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What the Future of Health Looks Like for Apple
What the Future of Health Looks Like for Apple
Apple's Health app keeps evolving, with aspirations to be a complete combination personal data archive, medical liaison and insight engine. But the goals, while ambitious, aren't fully realized yet. iOS 16 and WatchOS 9 are adding medication management and multistage sleep tracking to a growing list of features. But what comes next, and will it start to become a tool that interfaces with doctors even more than it has?
Apple just published a multipage health report (PDF), which aims to detail where the company sees its health focus heading on the iPhone and the Apple Watch. The report covers the app, research studies and initiatives with medical organizations.
As Google prepares to release a Pixel Watch that will connect to Fitbit's features and services, Apple looks to be strengthening its position by expanding beyond the watch to a larger spectrum of health services. Already, Apple Health and Fitness Plus are evolving into services you don't need an Apple Watch to use.
When will Health start to become an extension of how I connect with my own doctors? Will sleep tracking offer a doorway to other health insights? And why doesn't Apple have its own equivalent of the "readiness score" used by Fitbit and Oura?
Apple's vice president of health, Dr. Sumbul Desai, spoke with CNET about the goals of Apple Health and where goals are being set next. She sees the blend of lifestyle with clinical data, medication data and an increasing number of metrics in one place as helping future insights in other health measurements over time.
"You have to do it in a really thoughtful and meaningful way," Desai said. "Because there are also correlations you can make that are incorrect. That's where the work is, making sure that when you make those connections that they are correct, grounded in the science and make sense to the user."
Medication tracking on iOS 16 looks like another step to bring medical histories onto Health.
Apple
Where does Apple Health meet your doctor?
As I've found over the last few months, over several surgeries and doctor visits, my own medical care doesn't often connect with my wearable and phone apps. Apple's been aiming to make strides to connect Apple Health with medical providers, but the framework isn't fully there yet for digital health platforms. A lot of Apple's promised benefits are in identifying long-term data patterns and insights.
"I do think how they interact with each other is really important," said Desai, who points to the new tracking of atrial fibrillation patterns over time in Watch OS 9. "We are actually taking how much time you're in AFib and correlating it to your lifestyle. How much you're sleeping. How much you're moving, you'll see the changes in AFib. If you're using Mindful Minutes, do you see a change."
Apple has tried making data sharing easier with doctors, but right now it still doesn't go far enough. At the medical group where I'm a patient, for instance, there's no obvious way to share the data I'm collecting in Apple Health through the patient portal.
Sleep tracking is gaining sleep stages in WatchOS 9. Will that bring a wave of other health insights down the road?
Apple
Sleep as the next frontier?
Apple's addition of sleep stage-based sleep tracking in the upcoming Watch OS 9 looks to close the gap on other fitness trackers like those from Fitbit, Samsung and Oura. Apple's been pulling new features for the Apple Watch from work in some of the company's ongoing heart research studies, and sleep could end up being a place that evolves next.
"What I'm really excited to learn from a scientific standpoint is, does the amount of sleep that you're getting in certain stages, like core [replenishing sleep], does that actually translate to benefit during the day when you're moving?" Desai said. "Are there certain phenotypes of certain people who have more benefit versus others? There's so much to tackle from a research standpoint there. We would never put anything out until we knew we kind of had some scientific grounding. The whole causation-correlation thing can get very tricky."
Desai suggested future research combining sleep stage data with Apple's ongoing heart and move data from its ongoing study will possibly provide more insights, "but we're still a ways away from that."
Could Apple ever develop its own readiness score?
One thing Apple's evolving and elaborate set of Health insights currently doesn't have is any sort of attempt at a distilled score, or personal health rating. Fitbit, Oura, and a number of other wearables have daily personal scores derived from a variety of individual metrics. I asked Desai whether Apple might pursue a similar idea anytime soon. While it sounds like a direction Apple Health could head in, it also seems like Apple is still trying to lock down the best path to get there.
"It's a really good question. I think the answer is, to be honest, is we don't have a firm POV yet," Desai said. "We want to understand the science behind that, and what can we understand and glean from a scientific standpoint."
Desai suggests that the health measurements, and their meanings, can vary. "HRV [heart rate variability] is a great metric. I'm super fascinated by HRV. But HRV can be changed based on multiple reasons." She suggested that Apple's eventual evolution of its insights will need to come with clear guidance, too.
"I think for us, we want to be able to provide actionable information. So to understand to do that, you actually have to be able to draw it back to, what we think is actually causing that? We are really trying to understand the science behind all of these different metrics and focus on how we provide insights that we know we can back up."
On whether Apple Health could come to other non-Apple devices
Apple's aiming for Health to be a comprehensive, secure system for anyone to use, but it still flows through Apple hardware, which means a portion of the population will always be left out. I asked Desai whether Apple Health might ever be available beyond iPhones.
"We're always looking at ways to support the ecosystem. We just want to make sure we can support that in a private and secure way. That's fundamentally what drives our decision making," Desai said. "We have a ton of things in the App Store ecosystem that are super interesting that people are doing, and we're very supportive of supporting that work.
"Honestly, we make a lot of decisions driven by privacy. And there's a lot of things we choose not to do and choose to do, based upon that."
The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.
Apple's Health app keeps evolving, with aspirations to be a complete combination personal data archive, medical liaison and insight engine. But the goals, while ambitious, aren't fully realized yet. iOS 16 and WatchOS 9 are adding medication management and multistage sleep tracking to a growing list of features. But what comes next, and will it start to become a tool that interfaces with doctors even more than it has?
Apple just published a multipage health report (PDF), which aims to detail where the company sees its health focus heading on the iPhone and the Apple Watch. The report covers the app, research studies and initiatives with medical organizations.
As Google prepares to release a Pixel Watch that will connect to Fitbit's features and services, Apple looks to be strengthening its position by expanding beyond the watch to a larger spectrum of health services. Already, Apple Health and Fitness Plus are evolving into services you don't need an Apple Watch to use.
When will Health start to become an extension of how I connect with my own doctors? Will sleep tracking offer a doorway to other health insights? And why doesn't Apple have its own equivalent of the "readiness score" used by Fitbit and Oura?
Apple's vice president of health, Dr. Sumbul Desai, spoke with CNET about the goals of Apple Health and where goals are being set next. She sees the blend of lifestyle with clinical data, medication data and an increasing number of metrics in one place as helping future insights in other health measurements over time.
"You have to do it in a really thoughtful and meaningful way," Desai said. "Because there are also correlations you can make that are incorrect. That's where the work is, making sure that when you make those connections that they are correct, grounded in the science and make sense to the user."
Medication tracking on iOS 16 looks like another step to bring medical histories onto Health.
Apple
Where does Apple Health meet your doctor?
As I've found over the last few months, over several surgeries and doctor visits, my own medical care doesn't often connect with my wearable and phone apps. Apple's been aiming to make strides to connect Apple Health with medical providers, but the framework isn't fully there yet for digital health platforms. A lot of Apple's promised benefits are in identifying long-term data patterns and insights.
"I do think how they interact with each other is really important," said Desai, who points to the new tracking of atrial fibrillation patterns over time in Watch OS 9. "We are actually taking how much time you're in AFib and correlating it to your lifestyle. How much you're sleeping. How much you're moving, you'll see the changes in AFib. If you're using Mindful Minutes, do you see a change."
Apple has tried making data sharing easier with doctors, but right now it still doesn't go far enough. At the medical group where I'm a patient, for instance, there's no obvious way to share the data I'm collecting in Apple Health through the patient portal.
Sleep tracking is gaining sleep stages in WatchOS 9. Will that bring a wave of other health insights down the road?
Apple
Sleep as the next frontier?
Apple's addition of sleep stage-based sleep tracking in the upcoming Watch OS 9 looks to close the gap on other fitness trackers like those from Fitbit, Samsung and Oura. Apple's been pulling new features for the Apple Watch from work in some of the company's ongoing heart research studies, and sleep could end up being a place that evolves next.
"What I'm really excited to learn from a scientific standpoint is, does the amount of sleep that you're getting in certain stages, like core [replenishing sleep], does that actually translate to benefit during the day when you're moving?" Desai said. "Are there certain phenotypes of certain people who have more benefit versus others? There's so much to tackle from a research standpoint there. We would never put anything out until we knew we kind of had some scientific grounding. The whole causation-correlation thing can get very tricky."
Desai suggested future research combining sleep stage data with Apple's ongoing heart and move data from its ongoing study will possibly provide more insights, "but we're still a ways away from that."
Could Apple ever develop its own readiness score?
One thing Apple's evolving and elaborate set of Health insights currently doesn't have is any sort of attempt at a distilled score, or personal health rating. Fitbit, Oura, and a number of other wearables have daily personal scores derived from a variety of individual metrics. I asked Desai whether Apple might pursue a similar idea anytime soon. While it sounds like a direction Apple Health could head in, it also seems like Apple is still trying to lock down the best path to get there.
"It's a really good question. I think the answer is, to be honest, is we don't have a firm POV yet," Desai said. "We want to understand the science behind that, and what can we understand and glean from a scientific standpoint."
Desai suggests that the health measurements, and their meanings, can vary. "HRV [heart rate variability] is a great metric. I'm super fascinated by HRV. But HRV can be changed based on multiple reasons." She suggested that Apple's eventual evolution of its insights will need to come with clear guidance, too.
