Health
Daylight saving time and early school start times cost billions in lost productivity and health care expenses
Daylight saving time disrupts sleep, leading to increased heart attacks, accidents, and mental health issues. Advocating for permanent standard time and later school start times could significantly enhance public health and reduce economic costs.
Last Updated on March 8, 2025 by Rod Washington
Joanna Fong-Isariyawongse, University of Pittsburgh
Investigations into the 1986 Space Shuttle Challenger disaster revealed that key decision-makers worked on little sleep, raising concerns that fatigue impaired their judgment. Similarly, in 1989, the Exxon Valdez oil spill resulted in a massive environmental catastrophe. The official investigation revealed the third mate, in charge of steering the ship, was running on too little sleep, among other problems.
While these specific disasters were not caused by daylight saving time, they are conclusively linked to fatigue, based on postaccident investigations and reports. They underscore the well-documented dangers of sleep deprivation and fatigue-related errors. Yet a vast body of research shows that every year, the shift to daylight saving time needlessly exacerbates these risks, disrupting millions of Americans’ sleep and increasing the likelihood of accidents, health issues and fatal errors.
Imagine a world where one simple decision – keeping our clocks aligned with the natural cycle of the Sun – could save lives, prevent accidents and improve mental well-being. It’s not just about an hour of lost sleep; it’s about how small disruptions ripple through our health, our workplaces and even our children’s futures.
I’m a neurologist who specializes in sleep health. I’ve seen firsthand the negative impacts of poor sleep; it has enormous personal and economic consequences.
Yet despite overwhelming research supporting better sleep policies – such as delaying school start times to align with adolescent biology and the adoption of permanent standard time – these issues remain largely overlooked in public policy discussions.
Sleep deprivation comes with real costs
Chronic sleep deprivation does more than leave people tired. It costs an estimated US$411 billion annually in lost productivity and health care costs. Poor sleep leads to workplace mistakes, car accidents and long-term health issues that strain businesses, families and the economy as a whole.
Fortunately, there’s a fix. Smarter sleep policies – such as permanent standard time and later school start times – can boost efficiency, improve health and save lives.
Up before dawn
Teenagers are the most sleep-deprived age group in the U.S. Multiple studies and surveys show that anywhere from 71% to 84% of high school students report getting insufficient sleep.
This is largely due to early school start times, which force teens to wake up before their biological clocks are ready. If you have a teenager, you probably see it every day: The teen struggling to wake up before sunrise, rushing out the door without breakfast, then waiting in the dark for the school bus.
More than 80% of public middle and high schools in the U.S. start before 8:30 a.m., with 42% starting before 8 a.m. and 10% before 7:30 a.m. As a result, some districts have bus pickups as early as 5 a.m.
Teenagers are going through a natural shift in their circadian rhythms by about two hours. This shift, driven by hormones and biology, makes it hard for them to fall asleep before around 11 p.m. The bodies of teens aren’t wired for these schedules, yet schools and society have designed a system that forces them to function at their worst.
Declining scores, drowsy driving and depression
Sleep-deprived teens have lower grades and test scores, more car crashes caused by drowsy driving, more alcohol and drug use and higher rates of depression, anxiety suicide and aggressive behavior, including carrying weapons.
Along with the health benefits, studies have found that moving school start times to 8:30 am or later could add $8.6 billion to the economy within two years, partly by increased graduation rates.
While concerns about increased transportation costs exist, such as the need for additional buses or drivers due to staggered school start times, some districts have found that optimizing bus routes can offset expenses, making the change cost-neutral or even cost-saving. For instance, a study in Boston found that reorganizing bus schedules using advanced algorithms reduced the number of buses needed and improved efficiency, which allowed high school students to start later and better align with their natural sleep cycles. This change not only supported adolescent sleep health but also saved the district $5 million annually. https://www.youtube.com/embed/OR6il9otpqM?wmode=transparent&start=0 Studies show that daylight saving time does not reduce energy use.
More heart attacks, car wrecks and suicide
Every March, most Americans shift their clocks forward for daylight saving time. Studies show this change disrupts sleep and leads to measurable adverse outcomes, including a significant increase in heart attacks. These effects linger for days after the shift, as sleep-deprived workers struggle to adjust.
The mental health impact is also severe. Suicide rates increase in the weeks following the switch, particularly for those already vulnerable to depression.
Unlike daylight saving time, standard time follows the body’s natural circadian rhythm, which is primarily regulated by exposure to sunlight. Our internal clocks are most stable when morning light exposure occurs early in the day, signaling the body to wake up and regulate key biological functions such as hormone production, alertness and metabolism. In contrast, daylight saving time artificially extends evening light, delaying the body’s release of melatonin and making it harder to fall asleep at a biologically appropriate time.
