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Digestive problems, including ulcers in one's food pipe or <keyword id="60887" type="General" weightage="20" keywordseo="stomach" source="Orion">stomach</keyword>, could increase the risk of <keyword id="77524" type="General" weightage="100" keywordseo="parkinsons-disease" source="Orion">Parkinson's disease</keyword> by 76 per cent, according to a new study. Analysing endoscopy reports of 9,350 patients, the authors found that people having upper gastrointestinal conditions -- specifically, ulcers or other types of damage to the lining of the oesophagus, stomach, or upper part of the small <keyword id="700917" type="General" weightage="20" keywordseo="intestine" source="Orion">intestine</keyword> -- were far more likely to develop Parkinson's <keyword id="6361612" type="General" weightage="20" keywordseo="disease" source="Orion">disease</keyword> later in life. These findings, published in the Journal of the American Medical Association Network Open Researchers add to a growing body of evidence that ageing-related or neurodegenerative disease, long thought to originate in the brain, could begin in the gut. Gastrointestinal problems are known to be common in patients suffering from neurodegenerative disorders, the authors said. The researchers at the Beth Israel Deaconess Medical Center, US, said that gastrointestinal troubles experienced by patients of Parkinson's disease often appear up to two decades before symptoms such as tremors or stiffness in arms or legs, which interfere with one's movement and are usually the grounds for diagnosis. They said that digestive issues can involve constipation, drooling, difficulty in swallowing and a delayed emptying of the stomach. Constipation and difficulty in swallowing were strong risk factors related with a more than doubling of Parkinson's disease risk, the authors said. One of the possible biological mechanisms underlying these relationships between the gut and risk of Parkinson's disease could be problems in regulating dopamine, a brain chemical known to play a key role in digestion, they said. The authors also proposed that gastrointestinal conditions could trigger the building up of the protein 'alpha-synuclein', which is how Parkinson's disease presents in the brain. Future research could help understand these mechanisms better, they added.

Gastro problems could heighten Parkinson's disease risk by 76%, study finds

With the <keyword id="20613906" type="General" weightage="20" keywordseo="economic-survey" source="keywords">Economic Survey</keyword> flagging a rise in <keyword id="19956983" type="General" weightage="100" keywordseo="mental-health" source="keywords">mental health</keyword> issues among <keyword id="19916609" type="General" weightage="20" keywordseo="Indians" source="keywords">Indians</keyword> calling for a <keyword id="20740266" type="General" weightage="20" keywordseo="paradigm-shift" source="keywords">paradigm shift</keyword> on how to address the problem, experts on Monday said it is an unaddressed health crisis in India. They called for increasing accessibility to mental health resources, raising <keyword id="19927137" type="General" weightage="20" keywordseo="awareness" source="keywords">awareness</keyword>, reducing <keyword id="20448786" type="General" weightage="20" keywordseo="stigma" source="keywords">stigma</keyword> and developing robust support systems to tackle the issue while also highlighting the need to find comprehensive solutions to contributing factors such as work pressure and societal expectations, among others. "Mental health problems are an unaddressed health crisis in India. Nearly 20 per cent of people live with mental health problems in India. Depression and anxiety are common causes of disability. There is a treatment gap of more than 80 per cent," Achal Bhagat, Senior Consultant Psychiatrist and Psychotherapist at Indraprastha Apollo Hospital, Delhi, said. The indirect economic cost of loss of livelihoods due to mental health is significantly high as it is not only for the person living with mental health problems but also due to the loss of livelihoods for the caregivers, he added. Expressing similar views, Shambhavi Jaiman, Consultant Psychiatrist at Fortis Memorial Research Institute, Gurugram, said the impact on productivity is substantial, reflecting the broader implications for societal well-being and economic stability. "The contributing factors - work pressure, societal expectations, financial worries, and insufficient support systems - create a complex web of stressors that require comprehensive solutions," she added. Jaiman said addressing mental health issues involves increasing accessibility to mental health resources, raising awareness, reducing stigma and developing robust support systems. "Creating a supportive environment where mental health is prioritised is essential for fostering a healthier, more productive society," she said. Sameer Malhotra, Senior Director and Head Dept of Mental Health and Behavioural Sciences at Max Super Speciality Hospital, Saket, pointed out that factors such as growing consumerism, excessive competition, shrinking social and family support networks, increased pace of life and growing distress, timeline pressures, lesser time for self and family are driving rise in mental health problems globally. "Disturbed mindset influences concentration, productivity at work and economics as well," he added. The Economic Survey 2023-24 flagged a rise in mental health issues among Indians, calling for a paradigm shift towards a bottom-up, whole-of-community approach to address the problem. Although it noted that India is creating positive momentum in policy development by recognising mental health as a fundamental aspect of overall well-being, the survey said, "While most of the policy design is in place, proper implementation can accelerate the improvement on the ground. That said, there remain certain gaps in the existing programmes which need to be addressed to maximise their effectiveness". The fundamental issue of the lack of awareness about mental health and the stigma surrounding it can render any sincerely crafted programme unfeasible, it added. "Hence, there is a need to bring about a paradigm shift and utilise a bottom-up, whole-of-community approach in addressing the topic of mental health. Breaking the stigma starts with taking cognisance of the natural human tendency to accept physical ailments and seeking treatment for the same while being in denial about mental health issues," the survey said. To an extent, the denial is an outcome of fear about social attitudes and social acceptance after one 'comes out' with mental health issues, it said. "For public health officials, tackling mental health requires acknowledging and addressing this fundamental reluctance. Arguably, mental health issues drag down productivity more widely in the ecosystem than individuals' physical health issues. Hence, paying attention to mental health issues in society is both a health and an economic imperative," the document noted.

Mental health problem an unaddressed health crisis in India: experts after Economic Survey findings

In today's digital age, <keyword id="20114750" type="General" weightage="20" keywordseo="screen-time" source="keywords">screen time</keyword> is an integral part of life for people of all ages. However, recent preliminary research published in JAMA Network Open raises concerns about the impact of touch-screen <keyword id="22616884" type="General" weightage="20" keywordseo="tablet-games" source="keywords">tablet games</keyword> on <keyword id="20092400" type="General" weightage="20" keywordseo="toddlers" source="keywords">toddlers</keyword>, suggesting that frequent use may inhibit crucial interactions with their parents! The study highlights that early screen time is associated with delays in communication and problem-solving skills among toddlers. This aligns with a growing concern among parents regarding <keyword id="20083225" type="General" weightage="20" keywordseo="childrens-health" source="keywords">children's health</keyword>, with screen time topping recent polls as a significant issue. <div type="Article" hostid="261" msid="112016000" title="I run a preschool and see how gentle parenting has made parents less engaged with their kids. It&amp;#39;s time to ditch parenting scripts." mstype="2" mssubtype="0"></div>Dimitri A. Christakis, MD, MPH, director of the Center for Child Health, Behavior, and Development at Seattle Children's Research Institute, emphasised the importance of understanding <keyword id="21062651" type="General" weightage="20" keywordseo="digital-addiction" source="keywords">digital addiction</keyword>'s roots. “Compulsive use of screens appears to start in toddlerhood,” Christakis stated, highlighting a gap in current research focused on such young children. The researchers recruited 63 neurotypical toddlers aged 18 to 32 months to observe how they interacted with various stimuli and responded to attention bids from adults. The study involved providing toddlers with a farm toy, a tablet showing a child playing with the farm toy, a tablet with a farm-themed puzzle, a tablet with a farm-themed game, and a tablet with their favourite app. After one minute of exposure to each item, researchers and caregivers alternated attempts to capture the toddlers' attention. At the end, the researcher asked for the toy or tablet back. <h2>Evils of high screen time in children</h2>The findings revealed that toddlers were less responsive to prompts while playing the farm-themed game, which involved activities like shearing sheep. This effect was more pronounced as the children aged, and it was particularly significant among male toddlers, who took longer than female toddlers to acknowledge requests for behaviour changes. Additionally, toddlers with higher media usage at home were more likely to ignore prompts during the study. The study offers insights into the underlying mechanisms of delayed <keyword id="20607306" type="General" weightage="20" keywordseo="language-development" source="keywords">language development</keyword> linked to early screen use. Christakis explained, “early screen use deprives toddlers of opportunities to reciprocally engage with caregivers, which is a critical way children learn language and social skills.” The lack of joint attention during play with traditional toys, which is associated with better language skills, underscores the importance of human back-and-forth interaction for cognitive and social development. <div type="Article" hostid="261" msid="111816796" title="I&amp;#39;m a teacher and a parent. I support banning cellphones in classrooms." mstype="2" mssubtype="0"></div>While the study is preliminary, it sheds light on the need for further research to identify high-risk children and develop interventions promoting healthy screen use in early childhood. Christakis advocates for more comprehensive studies to understand better and mitigate the impact of screen time on young children's development. In conclusion, while touch-screen tablet games offer convenience and entertainment, their use should be balanced with traditional play and <keyword id="22616885" type="General" weightage="20" keywordseo="parent-child-interactions" source="keywords">parent-child interactions</keyword> to support <keyword id="22616886" type="General" weightage="20" keywordseo="healthy-development" source="keywords">healthy development</keyword> in toddlers. As research continues to evolve, it is crucial for parents and caregivers to stay informed and mindful of the potential long-term effects of early screen exposure.

