The Red State Brain Drain Isn’t Coming. It’s Happening Right Now.

The New Republic

The Red State Brain Drain Isn’t Coming. It’s Happening Right Now.

Timothy Noah – November 22, 2023

On Memorial Day weekend in 2022, Kate Arnold and her wife, Caroline Flint, flew from Oklahoma City to Cabo San Lucas for a little R&R. They had five kids, the youngest of them five-year-old twin girls, and demanding jobs as obstetrician-gynecologists. The stresses of all this were mounting. That they were a gay married couple living in a red, socially conservative state was the least of it. Caroline was born in Tulsa, spent much of her childhood in Oklahoma, and was educated at the University of Oklahoma. She cast her first presidential vote for George W. Bush. Kate, the more political of the two, was from Northern California and a lifelong Democrat. But her mother was born in Oklahoma City, and she felt at home there; she’d even given some thought to running for the state legislature.

Kate and Caroline flew down with the twins and their 16-year-old daughter. It says a lot about Kate Arnold that she adopted the three older children while she was attending medical school; the birth mother, whom Kate befriended while volunteering at a home for teenage mothers, was an addict who lost custody.

Arriving in Cabo, Kate and Caroline realized that it had been a very long time—too long— since their last date night. So one evening they ordered the kids room service and went off by themselves to a Taco Night theme dinner. “We sat outside with the little colored flags,” Kate recalled, “and they gave us blankets because it was cold and windy. We hadn’t been sitting for very long when I started saying I wasn’t happy.”

A little more than one week earlier, a disturbed high school student named Salvador Ramos had entered Robb Elementary School in Uvalde, Texas, with an AR-15 rifle and killed 19 children and two adults, injuring 17 more. It was the deadliest school shooting since the Sandy Hook massacre in 2012, and it happened just one state over as Kate and Caroline’s two youngest were about to start school. Two more mass shootings occurred in Oklahoma while they were in Cabo. A man named Michael Louis gunned down, with an AR-15, two doctors, a receptionist, and a patient at the Tulsa offices of his orthopedic surgeon because he was angry that his recent back surgery left him in pain. Then a man named Skyler Buckner killed one person and injured seven others at a Memorial Day festival in Taft, Oklahoma. States with permissive gun laws have a higher rate of mass shootings, and Oklahoma, with some of the most permissive gun laws in the country, has 45 percent more gun deaths per capita than the national average—higher even than in Texas.

That was one reason Kate wasn’t happy.

Another reason was that the state legislature was trying to limit access to contraceptives. In March, the state Senate had voted to require parental consent before a minor could take contraceptives. Kate was chair of the Oklahoma chapter of the American College of Obstetricians and Gynecologists, and she’d lobbied against this change. (The bill later died in the state House of Representatives.)

“You’re just gonna get my nine-year-old birth control without my knowledge?” one state legislator said to her.

“How does your nine-year-old need birth control?” Kate answered. “And yes, if she needs birth control … what’s worse than her coming home pregnant?”

Caroline had reasons to be unhappy, too. One year earlier, Oklahoma’s governor had signed a law barring public schools and charter schools from teaching that “an individual, by virtue of his or her race or sex, bears responsibility for actions committed in the past by other members of the same race or sex.” School boards interpreted this as an invitation to ban any book that touched on race or gender. Among the books targeted in Oklahoma, according to the free-speech organization PEN America, were Narrative of the Life of Frederick Douglass, A Raisin in the Sun, To Kill a Mockingbird, and Their Eyes Were Watching God. “Books are my thing,” Caroline told me. She couldn’t abide the idea that “books would be censored.”

Also, Caroline’s hospital wouldn’t let her perform gender-affirming surgery. The procedure was legal in Oklahoma, but this was a Baptist hospital, and fairly conservative. “I would do surgeries,” Caroline said, “like hysterectomies for patients who are transitioning. And I’d have to have another indication to do it.… I’d have to say, ‘Oh, they also have pain,’” or find some other reason.

Kate was director of women’s health at a large, federally funded nonprofit health center serving low-income patients. It was, she told me, “A job that I loved.” But five months before their Cabo dinner, Kate published an op-ed at a nonprofit Oklahoma news site criticizing state felony prosecutions of women who miscarried after taking drugs during pregnancy. “Anytime you criminalize drug use in pregnancy,” Kate explained to me, the addicts stop going to the hospital, “and you have worse and worse outcomes.”

After the op-ed appeared, somebody phoned Kate’s health center to complain. After that, Kate’s superiors effectively barred her from making public statements about anything. Kate’s boss explained why: The FBI had alerted the center to threats of violence “just for providing birth control.”

After the op-ed appeared, somebody phoned Kate’s health center to complain. After that, Kate’s superiors effectively barred her from making public statements about anything. That irked Kate until her boss explained why: The FBI had contacted the health center to alert them to threats of violence “just for providing birth control.” Did I mention that Oklahoma allows anybody over the age of 21 to carry a loaded firearm in public, open or concealed, without a license?

The last straw for the couple was Dobbs v. Jackson Women’s Health Organization. That windy June night in Cabo, the Supreme Court was still a few weeks away from overturning Roe v. Wade and allowing states to ban abortion. But it was no mystery what the decision would say, because one month earlier a draft had leaked to Politico. The Oklahoma legislature had already passed several trigger laws whose cumulative effect was to bar doctors from performing abortions starting at the point of conception, punishable by up to 10 years in prison (later reduced to five).

Kate and Caroline didn’t perform abortions themselves; they referred patients to Planned Parenthood. Or rather, they had done so until an Oklahoma law barred them from doing even that. That law would later be ruled unconstitutional, but ambiguities in the Oklahoma abortion ban’s exception for protecting the life of the mother make it potentially dangerous to treat any patient experiencing difficulty during pregnancy.

“When we left dinner that night,” Kate recalled, “we knew we needed to leave Oklahoma. We were both in a bit of shock as we walked back to our room. I said I was sorry, and that I didn’t know I had been thinking all of that till we finally had a minute. Caroline jokingly called me the worst date ever.”

For a day, they thought about moving to New Zealand, but they didn’t want to be that far from their parents, and besides, Kate and Caroline love this country, despite all its flaws; July Fourth is Kate’s favorite holiday. They thought about Northern California, but vetoed that because Caroline doesn’t like cold summer nights. That left Washington, D.C., a place Kate had enjoyed living in while attending medical school at Georgetown. They arrived this past May, settling into a blue bungalow on a quiet, leafy street near the Maryland border.

Kate Arnold and Caroline Flint are two bright, energetic, professionally trained, and public-spirited women whom Washington is happy to welcome—they both quickly found jobs—even though it doesn’t particularly need them. The places that need Kate and Caroline are Oklahoma and Mississippi and Idaho and various other conservative states where similar stories are playing out daily. These two fortyish doctors have joined an out-migration of young professionals—accelerated by the culture wars of recent years and pushed to warp speed by Dobbs—that’s known as the Red State Brain Drain.

Republican-dominated states are pushing out young professionals by enacting extremist conservative policies. Abortion restrictions are the most sweeping example, but state laws restricting everything from academic tenure to transgender health care to the teaching of “divisive concepts” about race are making these states uncongenial to knowledge workers.

The precise effect of all this on the brain drain is hard to tease out from migration statistics because the Dobbs decision is still fairly new, and because red states were bleeding college graduates even before the culture war heated up. The only red state that brings in more college graduates than it sends elsewhere is Texas. But the evidence is everywhere that hard-right social policies in red states are making this dynamic worse.

The number of applications for OB-GYN residencies is down more than 10 percent in states that have banned abortion since Dobbs. Forty-eight teachers in Hernando County, Florida, fed up with “Don’t Say Gay” and other new laws restricting what they can teach, resigned or retired at the end of the last school year. A North Carolina law confining transgender people to bathrooms in accordance with what it said on their birth certificate was projected, before it was repealed, to cost that state $3.76 billion in business investment, including the loss of a planned global operations center for PayPal in Charlotte. A survey of college faculty in four red states (Texas, Florida, Georgia, and North Carolina) about political interference in higher education found a falloff in the number of job candidates for faculty positions, and 67 percent of the respondents said they would not recommend their state to colleagues as a place to work. Indeed, nearly one-third said they were actively considering employment elsewhere.

In Oklahoma, Kate and Caroline belonged to a book group. They read “serious depressing books,” Kate said, like Evicted by Matthew Desmond and Demon Copperhead by Barbara Kingsolver. The book group had six people in it. Now it’s down to three, because another woman in the group moved to Washington state after Oklahoma banned transgender care for minors in May. Kate and Caroline named three additional friends who also left Oklahoma recently for political reasons.

The phrase “culture war” entered the academic lexicon in 1991 with publication of Culture Wars: The Struggle to Define America by James Davison Hunter, a sociologist at the University of Virginia. Hunter saw the culture wars of the late twentieth century as a continuation of American Protestants’ virulent anti-Catholicism and antisemitism during the nineteenth century and much of the twentieth. Where once a Protestant majority demonized rival faiths, today a shrinking cohort of orthodox adherents to all three faiths demonizes progressive rationalists and pluralists. And, just as a century ago politicians gleefully exploited such animosity, they do so today. At the 1992 Republican convention, Pat Buchanan borrowed Hunter’s phrase and turned it into a political truncheon. “My friends,” Buchanan said,

this election is about more than who gets what. It is about who we are. It is about what we believe, and what we stand for as Americans. There is a religious war going on in this country. It is a cultural war, as critical to the kind of nation we shall be as was the Cold War.

Buchanan’s us-versus-them philippic set the tone for congressional Republicans’ hyper-partisan opposition to Presidents Bill Clinton, Barack Obama, and now Joe Biden. It also inspired the snarling us-them rhetoric of former President Donald Trump and the various Trump imitators challenging him for the 2024 presidential nomination.

The culture war moved slowly into state politics, because, at first, Republicans didn’t have much of a foothold there. From 1971 to 1994, Democrats held most governorships. That flipped in 1995, and for the next dozen years, Republicans held the majority of governorships. But Republican governors still couldn’t advance the culture-war agenda, because state legislatures remained dominated by Democrats.

