travel study association

Harvard Alumni Travels

Discover, learn, and connect as you travel the world with Harvard study leaders and fellow alumni!  To learn more about our programs, contact us at  [email protected]  or call (617) 496-0806.

Mongolia: Land of the Blue Sky

Japan Family Adventure

Alaska family adventure.

Alpine Splendor

Cruising the Mediterranean: Athens to Rome

Western Mediterranean Civilizations

Exploring the South Caucasus (Azerbaijan, Georgia, Armenia)

Catalan Interlude

Legendary Turkey

Journey through Vietnam

Antarctica & South Georgia on L'Austral

Cuba's Cultural Heritage

Family tanzania safari.

Costa Rica Family Adventure

A Family Program in Cuba

Egypt & the Nile

Southeast Asia Odyssey

Bali to Phuket on Le Lapérouse

Colombo to Mumbai on Le Lapérouse

Southern Africa Odyssey

Moroccan Discovery

Epic Journey Across Time: Cyprus, Rhodes & Türkiye's Lycian Coast on Emerald Azzurra

Central asia's five 'stans.

Journey Through Britain

From the Scottish Highlands and Orkney Islands to Norwegian Fjords on Exploris One

Predators and Primates of East Africa: Rwanda and Tanzania

Greenland's Arctic Grandeur

Mysteries of Indonesia & Papua New Guinea on Le Soléal

Southern Italy & Sicily

Wonders of Croatia & Slovenia on Queen Eleganza

Legendary Türkiye

The best of south africa, botswana, namibia & zimbabwe.

Athens to Aqaba on Island Sky

Egypt & the Eternal Nile

Seychelles & Madagascar: Islands of the Indian Ocean on Island Sky

New Zealand by Sea: Queenstown to Auckland on Heritage Adventurer

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With Stanford Travel/Study, every trip is the trip of a lifetime. It's easy to see why our travelers keep coming back, year after year.

Embark on a Trip Unlike Any Other

Our diverse lineup of educational adventures lets you learn and explore endlessly—whether you are venturing somewhere new or looking to gain a deeper appreciation of a familiar destination.

Discover the Stanford Advantage

When you're looking to add top-notch educational opportunities, exclusive access to unique locales and the opportunity to connect with your fellow alums to your journey, look no further than Travel/Study.

Our Faculty Leaders

With Stanford scholars leading the way through every step of your journey, you're guaranteed an educational experience like no other. In addition to hearing their thought-provoking lectures, you'll have the opportunity to interact with these teachers who are masters at bringing our destinations to life.

Our Experience

In our nearly 50 years of creating educational journeys, we have covered nearly every corner of the globe — from the North Pole to Antarctica and from the mountains of Nepal to the Sahara. Our travelers have experienced it all: epic rail journeys, in-depth city sojourns, private air expeditions, mountain treks and so much more.

Our Connections

From people to places, Stanford knows (and has access to) them all. Stanford connections afford you the opportunity to enjoy rare behind-the-scenes visits to special sites, discussions with knowledgeable insiders and once-in-a-lifetime events all over the world.

Meet Some of Our Exceptional Faculty Leaders

Here's a unique perk you simply won't find anywhere else: a Stanford education to go. With renowned Stanford faculty and scholars leading the way, every Travel/Study trip is an intellectual adventure.

Christophe Crombez

Freeman Spogli Institute for International Studies

A specialist in European politics and the political economy of the European Union, Christophe has been at The Europe Center since 1999 and also serves on the faculty at the University of Leuven in Belgium .

Linda Paulson

Associate dean and director of the Master of Liberal Arts program at Stanford and an expert in comparative literature, Linda regularly retraces the footsteps of Charles Dickens, Jane Austen and the Brontë sisters in her trips to the U.K.

Allen Weiner

Stanford Law School

Allen serves as director of the Stanford Program in International and Comparative Law, director of the Stanford Humanitarian Program, and director of the Stanford Center on International Conflict and Negotiation.

Norman Naimark

The Robert and Florence McDonnell Professor of East European History, Professor Naimark's research has focused on the problems of radical politics in the Russian Empire and Eastern Europe.

Barbara Pitkin

Religious Studies

Barbara’s research and teaching focus on the place of religious beliefs, practices, and institutions in the intellectual traditions and cultural life of medieval and early modern Europe, roughly from 1000-1700.

Art and Art History

The Robert and Ruth Halperin Professor Emerita in Art History, Wanda specializes in the history of modern art, photography, and visual culture, with a special interest in the ways artists and art movements traveled globally in the early 20th century.

Collections Designed With You in Mind

Whatever your travel style, we have a trip that will meet your needs—and give you an unforgettable, enriching experience. Explore our curated collections to find your next big adventure.

Active Adventures

Get up close and personal with wildlife or just get moving. From walking and hiking to kayaking, snorkeling, diving and rafting, it’s easy to stay active wherever we go.

Learn about the geophysics of Everest, delve into the history of Southeast Asia, and explore the hidden gems of the largest and most populous continent.

In-Depth Learning

Want to do a deeper dive? Travel to amazing locales where you’ll enjoy lectures, seminars and in-depth talks with scholars, peers and local experts.

Nature & Wildlife

See stunning vistas and spectacular wildlife with experienced trip leaders, and immerse yourself in the rich biodiversity of our shared planet.

North America

From idyllic mountains and national parks to iconic cultural sites, discover the geographic wonders and rich history of North America.

Sea & River Cruises

Experience a cruise like none other and see a totally different side of the cities, towns and scenic seascapes along the way.

Family-Focused

On a Stanford Family Adventure, you and your loved ones will find yourselves immersed in new countries and cultures with hands-on activities, faculty lectures and unique learning opportunities for all ages.

Have a Question for Us?

Get in touch with someone at Travel/Study.

WE’LL TAKE YOU THERE

The American Society of Travel Advisors (ASTA), the world's leading association of travel professionals, is the global advocate for travel agencies, the travel industry and the traveling public. We champion ethical and traveler-friendly practices and policies at every level of government and throughout the travel and hospitality industry. Our members are all bound by a shared code of ethics.

TRAINING AND EDUCATION

ASTA's specialized courses range from legal issues and marketing to artificial intelligence. There’s also a wide array of travel advisor fam trips, training and certifications with significant ASTA member discounts on all programs.   

USING A TRAVEL ADVISOR

Planning a trip today can be complicated and time confusing. Travel advisors are here to help. If you’re ready to pack your bags and you know where you want to go, submit our form to connect directly with a travel advisor.

A TRAVEL ADVISOR

Are you looking for a career with high growth potential? The pandemic has made consumers increasingly appreciative and aware of the benefits of working with a travel advisor so their services are more in demand than ever.

Featured News

From travel tips and trends to hands-on advice from ASTA members and media coverage of the industry, here are some of our favorite stories.

NCL Connect: An Easy New Way to Build Your Business

John Chernesky shares the how and why of NCL’s powerful new marketing tool—and offers some special tips!

Travel Advisor Tech Startup Tern Wins Entrepreneur of the Year Competition and $10,000 Prize

Three finalists competed at the Travel Advisor Conference May 29-31 in Dallas, TX, where audience members voted for the award winner.

Travel Advisor Conference Concludes with the Society’s Most Prestigious Awards and Record-Breaking Funds Raised for Advocacy Efforts

Suppliers and members contributed $500,000 at the annual Advocacy Dinner, where Matthew Upchurch and Vanessa McGovern took home the top honors.

ASTA Appreciates American Airlines Recognizing the Value of the Travel Agency Distribution Channel, Supports Robert Isom’s Rollback of NDC and AAdvantage

Zane Kerby, President and CEO of the American Society of Travel Advisors (ASTA), issues the following statement in response to the recent news that American Airlines will adjust course on AAdvantage and NDC implementation

ASTA Welcomes the Newly Elected Members of the Board of Directors and Executive Committee

Top Marks: American Society of Travel Advisors Congratulates Award Winners at the Travel Advisor Conference

The best and brightest in the travel industry were recognized for their outstanding excellence and significant contributions to the industry.

Travel Advisor Community Aggrieved Over Senate Passage of the FAA Reauthorization Without a Ticket Refund Remedy

The amended FAA Reauthorization bill approved by the Senate leaves travel agencies on the hook for providing airline refunds in cases where they are the merchants of record.

A Travel Advisor Day Gift from IATA!

IATA is giving ASTA members 50% off its industry-trusted IATA/IATAN ID Cards' annual fee

Five Things for Travel Advisors to Love About Puerto Rico

Upcoming events.

ASTA events bring together the best minds in the industry. It is where Travel Agency Professionals, convene for inspiration, education, and entertainment. Browse through the series of upcoming events below and register now to start expanding your knowledge.

This invitation-only event with supplier executives and agency owners will be held in Maui.

Experience all things Caribbean with ASTA in Curaçao

Join us on Capitol Hill for the most important advocacy event of the year

Experience this exclusive event for ASTA Premium Members on the Virgin Voyages Valiant Lady.

Join us in Vienna to experience more than a dozen river cruise ships. WAIT LIST ONLY

The only industry event focused on the skills and insights you need to grow your travel business.

Proud Partners

We are grateful to our most supportive partners, ASTA Proud Partners. Recognizing how important travel advisors are to their success, these companies invest their time and resources to support ASTA’s mission and ensure a healthy and robust travel agency distribution channel.

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Featured Topics

Featured series.

A series of random questions answered by Harvard experts.

Explore the Gazette

Read the latest.

Testing fitness of aging brain

DNR orders for Down syndrome patients far exceeded pandemic norm

Researchers reverse hair loss caused by alopecia

Stroke risk higher for chronically lonely

Study of adults over 50 examines how feelings boost threat over time

Maya Brownstein

Harvard Chan School Communications

Chronic loneliness may significantly raise older adults’ risk of stroke, according to a new study led by the Harvard T.H. Chan School of Public Health. 

