Search Results for: quiet stores

Number of Results: 13

UK shops to offer “quiet support” to autistic customers

in a campaign titled the “Autism Hour.”  The Independent reports that “[t]he Autism Hour has been organized by the National Autistic Society to help draw attention to the difficulties that people with autism can face in noisy environments.” Autistic children often have difficulty dealing with loud spaces and when confronted with a noisy environment, they may go into a “meltdown.” To make shopping easier for them and their parents, beginning in the first week of October, “businesses will turn down music, reduce tannoy (loudspeaker) announcements and dim lights to help create a calming and less daunting environment.” Many major retailers have already signed up to participate, including Toys R Us.

Kudos to the National Autistic Society for getting major retailers on board this initiative. UK residents have been working on getting retailers to agree to trial a “quiet hour” program for some years, and some retailers agreed. With the launch of the Autism Hour campaign, one hopes that quiet accommodation is now a regular feature of retail stores in the UK. Meanwhile, Toys R Us has taken the lead in offering accommodation for autistic customers in the U.S., by simply modeling their U.S. program after their UK experience. Thanks to the persistence from those who need or prefer a quieter shopping experience, the U.S. is poised to catch up with the UK and offer accommodation for those who cannot tolerate noisy environments.

Looking for a quiet restaurant? Wall St. values this “quiet” chain at $7.5 billion

Photo credit: Mike Mozart CC by 2.0

By David Sykes, Vice-chair, The Quiet Coalition

Yearn for a quiet spot to dine where you can chat (or read) without clamour? If that seems hopeless in America’s noisy restaurants don’t give up—change is on the way.

It’s true that for decades restaurants in America have gotten louder and more cacophonous on purpose. Why? Restaurateurs and their designers say data show that profits climb when noise levels are high because their patrons are:

  1. attracted by the “buzz,”
  2. drink more alcohol,
  3. consume more food faster, and
  4. leave quickly, allowing more patrons to sit down and repeat the process.

True or not, those crowded, noisy eateries are designed to be that way. The good news is that, just as easily, they can be designed to be quiet. The bad news is that so many restaurateurs still don’t understand that the racket drives away large groups of potential patrons, and also alienates restaurant reviewers, some of whom now even carry sound level meters.

Is there such a thing as a successful quiet restaurant chain? One that profits from allowing patrons to converse with each other or read a book, or put a laptop on the table and work quietly–even at peak dining hours? Amazingly, yes. It’s one that already has 2000 stores, is the hottest “fast-casual” chain in America, and is growing faster than Starbucks. The name? Panera. Panera’s stores don’t pretend to be fashionable bistros nor do they serve alcohol. But the food is healthy, natural, fresh, and tasty and the atmosphere is definitely—and, according to acoustics experts, very consciously—designed to provide a haven where people can enjoy quiet conversations and each other without cacophony.

Quiet dining matters to lots of us—more folks than you might imagine. In fact, about 20% of people in their 20s suffer from hearing disorders (which can include hypersensitivities to noise with names like tinnitus, hyperacusis, and misophonia, conditions that make it impossible for them to enjoy restaurants or clubs). And about 50% of people in their 60s and an extraordinary 90% of people in their 80s suffer from an inability to understand speech when background noise levels are elevated. These are not “fringe” groups. Collectively, there are 40 million Americans who probably avoid dining in restaurants because they literally can’t stand the noise.

Do restaurant owners understand that? If they did, they might create quiet sections to broaden their market appeal. Many apparently do not. For those who do, the market opportunity may be considerable.

It just could be that “quiet dining” is the next trend.  For customers looking for quiet, the prospects are mouth-watering.

If you’d like to know how to make a restaurant quieter, check out: Why Acoustics are Important in Restaurant Design and Restaurant Acoustics: Restaurant Noise Reduction by Audimute.

David Sykes chairs/co-chairs four national professional groups in acoustical science: The Acoustics Research Council, ANSI S12 WG44, The Rothschild Foundation Task Force on Acoustics, and the FGI Acoustics Working Group. He is also a board member of the American Tinnitus Association, co-founder of the Laboratory for Advanced Research in Acoustics (LARA) at Rensselaer Polytechnic Institute, lead author of “Sound & Vibration 2.0 (2012, Springer-Verlag), and a contributor to “Technology for a Quieter America” (2011, National Academy of Engineering). A graduate of the University of California/Berkeley with graduate degrees from Cornell University, he is a frequent organizer of and speaker at professional conferences in the U.S., Europe, Asia and the Middle East.