That changed with the 2010 election. In a historic realignment largely unrecognized at the time, the GOP won a majority of governorships and legislative chambers. Today, Republicans control a 52 percent majority of governorships and a 57 percent majority of state legislative bodies, and in 22 states Republicans enjoy a “trifecta,” meaning they control the governorship and both legislative chambers (or, in the case of Nebraska, a unicameral legislature). At the time Dobbs was handed down, Republicans enjoyed even greater reach, with trifectas in 23 states.

The very last restraint on Republicans waging full-scale culture war—the presence of college graduates under the GOP tent—was removed by the 2016 presidential election. College graduates have always tended to be fairly liberal on social issues, but until the 1990s they were pretty reliably Republican, because college grads made more money and didn’t want to pay higher taxes. Even Adlai Stevenson, the Democratic presidential nominee caricatured by Republicans as an “egghead,” won only about 30 percent of college graduates in 1956. The Democrats’ egghead share crept up after that, but it wasn’t until 1992 that a Democrat, Bill Clinton, won the college vote (with a 43 percent plurality in a three-way race). Four years later, Clinton lost it to Bob Dole, and for the next two decades Joe College seesawed from one party to another. As recently as 2012, Mitt Romney eked out a 51 percent majority of college graduates.

But with the arrival of Donald Trump, college graduates left the Republican fold for the foreseeable future. Trump dropped the Republican share to 44 percent in 2016 and 43 percent in 2020. If Trump wins the nomination in 2024, the GOP’s share of college voters could drop below 40, and I don’t see any of Trump’s challengers for the Republican nomination doing much better. It isn’t clear they even want to, because today’s GOP sees college graduates as the enemy.

The heaviest artillery is trained on abortion rights. After Dobbs, wholesale abortion bans took effect in 14 states: Alabama, Arkansas, Idaho, Indiana, Kentucky, Louisiana, Mississippi, Missouri, North Dakota, Oklahoma, South Dakota, Tennessee, Texas, and West Virginia. All but Kentucky and Louisiana are trifecta states. In a fifteenth state, Wisconsin, uncertainty about how to interpret an 1849 statute concerning violence against a pregnant woman put abortions on hold for one year until an appeals court ruled that the statute did not apply to abortions.

Let’s call these hard-core abortion-ban states the Dobbs Fourteen. In 2020, more than 113,000 abortions were performed in the Dobbs Fourteen, according to the nonprofit Guttmacher Institute. During the first six months of 2023, that number fell to nearly zero; in Texas, for instance, about 20 women qualified for that state’s very narrowly drawn exemptions.

The Dobbs Fourteen made it nearly impossible to get an abortion, as intended. But they simultaneously made it much more difficult for a pregnant woman to give birth, because abortion bans drove OB-GYN like Kate Arnold and Caroline Flint away.

It was hard enough for red states to hold onto their OB-GYNs even before Dobbs. A little more than one-third of all counties nationwide are “maternity care deserts,” typically in rural areas, with no hospitals or birthing centers that offer obstetric care and no individual obstetric providers (not even midwives), according to the March of Dimes. This data was collected before the Supreme Court overturned Roe. But even then, those states with the most restrictive abortion laws invested the least in maternal care, affirming former Representative Barney Frank’s memorable complaint that for conservatives “life begins at conception and ends at birth.”

Maternity care deserts are typically in rural areas, not all of which impose strict abortion restrictions. But they’re much more common in states that imposed abortion restrictions after Dobbs, representing 39 percent of all counties in those states, compared to 25 percent in states that imposed no abortion restrictions. Texas has, after California, the highest GDP of any state. Yet 46.5 percent of its counties are maternity care deserts; for some women, the nearest birthing hospital is a 70-minute drive from their home. In some states, including Oklahoma and Mississippi, the majority of counties are maternity care deserts.

Where resources are inadequate for giving birth, infant mortality tends to be high. Among the Dobbs Fourteen, all but Idaho, North Dakota, and Texas have infant-mortality rates higher than the (shockingly high) national average of 5.42 deaths per 1,000 births. In some of these states, infant mortality is substantially higher. In Mississippi, it’s 9.39 deaths per 1,000 births. In Oklahoma, it’s 7.13 deaths per 1,000 births.

It hardly surprised me when Kate, comparing their houses in Oklahoma City and Washington, said their Washington bungalow was “half the size for double the cost.” But the two physicians also took substantial cuts in pay—not quite 50 percent for Caroline, and about 25 percent for Kate. How could that be? If Washington’s cost of living is higher, shouldn’t salaries be higher, too? For most occupations, yes. But OB-GYN salaries, Kate and Caroline explained to me, vary dramatically according to local demand. Washington has plenty of OB-GYNs; the nation’s capital is too urban and too geographically small to be a maternity care desert. Oklahoma, on the other hand, suffers a desperate shortage of OB-GYNs, and therefore must pay top dollar.

Mississippi is the poorest state in the country. But the average base salary for an ob-gyn at Wayne General Hospital in Waynesboro, Mississippi, is $350,000. (I take this and the salary figures that follow from the workforce data company Glassdoor, because the Bureau of Labor Statistics’ information is one year out of date.) Compare Waynesboro’s largesse to the average base salary for an OB-GYN at ClearMD Health Center in Manhattan: $275,000, or 21 percent less. (Even that’s a little high for New York City, where, according to Glassdoor, average ob-gyn pay is $243,000.) In Oklahoma City, average base salary for an OB-GYN at CompHealth Physician Obstetrics and Gynecology is $325,000. In Fort Smith, Arkansas, average base salary for an OB-GYN at CompHealth Physician Obstetrics and Gynecology is $312,500. Meanwhile, average base pay for an OB-GYN in Los Angeles is $235,000.

Throwing money at OB-GYNs helps red states manage the problem, but it doesn’t fix it. One Mississippi-based OB-GYN told the nonprofit news site Mississippi Today in September that the metropolitan area around Meridian (pop. 33,816) has six obstetric providers; as recently as five years ago, it had 12 or 13.

The Milken Educator Award bestows $25,000 each year on early- to mid-career elementary and secondary schoolteachers and administrators who further “excellence in education.” The prize is bankrolled by Michael Milken, the 1980s junk-bond king turned philanthropist who, yes, served two years in prison for securities fraud and was later pardoned by Trump. Notwithstanding that colorful backstory, the Milken Educator Award is quite prestigious, and winners always get fussed over in their home states. The 60 honorees chosen in April 2022 included Tyler Hallstedt, a 35-year-old man who taught eighth grade American history in Mt. Juliet, Tennessee (pop. 42,548), a suburb 20 miles east of Nashville.

Tyler was handed the prize at a school assembly by Tennessee Governor Bill Lee, a Republican. “We have some of the best schools in America in this state,” the governor told the crowd. “We have some of the best teachers in America in this state. And you have one of the best teachers in America in this school.”

Accepting his award, Tyler was a little subdued. “Teaching is a difficult job right now,” he said. “The reason I continue to do it is the relationships with my students are genuinely important to me.… Knowing that I get to see them grow and show them that I genuinely care about them, that’s what overrides the difficult and sometimes unfair parts of being a teacher.”

He could have said more, because at that point Tyler was pretty fed up with the state’s education policies. One month earlier, Lee had signed into law a bill requiring school districts to maintain lists of all teaching materials made available to students, to make these available on the school’s website, and to establish “a procedure to periodically review the library collection at each school to ensure that [it] contains materials appropriate for the age and maturity levels of the students who may access the materials.” Among the books subsequently removed from school curricula was Art Spiegelman’s Maus.

“I literally turned my bookshelf around,” Tyler told me, so that the books faced the wall. That was his silent protest. He kept the backward-facing bookshelf in his classroom all year.

For Tyler, the final straw was a dustup over a video he showed his class a few months after he collected his prize. The video was about the seventeenth-century English settlement in Jamestown, Virginia. It was hosted by John Green, author of the 2012 young adult novel The Fault in Our Stars. Green has engaged in some leftish activism, but the video, the third in a series called Crash Course U.S. History, isn’t notably didactic. It is, however, irreverent and funny in a manner intended to appeal to adolescents, and if you look closely you can see, on the back of Green’s laptop, a sticker that says THIS MACHINE KILLS FASCISTS. The words are borrowed from Woody Guthrie, who, feeling patriotic one day about America’s war against Hitler and Tojo, painted them onto his guitar; factory workers producing war materiel had scribbled these same words onto their lathes. Tyler received an email from a father complaining that the sticker, which you can barely see, was a call for violence. A nonmetaphorical way to use a laptop (or guitar) to kill a fascist does not spring readily to mind, but that wasn’t really the point, Tyler explained to me. “He just doesn’t like John Green.” Green’s sticker had previously drawn criticism from a Republican state legislator in New Hampshire, and Green’s 2005 young adult novel, Looking for Alaska, had been targeted by Moms for Liberty, an influential hard-right group that’s active in book-banning campaigns.

As a result of that single complaint, Tyler’s school barred him from showing his students any videos in the Crash Course series, even though he’d been using them for years. Eventually, the school backed down and permitted Tyler to show some of (but not all) the Crash Course videos; however, the damage was done. “It showed me that just one angry parent has a heckler’s veto,” Tyler said.

Tyler talked to his wife, Delana, and his adult stepson about seeking greener pastures. Delana was a teacher, too. She wasn’t particularly eager to move. But she understood what they were up against, and, at the end of the school year, all three moved to Tyler’s native Michigan, where he took up a post teaching seventh graders in Petoskey, a small resort town on Little Traverse Bay. He got a 35 percent raise, too. “I could tolerate the pay,” he told me, “but the culture wars are what finally convinced me. Things are so much better here.”

Since January 2021, 18 states have imposed restrictions on how teachers may address the subjects of race and gender, according to Education Week’s Sarah Schwartz. These include most of the Dobbs Fourteen and a few add-ons, including Florida and New Hampshire. According to a 2022 study by the RAND Corporation, legislative action not only accelerated after 2021 but also became more repressive, extending beyond the classroom to restrict professional development plans for teachers. Let’s call these teacher-harassing states the Morrison Eighteen, in honor of the late Nobel laureate Toni Morrison, whose The Bluest Eye is number three with a bullet on the American Library Association’s 2022 list of books most frequently targeted for removal. (The 1970 novel ranked eighth in 2021 and ninth in 2020.)

Taking a tour of the Morrison Eighteen, we find Texas teachers quitting at a rate that’s 25 percent above the national average. In Tennessee, the vacancy rate for all public schools is 5.5 percent, compared to a national average of 4 percent. South Carolina has teacher shortages in 17 subject areas this school year, more than any other state.

