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A skydiver stares up at his parachute. It’s on fire. Hurriedly, the skydiver pulls out his spare … but hesitates. There is something spooky about the spare parachute, with its lime-green glow. The vibes are off. Playing it safe, the skydiver casts his spare parachute into the clouds. Then he reveals his trusty knitting needles. As the ground rushes up to meet him, he frantically starts knitting yet another parachute.

This is one sequence in World Without End, the 200-page non-fiction comic created by climate scientist Jean-Marc Jancovici and cartoonist Christophe Blain. Knitting a parachute in mid-air is a metaphor for speculative climate solutions. Sure, smart cities and green hydrogen might help eventually, but there just isn’t time to find out. It’s a great example of the power of the medium: absurd imagery communicating urgent ideas.

World Without End is a hugely impressive feat, unfolding as a dialogue between its creators. Jancovici assumes the role of scientist and educator. Blain is the nervous student, adding jokes, mischief and pop culture references to lighten the heavy scientific detail.

The comic hints that competition is made to create uncertainty.
World Without End © Jean-Marc Jancovici and Christophe Blain, Particular Books

The original French edition, Le Monde sans Fin, was a surprise smash hit, sailing up through the bestseller lists faster than global temperature rises.

In our research on climate communication, my collaborators and I emphasise the importance of experimenting with all kinds of media, including comics and games.

It’s also crucial to offer models for action, and here’s where World Without End falls down a bit. After a majestic tour of energy and climate science and policy, the shift to “What can I do?” feels anticlimactic.

Suddenly, we are in the well-trodden territory of individual behaviour changes: eating less meat, opting for trains over planes. However, the book also hints at other models of action. The real answer to “What can one person do?” is to join with other people, and work collectively at every level – your workplace, your community, your voting constituency, your country, your global networks.

World Without End isn’t just a straight translation of the French original. It has been tweaked for its new audience. This is welcome, though some tweaks feel a bit slapdash. “To understand the difference 5 degrees can make, we need to go back … to the 20th century!” Huh? In the original French, it’s clear that we must go back thousands of years, not just a few decades, to see this difference. “Ça, c’est l’Europe du XXᵉ siècle … Ça, c’est la même Europe, il y a 20 000 ans” (“This is 20th century Europe … That’s the same Europe, 20,000 years ago”).

The backdrop is the political reality of Trump’s reelection. Innovative climate communication is worth celebrating. But no matter how great it is, communication alone can’t resolve issues that are rooted in material social and political conflicts.

Trump’s triumph is projected to pump the equivalent of four extra gigatonnes of carbon into the atmosphere by 2030. That’s more than the combined emissions of the 100 lowest-emitting nations of the world.

On the other hand, there is now a short- and long-term economic logic working in favour of renewable energy. Biden’s Inflation Reduction Act is funnelling benefits to Republican-voting areas. Energy transition may gain traction even in regions traditionally hostile to climate action.

A nuclear solution?

What about that spooky green spare parachute that the skydiver unwisely abandoned? For Blain and Jancovici, that represents nuclear power. It may not be perfect, but at least they know it works. We need it now, so let’s not get spooked.

The anti-nuclear thought process goes like this​.
World Without End © Jean-Marc Jancovici and Christophe Blain, Particular Books

While it deserves credit for debunking some myths, the book’s take on nuclear power has downsides. A little man with a moustache and a beret and a baguette tucked under his arm, exclaims: “Our cheeses may stink, but our nuclear stations don’t!” Unsurprisingly, he’s nowhere to be seen in the original French edition.

If there’s ever a Japanese edition, he’ll probably vanish again. Implicitly, it’s Fukushima that “stank”. Why is Monsieur Stereotype strutting around at all? Maybe to soften the message that “this chain of events could never happen in France,” which sounds a bit hubristic. Sure, the nuclear energy industry has learned lessons from past tragedies, but it will also keep innovating, and new tech may bring new risks.

Nuclear faces other challenges too. When you factor in the entire fuel chain, from mining uranium from the Earth to decommissioning power stations decades later, it looks less green. The success of nuclear depends on stable, long-term political and financial support – an issue the book highlights but doesn’t resolve.

At one point, Jancovici even seems to attack wind energy for cutting into nuclear revenue, making maintenance harder to fund. All of this really stems from Jancovici’s frustration with Germany’s recent nuclear phase-out. But it reads as a broader defence of nuclear, including speculative breakthroughs.

These distinctions matter, because the biggest challenge in climate communication today may not even be denial. Even Trump has described climate change as a “serious subject” that is “very important” to him.

After Fukishima​.
World Without End © Jean-Marc Jancovici and Christophe Blain, Particular Books

The biggest challenge may be overconfidence in speculative technologies. Nuclear contributes just 3-4% of global energy, similar to wind and solar, yet some Silicon Valley billionaires are banking on endless cheap, clean energy just around the corner.

Meanwhile, technologies like geoengineering and negative emissions technologies such as direct air capture and biochar are strangely absent from World Without End. These technologies can suck carbon out of the sky, but have achieved little so far. At a guess, Jancovici might call them more yarn for the parachute-knitting project. Knit, baby, knit.

Despite a few quibbles, World Without End deserves a spot on your holiday shopping list. Feedback loops are key to climate change. As ice melts, less sunlight reflects, so more ice melts – and feedback loops also explain surprise bestsellers. When all your friends are talking about a graphic novel, you’re more likely to buy it and spread the word too. If World Without End can spread its provocations to the Anglophone world, that would be utterly fabulous.

Don’t have time to read about climate change as much as you’d like?
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Although it is a cliche to call someone a giant of their profession, it is an apt description of Lord John Prescott, who has died at the age of 86. He was a giant of the Labour movement who played a vital role in supporting Tony Blair in leading the party into government after 18 years in opposition. As Blair has said in his own tribute, “it is no exaggeration to say the Labour Party could never have won three consecutive full terms without John”.

