Why the world cannot afford the rich

R. G. Wilkinson & K. E. Pickett

Nature.com

Originally published 12 March 24

Here is an excerpt:

Inequality also increases consumerism. Perceived links between wealth and self-worth drive people to buy goods associated with high social status and thus enhance how they appear to others — as US economist Thorstein Veblen set out more than a century ago in his book The Theory of the Leisure Class (1899). Studies show that people who live in more-unequal societies spend more on status goods14.

Our work has shown that the amount spent on advertising as a proportion of gross domestic product is higher in countries with greater inequality. The well-publicized lifestyles of the rich promote standards and ways of living that others seek to emulate, triggering cascades of expenditure for holiday homes, swimming pools, travel, clothes and expensive cars.

Oxfam reports that, on average, each of the richest 1% of people in the world produces 100 times the emissions of the average person in the poorest half of the world’s population15. That is the scale of the injustice. As poorer countries raise their material standards, the rich will have to lower theirs.

Inequality also makes it harder to implement environmental policies. Changes are resisted if people feel that the burden is not being shared fairly. For example, in 2018, the gilets jaunes (yellow vests) protests erupted across France in response to President Emmanuel Macron’s attempt to implement an ‘eco-tax’ on fuel by adding a few percentage points to pump prices. The proposed tax was seen widely as unfair — particularly for the rural poor, for whom diesel and petrol are necessities. By 2019, the government had dropped the idea. Similarly, Brazilian truck drivers protested against rises in fuel tax in 2018, disrupting roads and supply chains.

Do unequal societies perform worse when it comes to the environment, then? Yes. For rich, developed countries for which data were available, we found a strong correlation between levels of equality and a score on an index we created of performance in five environmental areas: air pollution; recycling of waste materials; the carbon emissions of the rich; progress towards the United Nations Sustainable Development Goals; and international cooperation (UN treaties ratified and avoidance of unilateral coercive measures).

The article is here.

The article argues that rising economic inequality is a major threat to the world's well-being. Here are the key points:

The rich are capturing a growing share of wealth: The richest 1% are accumulating wealth much faster than everyone else, and their lifestyles contribute heavily to environmental damage.

Inequality harms everyone: High levels of inequality are linked to social problems like crime, mental health issues, and lower social mobility. It also makes it harder to address environmental challenges because people resist policies seen as unfair.

More equal societies perform better: Countries with a more even distribution of wealth tend to have better social and health outcomes, as well as stronger environmental performance.

Policymakers need to take action: The article proposes progressive taxation, closing tax havens, and encouraging more equitable business practices like employee ownership.

The overall message is that reducing inequality is essential for solving a range of environmental, social, and health problems.

Canada Postpones Plan to Allow Euthanasia for Mentally Ill

Craig McCulloh

Voice of America News

Originally posted 8 Feb 24

The Canadian government is delaying access to medically assisted death for people with mental illness.

Those suffering from mental illness were supposed to be able to access Medical Assistance in Dying — also known as MAID — starting March 17. The recent announcement by the government of Canadian Prime Minister Justin Trudeau was the second delay after original legislation authorizing the practice passed in 2021.

The delay came in response to a recommendation by a majority of the members of a committee made up of senators and members of Parliament.

One of the most high-profile proponents of MAID is British Columbia-based lawyer Chris Considine. In the mid-1990s, he represented Sue Rodriguez, who was dying from amyotrophic lateral sclerosis, commonly known as ALS.

Their bid for approval of a medically assisted death was rejected at the time by the Supreme Court of Canada. But a law passed in 2016 legalized euthanasia for individuals with terminal conditions. From then until 2022, more than 45,000 people chose to die.

The info is here.

Summary:

Canada originally planned to expand its Medical Assistance in Dying (MAiD) program to include individuals with mental illnesses in March 2024.

• This plan has been postponed until 2027 due to concerns about the healthcare system's readiness and potential ethical issues.
• The original legislation passed in 2021, but concerns about safeguards and mental health support led to delays.
• This issue is complex and ethically charged, with advocates arguing for individual autonomy and opponents raising concerns about coercion and vulnerability.

I would be concerned about the following issues:

• Vulnerability: Mental illness can impair judgement, raising concerns about informed consent and potential coercion.
• Safeguards: Concerns exist about insufficient safeguards to prevent abuse or exploitation.
• Mental health access: Limited access to adequate mental health treatment could contribute to undue pressure towards MAiD.
• Social inequalities: Concerns exist about disproportionate access to MAiD based on socioeconomic background.

Citing Harms, Momentum Grows to Remove Race From Clinical Algorithms

B. Kuehn

JAMA

Published Online: January 17, 2024.

doi:10.1001/jama.2023.25530

Here is an excerpt:

The roots of the false idea that race is a biological construct can be traced to efforts to draw distinctions between Black and White people to justify slavery, the CMSS report notes. For example, the third US president, Thomas Jefferson, claimed that Black people had less kidney output, more heat tolerance, and poorer lung function than White individuals. Louisiana physician Samuel Cartwright, MD, subsequently rationalized hard labor as a way for slaves to fortify their lungs. Over time, the report explains, the medical literature echoed some of those ideas, which have been used in ways that cause harm.