Studies have found that adopting permanent standard time could prevent up to 5,000 suicides annually by reducing seasonal depression, decrease errors, injuries and absenteeism in the workplace and make roads safer, potentially preventing 1,300 traffic deaths each year.
Times are changing
The U.S. tried permanent daylight saving time in 1974. It was so unpopular that Congress repealed it within nine months.
Russia tried it too, in 2011, but switched back three years later. The United Kingdom dropped permanent daylight saving time in 1971 after three years, and Portugal in 1996 after four. All of these countries found that the switch caused widespread public dissatisfaction, health concerns, more morning car accidents and disrupted work schedules. No country is currently on year-round daylight saving time.
These examples provide real-world evidence that permanent DST is undesirable due to public dissatisfaction, safety concerns and negative health effects – all three countries attempted it and ultimately reversed course. Since 2022, there has been renewed debate, largely driven by former U.S. Sen. Marco Rubio’s Sunshine Protection Act, which aims to make DST permanent.
However, the name is misleading because it doesn’t “protect” sunshine but rather eliminates critical morning light, which is essential for regulating circadian rhythms. Major health organizations, along with the National Safety Council, strongly oppose permanent DST due to its well-documented risks.
There are signs that suggest the U.S. is finally waking up to these problems. Out of 13,000 school districts, 1,000 have independently adopted later school start times. California and Florida have enacted laws requiring high schools to start no earlier than 8:30 a.m. California’s mandate went into effect in 2022, and Florida’s is set to begin in 2026.
Permanent standard time and later school start times are not radical ideas. They’re practical, evidence-based solutions based on human biology. Implementing these changes nationally would require congressional action. However, current federal law already allows states to adopt permanent standard time, as Arizona and Hawaii have done, setting a precedent for the rest of the country.
Joanna Fong-Isariyawongse, Associate Professor of Neurology, University of Pittsburgh
This article is republished from The Conversation under a Creative Commons license. Read the original article.
Three new studies shared this week at the Society of NeuroInterventional Surgery (SNIS) 23rd Annual Meeting deliver a clear message: stroke care in the U.S. is improving, but those gains are not reaching everyone equally. Researchers found persistent disparities tied to race, geography, and socioeconomic status—factors that can shape whether a patient receives advanced treatment, how quickly they reach specialized care, and ultimately, whether they survive.
Stroke remains one of the nation’s leading causes of death and long-term disability. In recent years, breakthroughs in emergency response systems and minimally invasive procedures have expanded what’s possible in the critical first hours after a stroke. But the latest findings suggest that access to those life-saving advances still depends too heavily on who you are and where you live.
Study 1: Treatment gaps widen as strokes get more severe
The first study, “Racial Disparities in Endovascular Thrombectomy Widen with Stroke Severity: A National Inpatient Sample Analysis,” examined more than 325,000 acute ischemic stroke patients treated at U.S. teaching hospitals between 2018 and 2022.
The focus was endovascular thrombectomy (EVT), a minimally invasive procedure in which specialists remove a clot from a blocked artery in the brain. EVT can be a game-changer for eligible patients—but researchers found Black patients were less likely than white patients to receive it across all levels of stroke severity.
What stood out most: the disparity grew as stroke severity increased. At a National Institutes of Health Stroke Scale (NIHSS) score of 20, the predicted probability of receiving EVT was:
- 33% for white men
- 32% for white women
- 28% for Black men
- 26% for Black women
Co-first author Muhammed Amir Essibayi, MD, MSc, FRCP, noted that timely access becomes even more critical as severity rises—yet the treatment gap becomes more pronounced. The study also highlighted an intersectional pattern, with Black women consistently least likely to receive EVT.
Study 2: Hemorrhagic stroke deaths are falling—but disparities persist
The second study, “Reducing Inequalities in Stroke Events-Hemorrhagic Disparities (RISE-HD): A 10-year Statewide Analysis of Social Determinants of Mortality in Hemorrhagic Stroke,” analyzed more than 120,000 patients hospitalized with hemorrhagic stroke in Florida between 2013 and 2024.
There was good news: mortality rates declined significantly over the decade, suggesting real progress in stroke systems and hospital care.
But after adjusting for age, sex, and comorbidities, disparities remained. Black patients had higher odds of in-hospital mortality than white patients. Higher mortality was also associated with:
- Living in rural areas
- Having Medicaid or other non-commercial insurance
Researchers also found regional differences across Florida, pointing to uneven access to specialized stroke care.
Primary author Natália Vasconcellos, MD, MSc, emphasized that improving outcomes for everyone will require addressing barriers to specialized stroke systems—especially in underserved communities.