Prescott was an MP for 40 years and subsequently a member of the House of Lords for a further 14. Despite suggesting that he had no desire for one, he accepted a peerage in 2010 in order to continue contributing on environmental policy and to use the red benches as a platform for campaigning.

He remained an active peer even after suffering a stroke in 2019. Although he spoke in debates less after this time, he continued to vote in divisions until February last year. His departure from the House of Lords in July 2024 brought to an end a 54-year career in parliament.

Prescott, then shadow secretary of state for employment, holds a press conference in 1987.
Alamy

Prescott came from a working-class family and was a champion for the working classes within the Labour movement, especially after the party modernised in the 1990s. Peter Mandelson described him as the glue that held New Labour together and ensured the modernised party remained connected to its working-class roots.

His grandfather was a coal miner and his father worked on the railways. Prescott left school at 15 and, before his career in politics, he worked as a ship’s steward on passenger liners. During this time, he became an active and popular member of the National Union of Seamen.

He later attended Ruskin College in Oxford, which specialised in courses for union officials, and gained a diploma in economics and politics. He went on to study economics and economic history at the University of Hull. He remained in Hull for the rest of his life and it was a city that he loved dearly.

Champion of climate and devolution

In 1970, Prescott was elected as MP for Kingston upon Hull East, winning successive elections before stepping down in 2010. He was elected to the position of deputy leader of the Labour party in 1994 and is the party’s longest-serving deputy leader as well as the UK’s longest-serving deputy prime minister.

His centrality to the New Labour project was apparent as soon as he was appointed by Blair to lead a “super” department with responsibilities for the environment, transport and the regions.

Prescott may well be remembered for punching a member of the public who threw an egg at him in 2001 and for confessing to an affair with his diary secretary, but this is to overlook his role in some highly substantive policy decisions.

He helped to broker the Kyoto Protocol, which set legally binding targets to reduce greenhouse gas emissions. Indeed, former US vice-president Al Gore paid tribute to him as an “unwavering champion of climate action”.

Brown, Prescott and Blair in 2006.
Alamy/John Stillwell

Prescott was also a major proponent of devolution. He oversaw the creation of the directly elected mayor of London, although he was unsuccessful in his attempts to devolve power to regional assemblies in England. Nonetheless, the debates and discussions we have to this day about devolving power away from Westminster are cemented in the foundations he built in the late 1990s and early 2000s.

Later in the New Labour years, Prescott was called upon to mediate between Tony Blair and Gordon Brown as their relationship began to sour – truly becoming the glue that held New Labour together.

Above everything else, Prescott was a Labour loyalist. Despite distancing himself from Blair over the Iraq war, he continued to defend New Labour’s and Tony Blair’s legacy. He was also supportive of the party leaders who followed Blair and he advised Ed Miliband in the run up to the 2015 election.

Although not without periods of controversy, John is remembered for his no-nonsense approach and as a fierce debater and campaigner. Läs mer…

The discovery of antibiotics is one of the greatest medical breakthroughs of the 20th century. Before antibiotics, childbirth, a urinary tract infection, or a simple cut could lead to death from infection.

Antibiotics, a type of antimicrobial, have made many modern medical procedures possible, and now the global healthcare system relies on them.

Due to increasing antimicrobial use, microbes – such as bacteria, fungi and parasites – have developed the ability to resist the action of these medicines. The result is that common infections that were once easily treatable are becoming more difficult to cure and in some cases can be fatal.

Following the development of penicillin in the mid 1940s, many new classes of antibiotics were developed. However, since the 1980s there has been little investment into the development of new ones and very few have been approved.

There’s an urgent need for new antibiotics that work against drug-resistant bacteria. Drug-resistant infections are expected to claim more than 39 million lives between now and 2050 without further action.

So why are so few new antibiotics being successfully developed for medical use?

Investment in new drugs

Many pharmaceutical companies have left this area of research. On top of this, finding new and different types of antibiotics that will not be quickly rendered ineffective by existing antimicrobial resistance (AMR) is a formidable challenge.

Developing a new medicine is a complex, extremely expensive and time consuming endeavour. It can take 10 to 15 years from initial discovery all the way to approval, and costs more than US$1 billion.

Most existing antibiotics are cheap and readily available. Any new antibiotics are generally considered “last resort” drugs, used only when all other treatment options have been exhausted. This is to prevent the development of resistance against them.

This means that the return on investment is much lower for antibiotics compared to medicines for many other illnesses.

Pharmaceutical companies are therefore unlikely to recover the costs associated with developing a new antibiotic at the end of a lengthy research process.

Testing what works safely

When searching for new potential antibiotics, researchers screen extracts and compound libraries and also use Artificial Intelligence (AI) approaches to look for those that show promising antimicrobial activity.

The scientists then refine and improve the initial findings in the lab by testing these against infection-causing pathogens. At the same time they make sure the compounds will not be harmful to humans.

For an antibiotic to work in a patient, it must reach the areas of the body where the illness-causing pathogen is located in high enough concentrations to clear the infection. At the same time it must minimise any side effects.

Scientists need to modify many parameters of molecules for safety and efficacy prior to undertaking the next stages of development.

After early-stage development, lead compounds must undergo a series of human clinical trials under carefully controlled conditions. This is to make sure that these are first and foremost safe and effective at treating the disease.

Recent developments

Universities and small companies are now responsible for much of the discovery and early-stage antibiotic development.

At the Ineos Oxford Institute for antimicrobial research we are developing new classes of antibiotics and new combination therapies.

In a combination therapy, two or more drugs are given to a patient at the same time, with each drug having a particular role.

One drug is the antibiotic, such as penicillin, and kills the bacteria.

The second drug targets the resistance mechanism that bacteria have evolved to evade the antibiotic and acts as an antibiotic guardian.

By targeting the resistance mechanism, the second drug protects the antibiotic from destruction and allows the antibiotic to clear the infection and cure the patient.

A recent potential combination therapy developed by us involved two guardian molecules being administered with one existing antibiotic. This triple combination showed promise against a broad range of drug-resistant bacteria.

