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As much as the natural wine scene has exploded in the past 10 years in New York, reflecting the culture and passion for this juice in Paris, there are still few bars and restaurants that focus solely on natural wine. June Wine Bar, which opened in January of this year, is one of the few places in NY that boasts an all-natural list. June is successfully pouring things like Costadila 280, a sparkling orange wine from Italy. This, along with other unique selections has piqued the interest of curious drinkers and wine geeks alike from the five boroughs. Places like June, along with Reynard, Ten Bells, and Contra are proof that it is possible to go "all natural" in NYC and have success.
June was born when business partners Tom Kearney and Henry Rich joined forces and brought their idea of a natural wine bar to life – both men bringing unique backgrounds to the table, each with more than 20 years of restaurant experience. Henry, who owns and operates Rucola in Boerum Hill and Fitzcarraldo in Bushwick, had a very good sense of what would succeed in this space in Cobble Hill. When he mentioned a natural wine bar, Tom knew he was in.
While opening the restaurant Sweetwater in Williamsburg, Tom, who has a chef's background, was introduced to some of his first natural wines by bartender Sean Kranik, who was also working at Uva Wine Shop at the time. Afterward, he attended some Jenny & François portfolio tastings and caught the wine bug. Tom took his interest in wine and decided to work for Garnet Wine & Spirits, a retail shop, in order to learn from the ground up. It was a humble choice for someone already established in the restaurant industry but hungry for more wine knowledge. He later opened the Farm on Adderley in Ditmas Park where he has hosted an all-natural wine list since they opened in 2006. "Jenny has been great with bringing me along with her and the crew to connect with winemakers in Europe over the years." says Tom.
After working in high-end places like the River Cafe, Jean-Georges and Blue Hill, Tom wanted a more casual environment and followed the migration that was beginning across the bridge to Brooklyn. The concept of June, while inhabiting a beautiful and unique space, was to focus on the wine without the pressure to eat, but to still offer delicious food from traceable, sustainable sources. "The bar is the prominent feature – a bit like a stage, and there is an emphasis on tasting." While Tom says they're passionate about all of the wines they sell, he's particularly excited about discoveries from Partida Creus from Penedès, Spain, Franz Strohmeier from Austria, Eminence Road from the Finger Lakes, and Olivier Cousin from the Loire Valley. With his dedication to the importance of good ingredients at the Farm on Adderley, you can expect the same quality in his small plates at June where he serves up some beautiful dishes with seasonal vegetables like summer squash, white eggplant, and kale while still serving some classic wine bar snacks like chicken liver and a ham board. "I feel like it's a natural transition to make choices about the wines we sell with the same criteria in mind. We are interested in winemakers who farm organically, maintain a diverse ecosystem, produce in quantities that are traceable and eschew technological manipulation in the cellar."
After a few trips to June it was evident to me that the staff was educated and passionate about their list, and well versed on the wine. Tom says, "It starts with educating them about how commercial wine is made. I think the average person is mostly unaware of what goes into making a commercial wine. The use of spinning cones, reverse osmosis, enological enzymes, oak powder, grape extracts, catalogue yeasts; most of the staff seems sort of shocked that this is done at all. Consuming something that is free of this kind of manipulation is a lot more attractive to the average person. I think we're living in a time where overwhelmingly we distrust these large profit-driven paradigms that aim to maximize efficiency at the expense of quality."
The experience at June is truly exceptional. The ambience emulates a Parisian bar from the 1920's; the beautiful design somehow fuses cozy with glamorous and brings a staff that is friendly and knowledgable. They often invite winemakers for an evening to chat with customers in a casual setting while featuring their wines by the glass to encourage tasting everything. Nick Gorevic, a wine rep for J&F is also a consultant for the list at June and has built an amazing selection. From interesting Moravian wines (Czech Republic), to the gorgeous wines from Hervé Souhaut and unique Australian wines from Domaine Lucci, he listens to the feedback from customers and the list is invariably evolving. He was pleased to learn that people were requesting even more distinctive selections like orange wines and whites from Jura. Still, you don't have to be a wine professional or even have wine knowledge to enjoy an experience at June – just find a spot at the bar and you'll be met with unpretentious recommendations. We know we will keep coming back to discover new gems on the list, taste, learn, and simply to spend time in a place that promises a lovely evening.
Natural wine has come a long way in New York City since the days when we started this company 15 years ago. When Jenny and François first toured around the city with a suitcase full of wine talking about indigenous yeasts most sommeliers looked at them like they were insane. These days every distributor sales rep is sure to point out when a wine is made using indigenous yeasts. Natural wines are now present on the wine lists of a huge majority of fine dining and casual restaurants across the city.
But today we wanted to pay a bit of respect to the pioneers that really push the envelope and work only with natural wines. The list is small, but growing, in fact 4 of the establishments on this list didn't exist a few months ago and two of them just opened in the last month!
Click through the list to explore these places that represent not only the cutting edge in wine programs, but are also considered to serve some of the most cutting edge food in the city.
Note- For a better viewing experience, you may want to try a large screen map here.
In the fall of 2004 long-time couple Debbie Summer and Jan McGill opened Fermented Grapes, a neighborhood wine shop where they would sell wines which were true to their grape variety and terroir – wines with character. Brooklyn residents for over 25 years, Debbie & Jan say Prospect Heights was a neighborhood that initially brought doubtful laughs. Taking the "if we build it, they will come" approach, they are now running a fantastic little shop supported by neighborhood regulars and wine enthusiasts alike.
"10 years before opening the store, we had dinner together at a restaurant. It was the first time we ordered a bottle of wine with dinner where we noticed that the food made the wine taste better and the wine made the food taste better." says Jan. It was the beginning of a journey that led them to vineyard visits, wine classes, an importing gig, and countless tastings before finally opening their own shop.
They were pleasantly surprised at the friendliness of the neighborhood residents as well as the level of willingness to try new things. "That's why natural wines do so well here – people are open to learning something different." says Debbie.
The store has a tight-knit staff who taste and buy as a team, with Debbie and Matt making the final decisions. This really carries over into the level of customer service since their staff is knowledgable and passionate about each product. Matt says "I believe the homey feeling we've cultivated has helped to take the intimidation factor out of wine. For so many people, buying a bottle of wine is a process that comes riddled with fears: the fear of the "up-sell," the fear that the staff will be snooty or judgmental, and worst of all, the fear of feeling stupid."
With backgrounds in computer programming and TV/Film operations for MTV and ABC, Debbie and Jan love the challenges and newness of each day in the wine industry. "You're never finished, able to sit down and say there's nothing more to know," says Debbie. For Matt, he loves how the conversation about wine can turn into the story of the artist. "When we know the story behind a bottle of wine it can dramatically enhance our experience of it. For example, Olivier Cousin battling the Appellation system in court is almost a genius act of theater! When we drink those wines, we think about the significance of the conditions in which it was produced."
Over the years they've watched the world of people who are knowledgable about wine become much more diverse. The guts of a great wine shop is not only about interesting wines and winemakers, but people like the Fermented Grapes family who are dedicated to learning and relaying that information to thirsty customers.
While they like many different regions, at home, Jan's favorite is always Burgundy and Debbie tends to favor wines from the Loire." Matt has a special fondness for Domaine Binner. "I still have some bottles stashed away of the 2008 cuvee Beatrice Pinot Noir. Really superb stuff!" He also mentions the quality and value from Domaine des Sablonnettes. Normally avoiding multiple wines from an individual producer, the store carries three Sablonnettes labels. "They're subtle and humble, not screaming to be noticed. But there they are, waiting to be enjoyed."
Fermented Grapes hosts free tastings every Wednesday and Saturday evening. Stop by anytime and expect a gracious welcome, inspiring wine conversation and a diverse selection of real wine.
