Biogen Gives Up on Drug for Lou Gehrig’s Disease





A closely watched experimental drug to treat Lou Gehrig’s disease failed to work in a late-stage clinical trial, the drug’s developer, Biogen Idec, said Thursday. The company said it would discontinue further work on the drug.




Biogen said that the drug was not effective in either slowing the loss of muscular function or prolonging the lives of people with the disease, formally known as amyotrophic lateral sclerosis, or A.L.S.


There were also no signs that the drug, dexpramipexole, worked in any subgroup of patients, Biogen said.


“As a physician who has treated people with A.L.S., I hoped with all my heart for a different outcome,'’ Dr. Douglas Kerr, director of neurodegeneration clinical research at Biogen, said in a statement.


A.L.S., which attacks the nerves that control muscles, causes gradual paralysis and typically results in death within a few years of diagnosis. There are about 30,000 Americans with the disease.


There is only one drug approved to treat it, Rilutek, made by Sanofi, which doctors say has only modest effectiveness. Many other drugs have failed in clinical trials, in part because scientists do not understand the cause of A.L.S. and therefore do not know how to treat it.


While expectations had not been that high that dexpramipexole would succeed in its phase 3 trial, they were higher than for many previous A.L.S. drugs, given what some doctors viewed as strong results in a smaller, phase 2 trial.


“I’m more excited about this compound than any compound I’ve ever tested in A.L.S.,'’ Dr. Robert Miller, director of A.L.S. research at the California Pacific Medical Center in San Francisco, said in April on a call with investors hosted by Deutsche Bank. Patients getting the highest dose had an almost a 50 percent slower decline in muscular function than those receiving a placebo.


Biogen had licensed dexpramipexole from Knopp Biosciences, a privately held company in Pittsburgh. Biogen’s trial included 943 patients in 11 countries. The main measurement of success was a composite that took into account both deaths from the disease and the decline of functionality. Patients in the trial were allowed to take Rilutek.


Dr. Jeffrey D. Rothstein, director of the Brain Science Institute at Johns Hopkins University School of Medicine, said the results were disappointing but not surprising.


“We really, really need a new drug,'’ Dr. Rothstein, who was not involved in the phase 3 trial, said by e-mail. He said he thought the phase 2 results for dexpramipexole had been only “marginal,'’ so he was not surprised the latest trial did not succeed.


The reaction on Wall Street was somewhat muted because of the modest expectations for the trial to succeed. Biogen’s shares were down about 4 percent.


“We (and most of the Street) had characterized this trial as a high risk trial,'’ Mark Schoenebaum, an analyst at ISI Group, wrote in a research note Thursday.


Other companies are also developing drugs to treat A.L.S. Neuraltus Pharmaceuticals, a privately held company in Palo Alto, Calif., is preparing to enter the final stage of clinical trials for NP001.


The company announced in late October that its phase 2 trial, which involving 136 patients, failed to show a statistically significant benefit compared to a placebo. But the company said that 27 percent of patients getting the high dose of NP001 had no progression of their disease for six months, two and a half times as many as in the placebo group.


Cytokinetics, of South San Francisco, Calif., is in mid-stage testing of a compound, tirasemtiv, which might make muscles respond more forcefully to nerve signals.


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Brown plans extensive changes for school funding in 2013









SACRAMENTO — Gov. Jerry Brown will push this year to upend the way schools are funded in California, hoping to shift more money to poorer districts and end requirements that billions of dollars be spent on particular programs.


Brown said he wants more of the state's dollars to benefit low-income and non-English-speaking students, who typically are more expensive to educate.


"The reality is, in some places students don't enjoy the same opportunities that people have in other places," the governor said in an interview. "This is a way to balance some of life's chances."





He would also scale back — and possibly eliminate — dozens of rules that districts must abide by to receive billions in state dollars. Some of those requirements, such as a mandate to limit class size, have been suspended amid Sacramento's recurrent budget problems but are set to resume by 2015.