But Governor Ron DeSantis’s Florida is the undisputed champ. A 2022 study led by Tuan D. Nguyen of Kansas State University found that Florida had the most teacher vacancies in the country, followed by Georgia, Mississippi, and Alabama (all Morrison Eighteen states). Florida also logged the highest number of underqualified teachers.

The availability of state-level data is spotty, but teacher shortages in the Morrison Eighteen states would appear to be getting worse. According to Nguyen’s website, Florida’s teacher vacancies increased 35 percent in the school year after his study was published. Plugging in calculations from the Florida Education Association, teacher vacancies rose another 15 percent in the current school year. In Texas, the number of teacher vacancies more than doubled in the year after Nguyen’s study, and in South Carolina they increased 57 percent. (In fairness, this isn’t happening in all 18 states: Teacher shortages declined in Alabama and Mississippi.)

The culture-war capital of the United States is Tallahassee, Florida, thanks to DeSantis and his (thus far, frustrated) ambition to win the Republican nomination for president. Don’t Say Gay? Check. Don’t Say Race? Check. Pee Where Your Birth Certificate Says? Check. No Kids at Drag Shows? Check. No Preferred Pronouns in Class? Check. Go Ahead and Stuff a Permitless Glock Down Your Britches? Check. Florida also limited abortions to the first six weeks, but six weeks wasn’t quite reactionary enough to include Florida among the Dobbs Fourteen.

Frustration boiled over in Florida’s Hernando County last May, when hundreds of people showed up at a school board meeting to protest that a fifth-grade teacher named Jenna Barbee was put under investigation for showing her students Strange World, an animated Disney adventure film from 2022. Barbee’s offense was that one of the characters happened to be gay. “No one is teaching your kids to be gay,” a teacher named Alyssa Marano said at the meeting. “Sometimes, they just are gay. I have math to teach. I literally don’t have time to teach your kids to be gay.” After the meeting, 49 teachers, including Marano and Barbee, either quit or retired en masse.

Florida is also a recognized national leader in the harassment of college and university professors. Working with his majority-Republican legislature, DeSantis prohibited Florida’s public institutions of higher learning from maintaining diversity, equity, and inclusion, or DEI, programs; he effectively ended tenure at public universities by requiring post-tenure reviews every five years; and he seized control of New College, a well-regarded public institution in Sarasota, abolishing, through a handpicked board of trustees, its gender-studies program, pushing out the school president, denying tenure to five faculty members on political grounds, and abolishing gender-neutral bathrooms.

Amid this tumult, Hampshire College, in Amherst, Massachusetts, offered a place to any New College student who wished to transfer, at the same price they were paying the state of Florida. About 12 percent of the New College students applied for transfer, and in the end roughly three dozen students departed sunny Tampa Bay for the chilly Berkshires. About 40 faculty members left with them, and U.S. News & World Report dropped New College’s ranking from 76 to 100.

An August survey sponsored by the American Association of University Professors demonstrated low morale among faculty in the Morrison Eighteen states of Florida, Georgia, and Texas. But nowhere was morale worse than in Florida, where 47 percent said they were seeking positions in another state. “I’m a professor,” one Floridian who called himself “Brodman_area11” posted on Reddit in late September. “My university is like watching all the rats escape from the sinking ship. My department alone has lost two pediatricians, and we can’t seem to be able to recruit any qualified replacements. It’s going to be a diaspora.”

And good riddance to them, Florida Republicans would likely say. But that fails to recognize how important university communities, public and private, are in creating and sustaining a state’s economic growth. “The college,” Karin Fischer noted in a recent report by The Chronicle of Higher Education titled College as a Public Good, “has become the one institution that remains in cities and rural regions alike long after the factory shuts down or the corporate headquarters pulls up stakes.” A college isn’t an easy thing to move. And although colleges sometimes go out of business, it doesn’t happen a lot. Of the nation’s 3,600 nonprofit institutions of higher learning, only about five to 12 close each year. We lose more factories than that every day.

Consider Rochester, New York. For more than 100 years, Rochester was a company town, and the company was Kodak. Around the time of Kodak’s 1992 centennial, the company employed 60,000 people, nearly all of them in Rochester, which meant more than one in 10 people working in the Rochester metropolitan area worked at Kodak. When you included indirect employment, Kodak drove perhaps one-quarter of Rochester’s economy. Then came digital photography and bankruptcy. The company is still around, but today its Rochester payroll is approximately 1,300 employees.

Rochester is still a thriving company town, but now the company is the University of Rochester. The university employs 31,000 people, which means more than one in 15 people working in the Rochester metropolitan area work for the university, and that doesn’t even count the economic impact of its 12,000 students. The most recent unemployment figure for Rochester’s metropolitan area was 3.2 percent in September. That was lower than the national average and the average in New York state.

At this point in the discussion, someone is bound to ask: If red states are so awful, why are so many people moving there? It’s true. Between 2020 and 2022, the five states with the biggest net population growth were all red: Idaho, Montana, Florida, Utah, and South Carolina. The two biggest net population losers, meanwhile, were blue states: New York and Illinois. I just got done telling you what terrible places Oklahoma and Tennessee have become to live in. But Oklahoma and Tennessee are two of the fastest-growing states in the country. How can that be?

Part of the answer is that not many of us move at all, so broad migration patterns are not so consequential as you might think. The big migration story is that Americans have grown steadily less geographically mobile for most of the past century. As the Berkeley sociologist Claude S. Fischer pointed out two decades ago, the idea of the United States as a rootless nation, promoted by writers as varied as Vance Packard and Joan Didion, is simply wrong—a fantasy derived from the historical memory of westward expansion during the nineteenth century. Today, even immigrants tend to stay put once they arrive in the United States. During the past decade, the percentage of the entire population that moved from one state to another in any given year never rose above 2.5 percent, not even during the Covid pandemic. Even movement from one county in a given state to another is about half what it was before 1990.

When Americans do move, the motivating factor is typically pursuit of cheaper housing. In a country where decades can go by with no appreciable rise in real median income, it makes sense that if you’re going to move, it’s best to go where it’s cheaper to live. Red states almost always offer a lower cost of living. If the climate’s warm, as it is in many red states, so much the better. Conservatives like to argue that people move to red states because the taxes are lower, and it’s true, they are. But that confuses correlation with cause. In places where the cost of living is low, taxes tend to be low, too. The high-tax states are the more prosperous (invariably blue) ones where it’s more expensive to live.

But there’s an exception to the American reluctance to migrate: Joe (and Jane) College. College-educated people move a lot, especially when they’re young. Among single people, the U.S. Census Bureau found, nearly 23 percent of all college-degree holders moved to a different state between 1995 and 2000, compared to less than 10 percent of those without a college degree. Among married people, nearly 19 percent of college-degree holders moved, compared to less than 10 percent of those without a college degree. More recent data shows that, between 2001 and 2016, college graduates ages 22 to 24 were twice as likely to move to a different state as were people lacking a college degree.

As much as Republicans may scorn Joe (and Jane) College, they need them to deliver their babies, to teach their children, to pay taxes, and to provide a host of other services that only people with undergraduate or graduate degrees are able to provide.

The larger population may prefer to move—on those rare occasions when it does move—to a red state, but the college-educated minority, which moves much more frequently, prefers relocating to a blue state. There are 10 states that import more college graduates than they export, and all of them except Texas are blue. (I’m counting Georgia, which is one of the 10, as a blue state because it went for Joe Biden in 2020.) Indeed, the three states logging the largest net population losses overall—New York, California, and Illinois—are simultaneously logging the largest net gains of college graduates. It’s a sad sign that our prosperous places are less able than in the past—or perhaps less willing—to make room for less-prosperous migrants in search of economic opportunity. But that’s the reality.

Meanwhile, with the sole exception of Texas, red states are bleeding college graduates. It’s happening even in relatively prosperous Florida. And much as Republicans may scorn Joe (and Jane) College, they need them to deliver their babies, to teach their children, to pay taxes—college grads pay more than twice as much in taxes—and to provide a host of other services that only people with undergraduate or graduate degrees are able to provide. Red states should be welcoming Kate and Caroline and Tyler and Delana. Instead, they’re driving them away, and that’s already costing them dearly.

‘Devastating toll’ of climate change now impacting ‘all regions’ of the U.S., Biden says

Yahoo! News

‘Devastating toll’ of climate change now impacting ‘all regions’ of the U.S., Biden says

The federal government’s fifth National Climate Assessment, released Tuesday, details how climate change is affecting every corner of the country.

Ben Adler, Senior Editor – November 14, 2023

Every region of the United States is now seeing rapid warming due to climate change, according to the federal government’s fifth National Climate Assessment, which was released Tuesday.

“I’ve seen firsthand what the report makes clear: the devastating toll of climate change. And its existential threat to all of us,” President Biden said from the White House Tuesday morning. “I’ve walked the streets of Louisiana, New Jersey, New York, Florida, Puerto Rico, where historic floods and hurricanes wiped out homes, hospitals, houses of worship.”

“This assessment shows us in clear scientific terms that climate change is impacting all regions, all sectors of the United States — not just some, all,” he added.

The report lays out in stark detail how climate change is already harming communities nationwide.

“Climate change is finally moving from an abstract future issue to a present, concrete, relevant issue. It’s happening right now,” the report’s lead author, Katharine Hayhoe, chief scientist at the Nature Conservancy and a professor at Texas Tech University, said in a statement.

Here are the key takeaways from the assessment.

Everyone is feeling the heat
National Park Service Rangers pose for a photo next to a sign showing a temperature of 132 degrees.
National Park Service Rangers Gia Ponce (left) and Christina Caparelli are photographed by Ranger Nicole Bernard next to a digital display of an unofficial heat reading at Furnace Creek Visitor Center in Death Valley National Park in Death Valley, Calif., on July 16. (Ronda Churchill / AFP via Getty Images) (AFP via Getty Images)

This year is on pace to be the warmest on record globally, and in the U.S., the heat is being felt nationwide, according to the report, which the federal government is required by law to produce every five years:

  • Every single region has higher average temperatures today than it did between 1951 and 1980.
  • The U.S. is warming faster than most of the world. Since 1970, the Lower 48 states have warmed by 2.5 degrees Fahrenheit, and Alaska by 4.2 degrees Fahrenheit, compared with the global average temperature rise of 1.7 degrees Fahrenheit.
  • Phoenix set a record this year with 54 days of high temperatures of 110 degrees Fahrenheit or greater, including 31 straight days over 110.
  • In Alaska, melting glaciers, thawing permafrost and disappearing sea ice are destroying the hunting and fishing-dependent economy. Some Indigenous communities may need to be relocated to flee rising sea levels.
  • Since warming is happening faster at higher latitudes, the report projects that the U.S. will warm about 40% more than the global average in the future.