“Loneliness is increasingly considered a major public health issue . Our findings further highlight why that is,” said lead author Yenee Soh , a research associate in the Department of Social and Behavioral Sciences. “Especially when experienced chronically, our study suggests loneliness may play an important role in stroke incidence, which is already one of the leading causes of long-term disability and mortality worldwide.”

The study was published Monday in eClinicalMedicine.

While previous research has linked loneliness to higher risk of developing cardiovascular diseases, few have examined the impact on stroke risk specifically. This study is one of the first to examine the association between loneliness changes and stroke risk over time.

56% Greater stroke risk for study participants who experienced chronic loneliness than for those who consistently reported not being lonely

Using 2006-2018 data from the Health and Retirement Study, the researchers assessed the association between changes in loneliness and stroke incidence over time. During 2006-2008, 12,161 participants — all adults ages 50 and older who had never had a stroke — responded to questions on the Revised UCLA Loneliness Scale, from which the researchers created summary loneliness scores. Four years later (2010-2012), 8,936 participants who remained in the study responded to the same questions again. The researchers then placed the participants into one of four groups according to their scores across the two time points: consistently low (those who scored low on the loneliness scale at both baseline and follow-up); remitting (those who scored high at baseline and low at follow-up); recent onset (those who scored low at baseline and high at follow-up); and consistently high (those who scored high at both baseline and follow-up).

Among the participants whose loneliness was measured at baseline only, 1,237 strokes occurred during the follow-up period (2006-2018). Among the participants who provided two assessments of loneliness over time, 601 strokes occurred during the follow-up period (2010-2018). The researchers analyzed each group’s risk of stroke over the follow-up period in the context of their experiences with loneliness, controlling for other health and behavioral risk factors. These included social isolation and depressive symptoms, which are closely related to but distinct from loneliness.

The findings showed a link between loneliness and higher risk of stroke and found that chronic loneliness heightened risk the most. When loneliness was assessed at baseline only, the participants considered lonely had a 25 percent higher risk of stroke than those not considered lonely. Among the participants who reported loneliness at two time points, those in the consistently high group had a 56 percent higher risk of stroke than those in the consistently low group, even after accounting for a broad range of other known risk factors. While the baseline analyses suggest loneliness at one time point was associated with higher risk, those who experienced remitting or recent-onset loneliness did not show a clear pattern of increased risk of stroke — suggesting that loneliness’ impact on stroke risk occurs over the longer term.

“Repeat assessments of loneliness may help identify those who are chronically lonely and are therefore at a higher risk for stroke. If we fail to address their feelings of loneliness, on a micro and macro scale, there could be profound health consequences,” said Soh. “Importantly, these interventions must specifically target loneliness, which is a subjective perception and should not be conflated with social isolation.”

The authors noted that further research examining both nuanced changes in loneliness over the short-term and patterns over a longer period of time may help shed additional light on the loneliness-stroke association. They also noted that more research is needed to understand the potential underlying mechanisms, and that the study findings were limited to middle-aged and older adults and may not be generalizable to younger individuals.

Other Harvard Chan School authors included Ichiro Kawachi, Laura Kubzansky, Lisa Berkman, and Henning Tiemeier.

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College sees strong yield for students accepted to Class of 2028  

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Welcome to the School of International Studies

Our mission.

The Galilee Center for Biblical & Middle Eastern Studies

The School of International Studies (SIS) was created to provide educational certification through traditional classroom, on-site instruction, online curricula and text materials for individuals, families, students, and professionals. This function is realized through educational travel, intensive explorations, study abroad programs, huma

The School of International Studies (SIS) was created to provide educational certification through traditional classroom, on-site instruction, online curricula and text materials for individuals, families, students, and professionals. This function is realized through educational travel, intensive explorations, study abroad programs, humanitarian and service expeditions, internships, and educational resource production through transcultural community and educational materials that will enhance the lives of people in all regions of the world.  

[ https://www.elementsoflifeinstitute.com/about ]

The Galilee Center for Biblical & Middle East Studies

is the flagship of the School of International Studies 

providing students and families from throughout the world educational and cultural experiences in the Holy Lands.     

The Galilee Center offers individuals opportunities to build an understanding of principles that lift them in intel

The Galilee Center offers individuals opportunities to build an understanding of principles that lift them in intellect, character, and spirituality, and launch them into successful lives and careers through intensive international “on-site” study programs. More specifically, through academic and cultural experiences, the Galilee Center for Biblical and Middle Eastern Studies is to provide: 

A. ENHANCED UNDERSTANDING 

Curricula designed to enhance an understanding of the student's own religious and cultural heritage while gaining a knowledge of the peoples, places, and organizations indigenous to the region. 

B. SCHOLARSHIP 

The development of scholarship in all areas of Middle Eastern studies, reinforced by unique opportunities of residence and travel in the various lands of the region.

C.  CULTURAL EXPERIENCES 

Cultural experiences through personal contact and interaction with the peoples of the Near East, their way of life, their hopes, their ambitions, and aspirations. 

D.  SERVICE OPPORTUNITIES  

Service opportunities for students to discover the value of true charity, for charity is a virtue that develops fairness in self and society. 

Department of Travel Study

Department of educational publications, department of courses and conferences.

The Department of Travel Studies provides educational study abroad, humanitarian and professional development internships, intensive travel programs, and tours for individuals and families, students and professionals of all ages from throughout the world.  It offers certification units that may be acceptable at other institutions of secondary and higher education, professional organizations, etc.

The School of International Studies is a member of the Elements of Life Institute (ELI) that provides a host of courses and curriculum, seminars, and retreats a variety of subjects for individuals from all parts of the globe.  As a member of ELI, this school offers online courses, live seminars, and other educational conferencing that can lead to academic certifications.

As part of the educational mission of the School of International Studies, the department of Educational Publications produces all forms of educational media including books, pamphlets, online services, videos,   computer applications, other learning resources, and referrals to all forms of educational media that will enhance knowledge of the world and its cultures for individuals of all ages.

Current & Past Offerings of the Department of Travel Study

Study abroad programs, intensive explorations programs & co-sponsored tours.

62-DAY SUMMER TERM UNIVERSITY-LEVEL STUDENT PROGRAM  

• Travel in Israel, the Palestinian Authority & e Hashemite Kingdom of Jordan
•  Geographical, historical & archaeological certified units
• Hikes & biblical/historical walks
• Snorkeling in Red Sea
• Swimming in Mediterranean Sea
• Biblical meals
• World-class guest lecturers 
• Boating Sea of Galilee
• Camel Caravan Trek
• Experiencing Biblical lifestyle

& Much More!

LIMITED TO 42 QUALIFIED STUDENTS!

INTENSIVE EXPLORATION PROGRAMS  & CO-SPONSORED TOURS

FOR ALL AGES

Unlike any experience ever offered!

More than your typical Holy Land tours, this intensive 22-day experience is packed with unique and exciting activities, visits to sacred sites, ancient cities and archaeological ruins, “locals-only" cultural experiences, on-site guest lectur

More than your typical Holy Land tours, this intensive 22-day experience is packed with unique and exciting activities, visits to sacred sites, ancient cities and archaeological ruins, “locals-only" cultural experiences, on-site guest lecturers and expert faculty. 

Programs open to all ages , youth,   family groups , those who want more than a tour of the Holy Land!

TOURS AND CO-SPONSORED PROGRAMS

Recently added to this section is information on recommended short two-week tours (10-14 days) co-sponsored by other agencies and institutions.

Humanitarian & Professional Development Programs

These 14-day  to three-week dynamic expeditions offer youth, adults, and professionals an opportunities to provide humanitarian and relief services to people in many areas of the world , including the Holy Land, Ghana, Guatemala, Nepal, the Philippines and other areas.  The programs include instruction, relief, and life-saving humanitarian

These 14-day  to three-week dynamic expeditions offer youth, adults, and professionals an opportunities to provide humanitarian and relief services to people in many areas of the world , including the Holy Land, Ghana, Guatemala, Nepal, the Philippines and other areas.  The programs include instruction, relief, and life-saving humanitarian work among refugees and peoples from many cultures . Continuing education in transcultural nursing on some programs are offered. All obtain experience and education working among a vast array of religions and cultures which include Muslims, Jews, Druze, Samaritans, Ethiopians, Eastern Orthodox Christians, Circassians, Buddhists, Sikhs, Hindus, and others from many lands.

An Invitation to Join Us!

Check out The School of International Studies programs!

School of International Studies

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Phasing out legal short-term rentals could cost Maui $91.8 million in tax revenue

Study shows short-term rentals generated $2.2 billion in economic activity for maui and $11.3 billion across hawaii in 2023.

Maui Mayor Richard Bissen’s proposal to phase out approximately 7,000 short-term rentals on the Minatoya list in Maui County could lose up to $91.8 million in annual tax revenue and up to $280.9 million in total tax losses if all short-term rentals are discontinued in the county, according to a recent study. Courtesy photo

The Maui News

KAHULUI–On Thursday, the Travel Technology Association and Hawaii economic consultant Kloninger & Sims released a study on the economic and fiscal impacts of the short-term rental market in Maui County and across the state.

According to the report, under Mayor Richard Bissen’s proposal to phase out approximately 7,000 short-term rentals on the Minatoya list, Maui County could lose up to $91.8 million in annual tax revenue and up to $280.9 million in total tax losses if all short-term rentals are discontinued in the county.

If other counties followed suit and phased out short-term rentals, the State could lose as much as $554 million in annual tax revenue, according to the Travel Technology Association.