Brown and his aides are keeping most details under wraps. But advisers say his proposals, part of the budget blueprint to be unveiled early this month, will amount to the most extensive changes in decades in the relationship between school districts and state government.


His intentions are already raising concerns among school administrators, district officials and labor unions. The governor postponed earlier plans to push for the changes when the discord threatened to distract from his campaign for higher taxes. Voters approved the tax hikes in November, averting billions of dollars in education cuts.


Now, the transformation of school funding is at the top of his agenda. He says his goal is more local control.


"What the state has done for 40 years is develop one new program after another to compensate for underperforming" schools, he said. "What we have now is command and control issuing from headquarters in Sacramento."


Scores of programs set up by state mandate — for smaller classes, bilingual education and summer school, for example — have their own pots of money sent from Sacramento to pay for them. ¿The Public Policy Institute of California found that nearly 40% of every dollar sent to schools from both the state and federal governments is earmarked for such a purpose.


The programs vary in size and scope: $4.5 million to meet the needs of Native American students, $10 million to improve school Internet access, more than $618 million set aside for school buses, etc.


According to Brown's Department of Finance, 56 such programs received a total of $11.8 billion in state funds last year. ¿The result, the governor says, is a bloated school bureaucracy that takes money away from core instruction.


"You have to have administrators at the state level, district level and at the school level who are engaged in making sure this money is used for what it's supposed to be used for," Brown said. "This constant articulation of rules is a world unto itself that is not directly supporting the teacher in the classroom."


But many of the programs are popular with parents and various interest groups and have staunch defenders in the Capitol. They say lifting restrictions on how schools spend their money could hurt struggling students.


In recent years, state lawmakers have offered districts some flexibility to cope with rounds of budget cuts. The results, some say, have not always been good, leading to larger classes and sharp reductions in programs for adults trying to earn a high school degree.


Since 2008, the average class size in kindergarten through third grade has grown from 20 to 23, among the largest in the nation, according to a study from the Public Policy Institute of California. During the same period, the average class size elsewhere in the country remained at around 15 students.


In addition, "since schools have been given greater flexibility, adult education ... has been decimated throughout the state," said Jeff Freitas, secretary-treasurer of the California Federation of Teachers. "You can't just give the locals carte blanche with the money."


Shifting money to poorer schools at the expense of wealthier ones is also certain to stir protest.


Under a similar proposal the governor floated last year, the Department of Finance estimated that Compton Unified schools would see an uptick of more than $4,700 per pupil by the 2017-18 school year. Manhattan Beach Unified would get a per-student increase of just $681.


Those who have met with Brown's top education aides expect the governor to propose a similar formula in January, asking districts to account for the expenditures to make sure the funds serve higher-needs students.


Adonai Smith, a lobbyist for the Assn. of California School Administrators, said his members would not support a plan that amounts to a "redistribution of resources."


The governor says that even if funding is tweaked to favor more poor students and English learners, all schools will receive more money now that state revenue is on the uptick.


"I want to align more closely the money schools receive with the problems that teachers encounter," Brown said. "When somebody's teaching in Compton, it's a much bigger challenge than teaching in Beverly Hills."


anthony.york@latimes.com





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Go Bionic With These Wearable Arduino Projects

The emerging field of smart textiles, known as "Wearables" or e-textiles, has gained considerable momentum in the past few years as enthusiasts continue to build more and more complex projects with microcontrollers that keep growing in power while shrinking in size.

The LilyPad Arduino microcontroller board helped bring a large developer community into Wearables with its debut in 2007; since then it has allowed many of those who dream of blending technology and everyday clothing to build out their ideas.

The diminutive microprocessor, designed to be incorporated into apparel or other soft goods, has easy connectors that integrate with a range of sensors and actuators with conductive thread. This combination opens a new platform for technology and fashion, allowing for easy projects like embedded LEDS, or more advanced projects like motorized, moving components that react from environmental conditions.