“iPad kids” are less inclined to interact with their parents and show delays in problem-solving: Study

<ul class="summary-list"><li>Biden addressed questions regarding his health following his exit from the 2024 race.</li><li>The president told CBS News he had "no serious problem" and was just sick during the June debate.</li></ul>In an interview that aired Sunday, President Joe Biden rebuffed speculation over his health and said he was ready to stump for Vice President Kamala Harris.Biden, who <a target="_blank" class="" href="https://www.businessinsider.com/joe-biden-dropping-out-presidential-race-2024-7">stepped aside as the Democratic presidential nominee</a> last month after a poor debate performance in June, touched on his condition while laying out his plans to aid Harris' presidential campaign."I had a really, really bad day in that debate because I was sick, but I have no serious problem," Biden told CBS News on Sunday.Biden then pivoted to Harris' race, noting that he looked forward to stumping for the vice president in <a target="_blank" class="" href="https://www.businessinsider.com/kamala-harris-leads-trump-michigan-pennsylvania-wisconsin-swing-state-polls-2024-8">Pennsylvania</a>, a critical battleground state for both Harris and former President Donald Trump."I was talking to Governor [Josh] Shapiro, who's a friend. We have to win Pennsylvania, my original home state," he said. "He and I are putting together a campaign tour in Pennsylvania.""I'm going to be campaigning in other states as well, and I'm going to do whatever Kamala thinks I can do to help the most," he continued.Since ending his campaign, the president hasn't been almost entirely absent from the spotlight.Biden earlier this month oversaw a <a target="_blank" class="" href="https://www.businessinsider.com/russia-frees-political-prisoners-including-massive-exchange-2024-7">historic and complex prisoner swap</a> with Russia and other countries that freed at least 24 people. Three Americans — the Wall Street Journal reporter Evan Gershkovich, the former US Marine Paul Whelan, and the journalist Alsu Kurmasheva — were released as part of the exchange. It was the <a target="_blank" class="" href="https://www.washingtonpost.com/national-security/2024/08/01/deal-us-russia-prisoner-swap/">culmination</a> of months of negotiations.When the Americans landed at Joint Base Andrews in Maryland shortly after their release, both Biden and Harris were on hand to greet the group.During his CBS interview, Biden said he hoped Americans would remember him for proving that "democracy can work.""It got us out of a pandemic," he said. "It produced the single greatest economic recovery in American history. We're the most powerful economy in the world. We have more to do."

Biden says his health is not hurting his ability to campaign for Kamala Harris: 'I have no serious problem'

