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Inequality Is a Health Risk—and It’s Getting Worse

In 2024, the maternal mortality rate (MMR) in the United States and the United Kingdom will grow, although postmortem reviews conclude that 80 percent of maternal deaths in high-income countries are preventable. Rates in high-income countries across Western Europe and Asia did decrease between 1990 and 2010, yet in some of these countries, like the UK, MMRs have risen over the past decade. The US MMR has been an outlier throughout, almost doubling in the first decades of the 21st century.

Reasons to support the prediction that MMRs will go up include the continuing consequences of the Covid-19 pandemic. However, MMR increases in the US and UK predated Covid, suggesting the pandemic exacerbated deeper problems.

Neglect and systematic bias in medical care systems is one of them. In the US, critical challenges to improvement include the lack of universal health insurance and the increasingly competitive health care system: The US has hemorrhaged maternity care providers to the point that 36 percent of US counties, mostly rural, have none. In the UK, health care is theoretically available to all, yet the NHS has suffered insufficient investment in its facilities and equipment. Half of NHS Maternity Units are now judged substandard; shortages of midwives have hit crisis proportions. Obstetricians and midwives in both countries are suffering burnout and choosing to strike, practice abroad, retire, or change profession.

Racial and class inequity is entrenched. The highest MMRs and largest increases are in minoritized, working class, or deprived populations. Devastating as inadequate health care systems are for these groups, the fundamental causes of their health inequities are adverse living conditions, including the stigma and discrimination they face. Robust scientific evidence that the multiple systemic assaults with which they must contend in their daily round—material hardship, environmental toxicity, decaying municipal infrastructure, and structurally rooted psychosocial stressors—chronically activate their human physiological stress response.

Combined, the stressors and the tenacious coping they entail cumulatively damage health down to the cellular level, in effect accelerating biological aging. Such erosion, called “weathering,” leaves the marginalized, maligned, or exploited to suffer multiple infectious and chronic diseases, functional limitations, and even death, long before they are chronologically old. In populations subject to the most severe weathering, the increasing trend of having children at older ages increases the risk of adverse maternal and infant outcomes. Maternal mortality is a barometer of weathering’s contribution to excess deaths, as the physical stress of pregnancy is harder to withstand for a weathered body, while other manifestations of weathering often become life-threatening only after the reproductive ages.

In 2024, weathering will keep being fueled by racism, classism, xenophobia, political polarization, resentment, white nationalism, and austerity budgeting. Brexit, one outgrowth of this resentment, now exacerbates UK labor shortages, supply-chain bottlenecks, inflation, and a reduced gross domestic product. Neither the US nor Western Europe fully embrace their minority or immigrant populations.

In 2024, this problem will intensify as wars and climate change increase the flow of immigrants of color. Despite the facts, the official stance of the UK Equalities Minister is dismissive of systemic racism as a cause of health inequality. The 2021 Report by the UK Commission on Race and Ethnic Disparities turns to an unsubstantiated victim-blaming shibboleth, inferring that inequity stems from the failure of minoritized populations to exercise agency and take advantage of apparently abundant health-promoting opportunities. In the politically polarized US, active and influential populist movements seek to whitewash American history.

In 2024, countermovements to take racist and classist history seriously will continue to run up against strong undercurrents of political scapegoating and zero-sum thinking throughout both countries, increasing the severity and reach of weathering.

AI Hits the Campaign Trail

AI Hits the Campaign Trail

It’s an election year in the US, which means you can expect a fresh tsunami of campaign ads in your feeds, in your inbox, and jammed in front of YouTube videos. This is also the first election of the AI era, where anyone can generate just about anything—an image, a Twitter bot, a speech—by typing a few lines of text into a prompt. Whether it’s bad actors generating misleading deepfakes or candidates using text generators to write cringey campaign emails, AI is now firmly part of the election process.

This week on Gadget Lab, WIRED senior politics writer Makenna Kelly joins us en route from the Iowa caucus to talk about how scammers and political campaigns alike are using AI to influence voters at the polls.

Show Notes

Read more from Makena about the Iowa caucus and the end of Vivek Ramaswamy’s campaign. Scroll through her TikToks about the caucus. Follow all of WIRED’s coverage of the 2024 election and artificial intelligence.

Recommendations

Makena recommends Uniqlo under layers. Mike recommends the cringey Nathan Fielder and Emma Stone show The Curse. Lauren recommends the show Catastrophe.

Makena Kelly can be found on social media @kellymakena. Lauren Goode is @LaurenGoode. Michael Calore is @snackfight. Bling the main hotline at @GadgetLab. The show is produced by Boone Ashworth (@booneashworth). Our theme music is by Solar Keys.

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Global Emissions Could Peak Sooner Than You Think

Global Emissions Could Peak Sooner Than You Think

Every November, the Global Carbon Project publishes the year’s global CO2 emissions. It’s never good news. At a time when the world needs to be reducing emissions, the numbers continue to climb. However, while emissions have been moving in the wrong direction, many of the underpinning economic forces that drive them have been going the right way. This could well be the year when these various forces push hard enough to finally tip the balance.

