Artificial intelligence/Machine learning
If AI is going to help us in a crisis, we need a new kind of ethics

Ethics for urgency means making ethics a core part of AI rather than an afterthought, says Jess Whittlestone.

by Will Douglas Heaven  June 24, 2020

MS TECH | PIXABAY

Jess Whittlestone at the Leverhulme Centre for the Future of Intelligence at the University of Cambridge and her colleagues published a comment piece in Nature Machine Intelligence this week arguing that if artificial intelligence is going to help in a crisis, we need a new, faster way of doing AI ethics, which they call ethics for urgency. 

JESS WHITTLESTONE

For Whittlestone, this means anticipating problems before they happen, finding better ways to build safety and reliability into AI systems, and emphasizing technical expertise at all levels of the technology’s development and use. At the core of these recommendations is the idea that ethics needs to become simply a part of how AI is made and used, rather than an add-on or afterthought.

Ultimately, AI will be quicker to deploy when needed if it is made with ethics built in, she argues. I asked her to talk me through what this means.

This interview has been edited for length and clarity.

Why do we need a new kind of ethics for AI?

With this pandemic we’re suddenly in a situation where people are really talking about whether AI could be useful, whether it could save lives. But the crisis has made it clear that we don’t have robust enough ethics procedures for AI to be deployed safely, and certainly not ones that can be implemented quickly.

What’s wrong with the ethics we have?

I spent the last couple of years reviewing AI ethics initiatives, looking at their limitations and asking what else we need. Compared to something like biomedical ethics, the ethics we have for AI isn’t very practical. It focuses too much on high-level principles. We can all agree that AI should be used for good. But what does that really mean? And what happens when high-level principles come into conflict?

For example, AI has the potential to save lives but this could come at the cost of civil liberties like privacy. How do we address those trade-offs in ways that are acceptable to lots of different people? We haven’t figured out how to deal with the inevitable disagreements.

AI ethics also tends to respond to existing problems rather than anticipate new ones. Most of the issues that people are discussing today around algorithmic bias came up only when high-profile things went wrong, such as with policing and parole decisions.

But ethics needs to be proactive and prepare for what could go wrong, not what has gone wrong already. Obviously, we can’t predict the future. But as these systems become more powerful and get used in more high-stakes domains, the risks will get bigger.

What opportunities have we missed by not having these procedures in place?

It’s easy to overhype what’s possible, and AI was probably never going to play a huge role in this crisis. Machine-learning systems are not mature enough.

But there are a handful of cases in which AI is being tested for medical diagnosis or for resource allocation across hospitals. We might have been able to use those sorts of systems more widely, reducing some of the load on health care, had they been designed from the start with ethics in mind.

With resource allocation in particular, you are deciding which patients are highest priority. You need an ethical framework built in before you use AI to help with those kinds of decisions.

So is ethics for urgency simply a call to make existing AI ethics better?

That’s part of it. The fact that we don’t have robust, practical processes for AI ethics makes things more difficult in a crisis scenario. But in times like this you also have greater need for transparency. People talk a lot about the lack of transparency with machine-learning systems as black boxes. But there is another kind of transparency, concerning how the systems are used.

This is especially important in a crisis, when governments and organizations are making urgent decisions that involve trade-offs. Whose health do you prioritize? How do you save lives without destroying the economy? If an AI is being used in public decision-making, transparency is more important than ever.

What needs to change?

We need to think about ethics differently. It shouldn’t be something that happens on the side or afterwards—something that slows you down. It should simply be part of how we build these systems in the first place: ethics by design.

I sometimes feel “ethics” is the wrong word. What we’re saying is that machine-learning researchers and engineers need to be trained to think through the implications of what they’re building, whether they’re doing fundamental research like designing a new reinforcement-learning algorithm or something more practical like developing a health-care application. If their work finds its way into real-world products and services, what might that look like? What kinds of issues might it raise?

Some of this has started already. We are working with some early-career AI researchers, talking to them about how to bring this way of thinking to their work. It’s a bit of an experiment, to see what happens. But even NeurIPS [a leading AI conference] now asks researchers to include a statement at the end of their papers outlining potential societal impacts of their work.

You’ve said that we need people with technical expertise at all levels of AI design and use. Why is that?

I’m not saying that technical expertise is the be-all and end-all of ethics, but it’s a perspective that needs to be represented. And I don’t want to sound like I’m saying all the responsibility is on researchers, because a lot of the important decisions about how AI gets used are made further up the chain, by industry or by governments.

But I worry that the people who are making those decisions don’t always fully understand the ways it might go wrong. So you need to involve people with technical expertise. Our intuitions about what AI can and can’t do are not very reliable.

What you need at all levels of AI development are people who really understand the details of machine learning to work with people who really understand ethics. Interdisciplinary collaboration is hard, however. People with different areas of expertise often talk about things in different ways. What a machine-learning researcher means by privacy may be very different from what a lawyer means by privacy, and you can end up with people talking past each other. That’s why it’s important for these different groups to get used to working together.

You’re pushing for a pretty big institutional and cultural overhaul. What makes you think people will want to do this rather than set up ethics boards or oversight committees—which always make me sigh a bit because they tend to be toothless?

Yeah, I also sigh. But I think this crisis is forcing people to see the importance of practical solutions. Maybe instead of saying, “Oh, let’s have this oversight board and that oversight board,” people will be saying, “We need to get this done, and we need to get it done properly.”

WHOSE ETHICS

https://theanarchistlibrary.org/library/petr-kropotkin-ethics-origin-and-development

Ethics And Artificial Intelligence: An Unethical Optimization Principle

July 11, 2020

By Eurasia Review

Artificial intelligence (AI) is increasingly deployed around us and may have large potential benefits. But there are growing concerns about the unethical use of AI. Professor Anthony Davison, who holds the Chair of Statistics at EPFL, and colleagues in the UK, have tackled these questions from a mathematical point of view, focusing on commercial AI that seek to maximize profits.

One example is an insurance company using AI to find a strategy for deciding premiums for potential customers. The AI will choose from many potential strategies, some of which may be discriminatory or may otherwise misuse customer data in ways that later lead to severe penalties for the company. Ideally, unethical strategies such as these would be removed from the space of potential strategies beforehand, but the AI does not have a moral sense, so it cannot distinguish between ethical and unethical strategies.

In work published in Royal Society Open Science, Davison and his co-authors Heather Battey (Imperial College London), Nicholas Beale (Sciteb Limited) and Robert MacKay (University of Warwick), show that an AI is likely to pick an unethical strategy in many situations. They formulate their results as an “Unethical Optimization Principle”:

If an AI aims to maximize risk-adjusted return, then under mild conditions it is disproportionately likely to pick an unethical strategy unless the objective function allows sufficiently for this risk.

