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Get smarter, faster on what matters in Pittsburgh with Alexis Johnson, Ryan Deto, and Chrissy Suttles.

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Early red leaves are already dotting Pittsburgh's trees, but peak fall color is still about a month away.

The big picture: Leaf-peeping season starts in the North and at high elevations in the U.S. before making its way South, per travel brand SmokyMountains.com.

Zoom in: Peak foliage in Southwestern Pennsylvania arrives in mid-October, with the most vibrant colors expected between Oct. 6 and Oct. 20.

Yes, but: AccuWeather forecasts a mixed fall foliage season. While parts of the East may see brilliant colors, large stretches of the Smoky Mountain and Appalachian regions, including Pittsburgh, are expected to look duller than usual.

Experts say heavy spring and early summer rains may have fueled insect outbreaks and fungal damage, leading to muted colors and early leaf drop.

The historic dry spell that followed placed additional stress on trees, causing some to turn earlier than usual this year.

Threat level: Scientists say climate extremes are expected to play a growing role in the timing, duration, and vibrancy of fall foliage in the coming decades.

The bottom line: There will still be plenty of reds, yellows, and oranges to see in Pennsylvania. Here are some must-see spots to catch fall's fiery colors.

Fall colors may be less vibrant in Pittsburgh this year

A map of peak foliage seasons in the U.S.

Data: smokymountains.com; Map: Axios Visuals

Early red leaves are already dotting Pittsburgh&#x27;s trees, but peak fall color is still about a month away.The big picture: Leaf-peeping season starts in the North and at high elevations in the U.S. before making its way South, per travel brand <a class="gtmContentClick" data-vars-link-text="SmokyMountains.com" data-vars-click-url="https://smokymountains.com/fall-foliage-map/" data-vars-content-id="4c7989d0-aff1-40c6-a140-855c469016d2" data-vars-headline="Fall colors may be less vibrant in Pittsburgh this year" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://smokymountains.com/fall-foliage-map/" target="_blank">SmokyMountains.com</a>.

News

Climate

Things to Do

The average Pennsylvanian goes to bed at 11:41pm, slightly later than the average American, Apple Watch data shows.

Why it matters: Most people aren't getting the recommended seven to nine hours of sleep per night, which impacts mood and health.

Zoom in: The average duration of sleep for Pennsylvanians was about six hours, 38 minutes — based on watch data from adults who shared info with the Apple Heart and Movement Study.

Keystone State residents slept the 14th fewest hours among 50 states, Puerto Rico, and Washington, D.C.

The national average is six hours and 40 minutes.

What they found: Participants with the most consistent bedtimes throughout the week slept for 40 more minutes and spent 36% less time awake during sleep periods, compared to other Apple Watch wearers.

They also averaged 57% more time exercising.

Zoom out: Hawaiians were the earliest to bed (11:06pm) but also slept the least (six hours, 31 minutes).

D.C. residents had the latest bedtime (11:56pm) followed by New Yorkers (11:53pm).

What they're saying: The most important thing for sleep hygiene is going to bed at the same time daily, sleep medicine physician Shalini Paruthi tells Axios.

If you must catch up on Zs over the weekend, she recommends getting extra shuteye Saturday morning but waking up closer to your weekday time on Sunday, so you're tired enough to stick with your bedtime that evening.

Another tip: "Bright light first thing in the morning is incredibly important."

Pennsylvanians turn in later, sleep less than most

Apple Watch data finds Keystone State residents average 6 hours, 38 minutes of sleep

Green retro alarm clock tucked under a purple and yellow checkered blanket between two pink pillows on a purple bed, showing the time as 10:10.