<ul class="summary-list"><li>Some Americans move to Canada in search of less polarized politics and reduced risk of gun violence.</li><li>Two people who moved said they faced long waiting lists for healthcare and still-high housing costs.</li></ul>Born in the South, Mahlena-Rae Johnson moved to Los Angeles after graduating from high school. She eventually found a partner and a community of people who made California feel like home.Johnson, a 42-year-old Black woman, said she felt a turning point when <a target="_blank" class="" href="https://www.businessinsider.com/donald-trump">Donald Trump</a> beat Hillary Clinton in the 2016 US presidential election. She said she felt it laid bare profound political and ideological divisions within the nation, which resulted in a growing intolerance toward non-cisgendered Americans.In 2018, she and her partner <a target="_blank" class="" href="https://www.businessinsider.com/moving-to-canada-from-us-differences-pros-cons-guns-drugs-2023-12">relocated to Canada</a>, seeking what they perceived to be a more politically progressive and secure environment to raise their children."I watched videos of people who moved to Canada, and one man who had moved years ago said that he liked living in a place where he knew his country wasn't constantly at war," Johnson told Business Insider. "It is overall a place where I feel safer with my family."According to Google Trends, searches for "moving to Canada" tend to spike following polarizing events, such as the <a target="_blank" class="" href="https://trends.google.com/trends/explore?geo=US&amp;q=move%20to%20canada&amp;hl=en-US">presidential debate</a> between President Joe Biden and former president Trump on June 27. After that <a target="_blank" class="" href="https://www.businessinsider.com/what-happened-biden-trump-debate-takeaways-2024-6">disastrous debate</a>, Biden stepped aside, making way for Vice President <a target="_blank" class="" href="https://www.businessinsider.com/kamala-harris">Kamala Harris</a> to eventually become the Democratic nominee.Similar spikes have been observed during <a target="_blank" class="" href="https://trends.google.com/trends/explore?date=2016-11-01%202016-11-30&amp;geo=US&amp;q=move%20to%20canada&amp;hl=en-US">the 2016 presidential election,</a> the bitter <a target="_blank" class="" href="https://trends.google.com/trends/explore?date=2020-09-01%202020-10-31&amp;geo=US&amp;q=move%20to%20canada&amp;hl=en-US">debate between Trump and Biden</a> during the 2020 presidential election, and <a target="_blank" class="" href="https://trends.google.com/trends/explore?date=2022-06-01%202022-07-01&amp;geo=US&amp;q=move%20to%20canada&amp;hl=en-US">the Supreme Court's overturning of Roe v. Wade</a> in 2022. Searches for "moving to Canada" had already started to <a target="_blank" class="" href="https://trends.google.com/trends/explore?date=today%201-m&amp;geo=US&amp;q=move%20to%20canada&amp;hl=en-US">increase during the month</a> leading up to Election Day 2024, per Google Trends."Usually when there's an election cycle, or when people don't like who is elected, Americans in particular want to move to Canada," <a target="_blank" href="https://www.visaplace.com/">VisaPlace</a> CEO Michael Niren, an immigration lawyer with more than 25 years of experience in Canadian migration, told BI.A smaller number of Americans actually follow through on their internet dreams and make the move. According to <a target="_blank" href="https://open.canada.ca/data/en/dataset/f7e5498e-0ad8-4417-85c9-9b8aff9b9eda">immigration data from the Canadian government</a>, 93,095 Americans were granted permanent residency between 2015 and the end of the third quarter of 2024. The number of Americans granted permanent residence has increased almost every year. In 2015, 7,655 people got it; in 2023, 10,640 people did. 2021 saw the largest number: 11,955.Two Americans who recently moved to Canada told BI they did so to escape polarized and divisive politics, escape inadequate healthcare, and feel safer in their communities.While they said their overall quality of life had improved, they found the grass wasn't greener in every arena: There can be long waitlists for medical care, and it's very expensive to buy a home.<h2 id="8b3f63f9-a520-43d6-a1bc-b0b4a1463883">One mover said Canada's schools were better, but its free healthcare was still flawed</h2>Johnson, who primarily wanted to escape American politics, said she discovered some advantages of Canada's schooling system once her children enrolled.In LA, she said, "many of the schools are in trailers instead of actual buildings," but in Canada, "children can go to school and not worry about having a place that is safe or not being in an actual building."Johnson said she and her family had also enjoyed Canada's universal, <a target="_blank" href="https://www.commonwealthfund.org/international-health-policy-center/countries/canada">publicly funded healthcare system</a>, under which citizens and permanent residents get most medically necessary care and medications for free or at a very low cost.She added that there were some frustrations, including <a target="_blank" href="https://www.fraserinstitute.org/studies/waiting-your-turn-wait-times-for-health-care-in-canada-2022">lengthy waiting periods</a> for medical care. "During the pandemic, doctors couldn't see patients as regularly and non-emergency procedures were postponed, so there's a backlog," she said.Niren, who has lived in both the US and Canada, voiced similar concerns. He said his own mother, who needs a hip replacement, was on a waitlist for 18 months."There are people who have to fly to other countries — including the United States — to get cancer treatment because it takes too long," he said. "In the US, you can get a specialist appointment in two days."Niren also said Canadians paid elevated taxes to support such a comprehensive healthcare system."People call it free healthcare — it's not free," he said. "It's very expensive because you're paying through the taxes."<h2 id="8af511bd-4cef-4447-96f8-e2383dcbf3f4">An American found relief from the US's violence and opioid crises in Canada</h2>Chris Ouellet, 40, left Portland, Oregon, for Victoria, British Columbia, in 2020. It wasn't his first-choice destination, he said, but he ended up finding the peace and safety he was looking for.He and his partner had planned to move to <a target="_blank" href="https://www.businessinsider.com/americans-moving-to-new-zealand-california-nature-quality-of-life-2023-8">Wellington, New Zealand</a>, but were unable to because of pandemic border lockdowns. A lot of the characteristics Ouellet was looking for in New Zealand, he said, he found in British Columbia."We love the Pacific Northwest, and Canada is not far up the road," Ouellet told BI. "It's very similar weather, and they have a lot of the things that we wanted and what we were looking for in New Zealand, which was a lower cost of education, socialized healthcare, and politics that weren't so incredibly polarizing."Ouellet, who works for the provincial government at the Ministry of Health in British Columbia, spoke glowingly of Portland but did point out the "pretty bad" violence and opioid crises he witnessed in the US overall. Before Portland, he and his partner lived in Chicago. The violence they would read about or see on their daily commutes prompted them to move west and eventually out of the country altogether, he said.He hasn't had the same worries in Canada."In British Columbia, the regulations for being able to own a gun are extremely tight," he said. "When you're out in public, and you hear a noise, no one runs, no one checks over their shoulder, no one thinks that it could possibly be gun violence."He added that there was still an opioid crisis in British Columbia, but it wasn't as striking as it is in Portland. Ouellet said that in the three years he'd lived in British Columbia, he'd seen one syringe on the ground, compared with Portland, where he saw dozens a day.Ouellet said he had no regrets about moving to British Columbia, but <a target="_blank" href="https://www.businessinsider.com/canada-housing-crisis-bubble-imploding-real-estate-prices-rent-decline-2023-11">Canada's housing crisis</a> have so far sidelined his dreams of homeownership."The house that we had in Portland was three bedrooms, 2 ½ baths. It was about 1,800 square feet, and we bought it for $265,000. You can't find a place for that price here," he said. "Most condos are around $500,000 to $900,000. Single-family homes are almost a million."As Niren said, "Canada is one of the greatest countries in the world, but it's no utopia."This story was originally published on December 5, 2023, and was updated on November 5, 2024.Are you an American who moved to Canada? We want to hear from you. Reach out to the reporters, Alcynna Lloyd at <a target="_blank" href="mailto:alloyd@businessinsider.com">alloyd@businessinsider.com</a> and Jordan Pandy at <a target="_blank" href="mailto:jpandy@businessinsider.com">jpandy@businessinsider.com</a>, with your story.

Some Americans think moving to Canada will solve all their problems. But Canada has its own issues.

