‘71.3 years’ was the average life expectancy globally, according to the World Health Organization in 2021. When a certain number of people die in a year, that number adds to the mortality rate of a county. There are big differences in death rates depending on where people live, especially between different counties. Mortality rates of counties can reflect a lot about them, how well their healthcare system is, what diseases are more prevalent, and what resources they are lacking. These things show the quality of life led by people in that particular county.

So, what is stopping a county whose mortality rates are high from decreasing these deaths?

The difference in how many people die is often tied to things like education and income. Studies have already shown that areas with higher average incomes tend to see the biggest jumps in life expectancy and have lower death rates from all causes. But until now, few studies have specifically looked at death rates from particular diseases across counties based on how rich or poor they are.

Linking Poverty to Leading Causes of Death

Researchers at the American Cancer Society (ACS) recently studied how death rates in U.S. counties (not including Alaska and Hawaii) are connected to how much poverty exists in those counties. They examined death rates for all causes of death and for the 10 diseases that cause the most deaths in the county. These top 10 causes were responsible for almost all deaths in 2020.

• Heart diseases (like heart attacks, heart failure, artery blockages)
• Cancer
• Stroke and other brain blood flow issues
• Pneumonia/influenza
• Unintentional injuries (like falls, car accidents, poisoning, drug overdose)
• Chronic Obstructive Pulmonary Disease (COPD), a serious lung disease
• Alzheimer's disease
• Type 2 diabetes
• Suicide
• Kidney disease

The researchers looked at changes in death rates over two time periods: from 1990 to 1994, and from 2016 to 2020 (they avoided the main COVID-19 years). They defined the poorest counties as those where 20% or more residents lived below the federal poverty line (for example, a family of four earning less than $26,200 a year in 2020). The richest counties had less than 10% of residents below this line.

Have The Death Rates Improved?

Overall, death rates got better in all types of counties for general deaths and for four of the main causes: heart diseases, cancer, stroke-related diseases, and pneumonia/influenza.

However, the improvements were much bigger in counties with less poverty. Because the poorest counties saw less improvement, the gap in death rates actually grew wider between the richest and poorest areas.

These improvements also varied a lot by location. The biggest drops in death rates happened on the East and West coasts and in some northern parts of the U.S. The smallest improvements were in the Midwest, Appalachia, and parts of the South—areas that often have higher poverty levels. Heart disease and cancer death rates improved the least in the South and Midwest.

Where Have Death Rates Worsened?

Unfortunately, death rates actually increased across the nation from other leading causes of death: accidents/injuries, COPD, Alzheimer's disease, Type 2 diabetes, suicide, and kidney disease. The effect of poverty on these conditions was mixed. For COPD and Type 2 diabetes, death rates improved in the richest counties but got worse in the poorest ones.

Overall, death rates worsened the most for accidents/injuries (likely due to the ongoing drug crisis) and Alzheimer's disease (partly because people are living longer and doctors are better at diagnosing it). Interestingly, for women, Type 2 diabetes death rates improved in all income levels studied. For men, COPD death rates improved across all income levels.

Why These Gaps Exist?

Some health differences are getting bigger than others. The largest increases in the gap in death rates between rich and poor counties were for Type 2 diabetes, pneumonia/influenza, COPD, kidney diseases, and heart diseases.

Factors like smoking and obesity are more common in certain areas, particularly the South. These are big risk factors for many of the diseases studied. Also, some Southern states haven't expanded their Medicaid programs, which help low-income people get healthcare. Access to Medicaid has been linked to better health outcomes and lower death rates.

Labiaplasty, or "Barbie surgery," is still one of the most controversial of today's cosmetic surgeries. Although it may bring relief to women who are having physical pain or appearance-related insecurities, it's not a cure for every self-esteem or sexual issue.

We as a society need to deconstruct damaging beauty standards and make the variability of women's anatomy mainstream. Physicians, researchers, and media commentators have a responsibility to empower women—not with assurances of perfection, but with truthful information and respect for their autonomy.

In a world where looks are everything and social media perpetuates edited perfection, it's little wonder that increasing numbers of women are seeking cosmetic procedures to enhance their own self-esteem. Of these, one operation has evoked more controversy than most: labiaplasty, or, as it has been sensationally referred to, the "Barbie surgery." So what is the procedure, why are increasingly women having it, and how does it actually affect their sex life and mental health?

What is Labiaplasty?

Labiaplasty is a type of cosmetic vulvar surgery that reduces the size of the labia minora, the inner lips of the vulva. Frequently misunderstood as the more general term "vaginal rejuvenation," labiaplasty is technically a surgical procedure, in contrast to energy-based treatments such as laser or radiofrequency, which are purported to tighten the vagina or provide relief for dryness.

