Researchers found that the 2023 wildfires quietly pushed the death toll far beyond what met the eye

• Not just burns and smoke: August 2023 in Maui saw a 67 % spike in overall deaths, many not officially linked to the wildfire.

• Our homes became danger zones: 80% of excess deaths happened outside hospitals up from 68% in typical summers.

• Looking forward: Experts urge wildfire prevention grounded in Native Hawaiian ecological knowledge to avoid repeating this silent disaster.

Wildfires grab headlines for the visible flames and heartbreak, but theres often a quieter, hidden toll.

A recent Frontiers in Climate study revealed that the 2023 Lhain wildfires in Maui didnt just claim lives directly; they also spurred a dramatic rise in overall deaths across the county. And shockingly, many of these extra fatalities didnt even make the official wildfire death count.

Wildfires can cause a measurable, population-wide increase in mortality, beyond what is captured in official fatality counts, researcher Michelle Nakatsuka said in a news release. This suggests the true toll of the Lhain wildfire was even broader than previously understood.

It also points to the need for prevention strategies that go beyond reactive wildfire control. As Native Hawaiians, the co-first authors are especially hopeful that wildfire mitigation strategies will center knaka maoli perspectives, including the restoration of traditional agroecological systems.

The study

Rather than counting only confirmed fire-related fatalities, the researchers looked at a broader measure known as all-cause excess mortality thats how many more people died during the wildfire month than would normally have.

They trained a statistical model (called SARIMA) on five years of Maui County data (August 2018July 2023), excluding COVID-19-related deaths, to predict what the death count shouldve been.

Then, they compared that to the actual deaths in August 2023. To ensure the findings were solid, they ran 5,000 simulations and calculated confidence intervals, even checking what happens if COVID data stayed in the baseline for fairness.

The results

In August 2023, Maui County experienced an estimated 82 excess deaths a whopping 67% increase over expectations.

Additionally, during the peak week ending August 19, deaths surged by 367% more than triple what the model predicted. Interestingly, most of these fatalities happened outside medical facilities 80% versus 68% in prior months hinting that emergency access was severely hampered.

Although official reports noted around 100102 wildfire deaths, these excess mortality figures suggest other indirect causes like delayed treatment or smoke-related health crises played a role.

Wildfires can cause death in a variety of ways, researcher Dr. Kekoa Taparra of UCLA said in the news release.

In this case, recent reports suggest many deaths were due to direct exposure, smoke inhalation and burns. Others likely stemmed from disruptions in healthcare, like not being able to access critical medications or emergency treatment. Wildfires can also exacerbate pre-existing conditions.

Looking to the future

As events like this unfortunately become more commonplace, the researchers hope that these findings spark change for future wildfires.

In the short term, its critical for people exposed to wildfires to get immediate medical treatment, Nakatsuka said. Fast, accessible emergency care can save lives.

In the long term, wed like to see more policy investment in wildfire prevention rooted in Native Hawaiian ecological knowledge, Dr. Taparra added.

This includes restoring traditional agroecological systems, removing dry, non-native grasses, restoring traditional pre-colonial water systems, and improving fire risk modeling to better guide preparedness efforts.

Researchers look at how pushing harder on blood-pressure goals could save lives and still make sense for your wallet

• Intensive blood-pressure control (below 120 mm Hg) prevents more heart-related events than standard targets, even when real-world measurement quirks are considered.

• The study shows this aggressive approach is cost-effective with roughly $42,000 per quality-adjusted life-year gained.

• However, this approach also comes with added risks like falls or kidney issues and increases medication use and clinic visits, so its not a one-size-fits-all answer.

High blood pressure is a serious health hallmark linked to heart attacks, strokes, and heart failure.

Until recently, aiming for systolic pressure under 130 or even 140 mm Hg has been standard. However, new research from Mass General Brigham suggests that aiming lower below 120 mm Hg is not only more protective but also a smart investment in your health.

Our findings suggest the intensive said in a news release.

The study

The researchers used a simulation model combining data from trusted sources like the SPRINT clinical trial and nationwide surveys, plus other published findings. They looked at three blood-pressure targets: under 140, under 130, and under 120 mm Hg.

Their model also accounted for the fact that in everyday clinical settings, blood-pressure readings arent always perfect they included typical measurement error.

The simulation estimated long-term health outcomes, such as heart attacks, strokes, and heart failure, and balanced those against adverse events from treatment (like falls, kidney damage, low blood pressure, and slow heart rate), plus the added costs of more medications and clinic visits.

The results

Even with real-world blips in measurement, targeting under 120 mm Hg prevented more cardiovascular events than the 130 mm Hg goal.

Additionally, when researchers crunched the numbers, the cost per quality-adjusted life-year was about $42,000. In the U.S. health care world, thats seen as cost-effective.