<ul class="summary-list"><li>This post originally appeared in the Insider Today newsletter.</li></ul>Welcome back to our Sunday edition, a roundup of some of our top stories. As the debate over AI tools' usefulness rages on, here's an interesting data point. A recent survey found 77% of workers said the tech <a target="_blank" href="https://www.businessinsider.com/ai-workers-productivity-survey-2024-8">decreased their productivity and added to their workload</a>.On the agenda today:<ul><li>To save money, some people are <a target="_blank" href="https://www.businessinsider.com/millennial-subsidy-uber-airbnb-prices-surge-pricing-dynamic-2024-8">doing things the old-fashioned way</a>.</li><li>It's time to wave goodbye to the <a target="_blank" href="https://www.businessinsider.com/economic-fears-job-cuts-employers-less-flexible-with-workers-2024-8">dream of a four-day workweek</a>.</li><li>According to top VCs, these are the <a target="_blank" href="https://www.businessinsider.com/most-promising-startups-2024-according-top-vcs-2024-8">85 most promising startups of 2024</a>.</li><li>Amazon's big bet on YouTube's top star is <a target="_blank" href="https://www.businessinsider.com/how-mrbeast-reality-show-deal-became-problem-for-amazon-2024-8">proving to be a real headache</a>.</li></ul>But first: What goes down must come up.If this was forwarded to you, <a target="_blank" href="https://www.businessinsider.com/subscription/newsletter/insider-today-sunday-edition">sign up here</a>. Download Insider's app <a target="_blank" href="https://www.insider.com/app">here.</a><h3 id="58506b3b-b008-4ead-9e90-71439c9e98dd">This week's dispatch</h3><div type="image" title="recession fed down arrow red 4x3" height="1500" width="2000" msid="112444376" hostid="261" sizebytes="91030"></div><h2 id="f92dd04b-33cd-40fd-a590-cea6542d3732">Market U-turn</h2>What a week.The week kicked off with investors in <a target="_blank" href="https://markets.businessinsider.com/news/stocks/stock-market-selloff-today-jobs-report-recession-unemployment-tech-earnings-2024-8">full-blown panic mode</a>. A combination of disappointing earnings, surprisingly weak economic data, and the destruction of a <a target="_blank" href="https://markets.businessinsider.com/news/stocks/stock-market-crash-yen-carry-trade-unwind-fed-japan-rates-2024-8">trading strategy tied to the Japanese yen</a> culminated in a <a target="_blank" href="https://www.businessinsider.com/stock-market-meltdown-what-happened-interest-rates-trading-wall-street-2024-08">huge market sell-off on Monday</a>.The industry, to put it mildly, was freaking out.Was this the start of the <a target="_blank" href="https://markets.businessinsider.com/news/stocks/stock-market-investing-strategy-for-recession-tech-selloff-economy-inflation-2024-8">long-awaited recession</a>? Should there be an <a target="_blank" href="https://www.businessinsider.com/fed-rate-cuts-recession-outlook-economy-job-market-interest-rates-2024-8">emergency rate cut</a>? How could the Fed <a target="_blank" href="https://markets.businessinsider.com/news/stocks/stock-market-crash-fed-rate-cuts-economy-recssion-inflation-powell-2024-8">screw this up so badly</a>?But it wasn't long before the market started to stabilize. By Wednesday, experts were explaining why we shouldn't <a target="_blank" href="https://www.businessinsider.com/emergency-rate-cut-fed-recession-july-jobs-report-unemployment-powell-2024-8">get an emergency rate cut</a>.Thursday was the nail in the coffin of the week's recession-that-never-was. This time it was better-than-expected economic data — <a target="_blank" href="https://markets.businessinsider.com/news/stocks/stock-market-today-jobless-claims-data-economy-labor-market-recession-2024-8?utm_medium=ingest&amp;utm_source=markets">a drop in jobless claims</a> — that led the S&amp;P 500 to its <a target="_blank" href="https://markets.businessinsider.com/news/stocks/stock-market-today-dow-sp500-labor-market-jobless-claims-economy-2024-8">best day in almost two years</a>.When the dust finally settled, the S&amp;P 500 <a target="_blank" rel="noopener noreferrer" class="c-link" href="https://markets.businessinsider.com/news/stocks/stock-market-today-end-lower-for-4th-week-in-row-2024-8">ended the week nearly flat</a>.Risks remain in the market. Questions continue to mount about <a target="_blank" href="https://www.businessinsider.com/cmo-tried-google-ai-tools-stopped-using-them-2024-8">the real-world application of artificial intelligence</a>, and whether heavy spending on it can translate to bigger profits. That's not ideal for a market that's relied on the hype around the tech for nearly two years.But perhaps there is something to be learned from Jamie Dimon. The JPMorgan CEO said in a recent interview that people tend to <a target="_blank" href="https://www.businessinsider.com/jpmorgan-jamie-dimon-on-stock-plunge-fed-rate-cuts-significance-2024-8">overreact to the daily fluctuations of the markets</a>."Sometimes it's for good reason, sometimes it's virtually no reason," he said.<div type="image" title="Person with 3 hands floating around their head, holding a dumbbell, a car, and a credit card" height="1500" width="2000" msid="112444377" hostid="261" sizebytes="418870"></div><h2 id="1710b521-444b-4dce-9ed3-b88c97db4aa2">Reject modernity; embrace tradition</h2>Once upon a time, budding apps like Uber and Airbnb offered luxe conveniences at low prices. These burgeoning businesses believed they could build customer loyalty to their brands by slashing prices initially.But now that these brands have made it big, those once-low prices have shot up. That's left a generation accustomed to low-cost luxury resorting to old-fashioned alternatives, like hotels and public transit, to save money.<a target="_blank" href="https://www.businessinsider.com/millennial-subsidy-uber-airbnb-prices-surge-pricing-dynamic-2024-8">New problems require old solutions</a>.<div type="image" title="Four white coffee mugs and one red one with a post it that reads &quot; You are fired!&quot; on blue background." height="1500" width="2000" msid="112444375" hostid="261" sizebytes="57064"></div><h2 id="d01a1b77-bec8-4354-b126-52e59e39cf65">The times, they are a-changin'</h2>We're no longer in the job market where workers had more leverage than employers. July's weaker-than-expected jobs report, which spooked investors, could give companies cover to reconsider work policies.Job seekers hoping to land a remote job may be out of luck. Dreams of a four-day workweek may be dashed. But perhaps the biggest threat to the rank and file is layoffs, as jittery CEOs could make sweeping cuts.<a target="_blank" href="https://www.businessinsider.com/economic-fears-job-cuts-employers-less-flexible-with-workers-2024-8">Goodbye, four-day workweek</a>.Also read:<ul><li><a target="_blank" href="https://www.businessinsider.com/jobs-report-labor-market-hiring-layoffs-quits-recession-sahm-rule-2024-8">America's hiring boom is officially over</a></li></ul><div type="image" title="Image of top startup founders" height="592" width="1185" msid="112444378" hostid="261" sizebytes="90570"></div><h2 id="062f3031-7acf-4349-8972-a908782f9f95">Startups to watch</h2>For our annual list of the most promising startups, Business Insider asked 50 top venture capitalists to identify companies they believe are on the rise. Investors named 85 startups, including their portfolio companies as well as startups they have no financial ties to.Unsurprisingly, AI companies dominated the list. But these startups are focused on specific verticals — like health or military defense — as opposed to trying to be all-encompassing tools.<a target="_blank" href="https://www.businessinsider.com/most-promising-startups-2024-according-top-vcs-2024-8">See the full list</a>.<h2 id="3baae4f5-66e9-4cba-9fc5-51d43d92739b">A TV deal turned beastly</h2>When Amazon needed a hit, it bet on Jimmy Donaldson, the YouTube sensation better known as MrBeast. The "Beast Games" reality show, hosted by the internet personality, was supposed to be Amazon's bold bet on the future of TV.Instead, "Beast Games" was rocked by controversy before it was even released. Insiders say the show was risky from the start, and it's unclear what will happen to it next.<a target="_blank" href="https://www.businessinsider.com/how-mrbeast-reality-show-deal-became-problem-for-amazon-2024-8">How the deal went sour</a>.Also read:<ul><li><a target="_blank" href="https://www.businessinsider.com/youtuber-mrbeast-embroiled-in-controversy-involving-staff-amazon-show-2024-8">The internet's love affair with YouTube's biggest star is showing cracks</a></li></ul>This week's quote:"With the wiring I have, being an expert on recessions was probably not the smartest choice."— Claudia Sahm, the former Fed official, <a target="_blank" href="https://www.businessinsider.com/claudia-sahm-rule-profile-recession-indicator-unemployment-rate-interest-rates-2024-8">on her frustration that her recession indicator became a key talking point</a> among investors last week despite her optimism about the economy.More of this week's top reads:<ul><li>How the stock market can predict the outcome <a target="_blank" href="https://markets.businessinsider.com/news/stocks/stock-market-presidential-election-prediction-winner-donald-trump-kamala-harris-2024-8">of the presidential election</a>.</li><li>At Blackstone, <a target="_blank" href="https://www.businessinsider.com/how-to-succeed-at-blackstone-schwarzman-gray-career-advice-2024-8">nice guys finish first</a>.</li><li>Venture capitalists are <a target="_blank" class="" href="https://www.businessinsider.com/vcs-reality-check-ton-of-people-looking-get-out-2024-8">heading for the exits</a>. </li><li>Meet the new moms using <a target="_blank" href="https://www.businessinsider.com/basic-income-parents-afford-childcare-get-stable-jobs-gbi-ubi-2024-8">monthly basic income to afford childcare</a>.</li><li>Amazon is raising its hiring bar <a target="_blank" href="https://www.businessinsider.com/amazon-brings-back-bar-raisers-hiring-2024-8">for some tech jobs</a>.</li><li>Meet Michal Kosinski, <a target="_blank" href="https://www.businessinsider.com/oppenheimer-artificial-intelligence-michal-kosinski-predict-facial-recognition-2024-7">the Oppenheimer of AI</a>.</li><li>The Global Alliance for Responsible Media is <a target="_blank" href="https://www.businessinsider.com/ad-group-to-suspend-garm-initiative-following-elon-musk-lawsuit-2024-8">"discontinuing" after Elon Musk's X filed an antitrust lawsuit against it</a>.</li><li>I was part of Russia's prisoner swap with the US. Here's how it feels <a target="_blank" href="https://www.businessinsider.com/russian-artist-freed-sasha-skochilenko-prisoner-swaps-describes-release-freedom-2024-8">to suddenly be free</a>.</li><li>Inside the stressful culture at the <a target="_blank" href="https://www.businessinsider.com/bill-melinda-gates-stressful-work-culture-gates-foundation-book-excerpt-2024-8">Gates Foundation</a>.</li><li>Silicon Valley's political divide is now public — <a target="_blank" href="https://www.businessinsider.com/silicon-valley-political-divide-twitter-elon-musk-kamala-harris-2024-8">and petty</a>.The Insider Today team: <a target="_blank" href="https://www.businessinsider.com/author/dan-defrancesco">Dan DeFrancesco</a>, deputy editor and anchor, in New York. <a target="_blank" href="https://www.businessinsider.com/author/jordan-parker-erb">Jordan Parker Erb</a>, editor, in New York. <a target="_blank" href="https://www.businessinsider.com/author/lisa-ryan">Lisa Ryan</a>, executive editor, in New York. Amanda Yen, fellow, in New York.</li></ul>

