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Around the halls: Examining the impact of what does (or doesn’t) happen at COP26

The 26th U.N. Climate Change Conference (COP26) is scheduled to take place in Glasgow from October 31 to November 12, under the co-presidency of the United Kingdom and Italy. Brookings scholars from around the institution weigh in on how what does (or…

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By Amar Bhattacharya, David Dollar, Vanda Felbab-Brown, Jeremy Greenwood, Samantha Gross, Shuxian Luo, Sanjay Patnaik, Natan Sachs, Todd Stern, Rahul Tongia, David G. Victor

The 26th U.N. Climate Change Conference (COP26) is scheduled to take place in Glasgow from October 31 to November 12, under the co-presidency of the United Kingdom and Italy. Brookings scholars from around the institution weigh in on how what does (or does not) happen at the conference will impact their area of expertise. 


Climate change finance at the macro level


AMAR BHATTACHARYA
Senior Fellow, Center for Sustainable Development

Earlier this year, Special Presidential Envoy for Climate John Kerry described COP26 as “our last, best, chance on climate.”  Since then, evidence has mounted on the costs of climate change and the urgency of action. Most compellingly, the United Nations’ 2021 Intergovernmental Panel on Climate Change report amasses the scientific evidence on the rapid acceleration of climate change, dramatically narrowing the window for limiting global warming from 2°C to 1.5°C and underscoring the imperative to reach net zero emissions by 2050.

The U.K. COP26 presidency aims to respond to this urgency through four priorities: secure global net zero by mid-century and keep 1.5°C within reach; adapt to protect communities and natural habitats; mobilize finance; and work together to deliver. In each of these four areas there has been a substantial ramp up in ambition.  But this progress still falls short of what is needed.

One hundred and thirty countries have committed to net zero, and several — including the G-7 — have set much more ambitious targets for emission reductions by 2030. But many major emitters have not, and the aggregate commitment will fall far short. Many donors have stepped up their climate finance commitments, and a new delivery plan indicates that the $100 billion of climate finance per annum by 2020 commitment will be met no later than 2023. But we now know that around $1 trillion per annum will be needed in developing countries other than China, to accelerate climate investments at the pace needed.

All efforts must be made at COP26 to press for ambitious, concrete deliverables. Inevitably though, much more will need to be done. It will be a success, not a failure, for COP26 to clearly recognize the shortfalls and set a path that can allow us not just to deliver on climate goals but also realize the growth and development opportunities that lie in a low-carbon future.

China’s economic calculations on climate


DAVID DOLLAR (@davidrdollar)
Senior Fellow, John L. Thornton China Center

China has put itself in a tough situation heading into the Glasgow conference. It has created problems in its own power sector for reasons not directly related to climate change. It stopped importing coal from Australia because that country called for an independent international effort to find the origins of COVID-19. Strong rebound in China’s economy in the first half of the year then led to a surge in the price of coal. But prices for electricity were kept at arbitrary low levels, so that it was not economically efficient to use coal to generate power. The result has been the worst power shortages in 20 years, and still high prices of coal as China heads into the winter season.

Meanwhile, the world is looking to China — by far the largest emitter of greenhouse gases — to lay out bold new measures and targets for carbon reduction. But it is difficult for the government to make concrete commitments as long as its immediate energy crisis continues. With the right policies, Beijing could address both short and long-term issues at once. Most important would be a higher price for power and energy more generally, which would discourage wasteful use and solve the immediate power shortage. China has ambitious plans to increase reliance on solar, wind, hydro, and nuclear to generate power, and to transition its vehicle fleet to electric vehicles. But its plans still rely on coal for a long time. More commitment to energy efficiency and use of gas as a transition fuel would significantly reduce its near-term carbon footprint.

