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Articles by Anna Gage
Column: UNC needs more non-partisan voter registration organizations
As any out-of-state or international student will tell you, when we return home, we act as delegates for the University of North Carolina at Chapel Hill and the state as a whole. Our primary function is to accurately and wholeheartedly summarize the state’s culture to the outside world. I’ve found that voter registration season is a strong microcosm for understanding both Carolinas: the state and the university.
Column: Diagnosing your peers isn’t real mental health support
The mental health crisis has lingered in the American cultural and political limelight as a salient issue for a long time. It has spanned discussions relating to strategies for deprescription, destigmatization and self-diagnosis. This attention is imperative — suicide remains the third leading cause of death among individuals aged 10 to 24 in the United States, and clearly the crisis needs some form of intervention. September has been deemed suicide prevention month.
Satire: Chase and Lenoir dining halls to be demolished, relocated in 2026
Opinion Students head in and out of Lenoir Dining Hall on Tuesday, Nov. 14, 2023. Apr 1, 2026, 10:00 AM Amid all the recent University controversy regarding the potential relocation of the Dean E. Smith Center and breaking news that ground will be broken on the Carolina North project in 2027, one media release has slipped under the student body's radar.
Column: Accessing mental health support shouldn’t require a walk across campus
Mental health crises remain pervasive across college campuses. According to one , 37 percent of undergraduate students report experiencing symptoms of depression, and 11 percent face suicidal ideation. These numbers should disturb us all. While well-intentioned universities have developed mental health support systems, they are poorly designed to meet students’ needs.
Column: Reforming UNC’s transfer credit system would harm low-income students
Opinion Feb 24, 2026, 12:58 AM As UNC's deadline to list a class as pass/fail approaches, many of us are taking a long, hard look at our transcripts. Some of us are crying during office hours in fruitless attempts to raise our grades. Others are boosting their GPA by transferring community college credits to UNC. For some, this is nothing more than a way to pass the summer by and to mitigate the damage that a calculus class at UNC could do to their transcript.
Column: Public AI resume scores would level the playing field
Opinion Feb 4, 2026, 10:35 PM If I were to write a horror movie, it would go something like this: you’re 21 years old, college graduation impending. You’ve applied to over 100 jobs, and receive rejections to each one within the hour you apply. Your first self-esteem crisis is imminent. Sound scary? Turns out, a couple of job seekers agree with you and have taken action to ease the nightmare.
Column: UNC's grading system deserves an F
Opinion Photo assets courtesy of Adobe Stock. Jan 26, 2026, 12:43 AM After the fall 2025 final exam in Chemistry 430: Introduction to Biological Chemistry, students discovered that their instructor readjusted grade cutoffs, significantly lowering many students' marks relative to a typical scale. This is a pre-med student’s worst nightmare — they had to score a 95.44 to obtain an A- in the class, and a 97.49 percent to score an A.
The words of Bart Ehrman and the word of God
News Bart Ehrman, photo courtesy of Dan Sears. Photo assets courtesy of Adobe Stock. Senior Writer Jan 9, 2026, 2:21 AM Cody Parks is a UPS driver from Wilkes County, in rural western North Carolina. Last month, he came to Chapel Hill to hear the last lecture by a man who studies small fragments of ancient Greek manuscripts.
Location of births by health facility type: a time trend analysis from 1995 to 2023 in 130 low- and middle-income countries
Keywords Maternal health Neonatal health Facility delivery Health systems Health care facilities Low- and middle-income countries Evidence before this study We conducted a title and abstract search of the literature in PubMed on May 14, 2025, using the search terms “in-facility delivery”, “facility delivery”, “place of delivery”, “institutional delivery”, and “public”, “private” or “hospital”.
Column: Public backlash to UNC’s rebrand isn’t an irrational resistance to change
Opinion Nov 24, 2025, 10:43 PM When we are upset about a significant change in our lives, our discomfort is often attributed to a preference for the status quo. When I cried in my dorm room after my parents dropped me off at college, I chalked it up to the shock of the transition and missing home. But it can be harmful to assume that a resistance to change is purely emotional. It can dismiss rational opposition to a change that might need some legitimate consideration.
Column: Think twice before getting swept up in UNC's double major culture
This column was published as part of the 'Versus' series. To read the opposing view, click here. At Carolina, more often than not, the question “What’s your major?” is answered with a deep inhale. This is because it takes a whole lot of air to get through “I’m double majoring in political science and English and comparative literature with a concentration in creative writing, while also pursuing a minor in media and journalism on the journalism track” in just one breath.
Column: Middle-class college students can't afford a degree
For millions of middle-class students, the American dream of higher education is slipping away. Not because of grades, ambition or effort, but because of a financial aid system that limits those who make just a little too much. Higher-income students often benefit from 529 plans or college investment accounts that cover most essential expenses, allowing them to focus on school without financial strain.
