 Welcome to Learning English, a daily 30-minute program from the Voice of America. I'm Ashley Thompson. And I'm Dan Novak. This program is designed for English learners, so we speak a little slower, and we use words and phrases, especially written for people learning English. Coming up on the program, Faith, Perlo, and I have a story on why rural hospitals in the U.S. are closing maternity centers. Brian Lin has the science report on a new drug that could prevent bone loss in astronauts in space. Later, Jill Robbins and Andrew Smith present the English lesson of the day. Alicia Alderson is a 45-year-old woman from rural Eastern Oregon. In August, she was pregnant and just a few weeks from having her baby. But that month, the only hospital maternity center near to her closed. She decided to stay with her brother in the city of Boise, Idaho, to be close to a hospital. In the United States, many rural hospitals have been closing maternity centers. This center's are areas of the hospital used only for mothers to give birth to their babies. Fewer than half of rural hospitals are now believed to have maternity units. That means pregnant women might have to travel long distances to have their babies under hospital supervision in specialized centers. The Associated Press, AP, reports that birth centers are now increasing in the U.S. A midwife is a person who is trained to help women give birth, but who is not a doctor. The centers, however, still need a hospital nearby in case of serious problems. More than 2 million women of childbearing age live in places that some observers call maternity care deserts. These are mainly rural areas that do not have hospitals with specialized maternity centers or obstetricians. An obstetrician is a doctor who specializes in the health of pregnant women. Some doctors and researchers say that having fewer maternity units makes having babies less safe. A 2019 study of information from 2007 to 2015 said that rural residents have a 9% greater chance of facing life-threatening problems or death from pregnancy and birth compared with urban residents. Dr. Eric Scott Palmer specializes in helping babies born early and newborns with high-risk complications. He used to serve as a doctor at Henry County Medical Center in rural Tennessee before the hospital ended obstetric care in September 2023. He said moms have complications everywhere, babies have complications everywhere. Heiyin Hung is with the University of South Carolina's Rural and Minority Health Research Center. She said that there are several reasons why maternity units are closing. Hung said there has been a decrease in the number of births in the United States. There are few workers in hospitals. And there are other reasons. For example, health care providers say government health insurance for the poor, called Medicaid, does not pay them enough for their services. The chief of Henry County Medical Center in Paris, Tennessee, John Tucker, said that closing the obstetrics or OB unit of the hospital was necessary to save the hospital itself. Tucker said that 70% of the births there were covered by Medicaid. That number is above the national average of 42%. Tennessee's Medicaid program only pays the hospital $1,700 for each baby born. Private insurance usually pays more. In the state of Oregon in 2021, the median payment to hospitals for a caesarean section, or C-section, was $16,000. That is five times more than what Medicaid would provide for the same operation. Tucker also said there were problems with having the right number of workers. He said when there are fewer births, hospitals lose money because their costs are fixed. Whether we've got one baby on the floor or three, we still staff at the same level because you have to be prepared for whatever comes in. Karina Fitch is a midwife at the Farm Midwifery Center in Somertown, Tennessee. It is an independent center where pregnant women can receive maternity care. Fitch measures women's stomachs, takes their blood, listens to fetal heartbeats, and gives nutritional information. These kinds of centers could be an answer to the lack of maternity care choices in rural areas. Many states are now taking steps to support more independent birth centers. In Connecticut, Governor Ned Lamont signed a law that will license these centers, letting them provide care for low-risk pregnancies. A 2020 report from the National Academies of Sciences, Engineering, and Medicine said there is a lack of data about independent birth centers. It said researchers do not fully understand the relationship between birth settings and maternal death or complications. That is partly because there are a small number of births at independent centers. The Farm Midwifery Center reported that fewer than 2% of women decided to get a C-section. 5% of patients were transported to hospitals in the center's first 40 years. Usually, women give birth at the center or at their homes. Some doctors told the AP that rural hospitals still need to be parts of any answer. They think that state governments need to do more. This June in Oregon, Baker City Hospital announced that it was going to close its maternity center. Oregon politicians got involved. They suggested temporarily using obstetric nurses from the U.S. Public Health Service Commissioned Corps. The Corps is a group of military health care workers within the U.S. Department of Health and Human Services. The group usually helps with natural disasters and disease outbreaks. However, that did not happen. The Public Health Service sent officials who advised establishing an independent birth center, among other things. Alicia Alderson, the woman who had to go to Idaho for pregnancy care, is married to Shane Alderson. He said that rural communities should not have limited health care because of their size or because of the number of people on Medicaid. Alderson said, that's not equitable. People can't survive like that. I'm Dan Nowak. And I'm Faith Perlow. Researchers say a new drug compound has been found to prevent bone loss in humans visiting space. The drug was tested on mice on the International