A large body of research has explored opportunities to mitigate climate change in agricultural systems; however, less research has explored opportunities across the food system. Here we expand the existing research with a review of potential mitigation opportunities across the entire food system, including in pre-production, production, processing, transport, consumption and loss and waste. We detail and synthesize recent research on the topic, and explore the applicability of different climate mitigation strategies in varying country contexts with different economic and agricultural systems. Further, we highlight some potential adaptation co-benefits of food system mitigation strategies and explore the potential implications of such strategies on food systems as a whole. We suggest that a food systems research approach is greatly needed to capture such potential synergies, and highlight key areas of additional research including a greater focus on low- and middle-income countries in particular. We conclude by discussing the policy and finance opportunities needed to advance mitigation strategies in food systems.

IMPORTANCE One-third of US residents have trouble paying their medical bills. They often turn to their physicians for help navigating health costs and insurance coverage.OBJECTIVE To determine whether physicians can accurately estimate out-of-pocket expenses when they are given all of the necessary information about a drug's price and a patient's insurance plan. DESIGN, SETTING, AND PARTICIPANTSThis national mail-in survey used a random sample of US physicians. The survey was sent to 900 outpatient physicians (300 each of primary care, gastroenterology, and rheumatology). Physicians were excluded if they were in training, worked primarily for the Veterans Administration or Indian Health Service, were retired, or reported 0% outpatient clinical effort. Analyses were performed from July to December 2020. MAIN OUTCOMES AND MEASURESIn a hypothetical vignette, a patient was prescribed a new drug costing $1000/month without insurance. A summary of her private insurance information was provided, including the plan's deductible, coinsurance rates, copays, and out-of-pocket maximum.Physicians were asked to estimate the drug's out-of-pocket cost at 4 time points between January and December, using the plan's 4 types of cost-sharing: (1) deductibles, (2) coinsurance, (3) copays, and (4) out-of-pocket maximums. Multivariate linear regression was used to assess differences in performance by specialty, adjusting for attitudes toward cost conversations, demographics, and clinical characteristics. RESULTSThe response rate was 45% (405 of 900) and 371 respondents met inclusion criteria.Among the respondents included in this study, 59% (n = 220) identified as male, 23% (n = 84) as Asian, 3% (n = 12) as Black, 6% (n = 24) as Hispanic, and 58% (n = 216) as White; 30% (n = 112) were primary care physicians, 35% (n = 128) were gastroenterologists, and 35% (n = 131) were rheumatologists; and the mean (SD) age was 49 (10) years. Overall, 52% of physicians (n = 192) accurately estimated costs before the deductible was met, 62% (n = 228) accurately used coinsurance information, 61% (n = 224) accurately used copay information, and 57% (n = 210) accurately estimated costs once the out-of-pocket maximum was met. Only 21% (n = 78) of physicians answered all 4 questions correctly. Ability to estimate out-of-pocket costs was not associated with specialty, attitudes toward cost conversations, or clinic characteristics. CONCLUSIONS AND RELEVANCEThis survey study found that many US physicians have difficulty estimating out-of-pocket costs, even when they have access to their patients' insurance plans. The mechanics involved in calculating real-time out-of-pocket costs are complex. These findings suggest that increased price transparency and simpler insurance cost-sharing mechanisms are needed to enable informed cost conversations at the point of prescribing.

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American Indian tribes have inherent rights to national forestland and resources codified in treaties, the US Constitution, statutes, Presidential Executive Orders, and case law. These rights require a government-to-government relationship between each tribe and the US Forest Service (USFS), which recognizes federal trust responsibilities and tribal sovereignty. This is implemented through government-to-government consultation. Along with consultation, the USFS seeks to create opportunities to work in partnership with tribes to support natural resource management for mutual benefit. The purpose of this article is to explore partnership building and collaboration between the USFS and American Indian tribes in the context of the USFS tribal relations program. The article outlines successful practices and barriers for building partnerships between federally recognized tribes and the USFS. Qualitative research methods were used to analyze 26 semistructured interviews with USFS employees with tribal relations duties to understand their perspectives on building partnerships and fulfilling the government trust responsibility with American Indian tribes.