The study also underscores the significant economic activity short-term rentals contribute to Maui and Hawaii yearly.

The analysis found that short-term rental guests in Maui County directly spent $2.2 billion in 2023, resulting in $4 billion in economic activity. Across Hawaii, short-term rentals generated $11.3 billion in economic activity in 2023 and 66,000 jobs.

If all short-term rental units on the Minatoya List are phased out, Maui County could incur the following annual economic and fiscal losses:

• $53.3 to $91.8 million in real property (RPT), transient accommodations (TAT), and general excise tax (GET) to Maui County

• $1.3 billion in economic output

• 7,800 jobs

If all short-term rental units in Maui County are phased out, the following annual economic and fiscal losses could occur:

• $128.3 to $280.9 million in RPT, TAT and GET to Maui County

• $2.2 billion in economic output

• 23,000 jobs

If all short-term rental units throughout the state are phased out by the counties, the following annual economic and fiscal losses could occur:

• $803.3 to $955.9 million in taxes to the State and Counties, that includes:

• $554 million in State TAT and GET

• $121 million in all county GET and TAT surcharges

• $128.3 to $280.9 in Maui RPT

• $11.3 billion in economic output

• 66,000 jobs

“Roughly a third of all visitors to Hawaii use short-term rentals. On Maui, that ratio is even higher,” said Erik Kloninger, economist and partner of Kloninger & Sims. “Reducing the number of short-term rentals would limit accommodation options and likely lead to a decrease in visitors, resulting in job losses across various sectors of the economy and a significant shortfall in tax revenue for Maui County and the State.”

“Short-term vacation rentals have been a staple of the Maui economy for decades,” said Laura Chadwick, President and CEO of Travel Tech. “They’ve opened the island’s beauty to countless visitors and provided jobs and tax revenue to support the local community. We hope Maui and Hawaii leaders will consider other options to balance the economic benefits of short-term rentals and housing needs of the community.”

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Dermatology and Mental Health: Study Links Psoriasis to OCD

In an ongoing effort to better understand possible links between skin conditions and mental health, researchers at Yale School of Medicine have discovered an association between psoriasis and obsessive-compulsive disorder (OCD) that may have important implications for dermatology practice.

Their study , published in Archives of Dermatological Research on May 25, uses data from the All of Us Research Program , an NIH initiative that collects health information from patients across the United States. This health data is currently being used for thousands of research projects investigating a variety of health conditions, and at Yale, researchers used the surveys and electronic health records of over 250,000 diverse participants to demonstrate for the first time an association between OCD and psoriasis in U.S. adults.

We’re interested in the overlap between psychiatric disease and inflammatory skin disease. There may be opportunities for dermatologists to identify the potential for mental health disorders in one of our patients that would then allow us to appropriately refer that person to a mental health professional. Jeffrey Cohen, MD

Psoriasis is an immune-mediated inflammatory skin condition characterized by scaly plaques on the body. It affects more than 8 million people in the U.S. OCD, a psychiatric disorder characterized by obsessive thoughts and compulsions, may affect between 2 and 3 million people. Among the participants analyzed in the study, researchers found that those with psoriasis had a 1.5-fold increase in odds for an OCD diagnosis.

“We’re interested in the overlap between psychiatric disease and inflammatory skin disease,” says Jeffrey Cohen, MD, assistant professor of dermatology and principal investigator of the study. “There may be opportunities for dermatologists to identify the potential for mental health disorders in one of our patients that would then allow us to appropriately refer that person to a mental health professional.”

Symptoms, inflammation, and genetics

There are a few potential explanations for the OCD-psoriasis link that Cohen and his team found. It’s possible that symptoms associated with psoriasis—chronic itching, sleep troubles, disfigurement—might put patients at greater risk for developing OCD. But it’s also possible that certain OCD-related tendencies, such as too much bathing or handwashing, could exacerbate psoriasis.

“Excessive bathing can dry the skin and flare psoriasis. The itch of psoriasis can lead to a lot of scratching that can become a compulsion,” says Cohen.

Inflammation could also play a role. Both OCD and psoriasis are associated with elevated levels of inflammatory cytokines, such as IL-2, IL-6, and TNF-α, that play a role in the body’s immune response. Cohen believes this could be significant, especially considering genetic evidence that shows family members of people who have OCD have higher rates of immune-mediated disease, such as skin conditions that include psoriasis.

A diverse dataset

Though the same OCD-psoriasis association had previously been found in Taiwanese and Swedish populations, this study was the first to demonstrate the link in American adults, and in particular, those Americans who are often left out of biomedical research.

The All of Us database that Cohen and his team used collects health information from U.S. patients of various races, ethnicities, ages, gender identities, sexualities, and other classifications. This provides researchers such as Cohen access to a highly valuable and largely underrepresented data pool.

“It remains a really great database to use for this because it has information about a lot of people from diverse groups across the United States, and the data that’s there is quite powerful,” says Cohen.

Integrating mental health and dermatology

Cohen has been using All of Us data since 2021 to discover a number of other associations, such as eczema and eating disorders , and atopic dermatitis and OCD. His findings add to the growing body of research linking the skin with the mind, but despite such evidence, mental health is frequently not considered in dermatology practice. Cohen believes this is an area where the field could improve.

“In dermatology, we’re not that great at asking about certain mental health disorders that may be relevant,” says Cohen. “But if we identify it, if we see that someone might be at risk, we could put the wheels in motion to try to get them thoroughly evaluated and, if needed, treated for whatever it is that’s going on, in addition to what we’re doing for their skin.”

As medical professionals who often have frequent contact with their patients, dermatologists are well positioned to identify the potential for mental health concerns early on, Cohen says. Thus, increasing the awareness around research findings that link the skin and the mind will be key for dermatologists and their patients alike.

Featured in this article

• Jeffrey Cohen, MD Assistant Professor of Dermatology; Director, Psoriasis Treatment Program; Director of Safety, Dermatology

• Introduction
• Conclusions
• Article Information

Circles are proportional to sample size.

HW1 indicates heat wave definition 1: total number of hot days in the 4-day (or 7-day) window, represented by an ordinal variable with categories of 0, 1, 2, 3, or 4 days or more; HW2, heat wave definition 2: consecutive hot days in the 4-day (or 7-day) window, represented by binary indicators for 2 or more consecutive days, 3 or more consecutive days, or 4 or more consecutive days; and HW3, heat wave definition 3: mean degrees Celsius over the threshold during the exposure window, a continuous variable calculated as the 4-day (or 7-day) moving mean − the 97.5% threshold, and if less than 0, then set to 0.

HW2 indicates heat wave definition 2: consecutive hot days in the 4-day (or 7-day) window, represented by binary indicators for 2 or more consecutive days, 3 or more consecutive days, or 4 or more consecutive days; HW3, heat wave definition 3: mean degrees Celsius over the threshold during the exposure window, a continuous variable calculated as the 4-day (or 7-day) moving mean − the 97.5% threshold, and if less than 0, then set to 0 (results for heat wave definition 1 are available in eTable 4 in Supplement 1 ).

a Including American Indian, Alaska Native, Asian, Other Pacific Islander, and unknown.

eTable 1. Federal Information Processing System (FIPS) Codes for 416 Counties Included in the 50 Largest U.S. Metropolitan Statistical Areas in the 2010 Census

eTable 2. Total Births in Each MSA (or Sub-MSA for Los Angeles and New York City) Over the Study Period 1993-2017 and Counts of Preterm (28-37 Weeks) and Early-Term Births (37-38 Weeks) Included in Analysis

eTable 3. Adjusted Rate Ratios for Preterm and Early-Term Birth for Heatwaves Occurring in the 4-Day or 7-Days Before Birth, Shown Graphically in Figure 2

eTable 4. Adjusted Rate Ratios for Preterm and Early-Term Birth for Heatwaves Occurring in the 4-Day Before Birth (Lag 0-3) From Sensitivity Analyses: (1) Defining Heat Waves Based on a 95% Temperature Threshold (2) Excluding Medically-Induced Deliveries From Preterm and Early-Term Daily Counts (97.5%ile Threshold) (3) Random Effects Meta-Analysis of MSA-Specific Rate Ratios (97.5%ile Threshold)

eFigure 1. Rate Ratios and 95% Confidence Intervals for Heatwaves Based on 97.5%ile Thresholds of Minimum, Mean, and Maximum Temperature for the 4-Day Exposure Window

eFigure 2. Rate Ratios and 95% Confidence Intervals for Heatwaves in the 4 Days Preceeding Birth and Preterm and Early Term Birth, Stratified by Maternal Race/Ethnicity

eFigure 3. Rate Ratios and 95% Confidence Intervals for Heatwaves in the 4 Days Preceeding Birth and Preterm and Early Term Birth, Stratified by Maternal Education Level

eFigure 4. Rate Ratios and 95% Confidence Intervals for Heatwaves Occurring in the 4 Days Preceeding Birth and Preterm and Early Term Birth, Stratified by Maternal Age Group

eFigure 5. Rate Ratios and 95% Confidence Intervals for Heatwaves in the 4 Days Preceeding Birth and Preterm and Early Term Birth, Stratified by Infant Sex

eFigure 6. Rate Ratios and 95% Confidence Intervals for Heatwaves in the 4 Days Preceeding Birth and Preterm and Early Term Birth, Stratified by Live Birth Order

eTable 5. Adjusted Rate Ratios and 95% Confidence Intervals for Heatwaves in the 4 Days Preceeding Birth and Preterm and Early-Term Birth, Among Mothers ≤29 Years of Age and ≤ a High School Education and a Race or Ethnicity Other Than non-Hispanic White