Column: Gen Z’s overspending won’t get us any closer to buying homes
Opinion Nov 7, 2025, 1:04 PM I come from an incredibly open family, but there’s one topic my parents never broach with me: how little they paid for their first home. While I find it frustrating that the economic circumstances they entered the market in were different from what mine will be, I am always amazed by their fiscal responsibility. My mom laughs every time I tell her I buy a coffee to study.
Column: The obesity epidemic doesn’t end when the numbers decline
For the first time, the number of obese children and adolescents globally is greater than the number of those who are underweight. Thankfully, progress in obesity research and treatment is keeping up with the disease's rising prevalence. A recent clinical trial found that GLP-1 medication administered in pill form resulted in an average 13 percent reduction in body weight over a 64-week period.
Column: There's no neutral platform left
It is day 28 of the government shutdown and federal websites are sporting banners blaming the “Radical Left Democrats.” This message, under an assurance that you have landed on an official website of the United States government, could be considered surrealist modern art. Rhetoric is an expected part of political commentary. Specific news channels or social groups often signal their political affiliations, which in turn affects how audiences interact with them.
Column: The Democrats can come back through competence
Opinion Oct 14, 2025, 1:41 PM Over the last two election cycles, the Democratic Party’s prospects have soured considerably, losing a federal government trifecta to Republicans and losing the popular vote for the first time in 20 years. In response, there have been competing views among Democrats as to how best to respond.
Column: Holistic admissions is holistic rejection
My first college decision was a rejection. It came from Yale, which had been my dream school for years. I didn’t cry, but I took a long walk in the park by my house, remembering my humanity as I shivered in the December chill. Obviously, I did eventually get into college. The acceptance letters rolling in urged me to feel proud of my accomplishments and the person I am, validated by my admission to their esteemed and selective institution.
Column: Sick of polarization? Stop checking North Carolina’s Voter Registration System.
Printing news. Raising hell. Since 1893. Monday, Sept. 22, 2025 Newsletters Latest print issue In a public policy class, I overheard some gossip: “I can’t believe he wants to lower taxes,” someone said after having learned another student was a Republican. I laughed to myself, thinking how unexciting that observation was. And yet, America’s ideological divide has become so wide that comments like these are not uncommon. We agree on little across partisan lines.
Global, regional, and national cascades of diabetes care, 2000-23: a systematic review and modelling analysis using findings from the Global Burden of Disease Study - The Lancet Diabetes & Endocrinology
aInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA bSchool of Medicine, University of Washington, Seattle, WA, USA cGeneral Medicine Service, Department of Veterans Affairs, Seattle WA, USA dPostgraduate Program in Epidemiology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil eDepartment of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA fDepartment of Public Health, School of Medicine, National...
Global, regional, and national cascades of diabetes care, 2000-23: a systematic review and modelling analysis using findings from the Global Burden of Disease Study - The Lancet Diabetes & Endocrinology
Get full text access Log in, subscribe or purchase for full access. References 1. Magliano, DJ ∙ Boyko, EJ, Diabetes Atlas IDF 10th edition scientific committee. IDF Diabetes Atlas International Diabetes Federation, Brussels, 2021 2. ElSayed, NA ∙ Aleppo, G ∙ Bannuru, RR ∙ et al. Diagnosis and Classification of Diabetes: Standards of Care in Diabetes Diabetes Care. 2024; 47:S20-S42 5. Ferrari, AJ ∙ Santomauro, DF ∙ Aali, A ∙ et al.
Column: Referencing the Bible in class? Contextualize it first.
Printing news. Raising hell. Since 1893. Sunday, Sept. 7, 2025 Newsletters Latest print issue I was born and raised in Toronto, Canada — where the bacon is maple-flavored, the health care is free and the communities are secular. While there are certainly Canadians who believe in God, religion doesn’t bring us together. In fact, a 2021 study from the Association for Canadian Studies reported that 67 percent of Canadians never attend church services.
Column: Criticism isn’t a character judgment - taking it well is a skill to learn
Printing news. Raising hell. Since 1893. Tuesday, April 22, 2025 Newsletters Latest print issue Some of my most vivid childhood memories — aside from years of laughter with my loving parents — involve crying at the dinner table doing math homework with my dad. I’ve heard enough similar stories from my friends to prove that this is a common childhood experience. After the challenging homework was finished, I’d get a hug from my parents and usually forget about the incident.