Our work, however, cannot be done in isolation. Commitment from governments, the pharmaceutical industry and global public health bodies is required to support and sustain the antibiotic pipeline.

One strategy, in which the UK is a global leader, is to create a subscription-style model for purchasing antibiotics which is not linked to the number of antibiotics sold.

Healthcare providers would pay the pharmaceutical company a fixed fee for the antibiotics based on their usefulness, and not the amount used.

This separates demand from profit, making it more economically viable for companies to develop new antibiotics for global public health. Läs mer…

An estimated 18 million Americans are invested in cryptocurrency, according to the Federal Reserve. And the United States just elected a pro-crypto president.

Cryptocurrencies such as Bitcoin have become a trendy digital asset. Supporters claim that crypto subverts capitalism because it bypasses traditional bankers. Crypto can offer quick riches along with an air of high-tech sophistication.

Early adopters reaped enormous rewards, many becoming millionaires and billionaires.

Currently, there are about 100,000 crypto millionaires. Cryptocurrency wealth, furthermore, has built Fairshake, the largest political lobbying group in the U.S. During the recent election, it helped elect 253 pro-crypto candidates.

But is cryptocurrency a good ethical investment?

As a business professor who studies technology and its consequences, I’ve identified three ethical harms associated with cryptocurrency that might give investors pause.

The three harms

The first harm is excessive energy use, most notably by Bitcoin, the first decentralized cryptocurrency.

Bitcoins are created, or “mined,” by tens of thousands of computers in massive data centers, contributing significantly to carbon emissions and environmental degradation. Bitcoin mining, which represents the lion’s share of crypto energy consumption, uses as much as 0.9% of global demand for electricity – similar to the annual energy needs of Australia.

Second, unregulated and anonymous crypto is the payment system of choice for criminals behind fraud, tax evasion, human trafficking and ransomware – the latter costing victims an estimated $1 billion in extorted cryptocurrency payments.

Until about a decade ago, these bad actors generally moved and laundered money through cash and shell companies. But around 2015, many transitioned to cryptocurrency, a much less troublesome form of handling dirty money anonymously.

A bank cannot hold or transfer money anonymously. By law, a bank is passively complicit in money laundering if it isn’t enforcing know-your-customer measures to restrict bad actors, such as money launderers.

In the case of a crypto coin, however, legal and ethical accountability cannot be transferred to a bank – there is no bank. So, who is complicit? Anyone in the crypto ecosystem may be viewed as ethically complicit in enabling illicit activities.

Enegix staff work at a data center in Ekibastus, Kazakhstan, one of the world’s largest Bitcoin mines, on Jan. 3, 2023.
Meiramgul Kussainova/Anadolu Agency via Getty Images

I believe these first two harms are the most ethically troublesome. The first one harms the Earth and the second undermines global systems of trust – the interplay of institutions that underpin economic activity and social order.

Cryptocurrency’s third problem is its predatory culture.

A predatory system, especially without regulatory oversight, takes advantage of small investors. And some cryptos have enriched their founders while taking advantage of investors’ lack of knowledge about the virtual currency.

Some cryptocurrencies, especially the smaller coins and initial coin offerings, have characteristics of Ponzi schemes.

The now defunct Bitconnect, for example, promised large profits to investors who exchanged their Bitcoins for Bitconnect tokens. New investor money paid out “profits” to the first layer of investors with money from later investors.

Ultimately, Satish Kumbhani, the Bitconnect founder, was indicted by a federal grand jury, and as of 2024 his whereabouts are unknown.

Pernicious myth

Besides cryptocurrency’s ethical harms, a pernicious myth surrounds the digital coin. It is the myth of inclusion, that cryptocurrency has the power to benefit society’s disadvantaged, especially the unbanked.

The global poor who don’t have bank accounts, and who could use cryptocurrency for international money transfers to family back home, do not necessarily benefit from crypto’s advantages. That’s because of the need to pay fees when converting and transferring, say, dollars to crypto and then from crypto to the local currency of the person receiving the money transfer.

In reality, the distribution of crypto assets is highly concentrated among the wealthy. A 2021 study found that just 0.01% of Bitcoin holders control 27% of its value.

Democratizing finance is often framed as a movement to break the dominance of traditional financial institutions – private banks and government central banks. However, this narrative has not played out.

Instead, a new elite has emerged: cryptocurrency’s creators, early backers and maintainers, who tweak the crypto’s software code and influence its future direction. This group holds disproportionate control, including over the crypto coin’s governance. All of this replicates the concentration of power that crypto was meant to dismantle.

A bit more ethical?

To be fair, the crypto community hasn’t ignored the criticism, including calls for more environmental awareness.

In early 2021, members of the community founded the Crypto Climate Accord. The group enlisted some 250 crypto firms to reduce environmental harm.

The following year, Ethereum, with its Ether coin, took the most significant step. It reduced its energy consumption by over 99% by migrating to a coin mining mechanism called “proof-of-stake,” which doesn’t require miners to solve complex, energy-guzzling puzzles to validate transactions.

This was a brave move. However, Bitcoin, the largest cryptocurrency, hasn’t followed Ethereum’s lead. Bitcoin stands out because its energy consumption surpasses any other crypto coin.

A worker installs a new row of Bitcoin mining machines at the Whinstone US Bitcoin mining facility in Rockdale, Texas, on Oct. 9, 2021.
Mark Felix/AFP /AFP via Getty Images

To address cryptocurrency’s other harms, some regulatory bodies began controlling the crypto market in 2023. The European Union, United Kingdom and United States began attempting to curb illegal activities and protect investors.

In January 2024, U.S. regulators permitted exchange-traded funds, which are popular investment funds, to invest in crypto. This move was meant to help small investors trade in a safer marketplace.

But normalizing crypto trading can create perverse ethical repercussions.

For example, the most successful 2023 “ethical” fund, Nikko Ark Positive Change Innovation Fund, prospered with a 68% return because it made a bet on crypto. Its manager rationalized this investment by repeating the myth that cryptocurrency allows “provision of financial services to the underbanked.”