Study 3: The “Stroke Belt” has two different access problems
The third study, “Dual Pathways to Hemorrhagic Stroke Mortality Across the U.S. Stroke Belt: Rural Neurointerventional Isolation and Urban Structural Vulnerability,” looked at hemorrhagic stroke mortality across 433 counties in the “Stroke Belt,” a region long associated with higher stroke rates and worse outcomes.
Researchers compared factors linked to mortality in rural versus urban counties, including:
- Distance to the nearest Comprehensive Stroke Center
- Community-level socioeconomic disadvantage
- Racial and economic segregation
- HIV burden
They found the drivers of mortality differed sharply by setting:
- In rural counties, longer travel times to Comprehensive Stroke Centers were more strongly associated with higher mortality.
- In urban counties, racialized economic segregation and HIV burden were more strongly associated with poorer outcomes—even when specialized care was geographically closer.
Dylan Yates, a medical student at Tulane University School of Medicine, summarized the takeaway: the neurointerventional access gap in the Stroke Belt is “not one problem, it is two.” Solutions need to match the reality on the ground—strengthening transfer networks and specialty connections in rural areas, while addressing structural disadvantage and underinvestment in urban communities.
What to watch for: where the system can improve
Across all three studies, the common thread is that medical innovation alone doesn’t guarantee equitable outcomes. Researchers pointed toward targeted interventions that could help close the gap, including:
- More consistent, equitable treatment pathways for advanced stroke procedures like EVT
- Stronger stroke transfer networks to reduce delays—especially in rural regions
- Expanded access to specialty stroke care and Comprehensive Stroke Centers
- Community-level investment and structural reforms in underserved urban neighborhoods
For patients and families, these findings also reinforce the importance of recognizing stroke symptoms quickly and calling 911 immediately. Time is brain—yet the system must ensure that “time” and “access” don’t vary based on race, ZIP code, or insurance status.Source: Society of NeuroInterventional Surgery (SNIS), July
Related Links
- Society of NeuroInterventional Surgery (SNIS) — https://www.snisonline.org
- NIH: Stroke (overview, symptoms, treatment) — https://www.ninds.nih.gov/health-information/disorders/stroke
- CDC: Stroke (risk factors, prevention, data) — https://www.cdc.gov/stroke/
- American Stroke Association (ASA): Stroke resources — https://www.stroke.org/
- NIH Stroke Scale (NIHSS) basics (clinical context) — https://www.stroke.nih.gov/resources/scale.htm
- Find a certified stroke center (The Joint Commission) — https://www.qualitycheck.org/
SOURCE Society of NeuroInterventional Surgery
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Lifestyle
If You’re Feeling Stressed by Pricey Meds, Pharmacists Can Help
Stressed by Pricey Meds? If your wallet is feeling the squeeze of prescription drug costs as other living expenses like grocery and energy prices rise, you’re not alone. That’s where a powerful ally can help you manage drug costs: a health-system pharmacist.
If You’re Feeling Stressed by Pricey Meds, Pharmacists Can Help
(Feature Impact) If your wallet is feeling the squeeze of prescription drug costs as other living expenses like grocery and energy prices rise, you’re not alone.
More people are worrying about affording essential medications these days. In fact, more than 40% of adults said they skipped doses or didn’t fill prescriptions in the past year due to cost, according to a KFF Health survey.
People who take multiple drugs to manage chronic conditions often feel this pinch even more severely. They’re also more likely to make more frequent visits to their clinic or health system for care. That’s where a powerful ally can help them manage their drug costs: a health-system pharmacist.
These medication experts work side-by-side with the clinicians who prescribe drugs in health care practices – and sometimes prescribe medications themselves. Their deep knowledge can help people get the most out of the drugs they take.
“Pharmacists really know the full picture of medications, including pricing, insurance coverage, alternative therapies and potential side effects,” said Lindsey Amerine, PharmD, chief pharmacy officer for the Cleveland Clinic. “That’s why it’s helpful to not only count on your doctor to diagnose your condition and prescribe therapies, but also your pharmacist to optimize your medications.”
Get a Comprehensive Review of Your Medications
Asking the pharmacist on your health-system care team to go over your medications may reveal opportunities to save, Amerine said. Health-system pharmacists are uniquely qualified to provide this service because they keep close track of medication costs as well as approvals of new drugs and how those compare to older options.
A full review might reveal:
- Drugs once needed may not be as useful anymore. People often continue taking medications unaware that something new could offer greater benefits or their condition no longer requires the same therapy.
- Changes in your condition may mean you could safely take a lower dosage of a drug, thereby reducing costs.
- There may be less costly alternatives that would work as well such as a generic or older medication.