Biodiversity


VANDA FELBAB-BROWN (@VFelbabBrown)
Senior Fellow, Center for Security, Strategy, and Technology and Director, Initiative on Nonstate Armed Actors

Coming on the heels of the first part of COP15 to the Convention on Biodiversity, COP26 is an opportunity not only to implement meaningful climate commitments, but also to integrate them with biodiversity conservation. Climate change is one — but only one — manmade cause of critical biodiversity loss. Our current rate of biodiversity loss is the highest since the extinction of dinosaurs, and about one thousand times the historic average. Climate change compounds the extinction of species, yet biodiversity loss also hampers the planet’s natural climate control systems. In other words, the greater the biodiversity loss, the more the planet will heat up. This is merely one example of how many of the planet’s self-sustaining ecological systems are undermined by biodiversity loss.

Yet biodiversity protection has been the poor relation of climate mitigation efforts in international diplomacy. Worse yet, many proposed and even implemented climate mitigation measures ignore biodiversity protection, such as when they predominantly focus on urban areas and do not focus on preserving natural ecosystems like forests.

Some presumed climate mitigation measures even directly contradict biodiversity conservation. Take, for example, subsidized programs for planting trees. If such programs do not also provide funding for the conservation of mature and diverse forests and their biodiversity — and if such payments for conserving ecosystems are not significantly higher than the subsidies for cultivating new trees — local communities or industries frequently tend to fell existing forests (thus undermining or destroying the entire ecosystem) to qualify for subsidies for monocrop plantations. The resulting carbon capture is smaller, and biodiversity is lost.

Security around the Arctic

JEREMY GREENWOOD
Federal Executive Fellow, Center for Security, Strategy, and Technology

It’s been well-documented that the Arctic is the bellwether for how global warming is impacting our planet. So, it’s no surprise that leaders gathering for the 26th U.N. Climate Change Conference in Glasgow next week have been laser-focused on the Arctic.

Russia is often accused of doubling down on its future in fossil fuel development, much of it from its melting northern coastline that is rich in offshore oil and gas deposits. That same melting ice has opened up a transport corridor that Moscow has unilaterally formed as a maritime “toll road” — known as the “Northern Sea Route” — which has the potential to decrease sailing times from Europe to Asia by 40% compared to traditional Suez Canal routes. Moscow seems to have bet part of its future on these two cash cows, despite the worldwide focus on limiting carbon emissions from fossil fuels and preventing the very ice melt that is opening up this speedy shipping route.

With Russian President Vladimir Putin’s announcement that he will not attend in person, most have consigned the Russian delegation to a spoiler role, for which there is much evidence to support. But it might behoove Moscow to think a few steps ahead, as the melting Arctic may bring more chaos than treasure in the long run. Rampant climate change is likely to bring severe weather to the very offshore rigs that float in treacherous waters, and international law may eventually strip them of the thin veil by which they portend to control the Northern Sea Route. A recent major oil spill in Norilsk demonstrated the risks posed by melting permafrost to even land-based industrial activities. Meanwhile, Article 234 of the U.N. Convention on the Law of the Sea only allows coastal states to adopt regulatory measures for passing ships “where…the presence of ice covering such areas for most of the year create obstructions or exceptional hazards to navigation.” It’s only a matter of time until Russia’s northern coastline is not covered by ice most of the year, a planetary climate warning that terrifies most of the COP26 delegates and, if they had a longer vision beyond the increased shipping traffic, should also scare Russia.

The energy transition


SAMANTHA GROSS (@samanthaenergy)
Director and Fellow, Energy Security and Climate Initiative

COP26 is facing the highest expectations of any climate meeting since Paris in 2015. This marks the five-year point in the Paris Agreement, when countries are expected to renew and deepen their commitment to fighting climate change.

The United States and Europe, along with a varied slate of other countries that together account for most of the world’s emissions, have pledged to achieve net zero greenhouse gas emissions by mid-century. Even China and Saudi Arabia are pledging net zero emissions by 2060. But the burning question in my mind going into Glasgow is whether countries are on track to achieve those long-term commitments.

For now, the answer is no. The formal goals at Glasgow are for the near term, through 2030. If countries achieve these goals (Nationally Determined Contributions, in the lingo of the Paris Agreement), emissions in 2030 will be 16% greater than they were in 2010. To be on a path that limits warming to 1.5°C, the level scientist say is necessary to avoid the worst impacts of climate change, we need a 45% reduction in emissions instead.