Data Sharing Statement

• Preterm and Early-Term Birth, Heat Waves, and Our Changing Climate JAMA Network Open Invited Commentary May 24, 2024 Caleb Dresser, MD, MPH; Shruthi Mahalingaiah, MD, MS; Kari C. Nadeau, MD, PhD

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Darrow LA , Huang M , Warren JL, et al. Preterm and Early-Term Delivery After Heat Waves in 50 US Metropolitan Areas. JAMA Netw Open. 2024;7(5):e2412055. doi:10.1001/jamanetworkopen.2024.12055

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Preterm and Early-Term Delivery After Heat Waves in 50 US Metropolitan Areas

• 1 Department of Epidemiology, Biostatistics, and Environmental Health, School of Public Health, University of Nevada, Reno
• 2 Geriatric Research and Education Clinical Center, Veterans Affairs Health Care Systems, Palo Alto, California
• 3 Department of Biostatistics, School of Public Health, Yale University, New Haven, Connecticut
• 4 Department of Chemical Engineering, John and Marcia Price College of Engineering, University of Utah, Salt Lake City
• 5 Research Applications Laboratory, National Center for Atmospheric Research, Boulder, Colorado
• 6 Department of Biostatistics, Rollins School of Public Health, Emory University, Atlanta, Georgia
• Invited Commentary Preterm and Early-Term Birth, Heat Waves, and Our Changing Climate Caleb Dresser, MD, MPH; Shruthi Mahalingaiah, MD, MS; Kari C. Nadeau, MD, PhD JAMA Network Open

Question   Are heat waves associated with increased rates of preterm birth and early-term birth in the US?

Findings   In this cohort study of 53 million births, daily rates of preterm and early-term births were positively associated with heat waves, with stronger associations observed after heat waves of longer duration and higher mean temperatures.

Meaning   This study suggests that the increasing frequency and intensity of heat waves have implications for perinatal health in the US.

Importance   Heat waves are increasing in frequency, intensity, and duration and may be acutely associated with pregnancy outcomes.

Objective   To examine changes in daily rates of preterm and early-term birth after heat waves in a 25-year nationwide study.

Design, Setting, and Participants   This cohort study of singleton births used birth records from 1993 to 2017 from the 50 most populous US metropolitan statistical areas (MSAs). The study included 53 million births, covering 52.8% of US births over the period. Data were analyzed between October 2022 and March 2023 at the National Center for Health Statistics.

Exposures   Daily temperature data from Daymet at 1-km 2 resolution were averaged over each MSA using population weighting. Heat waves were defined in the 4 days (lag, 0-3 days) or 7 days (lag, 0-6 days) preceding birth.

Main Outcomes and Measures   Daily counts of preterm birth (28 to <37 weeks), early-term birth (37 to <39 weeks), and ongoing pregnancies in each gestational week on each day were enumerated in each MSA. Rate ratios for heat wave metrics were obtained from time-series models restricted to the warm season (May to September) adjusting for MSA, year, day of season, and day of week, and offset by pregnancies at risk.

Results   There were 53 154 816 eligible births in the 50 MSAs from 1993 to 2017; 2 153 609 preterm births and 5 795 313 early-term births occurring in the warm season were analyzed. A total of 30.0% of mothers were younger than 25 years, 53.8% were 25 to 34 years, and 16.3% were 35 years or older. Heat waves were positively associated with daily rates of preterm and early-term births, showing a dose-response association with heat wave duration and temperatures and stronger associations in the more acute 4-day window. After 4 consecutive days of mean temperatures exceeding the local 97.5th percentile, the rate ratio for preterm birth was 1.02 (95% CI, 1.00-1.03), and the rate ratio for early-term birth was 1.01 (95% CI, 1.01-1.02). For the same exposure, among those who were 29 years of age or younger, had a high school education or less, and belonged to a racial or ethnic minority group, the rate ratios were 1.04 (95% CI, 1.02-1.06) for preterm birth and 1.03 (95% CI, 1.02-1.05) for early-term birth. Results were robust to alternative heat wave definitions, excluding medically induced deliveries, and alternative statistical model specifications.

Conclusions and Relevance   In this cohort study, preterm and early-term birth rates increased after heat waves, particularly among socioeconomically disadvantaged subgroups. Extreme heat events have implications for perinatal health.

Preterm birth (delivery at <37 weeks’ gestation) is a leading cause of infant mortality and longer-term morbidities, including respiratory, cognitive, and behavioral outcomes. 1 Early-term infants (delivery at 37-38 weeks’ gestation) also experience increased morbidity and mortality relative to those born at 39 to 40 weeks’ gestation. 2 - 4 In the US, these outcomes affect many infants, with 10.5% of all infants born preterm and 28.8% born early term. 5 Given the high baseline risks and the influence on lifetime health trajectories of preterm and early-term births, factors that increase these pregnancy outcomes even modestly have large public health implications.

Previous research suggests an acute association of high outdoor temperatures in the week preceding birth with preterm birth. 6 , 7 Studying heat waves is considerably more difficult because of the large sample sizes required to estimate modest effects of rare multiday heat events. With a few exceptions, existing studies generally support a positive association between heat waves and preterm birth, but with considerable heterogeneity in the magnitude of effect estimates observed, the definition of heat waves, and the heat thresholds. 8 - 16 Although few studies directly address physiological mechanisms, there are several biologically plausible pathways. Heat stress and dehydration reduce uterine and placental blood flow, possibly affecting uterine contractility and/or hormone levels governing the induction of labor. 17 , 18 Heat stress causes oxidative stress and the release of heat shock proteins that may trigger an inflammatory cascade, plausibly affecting the induction of labor. 18 , 19 Extreme heat may also trigger the premature rupture of membranes, 20 leading to labor (spontaneous or medically induced); alternatively, it may motivate a medically indicated delivery by exacerbating maternal morbidities (eg, hypertension) or fetal distress.

In this study, we estimated the changes in rates of preterm and early-term births in response to heat waves, defined as multiday periods of extremely high temperatures relative to local norms. We investigated these associations using birth record data from the 50 largest US metropolitan areas, encompassing both urban and suburban areas, over a 25-year period to capture numerous heat wave events of variable duration and intensity. We applied previously validated methods that account for seasonally varying risk sets of ongoing pregnancies in each location. The results provide nationally representative and precise population-level associations for an exposure that has been historically rare but is increasing due to global climate change. 21

The project was approved by the University of Nevada, Reno institutional review board. The informed consent requirement was waived due to minimal risk to participants and because the research could not be practically carried out without the waiver. This report followed the Strengthening the Reporting of Observational Studies in Epidemiology ( STROBE ) reporting guideline for observational studies.

Natality data in the US for the birth years from 1993 to 2017 were obtained from the National Vital Statistics System at the National Center for Health Statistics (NCHS), Centers for Disease Control and Prevention. State and county Federal Information Processing Standards codes were used to identify births to mothers residing in the 50 largest metropolitan statistical areas (MSAs), based on the MSA-county delineation and populations in the 2010 US Census (416 counties total). Names and counties of MSAs are shown eTable 1 in Supplement 1 . The 2 largest MSAs (Los Angeles–Long Beach–Santa Ana, California; and New York–Northern New Jersey–Long Island) were further subdivided. 9 For simplicity, these 53 locations (48 MSAs and 5 sub-MSAs) are henceforth referred to as MSAs . The MSA was selected as the spatial scale of analysis to achieve high numbers of daily birth counts in each location while also limiting the geographic area assigned to shared heat wave exposure. Date of birth, state, county, gestational age, maternal age, maternal educational level, maternal race and ethnicity, infant sex, parity, induction of labor, and plurality were extracted from birth files and harmonized to accommodate birth record field changes over time. Race and ethnicity were maternal-reported on the birth record as Hispanic or non-Hispanic ethnicity and Alaska Native, American Indian, Asian, Black, Other Pacific Islander, or White race. To achieve sufficient numbers for analysis categories, these groups were collapsed into Hispanic, non-Hispanic Black, non-Hispanic White, and non-Hispanic other race. To examine possible effect modification of the association between heat waves and birth outcome by race and ethnicity and other factors, data were stratified by maternal age group (<25, 25-34, and ≥35 years), maternal educational level (≤high school, General Educational Development certification, or 12 years of school; associate’s or bachelor’s degree or 13-16 years of school; advanced degree or master’s, doctoral, or professional degree or ≥17 years of school), maternal race and ethnicity (self-reported then broadly categorized into any Hispanic origin; non-Hispanic Black; non-Hispanic White; or non-Hispanic other race, including American Indian, Alaska Native, Asian, Other Pacific Islander, and unknown), parity (eg, first born, second born), and infant sex. Preterm birth was defined as birth between 28 weeks and 0 days’ gestation and 36 weeks and 6 days’ gestation, and early-term birth was defined as birth between 37 weeks and 0 days’ gestation and 38 weeks and 6 days’ gestation. Extreme preterm births (≤27 weeks; 6% of preterm births) were excluded a priori due to greater association with intrauterine infection and congenital anomalies and to be consistent with our previous analysis. 1 , 9 , 22 , 23

Daily minimum and maximum temperatures were obtained at 1 × 1-km resolution for the continental US from Daymet, a National Aeronautics and Space Administration–supported product from the Earth Science Data and Information System and the Terrestrial Ecology Program. 24 Mean daily temperatures (mean of Daymet minimum and maximum) were spatially averaged over grids in each county, and then county-level estimates were combined into a single population-weighted spatial mean for each MSA on each day. County population weighting was based on the 2010 US Census population weights to maintain consistency over time.