We fell in love with this little restaurant in Long Island City and thought you might too. Owner/chef Alex Schindler and his wife Lisa DiClerico opened the neighborhood restaurant LIC Market in 2010, focusing on fresh ingredients and natural wine. Born and raised in Queens, Alex worked in many restaurants, and was an Executive Chef for 10 years in places like Giorgione, 508 and Hotel Giraffe where he learned many styles of cooking before opening the doors of LIC Market.
Alex says he fell in love with natural wine 8 years ago when friends in the food and wine world introduced him to the concept. "Natural wine seems like the logical choice to accompany the food we're cooking – it fits the same philosophy" says Alex. "Conventional wines can many times get in the way of food while natural wines are lively and fresh and work really well with food." He also likes the conversation it brings to the dining experience and getting people to talk about the food and wine is exactly the experience he imagined. In the very beginning customers were only asking what was new and exciting on the food menu, and now they ask the same about the wine list, which has doubled in size since those first days. Alex says, "[People] know they won't see the same wine here they see everywhere else." Lisa adds: "this is one of our goals for both the food and wine – that they will always be outstanding and offer a variety of interesting and out-of-the-ordinary choices. This is what sets our restaurant apart."
As far as food, they buy locally whenever possible, but also incorporate specialty products from all over the world to add some creativity. They focus on ingredients that can be cooked simply and stand on their own and believe the seasonal local food movement is not just a passing trend. People are much more aware of where their food is coming from and really appreciate this information as part of their dining experience.
Lisa has worked in the neighborhood since 2000 and really fell in love with the community which is full of artists, artisans and manufacturers. She found a genuine sincerity to the area which was gritty and industrial but for the right reasons – because it was being used for creative purposes. As they watched businesses move into the neighborhood they saw an opportunity to open a place where they would actually like to spend time. The response has been incredible. Lisa uses skills from her main profession, where she conserves and restores fine art objects and furniture at Lisa DiClerico studio (Lisadiclerico.com), her LIC based business to keep the space cozy and fresh. She designs and changes the restaurant interior personally, sometimes spicing up the walls with local art. This past Spring they added 18 extra seats to an outside space to maximize the restaurant but still maintain the intimate ambiance.
What's your favorite part of the business? I asked Alex as we sat amongst happy locals on their lunch breaks. "I get to work with people from all over the world and get to know other people's cultures and backgrounds. I have an opportunity to work with amazing ingredients and wines from all over the world and be creative with them every day."
We are continuing our series to take a look at one of our favorite winemakers, Emmanuel Lassaigne. Manu is a rare breed: someone who works very instinctively and puts all his powers of creativity into action, seemingly without fear of failure or concern for what the market wants. He makes the Champagnes he wants to make, and he takes huge risks in doing so; risks that others would never even consider taking. He does all this almost entirely by himself, working alone in the vines and in his cellar throughout the year. We find the results to be truly stunning: incredibly focused and alive wines of terroir that are crystal clear renderings of the best Champagne has to offer. We'll continue with this series throughout the fall season.
You can read reason #1 Manu is our Hero here.
You can read reason #2 Manu is our Hero here.
Emmanuel disgorges every single bottle of his wine by hand, himself. This is unheard of in Champagne. Emmanuel doesn't like to top off bottles. Normally Champagne is frozen at the neck for disgorgement, and then when the cap is removed, the frozen dead yeast expels itself. This involves a loss of some wine, which must then be topped up from other bottles. Emmanuel has figured out a technique, which when done correctly, leaves a perfectly clear Champagne with virtually no loss of wine. As he explains in this video we shot of him last year, one must raise the bottle at a certain tempo while popping the cap off. If you do it too slow, you'll have an empty bottle, and if you do it too fast, you'll have a cloudy bottle as much of the sediment falls to the bottom:
We are continuing our series to take a look at one of our favorite winemakers, Emmanuel Lassaigne. Manu is a rare breed: someone who works very instinctively and puts all his powers of creativity into action, seemingly without fear of failure or concern for what the market wants. He makes the Champagnes he wants to make, and he takes huge risks in doing so; risks that others would never even consider taking. He does all this almost entirely by himself, working alone in the vines and in his cellar throughout the year. We find the results to be truly stunning: incredibly focused and alive wines of terroir that are crystal clear renderings of the best Champagne has to offer. We'll continue with this series throughout the fall season.
You can read reason #1 Manu is our hero here.
Reason #2:
Emmanuel ripped up all his Pinot Noir vines. He previously made two cuvées, les Papilles Insolites, a 100% Pinot Noir champagne, and his rosé, which was light and just barely graced with a hint of red fruit from the 10% Pinot Noir in the blend. People (including us!) loved this wine as a light rosé Champagne with racing acidity. He sold both these Champagnes with ease every time they were released, and had totally viable markets for them. But Emmanuel thinks the best expression of his soil is through the Chardonnay grape, so he completely ripped out all the Pinot Noir vines and has since replaced them with Chardonnay. Emmanuel will not see the results of his labors for a minimum of another 10 years, and really it will be much longer than that; 3-5 years for the new Chardonnay vines to grow into anything that will produce grapes suitable for making wine, and then 3-5 more years for that first wine to ferment then age in the bottle. In fact it will be even longer than that before we really get to taste the results of this new vineyard, as Manu almost always combines at least 2 vintages to make one cuvée.
Manu makes radical choices, as we see time and time again, without regard for quick profit or the taste of the market. He makes the choices he wants to make, and what his instincts tell him are the right choices, for his soil, and the right long term choice for the winery.
There are moments of working in the NYC wine industry when we can feel disconnected from the wine we are working with. There is something about rolling a wine bag into the subway and down the crowded streets of the city that feels (and is) so very far away from where it began. This is why it's so important and refreshing to spend time on the vineyard – to feel the soil, breathe the clean air, get your hands (and feet) dirty and re-connect with the earth. This is, after all, where all the important things begin.
I had the pleasure of spending a few days with Joe Pedicini and his team outside of Hillsboro, Oregon in the Willamette Valley and experiencing the magic of harvest. Long hard work days are followed by long nights of talking and laughing over homemade food and wine and the reward is spending a lot of time with talented, amazing people and the ability to actually taste what they've created.
The weekend started on an uncharacteristically warm and sunny October weekend at Ruby Vineyard where Joe has been making his wine for 2 years now. Steve and Flora are a husband and wife team who own the house and vineyard where neighbors pop by for a coffee or to put in a few hours of work and even just to say hi to the crew and pet Stanley, the vineyard dog. Two interns and a handful of other harvest helpers make the winery buzz with excitement and a family vibe where it doesn't feel quite like "work." The backdrop is sprinkled with green hills and mountains with Mt. Hood standing proudly in the distance, wearing a pink hat at sunset and everyone stops to stare.
We processed 20 tons of fruit while I was there and 2014 was a perfect growing season. The fruit tumbled onto the sorting table in near perfection, only a few leaves here and there to pick out, all of us snacking on bunches throughout the day. I decided to pick Joe's brain about the other vintages and vineyards he works with.
The 2011 Crawford Beck just arrived in NY at the beginning of October. 2011 was a cool, rainy year – harvest was a nearly a month later than in 2014. Every vintner has a different way of deciding when to pick; Joe uses both testing and taste – and in 2011 when the brix were measuring but the flavors were not developed enough for his palate he waited a bit longer. A small and perfect window for picking finally arrived and though it was a bit hectic, the fruit came in beautifully and worth the wait. Crawford Beck vineyard is owned by David and Jeanne Beck and according to Joe is meticulously farmed. Always using at least 50% whole cluster fermentation, he likes what the stems bring to the wine, herbaceous aromatics, and silky tannins when the wine is aged and ready. The cool year brings great acidity and balance, and in the end a wine that is more delicate and floral than in warmer years.
The most interesting thing about the Crawford Beck Vineyard is the two soil compositions living right next to each other. The Dijon 115 clone is grown on a slope where the top slope is volcanic soil and the bottom is marine sediment. Though the fruit is grown just steps from one another they make completely different wines – terroir! Joe has always vinified the two wines separately and later blended them to make the Crawford Beck Pinot Noir we know and love in NY. But recently, he started making two separate wines to showcase how these soils produce very different wines from the same vintage. In the future he will make three wines from Crawford Beck, with grapes grown in the different soils alone, and one as a blend. We can't wait to taste them!
