Purdue Pharma and the Sackler family have reached a tentative $10-12 billion settlement agreement with thousands of municipal, tribal, and state governments over the company’s role in the opioid epidemic. So far, roughly half of the states currently suing Purdue Pharma in state courts have not agreed to these settlement terms. The New York Times reports that several attorneys general, representing states including Massachusetts, New York, Connecticut, Pennsylvania, Iowa, Wisconsin, and North Carolina are still “pressing the [Sackler] family to sell the company immediately and to discontinue manufacturing drugs for international markets. And regardless of what price Mundipharma fetched, the attorneys general said, they wanted the Sacklers to commit an additional $1.5 billion up front. The family refused to do so.” The Associated Press reported that Connecticut Attorney General William Tong opposed the current agreement, stating that “the scope and scale of the pain, death and destruction that Purdue and the Sacklers have caused far exceeds anything that has been offered thus far… Connecticut’s focus is on the victims and their families, and holding Purdue and the Sacklers accountable for the crisis they have caused.” At this point, it’s unclear what this settlement—if finalized—would mean for other legal cases against Purdue Pharma and the Sackler family. Reporting from USA Today raised further concerns, including the potential for Purdue Pharma to write off settlement payments. Citing a report by the report by the U.S. Public Interest Research Group Education Fund, USA Today reports that settlements “aren’t seen as a deterrent if companies can write them off on their tax returns…  And other taxpayers "must shoulder the burden of the lost revenue in the form of higher taxes for other ordinary taxpayers, cuts to public programs, or more national debt… When corporations deduct settlements for wrongdoing, the public is doubly harmed.” Altarum has previously estimated the costs of the opioid epidemic at over $1 trillion between the years 2001 and 2017, with an estimated $500 billion in additional costs before 2020. These costs include costs “borne by individuals in the form of lost wages; the private sector in lost productivity and health care costs; and federal, state and local governments in lost tax revenue and additional spending on health care, social services, education and criminal justice.”

National Public Radio reports on how rising heat in US cities affects wealthy and low-income neighborhoods unequally, with low-income neighborhoods and communities of color generally experiencing significantly higher heat indexes. “Across Baltimore, the hottest areas tend to be the poorest and that pattern is not unusual. In dozens of major U.S. cities, low-income neighborhoods are more likely to be hotter than their wealthier counterparts, according to a joint investigation by NPR and the University of Maryland's Howard Center for Investigative Journalism. Those exposed to that extra heat are often a city's most vulnerable: the poorest and, our data show, disproportionately people of color. And living day after day in an environment that's literally hotter isn't just uncomfortable, it can have dire and sometimes deadly health consequences — a fact we found reflected in Baltimore's soaring rates of emergency calls when the heat index spiked to dangerous levels… NPR analyzed 97 of the most populous U.S. cities using the median household income from U.S. Census Bureau data and thermal satellite images from NASA and the U.S. Geological Survey. In more than three-quarters of those cities, we found that where it's hotter, it also tends to be poorer.”

National Public Radio interviewed Christina Bethell, director of the Child and Adolescent Health Measurement Initiative at Johns Hopkins Bloomberg School of Public Health, on the role that positive childhood experiences can play in mitigating the health effects of adverse childhood experiences. After identifying seven types of positive relational experiences, like feeling a sense of belonging in school or having at least two nonparent adults who express care and concern, Bethell’s team found that “positive reports on any one of the seven types of positive experiences we assessed were indeed associated with lower rates of mental health problems and higher rates of having relationships as an adult where you get the social and emotional support you need. Yet, as we hypothesized, the biggest effect was when we counted up how many of these experiences were reported — just like it's done on all those other studies on adverse childhood experiences. We see that accumulation of positive experiences, just like the accumulation of adverse experiences, really packs a punch. Getting into the numbers, we found that having higher counts of those positive experiences was associated with 72% lower odds of having depression or poor mental health overall as an adult. We also found that those with higher levels of positive experiences were over 3 1/2 times more likely to have all the social and emotional support they needed as an adult.”

A new study from the UCLA Center for Health Policy Research found that students attending schools with high suspension rates reported feeling less “connected” at school—with “school connectedness” defined as “the feeling that adults at school care about students and their education. The study also found that lower levels of school connectedness were associated with lower attendance at schools, lower rates of volunteerism and more sick days. Latino teens and teens from low-income families reported lower levels of school connectedness, had lower rates of volunteerism, and were more likely to attend a school with high suspension rates.”

A new report from the Office of Inspector General at the Environmental Protection Agency finds that the EPA is failing to enforce lead abatement standards during home renovation, a major source of lead poisoning among children. "It's fairly clear that at every turn, the agency is failing," says Erik Olson, senior strategic director for health and food at the Natural Resources Defense Council, an environmental advocacy group. "It's really disappointing. It's kind of heartbreaking, to see this kind of thing."

California voters may have the opportunity to vote next year to repeal Article 34 of the state constitution, which currently requires local governments to gain voter approval for publicly funded low-income housing projects. The State Senate voted this week on the proposed constitutional amendment. If two-thirds of the State Assembly vote in favor of the amendment, it will be added to the 2020 ballot. Senator Scott Wiener described Article 34 as “a scar on the California constitution. It is a scar on the state of California… [sending] a very clear signal that we don't want economically diverse neighborhoods."

Discover Magazine makes the case for a public health approach to preventing gun violence: “The key to tackling firearm violence, Hemenway and peers say, is taking a science-driven public health approach. The method, as laid out by the CDC, is straightforward: define problems, identify risk and protective factors, develop and test prevention strategies, and assure their widespread adoption.” Earlier this week, the Washington Post reported that the Trump administration is “considering a controversial proposal to study whether mass shootings could be prevented by monitoring mentally ill people for small changes that might foretell violence.”

Earlier this month, Michigan became the first state to prohibit the sale of flavored e-cigarettes. This week, President Trump said the Food and Drug Administration  will propose banning thousands of e-cigarette flavors from the market. The FDA has had the regulatory authority to regulate or ban flavored e-cigarette cartridges since 2016. This comes as the Centers for Disease Control and Prevention reported that hundreds of people have been sickened by a mysterious vaping-related lung disease, with at least six deaths tied to vaping devices, and the FDA issued a warning letter to Juul for illegally marketing its products by making unsupported health and safety claims.

The New York Times reported that the Trump administration is considering revoking California’s legal authority to set stricter pollution standards: “California’s special right to set its own tailpipe pollution rules dates to the 1970 Clean Air Act, the landmark federal legislation designed to fight air pollution nationwide. The law granted California a waiver to set stricter rules of its own because the state already had clear air legislation in place. A revocation of the California waiver would have national significance. Thirteen other states follow California’s tighter standards, together representing roughly a third of the national auto market. Because of that, the fight over federal auto emissions rules has the potential to split the United States auto market, with some states adhering to stricter pollution standards than others. For automakers, that represents a nightmare scenario.”