“It is mind-blowing in some ways how deeply embedded in history some of this misinformation is,” Burstin said.

Renewed recognition of these harmful legacies and growing evidence of the potential harm caused by structural racism, bias, and discrimination in medicine have led to reconsideration of the use of race in clinical algorithms. The reckoning with racial injustice sparked by the May 2020 murder of George Floyd helped accelerate this work. A few weeks after Floyd’s death, an editorial in the New England Journal of Medicine recommended reconsidering race in 13 clinical algorithms, echoing a growing chorus of medical students and physicians arguing for change.

Congress also got involved. As a Robert Wood Johnson Foundation Health Policy Fellow, Michelle Morse, MD, MPH, raised concerns about the use of race in clinical algorithms to US Rep Richard Neal (D, MA), then chairman of the House Ways and Means Committee. Neal in September 2020 sent letters to several medical societies asking them to assess racial bias and a year later he and his colleagues issued a report on the misuse of race in clinical decision-making tools.

“We need to have more humility in medicine about the ways in which our history as a discipline has actually held back health equity and racial justice,” Morse said in an interview. “The issue of racism and clinical algorithms is one really tangible example of that.”

The info is here.

My summary: There's increasing worry that using race in clinical algorithms can be harmful and perpetuate racial disparities in healthcare. This concern stems from a recognition of the historical harms of racism in medicine and growing evidence of bias in algorithms.

A review commissioned by the Agency for Healthcare Research and Quality (AHRQ) found that using race in algorithms can exacerbate health disparities and reinforce the false idea that race is a biological factor.

Several medical organizations and experts have called for reevaluating the use of race in clinical algorithms. Some argue that race should be removed altogether, while others advocate for using it only in specific cases where it can be clearly shown to improve outcomes without causing harm.

Human bias in algorithm design

Morewedge, C.K., Mullainathan, S., Naushan, H.F. et al.

Nat Hum Behav 7, 1822–1824 (2023).

https://doi.org/10.1038/s41562-023-01724-4

Here is how the article starts:

Algorithms are designed to learn user preferences by observing user behaviour. This causes algorithms to fail to reflect user preferences when psychological biases affect user decision making. For algorithms to enhance social welfare, algorithm design needs to be psychologically informed.Many people believe that algorithms are failing to live up to their prom-ise to reflect user preferences and improve social welfare. The problem is not technological. Modern algorithms are sophisticated and accurate. Training algorithms on unrepresentative samples contributes to the problem, but failures happen even when algorithms are trained on the population. Nor is the problem caused only by the profit motive. For-profit firms design algorithms at a cost to users, but even non-profit organizations and governments fall short.

All algorithms are built on a psychological model of what the user is doing. The fundamental constraint on this model is the narrowness of the measurable variables for algorithms to predict. We suggest that algorithms fail to reflect user preferences and enhance their welfare because algorithms rely on revealed preferences to make predictions. Designers build algorithms with the erroneous assumption that user behaviour (revealed preferences) tells us (1) what users rationally prefer (normative preferences) and (2) what will enhance user welfare. Reliance on this 95-year-old economic model, rather than the more realistic assumption that users exhibit bounded rationality, leads designers to train algorithms on user behaviour. Revealed preferences can identify unknown preferences, but revealed preferences are an incomplete — and at times misleading — measure of the normative preferences and values of users. It is ironic that modern algorithms are built on an outmoded and indefensible commitment to revealed preferences.

The commentary is here.

Here is my summary.

Human biases can be reflected in algorithms, leading to unintended discriminatory outcomes. The authors argue that algorithms are not simply objective tools, but rather embody the values and assumptions of their creators. They highlight the importance of considering psychological factors when designing algorithms, as human behavior is often influenced by biases. To address this issue, the authors propose a framework for developing psychologically informed algorithms that can better capture user preferences and enhance social welfare. They emphasize the need for a more holistic approach to algorithm design that goes beyond technical considerations and takes into account the human element.

Medical Debt Is Disappearing From Americans’ Credit Reports, Lifting Scores

Noam Levey

KFF Health News

Originally published 2 Nove 23

The share of American consumers with medical debt on their credit reports has declined dramatically over the past year as major credit rating agencies removed small unpaid bills and debts that were less than a year old, according to a new analysis from the nonprofit Urban Institute.

At the same time, millions of Americans have seen their credit scores improve, making it easier for many to get a job, rent an apartment, or get a car.

“This is a very significant change,” said Breno Braga, an economist at the Urban Institute and a co-author of the study. “It affects a lot of people.”