Though its popularity is undeniable, so is the taboo. The mere mention of female genitalia, particularly in a medical setting, remains uncomfortable to this day. For this reason, full knowledge and open discussion about labiaplasty are nonexistent, leaving women misinformed or with utopian expectations.

Why Are Women Getting 'Barbie Surgery' Done?

Between 2001 and 2013, labiaplasty surgeries in Australia alone doubled more than twice—640 to 1,605 among public patients. This does not account for a substantial number done at private clinics, where national statistics are still not available. Contrary to popular misconceptions, it's not teen girls but women between the ages of 25 to 34 who most commonly undergo the surgery.

The "Barbie surgery" gets its name from the cosmetic ideal that inner labia must not extend beyond the outer labia—such as a Barbie doll's anatomically smooth shape. This has been greatly influenced by internet pictures and pornography, which tend to show only a single, unrealistic model of what female genitalia "should" be. Some women have taken these ideals to the point of pain and distress.

Why Women Opt for Labiaplasty?

There are different reasons for labiaplasty, while some women are in pain during running or sex. Yet, the majority have it done because they don't like the look of their genitals. Social, media, and even partner-induced expectations contribute to the idea that there's a "right" way a vulva should appear.

Women want labiaplasty to enhance their self-esteem as well as sexual confidence. Cosmetic surgery clinics exploit this expectation by advertising labiaplasty as a solution to achieving enhanced relationships as well as sexual fulfillment.

What Science Says About Sexual and Psychological Outcomes of Labiaplasty

A recent study appearing in Plastic and Reconstructive Surgery illuminates labiaplasty outcomes, and the results are both enlightening and sobering. The study tracked women who had labiaplasty and measured changes in psychological well-being before and after surgery.

Whereas most of them stated they were more satisfied with the way their genitals looked, there were no significant differences in general self-esteem or sexual self-confidence. In short, labiaplasty made them feel more confident about what they looked like—but not who they were or how they felt when they were intimate.

Unrealistic Expectations and Psychological Risks

One of the most striking findings from the study was that women experiencing psychological distress, such as depression or anxiety, or those in active intimate relationships, were more likely to be dissatisfied with the outcome. This suggests that some women may pursue labiaplasty with hopes of it resolving deeper emotional or relationship issues—expectations the surgery simply cannot fulfill.

This highlights the necessity of pre-surgical psychological assessment. Physicians need to dig deeper into the motivation of a patient and ensure that it is based on realistic results. For females who are undergoing emotional or relational pain, the first option may be more appropriately addressed in psychological therapy.

What is the Surgical Procedure of Labiaplasty?

There are various methods of labiaplasty, each specific to unique anatomy and cosmetic objectives. The most popular of these are:

Trim Technique: The most conventional and common method, wherein the redundant labial tissue is trimmed and stitched, making the face appear more symmetrical.

Wedge Technique: Is removal of a wedge of tissue from the thickest portion of the labia minora. It maintains the natural edge and gives a more natural post-operative appearance.

They need to see board-certified plastic surgeons who deal with labiaplasty to choose the procedure that best suits their goals and anatomy.

How Media, Misconceptions, and the Cultural Pressure Affects The Decision?

Media representation of the female genitalia has contributed immensely to labiaplasty rates. Pictures in pornography, airbrushed Instagram photos, and even some medical pictures tend to present an unachievable narrow, uniform ideal of genital appearance. This ideal is as far as possible from reality—female genitalia exist in a wide variety of shapes, sizes, and colors.

But such unrealistic pictures can sow seeds of insecurity. Women have reported feeling embarrassed, ashamed, or even inadequate about how their vulva appears in comparison to these pictures. In other instances, comments from partners fuel the problem, providing a strong incentive for surgery.

Can It Improve Your Sex Life?

Although the increasing link between labiaplasty and enhanced sexual experience gains a louder voice, studies contradict. Some women become less embarrassed after surgery, but no reliable evidence supports that the procedure fosters sexual satisfaction or orgasmic response.

The irony is that one of the leading reasons why women opt for labiaplasty—enhancing their sex life—is not scientifically supported. Rather, the main advantage of the surgery is for the alleviation of discomfort and enhanced appearance satisfaction.

The discussion on labiaplasty needs to move away from one of embarrassment or hyperbolic marketing and towards a realistic, medically grounded one. Women need to be completely informed about what the procedure can and cannot do. It's important to recognize that labiaplasty is not a solution for emotional insecurities, relationship issues, or inner issues related to self-worth.

With additional study, providers can further aid women by figuring out who could be helped by surgery—and who would be helped by therapy as an initial step.

In the end, a woman's confidence should not result from how well her body resembles an imaginary doll, but from the knowledge, encouragement, and self-acceptance that go beyond appearances.