Recommended reading

CBS News: 2023 ‘virtually certain’ to be warmest year recorded, climate agency says

South Florida Sun-Sentinel: Hot nights in South Florida: Nighttime low temperature set record high this weekend

‘Heavy precipitation events are increasing’
Vehicles make their way through floodwater.
Vehicles make their way through floodwater in Brooklyn, N.Y., on Sept. 29. (Ed Jones / AFP via Getty Images) (AFP via Getty Images)

Warmer air holds more moisture, so climate change is throwing the water cycle out of whack, researchers say. Since 2000, the western half of the country has endured a two-decade megadrought that has threatened freshwater supplies for millions of people.

But while annual rainfall has decreased in much of that region, the entire country has seen an increase in heavy precipitation events. As a result, this year saw a series of sometimes deadly flash floods from California to Vermont.

Hurricanes, which draw power from warm ocean waters, are also increasingly powerful, thanks in part to hotter ocean temperatures. (In July, the all-time record-high ocean temperature was set at 101.1 degrees Fahrenheit off of Florida’s Gulf Coast.)

‘More severe wildfires’
Burned trees in a forest.
Burned trees from recent wildfires stand in a forest in Fort Chipewyan, Alberta, Canada, on Sept. 3. The United States has been inundated with wildfire smoke from Canada this year. (Victor R. Caivano/AP Photo) (ASSOCIATED PRESS)

Warmer temperatures and dried-out vegetation from drought lead to more frequent and severe wildfires. Wildfires and the smoke they create have been an increasingly prevalent and severe problem in the West in recent years, but this summer the Northeast and Midwest were also at times enveloped in thick smoke from Canada’s record-setting wildfire season.

An economic toll

The report notes a sharp rise in the number of billion-dollar disasters in the U.S., with one occurring every three weeks since 2018. In the 1980s, the country experienced a billion-dollar weather disaster once every four months, according to the assessment.

“Extreme events cost the U.S. close to $150 billion each year — a conservative estimate that does not account for loss of life, health care-related costs or damages to ecosystem services,” the report stated.

Growing threats

The report also identifies frequent flooding due to sea-level rise and more powerful storms as a threat to low-lying regions across the country. Health risks, such as food and water contamination, increased air pollution from smoke, dust and pollen are also expected to worsen.

“Climate change threatens vital infrastructure that moves people and goods, powers homes and businesses, and delivers public services,” the report states.

The U.S. has begun to combat climate change
President Joe Biden delivers remarks beneath signage that reads: Historic Climate Action.
President Joe Biden delivers remarks on his administration’s actions to address the climate crisis in the South Court Auditorium of the White House on Tuesday. (Saul Loeb/AFP via Getty Images) (AFP via Getty Images)

The report also notes that U.S. greenhouse gas emissions dropped 12% between 2005 and 2019 thanks to the adoption of renewable energy sources like wind and solar energy.

The Biden administration has attempted to build on this progress through regulatory measures, like stiff new fuel efficiency standards for cars and trucks. And Congress approved $369 billion for investments in clean energy and electric vehicles in the Inflation Reduction Act. But those measures are only projected to cut emissions by 40% by 2030, not the 50% Biden has pledged to the international community.

A need to adapt, and to act

States and cities across the country have begun retrofitting infrastructure to meet the challenges of climate change, and measures such as enhanced storm drain capacity and improved forest management have increased in every region since the last assessment in 2018, according to the assessment.

But the report finds that faster, more ambitious adaptation investments are needed to minimize the still-growing costs of climate change.

Who’s to blame for climate change? Scientists don’t hold back in new federal report.

USA Today

Who’s to blame for climate change? Scientists don’t hold back in new federal report.

Dinah Voyles Pulver and Doyle Rice – November 14, 2023 President Joe Biden slams 'MAGA Republican leaders,' claims they deny climate change

Climate change is here and prompting unprecedented actions in every state to curb the greenhouse gas emissions fueling warming temperatures, but a new federal report out Tuesday says bigger, bolder steps are needed.

After several years of work by more than 500 authors from every state, Puerto Rico, the Virgin Islands, and Guam, the White House released the massive Fifth National Climate Assessment.

In remarks Tuesday morning, President Joe Biden announced more than $6 billion to bolster the electric grid, update water infrastructure, reduce flooding, and advance environmental justice.

“This assessment shows us in clear scientific terms, that climate change is impacting all regions, all sectors of the United States,” Biden said. “We’ve come to the point where it’s foolish for anyone to deny the impacts of climate change anymore.”

The assessment includes more evidence than ever before to demonstrate the cause and effects of the changing climate, said L. Ruby Leung, one of its authors. It also breaks from previous reports by saying unequivocally that humans are responsible for changes to Earth’s climate.

“It’s important for us to recognize that how much climate change we will be experiencing in the future depends on the choices that we make now,” said Leung, a climate scientist at the Pacific Northwest National Laboratory and lead author on the earth sciences chapter.

All of the impacts people are feeling, like sea level rise and extreme weather events, she said “are tied to the global warming level, to how warm the earth becomes,” Leung said. “And that depends very much on the level of CO2 concentration in the atmosphere.”

In other news, the United Nations released its latest analysis of national climate plans on Tuesday morning and found them “strikingly misaligned” with science. “The chasm between need and action is more menacing than ever,” said Secretary-General António Guterres. “It’s time for a climate ambition supernova in every country, city and sector.”

The impacts of climate change are felt in every corner of the country, the latest National Climate Assessment finds
The impacts of climate change are felt in every corner of the country, the latest National Climate Assessment finds
What is the 2023 National Climate Assessment?

The massive assessment describes the climate and economic impacts Americans will see if further action is not taken to address climate change. The report, issued roughly every four years, was mandated by Congress in the late 1980s and is meant as a reference for the president, Congress, and the public.

“Too many people still think of climate change as an issue that’s distanced from us in space or time or relevance,” said Katharine Hayhoe, an author of the report and chief scientist at The Nature Conservancy.

The assessment “clearly explains how climate change is affecting us here in the places where we live, both now and in the future and across every sector of human and natural society,” Hayhoe said. It also shows that “the risks matter and so do our choices.”

Climate Nexus, a nonprofit communications organization, said the new report is “essential reading,” because it highlights the seriousness of current impacts and shows the existing pace of adaptation isn’t enough to keep pace with future climate changes.

“Without deeper cuts in global net greenhouse gas emissions and accelerated adaptation efforts, severe climate risks to the United States will continue to grow,” the report states. “Each additional increment of warming is expected to lead to more damage and greater economic losses.”

However, greater reductions in carbon emissions could reduce the risks and impacts, and have immediate health and economic benefits, the report states.

Another heat record? Earth is historically and alarmingly hot. Now what?

What are the effects of climate change?

Millions are experiencing more extreme heat waves, with warmer temperatures and longer-lasting heat waves, the report states. It adds climate changes are apparent in every region of the country.

Among the noted effects:

◾ The number of nights with minimum low temperatures at or above 70 degrees has increased compared to 1901-1960 in every corner of the country except the northern Great Plains and Alaska.

◾ Average annual precipitation is increasing in most regions, except the Northwest, Southwest, and Hawaii.

◾ Heavier precipitation events are increasing everywhere except Hawaii and the Caribbean.

◾ Relative sea levels are increasing along much of the coast, except for Oregon, Washington, and Alaska.

◾ In the 1980s, the country experienced on average a $1 billion disaster every four months but now experiences one every three weeks. This year, the country has set a new record with 25 billion-dollar disasters.

Fishers and the warming climate Climb aboard four fishing boats with us to see how America’s warming waters are changing

Climate scientists around the world say 2023 is almost certain to be the globe’s warmest year in recorded human history. The global mean temperature through October was 1.4 Celsius (more than 2.5 degrees Fahrenheit) above the preindustrial average.

So far this year, the nation is experiencing its 11th warmest year on record through October, according to the National Oceanic and Atmospheric Administration. However, 12 states are experiencing their warmest or second warmest year on record.

Growing evidence that humans are changing the climate

This assessment is most notable for the certainty scientists have gained about warming and its impacts, said Leung, who served as the lead author for the report’s Earth Systems Processes chapter, which lays the scientific groundwork and is used to illustrate points throughout the report.

The chapter, a collaboration among more than a dozen authors, was intended to answer such questions as whether humans are causing global warming, whether warming is changing extreme weather and climate events and how much warming the planet might expect to see.

In prior reports, scientists often hedged their statements, for example saying they were 90% sure humans were responsible for the changes being seen,” Leung said. “In this NCA 5 report, we are now saying that we are totally sure.”

Starting from the 1900s, the observed warming has been caused by human activities, she said. “It’s definitive.”

Another key difference is scientists reduced by 50% the uncertainty in how much temperatures would warm if the concentration of carbon dioxide in the atmosphere doubles, she said. In previous assessments that number had hovered around a range from 2.7 degrees to 8 degrees. “It was a pretty big range,” she said. “Our goal has always been to narrow this down.”

Thanks to the increase in instrumental observations, satellite data, the study of the paleoclimate, and higher resolution computer modeling, scientists now have amassed more evidence than ever before, giving them more certainty, she said. “Now we can say that the global warming that is caused by a doubling of the CO2 in the atmosphere should be between 4.5 degrees Fahrenheit and 7.2 degrees Fahrenheit.”

The Fifth National Climate Assessment shows the U.S. has warmed rapidly since the 1970s.
The Fifth National Climate Assessment shows the U.S. has warmed rapidly since the 1970s.
Reducing greenhouse gas emissions

Efforts to adapt to climate change, reduce net greenhouse gas emissions, and be more energy efficient are underway in every U.S. region and have expanded since 2018, the report concludes.

Greenhouse gas emissions in the U.S. fell 12% between 2005 and 2019, mostly driven by changes in the way electricity is produced, the assessment concluded. The nation burns less coal, but more natural gas, which is cleaner. Because of the electrical industry’s 40% reduction in emissions, the transportation sector took the lead as the industry with the most emissions.