Since the debut of the Lilypad, there have been advancements in the open source wearable technology arena, with the Adafruit Flora being the next generation of that field, providing more advanced specs in an even smaller package.

Above:



Designer Lulin Ding has created a digitized version of eyeshadow, constructed from an Arduino Lilypad and thin wires that double as a supportive frame that surrounds the eye with a cyber look. Hoping to recreate the effect of standard eyeshadow that is primarily visible when the eyes are closed, Ding's high-tech version lights up in response to blinking.

Digitized Eyeshadow from Lulin Ding on Vimeo.



Photo: Courtesy Lulin Ding

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Low-cost Chinese film sets new record






BEIJING (AP) — A low-budget, domestically produced comedy has unexpectedly become the highest-grossing Chinese film to date.


Chinese state media say the wacky road movie “Lost in Thailand” has grossed more than 1 billion yuan ($ 160 million) since its Dec. 12 debut. The official Xinhua News Agency, citing an independent monitor of box office figures, said Wednesday that it also beat James Cameron‘s “Titanic” in 3-D, the most popular foreign film in 2012, in Chinese theaters.






Set in Thailand, the film tells the story of two businessmen who go searching for their boss in the north, and then link up with a tourist eager to explore the country. It is filled with slapstick humor and action scenes.


The previous record for a domestic film was 726 million yuan set by “Painted Skin 2.”


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Well: Good and Bad, the Little Things Add Up in Fitness

Phys Ed

Gretchen Reynolds on the science of fitness.

The past year in fitness has been alternately inspiring, vexing and diverting, as my revisiting of all of the Phys Ed columns published in 2012 makes clear. Taken as a whole, the latest exercise-related science tells us that the right types and amounts of exercise will almost certainly lengthen your life, strengthen your brain, affect your waistline and even clear debris from inside your body’s cells. But too much exercise, other 2012 science intimates, might have undesirable effects on your heart, while popping painkillers, donning stilettos and sitting and reading this column likewise have their costs.

With New Year’s exercise resolutions still fresh and hopefully unbroken on this, day two of 2013, it now seems like the perfect time to review these and other lessons of the past year in fitness science.

First, since I am habitually both overscheduled and indolent, I was delighted to report, as I did in June, that the “sweet sport” for health benefits seems to come from jogging or moderately working out for only a brief period a few times a week.

Specifically, an encouraging 2012 study of 52,656 American adults found that those who ran 1 to 20 miles per week at an average pace of about 10 or 11 minutes per mile — my leisurely jogging speed, in fact — lived longer, on average, than sedentary adults. They also lived longer than the group (admittedly small) who ran more than 20 miles per week.

“These data certainly support the idea that more running is not needed to produce extra health and mortality benefits,” Dr. Carl J. Lavie, a cardiologist in New Orleans and co-author of the study told me. “If anything,” he said, “it appears that less running is associated with the best protection from mortality risk.”

Similarly, in a study from Denmark that I wrote about in September, a group of pudgy young men lost more weight after 13 weeks of exercising moderately for about 30 minutes several times a week than a separate group who worked out twice as much.

The men who exercised the most, the study authors discovered, also subsequently ate more than the moderate exercisers.

Even more striking, however, the vigorous exercisers subsequently sat around more each day than did the men who had exercised less, motion sensors worn by all of the volunteers showed.

“They were fatigued,” said Mads Rosenkilde, a Ph.D. candidate at the University of Copenhagen and the study’s co-author.

Meanwhile, the men who had worked out for only about 30 minutes seemed to be energized by their new routines. They stood up, walked, stretched and even bounced in place more than they once had. “It looks like they were taking the stairs now, not the elevators, and just moving around more,” Mr. Rosenkilde said. “It was little things, but they add up.”