Insider Today: Amazon's MrBeast problem

<ul class="summary-list"><li>Gen Z consultants view consulting as a stepping stone, not a long-term career.</li><li>High-pressure work and a lack of passion drive young consultants to seek more fulfilling jobs.</li></ul>As a freshman at Penn State University, Ezra Gershanok was set on <a target="_blank" class="" href="https://www.businessinsider.com/how-to-get-hired-top-consulting-firms-bcg-mckinsey-pwc-2024-7">landing a job in consulting</a> after graduation. He joined a consulting club and spent countless hours preparing for interviews.He ended his senior year with three full-time offers, including one at Deloitte in the firm's government and public services sector and one, which he accepted, at <a target="_blank" class="" href="https://www.businessinsider.com/mckinsey-ai-consulting-focus-future-2024-6">McKinsey &amp; Company</a>."There's not really that many better jobs where you can work on different things, you can travel, you can work with young people, and there's a lot of perks," he told Business Insider. As a college student, the prospect of flying business class, staying at the Ritz Carlton, and, of course, learning from big-name executives in his first job had appeal.However, Gershanok quickly realized that his role wasn't all it was cracked up to be."My first project was working for a utility provider, and we were literally doing nothing," he said. "I was like, there's no problem-solving in this job. It's just babysitting."Within two years, he'd left the firm and launched his venture, a sublet startup called Ohana.Whereas <a target="_blank" class="" href="https://www.businessinsider.com/landing-dream-jobs-tech-consulting-banking-are-harder-than-ever-2024-5">consulting</a> was once a dream job for many, Gen Zers are starting to see it as a mere lucrative stepping stone. Four Gen Z consultants told BI they were not in the industry for the long haul. It's a stable job and a shiny badge on their résumés that opens doors for them to pursue their passions.<h2 id="c10b7109-3a20-43e7-b515-1d682b20b510">The missing work-life balance</h2>Vicki Salemi, a career expert for Monster, told BI that because <a target="_blank" class="" href="https://www.businessinsider.com/mckinsey-consultant-quit-mental-health-shattered-2024-4">consulting can be high-pressure</a> — think 60- to 80-hour weeks — some young workers are questioning whether it's right for them, at least for the long term."There has been a shift in terms of looking at this type of position and thinking, 'What did I sign up for?'" she said, adding, "When you reach that level, there's not a balance. It's typically all work."Salemi, who previously recruited for large consultancies and Big Four accounting firms, said many young people starting their careers are shifting from questions about benefits to focus more on areas like office culture.Yet she doesn't expect the consulting industry will go hungry for workers because of the opportunities the experience can bring. Beyond making contacts with client companies, workers early in their careers can learn from their more experienced colleagues and through offerings like in-house training programs."They may feel like they can give a lot in terms of their output for work, but also get a lot from the internal organizational structures and the immense knowledge that their mentors and bosses may bring to the table," Salemi said.She said the learning opportunities can help some young consultants cope with the long hours and stress of the gig."Some jobs are still high pressure, and that won't change," Salemi said.Gen Z consultants said the hours are worth it as long as they pick up new skills. But after a couple of years on the job, the learning curve tapers, and their work can lose meaning.Jorge García Febles, a senior consultant at Deloitte, told BI, "I guess a lot of people just coast through, but that's not what I'm looking for. I want to feel like I'm actually doing something meaningful."<h2 id="86050a4c-7b01-4656-b79b-9e54a3284a6e">It's a good launchpad, but the passion isn't there</h2>Clouds Joo, a Gen Z <a target="_blank" class="" href="https://www.businessinsider.com/day-in-life-consultant-mid-20s-great-job-recent-grad-2024-6">strategy and management consultant</a> at a leading global firm, said she has the ultimate entry-level job: You learn a lot very quickly, there's enough variety never to get bored, and, perhaps most appealing of all, it's an easy industry to leave."Because you are always working in different industries, there's so many great doors in terms of exit opportunities," Clouds, who preferred to go by her nickname for privacy reasons, told BI. "You don't confine yourself to one industry."There's also the prestige of landing at a top <a target="_blank" class="" href="https://www.businessinsider.com/the-consulting-business-demand-is-rough-right-now-2024-3">consulting firm</a> — something that does not go unnoticed or unappreciated by the social media generation.A Gen Z consultant at PwC said he thinks the job is ideal for grads who don't know what they want to do because it's a good way to pick up many generalist skills. But the consultant, who asked not to be named because his employer didn't authorize him to speak to the press, said it's not work he is passionate about.He thinks some longtime consultants he works with simply got comfortable in their jobs and gave up on their other ambitions and passions. To avoid that, he plans to leave consulting to do work that he feels is more impactful and in an industry he cares about.He said he's passionate about working out and healthy eating, so he might move on from consulting to working in public health, fitness, or nutrition."Consulting is not a passion industry," he said. "Some people genuinely love consulting. I think they're freaks."Some young consultants say that at some point, they have to gamble between staying at a job that offers prestige and some security and finding purpose in their careers.Gershanok said he was <a target="_blank" class="" href="https://www.businessinsider.com/mckinsey-consultant-layoffs-firing-over-hiring-client-demand-2024-4">pushed out of McKinsey</a> earlier than expected because the firm had overhired. However, he said he always planned to become an entrepreneur. The McKinsey brand on his résumé made it easier to raise funding for his startup, which has won the backing of big names like Zillow's cofounder and former CEO, Spencer Rascoff, and Airbnb's former director of engineering, Surabhi Gupta."In the consulting world, you have security. The brand is good, but your job is meaningless. At least in my experience, it was meaningless," he said. Now that he's running a startup, he has "a mission."