Hot days in each MSA were defined as those exceeding the 97.5th percentile threshold of the MSA-specific temperature distribution over the 25-year study period. Identification of heat waves was based on clusters of hot days within 2 acute exposure windows: the 7 days (lag, 0-6 days) and 4 days (lag, 0-3 days) preceding the birthdate, selected based on previous findings of positive associations in the 7-day window, 9 and evidence for heat stress and other outcomes suggesting a shorter lag time. 25 Heat waves were defined 3 ways to capture aspects of duration and intensity: (1) heat wave definition 1 (HW1): total number of hot days in the 4-day (or 7-day) window, represented by an ordinal variable with categories of 0, 1, 2, 3, or 4 days or more; (2) heat wave definition 2 (HW2): consecutive hot days in the 4-day (or 7-day) window, represented by binary indicators for 2 or more consecutive days, 3 or more consecutive days, or 4 or more consecutive days; and (3) heat wave definition 3 (HW3): mean degrees Celsius over the threshold during the exposure window, a continuous variable calculated as the 4-day (or 7-day) moving mean − the 97.5% threshold, and if less than 0, then set to 0.

Data were analyzed between October 2022 and March 2023 at the NCHS. A methodological challenge in studies of heat waves (or temperature) and pregnancy duration is the well-documented seasonal variation in conceptions 26 , 27 and the corresponding peak of pregnancies nearing term each year in July in the US when hot temperatures also peak, creating potential for confounding. 28 Our analytic approach was designed to avoid this bias and was informed by a simulation study evaluating different statistical approaches 29 that supported the use of a time-series approach incorporating control for the risk set of ongoing pregnancies and their gestational age distribution, 30 because the risk of preterm or early-term birth increases sharply as a pregnancy nears term. For each day in each MSA, counts of preterm and early-term births were tabulated, and pregnancies at risk during each gestational week enumerated. Daily outcome counts were then linked to the exposure metrics indicating the occurrence of heat waves in the previous 4 (or 7) days. Overdispersed Poisson regression models with scaled (Pearson) SEs included an offset term representing the expected count of preterm (or early-term) births on each day based on the counts and gestational ages of ongoing pregnancies. More details of the offset and model specifications are available in the eMethods in Supplement 1 .

Analyses were restricted to the warm season (May to September), and models included control for location (52 indicators), day of week (6 indicators), birth year (24 indicators), and a cubic spline on day of warm season (May 1 = 1 and September 30 = 153) to adjust for recurrent seasonal trends (1 knot on July 15, 4 total df ). The last day included in preterm birth analyses was August 17, 2017, because full enumeration of pregnancies at risk beyond that date would require birth records from 2018.

Sensitivity analyses were conducted to examine the robustness of results to different assumptions. Heat waves were redefined by (1) applying a 95% temperature threshold to define a hot day and (2) minimum and maximum daily temperature metrics from Daymet instead of the mean (97.5% threshold). In another analysis, medically induced births were excluded from daily counts of preterm and early-term births (but appropriately retained in daily risk sets). In addition, instead of conducting 1 overall model controlling for MSA, we conducted 53 MSA-specific models, allowing the day of season, birth year, and weekday covariate control to be MSA specific. The 53 risk ratios for each heat wave metric were then combined in a random-effects meta-analysis; details of this model are provided in the eMethods in Supplement 1 .

With the exception of the Daymet temperature data processing, all analyses were conducted onsite at the NCHS Research Data Center (Centers for Disease Control and Prevention) due to the restricted-use birthdate and geography variables and the central importance of these fields to the study questions. Analyses were conducted using SAS, version 9.4 (SAS Institute Inc) and R, version 4.2.1 (R Project for Statistical Computing). Calculated P values were from 2-sided tests.

A total of 55 748 869 births occurred in the included MSAs between 1993 and 2017, covering 52.8% of all US births during the time period. eTable 2 in Supplement 1 presents the total births by MSA, as well as the counts of preterm and early-term births analyzed after exclusions and warm season restriction. There were 53 154 816 births available after exclusions for multiple births (n = 1 889 189), missing gestational age (n = 381 458), and gestational age of 27 weeks or less (n = 323 406). A total of 30.0% of mothers were younger than 25 years, 53.8% were 25 to 34 years, and 16.3% were 35 years or older. Self-reported maternal race and ethnicity on the birth record indicated 26.1% Hispanic, 17.2% non-Hispanic Black, 48.8% non-Hispanic White, and 7.9% non-Hispanic other race. Figure 1 shows the study locations and relative birth sample sizes. In total, 2 153 609 preterm births and 5 795 313 early-term births occurring during the warm season were analyzed.

The Table shows the number of days in the analysis meeting each heat wave definition for the 4-day (lag, 0-3 days) and 7-day (lag, 0-6 days) exposure windows. For example, there was a mean (SD) of 2.0 (0.7) days per year per MSA that met the definition of a 4–consecutive day heat wave in the 4-day exposure window, and a mean (SD) of 4.2 (0.9) days per year per MSA met the definition of a 4–consecutive day heat wave in the 7-day exposure window. Heat waves were more common in later years of the study. For example, between 1993 and 2004, 1.8 days per year per MSA met the above definition, whereas 2.4 days per year per MSA met the definition from 2005 to 2017. Compared with the 4-day exposure window, more days indicated heat waves in the 7-day window for HW1 and HW2, because the longer window provided more opportunity for a multiday heat event to occur, but fewer days were above 0 for HW3, because a 7-day mean above the 97.5th percentile is more extreme than a 4-day mean above the same threshold.

Rate ratios and 95% CIs from the primary analysis for all heat wave definitions are shown graphically in Figure 2 and numerically in eTable 3 in Supplement 1 . Rate ratios for HW1 are expressed relative to 0 days above the 97.5th percentile threshold in the window, rate ratios for HW2 are relative to days without any 2–consecutive day hot period (or 3-day or 4-day, analyzed in separate models), and HW3 rate ratios are reported per 1 °C increase in mean temperature above the threshold. Heat waves were associated with an increase in daily rates of both preterm and early-term births, with stronger rate ratios observed for more days of heat (HW1), more consecutive days of heat (HW2), and higher mean degrees over the threshold (HW3). After 4 consecutive days of mean temperatures exceeding the local 97.5th percentile (HW2, 4-day), the rate ratio for preterm birth was 1.02 (95% CI, 1.00-1.03), and the rate ratio for early-term birth was 1.01 (95% CI, 1.01-1.02). Each 1 °C increase in mean temperature above the threshold (HW3) was associated with a 1% increase in the rate of both preterm birth (rate ratio, 1.01 [95% CI, 1.00-1.02]) and early-term birth (rate ratio, 1.01 [95% CI, 1.00-1.01]). Rate ratios for the more acute 4-day window tended to be higher than the 7-day window, so sensitivity analyses focus on the 4-day window.

Rate ratios and 95% CIs for sensitivity analyses of heat waves (HW2 and HW3) in the 4 days preceding birth are shown in Figure 3 (numerical results, including HW1, are available in eTable 4 in Supplement 1 ). Use of a 95th percentile temperature threshold instead of 97.5th percentile to define hot days yielded rate ratios that were generally lower than the primary approach, but with narrower 95% CIs due to more days classified as heat waves. Exclusion of induced births (5.9% of preterm births and 7.9% of early-term births), as well as the 53-site random-effects meta-analysis, yielded results highly consistent with the primary approach. When daily maximum or minimum temperature metrics were used to define heat waves, the rate ratios for early-term birth were highest based on minimum temperature, but this pattern was not evident for preterm birth (eFigure 1 in Supplement 1 ).

Results of subgroup analyses, stratified by maternal educational level, maternal age, maternal race and ethnicity, infant sex, and live birth order (first, second, third, etc), showed higher heat wave rate ratios among mothers of younger ages, mothers with lower educational levels, and Hispanic or non-Hispanic Black mothers ( Figure 4 ; eFigures 2-6 in Supplement 1 ). For preterm birth only, rate ratios were elevated among older mothers or those with advanced degrees (subgroups with high overlap). We then analyzed a joint subgroup defined by mothers with multiple susceptibility factors: mothers with high school education or less, from a racial minority group or of Hispanic ethnicity, and age younger than 30 years (instead of <25 years due to small counts). Among this group, the rate ratio for preterm birth was 1.04 (95% CI, 1.02-1.06), and the rate ratio for early-term birth was 1.03 (95% CI, 1.02-1.05) after 4 consecutive hot days (eTable 5 in Supplement 1 ).

In this nationwide analysis covering 52.8% of US births between 1993 and 2017, we observed a small increase in the rates of preterm and early-term births after multiday periods of locally extreme high temperatures. Increases were more pronounced for heat waves of longer duration and higher temperatures and among population subgroups associated with lower socioeconomic status. We also observed evidence of elevated preterm birth rates, but not early-term rates, after heat waves among mothers 35 years of age or older. Results indicated stronger associations for the shorter 4-day window compared with the 7-day window. To our knowledge, this is the first study to address this study question using national US birth data within the past 2 decades and constitutes the largest study to date on this question.