For years, medical debt has depressed credit scores, undermining the financial security of tens of millions of patients and their families.

Under mounting pressure from patient advocates and government regulators, the three major credit agencies over the last two years have taken a series of steps to remove some medical debts from credit reports, including unpaid medical bills under $500.

The changes appear to be having an impact. As of August, just 5% of adults with a credit report had a medical debt on their report, down from almost 14% two years earlier.

Urban Institute researchers also found that Americans with a medical debt on their credit report in August 2022 saw their VantageScore credit score improve over the next year from an average of 585 to an average of 615.

The info is here.

Here is my summary:

The article discusses a study conducted by the Urban Institute, focusing on the impact of removing medical debt from credit reports. The study reveals that eliminating medical debt from credit reports can significantly improve individuals' credit scores and financial well-being. The research found that once medical debts were removed, more than two-thirds of affected individuals experienced an increase in their credit scores, with an average rise of 16 points. This is particularly crucial as medical debt is often incurred unexpectedly, and its presence on credit reports can lead to long-lasting financial consequences for individuals, affecting their ability to secure loans or access favorable interest rates.

Furthermore, the study suggests that removing medical debt from credit reports can contribute to reducing racial and ethnic disparities in credit scores. It highlights that individuals from communities of color are disproportionately affected by medical debt and its consequences on creditworthiness. By addressing this issue, there is an opportunity to promote greater financial equity and inclusivity. The findings underscore the potential benefits of policy interventions or industry practices aimed at mitigating the adverse impact of medical debt on individuals' credit histories, thereby fostering a more equitable financial landscape.

Ethics of psychotherapy rationing: A review of ethical and regulatory documents in Canadian professional psychology

Gower, H. K., & Gaine, G. S. (2023).

Canadian Psychology / Psychologie canadienne. 

Advance online publication.

https://doi.org/10.1037/cap0000372

Abstract

Ethical and regulatory documents in Canadian professional psychology were reviewed for principles and standards related to the rationing of psychotherapy. Despite Canada’s high per capita health care expenses, mental health in Canada receives relatively low funding. Further, surveys indicated that Canadians have unmet needs for psychotherapy. Effective and ethical rationing of psychological treatment is a necessity, yet the topic of rationing in psychology has received scant attention. The present study involved a qualitative review of codes of ethics, codes of conduct, and standards of practice documents for their inclusion of rationing principles and standards. Findings highlight the strengths and shortcomings of these documents related to guiding psychotherapy rationing. The discussion offers recommendations for revising these ethical and regulatory documents to promote more equitable and cost-effective use of limited psychotherapy resources in Canada.

Impact Statement

Canadian professional psychology regulatory documents contain limited reference to rationing imperatives, despite scarce psychotherapy resources. While the foundation of distributive justice is in place, rationing-specific principles, standards, and practices are required to foster the fair and equitable distribution of psychotherapy by Canadian psychologists.

From the recommendations:

Recommendations for Canadian Psychology Regulatory Documents

1. Explicitly widen psychologists’ scope of concern to include not only current clients but also waiting clients and those who need treatment but face access barriers.
2. Acknowledge the scarcity of health care resources (in public and private settings) and the high demand for psychology services (e.g., psychotherapy) and admonish inefficient and cost-ineffective use.
3. Draw an explicit connection between the general principle of distributive justice and the specific practices related to rationing of psychology resources, including, especially, mitigation of biases likely to weaken ethical decision making.
4. Encourage the use of outcome monitoring measures to aid relative utility calculations for triage and termination decisions and to ensure efficiency and distributive justice.
5. Recommend advocacy by psychologists to address barriers to accessing needed services (e.g., psychotherapy), including promoting the cost effectiveness of psychotherapy as well as highlighting systemic barriers related to presenting problem, disability, ethnicity, race, gender, sexuality, or income.

Everything you need to know about artificial wombs

Cassandra Willyard

MIT Technology Review

Originally posted 29 SEPT 23

Here is an excerpt:

What is an artificial womb?

An artificial womb is an experimental medical device intended to provide a womblike environment for extremely premature infants. In most of the technologies, the infant would float in a clear “biobag,” surrounded by fluid. The idea is that preemies could spend a few weeks continuing to develop in this device after birth, so that “when they’re transitioned from the device, they’re more capable of surviving and having fewer complications with conventional treatment,” says George Mychaliska, a pediatric surgeon at the University of Michigan.

One of the main limiting factors for survival in extremely premature babies is lung development. Rather than breathing air, babies in an artificial womb would have their lungs filled with lab-made amniotic fluid, that mimics the amniotic fluid they would have hadjust like they would in utero. Neonatologists would insert tubes into blood vessels in the umbilical cord so that the infant’s blood could cycle through an artificial lung to pick up oxygen. 

