When it comes to stroke care, experts say, "time is brain." Now, a program launching in South Dakota will coordinate and strengthen stroke care across the state.

Nearly 400 South Dakotans died due to stroke in 2022. A new program from the American Heart Association of South Dakota, "Mission: Lifeline Stroke Initiative," aims to integrate all components of stroke care into a smooth system serving all patients quickly and effectively, whether they live in a city or a rural area.

Michele Bolles, national executive vice president of quality outcomes research and analytics for the American Heart Association, said it starts with early stroke identification.

"Generally, it's an acronym, FAST," Bolles outlined. "You look at someone's face, their arms may droop, their speech may be slurred, and ultimately the T stands for time. So, time is of the essence."

The initiative will also refresh emergency medical service providers on signs of stroke to kick-start the correct chain reaction for care, including assembling a hospital's stroke team and connecting patients with high-quality post-acute care. The Lifeline Stroke program has already rolled out in neighboring states including North Dakota, Montana, Nebraska and Iowa.

More than 90% of stroke patients live with a form of disability following their initial stroke, according to the American Heart Association.

Walter Panzirer, trustee of the Helmsley Charitable Trust, which provided a grant for the initiative, said patients will need different types of post-acute care, like physical therapy or speech pathology. The new program will provide certification for certain facilities.

"It's basically a gold seal of approval," Panzirer noted. "They can guarantee that every facility that meets it has the same standards."

Panzirer added while some people may have high-quality care nearby, others may need to travel.

Groups that advocate for clean water are applauding the Environmental Protection Agency's new rule on replacing lead pipes - but they warn that the drinking water in Wyoming schools remains at risk.

The agency has set a 10-year deadline for most utilities to replace lead service lines, but omitted requirements for schools to replace the water fountains or plumbing that have lead components.

John Rumpler, clean-water director for the Environment America Research and Policy Center, said it's up to school superintendents and legislators to ensure students' water is safe.

"This final rule now dispels the illusion that the federal government is going to come and do the clean-water homework for the state," he said.

The Wyoming Department of Environmental Quality in 2021 offered a voluntary program, funded by the EPA, to test drinking water in state schools and child-care facilities. According to results published in February, of more than 250 tests, a dozen led to the start of remediation projects. Only three were completed.

Several decades after the dangers of lead pipes were established, more than nine million remain in use. The toxic metal is particularly dangerous for children and can lead to brain or nervous-system damage, delayed development and behavioral problems.

Rumpler said the EPA missed an opportunity to better protect students, although a growing number of states and cities are now requiring lead filtration systems.

"If you're a school district," he said, "consider doing what Philadelphia, San Diego, Detroit, Milwaukee and so many other school districts are doing voluntarily to get the lead out and ensure safe drinking water for kids."

To help rural towns and cities comply with the new rule, the EPA is making an additional $3 billion available through the Bipartisan Infrastructure Law. The measure initially provided $15 billion to help cities replace their lead pipes, but government officials estimate the total cost will be several times higher.


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Clean water advocates in Maine are applauding the Environmental Protection Agency's new rule on lead pipe removals but warned drinking water in schools remains at risk.

The EPA set a 10-year deadline for most utilities to replace lead service lines but omitted requirements for schools to replace any fountains or plumbing with lead components.

John Rumpler, clean water director for the Environment America Research and Policy Center, said it is up to school superintendents and legislators to ensure students' water is safe.

"This final rule now dispels the illusion that the federal government is going to come and do the clean water homework for the state of Maine," Rumpler pointed out.

Rumpler argued Maine should follow Michigan's lead in requiring all schools to install filters certified to remove lead on all taps used for drinking or cooking. A recent report gave Maine a grade of "D" for its efforts to reduce exposure to lead in K-12 schools.

Several decades after the dangers of lead pipes were established, more than nine million pipes remain in use. The toxic metal is particularly dangerous for children and can lead to brain or nervous system damage, delayed development and behavioral problems. Rumpler added the EPA missed an opportunity to better protect students but a growing number of states and cities are requiring lead filtration systems themselves.

"If you're a school district, consider doing what Philadelphia, San Diego, Detroit, Milwaukee and so many other school districts are doing voluntarily to get the lead out and ensure safe drinking water for kids," Rumpler urged.

To help rural towns and cities comply with the new rule, the EPA is making an additional $3 billion available through the Bipartisan Infrastructure Law. The measure initially provided $15 billion to help cities replace their lead pipes, but government officials estimate the total cost will be several times higher.


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Two specific types of cancer are showing up in high numbers among people in jail and prison and Illinois is no exception.

A new study found a lack of resources for on-site treatment is one reason for the high rates. The data showed diagnoses and mortality numbers for liver and lung cancer are more prevalent among county jails and state prisons.

Dr. Jingxuan Zhao, senior scientist for the American Cancer Society and lead author of the study, said individuals may need to be transferred to outside facilities to receive cancer treatment, which is often denied or delayed, and people with cancer and those behind bars share some characteristics or risk factors.

"For example, some of the risk factors for developing liver cancer included hepatitis B and C," Zhao pointed out. "As we know that for lung cancer, smoking is a huge risk factor and those factors are also very common among people who are currently incarcerated or with incarceration history."

She added studies have shown people who have been incarcerated are actually more likely to receive breast and colorectal cancer screenings, compared to their counterparts. The Prison Policy Initiative estimates about 28,000 people are in Illinois state prisons, with another 17,000 in local jails.

The study examined the association of county jail and state prison incarceration rates and cancer mortality rates in the U.S., using data taken from nearly 3,100 counties and every state. Zhao noted researching incarceration and cancer care comes with some built-in challenges.

"There are several reasons, such as privacy and ethical concerns, also legal protection of incarceration data, and more importantly, the decentralization of the U.S. correctional system," Zhao outlined. "There are some ongoing efforts to link state cancer registry data and the state correctional facility data, but that's only among some single states."

Zhao added there is no multistate linkage for data, which is an important part for their research. The study stated the U.S. has one of the highest incarceration rates in the world. In one recent year, there were 350 people in prison and another 192 in jail per 100,000 population.


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