New Test May Ease Colorectal Cancer Screening

Dec. 22, 2004 — A unused, noninvasive screening test for colorectal cancer may empower more individuals to induce tried for the dangerous and regularly quiet malady.

Unused inquire about appears that the exploratory test, which screens for hereditary changes related with colorectal cancer found in stool, is more successful at identifying cancers and precancerous developments than the as it were as of now accessible noninvasive test, fecal mysterious blood stool testing (FOBT).

Whereas not one or the other of these noninvasive screening tests approaches the discovery exactness of a colonoscopy, analysts say the easy-to-administer test may offer a modern elective for colorectal cancer screening.

“A basic, noninvasive test that recognizes tumor-specific items with sensible affectability and specificity might overcome obstructions to screening among people who are not willing to have a more intrusive test, such as colonoscopy,” says analyst Thomas Imperiale, MD, teacher of medication at the Indiana College School of Pharmaceutical, in a news discharge.

In spite of the fact that colorectal cancer is the moment driving cause of cancer passing among grown-ups and proposals exist that energize screening for all grown-ups over 50, analysts say less than 40% of individuals matured 50 a long time or more seasoned are screened for colorectal cancer.

“There are numerous reasons why individuals do not get screened for colon cancer,” says Imperiale. “A few people don’t need colonoscopy since of inconvenience, in spite of cognizant sedation, its bother, or its hazard for complications; others are unwilling to spread“>spread stool tests on a card for the mysterious blood test each year.”

Modern Alternative in Colorectal Cancer Screening On the Way

Within the think about, which shows up within the Dec. 23 issue of The Modern Britain Diary of Medication, analysts compared the rates of fecal DNA testing with FOBT in recognizing colorectal cancers or precancerous developments (polyps) in more than 2,500 men and ladies over age 50 considered to be at normal chance for colorectal cancer.

Past considers have appeared the fecal DNA testing was viable at recognizing cancers and precancerous growths in individuals at tall hazard for the illness, but analysts say this think about is the primary to test fecal DNA discovery rates in huge numbers of individuals at normal hazard.

The fecal DNA test screens for 21 diverse hereditary changes related with colorectal cancer found in stool. It requires a single stool test, which is removed from the body straightforwardly into a holder.

The comes about appeared that the stool screening test was four times more delicate than the FOBT test in recognizing obtrusive colorectal cancers and more than twice as touchy in identifying precancerous developments.

Analysts say the fecal mysterious blood test found as it were 13% of colorectal cancers whereas the fecal DNA test found 52%, as confirmed by colonoscopy.

The fecal DNA testing identified 13 cancers that were missed by FOBT, whereas the FOBT identified one cancer that was missed by the fecal DNA test.

Analysts say FOBT testing is less precise since it screens as it were for blood found within the stool that’s emitted by cancerous or precancerous developments. But most cancerous developments drain as it were discontinuously and numerous precancerous developments don’t drain at all.

Past considers have appeared that precancerous and cancerous colorectal developments shed anomalous DNA, which is recognizable in stool, and this test is outlined to screen for those variations from the norm.

Analysts say most precancerous developments that were recognized by colonoscopy were not found by either test, but the stool DNA test found more of these developments than the FOBT test.

The stool DNA test has not however been endorsed by the FDA for spread;broad;far reaching”>far reaching utilize in colorectal cancer screening. But analysts say the comes about show that the test may be important as a more visit screening device to be utilized in combination with more precise tests that are utilized occasionally, such as colonoscopy.

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Kids With Food Allergies May Need 2 EpiPens

Walk 26, 2010 — Children with a history of serious nourishment hypersensitivities ought to carry two dosages of self-injectable epinephrine rather than one, a unused think about proposes.

Analysts surveyed results among more than 1,200 children treated for nourishment sensitivities in crisis rooms at two expansive Boston healing centers between 2001 and 2006.

Amid their unfavorably susceptible responses, 44% were treated with epinephrine and around one in 10 of these children required more than one dosage.