The device closest to being ready to be tested in humans, called the EXTrauterine Environment for Newborn Development, or EXTEND, encases the baby in a container filled with lab-made amniotic fluid. It was invented by Alan Flake and Marcus Davey at the Children’s Hospital of Philadelphia and is being developed by Vitara Biomedical.

The info is here.

Here is my take:

Artificial wombs are experimental medical devices that aim to provide a womb-like environment for extremely premature infants. The technology is still in its early stages of development, but it has the potential to save the lives of many babies who would otherwise not survive.

Overall, artificial wombs are a promising new technology with the potential to revolutionize the care of premature infants. However, more research is needed to fully understand the risks and benefits of the technology before it can be widely used.

Here are some additional ethical concerns that have been raised about artificial wombs:

• The potential for artificial wombs to be used to create designer babies or to prolong the lives of fetuses with severe disabilities.
• The potential for artificial wombs to be used to exploit or traffick babies.
• The potential for artificial wombs to exacerbate existing social and economic inequalities.

It is important to have a public conversation about these ethical concerns before artificial wombs become widely available. We need to develop clear guidelines for how the technology should be used and ensure that it is used in a way that benefits all of society.

Tackling healthcare AI's bias, regulatory and inventorship challenges

Bill Siwicki

Healthcare IT News

Originally posted 29 August 23

While AI adoption is increasing in healthcare, there are privacy and content risks that come with technology advancements.

Healthcare organizations, according to Dr. Terri Shieh-Newton, an immunologist and a member at global law firm Mintz, must have an approach to AI that best positions themselves for growth, including managing:

• Biases introduced by AI. Provider organizations must be mindful of how machine learning is integrating racial diversity, gender and genetics into practice to support the best outcome for patients.

• Inventorship claims on intellectual property. Identifying ownership of IP as AI begins to develop solutions in a faster, smarter way compared to humans.

Healthcare IT News sat down with Shieh-Newton to discuss these issues, as well as the regulatory landscape’s response to data and how that impacts AI.

Q. Please describe the generative AI challenge with biases introduced from AI itself. How is machine learning integrating racial diversity, gender and genetics into practice?

A. Generative AI is a type of machine learning that can create new content based on the training of existing data. But what happens when that training set comes from data that has inherent bias? Biases can appear in many forms within AI, starting from the training set of data.

Take, as an example, a training set of patient samples already biased if the samples are collected from a non-diverse population. If this training set is used for discovering a new drug, then the outcome of the generative AI model can be a drug that works only in a subset of a population – or have just a partial functionality.

Some traits of novel drugs are better binding to its target and lower toxicity. If the training set excludes a population of patients of a certain gender or race (and the genetic differences that are inherent therein), then the outcome of proposed drug compounds is not as robust as when the training sets include a diversity of data.

This leads into questions of ethics and policies, where the most marginalized population of patients who need the most help could be the group that is excluded from the solution because they were not included in the underlying data used by the generative AI model to discover that new drug.

One can address this issue with more deliberate curation of the training databases. For example, is the patient population inclusive of many types of racial backgrounds? Gender? Age ranges?

By making sure there is a reasonable representation of gender, race and genetics included in the initial training set, generative AI models can accelerate drug discovery, for example, in a way that benefits most of the population.

The info is here. 

Here is my take:

 One of the biggest challenges is bias. AI systems are trained on data, and if that data is biased, the AI system will be biased as well. This can have serious consequences in healthcare, where biased AI systems could lead to patients receiving different levels of care or being denied care altogether.

Another challenge is regulation. Healthcare is a highly regulated industry, and AI systems need to comply with a variety of laws and regulations. This can be complex and time-consuming, and it can be difficult for healthcare organizations to keep up with the latest changes.

Finally, the article discusses the challenges of inventorship. As AI systems become more sophisticated, it can be difficult to determine who is the inventor of a new AI-powered healthcare solution. This can lead to disputes and delays in bringing new products and services to market.

The article concludes by offering some suggestions for how to address these challenges:

• To reduce bias, healthcare organizations need to be mindful of the data they are using to train their AI systems. They should also audit their AI systems regularly to identify and address any bias.
• To comply with regulations, healthcare organizations need to work with experts to ensure that their AI systems meet all applicable requirements.
• To resolve inventorship disputes, healthcare organizations should develop clear policies and procedures for allocating intellectual property rights.

By addressing these challenges, healthcare organizations can ensure that AI is deployed in a way that is safe, effective, and ethical.

Additional thoughts

In addition to the challenges discussed in the article, there are a number of other factors that need to be considered when deploying AI in healthcare. For example, it is important to ensure that AI systems are transparent and accountable. This means that healthcare organizations should be able to explain how their AI systems work and why they make the decisions they do.

It is also important to ensure that AI systems are fair and equitable. This means that they should treat all patients equally, regardless of their race, ethnicity, gender, income, or other factors.

Finally, it is important to ensure that AI systems are used in a way that respects patient privacy and confidentiality. This means that healthcare organizations should have clear policies in place for the collection, use, and storage of patient data.