Joe started working with a couple of new vineyards in 2012 – Kathken vineyards and Momtazi, a biodynamic vineyard. Kathken Vineyard, from which the 2012 Pinot Noir also just arrived in NY, is a high elevation vineyard with Jory and Nokia soils. In 2012 the conditions were perfect — almost too hot in some areas but with the high elevation at Kathken, a cooler AVA from the nearby Pacific influence, the ungrafted old clones of Wädenswil and Pommard fared perfectly.
While Joe has a method for his winemaking it's refreshing to see that he's not afraid of the unknown – throughout the weekend he pulled some fruit aside for various experiments just for the sake of trying new things and learning by doing each year. While processing some perfect Gewürztraminer fruit we decided to hand squeeze a bunch into steel pots to skin ferment and later bury underground for a few months.
So what about the wine? It starts in the vineyard but it ends in the glass! The wines of Montebruno are reflective of the precise work that begins in the vineyard. In the glass they are expressive, thirst-quenching, and full of life. Wine that is delicate yet complex and interesting. Pinot Noir that embodies the terroir from which it came yet somehow echoes the style of Burgundy.
In honor of La Fete du Champagne, we're kicking off a new series to take a look at one of our favorite winemakers, Emmanuel Lassaigne. Manu is a rare breed: someone who works very instinctively and puts all his powers of creativity into action, seemingly without fear of failure or concern for what the market wants. He makes the Champagnes he wants to make, and he takes huge risks in doing so; risks that others would never even consider taking. He does all this almost entirely by himself, working alone in the vines and in his cellar throughout the year. We find the results to be truly stunning: incredibly focused and alive wines of terroir that are crystal clear renderings of the best Champagne has to offer. We'll continue with this series throughout the fall season.
Reason #1:
From the beginning of his winemaking carrier, Manu has been willing to take big risks based on his own instincts and make decisions in isolation from the opinions of others. Before Emmanuel took over the winery from his father Jacques in 1999, he worked in the industrial packing industry with zero experience making wine. He studied the vines and winemaking for a few years, by himself, and decided he was ready to make his first vintage in 2002. He then promptly cancelled all orders with their existing client list. He knew he was going to completely change the way the wine was made, and he didn't want to be beholden to any customers who preferred the old way. He chose to start completely from scratch. He built an entirely new list of clients, starting with the then small but slowly expanding Paris natural wine scene.
He began by converting to organic viticulture, putting a lot of time and effort into the land and the vines. At the time in France for certain, but especially in Champagne, this was considered complete madness. Grapes from Montgueux, the area in Champagne where his vineyard is situated, were and still are almost all sold to larger houses at very lucrative prices. Manu's neighbors thought he was a total lunatic at first, although they now respect what he has done. Manu did this because he had a vision to create wines of terroir; to showcase the unique different parcels of the vineyard. He didn't make these choices because he had spent time with other natural winemakers like Marcel Lapierre, and he had never heard of Anselme Selosse. He just thought it made sense, so he walked away from guaranteed income and clients to start everything anew and make wines the way he thought they should be made.
Dear Winelovers,
Come protest Global Warming with the Jenny & François team! We are passionate about this subject for many reasons, but as people of the wine industry who work closely with winemakers around the world, we have to acknowledge the effect of global warming on grape growing. On Sunday September 21st, we will join the People's Climate March at 11 AM on 77th St. and Central Park West to march as a group of wine lovers who want to take back the terroir and bring awareness to this growing problem. Check out the website here: http://peoplesclimate.org/
Research shows that if climate change patterns progress as expected with higher temperature and droughts, grape-growing regions will shrink by nearly 80 percent by the year 2100. We don't want to be in the raisin business! Please come by for an hour or two and walk with us – we'll be the ones holding the banner that says "Winelovers Unite: Take Back the Terroir!"
We'd love to see a giant group of wine drinkers, industry or not, walking with us on Sunday the 21st to continue the battle against global warming. Please send us an e-mail at email@example.com if you can make it so we know how many to expect. We look forward to marching with you!
In Vino Veritas,
The J&F Team
Jean Luc le Du has been a fixture in the New York City wine scene for almost two decades now. He helmed the list a sommelier at restaurant Daniel in the mid 1990's and also designed many of the lists at Daniel Boulud's renowned restaurants, including Café Boulud. He opened le Du's wines in 2005 and put together a slick, huge, and very successful wine store that is one of the city's best. Needless to say, Jean Luc has tasted and bought an incredible amount of the world's most storied wines.
However, we wanted to sit down and talk to him about another one of his passions- natural wine. Nestled amongst the Grand Cru Burgundies at le Du's, you'll find treasures from the world's top natural winemakers as well- Olivier Cousin, Frank Cornelissen, and Grange Tiphaine just to name a few. Check out the video to learn what Jean Luc likes about natural wines:


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text: Energy New EPA Rules Motivate Montana To Look Beyond Coal By Amy Martin • Sep 10, 2015 Colstrip, Mont., is true to its name — it exists because of coal. "Our coal's getting deeper, like everywhere else, because everybody's mining. They're getting into the deeper stuff," says Kevin Murphy, who has worked in the Rosebud Mine for 15 years running a bulldozer in the open pits. Everything about the mine is enormous, especially the dragline, a machine as big as a ship with a giant boom that extends 300 feet up into the air. The dragline perches on the lip of the pit, scraping away hundreds of feet of rocky soil to reveal the black seam of coal below. As New Rules Loom, Colorado Is Again Talking About Energy Industry Relations By Bente Birkeland • Sep 3, 2015 Oil drilling on Colorado's populous Front Range has forced more interactions between communities and the energy industry – and that's caused tension. At the recent annual Rocky Mountain Energy Summit, one of the discussions centered on how to improve relations between the industry and the public. It's an ongoing issue that the state will tackle in a new rule making hearing. A Word With Dan Haley, COGA's New Executive Director By Bente Birkeland • Aug 3, 2015 Dan Haley spent 20 years as a journalist and editor, the bulk of which was with The Denver Post. He then joined the private sector as a media consultant. Now though, Haley has taken on a new role – as the executive director of the state's largest oil and gas industry trade group, the Colorado Oil and Gas Association. A Push For Solar In Colorado's North Fork Valley By Laura Palmisano • Jul 9, 2015 Laura Palmisano / KVNF A few years ago, a grassroots program started in Portland to encourage people to adopt solar power. That idea spread across the county and inspired similar initiatives like one in a rural community in western Colorado. A crew of six is working to install mounts for solar panels on a residential rooftop in Delta County. This home sits atop a mesa that overlooks the North Fork Valley. And, it's the first to get a sun-powered system through a local pro-solar campaign. How Fracking Is Fueling A Power Shift From Coal To Gas When you flip on a light switch, odds are, you're burning coal. But as the fracking boom continues to unleash huge quantities of natural gas, the nation's electric grid is changing. Power plants are increasingly turning to this low-cost, cleaner-burning fossil fuel. Bill Pentak stands in the middle of a construction site, looking up at his company's latest project towering overhead — a new natural gas power plant. America's Next Economic Boom Could Be Lying Underground By Chris Arnold • Jun 11, 2015 There's a serious problem in the American economy: Big corporations are doing well, but real household income for average Americans has been falling over the past decade — down 9 percent, according to census data. "That's not good for America," says Harvard economist Michael Porter. "That's not good for America's standard of living. That's not good for our ultimate vitality as a nation." For Rural Colorado, Stability Of Severance Taxes Is Always In Flux By Bente Birkeland • May 7, 