Where does all this leave the ethical investor?

Investors, I believe, have two clear ethical choices on cryptocurrency: They can divest from Bitcoin or, at the very least, invest in other cryptocurrencies that minimize harms, especially harms that jeopardize the environment.

But even so-called ethical investments come with hidden ethical issues.

Many ethical investors invest in so-called ESG funds that stress social or environmental impact. Some of these ESG funds may avoid shares in petroleum companies while investing directly or indirectly in crypto.

This doesn’t seem ethically consistent.

While cryptocurrency offers exciting opportunities and the potential for high returns, its environmental impact, association with illegal activities and predatory nature all present significant ethical challenges. Läs mer…

‘The Triumph of St. Thomas Aquinas,’ by Benozzo Gozzoli.
Louvre Museum via Wikimedia Commons

Some years ago, I was rushing past the treasures of the Louvre in Paris, on the way to the “Mona Lisa,” when a painting stopped me in my tracks.

Massive and unusually elongated, “The Triumph of St. Thomas Aquinas” depicts the 13th-century saint throned in a golden sun, with Aristotle and Plato standing reverently on either side. The Renaissance artist Benozzo Gozzoli paints Christ and the writers of the Gospels looking down at Aquinas approvingly.

But who is the turbaned figure under Aquinas’ feet, crushed by his frankly famous weight and crawling away in defeat? That would be the 12th-century Muslim philosopher Ibn Rushd, or Averroes, as he became known in Latin Europe.

“Oh no,” I said out loud.

Us vs. them

As a Catholic philosopher and avid student of Aquinas, I am always fielding questions about whether this medieval saint is “still worth” reading today, nearly 800 years after his birth.

Aquinas is a giant of Western philosophy and theology, and for good reason. His writing is clear, well organized, free from bombast – ideas shine through his words. Famously, he insisted that faith and reason are in harmonious partnership, integrating the known science, philosophy and theology of his day into a comprehensive, interconnected system. All this helps explain why his work has maintained an enduring appeal, even as equally brilliant medieval thinkers have sunk into oblivion.

But Aquinas’ devotees have often used his ideas as blunt instruments, wielding the weight of his words against their own foes – giving him a reputation as a Catholic battle-ax.

There is a story that Aquinas was once dining with King Louis IX of France. Suddenly, the saint slammed his massive fist on a table, making the cups rattle. “That settles the Manichees!” he exclaimed, referring to an ancient religious sect.

His thoughts wandering, Aquinas had come up with a rebuttal against the Manichees’ belief that physical matter was evil – a view Aquinas fundamentally opposed, given his deep convictions about the goodness of all creation.

His followers have a history of attempting the same: thumping Aquinas’ writings down on the table to smite their enemies.

That’s the spirit Gozzoli and other painters channeled in their own times, painting Aquinas as a defeater of Muslim philosophy. They worked in the 15th century, as tensions between Christian and Muslim kingdoms were boiling over into war, from Spain and Italy to Constantinople.

‘St. Thomas Aquinas Confounding Averroës,’ by Giovanni di Paolo.
Saint Louis Art Museum via Wikimedia Commons

Similarly, in the 19th century, Catholic seminaries and universities elevated Aquinas’ teachings to beat back threatening ideas from modern philosophy – like the claim that all reality is material and that all truths can be deduced through reason alone.

In our own age, that kind of “us or them” dynamic is easy to recognize. Addicted to outrage endlessly amplified by social media, we are all too eager to cheer on champions who can “settle” our foes for us. We thrive on the public takedown, the snide meme, the clever quip from our political heroes, regardless of whether what they say is true.

Yet that dynamic leaves a bad taste. Aquinas’ dominance of Catholic theology collapsed in the 1960s. Today, many scholars of medieval philosophy sideline Aquinas, arguing that he has already had enough attention.

The ‘O.G.’ Aquinas

After all this, is it still worth reading Aquinas?

Well, which Aquinas?

A painting of Aquinas from the Cingoli Cathedral, Italy.
Sailko/Wikimedia Commons, CC BY

The Aquinas who gets hauled out to settle scores is, I’d argue, not the “O.G.” Aquinas. The Italian friar who crisscrossed Europe on foot, teaching and writing a mind-boggling 8 million words, offers a different kind of role model – one who sought intellectual understanding, not just victory.

Ironically, on my visit to the Louvre, I was in Paris for a conference of the Aquinas and the Arabs group. These researchers are documenting the extensive influence that Muslim and Jewish thinkers exerted on Aquinas. More broadly, the group also studies those thinkers’ impact on the tremendous burst of philosophical and theological creativity at universities across 13th-century Europe.

Take Averroes, the philosopher cowering under Aquinas in Gozzoli’s painting. Aquinas certainly had sharp things to say about Averroes’ notion of the soul, arguing, for instance, that it undermined free will. In one of his more heated moments, the typically more mild-mannered Aquinas wrote that Averroes’ theory was “repugnant to what is obvious.”

A detail of Averroes from a painting by Andrea di Bonaiuto.
Sailko/Wikimedia Commons, CC BY

Yet Aquinas’ entire theory of human knowledge is built on principles inherited from Averroes. Even in describing the highest Christian goal – beholding God in the afterlife, the “beatific vision” – Aquinas borrowed from the Muslim philosopher’s explanation of how human minds can be lifted to a higher plane of being.

Indeed, Aquinas continually drew inspiration from other thinkers with whom he did not share a faith: He cites the Persian Muslim philosopher-physician Ibn Sīnā, or Avicenna, the Jewish rabbi Maimonides, the Roman statesman and skeptic Cicero, and Aristotle himself.

Aquinas’ embrace of their insights stems from his passionate pursuit of the truth about God and creatures – a pursuit that demands an open heart.

If I don’t yearn to see reality for what it really is, there is no point listening to someone else’s insights. If nothing is true, there is no reason to disagree – but they have nothing to teach me either. I can collect their ideas like so many pebbles in a display case, but I cannot enter into a genuine conversation with them.