And that idea was, in fact, perhaps the most dominant exercise-science theme of 2012: that little things add up, with both positive and pernicious effects. Another of my favorite studies of 2012 found that a mere 10 minutes of physical activity increased life spans in adults by almost two years, even if the adults remained significantly overweight.

But the inverse of that finding proved to be equally true: not fitting periods of activity into a person’s daily life also affected life span. Perhaps the most chilling sentence that I wrote all year reported that, according to a large study of Western adults, “Every single hour of television watched after the age of 25 reduces the viewer’s life expectancy by 21.8 minutes.”

I am watching much less television these days.

But not all of the new fitness science I covered this year was quite so sobering or, to be honest, consequential. Some of the more practical studies simply validated common sense, including reports that to succeed in ball sports, keep your eye on the ball; during hot-weather exercise, pour cold water over your head; and, finally, on the day before a marathon, eat a lot.

But when I think about the science that has most affected how I plan my life, I return again and again to those studies showing that physical activity alters how long and how well we live. My days of heedless youth are behind me. So I won’t soon forget the study I wrote about in September detailing how moderate, frequent physical activity in midlife can delay the onset of illness and frailty in old age. Exercise won’t prevent you from aging, of course. Only death does that. But this study and others from this year underscore that staying active, even in moderate doses, dramatically improves how your aging body feels and responds.

Aging also inspired my favorite reader comment of 2012, which was posted in response to a research scientist’s name. “‘Dr. Head,’” the reader wrote. “That shall be the name of my all-senior-citizen metal band,” which, if its members gyrate and vigorously bound about like Mick Jagger on his recent tour, should ensure themselves decades in which to robustly perform.

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With a Mall Boom in Russia, Property Investors Go Shopping





MOSCOW — Shoppers who find that 250 stores aren’t enough can go ice skating, watch movies or even ride a carousel, all under a single roof.




While it sounds like the Mall of America, this mall is outside Moscow, not Minneapolis.


“I feel like I’m in Disneyland,” Vartyan E. Sarkisov, a shopper toting an Adidas bag, said recently while making the rounds of the Mega Belaya Dacha mall.


Instead of bread lines, Russia is known these days for malls. They are booming businesses, drawing investments from sovereign wealth funds and Wall Street banks, most recently Morgan Stanley, which paid $1.1 billion a year ago for a single mall in St. Petersburg.


One mall, called Vegas, rose out of a cucumber field on the edge of Moscow and became, its owners say, larger than the Mall of America if the American mall’s seven-acre amusement park is not counted in the calculation of floor space.


A few offramps away on the Moscow beltway, another mall scored a different kind of victory: the Mega Tyoply Stan shopping center drew 57 million visitors at its peak in 2007, well ahead of the 40 million annual visits reported by the Mall of America.


As American malls dodder into old age, gaptoothed with vacancies, Russia’s shopping centers are just now blossoming into their boom years, nourished by oil exports that are lifting wages.


“It’s 1982 all over again in Russia,” said Lee Timmins, the country representative of Hines, a Texas-based real estate group that is opening three outlet malls in Russia, referring to the heyday of the American mall experience. Russians, he said, love malls.


The mall boom illustrates an extraordinarily important theme in Russian economics these days. The growing crowds at malls, and the keen interest in Russian malls on the part of Wall Street banks, are signs that the emerging middle class that made up the street protests against Vladimir V. Putin in Moscow last winter is becoming a force in business as well as politics.


Investors, who with money at stake are a bellwether of the new trends, are not waiting for the next round of protests; they are already placing bets on the rise of a broad affluent class in Russia.


“Over the past 10 years, Russia has turned into a middle-class country,” Charles Slater, a retail analyst at Cushman & Wakefield, a commercial real estate consulting firm, said in an interview. “What better to do than go to an enclosed, warm environment with many things on offer, whether that be bowling, cinema or food courts, things the customers have not been used to in the past?”