The magnitude of associations that we observed for preterm birth and heat waves was generally lower than in previous studies, although these studies show considerable heterogeneity. 8 , 11 - 16 , 31 A 2020 six-study meta-analysis yielded a summary odds ratio for preterm birth after heat waves of 1.16 (95% CI, 1.10-1.23) based on populations from Montreal, Quebec, Canada; Alabama; Brisbane, Australia; Rome, Italy; Sabzevar, Iran; and China. 7 Previous US national analyses have not had access to the birthdate field 32 or were limited to the 1980s when birthdate and geography were not yet restricted by the NCHS. 9 Point estimates for preterm birth were similar to those previously reported in the 1980s, although most associations were not statistically significant in the data from the 1980s (the present study included 3.5 times the number of preterm births). We observed stronger associations with preterm birth among certain population subgroups, which is consistent with previous studies that reported stronger associations among the youngest and oldest mothers, members of racial and ethnic minority groups, and mothers with lower educational achievement. 12 , 33

Early-term birth has been studied less frequently than preterm birth, but the magnitude of acute increases in early-term birth observed here are consistent with the previous analysis from the 1980s. 9 Findings are also consistent with a California study (2005-2013 birth records) reporting a less precise hazard ratio of 1.03 (95% CI, 0.98-1.07) for 4 days of temperatures above the 98th percentile in the previous week. 8 Other smaller studies have reported relative increases of 10% to 30% for prolonged high temperatures in the week preceding early-term birth. 10 , 15 Although infants born early term exhibit lower morbidity and mortality relative to preterm births, a small relative increase in the probability of this common outcome (currently >28% of US births 5 ) has the potential to affect large numbers of pregnancies.

In the absence of a criterion standard definition of heat wave, we examined several definitions that incorporate duration and temperature intensity. The metrics were selected a priori and were informed by previous analyses of a broader suite of heat metrics (eg, including apparent temperature and excessive heat factor). 9 We chose not to examine apparent temperature, a measure incorporating relative humidity, because estimates from the 1980s were similar between those defined using temperature vs apparent temperature, and results from other studies making within-location temporal contrasts indicated little difference when humidity was considered. 8 , 34 Because all contrasts in our study were temporal (ie, comparing event rates over time within an MSA population), humidity differences between cities would not contribute to the estimated associations. Heat waves defined using mean, minimum, or maximum daily temperature thresholds were correlated and yielded mostly similar results. We observed some evidence for a stronger association between minimum temperature heat wave metrics and early-term birth, but not for preterm birth (eFigure 1 in Supplement 1 ), and 95% CIs overlapped.

This study has some strengths. Several design and analysis choices limited the potential for confounding in this study. Because all contrasts were temporal, potential confounders were limited to those that vary day to day. One particular a priori concern was the seasonal pattern of conception in the US that led to a peak of pregnancies in July. 26 , 28 A previously conducted simulation study evaluated several designs and statistical model specifications under these confounding conditions to inform our approach. 29 Based on these simulations, which indicated a small positive bias in time-stratified case-crossover models, we selected the time-series approach as implemented by Vicedo-Cabrera et al 30 to account for the changing gestational age distribution of the risk set. Long-term time trends were controlled by adjusting for birth year, and the smooth function on day of season adjusted for any recurrent seasonal trends over the course of the warm season. Weekday was independent of the exposure (heat waves) but was included because it reduced overdispersion.

A major strength of this study is the multisite approach and the application of consistent, validated 28 methods across locations. The primary analyses modeled all data together, controlling for MSA with fixed effects, but concern about residual confounding by MSA-specific seasonal or long-term time trends motivated the meta-analysis that allowed all covariate associations to vary by MSA (year, day of season, and weekday). Results of this random-effects meta-analysis strengthened our confidence in the primary analysis results.

This study also has some limitations. Observed rate ratios in this study represent the net population-level changes in rates of the outcome after heat waves. They cannot isolate the association of physical exposure to heat waves with the outcome because some pregnant individuals undoubtedly modify behavior in response to heat. Some of these behavioral modifications, such as avoiding physical exertion, may actually decrease the rates of preterm and early-term births. 35 The population-level estimated effects also obscure subpopulation vulnerabilities. 33 Variables systematically collected on birth records are only crude proxies of social and biologic factors that might modify the risks of heat waves, such as access to housing with reliable air conditioning, or coexposures, such as stress and underlying health conditions that increase susceptibility to the outcomes. In addition, our study excluded births in rural areas, where mothers could experience more vulnerability to extreme heat due to less access to cooling.

This 25-year cohort study based on 53 million births provides compelling population-based evidence of increased preterm and early-term birth rates in response to heat waves. The modest but robust elevated associations were strongest in the 4 days preceding birth and for longer durations of heat and higher temperatures. The findings also add to evidence that the effects of extreme heat events are not distributed evenly among population subgroups.

Accepted for Publication: March 16, 2024.

Published: May 24, 2024. doi:10.1001/jamanetworkopen.2024.12055

Open Access: This is an open access article distributed under the terms of the CC-BY License . © 2024 Darrow LA et al. JAMA Network Open .

Corresponding Author: Lyndsey A. Darrow, PhD, Department of Epidemiology, Biostatistics, and Environmental Health, School of Public Health, University of Nevada, Reno, 1664 N Virginia St, MS 0274, Reno, NV 89557 ( [email protected] ).

Author Contributions: Dr Darrow had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Darrow, Huang, Warren, Strickland, Chang.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Darrow, Chang.

Critical review of the manuscript for important intellectual content: All authors.

Statistical analysis: Darrow, Huang, Warren, Strickland, Chang.

Obtained funding: Darrow, Strickland, Holmes, Newman, Chang.

Administrative, technical, or material support: Darrow, Warren, Newman, Chang.

Supervision: Darrow.

Conflict of Interest Disclosures: None reported.

Funding/Support: This study was supported by grant R01ES028346 from the National Institute of Environmental Health Sciences.

Role of the Funder/Sponsor: The funding source had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Data Sharing Statement: See Supplement 2 .

Additional Contributions: We acknowledge the substantial contributions to the study by the following individuals: Jennifer Parker, PhD, Amy Branum, PhD, and Wanjun Cui, PhD, at the National Center for Health Statistics, Centers for Disease Control and Prevention, for key logistical contributions to the study and birth data expertise and management and Chris McClendon, BS, and Christina Hilfer, MS, at the Office of Information Technology, University of Nevada, Reno, for computing support in data management and processing. No compensation was received for these contributions.

Additional Information: The meteorology and birth data were originally collected and processed by governmental agencies.

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Americans are the worst (globally) at taking vacation time: Here's how many days we take

• Americans take the least vacations globally, averaging just 11 days.
• Only half of Americans plan to use all their allotted time off.
• The French are doing the opposite. In the survey, France won the spot as the country that gets the most days off, about a month.

Summer vacation mode may be in full swing, but it turns out Americans aren’t the ones packing their bags, according to a new study by travel platform Expedia. 

Expedia’s 24th annual Vacation Deprivation Report, which surveyed 11,580 people across 11 countries in March and April, found Americans to take the least vacations globally. Sixty-five percent of U.S. respondents said they feel as if they don’t take enough time off – the highest rate in 11 years.

Americans not only receive the fewest vacation days each year, averaging just 11 days, but only half of them even plan to use all their allotted time off. 

Going abroad? Here's how to to tip in Europe, Africa, Asia, Latin America, Australia and New Zealand

How much time off do Americans take?

The study found that Americans take 11 days off a year on average.

Learn more: Best travel insurance

The reasons are all too relatable: Americans said they’re just too busy, and planning a vacation can be “overwhelming.”

Compared with the rest of the world, Americans are almost twice as likely to go a year or more without taking a vacation. Japan, France and Hong Kong were all found to have healthy holiday habits in the study. (Hong Kong respondents actually took more time off than their earned paid time off.)

"Vacations are not a guilty pleasure, yet that's the way Americans have been treating time off for years now," said Mel Fish, vice president of Global Public Relations, Expedia Group Brands, in a statement to USA TODAY. 

“Guilt, hustle culture, and the stress of planning a trip are why 65% of Americans say they're 'vacation deprived,' the highest rate in over a decade of Expedia tracking it. With more than half of Americans not using all their PTO annually, despite getting the fewest amount of vacation days globally, we're clearly overdue for an overhaul when it comes to our relationship with vacation time.”

Even worse, about 19% of Americans said they save up their vacation days for a big trip and end up not even going. 

While Americans grind away at work and manage their busy schedules, the French are doing the opposite. In the survey, France won the spot as the country that gets the most days off, about a month. (You may have heard of the famous French August shutdown , when many businesses close and people get away from the cities.)

In Japan – one of the surveyed countries where its residents take the second-least amount of days off at 12 days – vacations are spread out throughout the year, about every month or so. That contributes to the Japanese having one of the lowest levels of vacation deprivation, according to the study. 

Americans may want to follow suit and take that step to finally book the trip on their bucket list. Going on vacation comes with a slew of benefits for someone’s well-being , like reducing depression. Taking a trip even helps us show up in our daily lives and jobs better. Unfortunately, Americans ranked the lowest out of the 11 countries for prioritizing rest and relaxation during their trips. (Seriously, turn off the email notifications.)

“You know how sometimes your computer needs a reboot? Our brains are much the same,” said Becky Spelman, a psychologist who partnered with Expedia, in a statement to USA TODAY. “Over time, work stress can build up to an unsustainable level and our brain functions start to slow down and work less effectively.” 

Tips to book that trip

◾ Go for the long weekend. Because a big annual trip can be costly and come with a lot of pressure, opt for booking shorter getaways, like a long weekend . Although holiday weekends can cause prices to surge, taking a Friday or Monday off for a long weekend during shoulder season means fewer crowds and lower prices. 

◾ Use technology. Artificial intelligence travel planners and price trackers are at our fingertips, and those can make the research and planning of booking a trip a little less overwhelming. Using a flight tracker to monitor flight costs can help you score the best deal. And if you don’t know where to go, an AI travel planner from Expedia or Booking.com can help you find accommodations and even decide on a destination based on your interests. 

“When we take a break, it’s easier for our brains to absorb new information, process new sensations and create new memories – a process known as ‘cognitive flexibility,’” Spelman said. “The benefits can last long after the vacation is over. By taking time off and ‘rebooting’ our brain, we return refreshed, which can lead to longer-term job satisfaction.”

