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This week, JAMA Internal Medicine published the results of a large new study that tracked mothers health from 2016 to 2023. It found that maternal mental health declined significantly over the past seven years. The crisis we regularly write about in Two Truths, my best-selling Substack on womens and maternal health, is now being reported in one of the world’s most respected medical journals. Which journals matter I read the story with interestnot just because I write about womens health for a living, but because I still pay a little bit more attention when I see JAMA in a headline. When I started my career as a health journalist at Mens Health magazine in 2011, we were quickly taught which medical journals mattered most. The New England Journal of Medicine (NEJM). The Lancet. JAMA. These were the powerhouses. When research appeared in one of them, it carried weight. It still does. {"blockType":"creator-network-promo","data":{"mediaUrl":"https:\/\/images.fastcompany.com\/image\/upload\/f_webp,q_auto,c_fit\/wp-cms-2\/2015\/08\/Two-Truths-single.png","headline":"Subscribe to Two Truths...","description":"a newsletter that explores the many truths of motherhood through news round-ups, trend reports, and expert-backed deep dives on topics that matter to moms. To learn more visit twotruths.substack.com","substackDomain":"https:\/\/twotruths.substack.com","colorTheme":"salmon","redirectUrl":""}} The maternal mental health study published this week found, among other things, that in 2016, 1 in 20 mothers rated their mental health as poor or fair. In 2023, that figure rose to 1 in 12. The research underscored the need for immediate and robust interventions in mothers mental health. Not a niche issue The study wasnt perfect; it was cross-sectional (meaning it examined women at different points versus following them over time) and it relied on self-reported healtha far from flawless strategy. Still, its presence in JAMA Internal Medicine signals what I know and what you know to be true: Maternal mental health is not a niche issue. Its national. Urgent. Undeniable. As my friend and trusted source Dr. Catherine Birndorf, cofounder of the Motherhood Center, told The New York Times, We all got much more isolated during COVID. I think coming out of it, people are still trying to figure out, Where are my supports? The sad truth is that theyre still missing; were actively fighting for them over at Chamber of Mothers. Corrupt vessels But heres the thing that really caught my attention in all of this: Earlier this week, Health and Human Services Secretary Robert F. Kennedy Jr. suggested potentially banning federal scientists from publishing in leading medical journals, calling The NEJM, The Lancet, and JAMA corrupt vessels of Big Pharma. He proposed creating government-run journalsones that would anoint scientists with funding from the National Institutes of Health. Its true: Leading medical journals do accept advertising and publish industry-funded studies. There is also a long history of criticism surrounding the influence of pharmaceutical companies in academic publishing. Kennedys concerns are not new. Whats also true is that these journals disclose their funding, have rigorous peer-review processes (where independent experts, usually leaders in a field, assess the research and flag concerns), and have low acceptance rates. They publish research that changes the way medicine is practiced globally, informs policy decisions, and protects patients, particularly women and mothers. (The U.S. Preventive Services Task Force recommendations on breast cancer screening, which many clinicians follow, have been published and updated in JAMA; The Lancet regularly highlights maternal mortality disparities; The NEJM has published large-scale trials on critical womens health issues, from cardiovascular disease to hormone replacement therapy.) Program terminated And heres something else you need to know: Last week, I interviewed a leading physician and expert on gestational diabetes at Massachusetts General Hospital in Boston. She shared a statistic that surprised me (sometimes hard to do when Ive been reporting on health for 15 years): Up to one-half of women who have gestational diabetes in pregnancy go on to develop type 2 diabetes within 5 to 10 years of giving birth. The landmark study that laid the groundwork for understanding diabetes prevention in high-risk groups, including women with a history of gestational diabetes? It was called the Diabetes Prevention Program, and it was first published in The NEJM in 2002. Recently, under Robert F. Kennedy Jr.s leadershipan administration that claims to be committed to ending chronic illnessthat program was terminated. Holding institutions accountable Im not a doctor, scientist, or researcher. Im trained as a health reporter. And I trust that trainingjust as I trust the countless physicians and researchers Ive interviewed over the years, many of whom have spent their careers trying to get their work published in the most rigorous medical journals out there. As a journalist, I believe in holding institutions, including medical journals, accountableespecially when it comes to conflicts of interest. Thats part of the job. But this administration has attempted to infuse a tremendous amount of chaos and confusion into a whole host of topics, health included. Health is nuanced. So is science. But lets be clear: Suggesting that medical research be