My hopes for the COP are twofold. First, I hope to see a spirit of cooperation to encourage further action to reduce emissions. The real action here won’t happen at Glasgow, but afterward, when leaders go back to their capitals to establish policy to actually implement their emissions goals. Sharing technology and policy successes among countries could help. Second, I hope to see a renewed commitment from wealthy countries to fund the low-carbon transition in the developing world, along with funding for resilience projects to help these countries adapt to our changing world. Using public funding as leverage to encourage more private investment will be particularly important to achieve a just transition.

Maritime security in Asia


SHUXIAN LUO (@joy_shuxian_luo)
Post-Doctoral Research Fellow, John L. Thornton China Center

There is a maritime security dimension as to why it is an imperative for leaders gathering in Glasgow to act collaboratively to tackle climate change. Global warming and the resulting rise of sea level is likely to affect Asia’s maritime security landscape in at least three ways.

First, available fish stock may further decline as ocean warming can cause fish populations to be less productive and/or migrate to other regions, aggravating the problem of fish depletion, intensifying fishery-related disputes and conflict, and negatively impacting millions of marine workers in coastal states who rely on fishing for their livelihood.

Second, it can alter the nature of a land feature in a way that raises questions about the maritime zones that the feature is entitled to. For example, a “high-tide elevation” is entitled to the surrounding 12 nautical miles as territorial sea (and an exclusive economic zone or continental shelf as well if it is capable of sustaining human habitation or economic life). But as the sea level rises, the feature may become submerged at high tide and remain above water only at low tide, making it “a low-tide elevation” which is not entitled to a territorial sea if it is located outside an existing territorial sea.

Third, and related to the second point, states might be tempted to protect their land features from being submerged by engaging in more land reclamation activities, which would likely exacerbate maritime environmental degradation and further complicate Asia’s existing maritime territorial disputes.

U.S. economic and financial implications of climate policy


SANJAY PATNAIK (@sanjay_patnaik)
Fellow, Economic Studies and Director, Center on Regulation and Markets

One of the most important aspects of climate change is that it is fundamentally an economic issue and a problem of risk management. Therefore, climate change itself, and any climate policies (and the lack thereof) will have significant implications for our economic and financial system. As the rest of the world and especially the EU move quickly to facilitate a transition towards a low-carbon economy, it will become even more important for the United States to follow the same path. Policy measures like a price on carbon, mandatory climate risk disclosures for publicly traded companies, and climate stress testing in the financial system are being implemented in countries around the world. These policies are critical to prepare countries for a low-carbon future, and are also significantly shaping global markets.

Without implementing a policy plan at home that can credibly lead to the reductions in greenhouse gas emissions needed to reach the Biden’s administration’s stated goals by 2030, the U.S. will have a difficult standing in Glasgow. Importantly, without credible climate policies, U.S. firms’ ability to remain competitive when operating in global markets will be impeded and the potential for the U.S. to become a leader in new, low-carbon technologies and industries will be reduced. It is therefore more critical than ever that the Biden administration and Congress implement a wide range of carrot and stick policies that address climate change and bring us in line with other developed nations. This will also strengthen our negotiating position at COP26.

Climate as a threat multiplier in the Middle East

NATAN SACHS (@natansachs)
Director and Fellow, Center for Middle East Policy

COP26 is an instance of the gaping disconnect between Middle Eastern stakes in climate change and the marginal role Middle Eastern countries assume in combating it and adapting to it. The region is already one of the worst affected by climate change, and the potential for future damage is huge. The Nile Delta for example, with dozens of millions of people, is at direct risk of rising sea levels, with the city of Alexandria facing potential inundation. Water insecurity throughout the region could worsen dramatically, necessitating costly and energy-intensive desalination, and fueling political crises in and between states. Millions could find themselves living in areas where working outside during the day becomes impossible due to heat. And many millions will likely find themselves seeking refuge in new places, exacerbating the already-acute refugee crises in and around the Middle East.