The average Pennsylvanian goes to bed at 11:41pm, slightly later than the average American, Apple Watch <a class="gtmContentClick" data-vars-link-text="data" data-vars-click-url="https://www.axios.com/local/san-francisco/2025/05/23/sleepmaxxing-sleep-tracker-oura-fitbit" data-vars-content-id="a0b779f3-d4f2-49d3-a756-42c48b3fd0c3" data-vars-headline="Pennsylvanians turn in later, sleep less than most" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.axios.com/local/san-francisco/2025/05/23/sleepmaxxing-sleep-tracker-oura-fitbit" target="_self">data</a> shows.Why it matters: Most people aren&#x27;t getting the recommended <a class="gtmContentClick" data-vars-link-text="seven to nine hours" data-vars-click-url="https://www.nhlbi.nih.gov/health/sleep/how-much-sleep" data-vars-content-id="a0b779f3-d4f2-49d3-a756-42c48b3fd0c3" data-vars-headline="Pennsylvanians turn in later, sleep less than most" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.nhlbi.nih.gov/health/sleep/how-much-sleep" target="_blank">seven to nine hours</a> of sleep per night, which impacts mood and health.

Health

Data: CDC; Note: Includes intended and unintended home births; Chart: Jacque Schrag/Axios

Home births keep rising in Pennsylvania and the nation years after the pandemic surge.

Why it matters: The shift reflects a growing distrust of the traditional medical system, a push for more personalized maternity care, and shrinking rural access to hospitals.

By the numbers: Home births in Pennsylvania rose from 1.9% of live births in 2019 to about 3.3% in 2023, per the Centers for Disease Control and Prevention.

In the U.S., home births rose from about 1% in 2019 to over 1.5% in 2023.

State of play: The U.S. maternal death rate is the highest of any high-income nation.

Black mothers have more than 3 times the mortality rate of non-Hispanic white women.

Those figures — coupled with the medical system's history of racial discrimination and overlooking women — drive some pregnant patients away from hospitals.

What we're hearing: "In general, patients have distrust of the established medical system — especially Black patients," says Veronica Gillispie-Bell, a Black OB-GYN and representative of the American College of Obstetricians and Gynecologists. "In the 17 years I've been in practice, there's definitely been a shift."

Home births are "a different power dynamic," says Michelle Palmer, fellow of the American College of Nurse-Midwives. "You're being invited to their home as a provider," and the patient calls the shots — from the menu to the birthing room.

Between the lines: Rural hospital closures may be pushing more women toward home births, too. About 12.4% of Pennsylvania women live more than 30 minutes from a hospital or birthing center — higher than the national rate of 9.7%, per a March of Dimes report.

Home births are also common among Amish families, and Pennsylvania has the nation's largest Amish population.

Reality check: Safety data on U.S. home births is limited.

Some studies suggest that giving birth at home is associated with an increased risk of perinatal and neonatal death, but data collection problems may exist.

If you only consider low-risk patients who are attended by qualified providers and have clear hospital transfer plans in case of emergency, births at home have comparable outcomes to those in birth centers, research suggests.

What we're watching: As Medicaid cuts and the government shutdown lead to the overburdening and closures of more hospitals in rural and underserved areas, pregnant patients may face more obstacles to getting personalized care, regardless of where they plan to deliver.

Home births see sharp rise in Pennsylvania

The shift reflects a growing distrust of the traditional medical system, a push for more personalized care, and shrinking access to hospitals.

Illustration of an empty white baby cradle against peach background.

Home births keep rising in Pennsylvania and the nation years after the <a class="gtmContentClick" data-vars-link-text="pandemic surge" data-vars-click-url="https://www.axios.com/2022/11/18/cdc-home-births-surged-during-pandemic" data-vars-content-id="bb4c798c-a30e-4659-9b2b-cbd443555cfe" data-vars-headline="Home births see sharp rise in Pennsylvania" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.axios.com/2022/11/18/cdc-home-births-surged-during-pandemic" target="_self">pandemic surge</a>.Why it matters: The shift reflects a growing distrust of the traditional medical system, a push for more personalized maternity care, and shrinking rural access to hospitals.

Strangers in Pittsburgh are coming together over cake and tea to chat about death.

