Given a paragraph, generate a claim that is supported by the given paragraph. 1) The claim must contain information from within the paragraph. 2) A sentence within the paragraph can be used as a claim. 3) The claim should not have contradictions within the paragraph. 4) The claim should be at most one sentence long.

Input: Consider Input: Peebles, a 30-year-old black man who’s skeptical of what he hears from the news media and government, initially didn’t see the need for alarm over the virus. “I felt it was a complete hoax,” Peebles said. “This thing happens every two or four years. We have an outbreak of a disease that seems to put everybody in a panic.” Peebles is among roughly 40 million black Americans deciding minute by minute whether to put their faith in government and the medical community during the coronavirus pandemic. Historic failures in government responses to disasters and emergencies, medical abuse, neglect and exploitation have jaded generations of black people into a distrust of public institutions. “I’ve just been conditioned not to trust,” said Peebles, who is now obeying the state’s stay home order and keeping his distance from others when he goes out. Some call such skepticism the “Tuskegee effect” — distrust linked to the U.S. government’s once-secret study of black men in Alabama who were left untreated for syphilis. Black people already suffer disproportionately from chronic conditions like diabetes and heart disease and are far more likely to be uninsured. How the government and medical community responds to the crisis will be especially crucial for outcomes among black Americans, civil rights advocates and medical experts say. “We are right to be paranoid and to ask tough questions,” said U.S. Rep. Ayanna Pressley of Massachusetts who joined other congressional leaders in asking the government to collect and release information about the race and ethnicity of people who are tested or treated for the virus that causes COVID-19. “History has shown us, when we do not” ask questions, said Pressley, who is black, “the consequences are grave, and in fact life and death.”  NAACP President Derrick Johnson, who hosted a coronavirus tele-town hall with U.S. Surgeon General Jerome Adams last month, said black and brown communities need reliable information about the crisis. “Now that this has been deemed a pandemic, I am most concerned with inequities in who’s provided tests, who’s provided treatment and how those tests and the treatments are administered, in a way that is open, transparent, and equitable,” Johnson said. For most people, the virus causes mild or moderate symptoms, such as fever and cough. But for some, especially older adults and people with existing health problems, it can cause more severe illness, including pneumonia and death. Cities with large black populations like New York, Chicago, Detroit, Milwaukee and New Orleans have emerged as hot spots for the coronavirus. Figures released by Michigan’s Department of Health and Human Services show 40% of those who have died from COVID-19 are black in a state where African-Americans are just 14% of the population. And many Southern states with large black populations have been slow to mandate statewide restrictions shown to slow virus spread. According to the U.S. Department of Health and Human Services, black adults are 60% more likely than non-Hispanic white adults to be diagnosed with diabetes, 40% more likely to have high blood pressure and are less likely to have those conditions under control. Additionally, in 2015, black women were 20% more likely to have asthma than non-Hispanic whites. Those disparities make the availability of a treatment or vaccine urgent, even as the virus is currently projected to claim tens of thousands of lives. But given history, Peebles said he wouldn’t rush to accept a remedy. “If we got to a place where the government says, ‘OK, now it’s time to take a vaccine,’ then I’m definitely going to be skeptical of their intentions,” he said. Launched in 1932 by the U.S. Public Health Service, the Tuskegee study involved roughly 600 poor black men in Alabama who weren’t treated for the sexually transmitted disease so researchers could track its progress. The program was exposed and ended in 1972, and then-President Bill Clinton formally apologized in 1997. The Tuskegee legacy has helped pollute the black community’s relationship with American medical science. A 2016 paper found the fallout included mistrust of medicine among black men, along with fewer interactions with doctors and higher mortality rates. In Tuskegee, where many families include descendants of victims, many residents don’t trust government health information, said Lucenia Dunn, a former Tuskegee mayor. So volunteers trying to get the word out about coronavirus have gone door-to-door distributing fliers with cartoon-like illustrations that don’t look “too official,” she said. “We have a general distrust in this community,’” Dunn said. “I call it ‘subconscious rejection.’ The attitude is, ‘I’m going to rebel against this. You people have been telling us lies for years. Why should I believe you now?’” In Los Angeles, Jahmil Lacey helped found a public health group for black men and boys, TRAPMedicine, that educates black barbers and organizes workshops to address health disparities among their customers. “People will quote the Tuskegee experiment as the reason why black people don’t trust health care, but there’s so much more than just that one example,” Lacey said. “We don’t trust systems that are connected to white supremacy. So, we have to do the work to repair it.” Indeed, Tuskegee didn’t happen in a vacuum. In the 1950s, doctors at the John Hopkins Hospital used cervical cancer cells from Henrietta Lacks, a black mother of five, to pioneer medical advances and research that continue globally today. Lacks, who died in 1951, never gave her consent and her family has never been compensated. One way to begin healing the mistrust is to increase black representation in the medical field, said Dr. Nicollette Louissaint, executive director of the Washington-based emergency response advocacy group Healthcare Ready. “We have to make sure that ... the message itself and the messengers are being adapted to the appropriate audience,” said Louissaint, who is black. “It’s going to be really important that we get that right.” ___ Reeves reported from Birmingham, Alabama. Both are members of the AP’s Race and Ethnicity team. Follow Morrison on Twitter at http://twitter.com/aaronlmorrison. Follow Reeves on Twitter at https://twitter.com/Jay_Reeves

Output: Amid coronavirus pandemic, black mistrust of medicine looms.