Growth in the capacity of wind, solar, and battery storage is supported by the falling costs of those technologies, and that ultimately means even more emissions reductions, the report states. For example, wind and solar energy costs have dropped 70% and 90%, respectively.

While the options for cleaner technologies and lower energy use have expanded, the authors found they aren’t happening fast enough for the nation to meet the goal of achieving a carbon-neutral energy system.

Without deeper cuts in global net greenhouse gas emissions and accelerated adaptation efforts, the scientists found severe climate risks to the United States will continue to grow. Each additional increment of warming is expected to lead to more damage and greater economic losses compared to previous increments of warming, and the risks of catastrophic consequences also increase.

But the report also finds that reducing greenhouse gas emissions and removing carbon dioxide from the atmosphere can limit future warming and associated increases in many risks, and bring immediate health and economic benefits.

What others are saying about the report:

The scientific assessment is “the latest in a series of alarm bells and illustrates that the changes we’re living through are unprecedented in human history,” said Kristina Dahl, a principal climate scientist at the Union of Concerned Scientists and a contributor to the report. “The science is irrefutable: we must swiftly reduce heat-trapping emissions and enact transformational climate adaptation policies in every region of the country to limit the stampede of devastating events and the toll each one takes on our lives and the economy.”

The report illustrates three things, said Arati Prabhakar, director of the White House Office of Science and Technology Policy.

◾ The events Americans have already experienced firsthand are “unfolding as predicted.”

◾ Communities in every state and territory have taken action.

◾ People across the nation can use the assessment to take future actions.

For example, Prabhakar said the report could be used by a water utility manager in Chicago trying to understand extreme rainfall, an urban planner deciding where to locate cooling centers in Texas, or a manager of a Southeastern hospital trying to get ahead of the diseases ticks and mosquitoes are bringing into their region as a result of the changing climate.

What an increase of 3.6 degrees Fahrenheit over pre-industrial temperatures would feel like in the United States.
What an increase of 3.6 degrees Fahrenheit over pre-industrial temperatures would feel like in the United States.

Mind-altering ketamine becomes latest pain treatment, despite little research or regulation

Associated Press

Mind-altering ketamine becomes latest pain treatment, despite little research or regulation

Matthew Perrone – November 6, 2023

Dr. Padma Gulur, a Duke University pain specialist, stands for a portrait on Friday, Oct. 27, 2023, in Durham, N.C. Prescriptions for ketamine have soared in recent years as doctors adopt the mind-altering drug as an alternative pain treatment. Gulur and other specialists see potential for ketamine as a pain therapy, but warn it also carries risks of safety and abuse. (AP Photo/Matt Kelley)
Dr. Padma Gulur, a Duke University pain specialist, stands for a portrait on Friday, Oct. 27, 2023, in Durham, N.C. Prescriptions for ketamine have soared in recent years as doctors adopt the mind-altering drug as an alternative pain treatment. Gulur and other specialists see potential for ketamine as a pain therapy, but warn it also carries risks of safety and abuse. (AP Photo/Matt Kelley)
Medical equipment used to customize ketamine infusions for patients is seen at the Duke Specialty Infusion Center, Friday, Oct. 27, 2023, in Durham, N.C. Ketamine prescriptions have soared in recent years as an alternative to opioids for pain. But with little research on its effectiveness, some experts worry about the risks of overprescribing another powerful drug that carries risks of safety and abuse. (AP Photo/Matt Kelley)
Medical equipment used to customize ketamine infusions for patients is seen at the Duke Specialty Infusion Center, Friday, Oct. 27, 2023, in Durham, N.C. Ketamine prescriptions have soared in recent years as an alternative to opioids for pain. But with little research on its effectiveness, some experts worry about the risks of overprescribing another powerful drug that carries risks of safety and abuse. (AP Photo/Matt Kelley)
The Duke Specialty Infusion Center is seen prior to opening for patients, Friday, Oct. 27, 2023, in Durham, N.C. Ketamine prescriptions have soared in recent years as an alternative to opioids for pain. But with little research on its effectiveness, some experts worry about the risks of overprescribing another powerful drug that carries risks of safety and abuse. (AP Photo/Matt Kelley)
The Duke Specialty Infusion Center is seen prior to opening for patients, Friday, Oct. 27, 2023, in Durham, N.C. Ketamine prescriptions have soared in recent years as an alternative to opioids for pain. But with little research on its effectiveness, some experts worry about the risks of overprescribing another powerful drug that carries risks of safety and abuse. (AP Photo/Matt Kelley)
Dr. Padma Gulur, a Duke University pain specialist, stands for a portrait on Friday, Oct. 27, 2023, in Durham, N.C. Prescriptions for ketamine have soared in recent years as doctors adopt the mind-altering drug as an alternative pain treatment. Gulur and other specialists see potential for ketamine as a pain therapy, but warn it also carries risks of safety and abuse. (AP Photo/Matt Kelley)
Dr. Padma Gulur, a Duke University pain specialist, stands for a portrait on Friday, Oct. 27, 2023, in Durham, N.C. Prescriptions for ketamine have soared in recent years as doctors adopt the mind-altering drug as an alternative pain treatment. Gulur and other specialists see potential for ketamine as a pain therapy, but warn it also carries risks of safety and abuse. (AP Photo/Matt Kelley)
Saline fluid runs through a tube demonstrating how ketamine would be administered to a patient at the Duke Speciality Infusion Center on Friday, Oct. 27, 2023, in Durham, N.C. Ketamine prescriptions have soared in recent years as an alternative to opioids for pain. But with little research on its effectiveness, some experts worry about the risks of overprescribing another powerful drug that carries risks of safety and abuse. (AP Photo/Matt Kelley)
Saline fluid runs through a tube demonstrating how ketamine would be administered to a patient at the Duke Speciality Infusion Center on Friday, Oct. 27, 2023, in Durham, N.C. Ketamine prescriptions have soared in recent years as an alternative to opioids for pain. But with little research on its effectiveness, some experts worry about the risks of overprescribing another powerful drug that carries risks of safety and abuse. (AP Photo/Matt Kelley)
A lockbox is held to show where ketamine is placed into while administered at the Duke Speciality Infusion Center, Friday, Oct. 27, 2023, in Durham, N.C. Ketamine prescriptions have soared in recent years as an alternative to opioids for pain. But with little research on its effectiveness, some experts worry about the risks of overprescribing another powerful drug that carries risks of safety and abuse. (AP Photo/Matt Kelley)
A lockbox is held to show where ketamine is placed into while administered at the Duke Speciality Infusion Center, Friday, Oct. 27, 2023, in Durham, N.C. Ketamine prescriptions have soared in recent years as an alternative to opioids for pain. But with little research on its effectiveness, some experts worry about the risks of overprescribing another powerful drug that carries risks of safety and abuse. (AP Photo/Matt Kelley)

WASHINGTON (AP) — As U.S. doctors scale back their use of opioid painkillers, a new option for hard-to-treat pain is taking root: ketamine, the decades-old surgical drug that is now a trendy psychedelic therapy.

Prescriptions for ketamine have soared in recent years, driven by for-profit clinics and telehealth services offering the medication as a treatment for pain, depression, anxiety and other conditions. The generic drug can be purchased cheaply and prescribed by most physicians and some nurses, regardless of their training.

With limited research on its effectiveness against pain, some experts worry the U.S. may be repeating mistakes that gave rise to the opioid crisisoverprescribing a questionable drug that carries significant safety and abuse risks.

“There’s a paucity of options for pain and so there’s a tendency to just grab the next thing that can make a difference,” said Dr. Padma Gulur, a Duke University pain specialist who is studying ketamine’s use. “A medical journal will publish a few papers saying, ‘Oh, look, this is doing good things,’ and then there’s rampant off-label use, without necessarily the science behind it.”

When Gulur and her colleagues tracked 300 patients receiving ketamine at Duke, more than a third of them reported significant side effects that required professional attention, such as hallucinations, troubling thoughts and visual disturbances.

Ketamine also didn’t result in lower rates of opioid prescribing in the months following treatment, a common goal of therapy, according to Gulur. Her research is under review for medical journal publication.

PSYCHEDELIC EXPERIENCE

Ketamine was approved more than 50 years ago as a powerful anesthetic for patients undergoing surgery. At lower doses, it can produce psychedelic, out-of-body experiences, which made it a popular club drug in the 1990s. With its recent adoption for pain, patients are increasingly encountering those same effects.

Daniel Bass, of Southgate, Kentucky, found the visual disturbances “horrifying.” His doctors prescribed four- to six-hour IV infusions of ketamine for pain related to a rare bone and joint disorder. Seated in a bare hospital room with no stimulation or guidance on the drug’s psychological effects, Bass says he felt “like a lab rat.”

Still, he credits ketamine with reducing his pain during the year that he received twice-a-month infusions.

“No matter how horrific an experience is, if it allows me to be more functional, I will do it,” Bass said.

Ketamine targets a brain chemical messenger called glutamate, which is thought to play a role in both pain and depression. It’s unclear whether the psychedelic experience is part of the drug’s therapeutic effect, though some practitioners consider it essential.

“We want patients to disassociate or feel separate from their pain, depression or anxiety,” said Dr. David Mahjoubi, owner of Ketamine Healing Clinic in Los Angeles. “If they feel like they’re just sitting in the chair the whole time, we actually give them more.”

Mahjoubi’s practice is typical of the burgeoning industry: He offers IV ketamine for alcohol addiction, chronic pain, anxiety and post-traumatic stress disorder. The ketamine doses for those indications are well below those used for surgery, but Mahjoubi favors higher doses for pain than for psychiatric conditions.

Patients pay cash because most insurers don’t cover non-surgical uses of ketamine, none of which are approved by the Food and Drug Administration. Mahjoubi’s background is in anesthesiology, not psychiatry or addiction.

Patients can pay extra for ketamine nasal sprays and tablets to use between infusions. Those formulations are also not FDA approved and are compounded by specialty pharmacies.

Sending ketamine through the mail has become its own profitable business for telehealth services, such as MindBloom, which jumped into the space after regulators relaxed online prescribing rules during COVID-19.

Pain specialists who study ketamine say there’s little evidence for those versions.