Originally posted at The Quiet Coalition.

Quiet City Map: Manhattan℠

We are happy to announce the launch of our sister site, Quiet City Map.   Quiet City Map is home to Quiet City Map: Manhattan℠, a map-based guide to places through out Manhattan where the sound levels are reliably comfortable (and, sadly, some places that are best avoided).  The map provides ratings for restaurants, bars, coffee shops, public spaces (e.g., parks, squares, and privately owned public spaces (POPs)), museums and retail stores according to sound level and sound quality.   Quiet City Map will host both the map and individual reviews for each map entry.  We hope that you find Quiet City Map: Manhattan℠ a useful guide as you navigate the city.

 

Why is New York City so noisy?

Winnie Hu, The New York Times, writes about the number one complaint in the city, noise, in, “New York Becomes the City That Never Shuts Up.” And we discover that the short answer to the question as to why the city is so noisy may be this: New York City needs more noise enforcers.

Hu interviews Richard T. McIntosh, a long-time resident of the Upper East Side who complains that he “has never heard such a racket outside his window.” Hu writes:

New York City has never been kind to human ears, from its screeching subways and honking taxis to wailing police sirens. But even at its loudest, there were always relatively tranquil pockets like the Upper East Side that offered some relief from the day-to-day cacophony of the big city. Those pockets are vanishing.

Construction is a huge factor in the increase in noise, but residents can’t escape outdoor noise by ducking into noisy city restaurants, gyms, and stores. And noise complaints have increased even after the city adopted an overhauled noise code in 2007. So what can be done? Hu writes that city councilman Ben Kallos, who represents the Upper East Side, “has made curbing noise one of his top priorities,” adding that “[h]e and Costa Constantinides, a councilman from Queens, are proposing legislation that targets some of the most grating sounds by requiring city noise inspectors to respond within two hours when possible to catch noisemakers in the act.”

Hu reports that while “the Police Department handles the vast majority of noise complaints, inspectors with the Department of Environmental Protection also investigate mechanical sources and environmental noise, including after-hours construction, air-conditioners and ventilation equipment, alarms and even barking dogs.” So how many inspectors does the Department of Environmental Protection have? Only 54 for a city of over 8 million residents. Apparently 8 more inspectors are going to be hired this year, bringing the total number of inspectors for all five boroughs to meager 62. And the response time is equally appalling. Hu reports that median response for police officers was 152 minutes, but the median response “for noise inspectors was four days in 2016.”

With construction noise before and after hours being the top complaint in every borough except for Staten Island, it’s unreasonable to expect noise violators to change their behavior when an inspector may show up four days after a noise complaint is filed. Indeed, a recent audit of New York City noise complaints by New York State Comptroller Thomas P. DiNapoli found that bars and nightclubs with “hundreds of complaints lodged against them faced little or no repercussions.”

City councilman Kallos believes that increasing the number of noise inspectors “would not only deter noise but also result in more violations and fines that would offset the cost of the legislation.” Kallos adds that “[i]t is time for the city to hire as many noise inspectors as it takes to respond to complaints when they happen.” We agree. We also agree with Dr. Arline Bronzaft, Chair of Noise Committee for Grow NYC, who notes that “with eight inspectors being hired soon, apparently we do not need legislation to hire inspectors, we just need the money for increased hires to be added to the budget NOW.”

If you live in New York City and want to see Kallos’ and Constantinides’ proposed legislation move forward, contact your city council person and ask him or her to sign on. While you’re at it, ask your councilperson what his or her answer is to New York City’s noise problem. Not sure who represents you in the city council? Click here to find out.  If you reach out to your councilperson’s office, please report back and tell us how they responded in the comments.

And Dr. Daniel Fink, Chair of The Quiet Coalition, weighs in with a letter to the editor of the New York Times.

Tired of background music in public spaces? Want to make it stop?

Photo credit: Andypiper licensed under CC BY 2.0

Introducing Quiet Ann Arbor! Finally, the U.S. has a local chapter of Pipedown, a UK organization that campaigns “for freedom from piped music” (i.e., ubiquitous background music) in “pubs, restaurants and hotels; in the plane, train or bus; down the phone; ruining decent television programmes; adding to the overall levels of noise pollution in public places.”