This principle can help risk managers, regulators or others to detect the unethical strategies that might be hidden in a large strategy space. In an ideal world one would configure the AI to avoid unethical strategies, but this may be impossible because they cannot be specified in advance. In order to guide the use of the AI, the article suggests how to estimate the proportion of unethical strategies and the distribution of the most profitable strategies.

“Our work can be used to help regulators, compliance staff and others to find problematic strategies that might be hidden in a large strategy space. Such a space can be expected to contain disproportionately many unethical strategies, inspection of which should show where problems are likely to arise and thus suggest how the AI search algorithm should be modified to avoid them,” says Professor Davison. “It also suggests that it may be necessary to re-think the way AI operates in very large strategy spaces, so that unethical outcomes are explicitly rejected during the learning process.”

Professor Wendy Hall of the University of Southampton, known worldwide for her work on the potential practical benefits and problems brought by AI, said: “This is a really important paper. It shows that we can’t just rely on AI systems to act ethically because their objectives seem ethically neutral. On the contrary, under mild conditions, an AI system will disproportionately find unethical solutions unless it is carefully designed to avoid them.

“The tremendous potential benefits of AI will only be realised properly if ethical behaviour is designed in from the ground up, taking account of this Unethical Optimisation Principle from a diverse set of perspectives. Encouragingly, this Principle can also be used to help find ethical problems with existing systems which can then be addressed by better design.”

WHOSE ETHICS
https://theanarchistlibrary.org/library/petr-kropotkin-ethics-origin-and-development

CANDYMAN 

More Criminal Cases Launched Against Former Ukrainian President Poroshenko

July 11, 2020 (RFE/RL) — The Ukrainian Prosecutor-General’s Office has launched four additional criminal cases against former President Petro Poroshenko, his lawyer Ihor Holovan said on June 10.

According to Holovan, the probes were launched at the request of tycoon Ihor Kolomoyskiy, who accuses Poroshenko of interference with the activities of PrivatBank — once owned by Kolomoyskiy — revealing sensitive information regarding PrivatBank’s activities, abuse of office, and money laundering.

Holovan called all the accusations against Poroshenko “politically motivated.”

Kolomoyskiy, Poroshenko’s long-time foe, lost control over PrivatBank in 2016 when the central bank took it over after it failed stress tests and was deemed to be undercapitalized. Poroshenko was president at that time.

Kolomoyskiy lived in self-imposed exile for nearly two years and returned after Volodymyr Zelenskiy’s election as president in April 2019.

Kolomoyskiy’s ties to Zelenskiy, who rose to fame as an actor on a TV channel owned by Kolomoisky, had raised concerns over the president’s independence from the oligarch.


On July 1, Poroshenko said that, in all, there are 24 probes launched against him, claiming that his successor “is behind all of them.”

Ukraine’s Prosecutor-General Iryna Venedyktova rejected Poroshenko’s claims, saying that the probes have nothing to do with politics.

On July 8, Venedyktova withdrew its request to place Poroshenko under pretrial arrest in one of the cases against him. The case is related to his alleged illegal appointment of a deputy chief of the country’s foreign intelligence service. Venedyktova said that the investigations in that case had been completed.

A billionaire confectioner, Poroshenko currently serves as a member of parliament.

His party ran on a pro-European, anti-Russian ticket in July parliamentary elections, winning 25 seats.

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India-Canada Energy Cooperation – OpEd

Canada has been one of the biggest success stories in oil over the past few years. India should consider financial investments in Canadian energy assets as a means to secure its energy supplies.

By Amit Bhandari*

July 11, 2020 Gateway House 


India's Prime Minister, Shri Narendra Modi with the Prime Minister of Canada, Mr. Justin Trudeau, at Hyderabad House, in New Delhi . Photo Credit: India PM Office.

By Gateway House

India is now the world’s third largest consumer of petroleum, and is expected to be a major driver for growth in global oil demand from 2020 to 2040. In 2019, India imported 4 million barrels per day (1.4 billion barrels per year), and this is projected to increase to 9 million barrels per day by 2040, as the country’s economy expands. Canada has the world’s third largest reserves of petroleum in the form of oil sands, and it is also the third largest exporter of oil worldwide. Canada’s oil production is expected to increase from 5.2 million barrels per day to 6.3 million barrels per day by 2030.

Is there an India-Canada oil match to be made?

It could be promising, if Indian companies and investors can be brought into Canada’s vibrant oil producing entities. India’s dominant state-owned oil companies can take minority stakes – purely financial – in Canada’s top oil producers. The investments can be made via a special purpose vehicle, with a mandate to make financial investments, rather than take direct stakes in those companies. The returns will move in line with oil prices, insulating India against fluctuations in the market, especially in higher prices, of oil.

A financial investment will also shelter Indian investors from the political and technical complexities of Canadian oil sands, and will not run foul of Canadian law on acquisitions by foreign state-owned enterprises. Over the longer term, Indian retail investors can be brought in via exchange-traded funds listed in India, which hold shares in major Canadian oil companies. This will bring stability to the market and deepen the bilateral.

How can this work for both sides? For India, investment in overseas oil and gas assets are one way to bring down the risk of high energy prices and disruptions due to geopolitical factors. Canada is among the most stable geographies across the world and is ideally placed to be a hedge against such risks.

For Canada, the big issue has been getting a fair price for its oil – Canadian oil trades at significant discount to common benchmarks due to lack of market access and a limited number of buyers. Getting investors and consumers from a growing market such as India into the upstream sector will also give Canadian companies a source of capital – a major competitive advantage in a world with surplus oil.

*About the author: Amit Bhandari is Fellow, Energy & Environment Studies Programme, Gateway House.

Source: This article was written for Gateway House: Indian Council on Global Relations.

Home » India-Canada Energy Cooperation – OpEd

Gateway House

Gateway House: Indian Council on Global Relations is a foreign policy think-tank established in 2009, to engage India’s leading corporations and individuals in debate and scholarship on India’s foreign policy and its role in global affairs. Gateway House’s studies programme will be at the heart of the institute’s scholarship, with original research by global and local scholars in Geo-economics, Geopolitics, Foreign Policy analysis, Bilateral relations, Democracy and nation-building, National security, ethnic conflict and terrorism, Science, technology and innovation, and Energy and Environment.

Iran Under Attack – Analysis

July 10, 2020  Neville Teller 1 Comment

According to Iran's Defense Ministry this explosion at the Parchin complex near Tehran was caused by an exploding gas-storage tanker. Photo Credit: Tasnim News Agency

By Neville Teller

Iranian media reported an explosion in western Tehran in the early hours of Friday, 10 July, causing electricity to be cut in surrounding suburbs. It was the latest in a string of mysterious blasts to rock the country. At least three are known to have occurred in or around Iranian nuclear facilities, and initial reports claimed that the latest explosion was at a missile depot belonging to Iran’s Islamic Revolutionary Guard Corps (IRGC). Occurring over some ten days, they cannot be easily explained away. The regime is undoubtedly under attack. The question so far unanswered is, from whom?