“The literature for the nasal and oral formulations is pretty scant,” said Dr. Eric Schwenk of Thomas Jefferson University. “There’s just not a lot of good evidence to guide you.”

Demand for ketamine has sent prescriptions soaring more than 500% since 2017, according to Epic Research, which analyzed the trend using a database of more than 125 million patients. In each year, pain was the No. 1 condition for which ketamine was prescribed, though depression has been rising quickly.

The prescribing boom has led to shortages of manufactured ketamine, driving up sales of compounded versions.

There is more evidence for ketamine’s use against depression than for pain. In 2019, the FDA approved a ketamine-related chemical developed by Johnson & Johnson for severe depression. The drug, Spravato, is subject to strict FDA safety rules on where and how it can be administered by doctors.

Guidelines from pain societies note some evidence for ketamine’s use in complex regional pain, a chronic condition that usually affects the limbs. But the experts found “weak or no evidence” for ketamine in many more conditions, including back pain, migraines, fibromyalgia and cancer pain.

THE ‘WILD WEST’ OF KETAMINE PRESCRIBING

While the science behind ketamine is murky, the business model is clear: Physicians can purchase ketamine for less than $100 a vial and charge $500 to $1,500 per infusion.

The recent boom has been fueled, in part, by venture capital investors. Another set of consulting businesses offer to help doctors set up new clinics.

A blog post from one, Ketamine Startup, lists “Five reasons you should open a ketamine clinic,” including: “You want to be your own boss” and “You want to take control of your money-making ability.”

The clinics are facing increasing competition from telehealth services like MindBloom and Joyous, which connect potential patients with physicians who can prescribe ketamine remotely and send it through the mail.

In May, federal regulators were scheduled to roll back the COVID-era policy that allowed online prescribing of high-risk drugs like ketamine and opioids. But the Drug Enforcement Administration, facing backlash for telehealth companies and physicians, agreed to extend the flexible approach through 2024.

The current landscape is a “wild west,” said Dr. Samuel Wilkinson, a Yale University psychiatrist who prescribes both Spravato and ketamine for depression. U.S. physicians have “quite a bit of latitude” to prescribe drugs for unapproved, or off-label, uses.

“There’s good things about that and not-so-good things about that,” he said.

When used at high doses, ketamine can cause bladder damage, sometimes seen in people who use the drug recreationally. Far less is known about the neurological effects of long-term use. Ketamine was linked to brain abnormalities in rat studies, FDA regulators note.

Last month, the FDA warned doctors and patients against compounded versions of ketamine, including lozenges and pills, saying the agency does not regulate their contents and cannot assure their safety. The warning followed a similar advisory last year about nasal spray versions of ketamine.

But most compounding pharmacies are small operations, overseen by state officials, not the FDA.

In April, Massachusetts’ board of pharmacy flagged the FDA’s warning to local pharmacies, but noted that state officials wouldn’t take any steps to stop “the continued compounding and dispensing of ketamine nasal spray.”

The FDA likewise has little leverage over physicians promoting ketamine, even those making exaggerated or misleading claims.

Drugmakers are subject to strict FDA regulation in how they promote their medicines — with requirements to balance risk and benefit information. Those rules don’t apply to physicians.

Even when the FDA has tried to regulate risky in-office procedures, such as unproven stem cell infusions, the agency has had a mixed track record of prevailing in court.

For now, experts say it’s unlikely regulators will go beyond their recent warnings about off-label ketamine.

“There’s an element of whack-a-mole and it’s essentially beyond their regulatory purview,” said Dr. Caleb Alexander, a drug safety researcher at Johns Hopkins University. “These clinics would represent yet another front that they would be hard pressed to manage and address.”

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

A man with Parkinson’s who was unable to walk without falling is enjoying Sunday strolls again thanks to a spine implant

Insider

A man with Parkinson’s who was unable to walk without falling is enjoying Sunday strolls again thanks to a spine implant

Kim Schewitz – November 6, 2023

  • A man who has had Parkinson’s for 30 years could hardly walk on his own and had to stay home.
  • Scientists implanted a device in his spine that stimulates his leg muscles with electrical impulses.
  • Two years on he can climb stairs, go shopping, and walk almost four miles independently.

A man diagnosed with Parkinson’s disease almost 30 years ago who could barely walk on his own can now climb stairs and go out independently again thanks to a potentially revolutionary device implanted in his spinal cord.

Marc Gautier, 62, from a small town near Bordeaux, France, has lived with Parkinson’s since he was 36, and was forced to stop working as an architect three years ago when his mobility got so bad that he was falling down five to six times a day, meaning he often had to stay at home.

“I practically could not walk anymore without falling frequently, several times a day. In some situations, such as entering a lift, I’d trample on the spot, as though I was frozen there,” Gautier said in a press release.

Two years since the device was surgically implanted, however, he can once again do many things he used to enjoy.

“Every Sunday I go to the lake, and I walk around six kilometers. It’s incredible,” he said.

The implant stimulates sensory fibers connected to muscles

Parkinson’s is a degenerative disease where people don’t have enough dopamine — a neurotransmitter responsible for many bodily functions — in their brain, which can lead to physical symptoms including rigidity and tremors.

Parkinson’s is most common in older people and men, with symptoms typically appearing in those over 50, but it can occur in people under 40, too.

Treatments typically include taking dopamine and deep brain stimulation, where electrodes implanted in the brain produce electrical impulses that affect brain activity. These are usually effective but can stop working as the patient’s condition worsens over time.

Around 90% of people with advanced Parkinson’s experience walking problems, such as gait impairments, balance problems, and freezing-of-gait episodes, which reduce their quality of life, study co-author Jocelyne Bloch, director of the NeuroRestore treatment center that researches implantable neurotechnologies, and senior attending neurosurgeon at University Hospital of Lausanne, Switzerland, said in a press video.

Scientists from Switzerland and France worked to develop the new treatment by designing and implanting a device, known as a neuroprosthesis, into Gautier’s spinal cord.

In healthy people without Parkinson’s, muscles move after being stimulated by sensory fibers. In Gautier’s case, the fibers in his legs were weakened by Parkinson’s, meaning the sensory feedback loop was not strong enough to make them move properly, co-author Grégoire Courtine, professor of neuroscience at the Swiss Federal Institute of Technology in Lausanne, told a press conference. The implant works by stimulating the weakened sensory fibers attached to the leg muscles.

“So if you imagine the stretch reflex, you go to the doctor, there’s a tendon with the hammer, you hit the tendon and then you have a reflex. That’s exactly this pathway that we are mobilizing with the stimulation,” he said. Gautier can turn the stimulation on and off himself, the authors said.

“Instead of focusing on the region of the brain that’s deprived of dopamine, we thought that we could focus on the spinal cord, that ultimately is responsible for the activation of leg muscle in order to walk,” Courtine said.

The team published their findings in Nature Medicine on Monday.

Gautier’s walking improved almost immediately

After the device was implanted, Gautier quickly saw his walking start to improve, according to the study, and following several weeks of rehabilitation, it had nearly returned to normal.

He currently uses his neuroprosthetic for around eight hours a day, only turning it off when sitting down for a long period or sleeping, according to the press release.

The study’s authors are excited about the possibility of turning this proof of concept into a widely available therapy to treat mobility problems in people with Parkinson’s, they told a press conference.

“I really believe that these results open realistic perspectives to develop a treatment that alleviates gait deficits due to Parkinson’s disease and therefore look forward to testing this new therapy in six additional patients,” Bloch said.

The authors said further testing would happen within the next 18 months, but if successful, the treatment would not be commercially available for at least five to ten years.

David Dexter, director of research at Parkinson’s UK, who was not involved in the study, told Insider: “This research is still at a very early stage and requires much more development and testing before it can be made available to people with Parkinson’s, however, this is a significant and exciting step forward and we hope to see this research progress quickly.”

Eduardo Fernández, director of the Institute of Bioengineering at the Miguel Hernandez University of Elche, Spain, who was also not involved in the research, said in a statement that Parkinson’s patients with mobility issues can often respond poorly to standard treatments that focus primarily on the areas of the brain directly affected by the loss of dopamine-producing neurons. He described the new approach as “very innovative” because it involves areas of the nervous system not affected by the disease.

“The future is hopeful, but it is necessary to advance little by little and not to create false expectations that could damage the credibility of this research,” he said.

China rushes to swap Western tech with domestic options as U.S. cracks down

Reuters

China rushes to swap Western tech with domestic options as U.S. cracks down

Reuters – October 25, 2023

FILE PHOTO: Servers are seen inside Huawei's factory campus in Dongguan, Guangdong province
FILE PHOTO: Huawei store in Shanghai

Servers are seen inside Huawei’s factory campus in Dongguan, Guangdong province

BEIJING (Reuters) – China has stepped up spending to replace Western-made technology with domestic alternatives as Washington tightens curbs on high-tech exports to its rival, according to government tenders, research documents and four people familiar with the matter.

Reuters is reporting for the first time details of tenders from the government, military and state-linked entities, which show an acceleration in domestic substitution since last year.

China has spent heavily on replacing computer equipment, and the telecom and financial sectors are probably the next target, said two people familiar with the industries. State-backed researchers also identified digital payments as particularly vulnerable to possible Western hacking, according to a review of their work, making a push to indigenize such technology likely.

The number of tenders from state-owned enterprises (SOEs), government and military bodies to nationalize equipment doubled to 235 from 119 in the 12 months after September 2022, according to a finance ministry database seen by Reuters.

In the same period, the value of awarded projects listed on the database totaled 156.9 million yuan, or more than triple the previous year.

While the database represents only a fraction of tender bids nationwide, it is the largest collection of state tenders publicly available and mirrors third-party data. China spent 1.4 trillion yuan ($191 billion) replacing foreign hardware and software in 2022, marking a year-on-year increase of 16.2%, according to IT research firm First New Voice.

But Beijing’s lack of advanced chip-manufacturing capabilities prevents it from completely substituting products with alternatives that are entirely locally made, analysts say.

Previous domestic substitution efforts stalled because China did not have the “technical chops to pull off localization until now, and to a certain extent they still kind of don’t,” said Kendra Schaefer, head of tech policy research at Beijing-based consultancy Trivium China.

FEAR OF DEPENDENCE

SOEs were instructed last year to replace office software systems with domestic products by 2027, the first time such specific deadlines were imposed, according to five brokerage firms that cited a September 2022 order from China’s state asset regulator. Reuters could not independently verify the order.