It is suggested that children and grown-ups with a history of serious nourishment sensitivity responses carry injectable epinephrine at all times.

The foremost broadly endorsed self-administered epinephrine is the EpiPen auto injector.

Pediatric allergist and consider analyst Susan Rudders, MD, of Children’s Healing center Boston, says the ponder affirms two pens offer more protection than one.

The investigate shows up within the April issue of Pediatrics.

“Eighty-eight percent of kids were fine with fair one write, but 12% required two measurements,” she tells WebMD. “The issue is, we truly do not have great ways of recognizing who will and will not require an additional measurements.”

Epinephrine Underused

Each year within the U.S., between 150 and 200 individuals kick the bucket from anaphylaxis, a genuine unfavorably susceptible response checked by hives, swelling, and brought down blood weight, after intentionally or unconsciously eating nourishments they are unfavorably susceptible to, Rudders says.

Prompt treatment with injected epinephrine can keep these unfavorably susceptible responses from getting to be life debilitating.

But indeed within the healing center crisis office setting, anaphylaxis is frequently misdiagnosed, she says.

Having side effects in two or more frameworks of the body, such as hives and throat swelling or inconvenience breathing and skin rashes, inside 10 to 15 minutes of eating ought to raise doubts of food-induced anaphylaxis.

The Boston think about shown that epinephrine is underused and hone rules are not continuously taken after.

Those rules prescribe epinephrine as the first-line treatment for food-related anaphylaxis in children. In expansion, patients ought to be alluded to an allergist, instructed about how to dodge issue nourishments, and be sent domestic with self-administered epinephrine.

In spite of the fact that 52% of the kids within the consider gotten a determination of food-related anaphylaxis, fair 31% gotten one dosage of epinephrine, and 3% gotten more than one measurements some time recently arriving at the healing center. Once there, 59% were treated with antihistamines, 57% were treated with steroids, and fair 20% were treated with epinephrine.

At release, less than half (43%) of patients were endorsed self-injectable epinephrine, and generally one in five was alluded to an allergist.

Peanuts, tree nuts, and drain activated the foremost unfavorably susceptible responses, but natural products and vegetables, shellfish, and eggs were moreover involved. In approximately one in five cases, a few another nourishment caused the response.

Nourishment Sensitivities on the Rise

Agreeing to the CDC, the number of Americans with nourishment hypersensitivities has expanded by approximately 20% in fair over a decade.

Mount Sinai School of Pharmaceutical teacher of pediatrics Scott H. Sicherer, MD, says his claim investigate and the investigate of others has appeared that two measurements of epinephrine are regularly required.

“It has been the general hone here to prompt most patients to carry two dosages of epinephrine,” he says.

Sicherer tells WebMD that guardians of children with nourishment sensitivities got to have an activity arrange in case anaphylaxis happens.

The foremost imperative thing is having epinephrine inside reach and knowing how and when to utilize it,” he says. “Our possess investigate appears that numerous times families, and indeed doctors, do not know how to legitimately utilize it.”

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Prematurity May Raise Risk of Type 2 Diabetes

Nov. 17, 2004 — Untimely babies may confront a more prominent hazard of sort 2 diabetes afterward in life, notwithstanding of their birth weight.

A modern ponder appears children who were born rashly were more likely to be less touchy to affront, which may be a major chance figure for sort 2 diabetes, indeed in case their birth weight was fitting for their birth age.

The discoveries recommend that children who are born rashly may share the same higher chance of sort 2 diabetes already found in moo birth weight babies who are born at term.

On the off chance that advance thinks about affirm these comes about, analysts say children and grown-ups who were born prematurely or of moo birth weight may have to be be focused on for sound way of life intercessions or drugs to extend affront affectability and possibly delay the improvement of sort 2 diabetes.