Get Help Exploring Discount Options
You’ve probably heard about programs that can help lower prescription costs, including discount and patient assistance programs. Pharmacists can help you understand how to navigate these programs and access potential discount programs and opportunities, Amerine said. Here’s how:
- Pharmacists can guide you through discount programs your health system offers.
- They can check your eligibility for drug maker discounts and help you understand how those discounts work with your insurance, especially if you have a high-deductible plan.
- Pharmacists can help you navigate the various prescription cost-savings programs and how they work.
- They can also help you learn about patient assistance programs that provide free or discounted medications to people who cannot afford them.
Medications are a vital part of your health care. Before you try to stretch a costly medicine or give it up altogether, talk to the medication expert on your health care team: your health-system pharmacist. For more information, visit yourpharmacist.org.
Why It Pays to Talk Meds with a Pharmacist
“My doctor prescribed it, so I must need it.” Often this is true, but not always. People sometimes take drugs longer than they need to, at doses higher than necessary or that may interact with other medications.
Just as you’d see a heart specialist about an odd pulse rate, it can help to see a pharmacist – your medication specialist – to discuss your prescriptions.
Of all health care professionals, pharmacists have the deepest knowledge of drug interactions and safety issues. They’re experts on how the effectiveness of different medications – brand name and generic – compare. They also closely track changes in prices and know when a drug’s cost has dropped or if an effective, less costly alternative is available.
Health-system pharmacists’ expertise is especially helpful for those with multiple chronic conditions who typically take several medications with more benefits, costs and side effects to balance.
Talking with a pharmacist can ensure your prescriptions are best for you and that you have access to the most affordable options.
SOURCE:
American Society of Health-System Pharmacists
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Health
Is Vaping Really Safer Than Smoking? Here’s What You Should Know
Vaping may expose users to fewer harmful chemicals than cigarettes, but it isn’t risk-free. Here’s what you should know about the health risks, side effects, and potential benefits of switching from smoking to vaping.
Over the past decade, vaping has become a common alternative to traditional cigarette smoking. While many people view e-cigarettes as a “healthier” option, the reality is more complicated. Experts generally agree that vaping exposes users to fewer harmful chemicals than burning tobacco, but that doesn’t mean it’s risk-free.
Unlike traditional cigarettes, vaping devices heat a liquid—often containing nicotine, flavorings, and other chemicals—into an aerosol that users inhale. Because there is no combustion, vaping eliminates many of the toxic substances produced by cigarette smoke, including tar and carbon monoxide. However, users are still exposed to potentially harmful chemicals and ultrafine particles that can affect the lungs and cardiovascular system.
Known Health Risks
Research has linked vaping to several potential health concerns, including:
- Nicotine addiction
- Increased heart rate and blood pressure
- Lung irritation, coughing, and wheezing
- Exposure to chemicals such as formaldehyde and heavy metals
- Possible long-term effects on heart and lung health that are still being studied
In addition, nicotine can affect brain development in adolescents and young adults, making vaping especially concerning for younger users.
Is It Better Than Smoking?
For adults who already smoke cigarettes, many public health experts believe that completely switching to regulated nicotine vaping products is likely less harmful than continuing to smoke traditional cigarettes. That’s because cigarette smoke contains thousands of chemicals, including dozens known to cause cancer.
However, vaping is not considered safe. The greatest health benefits come from quitting nicotine altogether. People who both vape and continue smoking cigarettes may see little reduction in health risks.
Common Side Effects
Some people who vape report:
- Dry mouth
- Sore throat
- Coughing
- Headaches
- Dizziness
- Nausea
- Sleep disturbances related to nicotine
The Bottom Line
If you don’t smoke, health experts recommend that you don’t start vaping. For smokers trying to quit, vaping may reduce exposure to many of the harmful chemicals found in cigarettes—but it should be viewed as a potential harm-reduction tool rather than a harmless habit.
Whether you smoke, vape, or are trying to quit, talking with your healthcare provider about evidence-based smoking cessation options can help you find the approach that’s right for you.
Your health is worth investing in—every step away from tobacco is a step toward a healthier future.
Related Links
- FDA — E-Cigarettes, Vapes and Other Electronic Nicotine Delivery Systems — Information about e-cigarettes and vaping products regulated by the U.S. Food and Drug Administration.
- Smokefree.gov — What We Know About Electronic Cigarettes — National Cancer Institute information about vaping, nicotine, potential health risks, and smoking cessation.
- American Lung Association — E-Cigarettes and Vaping — Resources covering vaping’s potential effects on lung health and nicotine addiction.
- American Lung Association — E-Cigarettes and Lung Health — A closer look at what researchers know about vaping and lung health.
- Smokefree.gov — Quit Vaping Resources — Practical information for people who want to stop vaping, including managing cravings and nicotine withdrawal.
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