2015 As a result of Colorado's booming oil production, energy companies are paying more in severance taxes – money they pay the state for taking minerals out of the ground. Half of it is supposed to go to back to local communities, both directly and through grants. But thanks to market forces – and political conditions in Denver – it's not always a stable source of funding. Office Of Consumer Counsel's Future Hinges On Debate In The Final Day Of The Session By Bente Birkeland • May 6, 2015 The debate over continuing the Office of Consumer Counsel won't be decided until the final day of the state's annual legislative session. The Office represents taxpayers when utility and telecom companies go to the state to ask for rate hikes. Without Senate Bill 271 [.pdf], the Office of Consumer Counsel would sunset and go away altogether. Determining the scope of the office's role though has been contentious. DMEA Forum Focuses On FERC Petition And Broadband By Laura Palmisano • Apr 16, 2015 Laura Palmisano / KVNF The Delta Montrose Electric Association is a cooperative meaning its customers are its owners. DMEA wants to hear what its consumers think about its desire to purchase more locally produced energy and it potentially entering the internet service game. Two months ago, DMEA filed a petition with the Federal Energy Regulatory Commission (FERC). "What we are asking FERC to rule on is to declare Tri-State a public utility which would allow us then to enter into agreements with qualifying facilities," DMEA CEO Jasen Bronec says. As Schuller Steps Down, What's Ahead For Colorado's Energy Industry? By Bente Birkeland • Mar 19, 2015 The executive director of the Colorado Oil and Gas Association, Tisha Schuller, recently announced that she's leaving the state's largest trade organization for the energy industry. In a statement released by COGA, Schuller said it was a "wild ride" and that she was honored to have represented the state's oil industry. While remaining in her position until the end of May, Schuller sat down to talk about the future of the industry and why she decided to leave her position. Washington State County Unsure If It Can Take Wave Of North Dakota Crude Oil companies in North Dakota are looking for the fastest and cheapest way to get their product to refineries, and they've set their sights on moving more of their product by rail to the Northwest. There are six new oil terminals proposed for Washington state. Half of them could be built in the small communities around Grays Harbor, a bay on the Pacific coast about 50 miles north of the mouth of the Columbia River. With Quakes Spiking, Oil Industry Is Under The Microscope In Oklahoma By Frank Morris • Feb 16, 2015 Out on Oklahoma's flat prairie, Medford, population about 900, is the kind of place where people give directions from the four-way stop in the middle of town. It seems pretty sedate, but it's not. "We are shaking all the time," says Dea Mandevill, the city manager. "All the time." The afternoon I stopped by, Mandevill says two quakes had already rumbled through Medford. "Light day," she laughs. But, she adds, "the day's not over yet; we still have several more hours." Mandevill may be laughing it off, but Austin Holland, the state seismologist, isn't. Bill To Boost Renewable Energy In Colorado Schools By Laura Palmisano • Feb 4, 2015 flickr/theentiremikey A bill that seeks to give grants to schools for alternative energy projects will be taken up by a state Senate committee next week. A federally funded program that started in 2007 gave grants to public school for wind energy projects. In Colorado 16 schools took advantage of it. The money for that program has since dried up, but a bill introduced by Democratic State Senator Kerry Donovan of District 5 seeks to revive it at the local level. State Of The State Is 'Strong' As Hickenlooper Outlines 2015 Plans By Bente Birkeland • Jan 15, 2015 Governor John Hickenlooper received a warm reception from lawmakers in both parties during his annual State of the State Address. The Governor talked about policies he wants the legislature to adopt, announced a few new initiatives and urged lawmakers to face facts about the challenges facing Colorado. During his roughly 45-minute speech Hickenlooper highlighted many of his budget proposals, such as giving more money to higher education and K-12 schools. He also pledged to look at ways to creatively fund roads and bridges, and threw his support behind a felony DUI law. Colorado is one of four states without one. KVNF Regional Newscast: Friday, Dec. 26, 2014 By Laura Palmisano • Dec 26, 2014 Newscast Holiday Travel Advisories Hammond's Candy Creates Iconic Candy Canes In Denver Colo. GOP Now Control Senate, A Look At How Dem. Plan To Regroup Helping Colorado Dairymen Lighten Your Milk's Energy Load Helping Colorado Dairymen Lighten Your Milk's Energy Load By Stephanie Paige Ogburn • Dec 25, 2014 What comes to mind when you think about milk? Like it or loathe it, you probably associate it with cereal, Oreos and milk mustaches. One thing you probably don't think about? Energy. It turns out, it takes a lot of energy to make a gallon of milk. Recently, a few Colorado dairymen have been working to lighten their milk's energy load. Forum Explores The Future Of The North Fork Valley By Laura Palmisano • Dec 4, 2014 Laura Palmisano About 100 people attended a forum on the North Fork Valley's economy and what can be done to improve it. Thirteen people ranging from the president of a coal mine to the head of the Paonia Chamber of Commerce spoke at the forum held at the Hive Paonia. "We have our farms," says Alexis Halbert, president of the chamber. "We have our hunting resources. We have are restaurants, wineries, [and] people who are creating things out of the natural assets of the valley." What You Need To Know About The Keystone XL Oil Pipeline By Jeff Brady • Nov 17, 2014 Update at 7:35 p.m. ET: The Senate voted against completing the Keystone pipeline. The remaining portion of the Keystone pipeline project, if completed, will be fewer than 1,200 miles long — just a fraction of the existing 2.6 million miles of oil and gas pipelines running beneath our feet in the United States. Low Gas Prices Haven't Slowed Domestic Drilling — Yet It's lunchtime in Douglas, Wyo., a town smack in the middle of the state's booming oil patch, and the line of cars at the McDonald's drive-through wraps around the building. A hiring poster hangs in the window, and the parking lot is full. Troy Hilbish, a tool hand for the oil field servicing company Schlumberger, says while he didn't know oil prices have been falling, he does know what falling prices mean. "If the oil prices go up, we drill more," Hilbish says. "If they go down, we don't drill as much." U.S. Energy Boom Spurs Massive Demand For New Pipelines By Stephanie Joyce • Oct 10, 2014 Copyright 2014 NPR. To see more, visit http://www.npr.org/. Transcript MELISSA BLOCK, HOST: Scientist Amory Lovins Talks Energy By Ali Lightfoot • Oct 2, 2014 Physicist and environmental scientist Amory Lovins has worked in the field of energy policy for over 40 years. He speaks with KVNF's Jake Ryan about the changing energy landscape around the world. Solar Advocates Fight Utilities Over Grid Access By Jeff Brady • Sep 25, 2014 The solar power business is growing quickly in the U.S. More than 500,000 homeowners and businesses installed solar panels in just the first half of this year, according to a Solar Energy Industries Association report. When people get electricity from the sun, they don't buy it from their local power company. But that utility still must have the generators and power lines to provide electricity when the sun is not shining. That's creating conflicts across the country. When The Power's Out, Solar Panels May Not Keep The Lights On The cost of solar panels is falling rapidly in the United States. And as the panels become more affordable, they're popping up on rooftops around the country. Meanwhile, the U.S. is trying to find better ways to back up its power system against blackouts. And while it may seem counterintuitive, more solar power does not mean fewer blackouts — at least not yet. The tiny town of Del Norte, in southwestern Colorado, is a perfect example. Despite being covered in solar panels, Del Norte is still at risk of losing power if its main power line goes down. "Uranium Drive-In" Tells Story of Struggling But Hopeful West End By Travis Bubenik • Jan 22, 2014 San Juan Huts Day 5 via Flickr (CC BY-SA) Residents from Montrose County's West End recently gathered for a screening of "Uranium Drive-In," a documentary that tells the story of the ill-fated Piñon Ridge Uranium Mill, and a tight-knit community desperate for jobs and some hint of a brighter economy. KVNF Regional Newscast: Thursday, January 2, 2013 By Travis Bubenik • Jan 2, 2014 Listen Listening... / 12:15 Headlines Denver Post Hires Marijuana Editor, Launches Pot Website Boulder District Attorney Discusses Future of Industry DMEA Customers to See Rate Increase This Year, San Miguel Power