Is this a covert onslaught masterminded by Israel, the US, or the two acting in concert? Did Israeli F-35 fighters actually bomb one of the sites? Are a group of anti-regime activists, working within Iran’s nuclear industry, taking covert action to prevent the regime acquiring nuclear weapons? Were the incidents the result of sophisticated cyber attacks, or were they sabotage, caused by old-fashioned explosives? There is a great deal of speculation, but so far nothing definitive has emerged.

It was on June 26, 2020 that the first of this series of incidents occurred. Despite initial assertions by the Iranian Defense Ministry that there had been a minor detonation in the Parchin military complex, satellite images showed that it was at the nearby missile production complex at Khojir that a bomb had damaged a cache of gas tanks. The blast was later described as “a massive explosion” that had “burned a hillside”. Parchin, near Tehran, is where Western powers suspect Iran carried out tests related to nuclear warhead detonations more than a decade ago.

On June 30 a detonation inside a medical center in Tehran resulted in a fire and the death of more than a dozen people.

The third, and perhaps the most serious, of this series of incidents occurred on July 2. The Atomic Energy Organization of Iran (AEOI) announced that there had been an explosion in one of the industrial sheds under construction at the Natanz uranium enrichment plant. US analysts identified it as a new centrifuge assembly workshop. Centrifuges are needed to produce enriched uranium, which can be used to make reactor fuel and nuclear weapons.

Hours before the AEOI statement, however, according to reports on the BBC’s website, journalists working for BBC Persian had received an email from a hitherto unknown group calling itself “Cheetahs of the Homeland”, claiming that it had attacked the building. The group said its members were part of “underground opposition with Iran’s security apparatus”, and that they had deliberately arranged for the attack to take place above ground so that it “couldn’t be denied”.

That the BBC did indeed receive an email with advance information about the Natanz explosion, and that the mysterious “Cheetahs of the Homeland” claimed responsibility, must be accepted. What remains unclear is the source of that message. Is there really a covert group within Iran, seeking to disrupt the regime’s nuclear program? Or was that email a piece of disinformation designed to camouflage the true source of the explosions?

Then on July 4 another massive fire damaged a power station in Khuzestan province. According to the on-line Intelli Times, the plant’s method of operation − regulating electricity through automation and industrial controllers – makes it open to a cyber attack.

As for the Natanz attack, the New York Times reported that two well-placed, but anonymous, sources had confirmed that that explosion was not the result of a cyber attack, but had been caused by a “powerful bomb”, and that Israel had masterminded the operation

This version was countered by the Kuwaiti newspaper Al-Jarida which maintained that Israeli F-35 fighters had bombed the Parchin site (not the nearby Khojir nuclear facility), but the Natanz incident was an Israeli electronic attack targeting computers controlling storage pressure devices.

Whichever agency carried out the Natanz attack, Iran has not attempted to deny that it has had a significant effect on the country’s nuclear program.

“The incident could slow down the development and production of advanced centrifuges in the medium term,” said the AEOI spokesman, quoted by the State news agency. “…Iran will replace the damaged building with a bigger one that has more advanced equipment.”

However, the damage to Iran’s nuclear project may be considerably more serious than this. Al-Jarida pinpoints the target as UF6 gas (uranium hexafluoride), used specifically for uranium enrichment. Iran has recently begun to produce UF6 for injection into the advanced IR-6 centrifuges it has been constructing at Natanz. The paper asserts that Iran has now lost 80% of its stock of this gas. Moreover, the Natanz explosion led to a “crack in the reactor building. Specialized groups went to the reactor to discover whether there was leakage of radioactive materials.” The building, which took six years to construct, became operational in 2018.

At a recent press conference Israel’s defense minister, Benny Gantz, said: “A nuclear Iran is a threat to the world and the region, as well as a threat to Israel and we will do everything to prevent that from happening.”

Israel’s foreign minister, Gabi Ashkenazi, was somewhat more succinct. “We take actions that are better left unsaid.”

Neville Teller
Neville Teller’s latest book is “The Chaos in the Middle East, 2014-2016” (2016), and writes the blog "A Mid-East Journal". He is also a long-time dramatist, writer and abridger for BBC radio and for the UK audiobook industry. Born in London and educated at Owen's School and St Edmund Hall, Oxford, he is a past chairman of the Society of Authors' Broadcasting Committee, and of the Contributors' Committee of the Audiobook Publishing Association. He was made an MBE in the Queen's Birthday Honours, 2006 "for services to broadcasting and to drama."

Germany: Extremist Violence Spikes

July 10, 2020   EurActiv

By Christina Goßner

(EurActiv) — The number of extremist crimes has increased significantly over the past year. The intensity of violent crimes is increasing on both sides of the extremist spectrum. Foreign espionage activities and cyber attacks also pose an increasing threat.

These are the findings of the annual report on the protection of the constitution, which provides an overview of anti-constitutional activity in Germany. The President of the Federal Office for the Protection of the Constitution (BfV), Thomas Haldenwang, presented them on Thursday (9 July) in Berlin together with Interior Minister Horst Seehofer (CSU).

The BfV recorded just under 22,000 criminal offences committed by right-wing extremists last year, an increase of around 10% compared to the previous year. Crimes by left-wing extremists saw an increase of 40%.

“Our greatest concern is the existing propensity to violence in almost all areas of extremism,” said Haldenwang at Thursday’s press conference.

“The inhibition threshold for the use of violence is continuously decreasing,” he added. The Internet in particular is paving the way for the use of violence.

Right-wing extremism remains the “greatest threat

Both the BfV and the Interior Ministry continue to see right-wing extremism as the greatest threat to Germany.

In addition to the number of criminal offences, the membership numbers among right-wing extremist groups as well as the number of right-wing extremists willing to use violence has also risen in the past year. This comes even though the total number of right-wing extremist-motivated acts of violence fell by 15%.

The assassination of Kassel’s district president Walter Lübcke and attack in Hanau in February clearly showed a new intensity of violence in the form of targeted homicides. “This intensified violence must cause us deep concern,” said Haldenwang.

Anti-Semitism remains an important ideological element of the far-right world view. According to the report, over 94% of all anti-Semitic crimes were committed by right-wing extremists last year.

The potential number of people involved in right-wing extremist activities has risen significantly to around 32,000. In 2018, the number was around 24,000.

This sharp rise is largely due to the fact that for the first time, this group now also includes the supporters of the now officially dissolved AfD sub-organisation “The Wing.” In mid-March, the BfV classified the faction as a “proven right-wing extremist endeavour,” whereupon the AfD party leadership called for the group to dissolve itself.
Rising propensity of left-wing extremist violence

Haldenwang called the developments in the left-wing extremist spectrum “extremely worrying.” “We are seeing a significant increase in militancy and a new quality in violent crimes against people,” he said.