Rashness Increments Diabetes Dangers

Within the ponder, which shows up within the Nov. 18 issue of The Modern Britain Diary of Medication, analysts compared the affront affectability of 72 solid children extending in age from 4 to 10 a long time ancient. Fifty of them had been born rashly, counting 38 who had a birth weight that was still considered typical for a rashly born newborn child.

Analysts found that children who had been born prematurely, whether their weight was fitting or moo for their birth age, had lower affront affectability compared with those who had not been born rashly.

In a piece that goes with the ponder, Check Sperling, MD, of the Children’s Clinic of Pittsburgh, says the “provocative discoveries require both reflection and activity.”

He says reflection is vital since thinks about have not however appeared a better rate of sort 2 diabetes among grown-ups who were untimely babies. Activity is required since the hazard of rashness and moo birth weight are both incredibly diminished by satisfactory pre-birth wellbeing and dietary care.

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Drug Combo May Prevent Diabetes

June 2, 2010 — Patients who have inconvenience controlling their blood sugar are 66% less likely to induce diabetes in case they take moo dosages of two diabetes drugs with distinctive modes of activity.

The finding comes from a four-year Canadian ponder of more than 200 patients with disabled glucose resilience, a sign of impending type 2 diabetes. It’s the primary consider to appear that a low-dose sedate cocktail — Avandia also metformin — can avoid diabetes way better than way of life mediation alone.

The low-dose combinationappears to diminish the hazard of common side impacts for each sedate, says consider analyst Bernard Zinman, MD, chief of the diabetes center at Toronto’s Mount Sinai Clinic and teacher of pharmaceutical at the College of Toronto.

Surprisingly, the impact of the combination was remarkablyrobust with over 60% diminish in hazard of diabetes,” Zinman tells WebMD. “And the well-known side impacts did not show up. There was no weight pick up, no liquid maintenance, breaks were rise to in both the treatment and fake treatment bunches, and whereas there was a few loose bowels, it was moo concentrated.”

The doses utilized within the think about were 2 milligrams of Avandia also 500 milligrams of metformin. Avandia every day measurements ordinarily run from 4 milligrams to 8 milligrams and metformin every day measurements as a rule extend from 500 milligrams twice every day up to a greatest of 2,000 milligrams every day.

Individuals who have inconvenience controlling their blood sugar are encouraged to lose weight, count calories, and increment their work out. This works exceptionally well. But not everybody is able to do this.

Individuals should always do way of life alter to begin with. The problem is, this is often difficult to realize,” Zinman says. “We did have an awfully organized way of life mediation as portion of the treatment for both the treatment and fake treatment gather in our consider.”

Zinman notes that the empowering consider discoveries must be confirmed in bigger clinical trials. Spyros Mezitis, MD, PhD, an endocrinologist at Unused York’s Lenox Slope Healing center, concurs.

This can be an vital consider, but we require expansive trials to investigate all the issues related to combination treatment,” Mezitis tells WebMD.

Avandia: Secure at Any Dosage?

Avandia is one of two affirmed drugs (the other is Actos) in a lesson known as the thiazolidinediones. Both drugs increment the chance of heart disappointment. But Avandia has too been connected to expanded chance of heart attack, although the drug’s producer, GlaxoSmithKline, debate this chance.

Steven E. Nissen, MD, chairman of cardiovascular medication at the Cleveland Clinic Establishment, was among the primary to raise questions almost Avandia’s heart security.

There’s no prove at all that lower doses of [Avandia] are ‘safe,'” Nissen tells WebMD through e-mail. “Any proposal that genuine cardiovascular poisonous quality can be maintained a strategic distance from by employing a little dosage speaks to immaculate hypothesis at best.”

Zinman concurs that his think about selected as well few patients, and was as well brief, to supply any data on Avandia’s heart security. Be that as it may, he proposes that whereas it was not examined, Actos would likely have the same impact when combined with metformin in a low-dose combination.

Mezitis concurs, but he’d like to see this bolstered by a clinical trial.