Domestic replacement projects this year have targeted markedly sensitive infrastructure, the tenders show.

One partially redacted tender for a “certain government department in Gansu province” assigned 4.4 million yuan to replace an intelligence-gathering system’s equipment, without providing specifics.

People’s Liberation Army units in the northeastern city of Harbin and Xiamen in the south last December meanwhile issued tenders to replace foreign-made computers.

Tech researchers such as Mo Jianlei of the Chinese Academy of Sciences, the country’s largest state-run research organization, said the Chinese government was increasingly concerned about Western equipment being hacked by foreign powers.

The state asset regulator did not return a request for comment.

Over the past year, state-linked researchers also called on Beijing to strengthen anti-hacking defences in its financial infrastructure due to geopolitical concerns.

One March research paper highlighted the dependence of China’s UnionPay credit card system on U.S software firm BMC for settlements.

“Beware of security vulnerabilities in hardware and software set by the U.S. side … build a financial security ‘firewall’,” the researchers wrote.

BMC declined to comment.

An article published this year in the journal Cyberspace Security by researchers from the state-run China Telecommunications Corporation concluded the country was overdependent on chips made by U.S. giant Qualcomm for back-end management, as well as on the iOS and Android systems.

“(They) are all firmly controlled by American companies,” the researchers wrote.

As China has not signed World Trade Organization clauses governing public procurement, the substitution effort does not appear to violate international accords, according to the U.S. Treasury. The U.S. has implemented similar rules barring Chinese companies from public sector bids.

Qualcomm, Google and Apple did not immediately return requests for comment.

WINNERS AND LOSERS

China’s effort to build an independent computing system dates back to at least its 2006 five-year plan for science and technology development, which listed the semiconductor and software systems sectors as national priorities.

This effort spawned state-owned companies that are increasingly winning major contracts. Two firms awarded the Harbin tenders were subsidiaries of China Electronics Corporation and China Electronics Technology Group Corporation – both heavily targeted by U.S. sanctions.

The state regulator’s 2022 order pushed SOEs away from U.S. companies such as Microsoft and Adobe, according to an employee of a Beijing-based firm that develops domestic office-processing software

China Tobacco, for example, in July began switching some subsidiaries from Microsoft Windows to Huawei’s EulerOS, according to an employee of a software vendor that services the state-owned manufacturer.

The people spoke on condition of anonymity because they were not authorized to discuss clients and competitors.

For years, Western tech companies have shared their source code and entered into partnerships with domestic firms to address Beijing’s concerns, but prominent computer scientists such as Ni Guangnan of the Chinese Academy of Engineering have said such measures are not sufficient for China’s security needs.

China Tobacco, Microsoft and Adobe did not respond to requests for comment.

In September, Reuters and other outlets reported that some employees of central government agencies were banned from using iPhones at work.

“In certain sectors, customers … are opting for domestic suppliers, with foreign suppliers frequently facing informal barriers,” the European Union Chamber of Commerce in Beijing said in response to Reuters questions.

In a 2023 American Chamber of Commerce (AmCham) in Shanghai report, 89% of the organization’s tech business members named procurement practices favoring domestic competitors as a regulatory obstacle. It was the highest percentage of any sector.

AmCham Shanghai President Eric Zheng acknowledged China’s national security concerns but said he hoped “normal procurement procedures will not be politicized so that US companies can compete fairly and pursue commercial opportunities … to benefit both countries.”

The U.S. Department of Commerce, China Electronics Corporation and China Electronics Technology Group Corporation did not return requests for comment.

HUAWEI PRIZED

Chinese tech conglomerate Huawei has emerged as the leading firm in this replacement cycle, according to three people familiar with China’s enterprise tech industry, who spoke on condition of anonymity given the sensitivity of the issue.

In 2022, Huawei’s enterprise business, which includes software and cloud computing operations, reported 133 billion yuan in sales, up 30% on the previous year.

One of the people said privately-held Huawei was seen as more nimble than state-owned groups in rolling out products and executing projects.

The other two sources highlighted Huawei’s broad product suite – spanning chips to software – as an advantage.

Clients also prize Huawei for its ability to process data on internal company servers and external cloud networks, as well as its wide offering of cybersecurity products, according to the employee of a China Tobacco tech supplier.

Huawei declined to comment.

The replacement drive has re-drawn entire sub-sectors of the software industry. The combined China market share held by five major foreign makers of database management systems – the majority of which are American – dropped from 57.3% in 2018 to 27.3% by the end of 2022, according to industry group IDC.

Despite heavy spending on domestic substitution, however, foreign firms are still dominant suppliers for banking and telecoms database management. Non-Chinese companies held 90% of market share for banking database systems at the end of 2022, according to EqualOcean, a tech consultancy.

Financial institutions are generally reluctant to switch database systems despite government pressure, said one of the industry sources, adding that they have higher stability requirements than many other sectors and local players cannot yet match their needs.

Even for personal computers, banks that switch from an international brand to China’s dominant supplier Lenovo would still be reliant on critical chip components provided by Western firms, one of the industry sources said.

($1 = 7.3165 Chinese yuan)

(Reporting by Beijing newsroom; Editing by Brenda Goh and Katerina Ang)

Facts about Glyphosate From drugwatch.com/roundup

By Michelle Llamas, Bd Cert. Patient Adv, October 11, 2023

Michelle Llamas has been writing articles and producing podcasts about drugs, medical devices and the FDA for nearly a decade. She focuses on various medical conditions, health policy, COVID-19, LGBTQ health, mental health and women’s health issues. Michelle collaborates with experts, including board-certified doctors, patients and advocates, to provide trusted health information to the public. Some of her qualifications include:

  • Member of American Medical Writers Association (AMWA) and former Engage Committee and Membership Committee member
  • Centers for Disease Control and Prevention (CDC) Health Literacy certificates
  • Original works published or cited in The Lancet, British Journal of Clinical Pharmacology and the Journal for Palliative Medicine
  • Board Certified Patient Advocate, Patient Advocacy Certificate from University of Miami.

“Glyphosate, the active component found in popular herbicides such as Roundup, sees extensive application in agriculture to combat unwanted weeds that compete with crops. Nevertheless, apprehensions have surfaced concerning its safety and potential impacts on health. Legal disputes have arisen, asserting that exposure to glyphosate through products like Roundup might be connected to specific types of cancer, notably non-Hodgkin lymphoma. Glyphosate operates by inhibiting the enzyme EPSP synthase, causing disruptions in plant growth that ultimately result in the plant’s demise. While some regulatory authorities consider the levels of glyphosate in food as safe, concerns regarding its long-term consequences continue to grow. Typical repercussions of exposure include skin and respiratory irritations, and research indicates potential associations between glyphosate and both cancer and neurological disorders. Certain countries within the European Union have imposed bans on glyphosate, and Bayer, the manufacturer of Roundup, has encountered significant settlements in legal actions in the United States lawsuits linked to glyphosate exposure.”

Tips for Reducing Glyphosate Exposure

People can avoid glyphosate use with several Roundup alternatives. These include manual or mechanical methods of weed pulling, such as small and large hand tools, tillers and other mechanical methods.

Natural or organic herbicides whose active ingredients are vinegar or essential oils are also an option. Ask your local home and garden center for organic or natural herbicides that do not contain glyphosate.

Drugwatch.com writers follow rigorous sourcing guidelines and cite only trustworthy sources of information, including peer-reviewed journals, court records, academic organizations, highly regarded nonprofit organizations, government reports and interviews with qualified experts. Review our editorial policy to learn more about our process for producing accurate, current and balanced content.

Rogue AI will learn to ‘manipulate people’ to stop it from being switched off, predicts British ‘Godfather of AI’

Fortune

Rogue AI will learn to ‘manipulate people’ to stop it from being switched off, predicts British ‘Godfather of AI’

Ryan Hogg – October 10, 2023

Ramsey Cardy/Sportsfile for Collision via Getty Images

The “Godfather of AI,” and one of its biggest critics, believes the technology will soon become smarter than humans and could learn to manipulate them.

Geoffrey Hinton, a former AI engineer at Googletold 60 Minutes he expected artificial intelligence to become self-aware in time, making humans the second most intelligent beings on the planet.

Humans have about 100 trillion neural connections, while the biggest AI chatbots have just 1 trillion connections, according to Hinton.

However, he suggests the knowledge contained within those connections is likely much more than that contained in humans.

Eventually, Hinton says, computer systems might be able to write their own code to modify themselves, in a sense going rogue. And if it does, he thinks AI will have a way to stop itself from being switched off by humans.

“They will be able to manipulate people,” Hinton told 60 Minutes.

“These will be very good at convincing because they’ll have learned from all the novels that were ever written, all the books by Machiavelli, all the political connivances. They’ll know all that stuff.”

Bigger threat than climate change

Hinton quit his role as an engineer at Google in May after more than a decade with the company, in part to speak out against the growing risks of the technology and lobby for safeguards and regulations against it.

While at Google, Hinton helped build the AI chatbot Bard, the tech giant’s competitor to OpenAI’s ChatGPT. He also set the foundations for the growth of AI through his pioneering neural network, which helped him win a prestigious Turing Award.

Since he quit, Hinton has been one of the leading voices warning of AI’s dangers. Following his resignation announcement in the New York Times, he told Reuters he thought the tech had become a bigger threat to humans than climate change.

In late May, he was at the top of a list of hundreds of experts, which included OpenAI founder Sam Altman, calling for urgent regulation of AI.

“Mitigating the risk of extinction from AI should be a global priority alongside other societal-scale risks such as pandemics and nuclear war,” the 22-word statement read.

Hinton’s biggest worry about AI right now pertains to the labor market. He told 60 Minutes he feared a whole class of people would find themselves unemployed as more capable AI systems take their place.

In the longer run, though, he worries about AI’s militaristic potential. In his interview with 60 Minutes, Hinton called for governments to commit to not building battlefield robots. The warning is akin to J. Robert Oppenheimer’s calls to stop world leaders from developing nuclear weapons after he pioneered the first atomic bomb.

Hinton summed up by saying he couldn’t see a path that guarantees safety, adding he wasn’t sure robots could ever be stopped from wanting to take over humanity.

The world’s major governments appear to have heard Hinton’s and others’ warnings loud and clear.

The U.K. will host the first global AI summit in November, which is expected to be attended by 100 politicians, academics, and AI experts.

