HJNO Jul/Aug 2025

MAHA REPORT 36  JUL / AUG 2025 I  HEALTHCARE JOURNAL OF NEW ORLEANS   266 United States Environmental Protection Agency. (2022). Current NPL updates: New proposed NPL sites and new NPL sites. https://www.epa.gov/superfund/current- npl-updates-new-proposed-npl-sites-and-new-npl-sites. 267 United States Environmental Protection Agency. (2015). Superfund, Brownfields and RCRA corrective action sites near 63 percent of the U.S. population. https://www. epa.gov/cleanups/superfund-brownfields-and-rcra-corrective-action-sites-near-63-percent-us-population. 268 Shrader-Frechette, K., & Biondo, A. M. (2020). Protecting children from toxic waste: Data-usability evaluation can deter flawed cleanup. International Journal of Environmental Research and Public Health, 17, 424. 269 Food and Agriculture Organization of the United Nations. (2023, December 18). Pesticides use and trade, 1990-2022. 270 U.S. Geological Survey. (n.d.). Pesticides. Retrieved from https://www.usgs.gov/centers/ohio-kentucky-indiana-water-science- center/science/pesticides. 271 U.S. Environmental Protection Agency. (n.d.). Understanding Exposures in Children’s Environments. from https://www.epa.gov/healthresearch/understanding- exposures-childrens-environments. 272 Huffling, K., & McLaughlin, J. E. (2022). Pediatric Chemical Exposure: Opportunities for Prevention. Journal of Pediatric Health Care, 36(1), 27–33. https://doi. org/10.1016/j.pedhc.2021.07.009. 273 Roberts, J. R., Karr, C. J., & Council On Environmental Health (2012). Pesticide exposure in children. Pediatrics, 130(6), e1765–e1788. https://doi.org/10.1542/peds.2012- 2758. 274 Gore, A. C., Chappell, V. A., Fenton, S. E., Flaws, J. A., Nadal, A., Prins, G. S., Toppari, J., & Zoeller, R. T. (2015). EDC-2: The Endocrine Society’s Second Scientific Statement on Endocrine-Disrupting Chemicals. Endocrine reviews, 36(6), E1–E150. https://doi.org/10.1210/er.2015-1010. 275 Interstate Technology & Regulatory Council (ITRC). (2023) PFAS Technical and Regulatory Guidance Document and Fact Sheets PFAS-1. Washington, D.C.: Interstate Technology & Regulatory Council, PFAS Team. https://pfas-1.itrcweb.org/. 276 National Academies of Sciences, Engineering, and Medicine. (2022). Guidance on PFAS exposure, testing, and clinical follow-up. National Academies Press: Washington, DC. 277 Rahman, A., Sarkar, A., Yadav, O. P., Achari, G. & Slobodnik, J. Potential human health risks due to environmental exposure to nano- and microplastics and knowledge gaps: A scoping review. Science of The Total Environment 757, 143872 (2021). 278 Nihart, A. J., Garcia, M. A., El Hayek, E., Liu, R., Olewine, M., Kingston, J. D., et al. (2025). Bioaccumulation of microplastics in decedent human brains. Nature Medicine, 31(4), 1114–1119. https://doi.org/10.1038/s41591-024-03453-1. 279 Amran, N. H., Zaid, S. S. M., Mokhtar, M. H., Manaf, L. A. & Othman, S. Exposure to Microplastics during Early Developmental Stage: Review of Current Evidence. Toxics 10, 597 (2022). 280 Soliman, A. T. et al. Long-term health consequences of central precocious/early puberty (CPP) and treatment with Gn-RH analogue: a short update: Long term consequences of precocious puberty. Acta Biomedica Atenei Parmensis 94, e2023222–e2023222 (2023). Psychosocial Factors and Mental Health Crisis Parallel to the decline in physical activity, American youth face a deepening psychosocial crisis. This is marked by rising mental health disorders, significant sleep deficits, chronic stress, and pervasive loneliness, all exacerbated by the widespread influence of technology. The crisis persists despite rising therapy rates, with some suggesting it may exacerbate issues. Declining Sleep Sleep is foundational to health, essential for children’s physical, mental, and cognitive development. Yet, American children, particularly adolescents, face a nationwide sleep crisis, with up to 75% of 17–18- year-olds reporting inadequate sleep and 95% of 12th graders getting less than recommended sleep time. 347348 While specific data before 2000 is limited, sleep duration has likely declined since the 1960s, driven by societal shifts like increased screen use and academic pressure. 349 350 351 Circadian rhythms, regulated by sunlight and disrupted by artificial light, play a critical role in sleep health. Morning sunlight synchro- nizes the body’s internal clock, boosting mood and metabolism, while nighttime light exposure, affecting 99% of Americans due to wide- spread light pollution, suppresses melatonin production and increases risks of metabolic disorders. 352 353 354 • High School Students: In 2021, 78% of U.S. high school students reported sleeping less than the recommended 8 hours per night on school nights, a rise from 69% in 2009. This trend disproportionately impacted female students (81%) and 12th graders (83%). 355 356 • Younger Children: In 2020-2021, 35% of children aged 4 months to 14 years had inadequate sleep. 357 • Light Exposure: Natural sunlight can reach up to 100,000 lux, significantly brighter than typical indoor lighting (100–300 lux), yet individuals, including children, typically receive only 1–2 hours daily in environments exceeding 1,000 lux. 358 Additionally, 36% of parents, according to one study, report leaving electronic devices powered on in their children’s bedrooms at night, contributing to sleep disruption through blue light exposure. 359 Chronic sleep deprivation has severe consequences: • Metabolic Health: Six days of four-hour nightly sleep reduces insulin sensitivity and impairs glucose tolerance. 360 • Physiological Impact: Sleep loss elevates oxidative stress and inflammation, contributing to insulin resistance. 361 • Screen Time: Evening screen time from electronic devices in children’s bedrooms delays melatonin production by up to 1.5 hours in children , disrupting sleep onset. 362 363 364 Poor sleep exacerbates mental health disorders, creating a vicious cycle. Chronic Stress Chronic stress among youth has surged, particularly since 2010, with mental distress scores rising sharply in 2022. 365366 Stress has become pervasive, with roughly 50% of Americans reporting frequent stress, a 16% increase over the past two decades. Stress levels have likely increased since the 1980s due to growing academic and social pressures. 367 • Prevalence: In 2021, the CDC reported that 42% of U.S. high school students experienced persistent feelings of sadness or hopeless- ness, up from 28% in 2011. 368 Female students faced disproportionate impacts, with 57% reporting persistent sadness or hopelessness and a 58% increase in suicidal ideation from approximately 19% in 2011 to 30% in 2021. 369 Approximately 20–25% 20% of adolescents reported anxiety symptoms and 15–20% over 15% reported depressive symptoms, with girls showing significantly higher rates. 370