Input: Consider Input: A University of Iowa study shows the state’s contribution to the Gulf dead zone spiked 47 percent to 618 million pounds in 2016, based on five-year running annual averages. “Just based on water quality data, I think we can say we’ve not made much progress over the past 20 years in terms of nitrogen,” said Chris Jones, a research engineer at the UI’s IIHR-Hydroscience & Engineering. Environmentalists say the study raises new questions about the effectiveness of Iowa’s approach to improving water quality and its reliance on voluntary ag compliance. “We’ve been pouring state and federal money into cutting nutrient pollution for decades, and this highlights the fact that the voluntary approach is not working,” said Jennifer Terry, executive director of the Iowa Environmental Council. “We’re not headed in the right direction. ... We need to follow the lead of other states and pass some environmental laws that will actually reduce loads and result in cleaner water,” Terry said. The Des Moines Register reports that the news comes as Iowa marks the five-year anniversary of the Iowa Nutrient Reduction Strategy, a plan designed to cut by 45 percent the nitrogen and phosphorus levels that leave Iowa and feed Gulf hypoxia — or the dead zone. Oxygen levels within the zone are so low that marine life can no longer survive, threatening the Gulf’s seafood industry. Most of the nutrient losses come from farming, although the strategy also targets losses from urban wastewater and industrial operations. Last year, Iowa invested $420 million in those water quality improvements, including helping farmers plant cover crops, build terraces and tackle other conservation practices that hold nutrients in place. But farmers expanding their drainage tile systems — along with increasing hog, cattle and chicken feeding operations, which provide manure to fertilize crops — likely outweigh those conservation efforts, UI scientists say. The nutrient reduction practices “being implemented are a tiny, tiny portion of what needs to be done, and it’s occurring in a system that’s changing,” Jones said. “We appreciate all that is being done with nutrient management and conservation farming. Unfortunately, we’re just impacting too few acres with too few practices,” added Larry Weber, executive associate dean for UI’s College of Engineering. Jones wrote the study with Weber and Keith Schilling, another UI research engineer. Increased nutrient pollution in water creates problems for people and animals beyond the dead zone. High phosphorus levels can lead to toxic algae blooms that can befoul lakes, rivers and streams, potentially killing pets and making people ill. And the federal government limits the amount of nitrates in drinking water to 10 milligrams per liter. Higher levels can be fatal to babies under 6 months old. Increased levels translate to higher costs for utilities for nitrate removal. “We need a dramatic increase, a rapidly-scaled up increase in conservation practices and more funding,” said Cindy Lane, the Iowa Environmental Council’s water program director. Schilling said the study shows that targeting nutrient reduction investment in Iowa can have a significant impact downstream. “Iowa has a dominant role in this Gulf hypoxia issue,” Schilling said. “Let’s invest the resources here, where we really need it. “If we solve Iowa, we solve the Gulf,” he said. The UI study gives Iowans new information in the fight to reduce the nitrogen levels that flow from the state into the Mississippi and Missouri rivers, which make their way to the Gulf of Mexico. Looking at Iowa Department of Natural Resources data from 23 monitoring stations, the study shows Iowa on average over the past 18 years contributed 29 percent of the total nitrogen headed to the Gulf from the Mississippi-Atchafalaya river basin. The river basin is a massive watershed that includes all or part of 31 states. Iowa’s nitrogen impact was even greater in other watersheds. The state averaged 45 percent of the nitrogen levels going into the Upper Mississippi River basin, and 55 percent of the nitrogen going into to the Missouri River basin. “When you look at the entire Missouri (River) watershed, our land comprises 3.3 percent of the total area ... and Iowa contributes nearly 12 percent of the water,” Jones said. But “we contribute 55 percent of the nitrate,” he said. “The way that pencils out is that the amount of water coming from Iowa has seven times more nitrates than the rest of the Missouri River watershed,” Jones said. If Iowa’s contributions were removed, the Missouri River would have little nitrogen contributions in some years. “We really need to take seriously the Missouri River’s contribution as a driver for Gulf hypoxia,” Jones said. The growing concentration of livestock feeding operations in western Iowa might account for Iowa’s large contribution to the Missouri River nitrate levels, the scientists said. “People tend to dismiss livestock influences, but maybe there’s more to it than people give credit it for,” Schilling said, adding that it would require more study to determine the impact. Iowa’s nitrogen levels, based on running five-year annual averages, have been above the 2003 value for 10 consecutive years, the study says. The scientists say 2003 was the first year the five-year rolling average could be calculated, with data that starts in 1999. The goal of the Gulf Hypoxia Task Force, made up of federal, state and tribal leaders, “will