TIME

6 Veggies You Only Think You Don’t Like

Brussels sprouts
Tonic Photo Studios, LLC—Getty Images

Brussels sprouts, broccoli, beets—yuck! Not so fast. Using a different cooking technique can totally transform the vegetables you thought you hated into mouthwatering sides you’ll want to make again and again. Here are 6 nutrient-packed vegetables you can instantly make taste better with a little know-how.

Brussels sprouts

Why you should eat them: These baby cabbages contain just 38 calories per cup and are packed with cancer-preventing phytonutrients and fiber.

Yuck-factor: An organic compound can cause Brussels sprouts to give off a stinky, sulfurous smell. “Boiling can make them seem slimy and even leach some of the nutrients into the water,” says Cynthia Sass, MPH, RD, Health‘s contributing nutrition editor.

Make them delicious: Roast Brussels sprouts to seal in nutrients and flavor. “Just slice in half, mist with a garlic and herb infused olive oil and roast on a baking sheet at 400 degrees,” Sass says.

Health.com: 13 Comfort Foods That Burn Fat

Broccoli

Why you should eat it: Broccoli, another cruciferous veggie, is high in vitamin C and fiber and racks up just 33 calories per cup.

Yuck-factor: Broccoli can taste quite dry when eaten raw, and watch out if it’s overcooked—you’ll end up with some very mushy florets.

Make it delicious: Broccoli tastes best blanched—a cooking technique where you dunk veggies into icewater after boiling them for two to three minutes. “This helps broccoli retain its crunchiness,” says Kristin Kirkpatrick, RD, wellness manager for Cleveland Clinic’s Wellness Institute. It also ensures the nutrients won’t get zapped from the food. After you’ve blanched the broccoli, you can pair it with an edamame dip for some extra fiber or top with lemon juice for an added kick, Kirkpatrick says.

Health.com: 20 Best Foods for Fiber

Peas

Why you should eat them: A cup of raw split peas has 50 grams of fiber and still contains 16 grams after being cooked.

Yuck-factor: “If you’ve only ever had the canned peas, then you are probably used to them being mushy,” says Tanya Zuckerbrot, RD.

Make them delicious: Peas are another food you will love after blanching. “Peas boiled very fast are going to have a nice snap to them,” says Zuckerbrot. Just make sure to follow the blanching times suggested by the National Center for Home and Food Preservation. The heat makes it easy for chlorophyll in the peas (or really any vegetable) to lose magnesium, leading to a chemical change that will leave them a yucky olive green if overcooked, Zuckerbrot says. When done just right, blanching will help your peas maintain ultimate freshness.

Health.com: 16 Ways to Lose Weight Fast

Spinach

Why you should eat it: At seven calories a cup, this superfood is filled with lutein, folate, potassium, and fiber, all nutrients vital to keeping your heart going strong.

Yuck-factor: Some people find raw spinach too bitter, while overcooking the leafy green leaves a soggy, mushy mess.

Make it delicious: Adding fruit to your spinach salad cuts the bitter flavor, Sass says. With a drizzle of olive oil for seasoning, it will taste even better. “When I cook it, I often lightly sauté in a little bit of hot chili oil, along with minced garlic and chopped sweet bell pepper.”

Cauliflower

Why you should eat it: Cauliflower is high in vitamin C, with more than a day’s worth of your daily intake, and has lots of water for extra hydration. Beyond that, it has phytonutrients that have been shown to lower cholesterol and fight your risk of cancer.

Yuck-factor: Boiling cauliflower can leave it soggy, bland, and smelly.

Make it delicious: Roasting cauliflower gives it a nutty, sweet flavor and creamy texture. Or, try Kirkpatrick’s favorite recipe: “Sauté them in olive oil then add in some walnuts, turmeric, and tomato sauce.”

Health.com: 26 Quick, Healthy Juice and Smoothie Recipes

Beets

Why you should eat them: Beets are rich in iron, fiber, folate, and potassium, and also full of disease-fighting antioxidants.

Yuck-factor: Beets contain the compound geosmin, also found in carp and catfish, which gives them an earthy flavor. Unfortunately it can also make beets taste like dirt. “That compound is most concentrated in the skin of fresh beets,” Zuckerbrot says. “That’s why you have to peel them first.”