By carefully considering all of these factors, healthcare organizations can ensure that AI is used to improve patient care and outcomes in a responsible and ethical way.

Yale University settles lawsuit alleging it pressured students with mental health issues to withdraw

Associated Press

Originally posted 25 Aug 23

Yale University and a student group announced Friday that they've reached a settlement in a federal lawsuit that accused the Ivy League school of discriminating against students with mental health disabilities, including pressuring them to withdraw.

Under the agreement, Yale will modify its policies regarding medical leaves of absence, including streamlining the reinstatement process for students who return to campus. The student group, which also represents alumni, had argued the process was onerous, discouraging students for decades from taking medical leave when they needed it most.

The settlement is a “watershed moment” for the university and mental health patients, said 2019 graduate Rishi Mirchandani, a co-founder of Elis for Rachael, the group that sued. It was formed to help students with mental health issues in honor of a Yale student who took her own life.

“This historic settlement affirms that students with mental health needs truly belong," Mirchandani said.

A joint statement from Elis for Rachael and Yale, released on Friday, confirmed the agreement "to resolve a lawsuit filed last November in federal district court related to policies and practices impacting students with mental health disabilities.”

Under the agreement, Yale will allow students to study part-time if they have urgent medical needs. Elis for Rachael said it marks the first time the university has offered such an option. Students granted the accommodation at the beginning of a new term will receive a 50% reduction in tuition.

“Although Yale describes the circumstances for this accommodation as ‘rare,’ this change still represents a consequential departure from the traditional all-or-nothing attitude towards participation in academic life at Yale,” the group said in a statement.

The dean of Yale College, Pericles Lewis, said he was “pleased with today’s outcome.”

The info is here.

The potential good news: The lawsuit against Yale is a step towards ensuring that students with mental health disabilities have the same opportunities as other students. It is also a reminder that colleges and universities have a responsibility to create a supportive environment for all students, regardless of their mental health status.

Fairytales have always reflected the morals of the age. It’s not a sin to rewrite them

Martha Gill

The Guardian

Originally posted 4 June 23

Here are two excerpts:

General outrage greeted “woke” updates to Roald Dahl books this year, and still periodically erupts over Disney remakes, most recently a forthcoming film with a Latina actress as Snow White, and a new Peter Pan & Wendy with “lost girls”. The argument is that too much fashionable refurbishment tends to ruin a magical kingdom, and that cult classics could do with the sort of Grade I listing applied to heritage buildings. If you want to tell new stories, fine – but why not start from scratch?

But this point of view misses something, which is that updating classics is itself an ancient part of literary culture; in fact, it is a tradition, part of our heritage too. While the larger portion of the literary canon is carefully preserved, a slice of it has always been more flexible, to be retold and reshaped as times change.

Fairytales fit within this latter custom: they have been updated, periodically, for many hundreds of years. Cult figures such as Dracula, Frankenstein and Sherlock Holmes fit there too, as do superheroes: each generation, you might say, gets the heroes it deserves. And so does Bond. Modernity is both a villain and a hero within the Bond franchise: the dramatic tension between James – a young cosmopolitan “dinosaur” – and the passing of time has always been part of the fun.

This tradition has a richness to it: it is a historical record of sorts. Look at the progress of the fairy story through the ages and you get a twisty tale of dubious progress, a moral journey through the woods. You could say fairytales have always been politically correct – that is, tweaked to reflect whatever morals a given cohort of parents most wanted to teach their children.

(cut)

The idea that we are pasting over history – censoring important artefacts – is wrongheaded too. It is not as if old films or books have been burned, wiped from the internet or removed from libraries. With today’s propensity for writing things down, common since the 1500s, there is no reason to fear losing the “original” stories.

As for the suggestion that minority groups should make their own stories instead – this is a sly form of exclusion. Ancient universities and gentlemen’s clubs once made similar arguments; why couldn’t exiled individuals simply set up their own versions? It is not so easy. Old stories weave themselves deep into the tapestry of a nation; newer ones will necessarily be confined to the margins.

The info is here.

My take: Updating classic stories can be beneficial and even necessary to promote inclusion, diversity, equity, and fairness. By not updating these stories, we risk perpetuating harmful stereotypes and narratives that reinforce the dominant culture. When we update classic stories, we can create new possibilities for representation and understanding that can help to build a more just and equitable world.  Dominant cultures need to cede power to promote more unity in a multicultural nation.

Your Land Acknowledgment Is Not Enough

Joseph Pierce

hyperallergic.com

Originally posted 12 OCT 22

Here is an excerpt:

Museums that once stole Indigenous bones now celebrate Indigenous Peoples’ Day. Organizations that have never hired an Indigenous person now admit the impact of Indigenous genocide through social media. Land-grant universities scramble to draft statements about their historical ties to fraudulent treaties and pilfered graves. Indeed, these are challenging times for institutions trying to do right by Indigenous peoples.