Column: Local communities must prepare as the Department of Education falls
Printing news. Raising hell. Since 1893. Sunday, April 6, 2025 Newsletters Latest print issue I’ve been fortunate to have a dad who has always done my taxes for me. Now that I live away from home, while he is still a phone call away for support, most of the responsibility to file taxes falls on me. It’s stressful. But I’m learning to adapt. A similar effect is set to be in place if the Department of Education is dismantled.
Column: Let's redefine what it means to be apolitical
Printing news. Raising hell. Since 1893. Thursday, March 27, 2025 Newsletters Latest print issue There are many words with multiple meanings. You can fall down, or take a walk on a fall afternoon. You can ship a package while you wait for your ship to dock. You can both tear up and tear your shirt after your March Madness bracket falls apart. I’d like to recategorize the word apolitical as one of these homonyms.
Column: Yes, Canadians are nice. But we're not nice enough to cede to America's attacks.
Printing news. Raising hell. Since 1893. Monday, March 24, 2025 Newsletters Latest print issue As a Canadian, I’ve been asked a few too many times if we’re really as nice as we seem. Well, the stereotypes are true. Canadians are, generally, a polite, reserved and yes, “nice” bunch. We take our shoes off when we go into a home. We apologize for anything and everything.
Column: UNC has a housing problem. Older adults can help fix it.
Printing news. Raising hell. Since 1893. Monday, March 3, 2025 Newsletters Latest print issue UNC placed 900 students on a waitlist for on-campus housing for fall 2024. In that same year, more than one in three older adults reported feeling a lack of companionship. What do these two situations have in common? They can be resolved simultaneously through intergenerational housing.
Disparities in telemedicine use and payment policies in the United States between 2019 and 2023 - Communications Medicine
Abstract The COVID-19 pandemic induced an increase in telemedicine use in the American health care system. We assess disparities in telemedicine usage, the diseases and conditions it is used for, and the association of payment parity policies with telemedicine use for January 2019–March 2023. We include health systems which reported electronic health record data to the Healthjump database.
Column: Dear Kenan-Flagler - stop pigeonholing business majors.
Printing news. Raising hell. Since 1893. Monday, Feb. 17, 2025 Newsletters Latest print issue It’s hard to pin down who the business majors really are, because they go by so many names. There are the assured-admits, who were accepted into UNC’s business school, Kenan-Flagler, before their years at UNC began.
Column: Love loading... Marriage Pact is not compatible with holistic dating
Printing news. Raising hell. Since 1893. Thursday, Feb. 6, 2025 Newsletters Latest print issue I've never had dating standards. As someone who went to an all-girls school, when boys eventually made their way into my life, I was so excited to date that I forgot to stop and set standards. The same cannot be said about my friends. From political affiliation to eye color, they are determined to find someone who fits the exact description of their dream person.
Column: New obesity guidelines give a needed change to our relationship with weight
Printing news. Raising hell. Since 1893. Sunday, Feb. 2, 2025 Newsletters Latest print issue It’s a story I’ve heard time and time again from friends. You walk into the doctor's office to see your body mass index being pointed to you on a screen. This ratio of height to weight categorizes you as overweight but not obese, but you have a healthy diet and go on a run a couple times a week. You wonder what you can do to change that label but also why you would have to in the first place.
Why It's Hard to Understand How COVID-19 Affected Global Health System Performance
by Anna Gage and Annie Haakenstad December 12, 2022 In early 2020, reports of tuberculosis cases fell by 60 percent in India. The massive decline of one of the world's most deadly infectious diseases might have been an unanticipated positive consequence of the pandemic. However, the decline occurred as stay-at-home orders were instituted, people steered clear of health facilities to avoid exposure to COVID-19, and health-care workers and supplies were stretched to their limit.
The role of teams in shaping quality of obstetrical care: a cross-sectional study in Dire Dawa, Ethiopia
Methods Conceptual framework We draw on the theory of small groups as complex systems to inform the conceptual framework for this analysis.11 In this analysis, we define a group of healthcare providers to be all providers who care for a specific woman and newborn over the course of the delivery. Their group identity is thus focused on the shared objective of providing high-quality care, and they draw on one another as well as the broader facility environment in achieving this objective.
Effect of the COVID-19 pandemic on health service utilization across regions of Ethiopia: An interrupted time series analysis of health information system data from 2019-2020 | PLOS Global Public Health
Loading metrics Open Access Peer-reviewed Research Article Abstract The spread of COVID-19 and associated deaths have remained low in Ethiopia. However, the pandemic could pose a public health crisis indirectly through disruptions in essential health services. The aim of this study was to examine disruptions in health service utilization during the first nine months of the COVID-19 pandemic across 10 regions in Ethiopia.