Make them delicious: After peeling, drizzle the beets with a bit of olive oil and roast them like a potato. Or you could try pickled beets, which have a crispy texture. “When they are pickled with a combination of vinegar, sugar, and spices, it gives them a similar taste to sweet pickles,” Zuckerbrot says.

13 Veggies You Only Think You Don’t Like originally appeared on Health.com.

TIME

Your Great Grandmother’s Exposure to Pesticides Could Be Making You Obese

The effects of pesticides can span three generations, according to the latest research

Your health, or unhealthy state, may be traced back to the stuff your grandparents were exposed to, say researchers from Washington State University (WSU).

They found that exposure to the pesticide methoxychlor, for example, can contribute to diseases in descendants up to three generations later, suggesting that the environment conditions in which your great grandparents lived and worked could affect your risk of obesity, kidney and ovarian diseases.

The heightened susceptibility to these conditions is passed down through genetics, although not in the direct, inherited way. The pesticide probably affected how genes were turned on or off in people three generations ago, and some of these changes, which are normally erased when the reproductive cells — the egg and sperm — join together, somehow were not deleted completely and were passed on to the next generation. And these changes may be affecting weight and cells in the kidneys and ovaries.

“What you’re ancestors were exposed to could radically affect the kind of diseases you get,” says Michael Skinner, the study’s lead author and founder of WSU’s Center for Reproductive Biology.

Skinner has been studying the genetic effects of pesticides for 15 years. His lab has observed such so-called transgenerational epigenetic effects from other toxins such as DDT, plastics, pesticides, fungicides, dioxins, hydrocarbons and bisphenol-A or BPA.

But this was the first study to show that disease risk was transmitted primarily through females. (The study also found the legacy of mutations in the sperm epigenome of great-grandchild male rats.)

Methoxychlor—also known as Chemform, Methoxo, Metox or Moxie—was introduced in 1948 and was widely used in the 1960s as a less toxic substitute for DDT. The pesticide can behave like the hormone estrogen, disrupting reproductive organs. It was used on crops, ornamental plants, livestock and pets, but was banned from the U.S. in 2003 after regulators determined that it, too, was toxic for people. But a generation of individuals had already been exposed, and the effects of that exposure, says Skinner, is still being seen today.

While it is no longer used in the U.S., the pesticide is still sprayed in Mexico, South America and in other countries around the world. But even people who were born after the compound was banned in the U.S., and who have never traveled to areas where it is used, showed the same genetic changes found in people who have been exposed to the chemical.

That means that it may be possible to scan for and potentially predict people’s increased risk for certain diseases by searching for these genetic legacies. “We have the ability to identify the epigenetic marks in ourselves. Some of these marks are exposure-specific. So in the future, we may be able to do an analysis of what you were exposed to or what your ancestors were exposed to and predict what diseases you’re going to get,” says Skinner.

And that could lead to improved treatments for these diseases, based on their epigenetic roots. “Knowing the high statistical probability that you’re going to get this disease, we may be able to come up with therapeutic things in advance,” he says. And by treating them, we may also be helping our great-grandchildren to live without them too.

TIME Opinion

The Millennial Approach to Marriage: Beta Test It First

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Archive Holdings Inc.—Getty Images

We are a generation reared on technology and choice. Why wouldn’t we want to test a lifelong relationship first? How millennials are redefining "forever."

You could say I beta-tested my relationship.​

It began with a platform migration ​(a cross-country move) and a bandwidth challenge (cohabitation in a 450-square-foot apartment). There was a false start (botched marriage proposal). Then, an emergency deglitching (couples therapy). We tried to take the product public before we were ready (I wrote about our relationship in Newsweek). And then, finally, we abandoned launch. There were simply too many bugs.

It’s a joke, kind of – except that when it comes to millennials and marriage, the beta test may be par for the course. And really, why wouldn’t it be? For a generation reared on technology, overwhelmed by choice, feedback and constant FOMO, isn’t testing a marriage, like we test a username, simply… well, logical?