The BfV counts about 33,500 persons on the left-wing extremist spectrum, of whom more than 9,000 are classified as prepared to use violence.

“We are dealing with new structures,” Seehofer said. “In recent years, violent actions related to demonstrations have increasingly been replaced by planned violent actions, independent of these gathering and partly organised by small groups.”

According to Seehofer, the 40% increase in the number of violent acts committed by left-wing extremists is particularly alarming, since the inhibition threshold to commit the most serious acts is falling.
Threat from Islamist terror “very high”

Islamist terrorism also continues to pose a threat. For example, the BfV counts about 650 “threats” in Germany. According to the report, a total of about 28,000 people are part of this scene.

In this respect, Haldenwang warned that the group is “under great pressure to succeed,” especially given the defeats of the Islamic State.

In addition, the BfV identifies cyber espionage activities as a threat, with the Russian and Chinese intelligence services posing a particular danger. Attacks by foreign intelligence services in Germany are “on a high and increasingly brutal level,” Haldenwang said.

In the field of espionage, the report also mentions the murder of the Chechen-born Georgian Zelimkhan Khangoshvili in Berlin in August 2019. In June, the Federal Prosecutor’s Office had brought charges against Vadim Krasikov. On the basis of “sufficient evidence,” the authorities are treating the case as a contract killing initiated by Russian state agencies.

Nikki Haley's Astounding Claims About Iran

For U.S. officials, past and present, to be professing concern for the stewardship of the Iranian people’s public funds strains credulity.

by Alireza Ahmadi

July 11, 2020 

The specter of the International Monetary Fund (IMF) extending a loan to Iran to assist with the challenges of the coronavirus epidemic has raised objections from many U.S. officials. In an opinion article, Ambassador Nikki Haley argued that the United States should do everything in its power to block the IMF loan based on Iran’s policies in the region. Her arguments in favor of a political response to a public health emergency is typical of Trump administration officials and speak to a broader politicization with the lives of innocent people hanging in the balance. So is this an effort to block funds from an unruly actor or a cynical ploy to use the circumstances created by an epidemic for political gain as Iran has charged?

Some of Haley’s claims require addressing. First, despite her claim, the IMF is not a “subsidiary” of the UN. These organizations do not function as privately-owned corporate entities do. The IMF is an independently developed intergovernmental organization that is only part of the “UN System” because of a negotiated agreement between the two in which the IMF retains its legal independence including a separate budget, staff and decisionmaking structure. Second, the notion that they would provide a loan to Iran at the current juncture is also not an anti-American conspiracy. For decades now, the IMF has made a mission of extending financial assistance in the form of loans to countries experiencing public health crises. In this context, Iran requested a $5 billion loan from the IMF to better deal with the coronavirus crisis.

Haley’s problems with understanding the structure and roles of international organizations were readily apparent during her time in office as well as afterward. Haley uses her book, published in 2019, to make her dislike of Secretary Rex Tillerson very clear. She has a cabinet-level position and a direct line to the president. This, she feels, should mean that she is ostensibly an independent organ of the U.S. government wholly separate from the State Department—or a “free electron” as former National Security Advisor John Bolton called her. She has no interest in the State Department having any input in her staffing, policy positions, or formal statements. Her connection to Trump may be direct but it seems too irregular and unsystematic to be an effective mechanism of policy coordination between the American Embassy in Turtle Bay and the White House.

Haley twice claims that Tillerson, trying to head off her trip to International Atomic Energy Agency (IAEA) headquarters in Geneva, lied about having a team to look into the organization’s monitoring of the Iran deal’s implementation. She wanted to personally travel there to interrogate IAEA staff about the Iran nuclear deal that she vehemently opposed. Haley says that Tillerson told her that the trip is unnecessary as he has staff in Geneva meeting with IAEA officials on Iran related issues. She then writes that “I strongly suspected that Rex was making things up as he went along. I had heard nothing about his staff consulting with the IAEA about the Iran deal”. The State Department has an Ambassador-level Permanent Mission to the International Organizations in Vienna which includes the IAEA.

A Lesson from COVID-19: Growth is Part of the Problem | Opinion
ROBERT ENGELMAN
ON 7/10/20

Robert Engelman is a senior fellow at the Population Institute and former president of the Worldwatch Institute.

This is a good week to ponder the dynamics of human population growth, and how it relates to the coronavirus pandemic, which is surging in the U.S. and globally, driven in part by population density. World Population Day, which highlights the importance of issues like family planning for sustainable development, is this Saturday. Meanwhile, this week the U.S. Supreme Court decided that the Trump administration could let employers opt out of mandated contraceptive coverage in the Affordable Care Act.

Does the pandemic demand a rethink of our attitudes toward growth, both demographic and economic? Is perpetual growth really a guarantor of human well-being? Can we create by fiat an endless future of unlimited human numbers and activity? At what point should hubris make some concessions to humility?

"We are as gods," Stewart Brand wrote in 1968 at the opening of his Whole Earth Catalogue, "and might as well get good at it." Half a century later, we are no better at it. The more apt metaphor today might be drawn from Shakespeare's King Lear: "As flies to wanton boys are we to th' gods,/They kill us for their sport."

With new cases of COVID-19 hitting records daily in the United States, the global caseload nearing 12 million and the global death toll well above half a million, the virus is making sport of human pretensions to godlike agency, and turning up the volume on a message that until now we've consigned to the faintest of whispers: growth itself could be part of the problem.

Environmentalists understand that humanity is part of nature and not its master, but most have shied away from connecting our growing numbers and footprint to the growth of infectious diseases. Public health experts and some science journalists, however, have been ringing the alarm bell for decades.

In 1992, the Institute for Medicine published a landmark report, Emerging Diseases, which discussed how population growth, density, and distribution can facilitate the spread of infectious diseases. Laurie Garrett, author of The Coming Plague, has long warned that population expansion and density raise the statistical probability pathogens will be transmitted.

As human population grows, we intrude more into natural habitats and consume more wildlife, giving deadly viruses more opportunity to jump from animals to humans. As human-to-human transmission evolves and accelerates, and travel and trade expand, epidemics sometimes become pandemics.

The scourges of Ebola, HIV/AIDS, Zika, Lyme, West Nile, Mad Cow, SARS, and now COVID-19 came seemingly out of nowhere. But they all have deep and intricate connections to the expansion of human interaction with the natural world. Even if COVID-19 disappears quickly, other new diseases will likely wallop us with increasing frequency and force in the years ahead.