In 2022, the International Energy Agency (IEA) said it expected global energy emissions to hit their peak by 2025. This estimate marked a big change from the year before, sparked by accelerated investments in low-carbon technologies following the war in Ukraine. Rystad Energy—another research and analysis group—also expects a peak by 2025. Ember Climate—the leading source on global electricity data—estimates that emissions from global electricity already peaked in 2022. Analysts might disagree on the exact date, but it’s clear that a peak in emissions is now well within our grasp.

The world is already steadily decarbonizing its electricity. Solar and wind are growing quickly, and in 2024 these two sources of renewable energy could outstrip the increase in electricity demand. If this happens, coal- and gas-burning will go down, and so will emissions.

Unsurprisingly, when we actually reach peak emissions will depend a lot on the world’s largest emitter, China. In 2023 its emissions were still rising. This is partly due to its continued recovery from Covid-19. An ongoing drought also means its hydropower output has dropped. These factors highlight, again, how difficult these things are to predict: One unexpected event can always flip a peak into another record-breaking year.

China’s peak, however, is going to come soon, because of record-high deployments of solar and wind, and an increase in nuclear power. Soon, the country will be adding enough sustainable energy to cover its growing electricity demand. China’s solar and wind output is already enough to cover the total electricity use of some of the world’s largest economies like Canada, Brazil, Russia, Japan, and even the world’s most populous country, India. In 2023 alone it could add enough to cover the UK’s entire electricity use.

Another reason why the peak in global emissions might arrive in 2024 is the electric car revolution. Global sales of petrol and diesel cars peaked half a decade ago, and the IEA estimated that almost one in five cars sold globally in 2023 were electric. Previously, the agency hadn’t expected this milestone to be reached until 2030. (In 2020, this figure was just 4 percent.) This move to EVs will start to eat into global oil demand, until its peak arrives too. According to a report by Bloomberg New Energy Finance, this could be as early as 2027.

Of course, peaking emissions is just the start. The world needs to then reduce emissions, and quickly. But the downslope will be easier than the turning point, as the energy transition will no longer be in its infancy. 2024 will hopefully mark the beginning of a mature low-carbon global economy.

Why Tech Workers Are Ditching Big Cities for Boise

Why Tech Workers Are Ditching Big Cities for Boise

The past year has brought a reckoning in the tech job industry across the US, upending career trajectories for recent grads. When they chose majors like computer science four years ago, they expected to follow those before them into a lucrative market with perks at Big Tech companies like Meta, Amazon, and others. But instead they’ve been met with hiring freezes and massive layoffs across the industry that have forced pivots. Those changes are bleeding into 2024. Twitch, Discord, Duolingo, Amazon, and Google all announced cuts last week. Some hopeful tech workers have spent countless hours applying to gigs without luck, and others are looking more to the government for tech work, seeking purposeful work and reliability.

There’s so much opportunity in Boise because the area’s nascent talent pool hasn’t caught up to meet the tech industry’s demands, says Nick Crabbs, partner and chief community officer at software company Vynyl and a native of Boise’s tech scene who previously helped lead Boise Startup Week. That has led to the in-migration, but the city’s unusually friendly nature and smaller industry also helps boost young careers, Crabbs says. “If you come to Boise, you can very quickly kind of accelerate yourself into career-advancing moves.”

In the wake of some 400,000 tech layoffs between 2022 and 2023, young people are looking for new types of work. More than 40 percent of job applications submitted by tech majors on Handshake went to internet and software companies in 2021, but that number fell to 25 percent by September 2023. In the same time, applications to government jobs doubled. Handshake also found that women in tech-related majors are more likely than men to submit applications to roles in finance, management, consulting, government, education, health care, and research companies, while men are more likely to apply to internet and software companies.

Some of the Boise boom will continue to be driven by Micron, which employs around 5,400 people in Boise. Its expansion is expected to create 17,000 jobs, with 2,000 of those directly at Micron, by 2030, says Scott Gatzemeier, the company’s corporate vice president of frontend US expansion. The company gave full-time jobs to nearly 200 of its interns last year, and plans to have some 370 more interns work at the company this year.

But there’s a startup and entrepreneurial culture driving growth, too. Boise today feels like Nashville or Austin two or three decades ago, says Clark Krause, executive director of the Boise Valley Economic Partnership, a regional business organization. A Boise chef won a James Beard award in 2023, the city has an annual music festival with dozens of artists, and there’s nearby skiing and hiking. A one-bedroom apartment rents for an average of $1,300 a month. “You can afford to have the lifestyle you dreamed about really easily here,” Krause says.

But as the tech industry simmers, the city is feeling the strain. “We’ve had all the benefits of growth, but also all the challenges of growth,” Krause says. Housing prices in Boise have jumped by more than 50 percent since 2019. The city is investing $340 million to make its downtown more walkable, and also announced plans to redevelop hundreds of affordable housing units last year. But it will need to build around 2,700 new housing units each year to keep up with demand, a 2021 analysis from the city found. Construction in Boise fell some 4,000 units behind that goal over a three-year period preceding the report.