Moscow now has 82 malls, including two of the largest in Europe, according to the International Council of Shopping Centers, a New York-based trade association. Both are owned by Ikea Shopping Centers Russia, the branch of the Swedish assemble-it-yourself furniture franchise that manages 14 malls here. In Russia, malls are still novel; the first Western-style suburban mall opened in 2000. They are now changing hands as developers sell to institutional investors, like Morgan Stanley, shedding light for the first time on their eye-popping values.


At the core of the attraction for investors is the rising disposable income of Russians, nudged along by policies favoring the middle class, lest their challenge to President Putin’s rule intensify.


Russia has a flat 13 percent income tax rate. Most Russians own their homes, a legacy of post-Soviet privatizations, and so pay no mortgage or rent. Health care is socialized.


Not surprisingly, then, Russians have become fanatical shoppers. Russians spend 60 percent of their pretax income on retail purchases, a category that includes food, according to Jones Lang LaSalle, a real estate consulting firm. The country in second place in Europe is Sweden, where retailing accounts for 40 percent of total private spending. Germans, by comparison, spend 28 percent of their salaries shopping, according to Jones Lang LaSalle.


Malls, where the secrets of Western capitalism were finally peeled open and laid bare, with fast food, clothes, ice rinks, electronics and appliances wherever the eye falls, have mesmerized shoppers here — much as they did in their early years in the United States, from the 1960s to the 1980s.


Olga N. Zaitsova, 55, who was in the Mega Belaya Dacha mall with her granddaughter Anastasia, said she came every weekend, drawn by the warm play area for toddlers. “It’s just not comfortable to be outside when it’s so cold,” she said.


When she shops, she said, “now we buy things we want, not things we need.”


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Ruling over bumper-car injury supports amusement park









SAN FRANCISCO — The California Supreme Court, protecting providers of risky recreational activities from lawsuits, decided Monday that bumper car riders may not sue amusement parks over injuries stemming from the inherent nature of the attraction.


The 6-1 decision may be cited to curb liability for a wide variety of activities — such as jet skiing, ice skating and even participating in a fitness class, lawyers in the case said.


"This is a victory for anyone who likes fun and risk activities," said Jeffrey M. Lenkov, an attorney for Great America, which won the case.








But Mark D. Rosenberg, who represented a woman injured in a bumper car at the Bay Area amusement park, said the decision was bad for consumers.


"Patrons are less safe today than they were yesterday," Rosenberg said.


The ruling came in a lawsuit by Smriti Nalwa, who fractured her wrist in 2005 while riding in a bumper car with her 9-year-old son and being involved in a head-on collision. Rosenberg said Great America had told ride operators not to allow head-on collisions, but failed to ask patrons to avoid them.


The court said Nalwa's injury was caused by a collision with another bumper car, a normal part of the ride. To reduce all risk of injury, the ride would have to be scrapped or completely reconfigured, the court said.


"A small degree of risk inevitably accompanies the thrill of speeding through curves and loops, defying gravity or, in bumper cars, engaging in the mock violence of low-speed collisions," Justice Kathryn Mickle Werdegar wrote for the majority. "Those who voluntarily join in these activities also voluntarily take on their minor inherent risks."


Monday's decision extended a legal doctrine that has limited liability for risky sports, such as football, to now include recreational activities.


"Where the doctrine applies to a recreational activity," Werdegar wrote, "operators, instructors and participants …owe other participants only the duty not to act so as to increase the risk of injury over that inherent in the activity."


Amusement parks will continue to be required to use the utmost care on thrill rides such as roller coasters, where riders surrender control to the operator. But on attractions where riders have some control, the parks can be held liable only if their conduct unreasonably raised the dangers.


"Low-speed collisions between the padded, independently operated cars are inherent in — are the whole point of — a bumper car ride," Werdegar wrote.


Parks that fail to provide routine safety measures such as seat belts, adequate bumpers and speed controls might be held liable for an injury, but operators should not be expected to restrict where a bumper car is bumped, the court said.