“Yes, able to make the affiliation that Actos would work the same way, but we do not have a ponder recommending that,” he says. “So I would feel more comfortable having a think about to begin with some time recently suggesting another medicine.”

The Zinman trial was supported by GlaxoSmithKline, and Zinman reports getting counseling expenses, honoraria, and allow support from the company. In any case, he says the think about was free of company impact which the think about agents started the consider, drew their conclusions, and distributed their discoveries without any company impact.

Mezitis reports that he already served on GlaxoSmithKline’s speakers bureau but pulled back when issues around Avandia cardiovascular security to begin with emerged.

The Zinman ponder shows up within the June 3 online version of The Lancet.

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Breast Cancer Decline Linked to HRT

Aug. 14, 2007 — Breast cancer rates are down, and that’s likely since less ladies are utilizing hormone substitution treatment (HRT) in menopause, a modern think about appears.

The consider, distributed online nowadays within the Diary of the National Cancer Organized, is the most recent passage in a discussion almost declining U.S. breast cancer rates.

A few specialists say the drop in breast cancer rates is mostly due to the reality that less ladies have been getting schedule mammograms to screen for breast cancer. Without those mammograms, breast cancers may fair be going undiscovered, or so the hypothesis goes.

Other analysts credit the reality that numerous menopausal ladies turned absent from hormone substitution treatment after July 2002. That’s when the Women’s Wellbeing Activity, a long-term women’s wellbeing think about, connected HRT to expanded chance of breast cancer.

The modern think about favors the HRT clarification, not the mammography hypothesis.

The analysts included Karla Kerlikowske, MD, of the College of California at San Francisco and the San Francisco Veterans Issues Restorative Center.

Kerlikowske and colleagues considered information on more than 600,000 mammograms performed on U.S. ladies ages 50-69 between 1997 and 2003.

The analysts picked those years because they span some a long time some time recently and after the Women’s Wellbeing Activity discoveries on breast cancer and HRT came out.

The consider appears a about synchronous drop within the women’s HRT utilize and estrogen-sensitive breast cancer, which is the kind of breast cancer that’s been connected to HRT utilize.

For occasion, between 2002 and 2003, HRT utilize fell by 34%. That lines up with a 13% drop within the women’s rate of estrogen-sensitive breast cancer.

The analysts point out that since they as it were examined ladies who got schedule screening mammograms, the downturn in breast cancer rates essentially can’t be due to missed mammograms.

Why didn’t breast cancer rates drop advance, given the drop in HRT utilize? Maybe breast cancer hazard falls slowly after ceasing HRT, suggest Kerlikowske and colleagues.

Will this consider settle the talk about? That remains to be seen, since the subject is “disputable,” as the analysts compose.

The sedate company Wyeth, which makes the postmenopausal hormone treatment medicate Prempro, messaged WebMD a explanation approximately the consider.

“Wyeth cautions against drawing the conclusion made by the ponder creators since the decay in breast cancer rate cannot be decided from this sort of ponder and there may be other components that may have an affect on breast cancer frequency rates. In expansion, Wyeth notes that the item labeling for Wyeth’s and other postmenopausal hormone treatments exhorts almost an expanded chance of breast cancer and proposes ladies taking treatment do month to month breast self exams and have schedule mammography screenings,” states Wyeth.

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Seal Flu: Next Pandemic Threat?

July 31, 2012 — A modern and destructive subtype of flu bug has developed among harbor seals in Modern Britain, analysts report.

Over a four-month period starting final September, 162 harbor seals were found dead or passing on along the coast of Unused Britain. An examination by famous infection seeker W. Ian Lipkin, MD, of Columbia College, recognized the executioner: a mutant flu bug transmitted to the seals by ocean winged creatures.

Infection confined from the seals had experienced a arrangement of critical transformations:

It got to be able to spread among warm blooded creatures, or at slightest from seal to seal. It got to be able to contaminate the seals’ aviation routes, pulverizing lung tissue or opening the entryway to deadly auxiliary contaminations. It got to be more destructive.