The findings of a new survey certainly reveal so. In conjunction with a new television drama, Satisfaction, which premiered on the USA Network last week, trend researchers asked 1,000 people about their attitudes toward marriage. They found all sorts of things: among them, that people cheat on the internet (uh huh), that young people don’t think their relationships are like their parents’ (of course), and that everyone seems to have taken to the term “uncoupling” (yuck).

They also uncovered a surprising gem. Buried in the data was the revelation that almost half of millennials (43 percent, and higher among the youngest subset) said they would support a marriage model that involved a two-year trial — at which point the union could be either formalized or dissolved, no divorce or paperwork required. Thirty three percent said they’d be open to trying what researchers dubbed the “real estate” approach – marriage licenses granted on a five, seven, 10 or 30-year arms, after which the terms must be renegotiated. And 21 percent said they’d give the “presidential” method a try, whereby marriage vows last for four years but after eight you can elect to choose a new partner.

In total, nearly half of all of those surveyed, ages 18 to 49 – and 53 percent percent of millennials — thought marriage vows should be renewed, and nearly 40 percent said they believed the “till death do us part” vow should be abolished. In other words: Beta marriages! Unions you can test and deglitch, work out kinks or simply abandon course without consequence. “This is a generation that is used to this idea that everything is in beta, that life is a work in progress, so the idea of a beta marriage makes sense,” the study’s author, Melissa Lavigne-Delville, told me. “It’s not that they’re entirely noncommittal, it’s just that they’re nimble and open to change.”

It’s not a new concept, entirely. In the 1970s, the anthropologist Margaret Mead predicted the growing popularity of “serial monogamy,” involving a string of monogamous marriages. Helen Fisher, the biological anthropologist, has advocated for much of the same: she believes humans aren’t meant to be together forever, but in short-term, monogamous relationships of three or four years. Stephanie Coontz, the author of Marriage: A History, has advised a marriage contract “reup” every five years — or before every major transition in life — “with a new set of vows that reflect what the couple has learned.”

More recently, Mexico City lawmakers proposed (unsuccessfully) a “renewable” marriage concept, whereby couples could simply renew or dissolve their unions after a period of two years. It’s not so unlike the setup described by a young writer in a Modern Love column in the New York Times last month, about how she overcomes “marriage anxiety” by renewing her vows with her husband every year like clockwork. “I think people are indeed trying to avoid failure,” says Andrew Cherlin, the author of The Marriage Go-Round.

And, why wouldn’t they? The United States has the highest divorce rate in the Western world. The data show clearly that the longer we wait to get married the more successful our marriages will be. And it’s not like we can’t move in together in the meantime: the rate of unmarried cohabitation has risen 1,000 percent over the last four decades. Not all of our marriages will work, no — but when they do, they’ll work better than at any other time in history, say scholars. And when they don’t, why not simply avoid the hassle of a drawn-out divorce?

“Millennials aren’t scared of commitment — we’re just trying to do commitment more wisely,” says Cristen Conger, a 29-year-old unmarried-but-cohabitating podcast host in Atlanta. “We rigorously craft our social media and online dating profiles to maximize our chances of getting a first date, and ‘beta testing’ is just an extension of us trying to strategize for future romantic success.”

In an era where, according to the survey, 56 percent of women and men think a marriage can be successful even if it doesn’t last forever, that might just make sense. Scholars have observed for some time that attitudes toward divorce have become more favorable over the last decade. Millennials in particular are more likely to view divorce as a good solution to matrimonial strife, according to the sociologist Philip Cohen — and more likely to believe it should be easier to obtain.

And, of course, it’s easy to understand why. We’re cynical. We are a generation raised on a wedding industry that could fund a small nation, but marriages that end before the ink has dried. (As one 29-year-old survey respondent put it: “We don’t trust that institution.”) We are also less religious than any other generation, meaning we don’t enter (or stay) committed simply for God. We feel less bound to tradition as a whole (no bouquet tosses here).

And while we have among the highest standards when it comes to a partner – we want somebody who can be a best friend, a business partner, a soul mate — we are a generation that is overwhelmed by options, in everything from college and first jobs to who we should choose for a partner. “This is a generation who has not had to make as many long-term commitments as previous generations, so the idea of not having an out feels a little stringent,” says Lavigne-Delville. “Divorce has happened for a long time. Maybe we should rethink the rules.”