Labor experts say the dust from tech layoffs is starting to settle. But Gen Z is focused on stability, says Christine Cruzvergara, chief education strategy officer at Handshake. “When you’re thinking about stability, and then you see headlines about layoffs, that doesn’t read stability,” she says. The move to more affordable, non-coastal cities in the US is appealing for a generation that has watched millennials struggle under student loan debt and rising housing costs. “As long as housing continues to skyrocket in some of the major cities, some of these secondary cities that are a little bit smaller, a little bit more manageable, will continue to see a bit of an increase in the number of young professionals that are willing to go there.”

WIRED has teamed up with Jobbio to create WIRED Hired, a dedicated career marketplace for WIRED readers. Companies who want to advertise their jobs can visit WIRED Hired to post open roles, while anyone can search and apply for thousands of career opportunities. Jobbio is not involved with this story or any editorial content.

Big Tech Won’t Let You Leave. Here’s a Way Out

Big Tech Won’t Let You Leave. Here’s a Way Out

The platform is the canonical form of internet business: a two-sided market that facilitates connections between end-users and business customers. Uber connects drivers with riders; Amazon and eBay connect sellers with buyers; TikTok and YouTube connect performers with audiences; social media connects people with something to say with people who want to hear it.

And yet, lax competition law has allowed companies to consolidate, cornering their markets. Consolidated sectors, meanwhile, find it easy to sing with one voice, blocking the passage of unfavorable regulation (there’s still no US national privacy law) or its enforcement (the EU’s General Data Protection Regulation shows that Ireland is even more valuable as a lawless regulation haven than it ever was as a mere tax haven).

Undisciplined by competition or regulation, platforms are free to slide into “enshittification,” in which the company extracts value from both sides of the two-sided market, relying on lock-in to keep users and business customers from defecting to a rival. The year 2023 was when the platforms soured: Twitch, Reddit, Twitter, Facebook, Instagram, Google Search, and Discord all spiraled into terminal enshittification, transferring value from users to shareholders, leaving behind shambling half-dead things that were disagreeable, but un-quittable.

The secret to that un-quittability is high “switching costs”—the economists’ term for the things you have to give up to leave a service. You hate Facebook, but you love connecting with your communities, friends, and customers. They’re holding you hostage on Facebook’s behalf—and you’re holding them hostage, too. Facebook literally banks on these high switching costs: The US Federal Trade Commission’s antitrust case against Facebook revealed internal memos in which a product manager explicitly sets out to design features that “make switching costs very high for users” in order to make it “very tough for a user to switch” to a rival service.

Regulators are increasingly alive to the fact that Big Tech deliberately designs its products to impose high costs on users who have the temerity to prefer their competitors. If a company fails to offer official means for users to take their data with them, or to continue to communicate with the contacts they leave behind when they change platforms, those users have little recourse. The once-common practice of reverse-engineering a rival platform to make an unofficial, interoperable bridge—say, a tool that scrapes your Facebook, Twitter, LinkedIn, and other messages for a common inbox on a new, privacy-respecting service—have been effectively outlawed by anti-circumvention laws, patents, copyrights, and exotic contract theories like “tortious interference.”

Despite these barriers to exit that keep users tethered to bad platforms, most of the regulatory response to Big Tech has been aimed at making it better, rather than making it easier to leave. We keep making rules obliging Big Tech to police disinformation, harassment, and a host of other evils, but with the passage of the EU’s Digital Markets Act (DMA), we’re finally focusing on making Big Tech less important to its users, and thus less sticky.

The DMA lets the commission draft per-service rules to facilitate “interoperability”—connectivity—with new services. This isn’t mere data portability, or downloading a blob containing all the messages you’ve sent and the photos you uploaded. It’s the ability to leave a service, set up elsewhere, and resume the conversations and transactions you left behind. For example, under the DMA, it should be possible to leave Facebook and set up on a community-run Mastodon server, and continue to participate in group discussions and exchange individual messages with the people who aren’t ready to leave (yet).

In the UK, the long-overdue Digital Markets, Competition and Consumers Bill finally gives enforcement powers to the Digital Markets Unit at the Competition and Markets Authority, which has dozens of smart engineers and policy people on HMG’s payroll, all champing at the bit to turn their detailed market studies into policy. If the bill passes, they’ll have broad latitude to fashion remedies for each dominant service, including interoperability mandates obliging walled gardens to install gateways for new market entrants, making it easy for users to leave without isolating themselves from important social relationships.

In the US, multiple interoperability bills with broad bipartisan support have made it out of committee, only to be denied a vote after intense lobbying by the tech sector. But if the UK and EU impose interoperability on tech firms, it won’t matter whether America’s captured legislature can’t manage to add its own—users all over the world will get the benefits of interop and its incineration of switching costs.

These remedies will start to come online in 2024. I believe we will see one or more of the Big Tech platforms facing a legal requirement to facilitate their users’ departure: “Mr. Zuckerberg, tear down that wall(ed garden).”