens at the collision of seemingly unrelated disciplines.” Diversity in the workplace is necessary, “but it’s not just diversity in the way people look: It’s diversity in how people think,” DuPont said. “There are people that think in dramatic and different ways. We need those people around the table. They might say: ‘If we just move this little thing over here’ … and it starts an avalanche that changes the world.” Involving the future generation During the Innovation Summit, students with an interest in STEM (science, technology, engineering, and mathematics) from St. Mark’s High School in Wilmington, Delaware, competed against one another at ChristianaCare’s inaugural HealthSpark ChallengeTM. Twenty-six high school juniors and seniors were divided into five teams, then challenged to brainstorm ideas for solutions to address the negative mental health effects of social media on teenagers. Each team created a concept poster and pitched their ideas to Summit attendees. The attendees then voted for their favorite solution. The winning solution, Editing Identifiers, is designed to help minimize negative feelings about body image among teens. The solution would use AI technology to identify altered photos on social media. The goal would be to show teens that photos of “perfect” people aren’t real and alleviate the feelings of body dysmorphia. Looking forward Summit speakers highlighted many ways that AI is already incorporated into health care, as well as ways that health tech, AI, and robotics may improve care for patients in the coming years. “We are just scratching the surface,” Rao said. “It’s like laparoscopic surgery – years ago, it was considered experimental or dangerous. Today, surgery is commonly done laparoscopically, with better outcomes and less infection. AI can help identify care gaps and get the right treatment to the right patient. It’s going to be good for the patient.” In a rapidly evolving landscape, the integration of AI into health care not only enhances patient care but also creates opportunities for innovation and collaboration, said ChristianaCare’s Gaboriault. “As AI continues to advance, the health care industry stands on the brink of a revolution, one where the possibilities are as vast as the data that fuels them.”
Villanova Professor Investigates Impacts of Hurricanes on Florida Coast
In October 2024, during the height of hurricane season, Hurricanes Milton and Helene swept across the southeastern United States. Their impact on Florida was severe, with damages totaling tens of billions of dollars. While communities in affected states continue to rebuild, a team of researchers mobilized to assess the damage caused in the hopes of better understanding the impacts of hurricane activity in the future. Jonathan Hubler, PhD, assistant professor of civil and environmental engineering at Villanova University, along with Villanova civil engineering graduate student Sarah Burghardt, traveled to Florida with a joint team from the Nearshore Extreme Events Reconnaissance (NEER) Association and the Geotechnical Extreme Events Reconnaissance (GEER) Association to investigate the immediate aftereffects of Hurricanes Milton and Helene. The National Science Foundation-sponsored trip gathered natural hazards research experts and practitioners from across the country, who quickly jumped at the opportunity to examine the impacts of two tropical storms that occurred in quick succession of each other. A few main areas of study were identified by the team so they could hit the ground running once they touched down in Florida. The researchers wanted to focus primarily on the effects of storm surge, waves, sediment erosion and deposition, and debris transport and accumulation from both hurricanes through pre-storm, during-storm, and post-storm data collection. Over 750 miles were covered across just a few days as data was surveyed and collected from Cedar Key, Horseshoe Beach, Venice, Port Charlotte, Port St. Lucie, Vero Beach and other coastal towns. “This was a unique opportunity for our team of scientists because our team collected data before the storms so we will be able to analyze the direct impacts of the storms utilizing the post-storm data that we collected,” said Dr. Hubler. “Although the destruction was difficult to witness firsthand, we are hopeful that our findings will help to mitigate the impact of these major storms in the future.” The data set collected from these storm sites is expected to improve the understanding, prediction, and mitigation of erosion as well as assess the performance of different shoreline protection systems during severe tropical storm events. Findings from the trip will be shared publicly through the NSF’s Natural Hazards Engineering Research Infrastructure (NHERI) DesignSafe-CI, a nationwide network tailored for data sharing among the natural hazards engineering research community. Local Florida communities will also be notified of relevant findings to increase awareness and understanding of risk assessments when preparing for tropical storm events. “It was a productive few days spent in Florida as we collected a significant amount of data and covered a lot of ground in a short span of time. I’m grateful to have been included on this research team and that I had the chance to bring one of my students along. This real-world experience in the field will help further her learning as she completes her studies,” said Dr. Hubler. Dr. Hubler traveled with the NEER and GEER team again in November for another data collection effort. Although the 2024 hurricane season has come to a close, researchers like Dr. Hubler continue to study their impact year-round to discover new mitigation strategies for next year’s season.