limited, controlled, or replaced by in-house publications is dangerous. Defunding evidence-based programs that serve high-risk groups, including mothers, is backward. Supporting high-quality, peer-reviewed research should be the bare minimum for anyone who cares about womens health. Canary in a coal mine In their report, the authors of the new JAMA Internal Medicine study wrote, Our findings are supportive of the claim made by some scholars that maternal mortality may be a canary in the coal mine for womens health more broadly. Its a statement that places maternal health where it belongs: at the center of womens health. As Dr. Tamar Gur, director of the Soter Womens Health Research Program at Ohio State, told The New York Times, Now I have something I can point towhen Im seeing a patient and say, Youre not alone in this. This is happening nationally, and its a real problem. Thats the power of credible, peer-reviewed research. Thats where real change starts. {"blockType":"creator-network-promo","data":{"mediaUrl":"https:\/\/images.fastcompany.com\/image\/upload\/f_webp,q_auto,c_fit\/wp-cms-2\/2015\/08\/Two-Truths-single.png","headline":"Subscribe to Two Truths...","description":"a newsletter that explores the many truths of motherhood through news round-ups, trend reports, and expert-backed deep dives on topics that matter to moms. To learn more visit twotruths.substack.com","substackDomain":"https:\/\/twotruths.substack.com","colorTheme":"salmon","redirectUrl":""}}
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E-Commerce
The goal for any leader is to build strong and productive relationships with their team and other stakeholders. And the best way to do this is by inspiring their audience every time they speak. This means creating believers with every set of remarks, whether theyre having a brief hallway conversation or delivering a keynote speech. But how? To inspire others, embrace these five fundamentals: 1. ADOPT AN INSPIRATIONAL MINDSET The starting point for becoming an inspiring leader is developing the right mindsetone that is focused not on informing but on inspiring. Information, even when its up-to-date and accurate, lacks the power to move others. Avoid content-rich presentations or conversations full of too many facts. Instead, always be in inspire mode. Inspire mode keeps you away from delivering content-heavy slides or numbing statistics, and instead gets you to engage your audience with your belief or idea. Bring your listeners to the realm of possibilities. 2. LISTEN INTENTLY To inspire others, you need to listen intently. Leaders who fail to listen will not understand their audiences mindset and they wont be able to focus their message so it has maximum impact. There are three ways to listen. First, listen with your body. Face your audience and align your body with the person (or people) to whom you are speaking. Stand or sit up straight. Keep a receptive expression on your face and make strong eye contact. Keep your arms open. This body language will send a message that you care about your audience. Second, listen with your mind. You need to listen for the points the other person is making, and you also need to show that youve heard what theyve said. You might interject phrases like Oh, thats so true or Yes, thats a good point or I agree or Tell me more about that. Such responses show that your mind is engaged and responsive. Third, listen with your heart. When you listen with your heart, you show that you are emotionally engaged. Heartfelt responses include being polite, being sensitive, and using expressions like I share your feelings and That must have been difficult. (For a full discussion of these three ways to listen, consult the chapter Listen, Listen, Listen in my book Speaking as a Leader.) 3. SPEAK WITH A MESSAGE If you want to inspire, you need to speak with a message. Without a big, central idea, you cant expect people to follow you. Your message should be stated at the beginning of your remarks and elaborated on by everything else you say. So, after opening your conversation or speech with a bridge or a grabber, get to your point. If youre giving formal remarks, you might say My message to you is . . . If its a less formal situation, you might say, I believe that . . . Own your message and present it clearly at the beginning. After you state your message, prove it. This requires sharing supporting evidence, usually in two to four points. Youll lift your audiences thinking from what is to what can be. 4. USE STRONG WORDS Inspiring leaders use compelling language. They know that every word testifies to their credibility. A leaders language is confident. They own what they are saying with expressions like I believe, I see, I know, and I care. They avoid tentative language like Im not sure, I dont know, and I cant. They also avoid filler expressions like um and ah. 5. END WITH ACTION Whether you are giving a formal presentation or offering a comment at a meeting, be sure to end your remarks with a call to action. After a job interview, you might say to the candidate, This has been a great meeting. Well be in touch with you shortly. You might conclude a more formal presentation with If we take the steps I have outlined, we will be a much stronger company. I look forward to your support for these initiatives. By ending with a call to action, youll move your audience from the present to the future you envision. You’ll inspire your listeners by taking them from what is to what can be.