"I think for us, we want to be able to provide actionable information. So to understand to do that, you actually have to be able to draw it back to, what we think is actually causing that? We are really trying to understand the science behind all of these different metrics and focus on how we provide insights that we know we can back up."
On whether Apple Health could come to other non-Apple devices
Apple's aiming for Health to be a comprehensive, secure system for anyone to use, but it still flows through Apple hardware, which means a portion of the population will always be left out. I asked Desai whether Apple Health might ever be available beyond iPhones.
"We're always looking at ways to support the ecosystem. We just want to make sure we can support that in a private and secure way. That's fundamentally what drives our decision making," Desai said. "We have a ton of things in the App Store ecosystem that are super interesting that people are doing, and we're very supportive of supporting that work.
"Honestly, we make a lot of decisions driven by privacy. And there's a lot of things we choose not to do and choose to do, based upon that."
The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.
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The pandemic changed health care, and there's no going back
The pandemic changed health care, and there's no going back
This story is part of The Year Ahead, CNET's look at how the world will continue to evolve starting in 2022 and beyond.
If the pandemic has taught us one thing, it's how to take our health into our own hands.
We've become our own triage nurse, analyzing a sore throat with such urgency that, in another time, would've been considered a little obsessive. We've been asked to monitor our temperatures and even become citizen public health surveyors with the help of at-home COVID-19 tests. But one day (hopefully soon), the consequences of leaving the house with a sore throat won't mean we're risking someone's life. Soon, our physical health will remain a core piece of our well being, but we'll shake the neurosis of a pandemic mindset – hopefully, keeping our newfound sensitivity to public health and a desire to not harm others in the process.
But will our health care system?
"The pandemic accelerated a lot of changes that were kind of percolating in the background," says Matthew Eisenberg, associate professor of health policy and management at Johns Hopkins Bloomberg School of Public Health. Eisenberg studies how neoclassical economics ("supply and demand") applies to health care. While COVID-19 "catalyzed" many of the changes -- and inequities -- already budding in health care, he said, it will be up to policy makers as well as the supply-and-demand cycle of health care to decide what sticks and what doesn't.
Telemedicine: a thing of the past, or the future?
Video-calls-as-doctor's-visit wasn't a tool created because of COVID-19, but the pandemic has transformed it from an obscure practice to the new way to do health care. Importantly, policy changes made during the pandemic helped knock down some barriers for telemedicine access, and helped providers get paid for it.
Private insurance companies as well as public payers (i.e. Medicare) relaxed their policies on telemedicine reimbursement for health care providers because of COVID-19. As more health care providers get paid for telemedicine (which gives them incentive to provide it), the more supply there is for patients, Eisenberg says.
"Prior to the pandemic, the only way a Medicare provider could be reimbursed for telemedicine would be if a patient was in a rural area where they could not physically travel to a provider," he says. "Even then, they had to go to a specialized facility and do the telemedicine at some out-patient facility's computer."
Even through a computer screen, there are roadblocks to accessing health care. Before COVID-19, some patients, depending on where they live and what medical condition they have, would need to drive across state lines to access a specialist (which requires an amount of time and money many patients don't have). The loosening of interstate licensure laws during the pandemic has allowed people to connect with a doctor miles away, and even fill a prescription across state lines.
Dr. Megan Mahoney is a family medicine doctor and the chief of staff at Stanford Health Care. Stanford Health Care, along with many other providers and organizations, have advocated to keep those restrictions loose once COVID-19 is no longer a public emergency, and the emergency rules no longer apply.
"We have noticed that there are states that don't have a single pediatric endocrinologist," says Mahoney. These specialists treat children with diabetes, for example. "We have a whole team of pediatric endocrinologists."
But in order to participate in telemedicine, you need an internet connection. Mahoney called the bipartisan infrastructure bill, which has a $65 billion budget for expanding internet access to rural communities and helping families pay their internet bill, a "tremendous" help in health care access. In the new virtual health landscape, access to broadband is a "social determinant of health," she says. Some policies and benefits put into place during the pandemic to help families access the internet, like the Emergency Broadband Benefit, were temporary. As broadband continues to mold in its form as a public good, its relationship to health care access will only strengthen.
FS Productions/Getty Images
Sliding into your doctor's DMs
In addition to telemedicine, the pandemic also gave us nearly unlimited access to our doctors' inbox through the patient portal. According to a report published in JAMA, which looked at instant messaging data between patients and their providers from March 2020 through June 2021, the number of patient messages increased, despite fewer patients seeking care in some specialties.
"The sheer demand that we're seeing is very much a testament to the patients' desire for this new channel of care," Mahoney says.
Even older patients, whose relationship with technology sometimes gets a bad rap, are sending their doctors messages and embracing telemedicine, she says.
"That was what propelled and accelerated the transformation," Mahoney says. When elderly people, who were originally reluctant to use telemedicine, were forced to use it in order to get care during the lockdown, "that helped them get over that hurdle."
"What I've noticed is the digital divide, while we do need to be aware of it, it can be overcome and sufficiently addressed through additional education," she says.
Some of that education for patients requires medical assistants to take on tech support roles. In addition to taking blood pressure and temperature when patients come into the room, they also need to make sure patients are comfortable signing into their patient account and feel comfortable with the technology, according to Mahoney.
That shift in the patient-provider dynamic, and more direct access to care, is necessary to maintain a system Mahoney says can help people get early intervention and, hopefully, prevent visits to the emergency room.
Many of the messages Mahoney receives from patients involve correcting misinformation patients have heard about COVID-19 -- the type of preventative, education-based work that the current health care structure "does not support," she says. For example, sustaining a more thorough patient-doctor messaging system would require providers be paid for their time consulting with patients off-hours. It also requires online communication to be in the patient's language – a barrier for many people in the US who don't speak English or speak it as a second language.
"I hope that health care can keep up with this cataclysmic shift that's happening," Mahoney said. "It will have to."
There are arguments against telemedicine as the end-all-be-all. Dr. Thomas Nash, an internist in New York City, told The New Yorker in a June 2020 report that though telemedicine is "doable...I worry that it's going to delay a good exam, and get in the way of deeper interactions between people and their doctors." The informal setting of telehealth may also be less likely to pick up on big issues which routine in-person exams would normally detect, such as high blood pressure, California Healthline reported. And it's more difficult to build an open relationship with your doctor through a screen than it is when you're sitting in their office.
But that also assumes people had a relationship to lose in the first place. As of Feb. 2019, one year before the pandemic began, about one fourth of all adults and half of all adults under 30 didn't have an ongoing relationship with a doctor, according to a report from the Kaiser Family Foundation. This is also a group that shows a strong preference for telehealth, and is the target audience for pre-pandemic care-on-demand services, including Nurx, which allows people to get birth control prescriptions and other medications online, sister sites Hims and Hers, Curology and more.
Sarah Tew/CNET
The great vaccine race
Scientists impressed the world by moving quickly to develop highly effective COVID-19 vaccines in record time – doses of Pfizer and BioNTech's vaccine, with Moderna's authorized right behind it, were available to the first round of eligible adults in the US less than a year after the the country went into lockdown. According to Nature, the fastest anyone developed a vaccine was for mumps in 1960, and that took four years from development to approval (Pfizer's vaccine for people age 16 and up has full approval by the US Food and Drug Administration, while Moderna and Johnson & Johnson have emergency use authorization). While there's much left to be desired about how the vaccines are distributed and accessed by populations in countries outside the US (only 8.9% of people in low-income countries have had a coronavirus shot), an estimate from the Yale School of Public Health reports the vaccines have saved about 279,000 lives and prevented 1.25 million hospitalizations a s of early July 2021.
Part of the reason the vaccines were developed so quickly was because research on the technology they use was already underway (the mRNA vaccines were developed using information from HIV research). While the global society has shown we can be very efficient at producing effective and safe vaccines, don't get your hopes up too high that it'll happen that fast again, says Michael Urban, an occupational therapist and program director at the University of New Haven.
"The thing people have to remember is that the federal government pumped tons and tons of money into this development," says Urban. "Globally, not just the United States."
One reason for that is because COVID-19 had such a prominent impact on our economy. "The fact that this [vaccine] came out is because this is disrupting the fabric of life," Urban says. "How we make money, how we engage with people – how we enjoy our lives."
While it's tempting to hope that because scientists banded together to create a vaccine for COVID-19 and the US government helped fund much of that work it will usher in more resources to find preventative measures and treatments for other diseases, it's unlikely. The incentive for the government to subsidize research and development of treatments for other things that are more individualized, such as cancer or HIV, Urban says, might not be as strong, which leaves it up to the drug companies themselves. And without a public health emergency as transmissible and widespread as COVID-19, it's unlikely drug companies will pour quite as much time and effort into finding treatments.
And when addressing a drug company that profits "billions off of cancer treatments," for example, is it really in the best interest of the company to find an effective preventative measure?
"If they can do one shot and get rid of cancer, is it really in their best interest?" Urban says. "I hate to say that," says Urban.
Two steps forward, two steps back
In addition to propelling us into trends that've been helpful in health care, the pandemic has magnified our shortcomings and has disproportionately affected the same people who have been mistreated by the medical system for years. Black and Hispanic Americans have been hospitalized with COVID-19, and died from the disease, in much greater numbers compared to white Americans.