Space Station, ISS. A new study reports the compound was engineered to help increase the formation of new bone material. The American Space Agency, NASA, has long studied the effects of space travel on human health. Astronauts who have spent long periods in space have taken part in major studies that looked at their health before, during, and after their trips or missions. NASA announced that American astronaut Frank Rubio recently set the agency's record for the longest single space flight by a U.S. astronaut. Rubio, who is set to return to Earth on September 27, has spent 371 days in space. NASA astronaut Mark Van De Huy set the earlier record in March of 2022 after living in space for 355 days. Some of the main health problems for humans are related to the gravitational conditions in space. Past studies have shown the low-gravity environments in space can greatly reduce or stop the formation of new bone material. NASA has estimated that astronauts spending more than six months in space can lose between 6 and 10 percent of bone matter. Some experiments in astronauts measured changes in their upper leg. Development of new bone can take at least three or four years after astronauts return to Earth, NASA says. The conditions astronauts experience in space can result in bone loss up to 10 times more than is seen in human patients dealing with the bone loss disease osteoporosis. NASA notes. Currently, physical exercise is the main method astronauts use to reduce bone loss during long periods in space. Generally, crew members aboard the ISS spend about 2.5 hours each day exercising in an effort to reduce the gravitational effects of space. Past research on the subject has suggested a group of drugs widely used to treat osteoporosis called bisphosphonates have shown promise in Earth-based experiments on bone loss. That research continues. But the new study shows success combining a bisphosphonate with another substance that has shown promise in helping to regrow bone material. That substance is called NEL-1. It was discovered by scientist Kong Ting at the Massachusetts-based Forsyth Institute. The study was led by a team from the University of California, Los Angeles, UCLA. In a statement, the research team said the resulting compound, a molecule called BPNELPEG, was given to mice aboard the ISS to test its effectiveness. The experiments were carried out by astronauts who arrived on the ISS in June 2017. Half the mice remained on the ISS for nine weeks, while the rest were flown back to Earth four and a half weeks after launch. Both sets of mice were given either BPNELPEG or a salt solution containing no medicine. The researchers reported both sets of mice who were given the BPNELPEG compound showed a significant increase in bone formation during the experiment period. The team added that neither the mice treated on Earth, nor those that received the drug in space, experienced any observable side effects. Chia Su is with UCLA's School of Medicine and helped lead the research. She said the findings hold great promise for, in her words, the future of space exploration, particularly for missions involving extended stays in microgravity. Another member of the team was former UCLA engineering professor Benjamin Wu. He noted that the study could open the door to the same compound being used to treat patients with extreme osteoporosis and other bone-related conditions on Earth. The scientists are still examining data on the live mice who returned to Earth halfway through the experiment. Chia Su said they hope the data will provide some insight on how to help future astronauts recover from longer space missions. I'm Brian Lin. Brian Lin joins me now to talk more about his science report. Thanks for being here, Brian. Of course, Dan. Thanks for having me. This week, your report dealt with a drug compound showing promise in blocking bone loss in astronauts spending long periods of time in space. This does seem important because it is the first time this kind of treatment has been considered for astronauts experiencing this problem, right? Yes, that's right. Currently, NASA mainly requires its astronauts to do a lot of exercise during long stays aboard the International Space Station in total about 15 hours a week. And while this can help slow bone loss in space, the new drug treatment has shown evidence it can actually help regrow bone material. So far, this drug compound has only been tested in mice, both on the space station and on Earth, but researchers are hopeful to try it on humans as well. Because this treatment is designed for long term space travelers, it could be even more important for future astronauts taking part in even longer missions, right? Yes, that's correct. In the report, we mentioned a NASA astronaut currently on the space station, Frank Rubio, just broke the record for a single space flight by spending more than a year there. But NASA has also made clear it plans much longer exploration missions in coming years not just to the space station, but to the moon and possibly Mars. And those would likely involve a lot more astronauts being sent regularly to space. It's always interesting talking to you, Brian. Thanks for being here. You're welcome. Thank you, Dan. My name is Anna Matteo. And my name is Jill Robbins. And I'm Andrew Smith. You're listening to Lesson of the Day on the Learning English Podcast. Welcome to the part of the show where we help you do more with our series, Let's Learn English. The series shows Anna Matteo in her work and life in Washington, D.C. In a recent Lesson of the Day on the Learning English Podcast, Jill and I talked about people watching. It's something Anna enjoys doing on her lunch break at work. Here's Anna in Lesson 15 of the series. Hello, people from all over the world come to Washington, D.C. When I'm at work, I love eating lunch outside. I like to watch people walking by. They all look very different. Today, my friend Ashley is eating lunch with me. Ashley, today the weather is beautiful, isn't it? Yes, it is. Oh, we have to return to work. No, we have time. Let's people watch a little