Association Rates to Hold Steady Connecting the Drops: Hydropower on the Colorado River By Maeve Conran • Dec 6, 2013 Maeve Conran A complex series of agreements govern the distribution of water throughout the state. Along the Colorado River, farms, cities & towns, and the recreation industry are all big players. But everyone takes a backseat to a tiny hydroelectric plant that's over one hundred years old. It's the Shoshone Generating Station, and it plays a critical role on the Upper Colorado. Post-Election, Oil And Gas Industry Steps Up Outreach By Bente Birkeland • Nov 24, 2013 Colorado's Energy industry is continuing to make the case that hydraulic fracturing is safe and a critical part of the state's economy. Major Layoffs at Oxbow Coal Mine By Elise Thatcher • Oct 16, 2013 Elise Thatcher/Aspen Public Radio Two weeks ago, the coal mine near Paonia owned by billionaire Bill Koch laid off more than half of its employees. The Koch owned Oxbow Mining company hopes to expand operations again in the future and rehire some of the workers. In the meantime the layoffs are creating hardships for a number of communities. "It's very sad time around the mine, you know to lose your income and lose your job is real traumatic, so it's very painful decision for us," says Mike Ludlow, the Executive Vice President of Oxbow's mining operations. KVNF Regional Newscast: Wednesday, October 9, 2013 By Travis Bubenik • Oct 9, 2013 Listen Listening... / 10:01 Headlines Colorado Wind Industry Expected to Grow Baca County Farmer Harvests First Hemp Crop in 56 Years Government Shutdown Not Affecting Mines Yet Thompson Divide Drilling Talks Suggest Deal is in the Works iSeeChange - Journaling with the Hardings Industry, Critics Gear Up for Post-Flood Fracking Fight By Bente Birkeland • Sep 27, 2013 Bente Birkeland/RMCR In November, voters in several Front Range communities will consider whether to ban or delay fracking. Many of these same areas are also recovering from September's devastating flooding. There's renewed attention on the fight over fracking thanks to Colorado's flooding. Recent figures show that 12 spills have polluted the South Platte with 37,000 gallons of oil. Both sides of the debate were out in full force during a recent community festival for the city of Broomfield. Voters there will decide whether to pass a five-year fracking moratorium. Pages1 2 next › last »


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Following a letter sent last week requesting that Environmental Protection Agency Administrator Gina McCarthy disclose plans for the cleanup of the Animas River contamination, Representative Scott Tipton, yesterday, wrote again to the EPA Administrator, with 15 questions Continue reading
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Tipton Sends 2nd Letter To EPA
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Tagged Animas River, cleanup, contamination, EPA, Gina McCarthy, letter, Scott Tipton
Lawmakers Urge Changes in Rural Broadband Funding
Colorado's rural communities were well represented last week in two separate letters to the Federal Communications Commission calling on the agency to update how rural companies receive funding for voice and broadband services. A bipartisan U.S. Senate letter featured signatures from 61 members, including Senators Continue reading
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Tagged Broadband Services, colorado, Connect America Fund, Cory Gardner, dial-up telephone service, Diana DeGette, Doug Lamborn, Federal Communications Commission, House of Representatives, Jared Polis, Ken Buck, Michael Bennet, Mike Coffman, rural communities, Scott Tipton, U.S. Senate
Kinkaid Lobbying Lawmakers to Visit Craig
Moffat County Commissioner John Kinkaid was in Washington D.C. this week representing the National Association of County Commissioners. Kinkaid says he has been working on getting Congressional members to visit Northwest Colorado. He says that he has convinced Colorado Senators Michael Bennet and Cory Continue reading
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Tagged Congressional members, Cory Gardner, Craig, Cynthia Lummis, House, House Energy Committee Field Hearing, Michael Bennet, Moffat County Commissioner John Kinkaid, National Association of County Commissioners, Northwest Colorado, Rob Bishop, Scott Tipton, Senate Energy Committee Field Hearing, Utah, Washington D.C., Wyoming
Moffat County Commissioners Support State Fight Against Sage Grouse Listing
The Moffat County Commissioners yesterday indicated they were happy that the state is going to fight the Gunnison Sage Grouse decision in court. U.S. Fish and Wildlife recently made the decision to list the Gunnison Sage Grouse as a threatened species. A decision on the Greater Sage Grouse is expected next year. The Greater Continue reading
Gunnison Sage Grouse Listed as Threatened
The Federal Government is going against the will of individual states, when it comes to listing sage grouse as threatened. That's according to Governor Hickenlooper's point man on sage grouse, John Swartout. Swartout says yesterday's decision to list the Gunnison Sage Grouse as threatened means that control of the species goes Continue reading
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Tagged colorado, Colorado Cattlemen's Association, Congressmen, conservation programs, Cory Gardner, critical habitat, Dan Ashe, federal government, Governor Hickenlooper, greater sage grouse, Gunnison sage grouse, individual states, John Swartout, Moffat County, oil and gas, sage grouse, Scott Tipton, threatened, U.S. Fish and Wildlife Service, Utah, Western Slope, Wyoming
McConnell Determined to Slow Down EPA
Incoming Senate Majority Leader Mitch McConnell of Kentucky says his top priority is reining in the EPA, and reversing new carbon pollution laws. McConnell says it won't be easy to block the regulations, because he feels the only good tool to do it is the spending process. But McConnell says he's angry that President Obama unilaterally included a Continue reading
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Tagged carbon pollution laws, Congress, EPA, Kentucky, Mitch McConnell, President Obama, REINS Act, Scott Tipton, Senate, Senate Majority Leader
Tipton Condemns New EPA Rule to Garnish Americans' Paychecks
Today, Congressman Scott Tipton (R-CO) demanded the withdrawal of a proposed Environmental Protection Agency (EPA) rule under which the agency would garnish Americans' paychecks to collect fines. The EPA, which quietly published the rule in the federal register last week, claims that the rule is not large enough to be subject to a public comment period, and is attempting to quietly Continue reading
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Tagged Environmental Protection Agency, EPA, fine, rule, Scott Tipton
Tipton and Gardner Urge Feds to Keep Hands off Vermillion Basin
Moe, Mazzola, Win Primary Races
Frank Moe won the Republican nomination for Moffat County Commissioner yesterday. Moe pulled in 1,366 votes to Tom Soos' 717 in yesterday's primary election. In another key Northwest Colorado race, Anthony Mazzola won the Republican primary Continue reading
Primary Election Ends Today
Ballots are due today in the Primary election. If you haven't mailed in your completed ballot, you'll need to take it in person to your local County Clerk and Recorder's Office. Rio Blanco County's Republican ballot will have Michael Joos facing off against Anthony Mazzola Continue reading
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Tagged Anthony Mazzola, ballots, Bob Beauprez, Chuck McConnell, County Clerk and Recorder's Office, County Sheriff, Dave Moloney, David Cox, Frank Moe, general election, governor, John Hickenlooper, Michael Joos, Mike Kopp, Moffat County, Moffat County Commissioner District 3, primary election, Republican, Rio Blanco County, Routt County, Scott Gessler, Scott Tipton, State Representative District 26, Tom Soos, Tom Tancredo
Gardner, Tipton Vote for Legislation to Improve Health Care to Veterans
Yesterday, Congressmen Cory Gardner and Scott Tipton joined an overwhelming bipartisan majority of the House of Representatives to pass H.R. 4810, the Veterans Access to Care Act. This legislation, which both cosponsored, allows the Department of Veterans Affairs (VA) to Continue reading
Investigation Into Obama's Prisoner Exchange Begins Wednesday
The first major action on the investigation into President Obama's prisoner exchange will occur Wednesday, when Defense Secretary Chuck Hagel is set to appear before the House Committee on Armed Services to answer questions about why the White House failed to notify Congress 30 days prior to the President Continue reading


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House Boat Di Irene Swier
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Tulips and Madame Tussauds
Woke up earlier today, packed up little bag and was off quite early by Taxi to the train station. The taxi was not sign-written, and incredibly plush with leather seats - it was a Mercedes!