“An extra concern is the potential [animal-to-human] danger that this infection postures, because it has as of now obtained changes … that are regularly, in spite of the fact that not only, respected as prerequisites for pandemic spread,” Lipkin and colleagues note in a commentary distributed in mBio, a diary of the American Society for Microbiology.

The fundamental sort of flu infection disconnected from the seals has long been known to science. It’s called H3N8. An H3N8 infection that caused flu in steeds entered the U.S. within the early 1960s. The canine H3N8 that in 2004 caused a flu flare-up among hustling greyhounds clearly came from the horse H3N8. It presently spreads effortlessly among mutts.

The great news is that not one or the other the equine H3N8 nor the canine H3N8 flu bugs taint people. It’s impossible the seal H3N8 infection will spread straightforwardly to people, either.

But Lipkin and colleagues propose that seals, like pigs, may be able to harbor feathered creature and warm blooded animal flu infections at the same time. The dangerous H5N1 winged creature flu is carried by ocean winged creatures. The stress is that mammal-adapted H3N8 will combine with H5N1, and a dangerous infection will rise.

That’s as it were a farther plausibility. However it’s clear that H3N8 infections as of now have learned to spread from winged creatures to steeds, pooches, and presently to seals. And in a questionable try with ferrets, analysts have appeared that H5N1 winged creature flu is able of changing into a shape that spreads among warm blooded creatures.

The caution from Lipkin carries weight among researchers. Lipkin coordinates Columbia University’s Center for Contamination and Resistance. He’s moreover chief of the World Wellbeing Organization’s center on rising infections, and is co-chair of the National Biosurveillance Counseling Subcommittee for the CDC.

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Teen Car Crash Deaths Decline

Oct. 21, 2010 — Adolescent activity passings declined about 17% in 2009 from 2008 for young people matured 15 to 19, the CDC says in a modern report. That’s approximately 500 less passings, for a add up to of around 3,000.

The CDC, in its Dreariness and Mortality Week by week Report for Oct. 22, says that the activity passing rate has moved forward somewhat since of graduated driver permitting (GDL) programs. Such programs expand the period for learner’s licenses, put driving limitations on youthful drivers, and restrain the number of travelers permitted in their vehicles.

Not as it were did the national high school activity passing rate decrease in 2009 for 15- to 19-year-olds, but drivers matured 16 and 17 included in deadly crashes declined 38% between 2004 and 2008, to a rate of 16.7 per 100,000 individuals, the MMWR report says.

Youngster Drivers More at Chance in A few States Than Others

Still, adolescent activity passing rates shift broadly among states, the CDC says.

The five-year annualized passing rate for 16- to 17-year-olds included in deadly crashes from 2004 to 2008 was 9.7 per 100,000 in Unused York, but 59.6 per 100,000 in Wyoming.

Wyoming moreover had the most elevated casualty rate from all crashes including traveler vehicles in 2008, at 24.8 per 100,000. Massachusetts had the most reduced at 4.9.

Creators of the article within the MMWR depict the patterns as “encouraging” but point out that engine vehicle crashes stay the driving cause of passing for youngsters.

CDC Propelling Programs to Assist High schooler Drivers, Their Guardians

The CDC says it is propelling a unused campaign called “Parents are the Key” during “National High schooler Driver Security Week” Oct. 17-23, to assist youngsters and their guardians head off mischances. For their report within the MMWR, analysts analyzed information from the Casualty Investigation Report Framework for 2004-2008.