Dr. Shantanu Nundy, a primary care physician and author of the book Care After Covid: What the Pandemic Revealed Is Broken in Healthcare and How to Reinvent It, told NPR in a May 2021 report that the pandemic scramble to find a testing site, get a vaccine appointment or access preventative care exposed those who might not have ever experienced it to the perils of health care.
"The pandemic magnified long-standing cracks in the foundation of the US healthcare system and exposed those cracks to populations that had never witnessed them before," said Nundy in the NPR interview.
Another weak spot exposed because of COVID-19 was the US public health response, and its subsequent communication to the public about what to do when you're sick. When the pandemic struck, public health agencies were relying on "old methodologies" in terms of quarantine requirements and testing rules for COVID-19, Urban says. Compared to other countries, we have issues with containment and quarantine restrictions that don't always prevent people from spreading the virus, he says. The CDC's latest isolation guidance for people who test positive for COVID-19, for example, has been criticized by some for being too relaxed and not requiring a negative test.
In the US, there's a one-and-done mentality. "You do a one-time test, you're cleared," Urban says. "Have a nice day."
When the next pandemic happens, he says the US is likely still not set up with the structure and tools needed to respond appropriately to a public health emergency. "We didn't learn from the Spanish flu," Urban says.
An early December report from the Global Health Security Index, an assessment of health security across the globe developed by the Johns Hopkins Center for Health Security and the Economist Impact, backs that up. According to the report, 195 countries across the globe are "dangerously underprepared for future epidemic and pandemic threats, including threats potentially more devastating than COVID-19."
But importantly, the blame isn't solely on public health agencies, Urban says. The CDC, for example, is "under pressure" to get people back to work and everyday life, Urban says. To do so, the agency has to work within US federal law and the vastly different state and local laws which govern what we can and can't expect people to do.
Looking forward
As we move away from the immediate threat of COVID-19, our appreciation for mental health care is likely to stay. Eisenberg says that we may see specialized mental health services, including some practices that are virtual-only, and some that are a hybrid of in-office and virtual visits. There may also be a shift away from medication treatments for mental health conditions and more provider-focused psychotherapy, Eisenberg finds.
"It's a small shift, but that could have big implications down the road," he says.
While there are structural and policy changes needed to ensure everyone has autonomy over their health, the pandemic has shifted the way care providers approach health care. Now more than ever, there's an emphasis on public health.
In an interview with the American Medical Association, Nundy explained the framework he believes is necessary to progress health care after the pandemic. Through the course of the pandemic, Nundy said, doctors "built a muscle" for operating with public health in mind.
"Let's take that muscle and let's start applying it to diabetes, let's start applying it to mental health," Nundy said. "So much more is possible."
Correction, Jan. 14: The original version of this story misspelled Shantanu Nundy's last name.
The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.
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What the Future of Health Looks Like for Apple
What the Future of Health Looks Like for Apple
Apple's Health app keeps evolving, with aspirations to be a complete combination personal data archive, medical liaison and insight engine. But the goals, while ambitious, aren't fully realized yet. iOS 16 and WatchOS 9 are adding medication management and multistage sleep tracking to a growing list of features. But what comes next, and will it start to become a tool that interfaces with doctors even more than it has?
Apple just published a multipage health report (PDF), which aims to detail where the company sees its health focus heading on the iPhone and the Apple Watch. The report covers the app, research studies and initiatives with medical organizations.
As Google prepares to release a Pixel Watch that will connect to Fitbit's features and services, Apple looks to be strengthening its position by expanding beyond the watch to a larger spectrum of health services. Already, Apple Health and Fitness Plus are evolving into services you don't need an Apple Watch to use.
When will Health start to become an extension of how I connect with my own doctors? Will sleep tracking offer a doorway to other health insights? And why doesn't Apple have its own equivalent of the "readiness score" used by Fitbit and Oura?
Apple's vice president of health, Dr. Sumbul Desai, spoke with CNET about the goals of Apple Health and where goals are being set next. She sees the blend of lifestyle with clinical data, medication data and an increasing number of metrics in one place as helping future insights in other health measurements over time.
"You have to do it in a really thoughtful and meaningful way," Desai said. "Because there are also correlations you can make that are incorrect. That's where the work is, making sure that when you make those connections that they are correct, grounded in the science and make sense to the user."
Medication tracking on iOS 16 looks like another step to bring medical histories onto Health.
Apple
Where does Apple Health meet your doctor?
As I've found over the last few months, over several surgeries and doctor visits, my own medical care doesn't often connect with my wearable and phone apps. Apple's been aiming to make strides to connect Apple Health with medical providers, but the framework isn't fully there yet for digital health platforms. A lot of Apple's promised benefits are in identifying long-term data patterns and insights.
"I do think how they interact with each other is really important," said Desai, who points to the new tracking of atrial fibrillation patterns over time in Watch OS 9. "We are actually taking how much time you're in AFib and correlating it to your lifestyle. How much you're sleeping. How much you're moving, you'll see the changes in AFib. If you're using Mindful Minutes, do you see a change."
Apple has tried making data sharing easier with doctors, but right now it still doesn't go far enough. At the medical group where I'm a patient, for instance, there's no obvious way to share the data I'm collecting in Apple Health through the patient portal.
Sleep tracking is gaining sleep stages in WatchOS 9. Will that bring a wave of other health insights down the road?
Apple
Sleep as the next frontier?
Apple's addition of sleep stage-based sleep tracking in the upcoming Watch OS 9 looks to close the gap on other fitness trackers like those from Fitbit, Samsung and Oura. Apple's been pulling new features for the Apple Watch from work in some of the company's ongoing heart research studies, and sleep could end up being a place that evolves next.
"What I'm really excited to learn from a scientific standpoint is, does the amount of sleep that you're getting in certain stages, like core [replenishing sleep], does that actually translate to benefit during the day when you're moving?" Desai said. "Are there certain phenotypes of certain people who have more benefit versus others? There's so much to tackle from a research standpoint there. We would never put anything out until we knew we kind of had some scientific grounding. The whole causation-correlation thing can get very tricky."
Desai suggested future research combining sleep stage data with Apple's ongoing heart and move data from its ongoing study will possibly provide more insights, "but we're still a ways away from that."
Could Apple ever develop its own readiness score?
One thing Apple's evolving and elaborate set of Health insights currently doesn't have is any sort of attempt at a distilled score, or personal health rating. Fitbit, Oura, and a number of other wearables have daily personal scores derived from a variety of individual metrics. I asked Desai whether Apple might pursue a similar idea anytime soon. While it sounds like a direction Apple Health could head in, it also seems like Apple is still trying to lock down the best path to get there.
"It's a really good question. I think the answer is, to be honest, is we don't have a firm POV yet," Desai said. "We want to understand the science behind that, and what can we understand and glean from a scientific standpoint."
Desai suggests that the health measurements, and their meanings, can vary. "HRV [heart rate variability] is a great metric. I'm super fascinated by HRV. But HRV can be changed based on multiple reasons." She suggested that Apple's eventual evolution of its insights will need to come with clear guidance, too.
"I think for us, we want to be able to provide actionable information. So to understand to do that, you actually have to be able to draw it back to, what we think is actually causing that? We are really trying to understand the science behind all of these different metrics and focus on how we provide insights that we know we can back up."
On whether Apple Health could come to other non-Apple devices
Apple's aiming for Health to be a comprehensive, secure system for anyone to use, but it still flows through Apple hardware, which means a portion of the population will always be left out. I asked Desai whether Apple Health might ever be available beyond iPhones.
"We're always looking at ways to support the ecosystem. We just want to make sure we can support that in a private and secure way. That's fundamentally what drives our decision making," Desai said. "We have a ton of things in the App Store ecosystem that are super interesting that people are doing, and we're very supportive of supporting that work.
"Honestly, we make a lot of decisions driven by privacy. And there's a lot of things we choose not to do and choose to do, based upon that."
The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.
What States Can and Can't Do When Banning Abortion
What States Can and Can't Do When Banning Abortion
For more information about your reproductive health rights and related federal resources, you can visit the US government's
Reproductive Rights
site.
Whether someone can get an abortion or related medical procedure mostly hinges on which state they live in after the Supreme Court overturned Roe v. Wade last month and ended the constitutional right to abortion. But the switch from federal protection to state law isn't straightforward and has led to confusion and misinformation on what pregnant patients and physicians can do.
In this still developing landscape, how confident can people be that their treatment is still legal?
"The answer to all your questions is 'Who the heck knows,'" said Dr. Louise Perkins King, a surgeon and bioethicist at Harvard Medical School. "And that's the problem."
The US Department of Health and Human Services issued guidance on July 11 reminding physicians of their responsibilities under the existing Emergency Medical Treatment and Labor Act, or EMTLA, which supports the need to treat and stabilize patients in an emergency, including pregnant patients who may require an abortion. Days later, Texas sued the Biden administration over the law, which allows for medical assistance to save the life of the mother, because, Texas Attorney General Ken Paxton said, it "seeks to transform every emergency room in the country into a walk-in abortion clinic."