Some institutions will seek the input of an Indigenous scholar or perhaps a community. They will feel contented and “diverse” because of this input. They want a decolonial to-do list. But what we have are questions: What changes when an institution publishes a land acknowledgment? What material, tangible changes are enacted?

Without action, without structural change, acknowledging stolen land is what Eve Tuck and K. Wayne Yang call a “settler move to innocence.” Institutions are not innocent. Settlers are not innocent.

The problem with land acknowledgments is that they are almost never followed by meaningful action. Acknowledgment without action is an empty gesture, exculpatory and self-serving. What is more, such gestures shift the onus of action back onto Indigenous people, who neither asked for an apology nor have the ability to forgive on behalf of the land that has been stolen and desecrated. It is not my place to forgive on behalf of the land.

A land acknowledgment is not enough.

This is what settler institutions do not understand: Land does not require that you confirm it exists, but that you reciprocate the care it has given you. Land is not asking for acknowledgment. It is asking to be returned to itself. It is asking to be heard and cared for and attended to. It is asking to be free.

Land is not an object, not a thing. Land does not require recognition. It requires care. It requires presence.

Land is a gift, a relative, a body that sustains other bodies. And if the land is our relative, then we cannot simply acknowledge it as land. We must understand what our responsibilities are to the land as our kin. We must engage in a reciprocal relationship with the land. Land is — in its animate multiplicities — an ongoing enactment of reciprocity.

A land acknowledgment is not enough.

The info is here.

Gender-diverse teams produce more novel and higher-impact scientific ideas

Yang, Y., Tian, T. Y., et al. (2022, August 29). 

Proceedings of the National Academy of Sciences, 119(36).

https://doi.org/10.1073/pnas.2200841119

Abstract

Science’s changing demographics raise new questions about research team diversity and research outcomes. We study mixed-gender research teams, examining 6.6 million papers published across the medical sciences since 2000 and establishing several core findings. First, the fraction of publications by mixed-gender teams has grown rapidly, yet mixed-gender teams continue to be underrepresented compared to the expectations of a null model. Second, despite their underrepresentation, the publications of mixed-gender teams are substantially more novel and impactful than the publications of same-gender teams of equivalent size. Third, the greater the gender balance on a team, the better the team scores on these performance measures. Fourth, these patterns generalize across medical subfields. Finally, the novelty and impact advantages seen with mixed-gender teams persist when considering numerous controls and potential related features, including fixed effects for the individual researchers, team structures, and network positioning, suggesting that a team’s gender balance is an underrecognized yet powerful correlate of novel and impactful scientific discoveries.

Significance

Science teams made up of men and women produce papers that are more novel and highly cited than those of all-men or all-women teams. These performance advantages increase the greater the team’s gender balance and appear nearly universal. On average, they hold for small and large teams, the 45 subfields of medicine, and women- or men-led teams and generalize to published papers in all science fields over the last 20 y. Notwithstanding these benefits, gender-diverse teams remain underrepresented in science when compared to what is expected if the teams in the data had been formed without regard to gender. These findings reveal potentially new gender and teamwork synergies that correlate with scientific discoveries and inform diversity, equity, and inclusion (DEI) initiatives.

Discussion

Conducting an analysis of 6.6 million published papers from more than 15,000 different medical journals worldwide, we find that mixed-gender teams—teams combining women and men scientists—produce more novel and more highly cited papers than all-women or all-men teams. Mixed-gender teams publish papers that are up to 7% more novel and 14.6% more likely to be upper-tail papers than papers published by same-gender teams, results that are robust to numerous institutional, team, and individual controls and further generalize by subfield. Finally, in exploring gender in science through the lens of teamwork, the results point to a potentially transformative approach for thinking about and capturing the value of gender diversity in science.

Another key finding of this work is that mixed-gender teams are significantly underrepresented compared to what would be expected by chance. This underrepresentation is all the more striking given the findings that gender-diverse teams produce more novel and high-impact research and suggests that gender-diverse teams may have substantial untapped potential for medical research. Nevertheless, the underrepresentation of gender-diverse teams may reflect research showing that women receive less credit for their successes than do men teammates, which in turn inhibits the formation of gender-diverse teams and women’s success in receiving grants, prizes, and promotions.

The research is here.

Neoliberalism and the Ideological Construction of Equity Beliefs

Goudarzi, S., Badaan, V., & Knowles, E. D. (2022). 