Exploring language as an early behavioral marker of Alzheimer's Disease
Professors from the University of Delaware and Carnegie Mellon University will use a $3.7 million RF1 grant from the National Institute on Aging (NIA) to examine language as an early behavioral marker of Alzheimer’s Disease. If successful, this research could pave the way for earlier interventions. “Identifying these individuals as early as possible gets them into preventive treatments sooner,” said Alyssa Lanzi, assistant professor of Communications Sciences & Disorders at UD. The study builds on pilot data gathered by Anna Saylor, a third-year doctoral student in the communication sciences and disorders doctoral program, housed in the UD's College of Health Sciences. “We know a lot about how language develops in childhood but not much about how it changes in older adults,” Saylor said. “Our data suggest subtle language changes might signal future cognitive decline.” To explore these changes on a larger scale, Lanzi is collaborating with MacWhinney, who founded TalkBank, open science database of language samples. Within TalkBank is DementiaBank, a shared database of multimedia interactions for studying communication in dementia. However, DementiaBank is outdated and limited in demographics, and the quality and rigor of the data need improvement. Lanzi is seeking to change that. Her five-year study seeks 300 older adults aged 60-90 nationwide from underrepresented backgrounds or populations vulnerable to health disparities. “Current DementiaBank data is representative of Caucasians of a higher socioeconomic status,” Lanzi said. “We must intentionally recruit people who are at the greatest risk — for example, adults who are Black, Asian, Hispanic, Latin and those living in rural areas.” The recruitment strategy, rooted in community engagement at locations in Wilmington, Delaware, is part of the novelty of Lanzi’s grant. “This is a feasibility study to see if our approach in Wilmington can be replicated in other states,” Lanzi said. Lanzi has also established an advisory committee of nationwide faculty with relevant expertise on specific priority populations. Their input will tailor plans to population needs while data is collected through a central site at UD. The Delaware Center for Cognitive Aging Research (DECCAR) also provides critical infrastructure for the study. “This project is an example of the success of DECCAR, and our impact extends far beyond state lines,” said Lanzi, an executive committee member with DECCAR. Participants selected for the study will participate in a comprehensive cognitive and language testing battery via telehealth, so they don’t have to travel to UD’s campus, which is novel and unique to this study. “To study their language, they’ll see pictures and be asked to describe them and share stories from their past,” Lanzi said. Study participants will receive a gift card for participating and feedback about their memory to share with their healthcare provider. “Building trust and giving back are key elements of our strategy,” Lanzi said. Lanzi is already preparing for the next phase of her research, supported by an additional $800,000 grant from the NIA. This phase will test the effects of an online treatment Lanzi developed for individuals identified as at risk. “If we find that language is an early marker of disease, I want to take this research to the next level and develop treatments that teach strategies to enhance independence and improve the quality of life for those at risk of developing dementia,” she said.
Drops in the Bank of Canada rate will not solve housing affordability.