Kathleen Wong is a travel reporter for USA TODAY based in Hawaii. You can reach her at [email protected] .

The Key Points at the top of this article were created with the assistance of Artificial Intelligence (AI) and reviewed by a journalist before publication. No other parts of the article were generated using AI. Learn more .

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Automotive, Travel, and Traffic Safety Information

Nearly 71 Million People Expected to Travel over July 4th Week

This year’s extended independence day forecast exceeds pre-pandemic numbers, sets new record.

WASHINGTON, DC (June 20, 2024) – AAA projects 70.9 million travelers will head 50 miles or more from home over the Independence Day holiday travel period*. For the first time, AAA looked at the entire July 4 th week, plus the Saturday before and the Sunday after the holiday. This year’s projected number of travelers for that time period is a 5% increase compared to 2023 and an 8% increase over 2019.

“With summer vacations in full swing and the flexibility of remote work, more Americans are taking extended trips around Independence Day,” said Paula Twidale, Senior Vice President of AAA Travel. “We anticipate this July 4 th week will be the busiest ever with an additional 5.7 million people traveling compared to 2019.”   

AAA projects a record 60.6 million people will travel by car over Independence Day week – that’s an additional 2.8 million travelers compared to last year. This year’s number also surpasses 2019 when 55.3 million people traveled by car over July 4 th week. AAA car rental partner Hertz says Dallas, Denver, Salt Lake City, Los Angeles, and San Francisco are the cities displaying the highest rental demand during the holiday week. The busiest pick-up days are projected to be Friday, June 28, Saturday, June 29, and Wednesday, July 3.   

Gas prices are lower than last year when the national average was $3.53. Pump prices will likely continue going down leading up to Independence Day.  At that point, they will likely level off and remain relatively stable until after Labor Day, similar to last year.  An important caveat is hurricane season – underway now – which could affect gas prices should a storm negatively impact Gulf Coast oil production and refining centers.  

The number of air travelers is also expected to set a new record. AAA projects 5.74 million people will fly to their July 4 th destinations. That’s an increase of nearly 7% compared to last year and a 12% increase over 2019. AAA booking data shows domestic airfare is 2% cheaper this Independence Day week compared to last year, and the average price for a domestic roundtrip ticket is $800. Airports will be packed throughout the week. AAA recommends arriving 2 hours early, reserving parking ahead of time, and traveling with carry-on luggage versus checked bags to save time and money.   

More than 4.6 million people are expected to travel by other modes of transportation, including buses, cruises, and trains. This category is seeing an increase of 9% compared to last year, but this year’s number is shy of 2019’s figure of 4.79 million. Cruising continues its remarkable post-pandemic comeback. This time of year, Alaska cruises are in high demand, making Seattle and Anchorage top domestic destinations. Cruise travelers are also finding deals this summer. With new ships coming onto the market – and going for a premium – some cruise lines have been offering targeted discounts to fill older inventory for remaining cabins.  

Best/Worst Times to Drive and Peak Congestion by Metro 

INRIX , a provider of transportation data and insights, says the worst times to travel by car before and on July 4 th are between 2pm and 7pm. Drivers should hit the road in the morning, and travelers returning on Monday, July 8 th should avoid rush hour traffic in the morning and afternoon.  

“Drivers in large metro areas can expect the worst traffic delays on Wednesday, July 3 rd , as they leave town, and Sunday, July 7th, as they return,” said Bob Pishue, transportation analyst at INRIX. “R oad trips over the holiday week could take up to 67% longer than normal. Travelers should monitor 511 services, local news stations, and traffic apps for up-to-the-minute road conditions.”  

Please note that the times listed below are for the time zone in which the metro is located.   

For example, Atlanta routes = ET and Los Angeles routes = PT.  

Source: INRIX  

  Top Destinations 

This July 4 th week, travelers are cooling off in the Pacific Northwest and Alaska – and by the ocean! Seattle, Vancouver, and Anchorage are top destinations because of the popularity of Alaska cruises this time of year. Beaches in South Florida, Honolulu, Punta Cana, and Barcelona are in high demand. Historical sites in European cities like London, Rome, Dublin, Paris, and Athens are also popular. The top 10 domestic and international destinations below are based on AAA booking data.  

Family Road Trip Checklist    

With road trips expected to set a new record this July 4 th week, AAA teamed up with Chicco to share safety tips for families with young children.  

• Check car seat fit. Before you hit the road, check your child’s weight and height to ensure they’re in the right seat and mode of use – especially when it comes to transitioning from rear to forward-facing. Children should remain rear-facing as long as possible for better protection of their head, neck, and spine in the event of a crash. If you are unsure which car seat is best for your child, Chicco offers a car seat comparison guide.    
• Double check car seat installation. Even if your car seat is already installed in the car, it’s worth checking everything is safe and secure. An easy at-home way to do this is with the “inch test.” Simply grab the seat at the car seat belt path and pull side to side and front to back. If it moves more than one inch in any direction, uninstall and start over until a secure fit is achieved. For any questions, utilize the car seat manual, QR codes, or online resources like those offered by Chicco.    
• Secure loose items in the car. Take time to organize and clean up your car before hitting the road. Storage organizers that secure to the back of the driver and passenger seats are simple solutions to make sure everything has a spot, especially loose items that can become projectiles in case of a sudden stop.  
• Be prepared for the unexpected. Pack an emergency kit with first-aid supplies, water, snacks, blankets, jumper cables, and flares. Make sure your phone is fully charged – and keep a charger in the car – to call AAA or request roadside assistance digitally if your battery dies, you lock yourself out, or you need a tow.   
• Map your route. Families with young children should plan for frequent and longer stops along the way. Map out your route ahead of time with AAA TripTik and browse hotels, restaurants, and other activities along the way on AAA Trip Canvas.  
• Bring entertainment. Make sure to place toys and books within reach to keep children entertained. If your kids use tablets or other electronics, make sure the devices are fully charged and pre-downloaded before leaving home. Another fun way to get the whole family excited for the road trip is to create a family playlist of everyone’s favorite songs!   

Holiday Forecast Methodology   

Travel Forecast    

In cooperation with AAA, S&P Global Market Intelligence (SPGMI) developed a unique methodology to forecast actual domestic travel volumes. The economic variables used to forecast travel for the current holiday are leveraged from SPGMI’s proprietary databases. These data include macroeconomic drivers such as employment, output, household net worth, asset prices, including stock indices, interest rates, housing market indicators, and variables related to travel and tourism, including gasoline prices, airline travel, and hotel stays. AAA and SPGMI have quantified holiday travel volumes going back to 2000.   

Historical travel volume estimates come from DK SHIFFLET’s TRAVEL PERFORMANCE/Monitor SM . The PERFORMANCE/Monitor SM is a comprehensive study measuring the travel behavior of U.S. residents. DK SHIFFLET contacts over 50,000 U.S. households each month to obtain detailed travel data, resulting in the unique ability to estimate visitor volume and spending, identify trends, and forecast U.S. travel behavior, all after the trips have been taken.  

The travel forecast is reported in person-trips. In particular, AAA and SPGMI forecast the total U.S. holiday travel volume and expected mode of transportation. The travel forecast presented in this report was prepared the week of May 27, 2024.   

Because AAA forecasts focus on domestic leisure travel only, comparisons to TSA passenger screening numbers should not be made. TSA data includes all passengers traveling on both domestic and international routes. Additionally, TSA screens passengers each time they enter secured areas of the airport, therefore each one-way trip is counted as a passenger tally. AAA focuses on person-trips, which include the full round-trip travel itinerary. As a result, direct comparisons of AAA forecast volumes and daily TSA screenings represent different factors.  

*Independence Day Holiday Travel Period   

For this forecast, the Independence Day holiday travel period is defined as the nine-day period from Saturday, June 29 to Sunday, July 7. Historically, the Independence Day holiday period included only one weekend. This is the first year the Independence Day holiday travel period is a longer timeframe with two weekends included.  

About AAA    

Started in 1902 by automotive enthusiasts who wanted to chart a path for better roads in America and advocate for safe mobility, AAA has transformed into one of North America’s largest membership organizations. Today, AAA provides roadside assistance, travel, discounts, financial and insurance services to enhance the life journey of 64 million members across North America, including 57 million in the United States. To learn more about all AAA has to offer or to become a member, visit AAA.com.   

About S&P Global   S&P Global (NYSE: SPGI) provides essential intelligence. We enable governments, businesses, and individuals with the right data, expertise, and connected technology so that they can make decisions with conviction. From helping our customers assess new investments to guiding them through ESG and energy transition across supply chains, we unlock new opportunities, solve challenges, and accelerate progress for the world. We are widely sought after by many of the world’s leading organizations to provide credit ratings, benchmarks, analytics, and workflow solutions in the global capital, commodity, and automotive markets. With every one of our offerings, we help the world’s leading organizations plan for tomorrow today. For more information, visit  www.spglobal.com .   

About DKSA    

DK SHIFFLET boasts the industry’s most complete database on U.S. resident travel both in the U.S. and worldwide. Data is collected monthly from a U.S. representative sample, adding over 60,000 traveling households annually, and is used daily by leading travel organizations and their strategic planning groups. DK SHIFFLET is an MMGY Global company.   

About INRIX     

Founded in 2004, INRIX pioneered intelligent mobility solutions by transforming big data from connected devices and vehicles into mobility insights. This revolutionary approach enabled INRIX to become one of the leading providers of data and analytics into how people move. By empowering cities, businesses, and people with valuable insights, INRIX is helping to make the world smarter, safer, and greener. With partners and solutions spanning across the entire mobility ecosystem, INRIX is uniquely positioned at the intersection of technology and transportation – whether it’s keeping road users safe, improving traffic signal timing to reduce delay and greenhouse gasses, optimizing last mile delivery, or helping uncover market insights. Learn more at INRIX.com.   