The justices noted that the state inspected the Great America rides annually, and the maintenance and safety staff checked on the bumper cars the day Nalwa broke her wrist. The ride was functioning normally.


Reports showed that bumper car riders at the park suffered 55 injuries — including bruises, cuts, scrapes and strains — in 2004 and 2005, but Nalwa's injury was the only fracture. Nalwa said her wrist snapped when she tried to brace herself by putting her hand on the dashboard.


Rosenberg said the injury stemmed from the head-on collision. He said the company had configured bumper rides in other parks to avoid such collisions and made the Santa Clara ride uni-directional after the lawsuit was filed.


Justice Joyce L. Kennard dissented, complaining that the decision would saddle trial judges "with the unenviable task of determining the risks of harm that are inherent in a particular recreational activity."


"Whether the plaintiff knowingly assumed the risk of injury no longer matters," Kennard said.


maura.dolan@latimes.com





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The Future Is Now: What We Imagined for 2013 — 10 Years Ago










Predicting the future is hard, but that doesn’t stop us from trying. We’re Wired, after all.


Ten years ago, we boldly declared that we’d be living with phones on our wrists, data-driven goggles on our eyes and gadgets that would safety-test our food for us. Turns out, a lot of the things Sonia Zjawinski conceptualized in our “Living in 2013” feature way back in 2003 were remarkably close to what we’ve seen. We even got the iPhone right (sort of).


And so, as we look back on life in 2013 circa 2003, we’re going to spin it forward once again to tell you what life will be like in 2023.





Mat Honan is a senior writer for Wired's Gadget Lab and the co-founder of the Knight-Batten award-winning Longshot magazine.

Read more by Mat Honan

Follow @mat on Twitter.



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‘Rings’ trilogy sound editor Hopkins dies in NZ






WELLINGTON, New Zealand (AP) — Oscar-winning sound editor Mike Hopkins, who worked on the “Lord of the Rings” trilogy and other Peter Jackson films, has died in a rafting accident in New Zealand. He was 53.


Hopkins drowned on Sunday when his inflatable raft capsized during a flash flood in a river on New Zealand‘s North Island, police senior Sgt. Carolyn Watson said. His wife survived.






The New Zealand Herald newspaper quoted “Rings” director Peter Jackson as saying many actors, directors and film crew members who were lucky enough to work with Hopkins would miss him deeply.


“Mike was a very genuine, caring and warm-hearted guy with a great sense of humor,” Jackson said.


A native New Zealander, Hopkins shared Oscars with sound editing partner Ethan Van der Ryn in 2006 for “King Kong” and in 2003 for “The Lord of the Rings: The Two Towers.” They also were nominated for 2007′s “Transformers.”


Hopkins also was sound editor on the two other “Rings” films and had worked on earlier Jackson movies including “Heavenly Creatures” and “The Frighteners.”


The Herald reported a family celebration of Hopkins’ life was planned on Thursday.


A river contractor, Bruce Slater, and his son used a jet boat to rescue Hopkins’ wife. Nicci Hopkins had been in the Waiohine River two hours and was clinging to a ledge in a narrow part of the gorge too dangerous for bigger boats or a helicopter.


Watson called the Slaters heroic. Slater told Fairfax New Zealand the flash flood raised the river 2 to 3 meters (9.8 feet) while the rafters were in the water.


“If they’d been half an hour earlier, they would have been clear of the gorge,” he said. And a half hour later, the water levels would have been noticeably dangerous before the rafters launched, Slater said.


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Hispanic Pregnancies Fall in U.S. as Women Choose Smaller Families





ORLANDO, Fla. — Hispanic women in the United States, who have generally had the highest fertility rates in the country, are choosing to have fewer children. Both immigrant and native-born Latinas had steeper birthrate declines from 2007 to 2010 than other groups, including non-Hispanic whites, blacks and Asians, a drop some demographers and sociologists attribute to changes in the views of many Hispanic women about motherhood.