The challenges are truly immense. Yet in many countries, the political structures are incapable or unwilling to meet them, busying themselves instead with geopolitical, ideological, and especially domestic rivalries. There are a few exceptions where capacity or resources allow for efforts to combat climate change on a serious scale, including the Gulf States and Israel. But the wealthiest countries in the Gulf, who could finance regional efforts, are also the major producers of fossil fuels, creating a conflict of interest on mitigation. So far, they’ve also exhibited vastly insufficient efforts on adaptation, as they prepare for a potential change in energy markets away from the oil and gas that provide their wealth and sustain their political model. As a result, most Middle East countries will not feature prominently at COP26 — a telling sign of historic political failure.

U.S. as a global leader on climate


TODD STERN (@tsterndc)
Nonresident Senior Fellow, Energy Security and Climate Initiative

The central measure of success for COP26 in Glasgow will be whether countries have ramped up their Paris emission targets enough in 2021 to “keep 1.5 alive.” This COP coincides with the first of the five-year cycles for countries to ratchet up their targets. And it is all the more important because the broad consensus of climate opinion has shifted since Paris from embracing a below 2°C temperature goal to embracing a limit on temperature increase of 1.5°C. This is an enormously challenging target, thought to require net zero global emissions by 2050 and a roughly 50% global emissions cut within this decade.

There has been some striking progress this year. The U.S., EU, and U.K., among a number of others, have announced 2030 emission reductions at the right scale. But other big players have not cranked up their Paris targets consistent with a 1.5°C effort, and the biggest and most important is China, responsible for 27% of global CO2 emissions — more than all developed countries put together. A strong move by China would also encourage other big emitters to follow their lead. However, if, as is likely, China does not make a serious move in Glasgow, it will be vital that the COP outcome send a clear message that 1.5 must still be kept alive and that countries who have not yet met their climate responsibility will be expected to do so in 2022. Failing to act in Glasgow should get no one off the hook.

India, net-zero, and equity


RAHUL TONGIA (@DrTongia)
Nonresident Senior Fellow, Energy Security and Climate Initiative

There is immense pressure on India to announce a carbon net-zero pledge at COP26. With emissions under half the world average, it would be rational for Delhi to avoid doing so just yet. India could announce a later date than China, which pledged net-zero by 2060. Or it could make sectoral plans, such as the aim to more than quadruple renewables in 10 years, or even to peak use of coal in the power sector. However, some plans could be conditional on global support, especially finance.

India, with others, will argue that we cannot entirely ignore equity issues. This is likely to come up in contentious issues like Article 6, which will set the rules for markets, transfers, and offsets. A number of countries are banding together for negotiations. The Like Minded Developing Countries (LMDCs), including China, India, and a few dozen others, have the clout of representing some half the world’s population, but it’s also questionable to speak of Saudi Arabia or China, who are not “low-emitters,” in the same vein as Mali or even India.

Once again, India risks being pegged, unfairly, as possible spoilsport. Delhi will have to walk a tightrope to show its actions, with or without a net-zero pledge, are globally leading but also don’t cap inevitable growth in emissions in the coming years. More meaningful than a grand ambition decades out is what India (or anyone else) does in the short and medium term. Watch for that.

Innovation and decarbonization


DAVID G. VICTOR
Nonresident Senior Fellow, Energy Security and Climate Initiative

Diplomacy will be in the spotlight at COP26 — along with a lot of posturing about which countries are making big enough efforts to cut emissions. But diplomacy, for the most part, is overrated. At best, it sets a general direction for cutting emissions. When the diplomats reach consensus, as they usually do, they make legitimate the efforts to push governments and firms to make deeper cuts in emissions.

But what really matters is innovation that disrupts old industries. As new technologies get cheaper they also rewrite the politics of decarbonization — making it easier to build and hold together the political coalitions for supporting policies.

COP26, while formally a diplomatic event, will also be a watering hole for the firms and governments that are doing the most to back innovation. Leaders from industries on the front lines — such as oil and gas, electricity, and transportation — will show up, keen to show serious plans that take decarbonization seriously. The bankers will be there too, for capital is already shifting into decarbonization.