Slept late because you partied too hard on the weekend? Found yourself unable to sleep because you were scrolling your phone till 3 am on a work-night? These things happen to the best of us, whether it is because you slept late, or slept too long, leaving your sleep pattern askew. We are all familiar with the feeling. Being so tired that you fall asleep the moment you come home, hoping to take a nap. However, is this nap costing you your health?

While napping after a long day of work may seem appealing, it could be inching you closer to an early grave.

A new study suggests that when you nap and how long you nap during the day might be linked to your risk of death. This is especially true for adults in their middle to older years. Researchers looked at data from wearable fitness trackers to understand these napping patterns. They found that specific ways of napping were connected to a higher risk of dying among older adults.

What the Study Found

Researchers used data from wearable activity trackers worn by nearly 87,000 adults, mostly around age 63. These devices tracked their sleep and activity patterns for a week. Over 11 years, thousands of these participants passed away. The research found a link between a higher risk of death and three things:

• taking longer naps
• napping at different lengths each day
• napping often around midday or early afternoon.

This research is important because it used real data from trackers, which is more accurate than just asking people about their naps from memory.

Does Napping Cause Health Problems?

It's important to know that this study doesn't prove naps cause death. It only shows a connection. This research is still new and hasn't been fully checked by other experts. It also might not apply to everyone. However, experts say the study offers strong evidence. It suggests that if someone naps a lot or at odd times, it might be a sign that they have an underlying health condition that's making them tired.

Connection Between Napping and Mortality

It's important to understand that this study doesn't prove naps cause death. Instead, experts think the link is more about why people are napping. For example, hidden health problems like sleep apnea (which messes up night sleep) or illnesses that cause a lot of tiredness, like heart disease, could be the real culprits. These conditions might make someone nap more and also increase their risk of death. It's also possible that very long or irregular naps might upset your body's natural clock, potentially affecting things like inflammation and heart health.

Should You Stop Napping?

There's no need to completely stop napping, especially if you are a shift worker or truly sleep-deprived. Scientists are still learning about this connection. However, for most people, it's a good idea to aim for certain nap habits:

Keep naps short: Naps less than 30 minutes are often best to help you feel refreshed without feeling groggy.

Nap earlier in the day: Napping earlier can help prevent your daytime sleep from interfering with your ability to fall asleep at night.

If you find yourself taking very long naps or needing regular naps throughout the day, especially if you still feel tired, it's a good idea to talk to your doctor. They might want to check for underlying health problems or recommend an evaluation for a sleep disorder.

Tips To Avoid Napping

• Stick to a consistent sleep schedule.
• Spend time outdoors in natural sunlight, particularly in the morning.
• Get regular physical activity.
• Limit your intake of caffeine and alcohol.
• Establish a relaxing bedtime routine.
• Eat regular, healthy meals and snacks.
• Practice relaxation techniques like deep breathing or meditation to reduce stress.

If you've been doing it all, counting calories, sweating through workouts at the gym and the scale still isn't moving, don't worry. For a lot of people, weight loss has nothing to do with willpower; it's got everything to do with biology. You might have heard the buzz around Mounjaro, perhaps your friend has been talking about it, or you saw it pop up on social media. But what in the world is Mounjaro, and can it actually work for weight loss, even if you don't have diabetes?

For the millions who suffer from obesity, weight loss has long been a Sisyphean task of diets, disillusionment, and defeat. But a new generation of medications, initially developed for diabetes, is rewriting that script. Leading the charge is Mounjaro—a injectable medication that has shown an incredible knack for suppressing appetite, enhancing insulin sensitivity, and encouraging sustained weight loss.

So, what is Mounjaro, anyway? Is it safe? How much does it cost? And is it right for you? Here's the lowdown—supported by science, informed by experts.

What Is Mounjaro?

Mounjaro is a brand name for tirzepatide, an injectable weekly treatment first approved by the U.S. Food and Drug Administration (FDA) for the control of Type 2 diabetes. Nevertheless, its potent effect on body weight has triggered an off-label rush for people without diabetes but with obesity or conditions of metabolic connection.

In contrast to old weight-loss drugs that act on metabolism or suppress appetite as their primary mechanism, Mounjaro acts upon two key hormones: GLP-1 (glucagon-like peptide-1) and GIP (glucose-dependent insulinotropic polypeptide). These control the release of insulin and sensations of fullness. Through the mimicry of their action, Mounjaro decreases hunger and enhances control of blood sugar—two key obstacles in successful weight maintenance.

How Mounjaro Works?

The key to Mounjaro's success is tirzepatide, a dual-acting peptide that acts on receptors in your brain and stomach. When taken, it sets in motion a chain reaction of signals that say to your brain, "You're full," basically cutting back on cravings and overeating.