Getting a ticket to Amsterdam was easy, and the train was very comfortable. At the other end, the logistics of carrying my small black bag, backpack, and slightly full yellow bag as well as towing my larger bag on wheels got the better of me. We had around ...
Hello Amsterdam!
... the weather changed from fine and sunny, to a mini tornado. We were 'peed' upon copiously from above and had to run for shelter. The wind was blowing the rain horizontal to the ground. Fortunately, it stopped within a few minutes and we were able to find a warm caf� and were dry by the time we had eaten. Apart from that excitement, the trip north was uneventful..
Have enjoyed buffet dinner and met more of ...
Tiptoeing through the tulips
... we arrived. The owner gave us a short tour, explaining seasonal growing cycles and other interesting aspects of the flower bulb industry. Later, a short video presentation gave us a better understanding about planting, harvesting, packaging, and worldwide distribution of the billions of flowers and bulbs produced in Holland each year.
After our tour of the bulb farm, it was just a fifteen-minute drive to the Keukenhof, where we disembarked for our ...
Amsterdam is the Best
... most famous, but pesto cheese also seems to be popular.
The Last Cities: Julia and I decided that we don't want to go back to France yet (not our favorite country), so we finally chose a nice mix of other places:
Brugge, Belgium.
Hamburg, Germany.
Prague, Czech Republic.
Vienna, Austria.
Heidelberg, Germany.
And last of course is Paris, France.
And then Home!
Day 28: London to Amsterdam
... while, Bruce rejoined Frank at the café. Fred was still snoring his head off in the cabin! They went for a bit of a look around the ship before heading back to the cabin to meet him and relax a little more! I'd say the rest of their trip went swimmingly, which ordinarily would mean it went fine, but in these circumstances could give the impression that the boat sunk and they had to swim. It didn't and they didn't, so I won't! Eventually they went and got some lunch, then settled ...
Other places to stay in Amsterdam
Hotelboat IdeaalCentre, Amsterdam | Innfrom $175


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by: mobileapps4u | 23
Free Beast (B2ST) link-same game. Based on the fun and popular speed linking game featuring all 6 members of this popular South Korean male band K-pop group. Pictures of members are Doojoon (Yoon Doo-Joon), Hyunseung (Jang Hyun-Seung), Junhyung (Yong Jun-Hyung), Yoseob (Yang Yo Seob), Kikwang (Lee Gi Kwang) and Dongwoon (Son Dong-Woon).
Link the 2 nearest identical images to clear the board as fast as you can. Timer reduces by 15 seconds for each subsequent rounds. Download this Beast (B2ST) game and start having fun now!
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In aging populations, the prevalence of multimorbidity is high, and the role of socioeconomic status and its correlates is not well described. Thus, we investigated the association between educational attainment and multimorbidity in a prospective cohort study, taking also into account intermediate factors that could explain such associations.
We included 13,781 participants of the Heidelberg cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC), who were 50–75 years at the end of follow-up. Information on diet and lifestyle was collected at recruitment (1994–1998). During a median follow-up of 8.7 years, information on chronic conditions and death were collected.
Overall, the prevalence of multimorbidity (>= 2 concurrent chronic diseases) was 67.3%. Compared to the highest educational category, the lowest was statistically significantly associated with increased odds of multimorbidity in men (OR = 1.43; 95% CI 1.28–1.61) and women (OR = 1.33; 95% CI 1.18–1.57). After adjustment, the positive associations were attenuated (men: OR = 1.28; 95% CI 1.12–1.46; women: OR = 1.16; 95% CI 0.99–1.36). Increasing BMI was more strongly than smoking status an intermediate factor in the association between education and multimorbidity.
In this German population, the prevalence of multimorbidity is high and is significantly associated with educational level. Increasing BMI is the most important predictor of this association. However, even the fully adjusted model, i.e. considering also other known risk factors for chronic diseases, could not entirely explain socio-economic inequalities in multimorbidity. Educational level should be considered in the development and implementation of prevention strategies of multimorbidity.
Aging populations are characterized by the co-occurrence of multiple chronic conditions. Two or more concurrent chronic conditions are defined as multimorbidity, whereas comorbidity refers to an index disease [1,2]. In the Netherlands, the prevalence of multimorbidity was 33.6% in 50–59 year old men, 60.5% in 60–79 year old men, and 74.2% in men 80 years or older, among women the prevalence was 35.9%, 64.9%, and 79.9%, respectively [2]. Similar numbers were reported from Canada and the U.S. [3,4]. Most studies on multimorbidity were performed in general practice setting [2] or on aggregated population level [5,6].
Socio-economic inequalities were shown to be associated with morbidity and mortality [5-11]. Educational attainment, occupational social class, and income are established indicators of socio-economic position (SEP) [12]. Moreover, pathways through which the socio-economic position influences morbidity have been proposed [13]. For example, SEP differences are likely to reflect differences in smoking [14], diet [15], alcohol consumption and physical activity [16]. Living conditions, chronic stress and access to the health care system were also examined in relation to health disparities [5]. Education as a marker for SEP may be associated with the prevalence of chronic medical conditions in later life. Because multimorbidity has an impact on quality of life and on life expectancy at the individual and population level, the knowledge about modifiable risk factors is valuable [2,17]. Up to now little is known about the determinants and the effect of potential risk factors such as diet and lifestyle on the prevalence of multimorbidity in the general population [17].
Thus, the aims of this study were to investigate the association between educational attainment and multimorbidity and to examine the mediating role of health behaviour among participants aged 50 years or older in the EPIC-subcohort of Heidelberg.
Study Subjects
Between June 1994 and October 1998, 24,540 participants were recruited in the EPIC-Heidelberg cohort, contributing to the European Prospective Investigation into Cancer and Nutrition (EPIC) [18]. Subjects were recruited from the general population [19]. For the present analysis participants younger than 50 years at the end of follow-up (N = 10,759) were excluded. Thus, the analytic cohort comprised 13,781 participants aged between 50 and 75 years at the end of a mean follow-up of 8.7 years.
The baseline assessment included a self–administered food frequency questionnaire (FFQ) and standardized anthropometric measurements including height and weight. Nutrient intake data were calculated from the food consumption data by means of the German Food Composition Tables. The participants were also asked to provide detailed information about their smoking history, physical activity and medical history. The investigation was approved by the ethics committee at the Heidelberg University.
Follow-up and outcome
Follow-up of the cohort began at the date of recruitment and ended at either death or date of the last contact, whichever came first. Prevalent chronic diseases at recruitment were assessed during face-to-face interview. Incident cases of cancer and other chronic diseases were identified by active follow-up. The follow-up consisted of a questionnaire on physician diagnosed chronic conditions and the year of diagnosis. Chronic diseases were regrouped into cancer (all except non-melanoma skin cancer), diabetes mellitus, thyroid disease, stroke, myocardial infarction (MI), heart diseases (except MI), lung diseases (asthma, chronic obstructive pulmonary disease), gastrointestinal diseases (reflux esophagitis, chronic gastritis, gastric ulcer, Crohn's disease, ulcerative colitis, chronic diverticulitis), liver/kidney diseases, pancreatitis, muscle/bone diseases (rheumatic disease, osteoporosis), diseases of the central nervous system (multiple sclerosis, Alzheimer disease, Parkinson's disease), hypertension, dyslipidemia, and hyperuricemia. All self-reports on incident cases of cancer were verified by comparison with the medical records. However, medical verification of other chronic diseases has not been done, except for a few small validation/pilot studies on incident cases of myocardial infarction, stroke, asthma [20], and diabetes. During follow-up, 800 decedents (576 men and 224 women) were registered, confirmed by death certificates, and all-cause mortality was determined. Participation rate was over 90% in each follow-up round. At the end of the 3rd follow-up, 5.8% of the study participants were lost for follow-up.