Between 1940 and 2004, as the global population soared from 2.5 billion to 6 billion, over 300 new infectious diseases emerged, and the rate of emergence increased. Those rates are likely to continue rising with population growth. Today, the global population is 7.8 billion and growing at an annual rate of about 80 million—the equivalent of adding three New York City metro areas each year. UN demographers project population will reach 10 billion by mid-century and 11 billion by 2100.

As human numbers grow, so does density. Urbanization is bringing us into closer contact with one another. Now, when social distancing is the most important bulwark against COVID-19 contagion, it's easier to see how density can cause trouble. We can't escape the confinement of our homes for the occasional foray into fresh air or friendly companionship without a raising our risk of contracting the virus. Wherever we go, there we are—in large numbers, with people masked and unmasked, coming up behind us or walking towards us, talking, coughing, and sneezing. Someone posts something about their secret, unpeopled spot in nature, and when we arrive there, hundreds of others, all potential carriers of disease, have already shown up.

If population and density growth declines, infectious diseases may follow suit. Fertility rates were already declining when the pandemic hit, but the coronavirus pandemic cuts two ways in that regard. It temporarily shut down major condom factories, disrupted contraceptive production and distribution and undermined access to safe, effective family planning services, sparking fears of a "COVID baby boom." The Trump administration's attacks on family planning could compound the problem. On the other hand, the pandemic has also prompted many to reconsider or postpone childbearing. Despite the concerns of some economists, that's a logical response and a positive development.

As a matter of human rights as well as public health, it's increasingly important for every woman to be free to make childbearing decisions herself. We need more education and autonomy for women and girls, and more innovative ways to deliver voluntary family planning services everywhere despite the pandemic.

Contrary to Steward Brand's view, we are not as gods. We are human beings, doing the best we can in an increasingly crowded and challenging world. We might as well get good at being human.

Here Are the Polls Trump Is Looking At

July 10, 2020 By Taegan Goddard 

President Trump gave some polling data to Marc Thiessen in an Oval Office interview: “President Trump was going over new polls — some internal, some not — showing him tied or leading Joe Biden in key swing states. ‘Pennsylvania tied. Florida, up one. Wisconsin, up one. Texas, up five. Arizona, Trump 49, Biden 45; North Carolina, Trump up three. And then Montana: Trump up a lot — 52-38,’ he said.”

Philip Bump: “Over and over, we’ve heard Trump wave away the idea that he’s in trouble in November, citing unspecified polls showing him doing well. And here some are — a couple without attribution and presumably internal, but a number with links helpfully included by Thiessen. The Wisconsin poll is from the Trafalgar Group; the Arizona and North Carolina ones from Gravis Marketing. The Montana poll is from the University of Montana.”

“Actual polls, allowing us at last to evaluate whether Trump is right to feel confident about November. He is not.”

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Trump Pushed To Give Intel To Russia While Staying Quiet On Taliban Arms Program

Former officials explain how Russia’s audacious bounty on U.S. soldiers may arise from Trump’s generous foreign policy.

Kremlin.ru / CC BY 4.0

Jul 8, 2020

In a July 8 report, Just Security explores the following question: “Why would the Russian government think it could get away with paying bounties to the Taliban to kill American soldiers?” Just Security concludes that Russia’s audacity may be the combined result of President Donald J. Trump’s non-action in the face of a Russian program to arm Taliban militants and his insistence that the Central Intelligence Agency provide counterterrorist intelligence to the Kremlin in spite of nonexistent returns on the cooperation.

Since February 2017, senior military officials have openly discussed “the problem of Russian provision of weapons to the Taliban.”
Former officials interviewed by Just Security emphasize that the weapons program is a far cry from the bounty program. In theory, “the Russian-Taliban arms program could also be potentially explained, or plausibly denied, by Moscow as an effort to assist the Taliban’s fight against the common enemy of ISIS.”

Nevertheless, the materials “reportedly became increasingly sophisticated,” eventually including night vision equipment that undercut America’s advantage in nighttime combat.
And in light of this growing concern, senior military officials continued discussing Russia’s weapons program in public spheres through September 2018. By then, General John Nicholson told the Voice of America that “We know that Russia is attempting to undercut our military gains and years of military progress in Afghanistan, and make partners question Afghanistan’s stability.”

However, during the same span of time Trump never brought up the issue in his own talks with Russian leaders. As late as July 2018, he “publicly side[d] with President [Vladimir] Putin over the U.S. intelligence community on the Russian interference in the 2016 presidential elections.”

In response to questions about the bounties on July 1, Secretary of State Mike Pompeo instead asserted that the administration “took… seriously” the Taliban arms program.
Just Security explains that while it can’t be ruled out that other officials such as Pompeo, may have raised the arms program with Russian leadership in private talks, “how much would that matter without President Trump’s taking action including in his public statements about Russia and engagements with Putin?”

Brett McGurk, who served as Special Presidential Envoy until December 2018, thinks that it would not have matted at all because “the Russians dismiss anything American officials say if not backed from the top.”

McGurk also asserted that both the Russian bounty and weapons programs “should have been flagged and raised in Trump’s frequent engagements with Putin. It’s even worse if Pompeo was raising the arming issue with Lavrov (as he claims) or Khalilzad with his counterpart, but Trump never raised the issue with Putin. That makes whatever Pompeo may have said irrelevant.”

In addition to Trump’s inaction on Russia’s provision of weapons to the Taliban, Just Security hypothesizes that Russia may have been further emboldened by Trump’s push for the Central Intelligence Agency to share counterterrorism intelligence with Russia’s Kremlin.
Marc Polymeropoulos, who retired in mid-2019 from the Senior Intelligence Service at the Agency, told Just Security that “There was a consistent push for CT [counterterrorism] cooperation with Moscow, coming from the White House, despite near universal belief within the IC [intelligence community] that this effort would be one sided and end up being a waste of time and energy.”
Polymeropoulos added, “To be fair, every administration wants a reset with Moscow, and thus the IC dutifully attempted to engage with the Russian government… Bottom line, we tried, as this was the guidance from policy makers. There was no ‘deep state push back,’ there was no stalling, there was a concerted effort to work with the Russians.”

Douglas London, a CIA Senior Operations Officer who retired at the end of 2018, corroborated this as the administration’s policy. He said, “despite increasing reflections of Russian material support to the Taliban raised publicly by Defense Secretary James Mattis in 2017 and throughout 2018 by General John Nicholson, President Trump pressured CIA to invest time and resources increasing counterterrorist cooperation with Russia.”

However, according to Polymeropoulous, the attempts were unproductive. Of a late 2017 trip to Moscow, he said, “it was a sisyphean task. We ended up only giving information, and not receiving anything worthwhile. I cannot think of anything of value that the Russians provided us, that saved any US lives, or was worth even the time it took to pick up the phone to set up the meetings.”