Among discoveries:

9,644 drivers matured 16 or 17 were included in deadly vehicle crashes. 4,705 crashes, or 50%, included one vehicle. 3,976 included two vehicles. 813 included three or more vehicles. 87% of the crashes come about in one casualty, 10% come about in two fatalities, and 3% come about in three or more fatalities. Drivers made up 37% of passings, and 31% of fatalities were travelers of those drivers. 18% of passings were drivers of other vehicles, and 7.3% or 805 were travelers in those other vehicles. 728 or 6.7% of the fatalities were other street clients such as bicyclists or people on foot. 65% of drivers 16-17 included in deadly crashes were male, or 6,280. 36% of the drivers, or 3,429, were detailed to be speeding at the time of the crash. Blood liquor concentration was measured in 46%, or 4,459, of the lethal crashes. Of the drivers, 947 had a positive blood liquor concentration. Of drivers who had been drinking, 678 or 72% had blood liquor substance levels of 0.08 grams per deciliter, a standard degree showing the individual is over the lawful restrain for drivers 21 and more seasoned. Drivers beneath 21 who can’t purchase liquor legitimately are subject to lower blood liquor substance levels in each state.

The MMWR article too states the rate for drivers 18 and more seasoned included in deadly crashes declined 20% from 2004 to 2008.

CDC analysts say a few of the diminish may be caused by decreases within the number of miles driven, maybe since of rising gasoline costs and destitute financial conditions.

The MMWR creators say the 2004-2008 decrease in high schooler crash fatalities expands a long-term descending slant that begun in 1996. The creators credit graduating learning programs for much of the advancement. Such programs work in 49 states also Washington, D.C., and all incorporate nighttime driving limitations.

The CDC prescribes that families of recently authorized teenagers effectively implement confinements of graduated preparing programs. The CDC moreover says expanded utilize of situate belts and decreases in driving beneath the impact of liquor have contributed to decays in passings of teenagers in crashes.

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Stronger Warning for Actos, Avandia

June 6, 2007 — The diabetes drugs Actos and Avandia will before long carry a “dark box” caution that the sedate may trigger heart disappointment.

The astonish declaration came in articulations made by FDA commissioner Andrew C. Von Eschenbach, MD, some time recently a U.S. House committee examining whether the FDA fizzled to regard notices of conceivable heart assault dangers postured by Avandia.

The modern dark box notices have nothing to do with heart assaults. The name will caution that the course of drugs to which both Actos and Avandia have a place increment a person’s hazard of congestive heart disappointment. The drugs current names caution of this hazard, but the modern caution will be distant more unmistakable.

The two drugs increment the body’s inclination <span class="words" data-synonyms="to accumulate;to construct up”>to construct up liquids due to insufficient pumping from the heart — a complication of diabetes. This could trigger heart disappointment.

A heart assault may be a distinctive issue. Heart assaults happen when something squares blood stream to the heart, causing heart tissue to kick the bucket.

The later firestorm over Avandia concerns prove recommending – but by no implies demonstrating — that Avandia may increment the as of now tall chance of heart assaults in individuals with diabetes. GlaxoSmithKline focuses to ponders that appear no clear expanded hazard of heart assault in patients taking Avandia. In any case, publications in this week’s issue of The Unused Britain Diary of Medication caution that the jury is still out which Avandia may posture a heart assault peril.

In declaration some time recently the House committee, GSK investigate and development chair Moncef Slaoui, PhD, guarded Avandia’s heart security.

“Avandia, when compared to other broadly utilized antidiabetes medications, isn’t related with an expanded chance of passing, counting passing from a cardiovascular occasion,” Slaoui said in a arranged explanation.

Actos has not been connected to any expanded hazard of heart attack.

“Takeda remains certain within the security and viability of Actos when utilized concurring to its name, and with this amendment, we will increase quiet and doctor mindfulness of an as of now known but genuine side impact,” Takeda senior restorative chief Robert Spanheimer, MD, says in a news discharge.

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Drops as Good as Patch for ‘Lazy Eye’

Walk 13, 2002 — Eye drops work fair as well as wearing an eye fix to adjust amblyopia –commonly known as “sluggish eye” — in children, concurring to a unused ponder. In spite of the fact that this to begin with head-to-head comparison of the two medicines found they work similarly well, analysts say the eye drops may before long ended up the favored choice of guardians.