The number of concurrent chronic conditions was counted to compute a score of morbidity (0 to ≥ 6). Multimorbidity (yes/no) was defined as two or more concurrent chronic conditions. In addition, multiple metabolic diseases is defined as the concomitant occurrence of metabolic diseases (0, 1, 2, ≥ 3) including diabetes, hypertension, dyslipidemia and hyperuricemia; the dichotomous variable 'metabolic diseases' (yes/no) reflects the existence of any metabolic disease.
Educational attainment was used to characterise a participant's SEP. The highest education achieved was measured by questionnaire at recruitment and summarized according to the German schooling system with three degrees: primary school or less (low), secondary school (middle), and grammar school (high). Subjects without school graduation (N = 113) were assigned to the lowest educational level. The highest category of educational attainment was used as the reference group.
As covariates known or potential risk factors of multimorbidity were considered. Smoking status was categorized as never smoker, ex-smoker or current smoker. Body mass index (BMI) was calculated as weight (kg)/height2 (m2). Alcohol consumption (g/day), fruit and vegetable intake (g/day) were included in the models as continuous variables. Physical activity was classified as inactive, moderately inactive, moderately active and active based on occupational activity, cycling, and sports [21].
Statistical analysis
This is a cross-sectional analysis of multi-morbidity, using all available information on prevalent chronic diseases collected at recruitment of the cohort and during follow-up rounds. Information on lifestyle factors, diet, and anthropometric data (measurements) was collected at recruitment. The prevalence of chronic conditions was analyzed in relation to educational attainment stratified by sex, because the association between educational level and health outcome could vary by sex as former reports have shown [2,3,22]. Age-adjusted logistic regression models were calculated to examine predictors of multimorbidity and Cox proportional hazard models (HR) for mortality, respectively. In order to explore mediating effects we introduced smoking status and increasing BMI (per increments of 5 kg/m2) in the age-adjusted models. Adjusted odds ratios (ORadj) and 95% confidence intervals (95% CI) for morbidity were calculated by inclusion of age (continuous, year), BMI (continuous, kg/m2), fruit intake (continuous, g/day), vegetable intake (continuous, g/day), alcohol consumption (continuous, g/day), smoking habits, and total physical activity in the models. Whether the associations differed by sex or age was assessed by including a cross-product term in the logistic regression equitation, and p for interaction was calculated with the log-likelihood test. For evaluation of the impact of the single multimorbidity scores, multinomial logistic regression models applying the generalized logit function (glogit) in PROC LOGISTIC were calculated. SAS statistical software 9.13 (SAS institute Inc, Cary, NC) was used for all calculations. A p-value < 0.05 was used to determine statistical significance.
Among 13,781 participants aged 50 to 75 years, the prevalence of multimorbidity was 67.3% in men and 67.4% in women. In men and women, dyslipidemia, hypertension, and gastro-intestinal diseases were the most common chronic conditions. High educational level was related to lower prevalence of dyslipidemia, hypertension, insulin-dependent diabetes, hyperuricemia, myocardial infarction, stroke and cancer in both men and women (Table 1). The distribution of baseline characteristics stratified by educational level and sex are displayed in table 2. Subjects in the highest education category were leaner, whereas in women no educational gradient was found. Irrespective of educational level men were prone to a more sedentary lifestyle.
Table 1. Prevalence of chronic conditions among participants aged 50 to 75 years in the in the EPIC-HD cohort by educational level and sex
Table 2. Baseline characteristics by educational level and sex of participants aged 50 to 75 years in the EPIC-Heidelberg cohort
The associations between education and morbidity by sex are shown in table 3. Low education category shows strong gradients with increasing number of chronic diseases overall as well as for metabolic diseases. All relationships were statistically significant, except for metabolic diseases in men.
Table 3. Age and multivariate adjusted odds ratios (OR, 95% CI) of the actual number of prevalent chronic diseases by educational level among men and women aged 50 to 75 years in the EPIC-Heidelberg cohort, applying multinomial logistic regression models (Reference category: highest educational level)
In the adjusted models, low educational attainment of men was statistically significantly associated with an increased prevalence of most chronic diseases except for cancer and stroke in men (data not shown). Among women no associations were found for cancer, myocardial infarction, pancreatic disease, liver/kidney diseases and thyroid disease. Diseases of the heart (other than MI), lung, liver/kidney, and central nervous system were not associated with educational level in men and women (data not shown).
Table 4 displays the age- and multivariate adjusted odds ratios for multimorbidity by education and sex. In the age-adjusted models, the associations between educational level and multimorbidity were slightly stronger in men (middle vs. high level OR = 1.32; 95% CI 1.12–1.55 and low vs. high level OR = 1.43; 95% CI 1.28–1.61) than in women (middle vs. high level OR = 1.13; 95% CI 0.97–1.33 and low vs. high level OR = 1.33; 95% CI 1.18–1.57). In women, the educational level had stronger impact on the occurrence of metabolic diseases (low vs. high level OR = 1.64; 95% CI 1.42–1.90) than in men (low vs. high level OR = 1.38; 95% CI 1.22–1.57). However, none of these suggested statistical interactions between sex and education were of statistical significance (multimorbidity p = 0.670 and metabolic disease p = 0.447). Differences in the strength of the association may be predominantly attributed to diabetes, which was more strongly associated with education in women than in men. By adjustment for potential risk factors the associations for multimorbidity, metabolic disease and mortality were attenuated. Concerning all-cause mortality, the introduction of smoking status and BMI in age-adjusted models attenuated the estimates with higher mortality among subjects in the lowest educational category.
Table 4. Age and multivariate adjusted odds (OR, 95% CI) and hazard ratios (HR, 95% CI) of multimorbidity, metabolic diseases, and mortality, including additional models adjusted for smoking status or BMI, by educational level among men and women aged 50 to 75 years in the EPIC-Heidelberg cohort
The introduction of BMI, but not smoking, in the age-adjusted models attenuated the estimates for multimorbidity and metabolic disease indicating that increasing BMI may contribute as intermediate factor to the relationship with education. Smoking habits had a moderate effect on the association between education and mortality in men, while increasing BMI had little effect on this relationship. In women, smoking status and increasing BMI had little impact on the relationship between education and mortality. Further adjustment for potential confounders such as alcohol consumption, fruit and vegetable intake, and physical activity did not substantially influence the associations between education and multimorbidity in both men and women.
Table 5 shows the results of analyses stratified by age group. In participants aged ≤ 60 years at recruitment, lower educational level was associated with higher prevalence of multimorbidity as well as for multiple metabolic diseases in men and in women. However, only in men the statistical interactions between age and education were significant for multimorbidity (p = 0.008) and metabolic diseases (p = 0.008) but not in women (p = 0.808 and p = 0.647).
Table 5. Multivariate adjusted odds ratios (OR, 95% CI) of multimorbidity and metabolic diseases by educational level and sex according to age groups among participants aged 50 to 75 years in the EPIC-Heidelberg cohort
Overall, multimorbidity was more prevalent among men and women aged 50–75 years with low educational level than in subjects with higher educational level. Higher BMI, but not smoking status, was identified as an intermediate factor in the relationships between education and multimorbidity and metabolic disease. However, the adjustment for these risk factors did not completely explain the effect of education on health outcomes.
Chronic diseases
Consistent with our findings, other authors identified hypertension, dyslipidemia, chronic ischemic heart disease, back pain and diabetes as most prevalent diagnoses among 60 to 70 year old persons in Germany [23]. The higher prevalence of gastrointestinal diseases may be attributed to younger age of the participants in our study. The prevalence of central-nervous system diseases, however, is likely to be underestimated because of the increasing study participants' disability to complete questionnaires.
Our observations are consistent with the well-known paradox that mortality in women is lower than in men of the same age despite higher levels of morbidity among women [24]. In our data, the sex difference of mortality was weaker compared to a previous review [25]. This may be explained by increasing smoking prevalence among women during the past decades [26].