London also corroborated this, explaining that “The direction [from President Trump to share counterterrorism intelligence] came despite assessments that Russia was not being forthcoming.” London was confident that Russian counterparts used counterterrorism engagements to further counterintelligence” against the United States.

Just Security concludes that as a result of both Trump’s inaction against Russia’s Taliban arms program and his willingness to offer counterterrorism intelligence while gaining little or nothing in return, Putin’s regime in Russia felt emboldened enough to offer Taliban-linked militants paid bounties for U.S. soldiers’ deaths in Afghanistan, confident that there would be no retaliation.

Finally, Just Security asked Ambassador Todd F. Buchwald, an Ambassador for America’s Office of Global Criminal Justice who retired in 2017, what he made of Trump’s response to Russia’s arms and bounty programs.

In an email response, Buchwald chose to compare Trump’s foreign policy toward Russia with his response to recent International Criminal Court allegations against American troops.


This episode just underscores how hard it is to figure out how the Administration decides what are and what are not our urgent national priorities—the situations in which it is appropriate for the President to invoke the extraordinary authorities that Congress long ago entrusted to Presidents upon a “declaration of national emergency.” Look at the administration’s reactions to two threats: the potential for an ICC case alleging U.S. detainee abuse in Afghanistan, and Russian support for the actual slaughter of U.S. service members there.

Just three weeks ago, the President asserted his “steadfast commitment to protecting American service members and defending our national sovereignty” as his basis for his Executive Order imposing sanctions against the International Criminal Court. There are lots of different views about the Court but in fact it has never—in its history—actually convicted, or even prosecuted, the acts of a service member of the standing military of any state, much less a state as strong—and as committed to the rule of law—as the United States. Meanwhile, the Russians have—since the early days of the Administration (see here and here)—been smuggling secret weapons to our battlefield adversaries, intent on conducting actual deadly attacks on those service members; and then, following the President’s lack of objection, appear to have breathtakingly upped the ante by offering bounties for killing American troops.

It is fair to ask: which of the two—the ICC or the Russians—actually imperils our troops in Afghanistan?; and which—in the words of the President’s Executive Order—actually constitutes “an unusual and extraordinary threat” to U.S. national security?

Read more.

THIRD WORD USA

America still doesn’t have enough N95 masks

Five months into the pandemic, the Trump administration hasn’t taken charge of a supply chain that’s been stretched thin.

 Rebecca Heilweil Jul 10, 2020

A member of the medical staff listens as Montefiore Medical Center nurses call for N95 masks and other critical PPE to handle the coronavirus pandemic on April 1, 2020, in New York. Bryan R. Smith/AFP via Getty Images

In the early weeks of the pandemic, it was nearly impossible to buy N95 masks. These masks, unlike surgical masks or cloth masks, are tight-fitting and filter airborne particles that can carry the virus, making them a key source of protection for health care workers, some of whom have died after being exposed to Covid-19 at their medical facilities. Now, as the United States continues to reopen and the number cases and hospitalizations surge, that troubling shortage of personal protective equipment — and especially N95 masks — is once again a problem.

A survey from the National Nurses Union found that 85 percent of nurses reported being asked to reuse personal protective equipment that’s meant to be single-use. At one private clinic in Arizona, medical workers are treating Covid-19 patients without being given any N95 masks, according to the New York Times. The shortage is so dire that the inventor of the powerful filtration material in these masks has come out of retirement to look for ways to decontaminate his invention and make them safer for reuse.

But why is there still a shortage? Despite months of shutdown that were meant to reduce pressure on the health care system and give the US more time to prepare, production for personal protective equipment, which includes N95 masks, medical gowns, and medical gloves, never adjusted to meet the massive demand caused by the pandemic. At the same time, reopening in many states has meant that other businesses, like outpatient medical offices and construction firms, are now in search of N95 masks too. Meanwhile, the recent surge in Covid-19 cases that has followed reopening is almost certainly leading to a greater need for protective equipment in hospitals, especially in the places currently experiencing massive outbreaks, like Florida and Texas.

In early April, Donald Trump invoked the Defense Production Act (DPA), which allows the federal government to order private companies to produce needed supplies, to obtain more masks produced by 3M, one of the major American mask manufacturers. Later that month, the Department of Defense announced several other contracts for N95 masks. But as it becomes increasingly evident that these measures weren’t enough, organizations like the National Nurses United, a nationwide nurses union, and the American Medical Association have in recent weeks called for the Trump administration to use the law more aggressively to address the PPE shortage.

Earlier this week, presidential candidate Joe Biden released a supply chain plan for Covid-19 that calls for more broadly invoking the DPA, in part to deal with the ongoing shortage of N95 masks. “The Trump administration is still dragging its feet on using the DPA to produce urgently-needed supplies to combat the COVID-19 pandemic, and has fallen far short of the domestic mobilization we need,” the plan says.

“There was sometime in May where I felt like it was getting to more of a steady state,” Anne Miller, the sourcing lead for Project N95, a protective equipment clearinghouse established during the pandemic, told Recode. “The whole tenor of everything seems to be ramping back up again, and we see lots of requests for N95 respirators, isolation gowns, and surgical masks.”
A growing number of cases is increasing demand

Since states across the country have moved toward full reopening, the coronavirus crisis has arguably gotten worse than it has ever been. On July 9, the US saw nearly 60,000 new Covid-19 cases. In a majority of US states, Covid-19 cases are increasing, according to the New York Times, and outbreaks risk overwhelming some rural hospitals and smaller cities that weren’t prepared for the pandemic.

“It feels like right now we see more demand this week than we did last week, and I think we will continue to see that,” said Miller, who expects that reopening schools and universities will also cause another surge in cases, though she notes that heightened demand for N95 masks never really went away.

But national coordination of a supply chain was never set up to effectively distribute personal protective equipment and other supplies, despite calls for the federal government to step in. The National Strategic Stockpile didn’t have a large amount of backup supplies to begin with, and it wasn’t set up to respond to the full needs of a pandemic. Without leadership from the federal government — which insisted that supplies should be handled on the local and state level — governors and hospital systems have been arranging their own private purchases of personal protective equipment, often directly competing with one another. It’s an approach that Illinois Gov. J. B. Pritzker recently likened to the Hunger Games.
Opening up means more people need protective equipment

When the pandemic first started, the country’s primary concern was getting protective equipment to hospital health care workers who were treating Covid-19 patients. But as the country opens back up, people working in medical and dental offices, as well as other industries like construction, are looking for N95 masks too.

Michael Einhorn, the president of the medical supplier Dealmed, said there’s also an understandable incentive for medical facilities to buy more safety stock beyond what they need for present day-to-day operations. He points to efforts like New York Gov. Andrew Cuomo’s 90-Day Supply Goal as an example. That guidance urges health care facilities to have in stock enough protective equipment to last about three months.