Indeed, at the end of the day, whatever you want to say about the hookup generation, or millennials’ inability to commit, the vast majority (69 percent, according to Pew) of millennials still want to get married. We simply need a little extra time to work out the kinks.

“Getting married is so much more weighted today, I get the impulse to want to test it,” says Hannah Seligson, the 31-year-old married author of A Little Bit Married, about 20-somethings and longterm unmarried relationships. At the same time, she adds, “I wonder if this is a false control study in a way. Yes, marriage terrifying, it’s probably the biggest leap of faith you’ll ever make. But you’ll never be able to peer into a crystal ball – or map it out on a spreadsheet.”

 

TIME medicine

Tylenol and Panadol Prove No Better Than Placebo at Helping Back Pain

Paracetamol Reportedly Not Effective Drug For Back Pain
Paracetamol tablets sit on a table on July 24, 2014 in Melbourne, Australia. In a new study published in the prestigious medical journal, 'The Lancet' the most common pain reliever for back pain, paracetamol, does not work any better than a placebo. Scott Barbour—Getty Images

Acetaminophen isn't curing your aches after all

Two-thirds of adults experience back pain sometime during their lives, and most take acetaminophen, found in brands like Tylenol and Panadol, for relief. But new research has found that those medicines are no more helpful than swallowing a sugar pill.

A study published this week in a medical journal called The Lancet split 1,643 people with acute low-back pain into three groups, each given two boxes. One group received two boxes of 500-miligram acetaminophen tablets, with instructions to use the second box “as needed’; the second group got a box of acetaminophen and an as-needed box of placebos; and the third group received two boxes of placebos. Researchers told the participants to take six tablets per day from the regular box and up to two from the as-needed box.

Over the course of three months, the researchers found no difference among the three groups. Subjects showed no variation in terms of pain, recovery time, function, disability, symptom change, sleep or quality of life. About 75% of the participants were happy with their results, whether or not they had received the placebos.

TIME Drugs

FDA Approves New Pain Pill Designed To Be Hard to Abuse

The FDA has been under growing pressure to fight the national epidemic of prescription opioid abuse

+ READ ARTICLE

The Food and Drug Administration approved on Wednesday a new pain pill that was created to discourage abuse, the Associated Press reports.

The new pill, Targiniq ER, combines oxycodone, a potentially addictive opioid used in many pain medications, with naloxone, often used to trim the effects of opioids. The naloxone isn’t activated if the pill is swallowed as normal. If a would-be drug abuser crushes the pill to snort or inject it, however, the naloxone activates. That can potentially make Targiniq ER less attractive to abusers.

“Targiniq ER has properties that are expected to deter, but not totally prevent, abuse of the drug by snorting and injection,” FDA said in a statement.

TIME Infectious Disease

There’s a Vaccine Against Cancer, But People Aren’t Using It

The only vaccine to protect against cancer, the HPV shot, isn't being used by young people who could benefit most

In a new report on immunization rates among young people, the Centers for Disease Control (CDC) reports relatively low numbers of adolescents getting the HPV vaccine, the only vaccine that can protect against cancers — in the cervix, anus and mouth — caused by the human papillomavirus virus.

The new data, published in the CDC’s Morbidity and Mortality Weekly Report, shows that only about one-third of adolescent girls between the ages 13 and 17 got all three doses of the HPV vaccine, which the CDC says is about the same as last year. The shot is recommended to protect adolescents before they become sexually active. Only about 57% of adolescent girls and 35% of adolescent boys for whom the shot is recommended received one or more doses.

The vaccine continues to face challenges from parents concerned that it would promote sexual activity among pre-teens and adolescents, despite data showing that immunized teens aren’t more promiscuous. The CDC data also shows that doctors can play a critical role in discussing the shot with parents and improving vaccination rates. Among parents whose daughters were vaccinated against HPV, 74% said their doctors recommended the vaccine. But the data also showed that among parents who did not vaccinate their girls, nearly half were never told by their doctor that they should consider it. The effect was even greater among boys, where only 26% of parents who did vaccinate their son received any advice from their doctor about it.

To boost vaccination rates, some researchers are investigating whether fewer doses of the vaccine could be effective, and so far those studies look promising.