be very difficult to achieve if nitrate retention cannot be improved in Iowa,” the report said. The task force, with Iowa Agriculture Secretary Mike Naig as chairman, seeks to reduce the dead zone to 1,900 square miles by 2035. The deadline was extended from 2015. Last year, the dead zone set a record, which, at 8,776 square miles, was more than four times the goal size. The report says about 90 percent of Iowa’s nitrogen levels “can be sourced to the 72 percent of the state’s land area that is in crop cultivation.” Iowa, an agriculture powerhouse, is a national leader in corn, soybean, pork, egg and beef production. “This intense production of carbohydrates and protein has resulted in the state being a leading contributor” to the nitrogen loads and Gulf hypoxia, the report said. Naig said farmers understand the important role they play in improving water quality and are scaling up efforts across the state “as we move from demonstration projects to larger, watershed-scale implementation projects. “We recognize that there is still a lot of work to be done, but we are on the right path,” said Naig, who adds farmers are working with more than 250 partners in 65 rural and urban demonstration projects. The UI scientists doubt that increased cropping is the reason for the increased nitrogen impact. Iowa’s cropped area has increased only 4 percent over the past 18 years, while other states’ farmed land has climbed 21 percent, particularly in Minnesota, North and South Dakota and Kansas. About 85 percent of Iowa’s acres are farmed, making it the fifth-highest in the nation, based on the 2012 U.S. Agriculture Census, so there are few acres left that can be brought into production compared with other states. “Iowa’s decline in the share of the region’s soybean area was especially pronounced, dropping from 18.6 percent in 1999 to 14.5 percent in 2016,” the report said. “One would expect our (nitrogen) contributions relative to the other areas would be diminished,” Jones said. “But the opposite has occurred.” Jones said it’s led the scientists to consider other factors. The scientists doubt that Iowa farmers are using significantly more fertilizer. “When we look at nitrogen sales data, it might change a little year over year. But on a per acre basis, that hasn’t changed a lot since 1990,” he said. And with little increase in corn and soybean acres, the scientists speculate that Iowa’s increased nitrogen levels could be coming from more drainage tiles. Or farmers could be using more manure as fertilizer from animal feeding operations. Without Iowa, the Gulf’s overall nitrate loads would have declined 43,400 tons over 18 years, based on five-year running annual averages, the scientists’ data show. Instead nitrate loads grew by 52,000 tons. “It’s pretty clear these loads from the Ohio basin have to be declining,” Jones said. “A lot that is coming from Indiana.” That state’s high level of cover crop adoption by farmers could be the reason, he said, and should be studied. Cover crops such as cereal rye slow the rate of water runoff, reduce erosion and improve soil fertility. Iowa also needs to honestly discuss the impact that drainage tiling has on nitrogen losses, Jones said. Iowa doesn’t collect data on how much underground drainage runs through the state, although officials estimate about 9 million acres are drained through tile. Environmentalists believe the number is much higher. Underground drainage tile helps improve yields by quickly removing excess water from fields. Iowa’s tiling system consists of a network of drainage lines that feed into large pipes. The massive network, first constructed in the 1920s, ’30s and ’40s, turned once swampy lands into some of the nation’s most productive farmland. But water quickly carried away by the tiling system misses cleansing that would naturally occur by filtering through soil or the roots of trees, shrubs and grasses in riparian buffers along streams. Des Moines Water Works unsuccessfully sued drainage districts in three north Iowa counties in 2015, claiming underground tiles funneled high levels of nitrates into the Raccoon River, a source of drinking water for 500,000 central Iowa residents. “We acknowledge that it’s important to track implemented conservation, and we encourage that,” Jones said. “But we also need to have the courage to talk about these things that drive the system in the other direction.” Terry said Iowa is “one of the most heavily tiled states in the nation,” and its 110-year-old law regulating the practice does little to protect water quality. ___ Information from: The Des Moines Register, http://www.desmoinesregister.com

Output: Study: Iowa nitrogen pollution in the water is getting worse.


Input: Consider Input: In a report released Wednesday, the experts said annual cases of Legionnaires’ jumped more than fivefold from 2000 to 2017, and that as many as 70,000 Americans get the disease every year. Legionnaires’ is caused by bacteria that can thrive in buildings with large water systems. About 20 outbreaks are reported each year, including recent ones at an Atlanta hotel and a hospital near Chicago. But there is no single set of widely accepted guidelines for preventing infections. The National Academies of Sciences, Engineering and Medicine report pushes for requirements like minimum temperature levels for hot-water heaters, and registration and monitoring of cooling towers.


Output: Experts call for steps to stem increases in Legionnaires’.