“There are biopsies that need to take place. People need to get screened and tested. There are people out there that need treatment outside of Covid,” Einhorn told Recode. “These facilities that treat these patients don’t have access to N95s, and it’s a very big problem.”

At the end of June, the American Medical Association (AMA) sent a letter to the Federal Emergency Management Agency (FEMA) emphasizing that doctor’s offices and practices outside of hospital systems were struggling to get access to personal protective equipment. James Madara, the AMA’s CEO and executive vice president, raised the alarm about “growing concern” from doctors about shortages and said that despite pleas to Congress, “a remedy remains elusive.” In fact, the problem in outpatient medical facilities was bad enough that Madara also sent a letter to Vice President Mike Pence, asking the administration to invoke the Defense Production Act.

“Without adequate PPE, physician practices may have to continue deferring care or remain closed, which will continue to have a dramatic impact on the health of their patients,” Madara wrote.

One major challenge is that many of these medical facilities don’t typically buy in bulk the way large hospital systems do and aren’t used to buying protective equipment for their daily operations. One doctor told a local paper in Pennsylvania that if his surgery center and clinic were to reach full capacity, it would only have enough PPE to last a week or two and would then have to shut down.

“If I’m a doctor, and I’m going to open my practice and … need a respirator every day, I only need a box of 20,” explains Miller, from the N95 Project. “But you can’t go out and buy a box of 20.”
The supply chain is still riddled with problems

On its own, the US simply isn’t producing enough N95 masks and other protective equipment to meet demand, despite major producers like 3M and Prestige Ameritech ramping up production. Even before the pandemic, the US relied significantly on imports, especially from China, and many point to a lack of leadership and coordination in the early months of the pandemic as a cause for the ongoing shortages.

The federal government actually turned down an early offer from Prestige Ameritech to produce millions of masks early this year, according to the Washington Post. Leading companies in the medical equipment distribution industry also told members of Congress that between January and March, the administration gave them little effective guidance, and there’s still no national coordination of a supply chain.

At the beginning of the pandemic, finding a steady and trustworthy supply of N95 masks was difficult. Hospitals ended up with counterfeit and otherwise unreliable products, while others placed orders for masks that would never arrive. There was also price gouging and hoarding, and a growing number of new, and often unreliable, suppliers attempting to take advantage of desperate buyers.

The murkiness of the supply chain has improved somewhat, though issues remain. Miller, who has kept an eye on the gray markets for protective equipment, said that many “opportunistic players have been winnowed out of the market.” The ones that remain are more reliable, and payment terms for bulk purchases have begun to return to normal. Dealmed’s Einhorn said that hospitals and buyers have become more aware of unreliable orders and the risk of counterfeit or otherwise suspicious products.

“Our government has basically said that we’re going to allow the free economy to fix the issues,” Val Griffeth, an Oregon-based doctor who co-founded a nonprofit PPE effort called Get Us PPE, told Vox last month. “Unfortunately, it takes time and capital to ramp up production, and because the government has not devoted capital to helping solve the situation, we’re seeing a delay in its resolution.”

In fact, officials don’t seem to think shortages are as significant as some medical workers have said. Vice President Mike Pence on Wednesday said that the supply of PPE is “very strong” and encouraged medical workers to re-use products.

“I’m not going to tell you we’re able to meet all demand, but there’s significantly less unfulfilled orders today than in April,” the navy official who is overseeing medical supplies distributed by the federal government, John Polowczyk, told the Washington Post in early July. “I don’t have the sense of there being severe shortages.”

It’s difficult to estimate exactly how bad the national shortage is at scale, but direct reports from medical facilities are alarming. Doctors at a medical center in Houston told the New York Times they’ve been instructed to reuse N95s for up to two weeks. A family physician in Virginia, who is on the state’s testing task force, told local news that surgical masks continue to be used unless they become dirty, and disposable gowns are also reused. In Bradenton, Florida, nurses have protested because, they say, they’re not given enough proper protective gear and aren’t updated about patients’ Covid-19 statuses.

If cases continue to surge, there’s no doubt that concerning reports like these almost certainly will, too.

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Housing segregation left Black Americans more vulnerable to Covid-19

Racist WWII housing policy might not sound like it has much to do with the coronavirus. But it does.

Dylan Scott@dylanlscottdylan.scott@vox.com Jul 10, 2020

Housing discrimination dating back to the 1940s put Black Americans more at risk of contracting and dying from the Covid-19 coronavirus. Here’s how. 

Matthew J. Lee/The Boston Globe via Getty Images

One thing hasn’t changed as a new surge of coronavirus cases has swelled across the United States: Black Americans continue to disproportionately get infected by and die from this novel pathogen.

The Los Angeles County health department reported this week that Black residents were dying at twice the rate its white residents were. The same is true of Black Alabamans. In Florida, Black people account for a higher share of Covid-19 hospitalizations and deaths than their share of the population.

The George Floyd protests forced a difficult conversation about the trade-offs of congregating in large groups during a pandemic and the urgency of fixing structural inequities. But more than a month later, there is little evidence the protests contributed to a significant acceleration of the coronavirus’s spread. The health consequences of US inequality, however, are still being felt by Black (and Hispanic and Native) Americans during the worst pandemic of our lifetimes.

Health disparities predate Covid-19, of course, as Jamila Taylor recently reviewed for the Century Foundation: Black Americans live shorter lives than white Americans, they have higher rates of chronic disease, they report worse mental health, they have less health care access, etc.

“Whether it’s from violence in the street or violence in the health care system, Black Americans have been dying for not just the last three months but the last three centuries,” Utibe Essien, a practicing physician who teaches at the University of Pittsburgh’s medical school, told me.

Let’s start with the obvious problem: interpersonal racism, whether tacit or explicit, directly harms Black people’s health. So does the distrust it has created between Black Americans and American institutions. This problem goes back centuries: US slaves were experimented on, and more recently, there are horrifying stories like the Tuskegee syphilis experiment. Numerous studies, some of them conducted as recently as 2016, have foundBlack people were less likely to be given pain medication in an emergency department.

And in the middle of the Covid-19 crisis, a new report found that Black people who reported Covid-like symptoms — namely, fever and cough — were less likely to be given a test for the virus compared to white people with the same symptoms. In all these ways, internalized and interpersonal racism lead to worse health outcomes for Black Americans.

But structural racism is also usually, and correctly, proposed as a critical explanation for these inequities.

After speaking last month with half a dozen Black scholars, I came to believe the best place to start in understanding how structural racism breeds racial health disparities is residential segregation. Where a person lives has direct health effects and, maybe as importantly, it will situate them for economic success or failure for the rest of their lives — which we also know is an important determinant for health.