On Tuesday, a judge in Texas blocked the EMTLA guidance, so physicians in that state may no longer be protected by federal law if they perform an abortion when they deem it medically necessary but it falls outside of Texas' interpretation of a life-endangering pregnancy. Physicians nationwide who are members of the American Association of Pro-Life Gynecologists and Obstetricians or the Christian Medical and Dental Association are also exempt -- a total of about 18,000 health care providers, according to the court document.
Texas' new trigger law -- which will be in effect on Aug. 25 -- bans all abortions except when the pregnancy puts the mother "at risk of death or poses a serious risk of substantial impairment of a major bodily function." Physicians who perform an illegal abortion will be committing a felony. It doesn't make exceptions for rape, incest or fetal abnormalities, and it also doesn't make an exception for when the pregnant person's risk of death would come from a "claim or diagnosis" that they'll be hurt or might die in the future. (This could be interpreted to mean a doctor can't provide an abortion if a woman threatens to die by suicide because she has depression.) All abortions are currently banned in Texas after the state's Supreme Court ruled that a law from the 1920s could stand.
Legal battles within some states will continue to shape post-Roe America, with the landscape changing by the day. And lawsuits like the one in Texas clarify the country's stance on whether state law preempts federal rule on abortion or reproductive health care. Basically, can federal regulations trump state law?
"There's going to be cases that are going to have to determine this question," I. Glenn Cohen, a professor and bioethicist at Harvard Law School, said.
The argument over medication abortion access -- which is banned or restricted in many states but still available to people if they order it (not without risk) online -- will likely also be one of the first big court cases post-Roe, Cohen said. Questions of whether federal regulations on medication abortion conflict directly enough with state restrictions will continue to be center stage.
Medication abortion, for use in early pregnancy, accounts for more than half of abortions in the US. Restricting the pills is the new frontier of abortion bans.
Robyn Beck/Getty Images
Other federal guidance issued by the Biden administration includes a reminder to pharmacists that they are required to fill medication and birth control prescriptions for patients. Failing to do so is discrimination based on pregnancy status. This was in response to the many reports of women having treatment delayed or prescriptions denied while health care workers try to navigate around new state laws.
Here's what we know today.
Can states ban abortion pills? Not completely, but some are trying.
Any state with a current total ban on abortion -- including Texas, Oklahoma, South Dakota, Alabama, Arkansas, Mississippi, Missouri and Wisconsin -- also bans medication abortion. Heavy restrictions in other states, including Tennessee and South Carolina, which ban abortion after about six weeks, also extend to medication abortion. This means providers can't prescribe the medication in those states and patients can't fill prescriptions at pharmacies.
"If a state law bans abortion broadly, that includes medication abortions," Elisabeth Smith, director of state policy and advocacy at the Center for Reproductive Rights, told MedPage Today.
But abortion bans and state laws seek to punish abortion providers or people who assist them, not the person seeking the abortion (there's reason to believe this might change in the future). For now, people living in the most restrictive states can still order pills from an overseas pharmacy, including Aid Access. However, the pills could take awhile to arrive and potentially put the person past the point of pregnancy for which the medication is safe and effective (about 10 weeks).
Peter Dazeley/Getty Images
The fate of medication abortion pills in Republican-leaning states centers on mifepristone, the first pill given in the two-dose regimen of medication abortion. Because the US Food and Drug Administration approved mifepristone as a safe and effective way to end a pregnancy over 20 years ago, states shouldn't be able to restrict it, the US attorney general's office argued the same day Roe was overturned. (Misoprostol, the second pill, is used off-label for abortion and miscarriage treatment. It's also used to treat health conditions such as stomach ulcers.)
Whether this federal regulation (and the FDA's stamp of approval) supersedes state laws will need to be decided. Cohen said this is likely to be determined by the Supreme Court as "one of the first post-Dobbs cases."
"It's unclear whether that's going to be a winner of an argument, to be perfectly honest," Cohen said.
Last year, the FDA extended a pandemic-era rule that allowed patients to get medication abortion pills through the mail, instead of requiring them to be prescribed in person. This was seen as a victory for the American College of Obstetricians and Gynecologists and other medical groups, which viewed the in-person requirement as unnecessary for a medication that's safe and effective in early pregnancy.
But states have their own requirements for medication abortion, and providers licensed in Montana can't prescribe pills to patients who travel over from a restrictive state like South Dakota, NPR reported.
Read more: Worries About Post-Roe Data Privacy Put Spotlight on Period Apps
Ectopic pregnancies can't result in a delivery and require medical treatment. Symptoms can start with typical pregnancy signs, including a missed period, but can progress to abdominal or pelvic pain, vaginal bleeding, weakness and more.
Svetlana Gustova/Getty Images
Can states ban treatment for high risk pregnancies? The HHS says no, but doctors say state laws are restricting care.
Even though the most restrictive states banning abortions leave room for some degree of medical emergency, practicing physicians need to decide where the medical emergency line is – and risk prosecution if a state sees it differently.
This month, the story of a 10-year-old girl who was raped and pregnant and who traveled to Indiana from Ohio, where abortion is banned around six weeks without exception for rape or incest, made headlines. Not only was the physician publicly questioned by Indiana's attorney general on whether she followed state law, but Ohio Attorney General Dave Yost said in the aftermath that the girl should've been able to legally get an abortion under the state law's medical emergency exemption. Ohio's OB-GYNs disagreed.
"It states specifically 'medically diagnosed condition,' and as far as I can tell, adolescent pregnancy is not a medically diagnosed condition that's listed," Dr. Jason Sayat, a Columbus OB-GYN, told the Ohio Capital Journal.
The Department of Health and Human Services reminded physicians and hospitals that if they want to keep their Medicare agreement and avoid "civil penalties," they must treat pregnant patients and provide abortions if necessary as required under the 1986 Emergency Medical Treatment and Labor Act. The EMTLA, now blocked in Texas, outlines certain life-endangering pregnancies that doctors must treat regardless of state law, including ectopic pregnancies, preeclampsia and complications of pregnancy loss.
But that narrow line of abortion exceptions for medical emergencies given by states like Wisconsin is what's troubling Dr. Jennifer McIntosh, a maternal-fetal medicine physician practicing in the state. While Wisconsin's attorney general said he wouldn't enforce a ban, physicians there stopped performing abortions because the state has a pre-Roe criminal statute that prohibits most abortions. The "save the life of the mother" abortion exception language in that law can leave out health conditions which may not be an immediate emergency but can become one down the line.
"Some of what we do is to prevent emergencies from happening," McIntosh said. "To have to wait for an emergency to actually appear puts your patient's life at risk."
The treatment for an ectopic pregnancy is termination, because terminating the pregnancy is the only safe outcome when an embryo grows outside of the uterus, typically in a fallopian tube. Without treatment, the fallopian tube is likely to rupture, which can lead to internal bleeding and death. But some laws, like one in Texas, specifically restrict medications including methotrexate, which has led to access problems for people who are pregnant as well as people who are taking methotrexate for another health reason.
Complicating confusion and risk over how abortion bans will affect treatments for ectopic pregnancies is the fact that more rare types of ectopic pregnancies exist, including ones where the pregnancy is growing inside a C-section scar or other area outside the safety of the main cavity of the uterus -- but still technically in the uterus. These rarer kinds of ectopic pregnancies are also life-threatening, and may be more difficult to diagnose and treat as such in a state that bans abortions with an emphasis on the pregnancy being in the uterus.
Saul Loeb/AFP/Getty Images
States are not prosecuting people who have abortions (yet)
Current state laws -- both those in effect and those in limbo in court -- prosecute other people involved in an abortion, not the person who's pregnant.
But the health impact may be already felt when a doctor is hesitant to treat patients, or pharmacists are reluctant to fill a prescription for mifepristone before interviewing a woman to ascertain whether her pregnancy is already ended and her situation is in line with state law.
"Even in these straightforward cases of basic OB/GYN practice, the laws leave providers questioning and afraid," Dr. Carley Zeal, an OB-GYN in Wisconsin, told The New York Times. "These laws are already hurting my patients."
Aside from hesitancy among health care providers, physicians also fear that worries people have about being prosecuted for having an abortion or miscarriage will stop patients experiencing complications from any kind of pregnancy loss from seeking care.
That's because it was already happening, before Roe was overturned. According to the National Advocates for Pregnant Women, there were over 1,700 arrests or prosecutions of women from 1973 (when Roe became law) to 2020 where their pregnancies were the focus of the case against them.
So will doctors report you if they suspect you had an abortion?
"The vast majority of health care professionals will not do that, because that's not caring for their patients," King said. But, she added, "I'm sure there's a very small, but unfortunately detrimental, minority who might."
Your current access to birth control shouldn't be impacted by the overturn of Roe v. Wade. However, there's reason to believe that could change in the future.
Carol Yepes/Getty Images
Birth control is still protected under the Affordable Care Act
Right now, IUDs, birth control pills and other birth control methods are legal in all 50 states. And they should also be covered at no out-of-pocket cost for those covered under the Affordable Care Act. The right to birth control is protected under two Supreme Court rulings: Griswold v. Connecticut (1965) and Eisenstadt v. Baird. (Another Supreme Court Case, Burwell v. Hobby Lobby Stores, chipped away a little of that protection, however, finding that some corporations are exempt for religious reasons.)
Plan B or "morning after pill" brands are also not included in abortion bans, because they will not end an existing pregnancy. Most health plans should also cover them.