It could lay the groundwork for sweeping regulatory changes by major countries including the United States.

The U.S. is crafting an AI Bill of Rights, and in the coming months is expected to bring in safeguards that tech companies must abide by.

The European Union is crafting its own guardrails around AI, titled the AI Act. However, the potential for varying regulations based on geography is creating tension.

In June, more than 150 major European execs requested the EU pull back on its proposed restrictions around AI, including increased bureaucracy and tests on certain tech’s safety. They argued these would create a “critical productivity gap” in the region that would leave it trailing the U.S.

Global temperatures are off the charts for a reason: 4 factors driving 2023’s extreme heat and climate disasters

The Conversation

Global temperatures are off the charts for a reason: 4 factors driving 2023’s extreme heat and climate disasters

Michael Wysession, Professor of Earth, Environmental, and Planetary Sciences, Arts & Sciences at Washington University in St. Louis. October 6, 2023

2023's weather has been extreme in many ways. <a href=
2023’s weather has been extreme in many ways. AP Photo/Michael Probst

Between the record-breaking global heat and extreme downpours, it’s hard to ignore that something unusual is going on with the weather in 2023.

People have been quick to blame climate change – and they’re right: Human-caused global warming does play the biggest role. For example, a study determined that the weekslong heat wave in Texas, the U.S. Southwest and Mexico that started in June 2023 would have been virtually impossible without it.

However, the extremes this year are sharper than anthropogenic global warming alone would be expected to cause. September temperatures were far above any previous September, and around 3.1 degrees Fahrenheit (1.75 degrees Celsius) above the preindustrial average, according to the European Union’s earth observation program.

July was Earth’s hottest month on record, also by a large margin, with average global temperatures more than half a degree Fahrenheit (a third of a degree Celsius) above the previous record, set just a few years earlier in 2019.

September 2023’s temperatures were far above past Septembers. <a href=
September 2023’s temperatures were far above past Septembers. Copernicus
July 2023 was the hottest month on record and well above past Julys. <a href=
July 2023 was the hottest month on record and well above past Julys. Copernicus Climate Change ServiceMore

Human activities have been increasing temperatures at an average of about 0.2 F (0.1 C) per decade. But this year, three additional natural factors are also helping drive up global temperatures and fuel disasters: El Niño, solar fluctuations and a massive underwater volcanic eruption.

Unfortunately, these factors are combining in a way that is exacerbating global warming. Still worse, we can expect unusually high temperatures to continue, which means even more extreme weather in the near future.

An illustration by the author shows the typical relative impact on temperature rise driven by human activities compared with natural forces. El Niño/La Niña and solar energy cycles fluctuate. The Hunga Tonga-Hunga Ha’apai volcano’s underwater eruption exacerbated global warming. Michael Wysession
An illustration by the author shows the typical relative impact on temperature rise driven by human activities compared with natural forces. El Niño/La Niña and solar energy cycles fluctuate. The Hunga Tonga-Hunga Ha’apai volcano’s underwater eruption exacerbated global warming. Michael Wysession
How El Niño is involved

El Niño is a climate phenomenon that occurs every few years when surface water in the tropical Pacific reverses direction and heats up. That warms the atmosphere above, which influences temperatures and weather patterns around the globe.

Essentially, the atmosphere borrows heat out of the Pacific, and global temperatures increase slightly. This happened in 2016, the time of the last strong El Niño. Global temperatures increased by about 0.25 F (0.14 C) on average, making 2016 the warmest year on record. A weak El Niño also occurred in 2019-2020, contributing to 2020 becoming the world’s second-warmest year.

El Niño’s opposite, La Niña, involves cooler-than-usual Pacific currents flowing westward, absorbing heat out of the atmosphere, which cools the globe. The world just came out of three straight years of La Niña, meaning we’re experiencing an even greater temperature swing.

Comparing global temperatures (top chart) with El Niño and La Niña events. <a href=
Comparing global temperatures (top chart) with El Niño and La Niña events. NOAA Space Weather Prediction Center

Based on increasing Pacific sea surface temperatures in mid-2023, climate modeling now suggests a 90% chance that Earth is headed toward its first strong El Niño since 2016.

Combined with the steady human-induced warming, Earth may soon again be breaking its annual temperature records. June 2023 was the hottest in modern record. July saw global records for the hottest days and a large number of regional records, including an incomprehensible heat index of 152 F (67 C) in Iran.

Solar fluctuations

The Sun may seem to shine at a constant rate, but it is a seething, churning ball of plasma whose radiating energy changes over many different time scales.

The Sun is slowly heating up and in half a billion years will boil away Earth’s oceans. On human time scales, however, the Sun’s energy output varies only slightly, about 1 part in 1,000, over a repeating 11-year cycle. The peaks of this cycle are too small for us to notice at a daily level, but they affect Earth’s climate systems.

Rapid convection within the Sun both generates a strong magnetic field aligned with its spin axis and causes this field to fully flip and reverse every 11 years. This is what causes the 11-year cycle in emitted solar radiation.

Sunspot activity is considered a proxy for the Sun’s energy output. The last 11-year solar cycle was unusually weak. The current cycle isn’t yet at its maximum. <a href=
Sunspot activity is considered a proxy for the Sun’s energy output. The last 11-year solar cycle was unusually weak. The current cycle isn’t yet at its maximum. NOAA Space Weather Prediction CenterMore

Earth’s temperature increase during a solar maximum, compared with average solar output, is only about 0.09 F (0.05 C), roughly a third of a large El Niño. The opposite happens during a solar minimum. However, unlike the variable and unpredictable El Niño changes, the 11-year solar cycle is comparatively regular, consistent and predictable.

The last solar cycle hit its minimum in 2020, reducing the effect of the modest 2020 El Niño. The current solar cycle has already surpassed the peak of the relatively weak previous cycle (which was in 2014) and will peak in 2025, with the Sun’s energy output increasing until then.

A massive volcanic eruption

Volcanic eruptions can also significantly affect global climates. They usually do this by lowering global temperatures when erupted sulfate aerosols shield and block a portion of incoming sunlight – but not always.

In an unusual twist, the largest volcanic eruption of the 21st century so far, the 2022 eruption of Tonga’s Hunga Tonga-Hunga Ha’apai, is having a warming and not cooling effect.

The Hunga Tonga-Hunga Ha’apai volcano’s eruption was enormous, but underwater. It hurled large amounts of water vapor into the atmosphere. <a href=
The Hunga Tonga-Hunga Ha’apai volcano’s eruption was enormous, but underwater. It hurled large amounts of water vapor into the atmosphere. NASA Earth Observatory image by Joshua Stevens using GOES imagery courtesy of NOAA and NESDISMore

The eruption released an unusually small amount of cooling sulfate aerosols but an enormous amount of water vapor. The molten magma exploded underwater, vaporizing a huge volume of ocean water that erupted like a geyser high into the atmosphere.

Water vapor is a powerful greenhouse gas, and the eruption may end up warming Earth’s surface by about 0.06 F (0.035 C), according to one estimate. Unlike the cooling sulfate aerosols, which are actually tiny droplets of sulfuric acid that fall out of the atmosphere within one to two years, water vapor is a gas that can stay in the atmosphere for many years. The warming impact of the Tonga volcano is expected to last for at least five years.

Underlying it all: Global warming

All of this comes on top of anthropogenic, or human-caused, global warming.

Humans have raised global average temperatures by about 2 F (1.1 C) since 1900 by releasing large volumes of greenhouse gases into the atmosphere. The amount of carbon dioxide in the atmosphere is up 50%, primarily from the combustion of fossil fuels in vehicles and power plants. The warming from greenhouse gases is actually greater than 2 F (1.1 C), but it has been masked by other human factors that have a cooling effect, such as air pollution.

Sea surface temperatures in 2023 (bold black line) have been far above any temperature seen since satellite records began in the 1970s. <a href=
Sea surface temperatures in 2023 (bold black line) have been far above any temperature seen since satellite records began in the 1970s. University of Maine Climate Change InstituteCC BY-NDMore

If human impacts were the only factors, each successive year would set a new record as the hottest year ever, but that doesn’t happen. The year 2016 was the warmest in part because temperatures were boosted by the last large El Niño.

What does this mean for the future?

The next couple of years could be very rough.

If a strong El Niño develops over the coming months as forecasters expect, combined with the solar maximum and the effects of the Hunga Tonga-Hunga Ha’apai eruption, Earth’s temperatures will likely continue to soar.

As temperatures continue to increase, weather events can get more extreme. The excess heat can mean more heat wavesforest firesflash floods and other extreme weather events, climate models show.

A heavy downpour flooded streets across the New York City region, shutting down subways, schools and businesses on Sept. 29, 2023. <a href=
A heavy downpour flooded streets across the New York City region, shutting down subways, schools and businesses on Sept. 29, 2023. AP Photo/Jake OffenhartzMore

In January 2023, scientists wrote that Earth’s temperature had a greater than 50% chance of reaching 2.7 F (1.5 C) above preindustrial era temperatures by the year 2028, at least temporarily, increasing the risk of triggering climate tipping points with even greater human impacts. Because of the unfortunate timing of several parts of the climate system, it seems the odds are not in our favor.

This article, originally published July 27, 2023, has been updated with September’s record heat.

Read more:

Michael Wysession 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.

Treasury’s Yellen says US overdependent on China for critical supply chains

Reuters

Treasury’s Yellen says US overdependent on China for critical supply chains

Reuters – October 3, 2023

WASHINGTON (Reuters) – U.S. Treasury Secretary Janet Yellen said on Tuesday the United States has become overly dependent on China for critical supply chains, particularly in clean energy products and needs to broaden out sources of supply.

Yellen, speaking at a Fortune CEO event in Washington, repeated her longstanding view that the United States does not want to decouple economically from China.

She said that she has not been “a strong believer” in industrial policy, but that the United States had stood by for too long while other countries built up semiconductor industries with massive subsidies.

The U.S. would face national security concerns without a robust semiconductor sector of its own, she said, adding that last year’s Chips and Science Act will help reverse that trend.

“We’re fooling ourselves if we think that abandoning, for all practical purposes, semiconductor manufacturing, is a smart strategy for the United States,” Yellen said.

(Reporting by David Lawder and Kanishka Singh in Washington; editing by Jonathan Oatis and Deepa Babington)