This study should give patients at high cardiovascular risk and their clinicians more confidence in pursuing an intensive blood pressure goal, Dr. Smith said in the news release.

While these findings are positive, the researchers also found that these lower blood pressure targets led to an increased health care spending due to more frequent doctors visits, as well as a higher risk of adverse events related to blood pressure treatment, such as falls, kidney injury, hypotension, and bradycardia.

Finding the right candidates

The researchers explain that its up to doctors to determine which patients are ideal candidates for these stricter blood pressure regulations.

Our results examine the cost-effectiveness of intensive treatment at the population level, Dr. Smith said. However, given the additional risk of adverse events related to antihypertensives, intensive treatment will not be optimal for all patients. Patients and clinicians should work together to determine the appropriate medication intensity based on patient preferences.

Crashes involving Autopilot may have been reported late or bundled with other reports

• NHTSA investigating whether Tesla delayed reporting crashes involving Autopilot and Full Self-Driving.

• Probe marks first Tesla safety investigation since Donald Trumps return to the White House.

• Investors had expected Trump era to ease scrutiny, but tensions with Elon Musk may change that.

Federal safety regulators have opened a new investigation into Tesla over whether the company failed to promptly report crashes involving its driver-assistance technology.

In a federal filing released Wednesday, the National Highway Traffic Safety Administration (NHTSA) said Tesla may have violated reporting requirements that mandate automakers disclose crash data within days of an incident. Regulators found numerous incident reports in which Tesla submitted information months late, often in bulk filings rather than on a rolling basis.

The inquiry zeroes in on Teslas Autopilot system and its so-called Full Self Driving technology, which are designed to assist motorists but still require an attentive driver behind the wheel. While NHTSA has launched multiple safety probes into Tesla vehicles in recent years, this marks the first such action since President Trump returned to office.

Political context

The timing underscores the shifting political context surrounding Teslas autonomous driving ambitions. Musk, once a close Trump ally and major donor, has since fallen out with the president. Investors had expected Trumps administration to curtail or even end federal safety investigations into Tesla, potentially accelerating Musks self-driving push. Instead, the new probe signals heightened scrutiny.

Tesla told regulators it has since corrected problems with its reporting system, but NHTSA said it will audit the companys data to confirm. Weve heard from industry partners that crash reporting requirements for automated vehicles is way too expensive, Transportation Secretary Sean Duffy said earlier this year. But these reports help DOT monitor road safety. So to balance these concerns, weve streamlined the process.

The investigation comes just weeks after a jury found Tesla liable in a fatal 2019 Autopilot crash, ordering the company to pay $329 million in damages. Tesla has vowed to appeal.

A slight decline in mortgage rates seems to have made a big difference

By Mark Huffman of ConsumerAffairs

• Existing-home sales rose 2.0% in July, reaching an annual rate of 4.01 million.

• Inventory hit its highest level since May 2020, giving buyers more options.

• Home prices showed near-zero growth, with many regions seeing price reductions.
  

Buyers returned to the housing market in July as mortgage rates drifted lower. Existing-home sales rose 2.0% to a seasonally adjusted annual rate of 4.01 million, according to the National Association of Realtors.

The rebound comes as wage growth outpaces home price gains, making ownership slightly more affordable and boosting buyer confidence.

Wage growth is now comfortably outpacing home price growth, and buyers have more choices, said Lawrence Yun, NARs chief economist. Condominium sales increased in the South region, where prices had been falling for the past year.

Regional trends

Sales momentum varied across the country. The Northeast posted the strongest monthly gain, up 8.7%, followed by the South, up 2.2%, and the West, up 1.4%. The Midwest slipped 1.1% compared with June. Year-over-year, sales improved in the South, Northeast, and Midwest, but fell in the West.

Median prices painted a mixed picture. Nationally, the typical existing home sold for $422,400, virtually unchanged from a year earlier. Regional disparities stood out: prices rose in the Northeast (0.8%) and Midwest (3.9%), but fell in the South (0.6%) and West (1.4%).

Inventory at a four-year high

Inventory climbed to 1.55 million units in July, a 15.7% increase from a year earlier and the highest level since the early months of the COVID-19 pandemic. That equates to a 4.6-month supply of homes, slightly below June but above July 2024.

Homebuyers are in the best position in more than five years to find the right home and negotiate for a better price, Yun said. The ever-so-slight improvement in affordability is inching up home sales.

Despite sluggish price growth, homeowners remain in solid financial shape. NAR reported that only 2% of transactions were foreclosures or short sales, a near-record low. Since July 2019, typical homeowners have gained 49% in home price appreciation.

Single-family sales rose 2.0% in July, while condo and co-op transactions gained 2.8% on the month. However, condo sales remain down 2.6% compared to last year, with prices slipping 1.2%.

Overall, NAR said the housing market appears to be shifting in favor of buyers, with more inventory and easing price pressures creating opportunities not seen since before the pandemic.