The Ann Arbor organization has just been formed, and the website is a work in progress, but it’s a start. If you live in Ann Arbor and want the piped in music to stop, contact them by clicking this link. Their mission is simple: to promote the benefits of silence and encourage noise moderation in public. Live in the U.S. but not in Ann Arbor? Contact Pipedown to start your own chapter.

Hear, hear!

And for those who think fighting public noise is ridiculous or not worth one’s time, we note that Pipedown scored a big victory last year when it got Marks & Spencer, the UK’s biggest chain store, to turn off the piped music in their stores.

Good luck, Quiet Ann Arbor!

The unintended consequences of CDC’s guidelines for preventing hearing impairment

by John Drinkwater, Founding Member, The Quiet Coalition

If you follow the Centers for Disease Control and Prevention (CDC) recommendations to protect your hearing then be prepared for isolation and depression. The CDC’s February 2017 issue of Vital Signs states that continued exposure to unsafe sound levels can cause stress, anxiety, depression, isolation, and other health issues. So in order to protect your hearing, the CDC recommends everyone:

  1. Avoid noisy places.
  2. Use earplugs, earmuffs and noise canceling devices when in noisy places.

Amplified sound levels at restaurants, retail stores, movie theaters, health clubs, nightclubs, and other public places often are unsafe.

Following recommendation No. 1: You don’t go.

Following recommendation No. 2: Your ears can’t function properly.

Imagine if the “solution” to second hand smoke at a restaurant was to wear a protective mask over your nose and mouth. How could you possibly communicate and enjoy your meal? Hearing “protection” simulates the effects of hearing loss and inhibits your ability to communicate and enjoy the event. It also trains your ears to get used to the effects of hearing loss and may inhibit recognizing gradual hearing impairment.

The National Institute for Occupational Safety and Health (NIOSH), a part of the CDC charged with conducting research and making recommendations for the prevention of work-related injury and illness, is highly critical of earplugs and earmuffs and recommends they should only be used when engineering controls are not feasible to reduce noise levels. According to NIOSH, the noise reduction rating system (NRR) used for earmuffs and earplugs greatly overstates “protection” and therefore is not NIOSH approved. Workers often do not use hearing protectors properly, and they interfere with communication. If earplugs are removed for a short period in order to communicate, there can be immediate and irreparable injury. Even double protection (earplugs and earmuffs) is inadequate when exposure exceeds 105 dB.

Manufacturers mislead the public with overstated marketing claims. A Dow Industrial company markets their “Professional Earmuff” as “Our Highest-NRR Rated Earmuff (30 Decibels), Patented Twin Cup Design.” The really small print in the inside of the box states the Company:

[M]akes no warranty as to the suitability of NRR as a measure of actual protection from any noise level since such protection depends on the sound level (loudness), how long you listen to the loud sound, and how well you fit the earplugs (sic) in your ears…The NRR is based on the attenuation of continuous noise and may not be an accurate indicator of the protection attainable against impulsive noise such as gunfire…[Company] recommends reducing the NRR by 50% for estimating the average amount of noise reduction provided.

Furthermore, no type of hearing protection or noise canceling device protects against low frequency sounds, which travel through your body causing stress and may damage unborn children. Accordingly, NIOSH’s primary recommendation of the most effective way to prevent noise-induced hearing loss (NIHL) is to “remove hazardous noise from the workplace or remove the worker from hazardous noise.”

If you follow the primary CDC and NIOSH guideline, avoiding noisy places, it results in the same isolation, depression, and other issues associated with hearing impairment. The only healthy solution is requiring safe amplified sound levels so no hearing protection is necessary–it doesn’t cost anything to Turn Up the Quiet.™ There are many architecturally safe and pleasing ways to reduce sound levels in public places: breaking up an open floor plan, using materials that absorb or diffuse sound on wall and ceiling surfaces, installing carpeting, curtains, and tapestries, and using attractive acoustic panels, to name a few. It is also good for business.

After meeting with a local health club, they agreed to institute a new “quiet” class with no amplified music on a trial basis. Management was surprised to hear positive comments from members who had simply stopped coming to classes due to the unsafe volumes. They learned that some members with hearing aids took them out, put in earplugs, and still found the classes unbearable. In a few months they added two more quiet classes.