Legislators in Missouri last year voted to block taxpayer funding for IUDs and emergency contraception, casting doubt that all birth control devices will be protected indefinitely, at least in some states. The claims of legislators like Paul Wieland, a Republican state senator in Missouri, are that anything that has the potential to disrupt a fertilized egg's implantation into the uterus is an abortifacient.
The medical community has been clear that IUDs and emergency contraception do not cause abortions and will not end an existing pregnancy. Copper IUDs work mostly by causing a chemical change in the sperm and egg before they meet, according to the World Health Organization. Hormonal IUDs like Mirena work mostly by thickening cervical mucus so sperm can't reach the egg, and can also prevent ovulation. Plan B and similar pills likely won't work if a person has already ovulated, meaning the chances of it stopping implantation are currently understood to be slim.
Nevertheless, unlikely occurrences or instances where a fertilized egg may be prevented from implanting into a uterus could be called into question in future court cases.
Read more: Could a Post Roe v. Wade World Impact Your Access to Birth Control?
The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.
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Inflation, Interest Rates and Jobs: How Today's Economy Compares to Recessions of the Past
Inflation, Interest Rates and Jobs: How Today's Economy Compares to Recessions of the Past
This story is part of Recession Help Desk, CNET's coverage of how to make smart money moves in an uncertain economy.
What's happening
There's still debate about whether the US economy is officially headed into a recession, but the economic downturn is causing widespread stress.
Why it matters
Periods of financial volatility and market decline can drive people to panic and make costly mistakes with their money.
What's next
Examining what's happening now -- and comparing it with the past -- can help investors and consumers decide what to do next.
Facing the aftershocks of a rough economy in the first half of 2022, with sky-high inflation, rising mortgage rates, soaring gas prices and a bear market for stocks, leading indicators of a recession have moderated slightly in the past month. That could mean the economic downturn won't be as long or brutal as expected.
Still, the majority of Americans are feeling the sting of rising prices and anxiety over jobs. The country has experienced two consecutive quarters of economic slowdown -- the barometer for measuring a recession -- even though the National Bureau of Economic Research hasn't made the "official" recession call.
At a time like this, we should consider what happens in a recession, look at the data to determine whether we're in one and try to maintain some historical perspective. It's also worth pointing out that down periods are temporary and that, over time, both the stock market and the US economy bounce back.
I don't mean to minimize the gravity and hardship of the times. But it can be useful to review how the economy has behaved in the past to avoid irrational or impulsive money moves. For this, we can largely blame recency bias, our inclination to view our latest experiences as the most valid. It's what led many to flee the stock market in 2008 when the S&P 500 crashed, thereby locking in losses and missing out on the subsequent bull market.
"It's our human tendency to project the immediate past into the future indefinitely," said Daniel Crosby, chief behavioral officer at Orion Advisor Solutions and author of The Laws of Wealth. "It's a time-saving shortcut that works most of the time in most contexts but can be woefully misapplied in markets that tend to be cyclical," Crosby told me via email.
Before you make a knee-jerk reaction to your portfolio, give up on a home purchase or lose it over job insecurity, consider these chart-based analyses from the last three decades. We hope this data-driven overview will offer a broader context and some impetus for making the most of your money today.
What do we know about inflation?
Historical inflation rate by year
Macrotrends.net
Current conditions: The US is experiencingthe highest rate of inflation in decades, driven by global supply chain disruptions, the injection of federal stimulus dollars and a surge in consumer spending. In real dollars, the 8.5% rise in consumer prices over the past year is adding about $400 more per month to household budgets.
The context: Policymakers consider 2% per year to be a "normal" inflation target. The country's still experiencing over four times that figure. The 9.1% annual rate in July was the largest jumpin inflation since 1980 when the inflation rate hit 13.5% following the prior decade's oil crisis and high government spending on defense, social services, health care, education and pensions. Back then, the Federal Reserve increased rates to stabilize prices and, by the mid-1980s, inflation fell to below 5%.
The upside: As overall inflation rates rise, the silver lining might be increased rates of return on personal savings. Bank accounts are starting to offer more attractive yields, while I bonds -- federally backed accounts that more or less track inflation -- are attracting savers, too.
What's happening with mortgage rates?
30-year fixed-rate mortgage averages in the US
Current conditions: As the Federal Reserve continues its rate-hike campaign to cool spending and try to tame inflation, the rate on a 30-year fixed mortgage has grown significantly. In June, the average rate jumped annually by nearly 3 percentage points to almost 6%. In real dollars, that means that after a 20% down payment on a new home (let's use the average sale price of $429,000), a buyer would roughly need an extra $7,300 a year to afford the mortgage. Since then, rates have cooled a bit, even dipping back down below 5%. What happens next with rates depends on where inflation goes from here.
The context: Three years ago, homebuyers faced similar borrowing costs and, at the time, rates were characterized as "historically low." And if we think borrowing money is expensive today, let's not forget the early 1980s when the Federal Reserve jacked up rates to never-before-seen levels due to hyperinflation. The average rate on a 30-year fixed-rate mortgage in 1981 topped 16%.
The upside: For homebuyers, a potential benefit to rising rates is downward pressure on home prices, which could cause the housing market to cool slightly. As the cost to borrow continues to increase with mortgages becoming more expensive, homes could experience fewer offers and prices would slow in pace. In fact, nearly one in five sellers dropped their asking price during late April through late May, according to Redfin.
On the flip side, less homebuyers mean more renters. Rent prices have skyrocketed, and housing activists are asking the White House to take action on what they call a "national emergency."
What about the stock market?
Dow Jones Industrial Average stock market index for the past 30 years
Macrotrends.net
Current conditions: Year-to-date, the Dow Jones Industrial Average -- a composite of 30 of the most well-known US stocks such as Apple, Microsoft and Coca-Cola -- is about 8.5% below where it started in January. Relative to the broader market, technology stocks are down much more. The Nasdaq is off almost 19% since the start of the year.
The benchmark S&P 500 stock index hit lows in June that marked a more than 20% drop from January, which brought us officially into a bear market. Since then, it's bounced back up a little, but some experts warn that a current bear market rally is at odds with expected earnings and we could see even lower stock prices in the near future.
The context: Stock price losses in 2022 are not nearly as swift and steep as what we saw in March 2020, when panic over the pandemic drove the DJIA down by 26% in roughly four trading days. The market reversed course the following month and began a bull run lasting more than two years, as the lockdown drove massive consumption of products and services tied to software, health care, food and natural gas.
Prior to that, in 2008 and 2009, a deep and pervasive crisis in housing and financial services sank the Dow by nearly 55% from its 2007 high. But by fall 2009, it was off to one of its longest winning streaks in financial history.
The upside: Given the cyclical nature of the stock market, now is not the time to jump ship.* "Times that are down, you at least want to hold and/or think about buying," said Adam Seessel, author of Where the Money Is. "Over the last 100 years, American stocks have been the surest way to grow wealthy slowly over time," he told me during a recent So Money podcast.
*One caveat: If you're closer to or living in retirement and your portfolio has taken a sizable hit, it may be worth talking to a professional and reviewing your selection of funds to ensure that you're not taking on too much risk. Target-date funds, a popular investment vehicle in many retirement accounts that auto-adjust for risk as you age, may be too risky for pre- or early retirees.
What does unemployment tell us?
US unemployment rates
Current conditions: The July jobs report shows the unemployment rate holding steady, slightly dropping to 3.5%. The Great Resignation of 2021, where millions of workers quit their jobs over burnout, as well as unsatisfactory wages and benefits, left employers scrambling to fill positions. However, that could be changing as economic challenges deepen: More job losses are likely on the horizon, and an increasing number of workers are concerned with job security.
The context: The rebound in theunemployment rate is an economic hallmark of the past two years. But the ongoing interest rate hike may weigh on corporate profits, leading to more layoffs and hiring freezes. For context, during the Great Recession, in a two-year span from late 2007 to 2009, the unemployment rate rose sharply from about 5% to 10%.
Today, the tech sector is one to watch. After benefiting from rapid growth led by consumer demand in the pandemic, companies like Google and Facebook may be in for a "correction." Layoffs.fyi, a website that tracks downsizing at tech startups, logged close to 37,000 layoffs in Q2, more than triple from the same period last year.
The upside: If you're worried about losing your job because your employer may be more vulnerable in a recession, document your wins so that when review season arrives, you're ready to walk your manager through your top-performing moments. Offer strategies for how to weather a potential slowdown. All the while, review your reserves to see how far you can stretch savings in case you're out of work. Keep in mind that in the previous recession, it took an average of eight to nine months for unemployed Americans to secure new jobs.
§
What's happening
Home prices overall are up by 37% since March 2020.
Why it matters
Surging home prices and higher interest rates make monthly mortgage payments less affordable.
What's next
Rising mortgage rates will make borrowing money more expensive, which will lessen competition to buy homes and eventually flatten prices.
Home prices continued to skyrocket in March as buyers tried to stay ahead of rising mortgage rates.
Prices increased by 20.6% this March compared to last year, according to the S&P CoreLogic Case-Shiller Indices, the leading measures of US home prices. This was the highest year-over-year increase in March for home prices in more than 35 years of data. Seven in 10 homes sold for more than their asking price, according to CoreLogic.