But that's not all, mounjaro also makes your body more responsive to insulin. In individuals with obesity, insulin resistance is frequent and can render weight loss dishearteningly slow. By enhancing insulin action, Mounjaro makes the body better able to control blood sugar and store less fat.

In a sense, Mounjaro doesn't simply allow you to eat less—it allows your body to use what you eat more efficiently.

Who Can Use Mounjaro for Weight Loss?

Mounjaro is approved by the FDA for individuals with Type 2 diabetes, but physicians can prescribe it off-label to individuals with:

A BMI of 30 or more (considered obese), or

A BMI of 27 or more with one or more weight-related health factors, including high blood pressure or high cholesterol.

Off-label prescribing is legal and widespread. Numerous medicines—from antidepressants to seizure medication—are commonly prescribed for different uses when clinical evidence is available.

But Mounjaro is not appropriate for all. Individuals who have had thyroid cancer, pancreatitis, or gallbladder disease should be careful. Should you be thinking of Mounjaro, complete medical assessment must be done prior to initiation of therapy.

How Much Weight Can You Lose on Mounjaro?

In the largest clinical trial, over 2,500 patients with obesity or overweight were given Mounjaro for 72 weeks (approximately 1.5 years). The patients on the 5 mg dosage lost 15% of their body weight on average. The higher doses had even more weight loss.

Non-diabetic participants also experienced substantial benefits, especially with the addition of lifestyle modifications such as more physical activity and a healthy diet. With regularity and supervision, Mounjaro provides long-term, clinically relevant weight loss—not fleeting outcomes.

How to Use Mounjaro?

Mounjaro is available in a pre-filled, one-time-use injection pen. You administer it once a week, ideally on the same day every week. Injection sites that are commonly used are:

• Abdomen
• Thigh
• Outer upper arm

Physicians usually start at 2.5 mg for 4 weeks, then increase stepwise by 2.5 mg per month to a target dose (in most cases, 10 mg or 15 mg). This stepwise titration minimizes side effects while optimizing efficacy. Take care to change injection sites to avoid irritation and not inject into scarred or bruised skin.

Potential Side Effects of Mounjaro

As is the case with most prescription drugs, Mounjaro can cause side effects—particularly within the first few weeks. The most frequent are gastrointestinal, such as:

• Nausea
• Vomiting
• Diarrhea
• Abdominal discomfort
• Constipation

In some instances, more severe side effects have occurred, including:

• Pancreatitis
• Inflammation of the gallbladder or gallstones
• Low blood sugar (hypoglycemia)
• Kidney issues because of dehydration
• Worsening in eye conditions in individuals with diabetes
• Elevated heart rate
• Reactions at the injection site

Mounjaro also has an FDA boxed warning for a rare risk of thyroid C-cell tumors from rodent studies. Although this has not been established in humans, the warning cautions against use in patients with a personal or family history of medullary thyroid carcinoma (MTC).

How Much Does Mounjaro Cost?

The price for Mounjaro can be quite variable depending on:

• Insurance coverage
• Pharmacy location
• Off-label use status

In the United States, without insurance, Mounjaro can range from $1,000 to $1,300 monthly. Yet, most patients can cut costs with:

• Manufacturer coupons (if qualified)
• Savings programs or discount cards
• Pharmacy benefit coverage (especially for treatment of Type 2 diabetes)

Note: If used off-label for weight loss, some insurance providers might not pay for the medication. Discuss with your provider and pharmacist to learn about affordability options.

Where to Get Mounjaro for Weight Loss?

If you're considering Mounjaro as part of your weight loss strategy, start by speaking with your primary care doctor, endocrinologist, or obesity medicine specialist.

If deemed medically appropriate, they will prescribe it and show you how to use the injection pen. It’s essential to have your lab tests monitored periodically during treatment and to follow dosage adjustments carefully.

Obesity is not a case of willpower. It is a chronic, complex disease related to metabolic, hormonal, and genetic factors. Mounjaro presents a new avenue for the treatment of this disease—especially for those who have not responded to lifestyle modifications alone.

Even so, Mounjaro isn't a panacea. The most ideal outcomes occur when medication is paired with:

• Healthy diet
• Exercise on a regular basis
• Behavioral support or counseling

For individuals with extreme weight issues, it could be the game-changer they've been hoping for.

Mounjaro is changing the face of how healthcare professionals treat weight loss, particularly for individuals with obesity and insulin resistance. Being able to suppress appetite, enhance blood sugar control, and facilitate sustainable weight loss, it's fast becoming one of the most promising weapons in the battle against ongoing metabolic disease.

However, as with any powerful tool, it must be utilized wisely, under professional guidance, and as part of an holistic health plan. If you're curious whether Mounjaro is for you, the best place to start is an open conversation with your doctor.