The reason that Aquinas is still worth reading today is not that he was right about everything, or that he provides easy-to-swallow, prepackaged formulas. Rather, it is that he opens up a great journey, urging readers to “lift up our minds and pursue the goal” of truth – a goal everyone can share.

At the end of his life, having experienced a vision of God beyond words, Aquinas said, “all I have written is straw.” To undertake such a great journey, with such a generous guide – this might just be the tonic we need today. Läs mer…

The United States presents a paradox: Though the media and public opinion suggest it is a nation deeply divided along partisan lines, surveys reveal that Americans share significant common ground on many core values and political issues.

As a political philosopher, I am deeply concerned about the perceived contrast between the public’s shared political concerns and the high level of polarization that is dividing the electorate.

Sharing common ground on key issues

Despite the prevailing narrative of polarization, Americans frequently agree on essential issues.

For instance, there is widespread support for high-quality health care that is accessible to all and for stronger gun-control regulations. Remarkably, many Americans advocate for both the right to bear arms and additional restrictions on firearms.

There is strong support for fundamental democratic principles, including equal protection under the law, voting rights, religious freedoms, freedom of assembly and speech, and a free press.

On critical issues such as climate change, a majority of citizens acknowledge the reality of human-caused climate change and endorse the development of renewable energy. Similarly, support for women’s reproductive rights, including the right to an abortion, is widespread.

Though Republicans tend to be more concerned about the economy when they vote, both Republicans and Democrats rank it highly as a top political priority. Despite a currently strong economy by many standards, however, supporters of both parties believe the economy is performing poorly.

This fact is likely the result of a combination of pandemic-related factors, from reduced spending and increased saving during the height of the pandemic to lingering inflation, partly triggered by the pandemic. Whatever the reason for this shared pessimism over the economy, it clearly helped Donald Trump win the 2024 election.

Overall, Americans have a positive view of immigration. That sentiment has declined in recent years, however, as most Americans now want to see rates of immigration reduced – Republicans more so than Democrats.

Part of the tension in the nation’s thinking about immigration is likely the result of a political culture that favors sensational stories and disinformation over more sober consideration of related issues and challenges. For instance, much of this election’s discourse over immigration was marred by fictional and bigoted accounts of immigrants eating pets and inaccurate portrayals of most immigrants as criminals. It should be evident that even shared political perceptions aren’t always based on good evidence or reasons.

Despite the existence of so much common ground, Americans see the nation as polarized. Shared values and concerns matter little if constant exposure to disinformation makes it nearly impossible for half the population to sort fact from fiction.

Believing there is conflict can itself breed more conflict.
wildpixel/iStock / Getty Images Plus

The effect of perception

The perception of division itself can fuel distrust where common ground might otherwise be found among citizens.

Even with substantial consensus on many issues, the perception of polarization often drives public discourse. This misalignment can be exacerbated by partisans with something to gain.

Research shows that when people are told that experts are divided on an issue, such as climate change, it can lead to increased polarization. Conversely, emphasizing the fact of scientific consensus tends to unify public concern and action.

The perception among U.S. voters that they disagree more than they agree can precede and perpetuate discord. Differing political camps begin to perceive each other as foes rather than fellow citizens.

This continued perception that Americans are more divided on issues than we actually are poses an enormous threat to democracy. The biggest threat is that people begin to see even neighbors and family members who vote differently as enemies. Stress about holiday interactions with relatives who voted differently is reportedly leading some people to cancel family gatherings rather than spend time together.

Yet, Americans are still potential allies in a larger fight to realize similar political aspirations. If people are too busy attacking each other, they will miss opportunities to unite in defense of shared goals when threats emerge. In fact, they will fail to recognize the real threats to their shared values while busily stoking divisions that make them increasingly vulnerable to disinformation.

Volunteering, like these people sorting donated meals for medical patients in Colorado in 2023, can be a way to share priorities and form real connections with community members who have different political views.
Hyoung Chang/The Denver Post

Bridging the gap

Recognizing the public’s shared values is an important step in healing political divides. Philosopher Robert B. Talisse has argued that one way to get started might be refocusing attention on community projects that are nonpolitical but bring together people who don’t normally think of each other as political allies.

This might include, for example, participating in civic or sports clubs, or volunteering to help with local community events. These actions are not overtly politically charged. Rather, they are collaborative in a way that supports community identity rather than partisan identity. It is an exercise in rebuilding civic trust and recognizing each other as fellow citizens, and perhaps even friends, without the tension of partisan politics. Once this trust in each other’s civic identity is healed, it can open a door for meaningful political discussion and understanding of each other’s shared concerns.

If we Americans don’t find ways to recognize our shared values, and even our shared humanity, we won’t be able to defend those values when they are challenged. Läs mer…

Over a three-year period beginning in 2021, 353 petitions were filed under Colorado’s red flag law, and 39% of those petitions led to firearms being relinquished, according to research our group published in Preventive Medicine Reports.

Red flag laws are also known as extreme risk protection orders. These orders temporarily bar individuals deemed by a judge to be at risk of violence from buying or possessing firearms.

We found that 54.6% of petitions across Colorado were filed by law enforcement. These petitions were granted 94.3% of the time.

Petitions filed by people outside of law enforcement were granted just 35% of the time.

When the petitions of either type are not granted, the individuals involved are allowed to keep their firearms.

Thirty-seven percent of all petitions in Colorado between 2020 and 2022 were filed in counties that made proclamations against red flag laws, calling themselves “Second Amendment sanctuaries.”

The name Second Amendment sanctuaries is modeled after the term “sanctuary cities,” a term used by local governments taking a stand against immigration enforcement.

These declarations are intended to send a political message against extreme risk protection orders. Supporters of the declarations are expressing concerns that the laws violate the U.S. Constitution, subvert due process and undermine residents’ ability to protect themselves. However, anecdotes have highlighted cases where protective orders have been sought and granted in many of the 37 sanctuaries. Our study provides data to back up those anecdotes.