Hospital delivery and neonatal mortality in 37 countries in sub-Saharan Africa and South Asia: An ecological study
Loading metrics Open Access Peer-reviewed Research Article Anna D. Gage , Günther Fink, John E. Ataguba, Margaret E. Kruk Anna D. Gage, Günther Fink, John E. Ataguba, Margaret E. Kruk Published: December 1, 2021 https://doi.org/10.1371/journal.pmed.1003843 Figures Abstract Background Widespread increases in facility delivery have not substantially reduced neonatal mortality in sub-Saharan Africa and South Asia over the past 2 decades.
Variation in HIV care and treatment outcomes by facility in South Africa, 2011-2015: A cohort study
Loading metrics Open Access Peer-reviewed Research Article Jacob Bor , Anna Gage , Dorina Onoya, Mhairi Maskew, Yorghos Tripodis, Matthew P. Fox, Adrian Puren, Sergio Carmona, Koleka Mlisana, William MacLeod Jacob Bor, Anna Gage, Dorina Onoya, Mhairi Maskew, Yorghos Tripodis, Matthew P.
In Low- And Middle-Income Countries, Is Delivery In High-Quality Obstetric Facilities Geographically Feasible?
Despite substantial reductions in the past twenty years, maternal and neonatal mortality remains high in many low- and middle-income countries. In 2015 the globally agreed-upon Sustainable Development Goals set targets for countries to reduce maternal and neonatal mortality by 2030.
Expectations of healthcare quality: A cross-sectional study of internet users in 12 low- and middle-income countries
Loading metrics Open Access Peer-reviewed Research Article Sanam Roder-DeWan , Anna D. Gage, Lisa R. Hirschhorn, Nana A. Y. Twum-Danso, Jerker Liljestrand, Kwanele Asante-Shongwe, Viviana Rodríguez, Talhiya Yahya, Margaret E. Kruk Sanam Roder-DeWan, Anna D. Gage, Lisa R. Hirschhorn, Nana A. Y. Twum-Danso, Jerker Liljestrand, Kwanele Asante-Shongwe, Viviana Rodríguez, Talhiya Yahya, Margaret E.
Predicted effect of regionalised delivery care on neonatal mortality, utilisation, financial risk, and patient utility in Malawi: an agent-based modelling analysis
Summary Background Health-care regionalisation, in which selected services are concentrated in higher-level facilities, has successfully improved the quality of complex medical care. However, the effectiveness of this strategy in routine maternal care is unknown. Malawi has established a national goal of halving its neonatal mortality by 2030. In this study, we aimed to assess the effect of obstetric service regionalisation in pregnant women and their newborn babies in Malawi.
The know-do gap in sick child care in Ethiopia
Abstract Background While health care provider knowledge is a commonly used measure for process quality of care, evidence demonstrates that providers don’t always perform as much as they know. We describe this know-do gap for malaria care for sick children among providers in Ethiopia and examine what may predict this gap.
Assessment of quality of primary care with facility surveys: a descriptive analysis in ten low-income and middle-income countries
Facility surveys do not capture key elements of primary care quality. The available measures suggest major gaps in primary care quality. If not addressed, these gaps will limit the contribution of primary care to reaching the ambitious Sustainable Development Goals. Data were available for 7049 facilities and 63 869 care visits.
High-quality health systems in the Sustainable Development Goals era: time for a revolution
In this Commission, we assert that providing health services without guaranteeing a minimum level of quality is ineffective, wasteful, and unethical. Moving to a high-quality health system—one that improves health and generates confidence and economic benefits—is primarily a political, not technical, decision.
Mortality due to low-quality health systems in the universal health coverage era: a systematic analysis of amenable deaths in 137 countries
Summary Background Universal health coverage has been proposed as a strategy to improve health in low-income and middle-income countries (LMICs). However, this is contingent on the provision of good-quality health care.
Does quality influence utilization of primary health care? Evidence from Haiti
This analysis examines how health service quality may influence community members’ decisions to seek care at a given facility. Aggregate quality of primary health care provided in Haitian facilities in 2013 was low; on average, facilities met just over half of the basic standards for infrastructure and for service delivery quality.
Training And Supervision Did Not Meaningfully Improve Quality Of Care For Pregnant Women Or Sick Children In Sub-Saharan Africa
In-service training courses and supportive supervision of health workers are among the most common interventions to improve the quality of health care in low- and middle-income countries. Despite extensive investment from donors, evaluations of the long-term effect of these two interventions are scarce.
PEPFAR Investments In Governance And Health Systems Were One-Fifth Of Countries’ Budgeted Funds, 2004-14
Launched in 2003, the US President’s Emergency Plan for AIDS Relief (PEPFAR) is the largest disease-focused assistance program in the world. We analyzed PEPFAR budgets for governance and systems for the period 2004–14 to ascertain whether PEPFAR’s stated emphasis on strengthening health systems has been manifested financially.
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