TIME Stress

Watching TV to Relieve Stress Can Make You Feel Like a Failure

Television set
Getty Images

Losing yourself to the small screen may seem like a good way to relieve stress, but it may only make things worse

It’s almost a reflex — after a tough day, you turn on the TV, or binge-watch your favorite show on Netflix. Getting lost in other people’s troubles, or laughing your way through a sitcom, is a good way to forgot your own worries, right? Turns out that people who rely on TV or video games to relax actually end up feeling like failures afterwards.

Some research has shown that using media can make you more relaxed, since it provides a momentary escape from whatever stresses are eating away at us, but researchers found that particularly busy and fatigued people actually felt guilty about spending so much time in front of the TV. In their study, published in the Journal of Communication, the scientists surveyed 471 people about their previous day, how they felt after work, and what media they turned to at the end of the day.

People who felt especially wiped out saw their media time as a form of procrastination, and felt they were avoiding other important things on their to-do lists. These participants were likely to describe “giving in” to media use, and that feeling prevented them from benefiting from the down time and relaxing. “We are starting to look at media use as a cause of depletion. In times of smartphones and mobile Internet, the ubiquitous availability of content and communication often seems to be a burden and a stressor rather than a recovery resource,” study author Leonard Reinecke of the Johannes Gutenberg University Mainz, Germany said in a statement.

It seems, however, that the content of what people watch on TV can alleviate some of this guilty pleasure perception. Other studies have shown that intellectually stimulating media content (like a History Channel segment or a documentary) can positively impact people’s emotional states, so the study authors believe that watching “low-brow” forms of entertainment (we’re guessing reality TV qualifies here) are more likely to make people feel guilty about using it as a stress-reliever.

The researchers acknowledge that their test set-up can’t prove that watching TV will make you feel worse about yourself; there are certainly other variables that could impact how people feel about their media consumption. If people weren’t satisfied with what they watched, for example, they might have been more likely to feel it was a waste of their time and not as stress-relieving as it could have been. If TV seems too hit-or-miss, there’s always exercise and meditation to help you forget your day.

TIME

5 Ways to Beat Stress-Induced Weight Gain

I think we can all agree that stress is bad. Excess stress can cause headaches, muscle tension, digestive problems, sleep disturbances, depression, and now new research shows it may also wreak havoc on metabolism.

We’ve known for some time that stress is connected to weight gain, because a high level of the stress hormone cortisol has been shown to up appetite, drive cravings for “junk” food, and make it oh so much easier to accumulate belly fat. But now, an Ohio State study shows that stress may also result in burning fewer calories—yikes!

RELATED: 25 Surprising Ways Stress Affects Your Health

In the study, researchers questioned women about stress they had encountered the previous day. The ladies were then fed a meal containing a very generous 930 calories and 60 grams of fat. After eating, scientists measured the womens’ metabolic rates and took blood samples. In the seven hours after eating the mondo meal, those who had reported being stressed out within the previous 24 hours burned less of the fat they consumed, and had higher levels of insulin, a hormone that contributes to fat storage. They also torched 104 fewer calories. That may not sound like much, but it’s enough of a difference to account for a weight gain of almost 11 pounds in one year’s time.

I understand that reports like this can be discouraging, but knowing this info actually offers a huge advantage. Even if you can’t fix the causes of your stress, you can make small changes to offset the effects. Here are five daily tweaks to help you beat stress-induced weight gain.

Choose your fats wisely

If stress causes your body to burn less of the fat you eat (making it more likely to be stored) aim to include some healthy fat in your meal—but avoid “doubling up.” For example, many clients tell me they order a healthy salad for lunch, but the toppings include both olive oil and avocado. Or they might snack on nuts alongside popcorn that’s been cooked in oil. I’m not saying you should eat low-fat meals: fat is important for satiety and it’s one of your body’s key building blocks. But to keep it in balance, choose only one high-fat item per meal. For example, if you want avocado on your salad, dress your greens with balsamic vinegar rather than an oil-based vinaigrette.