In Colorado, fewer petitions are granted in sanctuaries possibly because the percentage of orders filed by police is significantly lower. But red flag laws are still being used – with some notable differences.

The petitions filed and granted in sanctuary jurisdictions are more serious than those filed in nonsanctuaries. Nearly 1 in 5 involved a shooter threatening to kill at least three other people in addition to themselves. More than 90% included threats to shoot specific people such as family members, partners or law enforcement officers.

In many of these cases, the sense of danger was heightened because the person was reportedly experiencing hallucinations, had a history of contact with the police or was misusing drugs or alcohol.

Given that 60% of firearm deaths are suicides, we were surprised that just 8% of the petitions included only threats of self-harm.

Why it matters

While red flag laws show promise as a way to prevent firearm suicides and other violence in the 21 states plus D.C. where they’re in effect, at least 1,200 jurisdictions across the U.S. have made political declarations against their use.

When Colorado passed the Deputy Zackari Parrish Violence Prevention Act in 2018, it immediately sparked controversy. The law went into effect on Jan. 1, 2020. It initially allowed only certain people to file petitions: law enforcement officers, plus relatives, roommates and co-parents of the respondent. In 2023, it was expanded to allow health care and behavioral health professionals, educators and district attorneys to petition.

Nearly 4 in 10 Colorado counties have declared themselves Second Amendment sanctuaries, but red flag laws are still in effect.
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How we did our work

Our group at the University of Colorado School of Medicine’s Firearm Injury Prevention Initiative has been gathering petitions and court documents associated with every extreme risk petition filed in Colorado since they became available.

This allowed us to describe the kinds of cases where the risk of violence was seen as so severe that filings were made. The law is not explicit, so this threshold has been fuzzy – leaving a lot of discretion to judges. Our data helps shade in when a petition is likely to be brought and when it is likely to be approved.

We were also able to compare the use of extreme risk petitions in sanctuary counties with their use in other counties.

What still isn’t known

The use of extreme risk petitions in counties where they’re politically unpopular raises further questions. For example, do judges in sanctuary counties set a higher bar for granting a petition than in other jurisdictions? Does a sanctuary designation discourage law enforcement from filing petitions even when they have merit? Läs mer…

A cluster of people talking on social media about their mysterious rashes. A sudden die-off of birds at a nature preserve. A big bump in patients showing up to a city’s hospital emergency rooms.

These are the kinds of events that public health officials are constantly on the lookout for as they watch for new disease threats.

Health emergencies can range from widespread infectious disease outbreaks to natural disasters and even acts of terrorism. The scope, timing or unexpected nature of these events can overwhelm routine health care capacities.

I am a public health expert with a background in strengthening health systems, infectious disease surveillance and pandemic preparedness.

Rather than winging it when an unusual health event crops up, health officials take a systematic approach. There are structures in place to collect and analyze data to guide their response. Public health surveillance is foundational for figuring out what’s going on and hopefully squashing any outbreak before it spirals out of control.

Tracking day by day

Indicator-based surveillance is the routine, systematic collection of specific health data from established reporting systems. It monitors trends over time; the goal is to detect anomalies or patterns that may signal a widespread or emerging public health threat.

Hospitals are legally required to report data on admissions and positive test results for specific diseases, such as measles or polio, to local health departments. The local health officials then compile the pertinent data and share it with state or national public health agencies, such as the U.S. Centers for Disease Control and Prevention.

When doctors diagnose a positive case of influenza, for example, they report it through the National Respiratory and Enteric Virus Surveillance System, which tracks respiratory and gastrointestinal illnesses. A rise in the number of cases could be a warning sign of a new outbreak. Likewise, the National Syndromic Surveillance Program collects anonymized data from emergency departments about patients who report symptoms such as fever, cough or respiratory distress.

Public health officials keep an eye on wastewater as well. A variety of pathogens shed by infected people, who may be asymptomatic, can be identified in sewage. The CDC created the National Wastewater Surveillance System to help track the virus that causes COVID-19. Since the pandemic, it’s expanded in some areas to monitor additional pathogens, including influenza, respiratory syncytial virus (RSV) and norovirus. Wastewater surveillance adds another layer of data, allowing health officials to catch potential outbreaks in the community, even when many infected individuals show no symptoms and may not seek medical care.

Having these surveillance systems in place allows health experts to detect early signs of possible outbreaks and gives them time to plan and respond effectively.

An extremely busy emergency room could be a signal that an outbreak is underway.
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Watching for anything outside the norm

Event-based surveillance watches in real time for anything that could indicate the start of an outbreak.

This can look like health officials tracking rumors, news articles or social media mentions of unusual illnesses or sudden deaths. Or it can be emergency room reports of unusual spikes in numbers of patients showing up with specific symptoms.

Local health care workers, community leaders and the public all support this kind of public health surveillance when they report unexpected health events through hotlines and online forms or just call, text or email their public health department. Local health workers can assess the information and escalate it to state or national authorities.

Public health officials have their ears to the ground in these various ways simultaneously. When they suspect the start of an outbreak, a number of teams spring into action, deploying different, coordinated responses.

Collecting samples for more analysis

Once event-based surveillance has picked up an unusual report or a sudden pattern of illness, health officials try to gather medical samples to get more information about what might be going on. They may focus on people, animals or specific locations, depending on the suspected source. For example, during an avian flu outbreak, officials take swabs from birds, both live and dead, and blood samples from people who have been exposed.

Health workers collect material ranging from nose or throat swabs, fecal, blood or tissue samples, and water and soil samples. Back in specialized laboratories, technicians analyze the samples, trying to identify a specific pathogen, determine whether it is contagious and evaluate how it might spread. Ultimately, scientists are trying to figure out the potential impact on public health.

Finding people who may have been exposed

Once an outbreak is detected, the priority quickly shifts to containment to prevent further spread. Public health officials turn into detectives, working to identify people who may have had direct contact with a known infected person. This process is called contact tracing.