As a result, in 2011, the American birthrate hit a record low, with 63 births per 1,000 women ages 15 to 44, led by the decline in births to immigrant women. The national birthrate is now about half what it was during the baby boom years, when it peaked in 1957 at 122.7 births per 1,000 women of childbearing age.


The decline in birthrates was steepest among Mexican-American women and women who immigrated from Mexico, at 25.7 percent. This has reversed a trend in which immigrant mothers accounted for a rising share of births in the United States, according to a recent report by the Pew Research Center. In 2010, birthrates among all Hispanics reached their lowest level in 20 years, the center found.


The sudden drop-off, which coincided with the onset of the recession, suggests that attitudes have changed since the days when older generations of Latinos prized large families and more closely followed Roman Catholic teachings, which forbid artificial contraception.


Interviews with young Latinas, as well as reproductive health experts, show that the reasons for deciding to have fewer children are many, involving greater access to information about contraceptives and women’s health, as well as higher education.


When Marucci Guzman decided to marry Tom Beard here seven years ago, the idea of having a large family — a Guzman tradition back in Puerto Rico — was out of the question.


“We thought one, maybe two,” said Ms. Guzman Beard, who gave birth to a daughter, Attalai, four years ago.


Asked whether Attalai might ever get her wish for a little brother or sister, Ms. Guzman Beard, 29, a vice president at a public service organization, said: “I want to go to law school. I’m married. I work. When do I have time?”


The decisions were not made in a vacuum but amid a sputtering economy, which, interviewees said, weighed heavily on their minds.


Latinos suffered larger percentage declines in household wealth than white, black or Asian households from 2005 to 2009, and, according to the Pew report, their rates of poverty and unemployment also grew more sharply after the recession began.


Prolonged recessions do produce dips in the birthrate, but a drop as large as Latinos have experienced is atypical, said William H. Frey, a sociologist and demographer at the Brookings Institution. “It is surprising,” Mr. Frey said. “When you hear about a decrease in the birthrate, you don’t expect Latinos to be at the forefront of the trend.”


D’Vera Cohn, a senior writer at the Pew Research Center and an author of the report, said that in past recessions, when overall fertility dipped, “it bounced back over time when the economy got better.”


“If history repeats itself, that will happen again,” she said.


But to Mr. Frey, the decrease has signaled much about the aspirations of young Latinos to become full and permanent members of the upwardly mobile middle class, despite the challenges posed by the struggling economy.


Jersey Garcia, a 37-year-old public health worker in Miami, is in the first generation of her family to live permanently outside of the Dominican Republic, where her maternal and paternal grandmothers had a total of 27 children.


“I have two right now,” Ms. Garcia said. “It’s just a good number that I can handle.”


“Before, I probably would have been pressured to have more,” she added. “I think living in the United States, I don’t have family members close by to help me, and it takes a village to raise a child. So the feeling is, keep what you have right now.”


But that has not been easy. Even with health insurance, Ms. Garcia’s preferred method of long-term birth control, an IUD, has been unaffordable. Birth control pills, too, with a $50 co-payment a month, were too costly for her budget. “I couldn’t afford it,” she said. “So what I’ve been doing is condoms.”


According to research by the National Latina Institute for Reproductive Health, the overwhelming majority of Latinas have used contraception at some point in their lives, but they face economic barriers to consistent use. As a consequence, Latinas still experience unintended pregnancy at a rate higher than non-Hispanic whites, according to the institute.


And while the share of births to teenage mothers has dropped over the past two decades for all women, the highest share of births to teenage mothers is among native-born Hispanics.


“There are still a lot of barriers to information and access to contraception that exist,” said Jessica Gonzáles-Rojas, 36, the executive director of the institute, who has one son. “We still need to do a lot of work.”


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