RELATED: A Guide to Healthy Fats

Adjust your meal proportions

If there’s a chance that you’ll burn fewer calories in the hours after eating due to stress, shift your servings a bit to slash calories without having to eat less food. For example, eating one and a half cups of mixed veggies and a half cup of brown rice instead of one cup of each can save you 60-75 calories. Or instead of 1 cup of quinoa, mix half of that with half a cup of spinach to save about 100 calories. I think you see where I’m going with this—trading in a portion of your dense grains, even healthy ones, for low cal, fiber- and water-rich veggies is the easiest way to accomplish a quick calorie savings that doesn’t require sacrificing volume.

RELATED: 13 Veggies You Only Think You Don’t Like

Add metabolic boosters

Certain foods truly have been shown in research to raise your metabolic rate, and while the effects aren’t astronomical, they may just counter some stress-induced metabolism slumps. One of my favorite natural metabolic boosters is hot peppers. One study from Purdue University tracked 25 adults who consumed either no pepper, their preferred amount (half liked spicy food and half did not), or a standardized amount, which was about a half teaspoon of cayenne for six weeks. Overall both groups burned more calories when they ate spiced-up meals, and those who had been infrequent eaters of fiery food also felt less hungry and experienced fewer cravings for salty, fatty, and sweet treats. Try adding chili pepper or cayenne to steamed or sautéed veggies, or if you can handle a little more heat, garnish your dishes with a sliced jalapeno. Bonus: hot peppers have also been shown to boost immunity and lower cholesterol.

RELATED: 9 Foods That Boost Metabolism Naturally

Breathe before you eat

We continuously breathe without thinking about it, but recent Spanish research showed that relaxed, controlled breathing can effectively reduce cortisol levels. Before each meal, take a few minutes to sit comfortably in a chair, and spend a few minutes focusing on breathing, slowly and deeply, in through your nose and out through your mouth. You may be amazed how quickly this technique can help relieve muscle tension and shift your mindset.

Take a quick post-meal walk

Whenever possible, try to build in a brisk 15-minute stroll after meals. A recent study from George Washington University found that this habit helped normalize blood sugar levels for up to three hours after eating. Can’t fit in 15 minutes? Go for 10, even five—just breaking a sitting pattern and getting your blood pumping can shift your metabolism. A post-meal walk can also serve as a little “you time” to unwind, clear your head, connect with nature, or catch up with a walking buddy—all of which can help reduce feelings of stress.

Cynthia Sass, MPH, RD, is Health’s contributing nutrition editor and privately counsels clients in New York, Los Angeles, and long distance. Cynthia is currently the sports nutrition consultant to the New York Rangers NHL team and the Tampa Bay Rays MLB team, and is board certified as a specialist in sports dietetics. Her latest New York Times best seller is S.A.S.S! Yourself Slim: Conquer Cravings, Drop Pounds and Lose Inches.

This article originally appeared on Health.com.

TIME Aging

Gains in Life Expectancy in the U.S. May Be Slipping

Nearly four in five Americans over age 67 have multiple chronic medical conditions

The more chronic medical conditions you have, the shorter your life will be, say researchers from Johns Hopkins Bloomberg School of Public Health.

In the study, published in the journal Medical Care, the team found that nearly four in five Americans over the age of 67 have multiple chronic conditions such as heart disease, hypertension and diabetes.

Obesity may be driving much of this trend, and may responsible for slowing recent gains in life expectancy. Life expectancy has been growing at about .1 years per year in the U.S., (that’s slower than rates in other developed countries).

The study used the Medicare 5 percent sample, a nationally representative group of 1.4 million Medicare beneficiaries, which included data on 21 chronic conditions. On average, life expectancy decreased by 1.8 years with each additional chronic condition among older Americans.

“When you’re getting sicker and sicker, the body’s ability to handle illness deteriorates and that compounds,” says senior study author Gerard Anderson, a professor in the Department of Health Policy and Management at Johns Hopkins. “Once you have multiple conditions, your life expectancy becomes much shorter.”

For example, he says, a 75-year-old woman with no chronic medical conditions would likely live to at least 92 years old, or another 17.3 years. However, a 75-year-old woman with five chronic conditions will likely only live another 12 more years, and a woman of the same age with 10 chronic conditions would only live to about 80 years old. According to the data, women fare better than men and white people live longer than black people even with the burden of additional health conditions.