Often, contact tracers work backward from a positive laboratory confirmation of the index case – that is, the first person known to be infected with a particular pathogen. Based on interviews with the patient and visiting places they had been, the local health department will reach out to people who may have been exposed. Health workers can then provide guidance about how to monitor potential symptoms, arrange testing or advise about isolating for a set amount of time to prevent further spread.

Many states, including Nevada, set up contact tracing apps to help people determine whether they may have been exposed to the coronavirus.
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Contact tracing played a pivotal role during the early days of the COVID-19 pandemic, helping health departments monitor possible cases and take immediate action to protect public health. By focusing on people who had been in close contact with a confirmed case, public health agencies could break the chain of transmission and direct critical resources to those who were affected.

Though contact tracing is labor- and resource-intensive, it is a highly effective method of stopping outbreaks before they become unmanageable. In order for contact tracing to be effective, though, the public has to cooperate and comply with public health measures.

Stopping an outbreak before it’s a pandemic

Ultimately, public health officials want to keep as many people as possible from getting sick. Strategies to try to contain an outbreak include isolating patients with confirmed cases, quarantining those who have been exposed and, if necessary, imposing travel restrictions. For cases involving animal-to-human transmission, such as bird flu, containment measures may also include strict protocols on farms to prevent further spread.

Health officials use predictive models and data analysis tools to anticipate spread patterns and allocate resources effectively. Hospitals can streamline infection control based on these forecasts, while health care workers receive timely updates and training in response protocols. This process ensures that everyone is informed and ready to act to maximize public safety.

No one knows what the next emerging disease will be. But public health workers are constantly scanning the horizon for threats and ready to jump into action. Läs mer…

The Nov. 23, 2024, college football contest between Army and Notre Dame will fittingly take place exactly 100 years after the two storied programs met at New York City’s Polo Grounds – a clash many sports fans recall because of the dramatic column that sportswriter Grantland Rice published the next day.

In his opening paragraph, Rice famously compares the Fighting Irish backfield to the Four Horsemen of the Apocalypse and suggests that the “South Bend cyclone” simply overwhelmed the Army players:

“Outlined against a blue-gray October sky, the Four Horsemen rode again. In dramatic lore they are known as Famine, Pestilence, Destruction and Death. These are only aliases. Their real names are Stuhldreher, Miller, Crowley and Layden. They formed the crest of the South Bend cyclone before which another fighting Army football team was swept over the precipice at the Polo Grounds yesterday afternoon as 55,000 spectators peered down on the bewildering panorama spread on the green plain below.”

Based on this stirring introduction, it might have surprised readers at the time – let alone today’s readers – that Notre Dame did not overwhelm Army.

The game was a 13-7 cliffhanger. After the Notre Dame offense took a 13-0 lead in the third quarter, the Army offense responded with seven points of their own, before failing to take advantage of several opportunities in the fourth quarter to score the winning touchdown.

Of course, that was not the story that Rice wanted to tell.

More than a game

In my 30 years of teaching English and writing courses, I’ve read my fair share of essays that echo Rice’s purple prose. I’ll tell my students that it’s overblown and excessive.

But unlike for most first-year college students, Rice’s style served his purposes well.

Rice honed his craft as a sportswriter in the first two decades of the 1900s, just before the dawn of the period known as the Golden Age of Sports. In the 1920s and 1930s, newspaper circulation expanded rapidly, radio technology brought live sporting events to millions of American homes, and interest in college and professional sports boomed.

As journalism scholars Patrick Washburn and Chris Lamb have explained, before this golden age, many American sports writers sought to boost attendance at sporting events, with some of them even employed by leagues and teams. They also relayed the facts of the boxing matches, horse races and baseball games they were covering – the final score, key moments and top performances.

Rice, who had begun as a reporter for the Nashville Daily News and later became a columnist for the New York Tribune, believed that his job was not so much to recount what had happened in the game, but to instead craft a story that aligned with his vision of how sports ought to be celebrated in American culture.

He believed sports were not just a stage for men and women to demonstrate athletic prowess; he also sought to infuse their performances with biblical drama and turn athletes into contemporary gods. A classics major at Vanderbilt University who often penned original verse in his columns, Rice was the unofficial leader of the Gee Whiz school of sports writing, a group of writers who feted the achievements of athletes while ignoring or even keeping hidden their character flaws.

To Rice, athletes such as Babe Ruth, Jack Dempsey, Red Grange, Bill Tilden and Babe Didrikson Zaharias weren’t everyday people who happened to be good at sports. They were worthy of veneration in American culture itself – key characters in the greatest of dramas playing out on the nation’s fields, courts and racetracks.

Pushing a narrative

It is not hard to imagine a different sort of column for that 1924 game, one that highlighted Army’s grit and perseverance and the heartbreak its players faced at the end as they ran out of gas. That, too, would make a good story and be an easy sell for readers, especially given the military connection.

But Rice did not choose to valorize the tenacity that the Cadets showed in how they had “played the game.” Instead, he focused his column on the storyline of a South Bend cyclone that was too much for any team to handle. It was certainly an effective approach.

Moreover, there may have been another reason Rice sought to amplify Notre Dame’s win. According to sportswriter and critic Mark Inabinett, Rice was friends with Notre Dame coach Knute Rockne, and the victory presented an opportunity to position the Fighting Irish as the best team in the country.

Notre Dame football coach Knute Rockne had struck up a friendship with Grantland Rice.
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No matter that Notre Dame had won their first two games of the year by much larger margins. Rice used this rather close victory to anoint the Fighting Irish as an unstoppable powerhouse. His column – with an estimated New York readership in the hundreds of thousands and a syndicated readership of about 10 million – was a spectacular opportunity to push the case for the team’s dominance of college football.

When writerly touch goes too far

His column that Sunday morning in the fall of 1924 was just that – spectacular.

It is the embodiment of his approach to sports writing and remains his most well-known work.

His writing style inspired generations of sportswriters that followed him – including Bill Simmons, who, in 2011, named his influential ESPN-owned website Grantland after Rice. It also paved the way for a school of sportswriters to primarily treat games as potential storylines: opportunities to articulate their own notions of sport’s cultural function.