Consulting has a Gen Z problem

Brenna Carney was 26 when she started seeing videos circulating on TikTok of women her age <a target="_blank" href="https://www.businessinsider.com/fertility-doctor-says-best-time-to-freeze-eggs-your-20s-2022-11">freezing their eggs</a>. She began to panic. Was this something she should be thinking about? The Texas native was single at the time and had always wanted children. "When I was 18, I thought I'd be married by 24, with my first kid by 26," Carney told me. "That definitely did not happen."She started researching and found numerous articles preaching the advantages of freezing eggs before age 35 for higher viability in the future. "I felt the biological clock ticking," she said.<a target="_blank" href="https://www.businessinsider.com/froze-my-eggs-cost-risks-worth-it-2023-11">Egg freezing</a> offered a plan B. She wouldn't have to worry about her fertility declining or rushing into a relationship with someone — she would have viable eggs to use whenever she found the right partner or decided the time was right. So in 2022, at the age of 27, she discussed it with her primary-care physician and was referred to a fertility clinic. "I put a lot of thought into it, but I will say I was kind of just freaking out a little bit," she said.Carney is one of many young people who feel like they're <a target="_blank" href="https://www.businessinsider.com/medical-anthropologist-women-freezing-eggs-over-partnership-issues-2023-3">running out of time</a>. Ever since the American Society for Reproductive Medicine lifted the "experimental" tag from egg freezing in 2012, more people have decided to freeze their eggs. Between 2012 and 2020, procedures surged by 400% in the US, according to the Society for Assisted Reproductive Technology. Initially, ASRM recommended egg freezing only for women undergoing medical treatments that affected their fertility, but in 2021, thanks to improved technology, ASRM acknowledged "delaying childbearing" as a valid reason for the procedure. And in 2022, women were given the option to store their eggs for up to 55 years, a significant increase from the previous 10-year limit. For the first time, egg freezing was an option for younger women worried about their reproductive future.Since then, clinics have used platforms like TikTok and Instagram to entice an increasingly young base of women with the message that they're running out of time — the earlier you freeze your eggs, the better, they warn. From 2021 to 2022, the most recent year for which data is available, US egg-freezing procedures jumped another 20%, to nearly 30,000. Younger and younger women are posting online about freezing their eggs — and getting paid by clinics to do it. But the messaging often ignores a few key realities: Egg freezing is expensive, the chances of success vary significantly, and the idea that earlier is always better isn't clearly supported by research."Egg freezing is a really valuable and important technology," Zeynep Gurtin, a sociologist and lecturer at the Institute for Women's Health at University College London, told me. However, she said it's not a blanket positive. "What we're starting to see with egg freezing now is the overexploitation of egg freezing as a technology that's marketed as being potentially useful to all women who should use it as some kind of backup plan," Gurtin said. "That's absolutely not what this technology is designed for or is right for."The first step in Carney's egg-freezing journey was to go on birth control — something she had never done before. "That week, I was a raging bitch," she said. The pill sent her emotions spiraling in every direction. Then, Carney had to self-inject daily hormone shots for 10 days to coax her ovaries to mature as many eggs as possible. Finally, the doctor could remove her eggs.During a typical egg-retrieval procedure, a doctor guides a needle attached to a catheter through the vaginal wall and draws out the eggs using light suction while the patient is under anesthesia. The harvested eggs are immediately preserved in a cryogenic freezer in liquid nitrogen, where they stay until they're needed for in vitro fertilization. The whole procedure takes less than 20 minutes — but recovering from the anesthesia might take several hours.The more eggs the doctor can retrieve, the better the chance one will result in a successful pregnancy down the road. In a 2022 <a target="_blank" href="https://www.fertstert.org/article/S0015-0282(22)00254-0/fulltext">study</a>, women who froze their eggs before the age of 38 had a 70% chance of having a baby if they thawed 20 or more eggs. But if they thawed fewer than 10 eggs, the success rate plunged to 36%.Women under 38 typically get 10 to 20 eggs per retrieval, but of the eggs that are frozen, not all will survive the thawing process. Even fewer will be successfully fertilized, fewer still will become embryos, and even fewer will result in a live birth. At each stage of the process, there's a chance that something goes wrong. "Even in the best-case scenario, your success rate is never going to be higher than the average IVF cycle, which is around 30%," Gurtin said. Carney's retrieval resulted in only nine eggs. "I thought that I would get a lot more because I was 27 and very healthy," she told me. "Some women get, like, 25 to 30." She felt frustrated and discouraged. "I just did all that and now I only have nine?" she recalled thinking at the time. Most women undergo the entire process multiple times to retrieve more eggs and increase their chances of success. But that also comes with a cost — and Carney doesn't plan to do another round.<a target="_blank" href="https://www.businessinsider.com/39-year-old-woman-spent-6000-on-egg-retrieval-2022-6">Egg retrieval</a> typically runs you $8,000 per procedure, plus $2,000 to $5,000 for the hormone shots. Each year you store your eggs, you also have to pay a fee ranging from $400 to $800. And when you decide to use your eggs, it costs $3,000 to $5,000 for the frozen-embryo transfer. Insurance coverage for these procedures is rare, with exceptions in situations such as when a cancer patient's fertility is endangered by chemotherapy. Some employers do offer assistance — Meta and Apple, for instance, cover up to $20,000 for egg freezing, and since 2016, active-duty women in the US military can have the procedure covered — but everyone else is on their own.To pay for her procedure, Carney took out a $6,000 loan. Her insurance covered a couple of doctor visits, and her mother helped out with an extra $2,000 to $3,000 for the hormone treatments. Carney now pays $200 each month to pay off the loan, and when we last spoke, she had just paid her annual $600 fee to keep the eggs frozen. She plans to keep paying until she turns 36; if she hasn't used them by then, she'll have them destroyed to avoid paying more fees. Nine years of storage would bring her total cost to nearly $14,500, not including interest on the loan.While freezing eggs doesn't guarantee children, it's also not clear whether doing the procedure in your 20s gives you a significant advantage for a successful pregnancy. <a target="_blank" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7894970/">Most</a> <a