Amblyopia leads to impeded vision in an something else solid eye since the brain has learned to favor the other eye. An eye with amblyopia looks typical, but there’s a issue with the way the brain forms the visual data it supplies. The condition commonly happens when the eyes are crossed or misaligned or when there’s a critical contrast in refractive vision, such as farsightedness or nearsightedness, between the two eyes.

The issue more often than not creates early in life, and treatment is prescribed some time recently age 8. Until presently, most eye care experts treated it by setting a fix over the unaffected eye, constraining the child to utilize the apathetic eye and making a difference the portion of the brain that oversees locate to create more completely.

Within the think about, distributed within the Walk issue of Files of Ophthalmology, analysts compared the adequacy of this standard fix treatment with use of an atropine eye drop. The once-a-day drop works by briefly obscuring vision within the unaffected eye. That prompts the child to utilize the sluggish eye, which makes a difference create quality and make strides vision.

Analysts say visual sharpness within the influenced eye moved forward by 79% in children who wore a fix and by 74% among those who gotten the drops. In spite of the fact that both sets of guardians say their children endured their medications well, the guardians of the atropine drop group were more fulfilled with the treatment.

“With atropine, you basically put the drop in once within the morning and there’s not more observing of the child for the day,” says consider creator Michael X. Repka, MD, of the Johns Hopkins Children’s Center and Wilmer Eye Founded, in a news discharge. “With the fix, children ought to be observed since they frequently expel the fix.”

The creators say guardians and children are more likely to comply with a treatment that’s simpler to utilize, and say the drops may before long gotten to be the standard treatment for a few shapes of amblyopia. Agreeing to the National Eye Organized, the condition influences around 3% of Americans.

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NASA Ranks 2017 as the Second-Warmest Year on Record

Welcome to the Climate Fwd: newsletter. The New York Times climate team emails readers once a week with stories and insights about climate change. Sign up here to get it in your inbox.

A drought in South Africa is so severe that Cape Town could run out of water in April.Credit…Waldo Swiegers/Bloomberg, via Getty Images

After three consecutive years of record-setting global temperatures, 2017 turned out not to be a fourth record. That was expected, but global temperature data for last year — which government scientists made public on Thursday — showed that Earth’s long-term warming trend is continuing unabated.

There’s a fight brewing in California that has enormous consequences for the state’s climate policies. But it’s not about electric cars or renewable energy, it’s a battle over affordable housing.

This question was sent to us from Chris Brooks in Noblesville, Ind.:

I live far from the coasts. They will be spending billions/trillions on saving cities from rising seawater. Many have purposely put themselves in danger through coastal living. Why should I have to pay higher taxes to support their chosen lifestyles?

Four in 10 Americans live in coastal areas. Most of those areas, absent climate change, are no more dangerous than inland living. After all, no place is free of natural hazards. It’s climate change that has made many coastal locales more hazardous in recent years.

That said, it’s impossible to overlook the creeping expense. Last year was the United States’ costliest ever for extreme weather events: $306 billion in damage, much of that from hurricanes that struck coastal areas.

Guarding against future disasters will be expensive, too. A 2015 Rutgers Energy Institute report said protecting New York City alone from sea level rise would cost $120 billion. It is a hefty bill, but not one that will necessarily come from your tax dollars. In fact, so far, Congress has done little to help coastal areas adapt to rising waters, even though some at-risk states, like New York, contribute more to the federal coffers than they receive in federal spending.

And New York City, like many coastal areas, is an economic driver. Fourteen percent of the nation’s counties that are on a coastline produce 45 percent of the nation’s gross domestic product.

That said, some coastal areas prone to damage, like in Florida, Texas and Louisiana, receive a lot of money from the federal government. Some places have repeatedly benefited from the Stafford Act, under which the Treasury foots the bill for repairing storm-damaged infrastructure. Other neighborhoods have been rebuilt multiple times through the government-run National Flood Insurance Program, which is broke.

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