A technological perspective helps explain why most people overestimate how quickly the world economy will decarbonize in the short term — disruptive change is slow to take hold, and the incumbents don’t leave quietly — but underestimate just how transformative all the changes will be over the long haul. And when you look at entry of new low-carbon technologies you see quite a lot of hope. This hope comes from working on decarbonization sector by sector, not pretending that a global diplomatic committee will do the job.

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International

Chinese migration to US is nothing new – but the reasons for recent surge at Southern border are

A gloomier economic outlook in China and tightening state control have combined with the influence of social media in encouraging migration.

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Chinese migrants wait for a boat after having walked across the Darien Gap from Colombia to Panama. AP Photo/Natacha Pisarenko

The brief closure of the Darien Gap – a perilous 66-mile jungle journey linking South American and Central America – in February 2024 temporarily halted one of the Western Hemisphere’s busiest migration routes. It also highlighted its importance to a small but growing group of people that depend on that pass to make it to the U.S.: Chinese migrants.

While a record 2.5 million migrants were detained at the United States’ southwestern land border in 2023, only about 37,000 were from China.

I’m a scholar of migration and China. What I find most remarkable in these figures is the speed with which the number of Chinese migrants is growing. Nearly 10 times as many Chinese migrants crossed the southern border in 2023 as in 2022. In December 2023 alone, U.S. Border Patrol officials reported encounters with about 6,000 Chinese migrants, in contrast to the 900 they reported a year earlier in December 2022.

The dramatic uptick is the result of a confluence of factors that range from a slowing Chinese economy and tightening political control by President Xi Jinping to the easy access to online information on Chinese social media about how to make the trip.

Middle-class migrants

Journalists reporting from the border have generalized that Chinese migrants come largely from the self-employed middle class. They are not rich enough to use education or work opportunities as a means of entry, but they can afford to fly across the world.

According to a report from Reuters, in many cases those attempting to make the crossing are small-business owners who saw irreparable damage to their primary or sole source of income due to China’s “zero COVID” policies. The migrants are women, men and, in some cases, children accompanying parents from all over China.

Chinese nationals have long made the journey to the United States seeking economic opportunity or political freedom. Based on recent media interviews with migrants coming by way of South America and the U.S.’s southern border, the increase in numbers seems driven by two factors.

First, the most common path for immigration for Chinese nationals is through a student visa or H1-B visa for skilled workers. But travel restrictions during the early months of the pandemic temporarily stalled migration from China. Immigrant visas are out of reach for many Chinese nationals without family or vocation-based preferences, and tourist visas require a personal interview with a U.S. consulate to gauge the likelihood of the traveler returning to China.

Social media tutorials

Second, with the legal routes for immigration difficult to follow, social media accounts have outlined alternatives for Chinese who feel an urgent need to emigrate. Accounts on Douyin, the TikTok clone available in mainland China, document locations open for visa-free travel by Chinese passport holders. On TikTok itself, migrants could find information on where to cross the border, as well as information about transportation and smugglers, commonly known as “snakeheads,” who are experienced with bringing migrants on the journey north.

With virtual private networks, immigrants can also gather information from U.S. apps such as X, YouTube, Facebook and other sites that are otherwise blocked by Chinese censors.

Inspired by social media posts that both offer practical guides and celebrate the journey, thousands of Chinese migrants have been flying to Ecuador, which allows visa-free travel for Chinese citizens, and then making their way over land to the U.S.-Mexican border.

This journey involves trekking through the Darien Gap, which despite its notoriety as a dangerous crossing has become an increasingly common route for migrants from Venezuela, Colombia and all over the world.

In addition to information about crossing the Darien Gap, these social media posts highlight the best places to cross the border. This has led to a large share of Chinese asylum seekers following the same path to Mexico’s Baja California to cross the border near San Diego.

Chinese migration to US is nothing new

The rapid increase in numbers and the ease of accessing information via social media on their smartphones are new innovations. But there is a longer history of Chinese migration to the U.S. over the southern border – and at the hands of smugglers.