Effective Communication Strategies for Association Management Success

Effective communication is the backbone of any successful association. Having served association management customers for over three decades, we’ve seen firsthand how crucial it is to maintain clear and consistent messaging.  

From newsletters updating members on industry trends and event invitations for upcoming conferences and webinars to personalized emails recognizing member achievements and person-to-person emails addressing specific inquiries—each piece of communication plays a vital role. Furthermore, regular updates, strategic discussions with board members, and volunteer coordination ensure everyone stays aligned and engaged in crucial messaging.  

In our increasingly information-saturated world, it’s more important than ever for your messages to reach and resonate with your diverse audience.  

This article explores communication strategies that can drive success for your association, focusing on different audience types. Whether you’re engaging with long-time members, new recruits, or dedicated volunteers, a tailored approach to your communications can make all the difference.  

Understanding Your Audience

Associations serve various stakeholders, each with unique needs and preferences. By tailoring your communication strategies to these groups, you can enhance engagement, foster loyalty, and drive your association’s goals.  

Members are the lifeblood of any association. They join for various reasons, including networking, professional development, and staying updated on industry trends.  

Consistent Updates

Regular newsletters, emails, and social media updates keep members informed and engaged. Providing valuable content that addresses their needs and interests can significantly enhance member satisfaction.  

Personalized Communication

Personalization can significantly affect member engagement. Use data analytics to tailor your communications based on members’ preferences, behaviors, and past interactions.  

“Effective communication with your association membership is about understanding their needs and delivering relevant, timely information that adds value to their professional lives.” — Blaire McIsaac , Association Manager at Etherio  

A study by Grammarly and the Harris Poll revealed that poor communication costs US businesses up to $1.2 trillion (about $3,700 per person in the US) annually. Source  

Integrating strong communication practices can significantly enhance organizational performance, leading to higher productivity, better morale, and a more robust bottom line. Effective communication with teams and stakeholders is pivotal for organizational success, with nearly all business leaders* acknowledging its importance. Companies that excel in communication are more likely to see increased revenue growth and improved employee retention.  

*93% of business leaders  

Potential Members

Recruiting new members is essential for growth. Your communication strategy should highlight the benefits of joining your association and address the specific pain points of your target audience.  

Highlighting Benefits

Showcase the benefits of membership through case studies, testimonials, and success stories. Use your website, social media, and targeted campaigns to reach potential members.  

Clear Calls to Action

Ensure your communications include clear, compelling calls to action. Whether attending an event, signing up for a newsletter, or joining your association, make it easy for potential members to take the next step.  

Sponsors and Partners

Sponsors and partners play a crucial role in supporting your association’s activities. Effective communication with these stakeholders is critical to building solid and lasting relationships.  

Transparent Communication

Be transparent about your association’s goals, needs, and how sponsors and partners can contribute. Regularly update them on the impact of their support and any upcoming collaboration opportunities.  

Value Proposition

Clearly articulate the value proposition for sponsors and partners. Highlight the exposure and benefits they will receive by supporting your association.  

Volunteers  

Volunteers are often the unsung heroes of associations. Effective communication with this group is essential to ensure they feel valued and motivated.  

Regular Recognition

Recognize and thank volunteers regularly for their contributions. You can show gratitude through newsletters, social media shoutouts, and special events.  

Clear Instructions

Provide clear instructions and expectations for volunteers. Ensure they have all the information they need to perform their roles effectively.  

Event Attendees

Events are a cornerstone of many associations. Effective communication before, during, and after events can enhance the attendee experience and drive engagement.  

Pre-Event Communication

Keep attendees informed about event details, including schedules, speakers, and any changes. Use multiple channels like email, social media, and event apps to ensure your messages reach everyone.  

Onsite Communication

Use digital signage, push notifications, and live updates during the event to keep attendees informed and engaged.  

Post-Event Follow-Up

Follow up with attendees after the event to gather feedback, share highlights, and promote future events.  

Board Members

Board members play a strategic role in your association. Effective communication with this group ensures they are well-informed and aligned with the association’s goals.  

Regular Meetings

Schedule regular meetings to update board members on key initiatives, challenges, and opportunities. Provide comprehensive reports and data to support decision-making.  

Open Dialogue

Encourage open dialogue and feedback from board members. Their insights can be invaluable in shaping the association’s direction.  

The Key to Association Management Success

Effective communication strategies are crucial for the success of any association. By understanding the unique needs of your various audiences and tailoring your communication efforts accordingly, you can enhance engagement, build strong relationships, and drive your association’s goals.  

Effective communication is not just about sending messages but ensuring they are received, understood, and acted upon. By prioritizing communication, your association can thrive in today’s dynamic environment.

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Travelers Should Be Extra Mindful of Pickpockets in These European Countries, Study Shows

The study also mentioned specific attractions where pickpockets may be most prevalent.

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Nothing can ruin a vacation like being the victim of a pickpocketing scam. Throughout Europe specifically, a new study shows that there are some destinations where theft is more prevalent than others.

Travelers to Italy should be on their guard since the country ranked the highest for pickpockets among all popular European hotspots, according to a recent study by UK insurance price comparison platform Quotezone.co.uk . To determine the ranking, the study looked at pickpocketing mentions in visitor reviews at popular attractions like the Colosseum, Trevi Fountain, and Pantheon in Rome, the Duomo di Milano in Milan, and the Gallerie Degli Uffizi in Florence.

Overall, Italy had 478 pickpocketing mentions for every million British visitors, the highest of countries studied in Europe, according to the report.

“Theft can happen anywhere and tourist hotspots are convenient places for criminals to target holidaymakers’ wallets and purses whilst they are busy taking in the sites,” Greg Wilson, the founder and CEO of Quotezone.co.uk, said in a statement. “It is essential always to remain vigilant, leave valuables, like expensive [jewelry], in a safe in the hotel and always travel with a secure cross-body bag with zips to secure phones and wallets or even a money belt.”

Travelers heading to France should also be aware of their surroundings since the country ranked second on the list with 251 mentions of being pickpocketed for every million British visitors. That’s especially true for the area around Paris’ most iconic structure, the Eiffel Tower, which the study found was the worst for pickpockets in the country.

That was followed by Spain — and particularly Barcelona’s Las Ramblas — and Germany, which each saw 111 mentions of being pickpocketed for every million British visitors. 

On the other end of the spectrum was Ireland, which had only seven mentions of pickpocketing for every million British visitors, according to the study. Where you want to watch out for your bag is the Guinness Storehouse in Dublin, a notorious tourist trap but a worthwhile one nonetheless .

If you do get pickpocketed, Wilson encouraged travelers to file a police report to be covered for any possible insurance claims.

It’s also a good idea to make copies of important documents and make sure all your devices are password-protected.

And remember: you’re not alone. Even the most seasoned travelers can fall victim to pickpockets, just like Rick Steves did when he wasn't wearing his money belt on the Paris Metro a few years ago.

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New grant aids MSU’s International Institute in issuing student passports, expanding study abroad experiences

Contact: Harriet Laird

STARKVILLE, Miss.—Mississippi State continues to open more pathways for study abroad as a recent recipient of an international grant giving students an opportunity for their first passport and overseas travel.

MSU’s International Institute will provide up to 25 students—whose circumstances previously hindered experience with study abroad—with advising and support for education in other countries through the American Passport Project. The initiative is part of the Institute of International Education headquartered in New York City.

“We are pleased the Institute of International Education is supporting the application of 25 MSU students for their first passport,” said Dan Reynolds, associate vice president for international programs and executive director of the MSU International Institute. “Securing a passport is one of the first hurdles in fulfilling the necessary steps of participating in a study abroad program which may transform the way students see and understand the world in which they live and work.”

The program prioritizes students early in their higher education experience to allow them ample time to go through the passport application and study abroad planning process, while also removing any financial barriers. It aligns seamlessly with MSU’s strategic plan’s call-to-action to “serve the whole student” through expansion of experiential, or hands-on, learning opportunities.

The not-for-profit IIE works with governments, policymakers, educators and employers to prepare students and professionals for the global workforce and equip them to solve complex challenges facing the world. IIE’s Passport Project has supported 176 higher education institutions in 41 states since its inception in 2021 and aims to grant 10,000 passports to U.S. students by the decade’s end.

For more information on MSU’s International Institute and study abroad, visit www.international.msstate.edu .

Mississippi State University is taking care of what matters. Learn more at  www.msstate.edu .

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Traveling With Us

Discovery at its best.

Every journey has the potential to be a transformative experience. Travel enriches us. It helps us learn about the world, humanity, and ourselves. When you're looking to add top-notch educational opportunities, exclusive access to unique locales, and the chance to connect with your fellow alums to your journey, look no further than Travel/Study.

Next-Level Learning

Ancient civilizations. Emerging democracies. Dynamic systems at play in the natural world. You can see it all firsthand and delve into the essence of your destination with Stanford scholars. Explore the world with Travel/Study and soak up the education that comes with the adventure!

Above-and-Beyond Experiences

When you travel with us you enjoy:

The company of renowned Stanford faculty and scholars

Savvy, articulate guides

Memorable encounters with diverse cultures and peoples

The opportunity to meet with individuals who are leading change in the places we visit

Hard-to-get access to exclusive events and regional experts

The full attention of an experienced Stanford tour manager

Packing lists and reading lists to help you prepare

Top-star hotels and small luxury sailing ships

Minimal medical, accident, and evacuation coverage

All the extras, such as entrance fees, on-tour flights, ground transportation, most meals, airport transfers, baggage handling...and all of your gratuities!

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