more. OK. Anna enjoys noticing the differences and similarities between the people she sees walk by. Her friend Kiana likes to watch people too and joins her. The weather is beautiful and people watching is fun. I love people watching too. Well, have a seat. It is fun to see how people are different or the same. It is. For example, Anna, you are tall, but Ashley and I are short. And Kiana, you and Ashley have brown eyes. I have blue eyes. You two have black skin and I have dark skin. Ashley, you have straight hair. Kiana and I have curly hair. You have very curly hair, Anna. These differences between people are easy to see. We can say that the differences are obvious, which means easy to see or understand. But other differences are more subtle. That's spelled S-U-B-T-L-E. But we do not pronounce the letter B in the word. Subtle describes something that is not immediately obvious or easy to notice. As we were saying in a previous podcast, if you know a culture really well, then you might be able to notice subtle differences within that culture. Like an American might be able to make a better guess about where a person is from in the US or about their socioeconomic status based on the person's clothes or accent or maybe some other small details than a person who is not from the US. True, the American might notice more small differences, but we still have to be careful not to judge other people too quickly. For example, a rich person and a poor person might wear almost the same kind of informal clothes like a jeans and a t-shirt. Yep, that's right. I remember when I was working in a store, our manager reminded us that you can never be sure which customers have a lot of money. A millionaire can look just the same as somebody who has almost no money. You're listening to Lesson of the Day on the Learning English Podcast. Andrew, I noticed you're using some more advanced vocabulary today. Let's explain the term socioeconomic. It generally refers to the combination of the amount of money you make, your education, and certain kinds of power you have. So, if you have a lot of education plus a high income plus a high position in business or government, your socioeconomic status is high. Status can refer to the importance and respect you have in your group or in society, such as your level within a hierarchy. That's another advanced but useful word, hierarchy. That's spelled H-I-E-R-A-R-C-H-Y. A hierarchy is a system of organizing people into different levels of importance or power. The military is probably the best example. There is a clear hierarchy from the generals at the top to the ordinary soldiers at the bottom with different levels of officers in between. Let's review the vocabulary we've explained. The words are obvious, subtle, socioeconomic, and hierarchy. Obvious and subtle have opposite meanings. And socioeconomic status can refer to one's position in the hierarchy of a society. Jill, a minute ago you said that we have to be careful not to judge other people too quickly. I certainly agree. And that reminds me of another word we started to talk about in a previous Learning English podcast. You mean the word stereotype? I do. Did you explain a bit about this word? Sure. A stereotype is a kind of oversimplified generalization about a group of people based on a fixed image or idea about that group. And when you say fixed, you mean unchanging. Yes, stereotypes don't allow for much change. They assume that a group of people always have the same characteristics. And that's just one way they oversimplify or overgeneralize. So for example, if I said something like, Italians love to eat pasta, listen to opera, and watch soccer, that would be an obvious example of stereotyping. Right. Because while it's true that a lot of Italians do like soccer or eat pasta, there's probably millions of people in Italy who do not like to eat pasta or watch soccer. Just like a lot of Americans do not like to eat hamburgers and hot dogs. After all, there are about 300 million people in the U.S. With that many people and people coming from all over the world to live in the U.S., there's quite a bit of cultural variety. And this topic reminds me there's an interesting talk our listeners can watch and listen to online by the writer Chimamanda Ngozi Adichie. It's called The Danger of a Single Story. Adichie grew up in Nigeria, and she talks about how people in Western countries can have stereotypes about people from Africa, and how she herself sometimes oversimplified other groups of people. So if we only have a single story or a stereotype about other people, that means we are missing the complexity of individuals and the diversity within their culture. Jill, where can people find Adichie's talk online? The website is ted.com, and that's spelled T-E-D. There are a lot of talks there, and they're often called TED talks. You can search for The Danger of a Single Story on the website, and you can also read a transcript of what she says. I've just found it on my computer. Wow! It says her talk has been viewed over 34 million times. Well, I thought it was interesting, and I guess a lot of other people do too. Well, Jill, we've gone from Anna, people watching at her lunch break, to an inspiring talk by a writer from Nigeria. It's interesting how one thing leads to another. And how one word can lead to another. Let's repeat a few key vocabulary words from today's podcast. Good idea. I'll say one, then you say one. Okay. Obvious. Subtle. Socioeconomic. Status. Hierarchy. Stereotype. Fixed. And how about inspiring? You said Aditya's talk on ted.com was inspiring. That's right. I did. And inspiring means it gives you a strong, positive feeling, and perhaps makes you want to do something good. And we certainly hope our listeners are inspired to learn more with the series Let's Learn English, and with the lesson of the day on the Learning English podcast. Thanks for listening. I'm Jill Robbins. And I'm Andrew Smith. And that's our program for today. Join us again tomorrow to keep learning English through stories from around the world. I'm Ashley Thompson. And I'm Dan Novak.