target="_blank" href="https://link.springer.com/epdf/10.1007/s10815-020-01791-w?sharing_token=5aJMPlNNTd2Lpy55EKMYUfe4RwlQNchNByi7wbcMAY52MkJi-03fy3R8QlAUPDUXI7F-oi_YXVldV0sf3AKhF6vLMpipo1fUorXJhOToCt5qlLs07g20-OrtikK0T3uGl7gWuuwJnFR_oK_wErpuO9oyTnBD-c-caiJgQ7uj3YE%3D">studies</a> compare women in their early 30s with those in their late 30s and early 40s. In those studies, women under 35 tended to have better outcomes than those who froze their eggs at 40 or later. But that doesn't mean earlier is always better. <a target="_blank" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10342811/">Other</a> <a target="_blank" href="https://pubmed.ncbi.nlm.nih.gov/25881876/">studies</a> have found that there isn't much added benefit to freezing eggs earlier than 30. One 2015 paper looked at the optimal time to freeze eggs among women 25 to 40. It found that freezing your eggs before your 30s didn't generally improve your chances of having a live birth over trying naturally. While egg freezing has the highest chance of success when done before 35, the researchers found the age at which freezing your eggs made the most sense in terms of both viability and cost-effectiveness was 37."I generally recommend women who are considering freezing their eggs do so before the age of 35 if they can," Dr. Geeta Nargund, the medical director of the fertility center ABC IVF, told me. "If there is no medical reason to freeze your eggs in your 20s, I would advise that you would be in a better position to make an informed decision in your early 30s instead, while the chances of success of treatment remain good." There's also the chance that someone never uses their frozen eggs. In fact, very few women do — only 16% of women who froze their eggs at one London hospital between January 2016 and March 2022 came back to use them, a 2023 <a target="_blank" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10342811/">study</a> found. It's another reason earlier isn't always better: In your 20s, you still have a lot of runway. The right partner might be around the next corner, and when it comes to conceiving naturally, time is on your side. More women are having children into their late 30s, and if someone reaches that point and still doesn't see kids in their immediate future, there's still time to explore options."A 27-year-old doesn't need to feel like she's left behind or left out because she's not freezing her eggs," Gurtin said. "The reality is, most women, let alone women in their 20s, are not freezing their eggs, don't need to freeze their eggs, and don't need to think about freezing their eggs."Fertility clinics have an obvious business case for trying to convince as many people as possible that egg freezing is something they should do. In a 2020 study, Emily Tiemann, then a regulatory-policy manager at the Human Fertilisation and Embryology Authority in the UK, dug into the marketing strategies of egg-freezing companies. First, she noticed a significant lack of comprehensive information on egg-freezing sites. Second, she was struck by the language used, which seemed to target young women at a particular stage in their lives. Phrases such as "you haven't found the right partner," "you're waiting for Mr. Right," and "you want to take control of your life" were common, she told me, adding: "The kinds of messages that you wouldn't necessarily think would be on a clinical site that offers medical treatment."Since then, marketing toward younger women has amped up. <a target="_blank" href="https://www.businessinsider.com/how-fertility-startup-kindbody-began-working-with-employers-2021-6">Kindbody, a venture-backed egg-freezing company</a> that launched its first "boutique" clinic in New York City in 2018, traveled nationwide in 2020 with an Instagram-friendly van providing complimentary hormone tests to check fertility and marketing its services. Another well-known fertility studio, <a target="_blank" href="https://www.businessinsider.com/egg-freezing-nyc-trellis-fertility-studio-clinic-photos-2018-11">Trellis Health</a>, calls itself "the Equinox of egg freezing," a nod to the $385-a-month luxury gym chain popular among millennials. Several companies have partnered with social-media stars to leverage their reach. <a target="_blank" href="https://www.instagram.com/stories/highlights/17851263305348542/?hl=en">Alex Stewart</a>, an influencer who was 35 at the time, was offered a significant discount by the fertility-preservation program Ova to share her experience with her Instagram and podcast audiences. Similarly, <a target="_blank" href="https://www.instagram.com/serenakerrigan/p/C3GWOw5J7_K/">Serena Kerrigan</a>, a 28-year-old content creator, decided to freeze her eggs with Spring Fertility in New York after it approached her for a paid Instagram collaboration. Other companies have targeted women in their 20s, with <a target="_blank" href="https://laivfclinic.com/blog/benefits-of-freezing-my-eggs-in-my-20s/">blog</a> and <a target="_blank" href="https://www.tiktok.com/@freezebyco/video/7188974362983255342">social-media posts</a> that tout "having children on YOUR time" and say, "Don't feel you have to rush into a relationship this year."When Carney began exploring fertility services, she couldn't ignore the targeted ads that followed her everywhere, recalling ones featuring the popular reality-TV star Lala Kent. Carney also documented her own journey on <a target="_blank" href="https://www.tiktok.com/@brennacarney3/video/7215376131204222254">TikTok</a>.Since most women who use their eggs are in their late 30s, clinics make money on the prolonged storage times. "The earlier, the more expensive," as Tiemann put it. In 2022, <a target="_blank" href="https://www.businessinsider.com/fertility-startups-booming-despite-market-downturn-2023-6">fertility-tech startups raised $855 million</a>, according to PitchBook — a significant jump from the $306 million raised in 2017. And in fiscal year 2023, <a target="_blank" href="https://www.businessinsider.com/exclusive-kindbody-fertility-startup-raising-30-million-fertility-2024-2">Kindbody</a> grew its revenue by 50% to about $180 million.Yoojin Jang, now 32, said she regretted freezing her eggs at 30 in a video posted on her <a target="_blank" href="https://www.youtube.com/watch?v=wLZFj-Fpezg">YouTube</a> channel. The procedure affected her body, she said, causing muscle loss and fat gain. It also influenced her dating life. "Before going on a first date, I would think to myself, 'Is this guy worth the 23 hormone injections that I just had?'" she said, adding: "My standards became ridiculous." She said she wished she had waited until she was 35 and seen where she was in life. In a 2018 survey by researchers at the University of California, San Francisco, one in six women who'd had their eggs frozen reported feeling significant regret.Carney has mixed feelings about her procedure. Whether she meets someone in the next few years and gets pregnant naturally or gets a sperm donor to inseminate her eggs down the line, she can't predict the future. In that sense, she doesn't regret her decision to give herself a fighting chance at becoming a mother. But knowing everything she knows now, she wonders about her timing: "I would still do it. I would just wait a little bit longer."<a target="_blank" rel="" href="https://www.businessinsider.com/author/eve-upton-clark">Eve Upton-Clark</a> is a features writer covering culture and society.