From 1882 to 1943, the United States banned all immigration by male Chinese laborers and most Chinese women. A combination of economic competition and racist concerns about Chinese culture and assimilability ensured that the Chinese would be the first ethnic group to enter the United States illegally.

With legal options for arrival eliminated, some Chinese migrants took advantage of the relative ease of movement between the U.S. and Mexico during those years. While some migrants adopted Mexican names and spoke enough Spanish to pass as migrant workers, others used borrowed identities or paperwork from Chinese people with a right of entry, like U.S.-born citizens. Similarly to what we are seeing today, it was middle- and working-class Chinese who more frequently turned to illegal means. Those with money and education were able to circumvent the law by arriving as students or members of the merchant class, both exceptions to the exclusion law.

Though these Chinese exclusion laws officially ended in 1943, restrictions on migration from Asia continued until Congress revised U.S. immigration law in the Hart-Celler Act in 1965. New priorities for immigrant visas that stressed vocational skills as well as family reunification, alongside then Chinese leader Deng Xiaoping’s policies of “reform and opening,” helped many Chinese migrants make their way legally to the U.S. in the 1980s and 1990s.

Even after the restrictive immigration laws ended, Chinese migrants without the education or family connections often needed for U.S. visas continued to take dangerous routes with the help of “snakeheads.”

One notorious incident occurred in 1993, when a ship called the Golden Venture ran aground near New York, resulting in the drowning deaths of 10 Chinese migrants and the arrest and conviction of the snakeheads attempting to smuggle hundreds of Chinese migrants into the United States.

Existing tensions

Though there is plenty of precedent for Chinese migrants arriving without documentation, Chinese asylum seekers have better odds of success than many of the other migrants making the dangerous journey north.

An estimated 55% of Chinese asylum seekers are successful in making their claims, often citing political oppression and lack of religious freedom in China as motivations. By contrast, only 29% of Venezuelans seeking asylum in the U.S. have their claim granted, and the number is even lower for Colombians, at 19%.

The new halt on the migratory highway from the south has affected thousands of new migrants seeking refuge in the U.S. But the mix of push factors from their home country and encouragement on social media means that Chinese migrants will continue to seek routes to America.

And with both migration and the perceived threat from China likely to be features of the upcoming U.S. election, there is a risk that increased Chinese migration could become politicized, leaning further into existing tensions between Washington and Beijing.

Meredith Oyen does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

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Government

Vaccine-skeptical mothers say bad health care experiences made them distrust the medical system

Vaccine skepticism, and the broader medical mistrust and far-reaching anxieties it reflects, is not just a fringe position in the 21st century.

Women's own negative medical experiences influence their vaccine decisions for their kids. AP Photo/Ted S. Warren

Why would a mother reject safe, potentially lifesaving vaccines for her child?

Popular writing on vaccine skepticism often denigrates white and middle-class mothers who reject some or all recommended vaccines as hysterical, misinformed, zealous or ignorant. Mainstream media and medical providers increasingly dismiss vaccine refusal as a hallmark of American fringe ideology, far-right radicalization or anti-intellectualism.

But vaccine skepticism, and the broader medical mistrust and far-reaching anxieties it reflects, is not just a fringe position.

Pediatric vaccination rates had already fallen sharply before the COVID-19 pandemic, ushering in the return of measles, mumps and chickenpox to the U.S. in 2019. Four years after the pandemic’s onset, a growing number of Americans doubt the safety, efficacy and necessity of routine vaccines. Childhood vaccination rates have declined substantially across the U.S., which public health officials attribute to a “spillover” effect from pandemic-related vaccine skepticism and blame for the recent measles outbreak. Almost half of American mothers rated the risk of side effects from the MMR vaccine as medium or high in a 2023 survey by Pew Research.

Recommended vaccines go through rigorous testing and evaluation, and the most infamous charges of vaccine-induced injury have been thoroughly debunked. How do so many mothers – primary caregivers and health care decision-makers for their families – become wary of U.S. health care and one of its most proven preventive technologies?