Why it matters: As anxiety about longevity and end-of-life care grows, death cafes are normalizing conversations about death and creating spaces for shared learning, organizers say.

How it works: A death cafe is not a grief group or a counseling session.

It's typically a free, small gathering in a "safe, welcoming" space where people speak candidly about death in whatever way feels meaningful to them, says Helen Stickney, a death doula and member of Pittsburgh Community Deathcare who currently facilitates death cafes at Millvale Community Library.

Conversations span mortality, burial, fears, cultural traditions, and the importance of advance directives, says Stickney.

Catch up quick: Launched in 2011 in East London, death cafes were built around tea and cake by design — simple comforts to make space for hard conversations.

The idea spread fast. Today, groups meet around the world, with more than 11,000 listed in the U.S. alone.

The big picture: Those pushing to make death talk less taboo say silence makes it easy to skip emotional, financial, and practical preparation.

Case in point: Research shows only about a third of U.S. adults have completed advance directives, or legal documents such as living wills or powers of attorney.

Zoom in: Stickney has been coordinating death cafes since before the pandemic. Once fairly popular, the format waned during COVID shutdowns and is now beginning to draw interest again across the region, she says.

While the concept may feel heavy for some, Stickney says the friendly tone often surprises newcomers.

What they're saying: "Part of it is just the act of speaking it," says Stickney. "The act of being in a room where people are actually interested in hearing about your grandfather's funeral. What I see is people showing up a little bit uncertain, and often grieving, and by the end …" they're more open to the discussions.

What's next: Follow Millvale Community Library for the announcements on the next death cafe — which fill up fast, organizers say, and often have a waitlist due to high demand.

Another is planned at Waverly Presbyterian Church in Regent Square on Feb. 23.

For updates on death cafes in Western Pennsylvania, join the Pittsburgh Death Cafes Facebook group.

Pittsburgh death cafes are drawing crowds

Strangers are coming together over cake and tea to chat about death.

Illustration of a raven holding a tea bag in its beak.

Strangers in Pittsburgh are coming together over cake and tea to chat about death.Why it matters: As anxiety about <a class="gtmContentClick" data-vars-link-text="longevity" data-vars-click-url="https://www.axios.com/pro/health-tech-deals/2025/12/29/longevity-companies-surging-2026" data-vars-content-id="bda90537-6afb-4eff-bb51-ded64a6c105f" data-vars-headline="Pittsburgh death cafes are drawing crowds" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.axios.com/pro/health-tech-deals/2025/12/29/longevity-companies-surging-2026" target="_self">longevity</a> and end-of-life care grows, death cafes are normalizing conversations about death and creating spaces for shared learning, organizers say.

Culture

Data: Commonwealth Fund 2026 State Health Disparities Report; Chart: Chrissy Suttles/Axios

Black and Hispanic Pennsylvanians still face the largest gaps in health care access and quality, per a new Commonwealth Fund report.

The big picture: No state has eliminated health disparities across racial and ethnic groups, and researchers warn that recent federal policy shifts will likely widen them.

Nationally, rates of people skipping needed care because of cost are rising after hitting record lows in 2021 and 2022, per the report.

Zoom in: In Pennsylvania, Asian American, Native Hawaiian and Pacific Islander (AANHPI) and white residents had the best overall health care outcomes, access and quality — ranking in the 86th and 80th percentiles, respectively. These outcomes are often linked to higher income levels.

Hispanic and Black residents experienced the worst overall health outcomes, access and quality, scoring in the 28th and 43rd percentiles, respectively.

By the numbers: Hispanic adults (18%) are significantly more likely to be uninsured than other groups, all between 6 and 9%. They're also most likely to go without care due to cost (24%).

Black Pennsylvanians die of avoidable causes much more frequently (314 per 100,000) than their white (178), Hispanic (159) and AANHPI (76) counterparts.

