Should you try a full-body MRI?

Plus: Why it's hard for disabled Americans to marry

View this email online June 23, 2024 by Andrea Muraskin This week: A primary care doctor wants to tone down the hype around full-body MRI scans and refocus on routine screenings. And: Thanks to improvements in medicine and legal protections, there’s been a revolution in the expectations for disabled people’s lives in the past 50 years. But rules for disability benefits have not kept up, and couples who get married risk losing health care and income. Plus: An author corrects harmful myths about women runners. Couples say they can't get married because of this government program's outdated rules Narayan Mahon for NPR Amber Weise, who was born with spinal muscular atrophy and requires assistance from aides and nurses throughout the day, felt it was important to marry her partner Devin because of their strong Christian faith. When he got a small pay boost at his job cleaning hospital rooms, they exceeded the asset limit set by the federal government, and Amber lost access to the Medicaid that paid for her care. “We’re being penalized for just trying to live,” Devin says.  Americans with severe disabilities are often stuck between a rock and a hard place financially. To get the expensive care they need, many rely on Supplemental Security Income. The federal program sets an asset limit on people getting SSI – if you have too much money, you lose the benefit. The current cut-off for an individual was set in 1989, and is $2,000, aside from a home and a car.  One way people can lose SSI benefits is by getting married, as NPR’s Joseph Shapiro reports. That’s because the savings and asset limit for a married couple is just $3,000. NPR interviewed dozens of people who rely on SSI but, as a result, say they are stuck because of the program’s treatment of those who marry.  Gabriella Garbero, a St. Louis lawyer who would like to marry her long-time partner, says the marriage penalty sends a message that disabled people are “just mooching off of government … just an expense, not a population that has dreams and hopes and wants and needs, just like everybody else.”  Learn more, including about efforts in Congress to raise the asset limit and end the marriage penalty for people with disabilities.  Plus: These disabled people tried to play by the rules. It cost them their federal benefits Abby Oullette for NPR Need help getting ZZZZs? Sign up for Life Kit’s Guide to Better Sleep I recently saw an Instagram reel titled something like “Bedtime when you're over 40.” In it, a woman in a purple nightgown and matching bonnet practically bounds up the steps of her home, her fists clenched in anticipation. When she reaches her bed, she fluffs her pillow lovingly and curls up blissfully, like a character in an old Bugs Bunny cartoon.  I agree with the sentiment. Going to sleep is pretty exciting at my age. Not only do I look forward to vivid dreams, but getting enough sleep improves memory and brain performance, enhances physical health and makes us more attentive to the people around us. Who doesn't want a better shot at being your best self? But unlike the ebullient woman in that Instagram video, evidence suggests that for most people, it’s better to wind down than rev up for a restful night’s sleep. I have my own bedtime rituals, including putting a heating pad on my belly, and sometimes watching an ASMR video to relax. And I always use an actual alarm clock and turn off my phone before turning in. What are your rituals – or sleep challenges? Many of us could use help sleeping better, deeper and longer. So what does it take to sleep better, deeper and longer -- at any age? Over the past two months, NPR Life Kit producer Claire Marie Schneider has been gathering insight from researchers, physicians and psychologists. They share specific and actionable ideas to help improve the quality of our rest. To receive these tips and strategies, sign up for Life Kit's Guide to Better Sleep. Over the course of a week, you’ll receive three emails on the following topics.  Bedtime routines to help your brain unwind. In this email, we’ll share wind-down activities to help you release your day and prepare you for sleep. We’ll cover how to create a to-do list that won’t stress you out, explain the importance of light and temperature at bedtime and how to calculate your “sleep opportunity” window. How your lifestyle can affect sleep. This newsletter will cover diet, exercise and substances like alcohol and caffeine, which can all impact the quality of our rest. Plus, can common sleep supplements help you doze off more quickly? Setting realistic expectations about nightly screen time. Sleep experts discuss the use of electronic devices before bed. How does the light affect our sleep? What about the content we consume? They also discuss the consequences of “sleep displacement.” Sign up for Life Kit's Guide to Better Sleep now. Newsletter continues after sponsor message Opinion: Full body scans miss the mark when it comes to improving disease prevention Mindful Media/Getty Images/E+ Wouldn’t you like to lie down inside of a machine that could give you a holistic picture of your health, and detect cancers and other conditions anywhere in your body with one elegant scan?  