Perspectives on Psychological Science. 

https://doi.org/10.1177/17456916211053311

Abstract

Researchers across disciplines, including psychology, have sought to understand how people evaluate the fairness of resource distributions. Equity, defined as proportionality of rewards to merit, has dominated the conceptualization of distributive justice in psychology; some scholars have cast it as the primary basis on which distributive decisions are made. The present article acts as a corrective to this disproportionate emphasis on equity. Drawing on findings from different subfields, we argue that people possess a range of beliefs about how valued resources should be allocated—beliefs that vary systematically across developmental stages, relationship types, and societies. By reinvigorating notions of distributive justice put forth by the field’s pioneers, we further argue that prescriptive beliefs concerning resource allocation are ideological formations embedded in socioeconomic and historical contexts. Fairness beliefs at the micro level are thus shaped by those beliefs’ macro-level instantiations. In a novel investigation of this process, we consider neoliberalism, the globally dominant socioeconomic model of the past 40 years. Using data from more than 160 countries, we uncover evidence that neoliberal economic structures shape equity-based distributive beliefs at the individual level. We conclude by advocating an integrative approach to the study of distributive justice that bridges micro- and macro-level analyses.

From the Conclusions section

The extant literature in psychology conceptualizes neoliberalism as a belief system that can vary dispositionally and situationally (Beattie et al., 2019; Bettache & Chiu, 2019). Bay-Cheng and colleagues (2015) developed a Neoliberal Beliefs Inventory that taps into four subfacets of neoliberal thinking: System Inequality, conceptualized as views about the existence and the extent of inequality in society; Competition, which measures the extent to which one views competition as natural and beneficial; Personal Wherewithal, defined as attributing outcomes and success to personal dispositions such as hard work and merit; and Government Interference, which gauges the extent to which state intervention is seen to constrain personal freedom and endanger the meritocratic ideal. In another attempt, Grzanka and colleagues (2020) created the single-facet Anti-Neoliberal Attitudes Scale using items from existing inventories. Moreover, the endorsement of neoliberal policies has been shown to predict other orientations and belief systems that legitimize group and system inequalities (Azevedo et al., 2019). Becker (2021) examined the situational effect of neoliberal beliefs and found that exposure to neoliberal messages that prioritize freedom over justice and equality, individual success over public spirit, and distributions according to ability over need induced antielite sentiment and that this was mediated by feelings of threat, unfairness, and hopelessness.

Although the research described above is informative, from a cultural-psychological perspective, the notion of ideology also includes laws, policies, institutions, and practices embodying prescriptive and descriptive ideas about fair socioeconomic arrangements. Therefore, a sociocultural model of neoliberal ideology entails empirically investigating the dynamics of neoliberal belief systems (at an individual level) with neoliberal laws, institutions, and cultural practices and products, as in the present analysis. To our knowledge, the empirical analysis presented in this article is the first illustration within psychology and related fields of how neoliberal macro structures influence distributive preferences and beliefs.

The research is here.

Health Care in the U.S. Compared to Other High-Income Countries: Worst Outcomes

The Commonwealth Fund

Mirror, Mirror 2021: Reflecting Poorly

Originally posted 4 Aug 21

Introduction

No two nations are alike when it comes to health care. Over time, each country has settled on a unique mix of policies, service delivery systems, and financing models that work within its resource constraints. Even among high-income nations that have the option to spend more on health care, approaches often vary substantially. These choices affect health system performance in terms of access to care, patients’ experiences with health care, and people’s health outcomes. In this report, we compare the health systems of 11 high-income countries as a means to generate insights about the policies and practices that are associated with superior performance.

With the COVID-19 pandemic imposing an unprecedented stress test on the health care and public health systems of all nations, such a comparison is especially germane. Success in controlling and preventing infection and disease has varied greatly. The same is true of countries’ ability to address the challenges that the pandemic has presented to the workforce, operations, and financial stability of the organizations delivering care. And while the comparisons we draw are based on data collected prior to the pandemic or during the earliest months of the crisis, the prepandemic strengths and weaknesses of each country’s preexisting arrangements for health care and public health have undoubtedly been shaping its experience throughout the crisis.

For our assessment of health care system performance in Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States, we used indicators available across five domains:

• Access to care
• Care process
• Administrative efficiency
• Equity
• Health care outcomes

For more information on these performance domains and their component measures, see How We Measured Performance. Most of the data were drawn from surveys examining how members of the public and primary care physicians experience health care in their respective countries. These Commonwealth Fund surveys were conducted by SSRS in collaboration with partner organizations in the 10 other countries. Additional data were drawn from the Organisation for Economic Co-operation and Development (OECD) and the World Health Organization (WHO).

The info is here.

Women Carry An Undue Mental Health Burden. They Shouldn’t Have To

Rawan Hamadeh

Ms. Magazine

Originally posted 12 June 21

Here is an excerpt:

In developing countries, there is a huge gap in the availability and accessibility of specialized mental health services. Rather than visiting mental health specialists, women are more likely to seek mental health support in primary health care settings while accompanying their children or while attending consultations for other health issues. This leads to many mental health conditions going unidentified and therefore not treated. Often, women do not feel fully comfortable disclosing certain psychological and emotional distress because they fear stigmatization, confidentiality breaches or not being taken seriously.