The problem with the egg-freezing boom

Here's the essential nutrients for long and shiny nails thatyou must include in your diet​

When Josef Woodman's shoulder gave out in 2012 — strained from chopping firewood on his farm outside Chapel Hill, North Carolina — he said he was quoted between $2,400 and $3,200 for an MRI at Duke University Hospital.He didn't want to shell out the cost of a nice vacation just to find out he didn't need surgery, so he decided to wait, even as his mobility decreased to the point where he had to severely limit his farm work and could hold only one-third of the weight he normally could. Two years later, his patience was rewarded: While on a work trip to Bangkok, he got an MRI for just $460, landing an appointment two days after his consultation at a hospital."The results came back and they said, 'You don't need surgery. You've got a separated rotator cuff,'" Woodman said. The surgeon prescribed physical therapy, which he completed in the US. "The shoulder got way better," he told me. He was glad he waited.Like Woodman, millions of Americans travel abroad for medical procedures each year, saving anywhere from 40% to 90% on the services they receive. Many <a target="_blank" href="https://www.amjmed.com/article/S0002-9343(18)30620-X/fulltext">don't have health insurance</a> or don't get coverage for the procedures they seek out — dental work and cosmetic procedures like breast implants and liposuction are by far the most popular. There's also a small but growing market for people seeking thorough checkups and testing abroad. An ascendant medical-tourism industry is offering these types of screenings, including MRIs and electrocardiograms, in beautiful locations around the world and packaging them with transportation, accommodations, food, shopping, and sightseeing. And with an increasing obsession with "wellness" and celebrities like Kim Kardashian promoting full-body imaging, it's easy to see why more and more Americans are looking to pair cabanas with CAT scans."If you've got some kind of joint pain, or if you have some kind of condition that isn't progressing, incorporate that into your normal travel plans," Woodman, now 72, said. In 2007, he founded Patients Beyond Borders, a healthcare-consulting company that helps Americans plan medical vacations, after growing up taking trips to Mexico for dental work with his dad. "In any kind of industrialized nation, you'd be able to get access to good-quality screening and people who can interpret the results," he said.Medical tourism comes with risks; the American Medical Association recommends going only to medical facilities recognized by international accrediting bodies and following up testing with care at home. But a growing number of Americans are willing to take those risks, as suites of tests abroad are often cheaper and faster than just a single test in the US."We just don't have a preventative-oriented society here in the United States," Woodman said. "Our approach is reactive."In a July <a target="_blank" href="https://www.tiktok.com/@bryn.elise/video/7386406512593325355?lang=en">TikTok</a> that's amassed over 17 million views, Bryn Elise documented her experience at a Turkish hospital where she received over 30 scans and tests, including an EKG, chest X-ray, and abdominal and thyroid ultrasounds, in a single day. The bill? $830. Without insurance, the cost of an EKG alone in the US <a target="_blank" href="https://enhancehealth.com/blog/how-much-does-an-ekg-cost-at-urgent-care-without-insurance/#:~:text=The%20total%20cost%20of%20an,where%20you%20get%20the%20service.">can vary from $100 to $5,000</a>."Personally, I'd rather spend $700 on a flight to Turkey, get dozens of tests there, and take a whole vacation than spend the thousands that this would have cost in the United States," Elise said in the video, which also featured clips of her on a beach, poolside, and eating a spread of delicious-looking Turkish veggie bowls. The 29-year-old health- and beauty-tourism influencer said she booked the trip because she wanted to investigate some "mysterious ailments," including brain fog, vision problems, and heart palpitations, without paying America's sky-high healthcare costs. She told her followers she had struggled with an eating disorder for 10 years and that "since our US checkups are only a tap on the knee and a blood-pressure check, I've been low-key terrified that I've caused permanent damage to my body but would never find out until it's too late."Her tests unearthed an astigmatism, early signs of osteoporosis, and "critically low" levels of vitamin B12. "The feeling of impending doom I've had due to health concerns is gone," Elise said.She chose a hospital that had been accredited by the Joint Commission International, an Illinois-based organization that has accredited over 1,000 health facilities in more than 70 countries. Dr. Paulo Neno, an international-accreditation surveyor at the commission, told Business Insider the accreditation process takes up to two years to complete and is renewed every three years. It includes a 12-part evaluation, during which a team of doctors and nurses visit the medical facility and assess everything from its operating theaters and intensive-care units to its power and water systems."We are focused on understanding how they are providing safe care for high-risk patients," Neno said.It's unclear, though, how many medical tourists visit accredited facilities, and there's still the question of whether all these tests are useful for someone who is seemingly in good health. Woodman knew he had an issue that needed to be examined, but Elise was more interested in a holistic screening regimen. One person commented on Elise's TikTok, "The hypochondriac in me thinks this is the perfect vacation. I'd go every year."Since COVID-19 came into the picture, health screenings and extensive physicals have received some buzz. Last year, Kardashian got a full-body MRI done by Prenuvo, a US chain of diagnostic clinics that offers the service for $2,500. In an Instagram post promoting it, Kardashian described it as a "life saving machine" that could detect cancer or conditions like aneurysms in their earliest stages. Especially given the <a target="_blank" href="https://www.businessinsider.com/colon-cancer-cases-doubled-young-people-2024-5">rise in colon cancer</a> among young people — a disease that can spread with no or minimal symptoms — <a target="_blank" href="https://www.businessinsider.com/get-colonoscopy-colon-cancer-symptoms-colorectal-oncologist-2024-4">early screenings</a> are on more people's minds.But Arturo Vargas Bustamante, an associate professor of health policy and management at the University of California, Los Angeles, said these kinds of rigorous tests can often do more harm than good."You may get a lot of things that you may not need based on your age profile, or you may get screenings that ultimately would find something that could lead to treatment that may harm you," he said. US guidelines on which demographics should get tested are based on scientific evidence, he added, while clinics abroad may be more motivated by profit.If a test finds cancer at a very early stage when it's very slow-moving, Vargas Bustamante said, the patient may feel compelled to treat it immediately, subjecting themself to chemotherapy and radiation. But in reality, it's possible they could have gone years without needing to start treatment. "Sometimes knowing too much may not be that good for you," he said.Others, however, think that America's lack of access to robust preventive screening is a critical failure.Dr. Misael Uribe Ramos is the director of international medicine at Médica Sur in Mexico City, a Joint Commission International-accredited hospital that offers checkups with eight different specialists for $1,600. Uribe Ramos has seen interest in rigorous physicals boom since the outbreak of the COVID-19 pandemic — and he thinks it's a good thing.Often when you go to the doctor, it's to treat a specific issue or disease, he said. "But why is that? Because you don't have prevention," he said. "Prevention is the best way to be healthy."In America, chronic illnesses such as heart disease, diabetes, and cancer are leading causes of death and disability, driving the majority of the US's $4.5 trillion in yearly healthcare expenses, <a target="_blank" href="https://www.cdc.gov/chronic-disease/about/index.html">according to</a> the Centers for Disease Control and Prevention. These illnesses are largely preventable. The CDC also says that between 30% and 50% of cancers diagnosed today could be prevented by reducing risk factors (like not smoking and maintaining a healthy body weight) and getting recommended screenings and vaccinations. However, according to the <a target="_blank" href="https://health.gov/news/202401/prevention-still-best-medicine">US Office of Disease Prevention and Health Promotion</a>, only 5.3% of Americans 35 and older received all recommended clinical prevention services in 2020 — a number that dropped from 8.5% in 2015. Why? Simply put, many Americans aren't regular healthcare users. They often don't have a family doctor, they live too far from one, they don't have a way to get there, or they simply can't afford it, the Office of Disease Prevention and Health Promotion says. Meanwhile, preventive-care services aren't prioritized because healthcare providers are paid to treat diseases — not to prevent them by keeping people healthy. A 2020 study said the National Academy of Medicine <a target="_blank" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7309216/">estimated</a> that missed prevention opportunities cost the US $55 billion annually.Other countries take a different approach. In Japan, for instance, the most basic annual checkups include EKGs, chest X-rays, blood tests, eye and hearing tests, and stool and urine tests. And some residents require a more comprehensive version that includes cancer screening. Japanese employers are required to provide them for all of their employees. In 2019, about 74% of men and 66% of women in Japan completed some type of medical checkup, according to the country's Ministry of Health, Labour and Welfare.South Korea's regimen is similar to Japan's. On a work trip there in 2010, Woodman had extensive testing done, including an MRI and CT scan, as part of a "wellness preventative program" he tried out for work, he said. He was offered an endoscopy and colonoscopy as part of the package but declined."Testing in the United States is really kind of pathetic," Woodman said. "They weigh you. They take your blood test. 'How tall are you?' And that's pretty much it."Americans seeking better preventive screening tend to visit South Korea, Thailand, and the United Arab Emirates, while Mexico, Barbados, and Thailand are popular for genetic and fertility testing, as well as testing related to gender-affirming care, medical-tourism advocates told BI.Many of these countries have hospitals that cater to foreigners. In Mexico, Médica Sur's checkups take about five hours, with screenings across disciplines such as internal medicine, cardiology, gynecology, and ophthalmology. (In the US, a typical physical takes less than an hour.) Packages include breakfast, transportation, accommodation, menus catering to dietary restrictions, discounted sightseeing for an extra cost, and concierge staff who help patients coordinate their stay and remain by their side for the duration. The hospital is also connected to a Holiday Inn if visitors want to stay on-site.Results are available within two weeks, at which point the patient can discuss the findings with a doctor in person or remotely; a checkup three months later is also included in the price. If, for example, the screenings indicate a malignant tumor, Uribe Ramos said, doctors will explain to a patient which follow-up tests they need, either in their home country or at Médica Sur. He recommends getting a thorough exam once a year.Since opening its international-medicine wing in 2019, the hospital has seen 5,000 foreign patients, most of them American and Canadian, Uribe Ramos said.Imani Bashir was living in Cancún three years ago when she felt what she thought was a lump in her breast. At the time she was 34 — <a target="_blank" href="https://www.cancer.org/cancer/screening/screening-recommendations-by-age.html#:~:text=Women%20ages%2040%20to%2044,should%20get%20mammograms%20every%20year.">young</a> to be receiving a mammogram — but her family had a history of the disease, so she booked an appointment anyway. In the US, the median <a target="_blank" href="https://ascopubs.org/doi/10.1200/JCO.2023.41.16_suppl.e18917">cost</a> of a mammogram ranges from $140 to $360 for women who aren't insured. In Mexico, it was under $50. As a Black woman who grew up in the US without health insurance, the 37-year-old communications director found the experience especially validating."When we go to the doctor and say that we're in pain, it's kind of just shooed away, like it's not a big deal," Bashir said. In Mexico, the medical center didn't question her. Now that she's living in Washington, DC, she continues to travel to Mexico for both her and her son's dental appointments and other medical issues because it's cheaper and easier to get appointments. "It always feels good when you feel like you can take care of yourself, and financially, it's not going to be a detriment to your life and your health," she says.Given how many people experience difficulty navigating the American healthcare system, it's no surprise that the medical-tourism market is growing rapidly. Patients Beyond Borders estimates the industry is growing between 15% and 25% each year. And 2022 <a target="_blank" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9104082/#:~:text=The%20increase%20in%20medical%20tourism,other%20time%20in%20the%20past.">research</a> found that the increase in international tourism had helped fuel the trend. As <a target="_blank" href="https://www.businessinsider.com/travel-agents-back-gen-z-millennials-vacation-planning-overseas-resorts-2024-6">more people spend time abroad</a>, it becomes easier to tack a few small medical tests onto your trip.Vargas Bustamante thinks traveling internationally for rigorous testing probably most benefits healthy people who just want "peace of mind." Despite the risk factors, the industry's growing appeal illustrates the limitations of American healthcare."Why would someone have to buy a plane ticket to go all the way on the other side of the world just for an adequate amount of healthcare? It's nuts," Bashir said. "But if people have the privilege, if people have the money to be able to do so, then I say, yeah."<a target="_blank" class="" href="https://www.businessinsider.com/author/manisha-krishnan">Manisha Krishnan</a> is an Emmy award-winning journalist who covers healthcare. She is based in Brooklyn.

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