Out of the 20 cities tracked by the 20-city composite index, Tampa, Phoenix and Miami saw the highest year-over-year gains in March. Tampa saw the greatest increase, with an almost 35% increase in home prices year-over-year. All 20 cities experienced double-digit price growth for the year ending in March.
The strongest price growth was seen in the south and southeast, with both regions posting almost 30% gains in March. Seventeen of the 20 metro areas also saw acceleration in their annual gains since February.
"Those of us who have been anticipating a deceleration in the growth rate of US home prices will have to wait at least a month longer," said Craig Lazzara, managing director at S&P DJI, in the release. "The strength of the Composite indices suggests very broad strength in the housing market, which we continue to observe."
Since the start of the pandemic in March 2020, home prices overall are up by 37%. The current surge in home prices is a result of tight competition between buyers in a low-inventory market as they attempt to lock in lower mortgage rates before rates jump even higher throughout the year, as experts predict they will.
If you're considering buying a new home -- or are actively in the market -- the news isn't all bad. Interest rates are at their highest point in more than 40 years, and one potential benefit of that may, eventually, be downward pressure on home prices. As it becomes increasingly expensive to borrow money, fewer people will seek to do so, and homes for sale may receive fewer offers leading to, eventually, lower prices. In fact, nearly one in five sellers lowered their asking price during a four-week period in May and April, according to Redfin.
"Mortgages are becoming more expensive as the Federal Reserve has begun to ratchet up interest rates, suggesting that the macroeconomic environment may not support extraordinary home price growth for much longer," said Lazzara. "Although one can safely predict that price gains will begin to decelerate, the timing of the deceleration is a more difficult call."
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Netflix: The 50 Absolute Best TV Shows to Watch
Netflix: The 50 Absolute Best TV Shows to Watch
Netflix has a bulging library of TV shows. Because each week brings new series to watch, it can be tough to find the best of the bunch. No need to worry. We've done the hard work for you.
You'll find highlights of new content below, as well as CNET's full list of best TV originals on Netflix.
What's new this week (Aug. 29 to Sept. 4)
Check out this week's highlights.
Tuesday
I Am a Killer (Season 3): Documentary. Murderers recount the true stories of their crimes, including a woman who killed her abusive husband and the man behind a deadly New Year's Eve party.
Wednesday
Club América vs. Club América (Limited Series): Documentary. This docuseries delves into the past, present and future of América, the most winning and controversial soccer club in Mexico, and its players' DNA.
Family Secrets (Season 1): Polish drama. A couple's wedding day threatens to turn disastrous when they begin to unravel a web of secrets and lies that connects their two families.
Thursday
Off the Hook (Season 1): French rom-com. Realizing they both have a toxic relationship to the Internet, roommates Léa and Manon decide to do the unthinkable: abandon all devices for 30 days.
Friday
Buy My House (Season 1): Reality. Homeowners from across the US pitch properties for sale to four experienced real estate investors, hoping to make a life-changing deal on the spot.
Dated & Related (Season 1): Reality. Single siblings help each other search for their soulmates, hoping to find love (and maybe win $100,000) while living at a luxurious villa.
Devil in Ohio (Limited Series): Crime mystery starring Emily Deschanel. Determined to protect a young patient who escaped a mysterious cult, a psychiatrist takes the girl in, putting her own family -- and life -- in danger.
Fabulous Lives of Bollywood Wives (Season 2): Reality. Cameras follow the banter and bonding between four fun-loving women from Bollywood's inner circle as they juggle professions, family and friendship.
Fakes (Season 1): Teen drama. Emilija Baranac and Jennifer Tong lead this YA dramedy series about friendship and fraud told from different perspectives.
You're Nothing Special (Season 1): Spanish teen drama. Life in Amaia's new hometown starts to get a lot more interesting when a rumor spreads at school that she's inherited her grandmother's magical talents.
Read more: The Absolute Best Movies on Netflix
Best Netflix original TV shows
At the time of writing, these TV shows all scored at least 70 on Metacritic.
Thriller
Netflix
Lupin (2021—)
If you enjoyed Money Heist, then meet Lupin, another non-English language show with an action-packed story. This time we're in France, where professional thief Assane Diop enacts his revenge mission on the man responsible for his father's death. Inspired by a book about gentleman thief Arsène Lupin, Assane uses disguises, thieving know-how and a good dose of charisma to expose the wealthy and powerful Hubert Pellegrini's crimes.
Netflix
Bodyguard (2018)
Bodyguard broke records when it first aired in Britain, climbing from cliffhanger to cliffhanger at a relentless pace. This might be the definition of the unstoppable binge, not surprising given it comes from the mind of Line of Duty's Jed Mercurio. Game of Thrones' Richard Madden plays the titular bodyguard, who suffers from PTSD after serving in the Afghanistan war. On top of that, he's assigned to protect the Home Secretary (Keeley Hawes), whose politics he despises. Taking provocative turns, and crafting one of the best-ever 20-minute opening scenes, Bodyguard is an expert tension-building balancing act.
Netflix
House of Cards (2013-2018)
While Kevin Spacey's sexual harassment allegations ended up marring this slick, fourth-wall breaking slice of politics' dark side, it's still worth watching if you dig power games and the occasional backstabbing. Initially following Spacey's Frank Underwood, House of Cards' sixth and final season pivots to follow his wife Claire (Robin Wright) as she takes on more and more power in the Oval Office.
Horror
Netflix
Midnight Mass (2021)
From the auteur who brought us The Haunting of Hill House and Bly Manor, comes another slow-burning horror series that'll haunt you for days. Midnight Mass is Mike Flanagan's latest creation, a meticulously crafted mystery spanning seven hourlong episodes. Riley Flynn, still paying the price for a drunk driving accident four years ago, returns home to Crockett Island, where the arrival of a charismatic new priest coincides with astonishing miracles around the town. Pregnant with a sense of foreboding and dread, Midnight Mass is an eloquent interrogation of faith, with horrifying supernatural monsters along for the ride.
Steve Dietl/Netflix
The Haunting of Hill House (2018)
Mike Flanagan's The Haunting of Hill House, loosely based on Shirley Jackson's novel of the same name, weaves its horror into a deeply affecting story about a broken family. Fractured after growing up in a haunted house, the Crains can't ignore their past and must do what you never want to do: Go back down those dark corridors. The impressive set-pieces will please horror fans, but it's the sad story of the Crains that will, yes, haunt you for days. Good news: The second chapter of the anthology, The Haunting of Bly Manor, is a similarly affecting Gothic romance.
Netflix
Crazyhead (2016)
If you were a fan of Howard Overman's insanely entertaining Misfits, Crazyhead might be where you want to head next. Overman's follow-up show, which first aired in the UK in 2016, is a comedy-horror starring Cara Theobold (the voice of Tracer in Overwatch) and Susan Wokoma as unlikely friends who bond over being able to see demons gallivanting about in normal society. Their brilliant double-act is at the heart of this disturbingly entertaining series, featuring exorcisms, accidental roommate killings and demon fathers. Yeah, you need to watch this for yourself.
Sci-fi
Netflix
Archive 81 (2022)
Enjoy sci-fi series that play with two timelines? Have a special spot for cults and mysteries? Meet Archive 81. The multiple genre-straddling show stars Mamoudou Athie as Dan Turner, an archivist who takes a gig restoring a collection of damaged videotapes from the '90s. He gets far more than he bargained for, drawn into an investigation of a mysterious cult and a young woman who may or may not be dead. A supernatural thriller with horror, mystery, noir and sci-fi seeped into its creepy atmosphere, Archive 81 has it all.
Netflix
Dark (2017-2020)
Germany's answer to Stranger Things deliberately takes its time before stepping into completely compelling and original places. A sci-fi noir, Dark folds time travel, conspiracies and estranged families into a generation-spanning story kicked off by a child's disappearance. If those kinds of meticulously-crafted layers are what you're after in your storytelling, settle in. All three seasons of Dark's meditative look at time travel and its effect on human nature are waiting to hit you at full force.
Netflix
Stranger Things (2016—)
It wouldn't be a best list without Stranger Things. If somehow you've missed the Duffer Brothers' ode to '80s horror and Steven Spielberg, things are about to get tubular. We follow El, a near-mute girl who was the subject of scientific experiments. She develops telekinetic powers, which she uses to fend off monsters who invade from a frightening alternative dimension. The world of Indiana, Hawkins, is lovingly detailed for anyone in need of an '80s nostalgia hit and the misfit characters, played by a stellar young cast, are part of everything that makes this show a tour de force.
Netflix
Travelers (2016-2018)
Full disclosure: Netflix sadly canceled Travelers after its third season, but this tightly plotted sci-fi out of Canada does manage to end with an ambitious bang. We start with Marcy, a disabled woman who's beaten up after helping a friend escape thugs. She dies -- then comes back to life. This strong character-driven sci-fi reveals its secrets in clever ways, following operatives from the future tasked with preventing the collapse of society but also navigating the tricky territory of living a double life.
Laurie Sparham/Netflix
Black Mirror (2011—)
While Charlie Brooker's bleak tech anthology series can be hit and miss, at its best, Black Mirror packs its mini-movies with an exploration of futuristic technological ideas through painfully human stories. One of those is San Junipero, following two women in the '80s (cue banging soundtrack) as they fall for each other in ways they couldn't do in their "real" lives outside the beach city. The tech aspect is revealed with genius timing and, in general, the show explores the consequences of our plugged-in lives in disturbing and occasionally uplifting ways.