It’s OK to ask the grocery store, the clothing store, and other retailers to turn off the amplified music while you are shopping. Many will happily accommodate you, and it encourages others to do the same. Some businesses are establishing regular “quiet” hours of operation and finding more satisfied, and even new, customers who spend more time at the establishment.

In addition, “silent discos” are gaining popularity, where instead of amplifying music through speakers it is “silently” delivered via Wi-Fi to smartphones for patrons to listen without disturbing others. The local mayor wants to try it as part of the Summer Concerts in the Park series. It will allow those who may not want amplification to enjoy the Park, and won’t interfere with nearby businesses or residents. The same technology can be applied to other music events such as outdoor exercise, and speech events, such as public ceremonies, political speakers, and other large public gatherings.

These and other creative ways to avoid unsafe levels will allow all of us to fully participate and enjoy public gatherings without the risk of injury.

John Drinkwater is a composer, musician, and attorney with a background that includes science and architecture studies. He is the founder of secondhandsound.org, and he also owns the trademark Turn Up the Quiet™ All Rights Reserved.

Originally posted at The Quiet Coalition.

Text Copyright 2017 John Drinkwater
Photo Copyright 2014 secondhandsound.org
All rights reserved

Top researchers work toward treatments, but prevention remains the best medicine.

By Daniel Fink, MD, Chair, The Quiet Coalition

Humans are born with only 15,000 cochlear hair cells. When these are destroyed by noise they don’t regenerate, unlike cochlear hair cells in other animals, such as chickens. If a way can be found to regenerate human cochlear hair cells, perhaps hearing can be restored.

A recent report from Harvard and MIT holds promise for treating hearing loss in the future. Researchers there were able to increase the number of stem cells from mouse cochlear hair cells in vitro using a cocktail of small-molecule chemicals. It’s hard to do basic science research on humans–one can’t hurt people doing research–but mice share 99% of our genetic material, and being small and inexpensive, they are good substitutes in the lab. The researchers hope to begin testing their approach in humans in 18 months.

This is great news for millions of Americans with hearing loss. It’s possible that with additional advances, one day their hearing could be restored. But I have one problem with the report: The researchers are developing a treatment, probably not an inexpensive one, for a problem that is entirely preventable.

The public health mantra is that prevention is always better and cheaper than treatment, which in turn is better and cheaper than rehabilitation. Noise-induced hearing loss is 100% preventable. How? Avoid loud noise. If you can’t avoid noise exposure, use hearing protection (earplugs and ear muff hearing protective devices). You can find these in your drugstore, in “big box” home improvement stores like Home Depot or Lowe’s, or online. There is even an online retailer devoted only to hearing protection.

So kudos to the researchers at Harvard and MIT. No doubt their work and the work of other researchers will eventually help the millions of Americans who already suffer from hearing loss and other hearing damage. But let’s put time, money, and effort in promoting a cheaper and safer approach to hearing health–prevention. No more research is needed, and we can avoid hearing loss today.

Dr. Daniel Fink is a leading noise activist based in the Los Angeles area.  He serves on the board of the American Tinnitus Association and is the interim chair of Quiet Communities’s Health Advisory Council and the founding chair of The Quiet Coalition, an organization of science, health, and legal professionals concerned about the impacts of noise on health, environment, learning, productivity, and quality of life in America.

Originally posted at The Quiet Coalition.

Another Silent Spring

By Daniel Fink, MD, Chair, The Quiet Coalition

In 1962, Rachel Carson’s “Silent Spring” described the harmful effects of insecticides and herbicides on birds, beneficial insects, animals, and humans.  Her book helped start the environmental movement. For too many people, this will be another silent spring, caused not by a dearth of birds but because people can’t hear birds sing. They have hearing loss from another environmental pollutant, noise.

Carson described how nature’s balance controlled pest species naturally, and how these species became problems only when humans changed the environment. She noted the difference between apparent short-term safety of agrichemicals and longer-term danger. People could get sprayed with pesticides or even ingest them without apparent immediate harm, with cancer and birth defects coming later.