For the health conscious, the appeal of full-body MRI scans, currently available in more than a dozen cities and spreading across the country – is hard to deny. The scans commonly rely on magnetic resonance imaging (MRI), supported by artificial intelligence, to assess major organs for hidden disease.  On first blush, these scans might seem in keeping with a shift towards preventive care that could keep more Americans out of hospitals, without the inconvenience of multiple appointments with different providers. But unlike your annual checkup with your primary care provider or a cancer screening like a mammogram or colonoscopy, full-body MRI scans are not covered by health insurance, and they can cost as much as $2,500. The high price tag is just one problem with the full body MRI trend, writes Lisa Doggett, a family medicine physician at UT Health Austin. The evidence for the benefits of these MRIs is scant, she says. Instead, she wishes more people would get the proven, if unsexy, screenings that already exist. For example, nearly a quarter of women ages 50-74 are not up-to-date with their mammograms, even though breast cancer patients who find out early have a 99% survival rate. Doggett says a concerted effort to raise awareness of preventive health care could do far more to improve Americans’ health.  Full-body MRIs could also lead to unnecessary treatments. According to Dr. Richard Bruno, regent-at-large with the American College of Preventive Medicine, the availability of these screenings to those without symptoms may lead to “incidentalomas” — benign findings in otherwise healthy people. Read about full-body scans in Lisa Doggett’s op-ed. Also: More patients are losing their doctors – and their trust in the primary care system Support your local station with NPR+ NPR+ is a great new way to support mission-driven journalism while getting something great in return (aside from that warm fuzzy feeling of making a difference). Enjoy Sponsor-free listening from your favorite NPR podcasts, and even get fun bonus episodes from select shows like Fresh Air, Planet Money, Wait Wait Don't Tell Me! And more. All in return for a simple recurring donation to your local station. Get NPR+ 8 things the world got wrong about women runners David L. Ryan/Boston Globe/Getty Images Every May, Eastern Massachusetts gears up for the Boston Marathon, where tens of thousands of men and women run 26 miles from way out in the exurbs to the heart of the city. From here, it’s hard to imagine that the first woman ever to run the Boston Marathon had to do so in stealth mode.  Bobbi Gibb’s application to the 1966 marathon was rejected by the race director, who said that women weren’t “physiologically able” to run 26 miles. So Gibb donned a hoodie and a pair of loose-fitting shorts and snuck into the race, finishing ahead of ⅔ of the men that year.  That’s one of the misconceptions about women and sports that sports journalist Maggie Mertens explores in the new book, Better, Faster, Further: How Running Changed Everything We Know About Women. Running “has been used for years and years and years to define women as being lesser than men,” says Mertens, which has caused women to receive less compensation, access, health support, and recognition than their male peers in sport.  Mertens spoke with NPR contributor Maya Silver about the book in advance of the Summer Games, which kick off next month in Paris, and mark the 40th anniversary of the Olympic Women’s Marathon. Find out how women runners have overcome false beliefs about their bodies and abilities. Plus: Why Nike's new Olympic track uniform for women is stirring controversy Before you go: Chip Somodevilla/Getty Images Listen: Dr. Anthony Fauci on his memoir, On Call: A Doctor’s Journey in Public Service As they enter their 60s, Gen Xers are projected to see higher cancer rates than Boomers A prevention task force recommends intensive counseling for kids with obesity What it's like living through a 121 degree day We hope you enjoyed these stories. Find more of NPR's health journalism online. All our best, Andrea Muraskin and your NPR Health editors Listen to your local NPR station. Visit NPR.org to hear live radio from Central Florida Public Media (edit station). What do you think of today's email? We'd love to hear your thoughts, questions and feedback: health@npr.org Enjoying this newsletter? Forward to a friend! They can sign up here. Looking for more great content? Check out all of our newsletter offerings — including Goats & Soda, Up First, Life Kit and more! 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