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E-Commerce
Krista Vasquez had her heart set on getting married in a body-hugging, halter-style gown from Spain. In April, the Atlanta paramedic learned her dream dress would cost nearly $300 more because of new U.S. tariffs on imported goods. With little wiggle room in her timing, the bride-to-be quickly checked around for similar styles. The story was the same: Any dresses from Europe would come with tariff-driven price increases ranging from $150 to $400. And that was before President Donald Trump said he would increase the tariff on goods produced in the European Union from 10% to 50%. Vasquez, 33, went with her first choice, fearing shipping delays or additional costs like a rush fee before her October wedding if she placed an order elsewhere. It’s already expensive enough to get married, she said. It just kind of made me a little sad.” Wedding cakes, decor, attire, flowers, party favors, photo and video equipment, tableware, wine and Champagne. Not many goods used in the wedding industry remain untouched by the tariffs Trump has imposed since returning to office. How much of the import taxes get passed down to consumers is up to florists, photographers, caterers, and myriad other vendors and intermediaries, such as wholesalers. Olivia Sever, a 28-year-old online content creator in San Diego, has a lot of wedding shopping ahead of her. Much of what she wants may cost more because of tariffs. An immediate concern is some of her paper goods. Her wedding planner has already flagged a 10% price increase for the menus, place cards, and signage she wanted for her September celebration in Hawaii. Sever said shifting to American goods isn’t always cost-effective. For instance, flowers grown in Hawaii are in high demand, with increased prices to match, in response to 10% tariffs imposed on a large number of imports around the world. That includes flowers from Ecuador, Colombia, and other countries that grow the bulk of the flowers the U.S. imports. There’s just so many unknowns, but we have our budget and were trying to work within our budget, Sever said. If that means we cant get these, you know, specific shell cups I want, then we just wont get them and well get something else. Here’s a look from inside the wedding industry on tariffs. Tariffs and the wedding cake industry Clients of Phoenix cake artist Armana Christianson pay roughly $750 to $800 for one of her creations. She spent two years perfecting the 16 flavor combinations she offers. They range from simple vanilla bean, made with vanilla bean paste imported from Mexico, to dark chocolate raspberry with a whipped hazelnut ganache that’s dependent on chocolates and powders from Belgium. Not all of Christianson’s cost woes are tariff-driven. The chocolate industry was already struggling because of a cocoa bean shortage. I’m a small business with just myself as my employee. I’ve seen at minimum a 20% increase in just the chocolate I use. It’s a type of chocolate that I’ve built into my recipes. Changing brands isn’t acceptable, Christianson said. The imported white chocolate in her white chocolate mud cake, a popular flavor, shot up from $75 or $100 per cake to $150. She used nearly 10 pounds of it in a recent order, a cake that had five tiers. Christianson may have to come up with new recipes based on less expensive ingredients. In the meantime, she said, she’s eating the cost of tariffs for clients already on her books. I don’t have it in my contract where I can raise prices for unexpected events like this, she said. Unfortunately, that’s something I have to add to new contracts for my future couples. Tariffs and the wedding dress industry Almost all bridal gowns are made in China or other parts of Asiaand so are many of the fabrics, buttons, zippers, and other materials used, according to the National Bridal Retailers Association. Manufacturing in those countries, where labor generally costs less, has put the price of high-quality bridal gowns within reach for many American families. Retailers and manufacturers say the U.S. lacks enough skilled labor and production of specialized materials to fully serve the market. Skilled seamstresses are hard to find and often come from older generations. The materials that we sell in a bridal shop include lace, beadwork, boning for the corsetry. We dont really make stuff like that in this country. There just arent very many designers who create and put their whole looks together in this nation, said Christine Greenberg, founder and co-owner of the Urban Set Bride boutique in Richmond, Virginia. The designs done here are normally very simple designs. You dont see a lot of American-made gowns that have a lot of detail, a lot of embroidered lace, and thats a really popular wedding gown style, she said. Many designers with gowns labeled “made in the U.S.” still are using imported materials, Greenberg noted. If Trump’s highest tariffs on China are reinstated after a current pause, Greenberg said her small business will pay between $85,000 and $100,000 extra in import taxes this year. For a small, family-owned business that only hosts one bride at a time, this will absolutely lead us and many others to close for good, she said. We can’t buy American when the products don’t exist. Tariffs and the cut flower industry Roughly 80% of cut flowers sold in the U.S. come from other countries. And lots of quality faux flowers are made in China. Colombia is a large supplier of roses, carnations and spray chrysanthemums. Ecuador is another major rose supplier. The Netherlands produces a huge share of tulips and other flowers. In addition, some of the cut greens used as filler in flower arrangements and bouquets in the U.S. are imported. If youre talking about cars and computer chips, theyve got inventory thats sitting there. Its already stateside. Our inventory turns in days, and we saw the impact almost immediately, said Joan Wyndrum, co-founder of the online floral distributor Blooms by the Box. Were all absorbing a little bit, but its inevitable that it comes out on the consumer end of it. Wyndrum, who works drectly with wholesalers and growers, said the U.S. flower industry isnt capable at the moment of absorbing all the production from elsewhere. She does a lot of business with U.S. suppliers, though, and sees a huge opportunity for growth stateside. Theres a benefit to the U.S. bride to have flowers grown here. Its the simple reason of freshness, she said. Tariffs and the wedding industry overall Jacqueline Vizcaino is a luxury wedding planner and event designer in Atlanta. She’s also national president of the Wedding Industry Professionals Association, a 3,500-member, education-focused trade group whose members include transportation and photo booth providers, makeup artists, caterers, linen distributors, and planners. Any one wedding may involve 40 or more vendors, Vizcaino said. Huge jumps in costs are already widespread due to tariffs, she said, with florals and fabrics among them. With many weddings planned up to a year or more in advance, she and others in the industry are girding for more bad news. We’re going to see a lot of interactions that aren’t so pleasant in the next eight to 12 months,” she said. Tariffs have delayed decision-making among many couples planning weddings. Decisions are taking double the time because of the uncertainty. People are shopping around more and wanting [vendors] to lock in at the lowest price possible, Vizcaino said. McKenzi Taylor, a planner who coordinates weddings in Las Vegas, San Diego, and the Black Hills in South Dakota, said: Our inquiry-to-booking window has grown from 40 days to 73. Cancellations are up so far this year, on pace to double from last year, with costs definitely being a concern for couples. My vendors are shaking in their boots. By Leanne Italie, AP lifestyles writer
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