This analysis isn’t meant to be comprehensive. That would require a whole book. But if you want to better understand how structural racism translates to the health disparities that have left Black Americans prone to Covid-19, those factors should be a good place to start.
Residential segregation is one of the primary causes of health disparities

Every scholar I spoke with included residential segregation as a primary driver of racial health disparities — taken together, they identified it as maybe the primary driver.

“I think of residential segregation by race as one of the upstream drivers,” David Williams, a professor of public health and sociology at Harvard, told me. As he wrote in a May 2020 editorial for JAMA on Covid-19 and health equity: “Social inequities are patterned by place, and opportunities to be healthy vary markedly at the neighborhood level.”

The culprit for racial housing segregation is what was called “redlining” during the mid-20th century. If you’d like to read a book about it, I would recommend Richard Rothstein’s The Color of Law for the full story. But in brief, redlining meant that certain neighborhoods were given preference by the Federal Housing Administration. To receive loans to build housing developments or mortgages to buy one of those homes, real estate developers and homebuyers were directed to areas with “harmonious” racial groups (i.e. Black or white). Red lines were drawn around Black communities; white people did not get loans to build or buy houses in them, while Black people were only given loans to build or buy houses there.

And though racial discrimination is no longer enshrined in official government policy, its legacy is still felt among Black homebuyers today.

“There is a direct line from US government-led discrimination against Black people in housing — also known as redlining — to racism against Black buyers in housing in real estate today,” Belinda Archibong, an economics professor at Columbia University, told me. She cited a three-year investigation published by Newsday in late 2019 that found half of Black homebuyers on Long Island faced some kind of discrimination from real estate agents.

That helps explain why housing segregation persists. As the Economic Policy Institute reviewed earlier this year, just 13 percent of white students attend a school that has a majority of Black students, while nearly seven in 10 Black students do.

How does that discrimination affect Black people’s health? If you’re well-versed in health wonk lingo, you know the phrase “the social determinants of health.” First and foremost, those determinants reflect where a person lives. Williams, in his JAMA piece, ticked through all the ways in which the simple location of a person’s residence can affect their health:

Segregation also adversely affects health because the concentration of poverty, poor-quality housing, and neighborhood environments leads to elevated exposure to chronic and acute psychosocial (eg, loss of loved ones, unemployment, violence) and environmental stressors, such as air and water pollution. Exposure to interpersonal discrimination is also linked to chronic disease risk. Greater exposure to and clustering of stressors contributes to the earlier onset of multiple chronic conditions (eg, hypertension, heart disease, diabetes, asthma), greater severity of disease, and poorer survival for African American individuals than white persons. For example, exposure to air pollution has been linked to hypertension and asthma, as well as more severe cases of and higher death rates due to COVID-19.

During Covid, we have seen Black neighborhoods in New York City bear the brunt of infections and deaths. These disparities are even found in testing sites; News 5 in Cleveland reported this week that many chain pharmacy locations inside the city were not offering coronavirus testing, while the stores situated in the suburbs were much more likely to make tests available.

So place, determined in large part by residential segregation set in motion long ago, affects Black people’s health to this day. But its effect is more pernicious than that.
Residential segregation also helps determine economic opportunity, which strongly influences health

It’s not just how the environment affects one’s health. It’s how your place of residence affects your economic opportunities, which in turn can also have an outsized impact on a person’s health.

“Homeownership was and has been the way that Americans build wealth and are able to pass that wealth down,” Jessie Marshall, who studies health disparities at the University of Michigan’s medical school, told me. “With these government-subsidized mortgages being made available to whites and not so for Blacks, that really further set the stage for income inequality.

“As a result of that, there was continued investment into those communities that benefited from the subsidized government mortgages. The building of wealth but then also the building of public K-12 education of good quality,” Marshall continued. “In contrast to those on the other side of that red line, essentially neighborhoods of largely Black folks who did not have those same opportunities, they were not able to build or pass down wealth and were left to be in neighborhoods that were poorly funded for K-12 public education.”

The second and third-order effects have continued to ripple out over the last 75 years. As of 2018, Black Americans had accumulated just 10 cents of wealth for every dollar of wealth possessed by white Americans. In their incomes, Black Americans make just 59 cents for every dollar white Americans are paid. Research has indicated that if residential segregation were to be ended, many of those economic disparities would be dramatically reduced.

Instead, segregation preserves economic and education inequities, which in turn have perverse health effects. Returning to Williams’s JAMA op-ed, he wrote: “Segregation is a critical determinant of economic status, which is a strong predictor of variations in health.”

People who live in lower-income neighborhoods typically have more tobacco shops in their neighborhood (which drives up smoking) and they have less access to fresh food (which drives up obesity). Both smoking and obesity are precursors to the higher rates of diabetes and heart disease seen among Black Americans. As Health Affairs covered in a 2018 article, a person’s income can influence their health in disturbingly literal ways:

A robust literature links chronic stressors, including financial hardship, to deleterious genetic and hormonal changes—such as impaired DNA repair mechanisms and higher cortisol and adrenaline levels—that increase the risk of chronic disease. The negative cardiometabolic effects of poverty seem to start early and continue throughout the life course.

Something as simple as insurance coverage, which correlates to better health outcomes, follows from one’s economic well-being. The uninsured rate among white Americans is 8 percent; among Black Americans, it’s 11 percent. (It’s even higher for Hispanic Americans and Native Americans.) Black Americans are less likely to receive health insurance through their work and they are more likely to depend on Medicaid than white Americans.

Black Americans have also been disproportionately harmed by mostly southern states refusing to expand Medicaid under the Affordable Care Act. More than 2 million people have been left without any health insurance because of that policy choice, and “uninsured Blacks are more likely than Whites to fall in the coverage gap in states that have not expanded Medicaid,” according to the Kaiser Family Foundation; 15 percent of all uninsured Black Americans would qualify for Medicaid coverage if their state accepted the expansion

Race, place, income, and health, as should be obvious by now, are inextricably linked. And the health consequences of these inequities have been especially evident during the Covid-19 pandemic, as Williams covered:

Economic status matters profoundly for reducing the risk of exposure to SARS-CoV-2. Lower-income and minority workers are overrepresented among essential service workers who must work outside the home when shelter-in-place directives are given. Many must travel to work on buses and subways.

Black Americans have been squeezed from both sides by the coronavirus crisis: Many of them work in the industries enduring serious layoffs, and they are also more likely to work in jobs that are considered “essential,” which requires them to go into work and risk exposure to the coronavirus.

Either way, their health is at risk. And we are seeing the consequences in the Covid-19 death rates.

“It’s America’s institutions and laws, replicated cumulatively over time, that have led to more Black Americans being disproportionately — relative to the rest of the population — classified as essential workers,” Archibong told me, “and concentrated in low-wage service sectors that have placed them at higher risks from infection and mortality from Covid-19 today.”