Differences in socio-economic position are associated with inequalities in health that may be mediated by differences in health-related behaviour [27]. In line with former research [15,27-30], we observed that participants with a higher educational level were leaner, ate more fruits and vegetables, and were less likely to be smokers at recruitment. Consistent with our results, it was also noted that moderate drinking was not associated with a SEP gradient, while heavy drinking was more prevalent at lower levels [31,32]. We observed that the smoking prevalence and, in consequence, number of smoking related diseases were higher in low education groups than in their counterparts. This observation is in consistency with other reports [28,31]. In our study, however, middle and highly educated men were less physically active than less educated men (please see table 2). The combination of physical inactivity and other adverse lifestyle factors could explain the high prevalence of metabolic disease in men at intermediate educational level.
Our observation that low SEP was recognized as a determinant for higher risk of chronic diseases are in line with the literature [5,6,31]. We observed that the association of education differed by disease and adjustment attenuated the relationships differentially [6,33]. Our results suggest that higher BMI, but not smoking status, may act as an intermediate factor of education on multimorbidity. However, smoking status attenuated the estimates for mortality. Potential explanation could be that in the age group 50 to 75 years smoking habits are rather associated with mortality than with multimorbidity.
Research on mortality has shown that the associations with education were partially eliminated after adjustment for covariates [34]. Other authors found that both social class in childhood and adulthood contribute to disease risk applying objective measures in mid-life [35].
Consistent with other studies, we observed that low educational level was statistically significantly associated with a higher prevalence of multimorbidity compared to high educational level [2,6]. Stronger associations between education and multimorbidity were found among the participants aged 50 to 60 years than among elders, which can be explained by premature mortality in low SEP groups [36]. Growing evidence exists that SEP differences are also reflected in biological markers of disease [5,6]. In a cohort study on cardiovascular risk factors among men in France and Northern Ireland, education was inversely associated with blood pressure and BMI but not with total cholesterol concentration [31]. Our data further suggest that the educational attainment is not only associated with multimorbidity, but that the social gradient is related to the number of diseases. Our observation that education has an impact on multimorbidity is supported by numerous studies on the relationship between low education and high mortality [9,13,23]. Further evidence comes from a study on morbidity during the last years of life among US citizens, which revealed lower morbidity and disability in those with higher education [37].
Further unmeasured factors may contribute to the relationship between education and multimorbidity such as psychosocial factors, stress and other environmental factors [7,38-40]. It has been hypothesized that low control in terms of autonomy and low social participation are likely contributors to health inequalities [41]. Psychosocial variables such as employment, active coping style, high occupational class and an external locus of control were associated with low prevalence of multimorbidity [42].
Sex differences in health were hypothesized to be related to differential exposure and differential vulnerability [43]. In the present study, pancreatitis and hyperuricemia were more frequent in men and stroke was more frequent in women. Higher prevalence of diabetes in women than in men was found by other authors [6,44]. Our results suggest differential associations between education and multimorbidity by sex, which may be explained by differences in lifestyle [26], however, these differences could also be due to chance variation by stratification. Also behavioural aspects are likely to be linked with the outcome [40,43].
Some potential limitations of this study should be considered. We analyzed school attainment as indicator of SEP, but no other indicator such as profession or income. However, measures for adulthood SEP such as occupation or income and measures of economic distress have been shown to be in good correlation with each other [45]. Participants of EPIC-Heidelberg were recruited from the general population [19], but the response rate in less educated subjects tends to be lower than in well-educated ones, implying that the real differences may actually be underestimated.
Our study was largely based on the participants' self-reports, which could have introduced some bias. However, all self-reports on cancer were verified by comparison with medical records, and validation studies were conducted for diabetes, myocardial infarction, and stroke. Misreporting could be linked to the respondents' educational levels, resulting in underestimation of educational inequalities in a previous study [46]. Also, non-response is higher in groups of low SEP and of ill-health [47], which may also result in attenuated estimates. Information on habitual diet and lifestyle factors may be affected by morbidity itself since reverse causation can not be excluded. However, dietary habits and other lifestyle factors were found to be relatively stable over time in our cohort [48]. For some chronic diseases it is difficult to determine whether or not they can be considered independently from each other, such as diabetes mellitus, hypertension, and myocardial infarction [49]. From the public health point-of-view, however, this is irrelevant because persons with several diseases are likely to take more medications and to have more medical consultations.
The strengths of this study are the use of prospective data, its population-based approach, and the possibility to adjust for relevant confounding variables.
In this large prospective study, low educational attainment was associated with higher prevalence of multimorbidity. Our results suggest that higher BMI is an intermediate factor for multimorbidity among subjects aged 50 to 75 years. Adjustment for other potential risk factors did not completely explain the relationships. Aspects of SEP, sex and BMI need consideration in public health actions to prevent multimorbidity.
Competing interests
The authors declare that they have no competing interests.
Authors' contributions
GN and RP initiated and designed the project and GN conducted the statistical analyses. JL is principal investigator of the EPIC-Heidelberg cohort study and contributed to the study design. SR and SH were involved in data collection and contributed to the variable selection. SB and SR provided advice on design and statistics. All authors provided specialist knowledge in the advancement of the analyses and provided input in re-drafting the manuscript. GN drafted the first manuscript and wrote the final version, which was seen and approved by all authors.
We thank all EPIC-Heidelberg participants as well as Dorothee Zoller and Jutta Schmitt for their excellent support in data management.
Funding: The EPIC-Heidelberg study was funded by "Europe Against Cancer" Programme of the European Commission (SANCO); German Cancer Aid; German Cancer Research Center; German Federal Ministry of Education and Research, and Kurt-Eberhard-Bode-Stiftung.
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Pre-publication history
The pre-publication history for this paper can be accessed here:


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Product Information:
Weights & Dimensions
|Product Type: Vertical filing cabinet
|Style: Contemporary
|Solid Wood Construction: No
|Primary Material: Manufactured wood
|Number of Items Included: 1
|Fire Resistant: No
Wheels Included: Yes
Drawers Included: Yes
|File Bars Included: Yes
|Locking: Yes
|Stacking: No
|Commercial Use: Yes
|Country of Manufacture: China
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About the ManufacturerJesper Office specializes in making modular office furniture for the home and small business, along with a complementary line of modular library and home entertainment furniture. The company, originally based in Denmark, has been designing and manufacturing high quality furniture since 1935. Today, Jesper Office is based in Bridgewater, New Jersey where it maintains a U.S warehouse and sales office along with several manufacturing facilities overseas.
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Great looking cabinet JLH from Coldstream, BC on 02/01/2015 – Verified Buyer
This filing cabinet looks good, once assembled , it seems sturdy enough but was difficult to get out of its box.I made the mistake of pulling and the top came off, my mistake but I'm not very strong. It occurred to me that although it's lockable, someone could have access by pulling the top off !! Just watch the screws supplied for the castors, my husband described them as rubbish, as several of them sheared off even though he was careful. He eventually used his own, better quality ones. Now they are complete, I do like them and despite my issues would recommend.
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Owner Marc from Cupertino, CA on 10/28/2014 – Verified Buyer
Great office furniture for one of our cubicles. Very organizable and easy to open and close.
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Jesper Mobile cart 500 series ian from Getzville, NY on 10/15/2014 – Verified Buyer
This was an excellent product and delivery was quick. Jesper makes good quality products
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Perfect fit Bradley from Chicago, IL on 04/13/2014 – Verified Buyer
Just as described. It has a nice sleek and modern look to it with the handles. It's very durable and looks exactly like its picture. Great item for the money.
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Good filing cabinet Yvonne from Seattle, WA. on 08/21/2012
I ordered 2 of these for our office and they work great. They arrived fully assembled which I liked. The quality seems good and they are durable and well made. All in all a good cabinet that I am very pleased with.
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