If Carson were alive today, she might write about noise pollution, which interferes with animal feeding, communication, mating behaviors, and navigation in forests, fields, and oceans, and causes hearing loss and other medical problems in humans.  In nature’s quiet, animals developed exquisite hearing to find food or avoid being eaten. An owl can find a mouse under a foot of snow, and zebras can hear lions approaching in the veldt.

Humans are also born with excellent hearing.  Brief exposure to loud noise usually doesn’t cause obvious auditory damage in humans, but longer or repeated exposure does. The relationship between noise and hearing loss was first noted in medieval times in bell ringers and miners, then in boilermakers during the industrial revolution.  Noise wasn’t a widespread problem, and except in large cities life was usually quiet.

Industrialization, mechanization, and urbanization made life noisier.  Noise was recognized as a public health hazard in the early days of interstate highways and jet travel, but was also considered an environmental pollutant. In 1972 Congress passed the Noise Pollution and Abatement Act, empowering the Environmental Protection Agency (EPA) to establish noise standards and require noise labeling for consumer and industrial products.

During the Reagan administration, however, Congress defunded EPA noise control activities. Little has been done since to control noise, and our country has gotten noticeably louder. Sound levels of 90-100 decibels or louder are reported in restaurants, clubs, retail stores, movie theaters, gyms, sports events, concerts, and parties, from sirens, vehicles, landscape maintenance equipment, and construction, and for those using personal music players.

The National Institutes of Health states that prolonged exposure to noise at or above 85 decibels can cause hearing loss. This is misleading, because no exposure time is given and hearing damage occurs at much lower levels. The 85-decibel standard is an occupational noise exposure standard, not a safe noise level for the public.. The EPA adjusted the occupational standard for additional noise exposure outside the workplace to calculate the noise level for preventing hearing loss to be a daily time-weighted average of only 70 decibels.

Hearing is the social sense, required for spoken communication. About 40 million American adults age 20-69 have noise induced hearing loss, half of them without noisy jobs. Why is this happening? They are exposed to loud everyday noise.  Cumulative noise exposure eventually causes hearing loss, affecting 25% of those in their 60s, half in their 70s, and 80% in their 80s, and is correlated with social isolation, depression, dementia, falls, and mortality. Due to denial, stigma, and cost only 20% of older Americans with hearing loss acquire hearing aids, after an average seven-year delay, and 40% of people with hearing aids don’t use them much, largely because hearing aids don’t help users understand speech well in noisy environments.

Preventing noise-induced hearing loss is simple: avoid loud noise. If it sounds too loud, it is too loud. Free or inexpensive smart phone sound meter apps make it easy to measure sound levels, but if one can’t converse without straining to speak or to be heard, ambient noise is above the auditory injury threshold of 75-78 decibels and auditory damage is occurring.

A quieter world is easily attainable. Whisper-quiet dishwashers, cars with quiet interiors and exhausts, the Airbus A380, and a few quiet restaurants and stores prove this.   Effective noise control technologies have long existed, including noise reduction via design and material specifications and sound insulating, isolating, reflecting, diffusing, or absorbing techniques.  Indoors, all that may be necessary is turning down the background music volume, which costs nothing.

In the 1950s and 1960s, half of all American men smoked and public spaces and workplaces were filled with tobacco smoke. When research showed that tobacco smoke caused cancer and heart disease, governments restricted smoking, leading eventually to today’s largely smoke-free society. Smokers can still smoke, but can’t expose others involuntarily to their smoke.

Noise causes hearing loss. Governments should set and enforce indoor and outdoor noise standards, to reduce each person’s daily noise dose. Adults have the right to make and listen to all the noise they want, but not where others can hear them. If we can breathe smoke-free air, we can make a quieter world, so future generations won’t have to endure another silent spring.

Dr. Fink is a leading noise activist based in the Los Angeles area.  He serves on the board of the American Tinnitus Association and is the interim chair of Quiet Communities’s Health Advisory Council and the founding chair of The Quiet Coalition, an organization of science, health, and legal professionals concerned about the impacts of noise on health, environment, learning, productivity, and quality of life in America.

Originally posted at The Quiet Coalition.

Accommodation for autistic customers gaining steam in the UK

Photo Credit: Clive Darra

Tesco trialling a ‘quiet hour’ to help autistic customers do their shopping. Maya Oppenheim and Katie Forster, The Independent, write about Tesco’s pilot scheme, which it is trialing at one of its locations for six weeks on Saturday mornings. If the trial is successful, the quiet hour will be rolled out across Tesco stores nationwide.  What will Tesco be doing to make the shopping experience more tolerable for autistic customers? “The trial includes a wide range of measures to improve the browsing and paying experience for autistic customers such as dimmed lights and quieter tannoys [loudspeaker systems].”