COVID-19 has put the mental well-being of the entire world at risk. More adults are reporting struggles with mental health and substance use and are experiencing more symptoms of anxiety and depressive disorders. The stressors caused by the pandemic have affected the entire population; however, the effect on women and mothers specifically has been greater.

Women, the unsung heroes of the pandemic, face mounting pressures amid this global health crisis. Reports suggest that the long-term repercussions of COVID-19 could undo decades of progress for women and impose considerable additional burdens on them, threatening the difficult journey toward gender equality.

Unemployment, parenting responsibilities, homeschooling or caring for sick relatives are all additional burdens on women’s daily lives during the pandemic. It’s also important that we acknowledge the exponential need for mental health support for health care workers, and particularly health care mothers, who are juggling both their professional duties and their parenting responsibilities. They are the heroes on the front lines of the fight against the virus, and it’s crucial to prioritize their physical as well as their mental health.

The article is here.

For Biden Administration, Equity Initiatives Are A Moral Imperative

Juana Summers

www.npr.org

Originally posted 6 Feb 21

Here is an excerpt:

Many of the Biden administration's early actions have had an equity through-line. For example, the executive actions that he signed last week include moves to strengthen anti-discrimination policies in housing, fighting back against racial animus toward Asian Americans and calling on the Justice Department to phase out its contracts with private prisons.

The early focus on equity is an attempt to account for differences in need among people with historically disadvantaged backgrounds. Civil rights leaders and activists have praised Biden's actions, though they have also made clear that they want to see more from Biden than just rhetoric.

"The work ahead will be operationalizing that, ensuring that equity doesn't just show up in speeches but it shows up in budgets. That equity isn't simply about restoring us back to policies from the Obama years, but about what is it going to take to move us forward," said Rashad Robinson, the president of the racial justice organization, Color of Change.

Susan Rice, the chair of Biden's Domestic Policy Council, made the case that there is a universal, concrete benefit to the equity policies Biden is championing.

"These aren't feel-good policies," Rice told reporters in the White House briefing room. "The evidence is clear. Investing in equity is good for economic growth, and it creates jobs for all Americans."

That echoes what Biden himself has said. He has linked the urgent equity focus of his administration to the fates of all Americans.

"This is time to act, and this is time to act because it's what the core values of this nation call us to do," he said. "And I believe that the vast majority of Americans — Democrats, Republicans and independents — share these values and want us to act as well."

The info is here.

The Tricky Ethics of Google's Project Nightingale Effort

Cason Schmit
nextgov.com
Originally posted 3 Dec 19

The nation’s second-largest health system, Ascension, has agreed to allow the software behemoth Google access to tens of millions of patient records. The partnership, called Project Nightingale, aims to improve how information is used for patient care. Specifically, Ascension and Google are trying to build tools, including artificial intelligence and machine learning, “to make health records more useful, more accessible and more searchable” for doctors.

Ascension did not announce the partnership: The Wall Street Journal first reported it.

Patients and doctors have raised privacy concerns about the plan. Lack of notice to doctors and consent from patients are the primary concerns.

As a public health lawyer, I study the legal and ethical basis for using data to promote public health. Information can be used to identify health threats, understand how diseases spread and decide how to spend resources. But it’s more complicated than that.

The law deals with what can be done with data; this piece focuses on ethics, which asks what should be done.

Beyond Hippocrates

Big-data projects like this one should always be ethically scrutinized. However, data ethics debates are often narrowly focused on consent issues.

In fact, ethical determinations require balancing different, and sometimes competing, ethical principles. Sometimes it might be ethical to collect and use highly sensitive information without getting an individual’s consent.

The info is here.

Strengthening Our Science: AGU Launches Ethics and Equity Center

Robyn Bell
EOS.org
Originally published February 14, 2019

In the next century, our species will face a multitude of challenges. A diverse and inclusive community of researchers ready to lead the way is essential to solving these global-scale challenges. While Earth and space science has made many positive contributions to society over the past century, our community has suffered from a lack of diversity and a culture that tolerates unacceptable and divisive conduct. Bias, harassment, and discrimination create a hostile work climate, undermining the entire global scientific enterprise and its ability to benefit humanity.

As we considered how our Centennial can launch the next century of amazing Earth and space science, we focused on working with our community to build diverse, inclusive, and ethical workplaces where all participants are encouraged to develop their full potential. That’s why I’m so proud to announce the launch of the AGU Ethics and Equity Center, a new hub for comprehensive resources and tools designed to support our community across a range of topics linked to ethics and workplace excellence. The Center will provide resources to individual researchers, students, department heads, and institutional leaders. These resources are designed to help share and promote leading practices on issues ranging from building inclusive environments, to scientific publications and data management, to combating harassment, to example codes of conduct. AGU plans to transform our culture in scientific institutions so we can achieve inclusive excellence.

The info is here.