The type of chronic disease older people develop also seems to affect their life expectancy. A 67-year-old diagnosed with Alzheimer’s will only live an additional 12 years, while someone with a heart condition can expect another 21.2 years. But once people develop more than one chronic condition, the specific illnesses no longer matter.

“There are interaction effects among the diseases that result in decreases in life expectancy. Any condition on its own has a particular effect. When you have heart disease plus cancer, that has a particular affect, and then those start to accumulate,” says lead study author Eva DuGoff.

The findings may be important for calculating health costs in coming years, especially for Social Security and Medicare programs. Currently, 60% of people over age 67 have three chronic medical conditions that require medical care — a significant increase from previous years when individuals didn’t live long with chronic conditions.

“In some ways we’re a victim of our own success. As we’re living longer and our health system has gotten better, no longer are people dying of heart disease at age 50 so now they’re dying of heart disease later when they have other things like cancer as well,” says DuGoff. Whatever gains improved health care has provided may be eroded by the effect of these accumulating chronic conditions. “We need to reorient our healthcare system to care for chronic conditions. If we don’t reorientate ourselves in that way, the impact of chronic conditions on life expectancy could be extremely negative.”

TIME Heart Disease

Mississippi Men Learn About Heart Disease — At the Barber

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John Sigler—Getty Images

Barbershops may be the new doctor's office, at least in Mississippi where African American men are learning about high blood pressure...while they get their hair cut

Barber shops and hair salons are great community hubs where residents gather for both grooming and gossip. So public health experts in the Mississippi Delta have decided to exploit these social meccas to connect with groups that don’t often see health care providers, including African American men.

Heart disease and stroke, for example, disproportionately affect this population of men, partly due to genetics, and partly due to lifestyle behaviors. But in places like the Mississippi Delta region, these men also do not get regular heart disease screenings. They do, however, go to barbershops for trims and to catch up on community news. So the Centers for Disease Control and Prevention (CDC) is funding a barbershop initiative called Brothers (Barbers Reaching Out to Help Educate Routine Screenings) located throughout the Mississippi Delta, where heart disease and stroke are the second and fourth leading causes of death in black men.

The Mississippi Department of Health spent a year recruiting and training barber shop workers on how to read a blood pressure screening, and discuss risk factors. During appointments, barbers talk to their clients about heart health, take their blood pressure, and refer them to a physician if they need further counseling. Recruitment was, and continues to be a challenge since some of the barbers were on board with the benefits of educating their clients, but worried about whether the program would hurt their business.

So far, thought, the barbers are being pretty persuasive. The project, which involves 14 barbershops that have so far served 686 men, just released its first set of data. Only 35% of the customers said that they had a doctor and 57% did not have health insurance. Among the men who received blood pressure readings, 48.5% had prehypertension, and 36.4% had high blood pressure. The findings, published in the journal Preventing Chronic Disease, shows that the program provides care to men who need it, as well as gives public health care workers a better idea of how prevalent heart disease is in the region, and how many patients are in need of medical care. The next step for the researchers is to create a community health worker network that could introduce these men to the health care system and help them navigate more regular screenings and better treatment of their condition.

Shifting health care from the clinic to the community isn’t a new idea; in some areas, health screenings and education are conducted in churches. But the faithful are a select group, and the study’s lead author says it’s important to bring services to hard-to-reach populations, such as young black men, to where they are. “We realized in our standard community health screenings–which were happening in churches–that we were not reaching adult black men,” says lead study author Vincent Mendy, an epidemiologist at the Mississippi State Department of Health. “We think the best way to reach them is through barbershops.” The program is part of a partnership between the CDC and the Mississippi State Department of Health, and is funded through September 2015.

Mendy is hopeful that the program will reach more men and bring them into treatment, since a similar 2011 initiative in Texas, funded by the National Institutes of Health, found that barbers helped to lower blood pressure in a population of African American men by 20%. Based on this growing body of research, the CDC is considering relying on community health workers to help improve the health of minority groups that have a disproportionate risk of disease and death in the U.S. — but are often outside of the health care system. Barbershops aren’t clinics, but they do seem to be a good place to get health messages across.

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