Drama
Netflix
Extraordinary Attorney Woo (2022—)
Extraordinary Attorney Woo hasn't even finished airing its first season on Netflix, and it's already a runaway winner. Its unique concept: A woman who has autism becomes a lawyer in South Korea, elevated by her brilliant and unexpected ways of approaching cases. An inspiring heroine, Woo Young-woo (Park Eun-bin) brings extraordinary representation to the screen. Charming, heartwarming, as radiant as the sun -- you could watch this show for days.
Mike Kollöffel/Netflix
Borgen (2010—)
Denmark's bleaker answer to the West Wing. Borgen is the epitome of sophisticated political dramas, chronicling the inspiring fictional underdog story of how, against all odds, Birgitte Nyborg Christensen (Sidse Babett Knudsen) becomes the first female prime minister of Denmark. Produced by the same company behind The Killing, Borgen is four influential seasons of one woman's complicated, intricate rise to power.
Netflix
Maid (2021)
Margaret Qualley is the heart of this miniseries based on a memoir. Maid follows Alex, a young mother trying to support her daughter by working as a housecleaner. Alex's task is made slightly more difficult thanks to an abusive relationship, poverty, homelessness and more. But it's not all heavy subject matter, with light and charming moments that give Maid an extra sheen. Not only a moving story expertly crafted, Maid cements Qualley as a major star.
Netflix
The Queen's Gambit (2020)
How do you make chess the thrilling centerpiece of a coming-of-age tale? You shake it into a cocktail of stylish visuals, a rocking '60s soundtrack and the magnetic Anya Taylor-Joy as Beth Harmon, one of the youngest (and few female) chess players in the world. The fictional story in The Queen's Gambit, named after a chess opening, follows her rise from an orphanage to toppling the best players in the world -- as long as her drug addiction and bags of wine bottles don't get in the way.
Netflix
Unorthodox (2020)
This miniseries is based on a memoir and told primarily in Yiddish with painstaking detail. Almost a thriller, Unorthodox follows 19-year-old Esty Shapiro, who escapes her arranged marriage in an ultra-Orthodox community in Brooklyn. She ends up in Berlin, exploring a new life outside the strict beliefs she grew up in, but her community doesn't let go that easily. Featuring a stunning performance from Shira Haas, Unorthodox lets you take a step into a relentlessly compelling world.
Netflix
Godless (2017)
This miniseries carves itself firmly into the Western genre, with a female-led cast boasting Merritt Weaver and Downton Abbey's Michelle Dockery. With its 1880s New Mexico vistas swirling around it, Godless draws up the violence in a tale that sees an outlaw on the run from his boss seek refuge with an outcast widower. Oh, Jeff Daniels is in this too, if the show wasn't enticing enough.
Netflix
The Crown (2016—)
Sumptuous is one word to describe the production values of The Crown's drama about the British monarchy. Following Queen Elizabeth II's life, starting in her 20s with a powerhouse performance from Claire Foy, The Crown captures the grand workings of historical events from deep within Buckingham Palace. Figures like Winston Churchill, Princess Margaret, Margaret Thatcher and more are treated with the highest cinematic sophistication. A fifth and sixth season are on their way to round out your knowledge of the queen's reign into the early 21st century.
Fantasy
Netflix
Arcane (2021—)
One of the best TV shows of 2021 was an animated series. That's right -- if you're animation-unfriendly, Arcane is the show to change your mind. The action-adventure introduces us to the steampunk world of Piltover and Zaun, two cities grinding on opposing values and fortunes. Then there's Violet (Hailee Steinfeld) and Jinx (Ella Purnell), two sisters torn apart by tragedy and fighting to survive. Arcane is the kind of moving portrait that gets under your skin on a par with Pixar. The characters will draw you to tears. A must-watch.
Netflix
Sweet Tooth (2021—)
This fantasy based on Jeff Lemire's comic book is the definition of weird and wonderful. Sweet Tooth follows Gus (a stellar Christian Convery), a half-deer half-human child, who lives a sheltered life in the forest with his dad Pubba (Will Forte). Events relating to The Great Crumble, a viral pandemic, sweep Gus into an adventure branching down mysterious, action-filled and highly entertaining paths. Echoes with real-world struggles can be heard in the treetops of this immersive, riveting fantasy world. Genre fans settle in for this fantastic ride.
Kevin Baker / Netflix
The Dark Crystal: Age of Resistance (2019)
We weren't ready for The Dark Crystal: Age of Resistance. Canceled after one season, the critically acclaimed fantasy series is, well, a gem. A prequel to the 1982 Jim Henson film, the series returns to the planet Thra, where three Gelflings inspire a rebellion against the absolutely diabolic Skeksis. The puppet design and performances -- from a stunning cast including Taron Edgerton, Anya Taylor-Joy and Nathalie Emmanuel -- sneak up on you. You'll find yourself deeply invested in the poor, oppressed Gelflings' lives, hurt just as much as the puppets whenever one of their own is harmed. A full-on fantasy epic, built with love, care and staggering detail.
Crime
Netflix
Unbelievable (2019)
This miniseries, based on a true story of rape, deftly navigates its disturbing and tricky subject matter with the help of a remarkable performance from Kaitlyn Dever. She plays Marie, a teenager who's charged with lying about being raped, but of course it's more complicated than that. Toni Collette and Merritt Wever team up as whip-smart detectives who see what others fail to, adding another layer to Unbelievable's delicate, powerfully moving triumph.
Netflix
When They See Us (2019)
Ava DuVernay's When They See Us comes under the tough but essential viewing banner. It depicts the real-life events of the 1989 Central Park jogger case, involving five male suspects of color who were falsely accused of rape and assault. Not only sensitively drawing the humanity of the boys into focus, When They See Us demands outrage at the injustice of systemic racism.
Netflix
The Sinner (2017—)
Four fascinating seasons of The Sinner await to be cracked open, each one focused on a murder committed by an unlikely offender in even stranger circumstances. Season 1 follows Jessica Biel's Cora, who stabs a man to death on a beach in a sudden frenzy, but has no idea why. It's up to Bill Pullman's Detective Ambrose to unravel the shockingly disturbing events embedded in her psyche that lead to her being triggered.
Netflix
Money Heist (2017—)
This series is loved by many (and Netflix loves you for it), but in case you haven't heard what all the fuss is about, Money Heist is, yep, about a heist. The mastermind doing Ocean's Eleven-level prep work with equally satisfying reveals is The Professor. He's got banks in his sights and we see how his intricate plans come together with slick flashbacks, time-jumps and even an unreliable narrator. This is captivating TV with a distinct Spanish identity -- don't let the subtitles put you off.
Netflix
American Vandal (2017-2018)
The first two seasons of this mockumentary series burst onto Netflix with a potent combination of potty humor and social commentary. A parody of true crime documentaries such as Netflix's own Making a Murderer, American Vandal follows the aftermath of a high school prank gone wrong. After 27 faculty cars are left fatally vandalized with grievous phallic images, it's up to a couple of sophomores to crack the crime, before the wrong person is expelled for good. Yep, this is a satire. But it weaves a surprisingly engrossing mystery that creates an accurate bigger picture of contemporary high school life. A hefty achievement.
Netflix
Alias Grace (2017)
This miniseries is from a couple of years ago, but in case you missed it, it's definitely worth checking out. In the vein of The Sinner, Alias Grace steps back into its young female protagonist's past to figure out why she commits murder, of which she has no memory. An adaptation of a Margaret Atwood novel, the show stars a hypnotic Sarah Gadon as Irish immigrant Grace, navigating a turbulent life as a servant for a family in colonial Toronto. Partly based on a true story, this isn't a straightforward mystery with straightforward answers and that's what makes it all the more captivating.
Netflix
Mindhunter (2017-2019)
David Fincher directs a stash of episodes in this psychological crime thriller's two-season run (the third is on indefinite hold), so meticulous visuals and captivating storylines are a given. Holden Ford (Jonathan Groff) is a special agent in the FBI, sent to interview serial killers in prison to build a profile of what makes them tick. Cameron Britton as real-life serial killer Ed Kemper is absolutely chilling. Mindhunter is smarter and richer than your average crime show, somehow growing with its complex characters. It would be a shame if the third season didn't happen (although that seems to be the case).
Netflix
Narcos (2015-2017)
Drug kingpin Pablo Escobar is the subject of this, yes, addictive series that races through his rise to becoming the infamous cocaine distributor and billionaire. A true-to-life account that blends in archival footage, Narcos manages to present a sympathetic side to Escobar without undermining the gravity of its material. Plus, the DEA's hunt to bring Escobar down ratchets up the suspense. After you finish the three series, head to Narcos: Mexico, a companion series that focuses on the illegal drug trade in Mexico.
Netflix
Peaky Blinders (2013-2022)
Netflix wisely snapped up the rights to Peaky Blinders and there are six seasons (and eventually a spinoff film) to traverse the stunning rise of 1900s Birmingham gang leader Thomas Shelby. Prepare yourself for a mesmerizing performance from Cillian Murphy in this family saga that has a fantastic amount of fun and flair showing Shelby's dealings with other gangs, the police and the occasional lover.