Summary: The Bank of Canada’s interest rate cuts won’t resolve Canada’s housing affordability crisis. Factors such as skyrocketing home prices, unaffordable down payments, and stagnant wage growth are other primary challenges to address. A personal example offered by the author shows how the price of her Toronto home surged over 1,000% from 1983 and 2024 while her wages during the same period rose only 142%. While some see this issue as a consequence of Baby Boomers remaining in their homes, it's more nuanced than that. We have systemic barriers in Canada that necessitate targeted policy changes. It’s time to tackle affordability and implement effective solutions. The Bank of Canada met today, to determine interest rates for the last time this year. They announced a drop of .50 basis points. This is part of a broader effort to stimulate economic growth in Canada, which faces challenges, especially a softening labor market and persistent inflation. Why Should You Care? Interest rates determine how affordable our debt will be and what return we can expect on our savings. Since mortgages represent most consumer debt, interest rates directly impact affordable housing costs, making them very newsworthy. However, interest rates only tell part of the story. When the Bank of Canada lowers its rate, it primarily impacts variable-rate mortgages. These are tied directly to the BoC's overnight rate, so a rate cut can reduce the interest costs on these loans. Homeowners with variable rates would likely see a reduction in their payments, with more of their payments going toward principal rather than interest. People without debt and savings (primarily seniors) will see a drop in their investment returns. In contrast, fixed-rate mortgages, which are not directly tied to the BoC's rate, are influenced more by the bond market, particularly the 5-year government bond yield. The current trend in bond yields suggests that fixed mortgage rates could also decrease over time. Let’s pause here and talk about the affordability of houses and how interest rates are not the reason housing is out of reach for most first-time buyers. A walk down memory lane might offer some perspective. I purchased my first home in the fall of 1983 for $63,500 (insert head shake). I was 27 years old, and before you do the math, yes, I am a Baby Boomer. My first serious (so I thought) live-together relationship had just ended, and I was looking for a place to live. I had finished school and had a good full-time job with Bell Canada. A rental would have been preferred, except I had a dog. Someone suggested that I buy a home. I did not know very much about purchasing real estate or homeownership, for that matter. But I was young and willing to learn. I had been working full-time for two and a half years. During my orientation at Bell Canada, my supervisor told me to sign up for their stock option program. She said I would never miss the money or regret signing up for the plan. She was right. When I purchased my home, there was enough money in my stock account for a down payment and closing costs. My interest rate was a terrifying 12.75%, yielding a mortgage payment of just under $670 monthly. The lender deemed this affordable based on my $18,000 annual wage. Life was good. This was in 1983, when the minimum down payment for a home purchase in Canada was typically 10% for most buyers. However, a lower down payment could be possible with mortgage insurance (provided by organizations like Canada Mortgage Housing Corporation (CMHC), which allowed buyers to put down as little as 5%, provided they qualified for insurance. This was commonly available for homes under $150,000, with stricter terms for higher-priced homes. If you had a higher down payment of 25% or more, mortgage insurance wasn't required, and you could avoid extra costs associated with insured mortgages. This was part of broader efforts by the government to make homeownership more accessible, especially amid the high interest rates of the time. So let's do the math. Circa 1983 I first needed to prove that I had saved $3,175 in down payments and $953 in closing costs for $4128. In the 2.5 years I worked at Bell Canada, I saved $4,050 (including Bell Canada’s contribution) in stocks. I also had another $5,000 in my savings account. $9,000 was enough to complete the transaction and leave me with a healthy safety net. Fast forward to 2024 Let’s compare what the same transaction would look like today. Using the annual housing increase cited on the CREA website, the same house would be valued at approximately $700,000 today. Interest rates are much lower today, at 4.24%, yielding a mortgage payment of $3,545. 1. The down payment rules have changed. For the first $500,000, The minimum down payment is 5%. 5% X 500,000=25,0005\% \times 500,000 = 25,0005% X 500,000 = $25,000 2. The minimum down payment for the portion above $500,000 is 10%. 