Tesco is the largest grocery chain in the UK, and it also has stores in 12 countries across Asia and Europe. If the pilot scheme is successful and Tesco implements a quiet hour on a larger scale, this could be a significant victory for autistic and noise sensitive people.

Link via @QuietEdinburgh.

 

Is Your Noise Making Me Fat?

Photo credit:

Photo credit: Yukari

By Daniel Fink, M.D.

Is your noise making me fat?  That may seem like a silly question to ask, but there is strong scientific evidence that traffic noise causes obesity.  More specifically, increased traffic noise–whether from highways, airplanes, or trains–is strongly correlated with central obesity.  Central obesity (or “truncal obesity”) is in turn linked with increased risk of diabetes, hypertension, and cardiac disease leading to increased mortality.

Why would noise cause obesity?  The auditory system evolved from vibration sensing mechanisms in primitive organisms which were used to sense predators, or by predators to find food.  Noise perception remains a major warning system, even in mammalian species.  Except for fish, most animals above the phylum Insecta close their eyes when they sleep but cannot close their ears, except for some which swim or dig.  Noise at levels not loud enough to cause hearing loss in humans interferes with sleep, causing a rise in stress hormone levels. These in turn alter carbohydrate and fat metabolism, leading to fat deposition. And that can cause diabetes and high blood pressure, which in turn cause heart disease.

A study published in 2015 showed a clear association between noise exposure and central obesity.  Another study published that year showed that noise caused increased heart disease and death.

And 100 million Americans are exposed to noise levels loud enough to cause these problems.

There is probably nothing specific about traffic noise that makes it more likely to cause health problems than any other source of noise, except, perhaps, the factor of unanticipated noise may be important.  It’s just easier to study the effects of traffic noise on humans than asking thousands of people to use personal sound monitors for long periods of time and then collecting and analyzing those data.  Noise is noise.

It’s obviously difficult to measure the non-auditory health impacts of everyday noise exposure–in the streets, in restaurants and stores, at sports events, at concerts–on an individual, but noise has powerful physiologic effects.

So as both noise levels and obesity levels rise in the United States, the answer to the question, “Is YOUR noise making ME fat?” may be “Yes!”

What can we do? For those living near highways, airports, or railroad tracks, double pane windows and wall and attic insulation may provide some protection.  But the best approach to noise is to limit it at its source, which will require political pressure to get laws passed to require quiet, especially nighttime quiet.

After the Environmental Protection Agency’s Office of Noise Abatement and Control was defunded 35 years ago (pdf), noise is largely a local government issue.  So if you want change, you have to speak up for yourself.  One easy step is to look at your local government’s website to see if noise is identified as a constituent issue.  If not, contact your local government representative and ask to speak to him or her about noise problems in your neighborhood or around your workplace.  In addition, an internet search should reveal whether your community has a group that is organized to fight noise in your town (click this link for a map of noise activist and quiet advocacy organizations).  Find out if they are active and go to a meeting to see what they are doing.  If politicians see that an issue is important to constituents, it is in their best interest to address that issue it they want to be re-elected.  If they ignore it, they can be replaced.  An active constituency ensures a responsive politician, at least on the local level.

Noise is omnipresent and insidious.  Because it’s everywhere, people assume that it must be tolerated and cannot be regulated.  But when air pollution became so noticeable and obviously unhealthy that it couldn’t be ignored, government responded with forceful legislation.  As a result, our air is cleaner today than it was in 1970America has gotten noisier and hearing loss in on the increase.  As with air pollution, we need robust government action to regulate noise.  If you care about your health and the health of your family, push back against noise, demand action, and join your neighbors to promote a peaceful, quiet, and healthy environment.

Dr. Fink is a leading noise activist based in the Los Angeles area.  He serves on the board of the American Tinnitus Association, is the interim chair of Quiet Communities’s Health Advisory Council, and the founding chair of The Quiet Coalition, an organization of science, health, and legal professionals concerned about the impacts of noise on health, environment, learning, productivity, and quality of life in America.