I’m a cultural anthropologist who studies the ways feelings and beliefs circulate in American society. To investigate what’s behind mothers’ vaccine skepticism, I interviewed vaccine-skeptical mothers about their perceptions of existing and novel vaccines. What they told me complicates sweeping and overly simplified portrayals of their misgivings by pointing to the U.S. health care system itself. The medical system’s failures and harms against women gave rise to their pervasive vaccine skepticism and generalized medical mistrust.

The seeds of women’s skepticism

I conducted this ethnographic research in Oregon from 2020 to 2021 with predominantly white mothers between the ages of 25 and 60. My findings reveal new insights about the origins of vaccine skepticism among this demographic. These women traced their distrust of vaccines, and of U.S. health care more generally, to ongoing and repeated instances of medical harm they experienced from childhood through childbirth.

girl sitting on exam table faces a doctor viewer can see from behind
A woman’s own childhood mistreatment by a doctor can shape her health care decisions for the next generation. FatCamera/E+ via Getty Images

As young girls in medical offices, they were touched without consent, yelled at, disbelieved or threatened. One mother, Susan, recalled her pediatrician abruptly lying her down and performing a rectal exam without her consent at the age of 12. Another mother, Luna, shared how a pediatrician once threatened to have her institutionalized when she voiced anxiety at a routine physical.

As women giving birth, they often felt managed, pressured or discounted. One mother, Meryl, told me, “I felt like I was coerced under distress into Pitocin and induction” during labor. Another mother, Hallie, shared, “I really battled with my provider” throughout the childbirth experience.

Together with the convoluted bureaucracy of for-profit health care, experiences of medical harm contributed to “one million little touch points of information,” in one mother’s phrase, that underscored the untrustworthiness and harmful effects of U.S. health care writ large.

A system that doesn’t serve them

Many mothers I interviewed rejected the premise that public health entities such as the Centers for Disease Control and Prevention and the Food and Drug Administration had their children’s best interests at heart. Instead, they tied childhood vaccination and the more recent development of COVID-19 vaccines to a bloated pharmaceutical industry and for-profit health care model. As one mother explained, “The FDA is not looking out for our health. They’re looking out for their wealth.”

After ongoing negative medical encounters, the women I interviewed lost trust not only in providers but the medical system. Frustrating experiences prompted them to “do their own research” in the name of bodily autonomy. Such research often included books, articles and podcasts deeply critical of vaccines, public health care and drug companies.

These materials, which have proliferated since 2020, cast light on past vaccine trials gone awry, broader histories of medical harm and abuse, the rapid growth of the recommended vaccine schedule in the late 20th century and the massive profits reaped from drug development and for-profit health care. They confirmed and hardened women’s suspicions about U.S. health care.

hands point to a handwritten vaccination record
The number of recommended childhood vaccines has increased over time. Mike Adaskaveg/MediaNews Group/Boston Herald via Getty Images

The stories these women told me add nuance to existing academic research into vaccine skepticism. Most studies have considered vaccine skepticism among primarily white and middle-class parents to be an outgrowth of today’s neoliberal parenting and intensive mothering. Researchers have theorized vaccine skepticism among white and well-off mothers to be an outcome of consumer health care and its emphasis on individual choice and risk reduction. Other researchers highlight vaccine skepticism as a collective identity that can provide mothers with a sense of belonging.

Seeing medical care as a threat to health

The perceptions mothers shared are far from isolated or fringe, and they are not unreasonable. Rather, they represent a growing population of Americans who hold the pervasive belief that U.S. health care harms more than it helps.

Data suggests that the number of Americans harmed in the course of treatment remains high, with incidents of medical error in the U.S. outnumbering those in peer countries, despite more money being spent per capita on health care. One 2023 study found that diagnostic error, one kind of medical error, accounted for 371,000 deaths and 424,000 permanent disabilities among Americans every year.

Studies reveal particularly high rates of medical error in the treatment of vulnerable communities, including women, people of color, disabled, poor, LGBTQ+ and gender-nonconforming individuals and the elderly. The number of U.S. women who have died because of pregnancy-related causes has increased substantially in recent years, with maternal death rates doubling between 1999 and 2019.