For some writers, that has meant treating a hockey game as a geopolitical standoff. For others, it has meant portraying a Major League Soccer game as a landmark moment for LGBTQ+ people or seeing a tennis match as a lesson in aesthetic pleasure.

These are all well-written stories, and there is nothing inherently wrong with pursuing storylines and constructing certain narratives about games. Sports do serve a cultural function, and it’s the writer’s prerogative to channel their vision.

However, you might wonder what gets lost in a treatment of a game as a means to an end of the writer’s making. The untold narrative might represent a more accurate account of what happened on that field that day.

Even if it was all in a losing effort. Läs mer…

You have scheduled an appointment with a health care provider, but no matter how hard you try, no one seems to be able to reliably tell you how much that visit will cost you. Will you have to pay US$20, $1,000 – or even more?

Patients are increasingly on the hook for health care costs through deductibles, co-pays and other fees. As a result, patients are demanding credible cost information before appointments to choose where they seek care and control their budget.

Yet, in spite of recent legislation and regulations, upfront information on patient out-of-pocket costs is still difficult to obtain from both health care providers and insurers.

Predicting out-of-pocket costs

Why is it so difficult to tell patients in advance how much their care is going to cost?

This is a question health economists like me try to answer. Although the fundamental reason is simply the unpredictable nature of health care, the fact that it translates to unpredictable out-of-pocket costs for patients is a policy choice.

Health insurance plans in the U.S. such as Medicare and Medicare Advantage, as well as most individual and group plans, leave a percentage of the cost of care for patients to settle out of pocket. These include deductibles – the amount patients have to pay for a service before their insurance kicks in – or coinsurance, a percentage of the cost of care that patients must pay after they have met their deductible.

Understandably, most patients want to know their out-of-pocket costs before a doctor’s office visit or a trip to the hospital. However, the cost of care – and thus the percentage of the cost patients will pay – often isn’t available until after care has been delivered. This is because of the way health care providers are paid for their work.

How many health care services you’ll need for a given illness or procedure can be unpredictable.
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Health care providers typically seek payments for each patient retrospectively, based on the volume and intensity of services they have delivered. But both are hard to predict. A physician usually needs to see a patient before deciding how to address their health care needs. Sometimes, an extra test or imaging scan is needed to confirm a diagnosis or plan treatment.

Crucially, a variety of unexpected complications can occur even during routine procedures. Addressing these unforeseen complications often requires providing unanticipated services and involving other health care providers who might not have been part of the visit otherwise. And these extra services cost money.

As long as policymakers keep health care payments tied to the volume and intensity of performed medical services – which are uncertain – and patient cost-sharing tied to health care payments, patients will not be able to know what their out-of-pocket costs will be in advance. Simply making health care service prices publicly available will not change that.

What can be done to guarantee out-of-pocket costs before patients have their appointments?

Health care delivery as a supply chain

One idea researchers have proposed is to reorganize health care delivery into a supply chain. This would shift production risk to health care providers similarly to how other complex products are offered to consumers.

Consider air travel tickets. Consumers taking a flight from one city to another receive services from multiple entities, such as airlines, airports, aviation fuel suppliers and catering companies. Many of these entities face operational uncertainties such as departure delays or variable fuel consumption due to unpredictable weather. But airlines – as the final link in the supply chain – provide consumers with upfront prices for the entire trip.

The No Surprises Act reduces patient bills from out-of-network providers.

In health care, the principal provider from whom a patient seeks care could serve as the price-guaranteeing entity. They would collect a single, guaranteed price for the appointment and compensate other providers involved as needed. Some researchers have proposed aspects of this idea as a potential way to reduce surprise billing from out-of-network emergency physicians working at in-network hospitals.

However, such a major reorganization of health care delivery would be extremely challenging, as it would require all providers to enter into new contractual arrangements with each other. It would not only cause a legal undertaking of unprecedented scale, but it could also end up being financially devastating for small physician practices.

Co-payment-only health plans

There are other approaches to providing patients with reliable, upfront prices that would not require a complete overhaul of the health care system. The U.S. already has much of the needed infrastructure in place: health insurance.

A primary purpose of health insurance is to protect beneficiaries from financial shocks. Health insurers could modify the benefit design of policies to ensure patients obtain guaranteed out-of-pocket cost information before receiving care.

One way to achieve that would be saying goodbye to deductibles and coinsurance and having insured patients pay for their care only in the form of co-payments – fixed dollar amounts per encounter, such as $20 per doctor’s visit, $35 per prescription drug fill or $500 per hospital stay. Some insurance plans already offer this.

However, this approach removes incentives for patients to seek care from providers that offer quality services at a low price. It also could potentially increase monthly health insurance costs, also called premiums.

Improving how health care is delivered could make for more transparent out-of-pocket costs for patients.
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Innovative health insurance design

Based on my own research, I propose that an alternative solution to providing patients with reliable, upfront prices could be implementing episode-based cost-sharing into health insurance plans.

Under this model, health insurers would create bundles of services that patients may receive during a health care visit. This approach would provide patients with a single upfront price for the entire bundle based only on factors known in advance, such as their health insurance benefits and who their principal health care provider is. For example, you would have a guaranteed price tag for the cost of going to the hospital to give birth to a child or replace a joint.

Any deviation from the ultimate cost of care due to unforeseen situations patients have little control over would be borne by the insurer. That is what insurers do for a living – they know how to manage risk. Such a modification to health insurance benefit design would protect patients from unexpected health care costs, while preserving the incentive to seek care with high-value providers. It would also help keep health insurance premiums intact.

Seeking care for a health concern is already stressful. It does not have to be more stressful because of cost uncertainty. Several approaches to help patients know how much their care is going to cost in advance are available for policymakers to consider. In the meantime, patients may need to pick up the phone, call their hospital billing office and hope that the amount they obtain will be close to the amount they will eventually find on their medical bills. Läs mer…