Romance
Netflix
Heartstopper (2022—)
If you're in the market for an impeccable new happy place to move into, look no further. Heartstopper is a bright spark of a coming-of-age series, telling an LGBTQ+ love story with compassion and grace (and no one dies). Charlie falls in love with Nick, but Nick is still figuring out his sexuality. With real teenagers playing teenagers, fleshed out characters and little animations that evoke Alice Oseman's graphic novel of the same name, Heartstopper is a safe, joyous, life-affirming queer romance. Essential viewing.
Netflix
Bridgerton (2020—)
Known as Jane Austen but with sex, this period piece offers a different take on the early 19th century dating scene. With lavish production designs and colorful costumes, this is Regency London like you've rarely seen it. The Bridgerton siblings' adventures in love are captured by a scandalous newsletter, written by Regency London's version of Gossip Girl, voiced by none other than Julie Andrews. Settle in for this gorge-worthy viewing.
Netflix
Love (2016-2018)
This Judd Apatow creation draws the best out of the talented Gillian Jacobs (Britta in Community) and Paul Rust. They play Mickey and Gus respectively, an opposites-attract couple, who go to messy, frustrating and endearingly down-to-earth places that make this an honest look at a relationship being built over time. Iris Apatow is a standout as the unhappy child actress Gus tutors who gets away with just about anything.
Netflix
Lovesick (2014-2018)
Easy, enjoyable viewing with a premise ripe for embarrassment humor. Helpless-in-love Dylan discovers he has chlamydia and must track down past flings and inform them they might have it too. A flashback narrative keeps us on our toes, especially when the focus turns to Dylan and best friend Evie's feelings for each other. It never goes into soapy territory, with an eccentric but loveable supporting cast playing English flatmates in a Glasgow setting.
Comedy
Netflix
The Chair (2021—)
A comedy-drama starring Sandra Oh? The Chair is elevated by Oh's impeccable charm. Set at the fictional Pembroke University, The Chair follows Oh's Professor Ji-Yoon Kim, the newly appointed chair of the English department. She's the first woman chosen for the position and faces an uphill battle to move the stale department along with the changing times. With astute observations about academia, scene-stealing appearances by Holland Taylor as a senior faculty member, and ambitious social commentary, The Chair reaches worthy heights.
Netflix
Never Have I Ever (2020—)
Devi is your average high schooler who wants nothing more than to be cool and get a boyfriend. But it's hard to stay chipper after your dad dies. Mindy Kaling's coming-of-age story covers familiar territory and yet it stands out from the pack in multiple ways. Get this: Its narrator is John McEnroe. The sporting connection is just one layer of this surprising, charm-your-socks-off show, depicting an Indian family living in California. You've seen these stories before, but not with these unique characters.
Netflix
Julie and the Phantoms (2020—)
Stick with Julie and the Phantoms' silly premise before making any judgements. Julie is a teenager who accidentally summons a boy band from the '90s -- The Phantoms. While Julie helps the band achieve their potential, they help her enjoy music and life again after the death of her mother. As music tends to do, the catchy tunes will send you soaring through the joyous, ridiculously entertaining and, of course, romance-filled first season. Ghost jokes are included.
Netflix
Feel Good (2020-2021)
Comedian Mae Martin's Feel Good really does try to do what it says on the tin. It follows the repressed George (Charlotte Ritchie) as she falls for Martin's Mae after seeing her stand-up show. Their London-based romance sees George grappling with coming out to her middle-class friends and family, while Canadian Mae has a drug problem that makes their love even more difficult. A confidently told story with its sense of humor nailed on from the start, Feel Good exudes sweetness and grace.
Sam Taylor/Netflix
Sex Education (2019—)
Binging Sex Education is a no-brainer: The self-aware, John Hughes-possessed mishmash of American and British high school culture is a joyful breeze to watch. We follow Otis (Asa Butterfield), the son of a sex therapist (Gillian Anderson), as he embarks on his sexual awakening. The explicit sex talk and scenes are addressed in refreshingly healthy and honest ways. Built around a diverse cast with pure charisma, the show gets even bigger in season 3.
Netflix
Russian Doll (2019—)
Russian Doll takes its Groundhog Day premise and wrenches it apart in the most unpredictable ways. Natasha Lyonne is the crackling spark at the center of its time-looping mystery, playing Nadia, a game developer who repeatedly dies on the night of her 36th birthday party. The Amy Poehler co-created show uses time travel to explore self-reflection on a whole new level, making this a definite one-sitting appointment.
Guy D'Alema/Netflix
Cobra Kai (2018—)
Initially Cobra Kai, a series based on the Karate Kid films, might sound like a cynical money-making spinoff of the martial arts franchise. But it's become one of Netflix's most popular shows, thanks to well-written characters and a good measure of nostalgia. The series follows Johnny Lawrence, 34 years after he was jump-kicked in the face by Daniel LaRusso. Taking this subversive viewpoint, Cobra Kai is four seasons of self-aware, light-hearted and full-of-heart fun.
Netflix
Derry Girls (2018—)
Another unmissable show, Derry Girls follows the mishaps of Erin and her friends in 1990s Derry, Ireland. Their teenage woes are paired with antics from their equally hilarious parents, set on a backdrop of the Northern Ireland conflict. While you can make comparisons with The Inbetweeners, Derry Girls draws from its own well of sweet charm and the historical context paves ground for surprisingly dark humor.
Michele K Short/Netflix
Maniac (2018)
This dark comedy miniseries stars Emma Stone and Jonah Hill as two strangers, Annie and Owen, who sign up for a mysterious pharmaceutical trial (because that's a good idea) that induces wild, often distressing dreams. Entrenched in dazzlingly crafted visuals, Maniac is a multilayered dive into the subconscious. Which means it's dark and unpredictable, with a surprising touch of the warm sentimental stuff.
Netflix
GLOW (2017-2019)
A show inspired by the true story of the first pro female wrestling syndicate in the '80s? Starring Alison Brie? Produced by Jenji Kohan? Dreams do come true. GLOW's purely fun comedy, packed with eccentric female characters, teams campiness with underdog triumph and soars. Season 3 progresses deeper into the lives of its diverse ensemble, shifting the series to Las Vegas. A fourth and final season was in the works, but sadly production fell victim to the pandemic and Netflix canceled the show.
Netflix
Dear White People (2017-2021)
This provocatively titled show delivers a timely look at modern race relations through the eyes of a different character each episode. Following several Black students at Winchester, an Ivy League institution, Dear White People manages to blend its social commentary with a sharp sense of humor. With its fourth and final season now in the books, this remains a powerful eye-opener.
Netflix
The End of The F***ing World (2017-2019)
If you like your dark British humor, look no further than The End of The F***ing World. Psychopath James (Alex Lawther) comes up with a plan to kill Alyssa (Jessica Barden) while on the run from their lousy parents. But as they soar across the open road and commit a couple of violent crimes, their callous hearts soften and they develop feelings for one another. Surprising, fast-paced and surreal, both seasons of this deadpan teenager of a show, with its headphones pumping the best sad '50s, '60s and '70s doo-wop, will blow you away.
Netflix
Crashing (2016)
Before she electrified everyone with the word-for-word perfect Fleabag, Phoebe Waller-Bridge wrote a six-part comedy that showcased the early stages of her astonishing talent. Crashing follows six twenty-somethings living in a disused hospital, casually observing the strict rules in exchange for cheap rent. The oddball characters subvert expectations wherever hilariously possible, with Waller-Bridge dropping in as the ukulele-playing Lulu. Not only disrupting the Friends setup, she gets herself into occasionally jaw-droppingly dark situations (see the all-too-touchy Aunt Gladys).
Netflix
Master of None (2015—)
On the surface a comedy about a 30-year-old New Yorker who loves his pasta, Master of None casually throws in nuanced and moving episodes about immigrant families and their second-generation children. Then it drops an entire episode about Tinder. Dev's relatable experiences bubble with creator and star Aziz Ansari's wit and charm and, personal controversy aside, the romantic and cultural themes he explores are remarkably mature. Season 3 takes things down a different road again, starring Lena Waithe and Naomi Ackie. Ansari features in an episode, letting us know where Dev's at in his love life.
Netflix
Call My Agent! (2015-2020)
Thinking about dipping your toe into more of Netflix's international content? French comedy Call My Agent! hosts an ever-growing list of famous actors playing themselves, from French stars to Americans like Sigourney Weaver (!) in the latter seasons. But we look at the world of showbiz from the perspective of the long-suffering agents, including Camille Cottin's scene stealing powerhouse agent Andréa Martel, who rebuffs male colleagues with lines like: "When I moved on from guys to girls, it was like graduating from the sandpit to the football pitch." A brilliant series with four seasons poking fun at the entertainment industry (a fifth season and a TV film are on their way).
Netflix
BoJack Horseman (2014-2020)
When it comes to cartoons that lower your guard before gut-punching you with reflections on mental health, BoJack Horseman takes the cake. Set in an LA filled with anthropomorphic animals, it follows a washed-up ex-sitcom star who tries to climb back to his former celebrity by releasing an autobiography. While at first it might take you some time to digest this unconventional cocktail, BoJack Horseman soon astounds you with its truths about struggling with depression and addiction on the path to getting your life back on track.