Black residents had the highest rates of obesity, smoking, and breast and colorectal cancer death rates. The infant mortality rate for Black Pennsylvanians is 9.8 per 1,000 live births, more than double the rate of white Pennsylvanians (4.5).

Between the lines: Hispanic residents had lower mortality rates from preventable causes than white Pennsylvanians despite less access to care and higher rates of smoking and obesity.

Axios Arkansas reports that researchers call this the "Hispanic paradox." However, that trend could be fading, per the American Heart Association.

Zoom out: The report found that Pennsylvania's health systems still outperformed other states on average across all racial and ethnic groups.

How it works: The Commonwealth Fund analyzed 24 performance indicators across three domains — health outcomes, health care access and quality and use of services — using federal data from 2022 to 2024.

Researchers calculated standardized scores for five racial and ethnic groups and ranked each group's experience on a 1-to-100 percentile scale relative to all groups nationally.

The data predates 2025–2026 federal policy shifts in Medicaid and ACA coverage.

The bottom line: The report finds that Medicaid eligibility, lower medical debt and strong family support improve health outcomes. Researchers urge Congress to expand insurance access, strengthen primary care and protect access to preventive services.

Researchers hope the findings encourage local leaders to bolster support for affordable housing and food security programs, too.

Health care gaps persist for Black and Hispanic Pennsylvanians

A new report finds disparities in access, cost and outcomes across racial groups in Pennsylvania.

an illustration of a stethoscope surrounded by shapes and cutouts of money

Black and Hispanic Pennsylvanians still face the largest gaps in health care access and quality, per a new <a class="gtmContentClick" data-vars-link-text="Commonwealth Fund report" data-vars-click-url="https://www.commonwealthfund.org/publications/fund-reports/2026/apr/commonwealth-fund-2026-state-health-disparities-report" data-vars-content-id="cfd44f41-9b94-42b0-b134-d0873e83a5dc" data-vars-headline="Health care gaps persist for Black and Hispanic Pennsylvanians" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.commonwealthfund.org/publications/fund-reports/2026/apr/commonwealth-fund-2026-state-health-disparities-report" target="_blank">Commonwealth Fund report</a>.The big picture: No state has eliminated <a class="gtmContentClick" data-vars-link-text="health disparities" data-vars-click-url="https://pmc.ncbi.nlm.nih.gov/articles/PMC11806735/" data-vars-content-id="cfd44f41-9b94-42b0-b134-d0873e83a5dc" data-vars-headline="Health care gaps persist for Black and Hispanic Pennsylvanians" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://pmc.ncbi.nlm.nih.gov/articles/PMC11806735/" target="_blank">health disparities</a> across racial and ethnic groups, and researchers warn that recent federal policy shifts will likely widen them.

Maternal mental health scores: Which states get a "D"

National

Maternal mental health grades, by state, 2026

Data: Policy Center for Maternal Mental Health; Map: Sami Sparber/Axios

What's new on streaming: "Star City" to "Spider-Noir"

Axios Indianapolis

Tick bites surging in Indiana, Midwest as summer starts

Indianapolis

Axios Des Moines

Iowa reports more tick bites, illnesses

Des Moines

Axios Salt Lake City

Tick bite ER visits soar in western states

Salt Lake City

A column chart that shows Western U.S. emergency department visits for tick bites each April, measured per 100,000 ED visits. Rates were 17 in 2022, 16 in 2023, 20 in 2024, 22 in 2025 and 31 in 2026.

Western U.S. tick bite ER visits in April

Data: CDC National Syndromic Surveillance Program; Note: 2026 data is preliminary; Chart: Carly Mallenbaum/Axios

Carly Mallenbaum

Featured stories

Maternal mental health scores: Which states get a "D"

What's new on streaming: "Star City" to "Spider-Noir"

Tick bites surging in Indiana, Midwest as summer starts

Iowa reports more tick bites, illnesses

Tick bite ER visits soar in western states