The prevalence of medical harm points to the relevance of philosopher Ivan Illich’s manifesto against the “disease of medical progress.” In his 1982 book “Medical Nemesis,” he insisted that rather than being incidental, harm flows inevitably from the structure of institutionalized and for-profit health care itself. Illich wrote, “The medical establishment has become a major threat to health,” and has created its own “epidemic” of iatrogenic illness – that is, illness caused by a physician or the health care system itself.

Four decades later, medical mistrust among Americans remains alarmingly high. Only 23% of Americans express high confidence in the medical system. The United States ranks 24th out of 29 peer high-income countries for the level of public trust in medical providers.

For people like the mothers I interviewed, who have experienced real or perceived harm at the hands of medical providers; have felt belittled, dismissed or disbelieved in a doctor’s office; or spent countless hours fighting to pay for, understand or use health benefits, skepticism and distrust are rational responses to lived experience. These attitudes do not emerge solely from ignorance, conspiracy thinking, far-right extremism or hysteria, but rather the historical and ongoing harms endemic to the U.S. health care system itself.

Johanna Richlin does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

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Survey Shows Declining Concerns Among Americans About COVID-19

Survey Shows Declining Concerns Among Americans About COVID-19

A new survey reveals that only 20% of Americans view covid-19 as "a major threat"…

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Survey Shows Declining Concerns Among Americans About COVID-19

A new survey reveals that only 20% of Americans view covid-19 as "a major threat" to the health of the US population - a sharp decline from a high of 67% in July 2020.

(SARMDY/Shutterstock)

What's more, the Pew Research Center survey conducted from Feb. 7 to Feb. 11 showed that just 10% of Americans are concerned that they will  catch the disease and require hospitalization.

"This data represents a low ebb of public concern about the virus that reached its height in the summer and fall of 2020, when as many as two-thirds of Americans viewed COVID-19 as a major threat to public health," reads the report, which was published March 7.

According to the survey, half of the participants understand the significance of researchers and healthcare providers in understanding and treating long COVID - however 27% of participants consider this issue less important, while 22% of Americans are unaware of long COVID.

What's more, while Democrats were far more worried than Republicans in the past, that gap has narrowed significantly.

"In the pandemic’s first year, Democrats were routinely about 40 points more likely than Republicans to view the coronavirus as a major threat to the health of the U.S. population. This gap has waned as overall levels of concern have fallen," reads the report.

More via the Epoch Times;

The survey found that three in ten Democrats under 50 have received an updated COVID-19 vaccine, compared with 66 percent of Democrats ages 65 and older.

Moreover, 66 percent of Democrats ages 65 and older have received the updated COVID-19 vaccine, while only 24 percent of Republicans ages 65 and older have done so.

“This 42-point partisan gap is much wider now than at other points since the start of the outbreak. For instance, in August 2021, 93 percent of older Democrats and 78 percent of older Republicans said they had received all the shots needed to be fully vaccinated (a 15-point gap),” it noted.

COVID-19 No Longer an Emergency

The U.S. Centers for Disease Control and Prevention (CDC) recently issued its updated recommendations for the virus, which no longer require people to stay home for five days after testing positive for COVID-19.

The updated guidance recommends that people who contracted a respiratory virus stay home, and they can resume normal activities when their symptoms improve overall and their fever subsides for 24 hours without medication.

“We still must use the commonsense solutions we know work to protect ourselves and others from serious illness from respiratory viruses, this includes vaccination, treatment, and staying home when we get sick,” CDC director Dr. Mandy Cohen said in a statement.

The CDC said that while the virus remains a threat, it is now less likely to cause severe illness because of widespread immunity and improved tools to prevent and treat the disease.

Importantly, states and countries that have already adjusted recommended isolation times have not seen increased hospitalizations or deaths related to COVID-19,” it stated.

The federal government suspended its free at-home COVID-19 test program on March 8, according to a website set up by the government, following a decrease in COVID-19-related hospitalizations.

According to the CDC, hospitalization rates for COVID-19 and influenza diseases remain “elevated” but are decreasing in some parts of the United States.

Tyler Durden Sun, 03/10/2024 - 22:45

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