10% X (700,000−500,000) = 20,00010\% \times (700,000 - 500,000) = 20,00010% X (700,000−500,000) = $20,000 3. Total minimum down payment: 25,000+20,000 =4 5,00025,000 + 20,000 = 45,00025,000+20,000 = $45,000 Thus, the minimum down payment for a $700,000 home is $45,000. Here is the comparison: 1983 Scenario 2024 Scenario Variance Purchase Price: $63,500 $700,000 up 1002% Down Payment: $3,175 $45,000 up 1317% Loan Amount: $60,325 $655,000 up 986% Interest Rate: 12.75% 4.24% down 200% Monthly Mortgage Payment: $670 $3,545 up 429% Wage: $18,000 $43,500 up 142% Gross Debt Service Ratio: 44.6% 97.8% up 119% Time to Save for Down payment: 2 years 12.4 years up 520% *Please note that this example does not include mortgage insurance The real problem As you can see, housing was much more affordable for me in 1983 and far from cheap in 2024. During the past 41 years, wages have increased by 142%, yet interest rates have dropped by 200%. But the most significant impact on affordability has been the over 1,000% increase in housing prices. So why is all the focus on interest rates? At the risk of oversimplifying a complicated issue, I believe the media often uses interest rates as a "shiny penny" to capture attention, diverting focus from deeper housing affordability issues. This keeps the spotlight on inflation and monetary policy, aligning with economic agendas while ignoring systemic problems like down payment barriers and the shortage of affordable homes. Indeed, a movement in interest rates often has an immediate and noticeable impact on borrowers' affordability, making it a hot topic for news and policymakers. However, the frequency and consistency of the Bank of Canada meetings on interest rates give the impression that rates are the primary issue, even though they are just one part of a complex system. For example, even if the Bank of Canada dropped interest rates below zero, it would do little to solve today’s homeownership affordability issue. The real problems: 1. Down Payment Challenges: With housing prices skyrocketing, the 5%- 20% down payment required has become insurmountable for many, particularly younger buyers. High rents, stagnant wage growth relative to home prices, and rising living costs make saving nearly impossible. 2. Lack of Affordable Starter Homes: Due to profitability and zoning restrictions, housing developments often prioritize larger, higher-margin homes or luxury condos over affordable single-family starter homes. 3. Misplaced Generational Blame: Blaming Baby Boomers for "holding onto homes" oversimplifies the issue. They are staying put due to limited downsizing options, emotional attachments, or the need for housing stability in retirement, not a desire to thwart younger generations. 4. Political Challenges: Addressing structural issues like zoning reform or incentivizing affordable housing construction requires political will and collaboration, which can be slow and contentious. A broader lens is needed to understand and address the actual barriers to home ownership. Interest drops are merely a band-aid solution that misses the central issue of saving a down payment. The suggestion that we have an intergenerational issue needs to be revised. The fact that Baby Boomers are holding on to their homes should not surprise anyone. However, Real Estate models that predicted copious numbers of Baby Boomers selling their homes to downsize got it wrong. Downsizing was a concept conceived in the 1980s. Unfortunately, it did not account for record-setting home price increases or inflation, leaving it undesirable for today’s seniors. Although this is a complex issue, a few suggested solutions are worth exploring. What can be done? Focus on Policy Innovations: To create housing, increase supply, curb speculative investments, and provide targeted assistance for builders to build modest starter homes. To create rentals, homeowners should also receive income tax incentives to build Accessory Dwelling Units (ADUs). These could be used as affordable rentals or to house caregivers for senior homeowners. Today, The federal government announced a doubling of its Secondary Suite Loan Program, initially unveiled in the April 2024 budget. This is a massive step in the right direction. To create down payments, adopt a policy allowing first-time home buyers to avoid paying tax on their first $250,000 of income. Then, they could use the tax savings as a down payment. Focus on Education and Advocacy: Include a warning that helps consumers understand that withdrawing from RSPs results in a significant loss of compound interest related to withdrawals and how this can harm income during retirement. Encourage early inheritance to create gifted down payments. Normalize the concept by emphasizing the benefits to the giver and the receiver. Educate the public on using financial equity safely and create down payments as an early inheritance for their heirs. This will shift the conversation and initiate an intergenerational transfer of wealth that empowers the next generation to own a home. The Bottom Line While the Bank of Canada interest rate cut may ease some financial strain for homeowners with variable-rate mortgages, it will do little to address the core issue of housing affordability. The media's fixation on interest rates as a "shiny penny" distracts from more profound systemic barriers, such as the inability to save for a down payment and the lack of affordable housing stock. These challenges require targeted policies, structural reforms, and intergenerational collaboration to be tackled effectively. The focus must shift from short-term rate adjustments to long-term solutions that prioritize accessibility and affordability in housing. Without meaningful action, homeownership will remain out of reach for many, perpetuating the cycle of financial inequity across generations. Dont't Retire... Re-Wire! Sue
